Practical Nursing Diploma Program

Mid-term/Final Clinical Evaluation Form

Student: Sharon Taylor

Student Number:

822-734-778

Course: Practical Nursing

Dates:

Section

Oct, 15, 2013

to

S: Satisfactory
Summary of Areas of
Practice
Competent and safe
practice in a professional,
legal and ethical framework

Communication

Student Comments:
Summary of clinical
experience
S: k

U:

U: Unsatisfactory
Faculty Comments:
Summary of clinical
Experience

S:

U:

S:

U:

S:

U:

S:

U:

I have demonstrate
professionalism with
attendance, punctually, dress,
code, behavior, language and
timely submission of
assignments. I have accepted
responsibility for own actions
and self-directed learning.
S:

U:

I have participated in group

sharing discussions. I have
documented clearly,
accurately and concisely
using written methods.
Maintain privacy and
confidentiality. Uses
technology to retrieve
information from texts and
other sources.
Caring relational practice

S:

U:

I have established respectful,

polite and honest
relationships with peers,
professors/ clinical teachers
and lab technologist. I have
exhibited collaborative
relationships with team
members.
Leadership and advocacy

22

S:

U:

I have provided feedbacks to

peers and accepted
feedbacks from peers. Ask
relevant questions to clarify

understanding. Respond
appropriately to unsafe and
acceptable behaviors.
Plans of care: Meeting
Clients Needs and Mutually
Agreed Expected Outcomes

Collaborative Practice

S:

U:

S:

U:

S:

U:

S:

U:

S:

U:

I have learned how to plan

holistic, client centered
assessments and
interventions that are based
on appropriate rational. I have
completed health
assessments, interviewing
and nursing skill in a timely
manner. I have identified the
importance of assessing
clients unique needs.
Learned how to utilize
infection prevention and
control practice, including but
not limited to hand washing
and basic personal protective
equipment.
S:

U:

I have participated
knowledgeably in discussion
with peers and faculty. I have
demonstrated respect for
peers and others.
Quality Assurance

S:

U:

I have identified strengths

and areas for improvement
using reflective practice.
Utilized self-reflection and
feedback from
professors\clinical teacher
and peers to identify strength
and areas for improvement. I
have assumed the
responsibility to seek out
learning opportunities that
foster professional
development.
Critical Thinking, Problem
Solving and Decision
Making

S:

U:

I have learned how to apply

knowledge from nursing,
health, biological and social
sciences. I have
demonstrated
professionalism and
accountability. I recognize

strengths and limitations and

seek appropriate assistance
and support.

I have read and understand this form and its contents

Student Signature:

Faculty Signature:

S. Taylor

Date: Oct, 15, 2013

Date: