Multi Rater Competency Assessment

2015 - 2016 - NURS 253 Practical Nursing Pre-graduate Experience MRA Mid (201508)
NURS 253 Practical Nursing Pregraduate experience (PN, 18-Jan-2016 - 07-May-2016)
Student :
Clinical Teacher/Preceptor :
Advisor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Raymond Estrella
Gilbert Garcia
Zabrina Chevannes
Judy Martin
William Osler Health Centre/Brampton Civic Hospital
Agency
N2
18-Jan-2016 To 07-May-2016
248
200
248

I declare that this is my original work and the sources used are acknowledged.

Abilities and Outcomes / Learning Outcomes

Student Rating

Teacher Rating

1. Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies and procedures of the
practice setting.

1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies and

Satisfactory

Satisfactory

procedures.
R.E. : Complied with the regulatory standards, relevant legislation and practice setting's policies and procedures of Brampton Civic Hospital and the
CNO

1. 2 Act in a professional, responsible, ethical and accountable manner.

Satisfactory

Satisfactory

R.E. : Have acted professionally, responsibly, ethically and in an accountable manner when on the floor at the placement of Neurology Unit Brampton
Civic Hospital

1. 3 Use the three factor and decision making frameworks to determine strengths and limitations and

Satisfactory

Satisfactory

when to collaborate and consult with other professionals.

R.E. : Have used the three factor and decision making frameworks in the practice setting and have collaborated and consulted with various members
of the healthcare team and other professionals

1. 4 Integrate evidence-informed practice and a theory based approach into nursing care.

Satisfactory

Satisfactory

R.E. : Have used and integrated evidence- informed practice and theory based approach into nursing care

1. 5 Assess practices and risk management principles and take action to ensure safety of clients,

Satisfactory

Satisfactory

self, and others.

R.E. : Have ensured the safety of clients, self and others by assessing practices and risk management principles while on Neurology

1. 6 Question and clarify unclear orders or directions and when uncertain.

Satisfactory

Satisfactory

R.E. : Have always questioned and clarified unclear order and directions whenever ever I have been doubtful

1. 7 Question, clarify or challenge questionable orders, decisions or actions by others.

Satisfactory

Satisfactory

R.E. : Regarding questionable orders, decisions or actions by others, I question and clarify the rational behind the orders, decisions or actions to
understand or even challenge the rational.

1. 8 Respond in a professional manner to situations in which there is unsafe, unacceptable or

Satisfactory

Satisfactory

unprofessional behavior.
R.E. : Whenever there was unsafe, unacceptable or unprofessional behavior, have responded professionally to the parties involved

1. 9 Demonstrate understanding about the role of the nurse within health care.

Satisfactory

Satisfactory

R.E. : Have demonstrated the understanding about the role of the nurse within healthcare at Neurology

Teacher comments for Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies
and procedures of the practice setting. :
Students demonstrates safe practice and asks senior staff when unsure.

Advisor comments for Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies and
procedures of the practice setting. :
agreed

2. Communicate using strategies and technology to effect accurate and timely information sharing including data, research, and other
information.

2. 1 Contribute to team sharing and discussions.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

R.E. : Have contributed to team sharing and discussions on the Unit

2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic methods.

R.E. : Have documented clearly, accurately and concisely using Medi-Tech (electronic method) in a timely manner

2. 3 Use effective communication techniques when reporting relevant information and providing

Satisfactory

Satisfactory

feedback to the appropriate members of the interprofessional heath care team.

R.E. : Used communication techniques in an effective manner when reporting relevant information and feedback to appropriate members of the
healthcare team.

2. 4 Evaluate and refine techniques used to communicate and share information with clients and the

Satisfactory

Satisfactory

interprofessional health care team.

R.E. : Have evaluated and refined the communication techniques that I have used in order to share information with clients and the healthcare team

2. 5 Ensure privacy and confidentiality.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

R.E. : Have constantly ensured privacy and confidentiality during my time at Neurology

2. 6 Use technology to retrieve information including research and other date and to obtain and
forward information both within and outside the practice setting.

R.E. : Have used technology to retrieve information to forward the information in and outside of the practice setting including with the research.

Teacher comments for Communicate using strategies and technology to effect accurate and timely information sharing including data,
research, and other information. :
Needs improvement with doing TOA. Report needs to be more organized.

Advisor comments for Communicate using strategies and technology to effect accurate and timely information sharing including data,
research, and other information. :
continue to review theory specific to using SBAR when communicating.

3. Engage in relational practice that is caring, compassionate and respectful.

3. 1 Establish therapeutic caring, compassionate, and culturally safe relationships with clients and

Satisfactory

Satisfactory

health care team members.

R.E. : Have established a therapeutic caring, compassionate and safe relationship with the healthcare team and especially clients

3. 2 Establish a caring environment that supports clients in meeting their needs and outcomes,

Satisfactory

Satisfactory

managing their illness, or experiencing a peaceful death.

R.E. : Have promoted and established a caring environment to support clients to meet their needs/outcomes, manage their illness or experience a
peaceful comfortable death.

3. 3 Demonstrate therapeutic use of self to foster client well-being.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

R.E. : Have demonstrated therapeutic use of Self to foster client well-being

3. 4 Utilize relational knowledge and skills, and ethical principles to support clients and to interact
with health care providers.

R.E. : Used rational knowledge, skills and ethical principles to support clients and interact with the health care providers

3. 5 Use self-awareness to identify the effects that beliefs, values, and personal experiences have on

Satisfactory

Satisfactory

relational practice.
R.E. : Identified the effects of beliefs, values and personal experiences have on relational practice by using self-awareness

3. 6 Collaborate with clients, members of the interprofessional and health care teams; and, consult
appropriately.
R.E. : Have collaborated with clients, members of the health care teams and consults appropriately

Satisfactory

Satisfactory

3. 7 Uphold practices and systems that support the diversity of clients and of the interprofessional

Satisfactory

Satisfactory

health care team.

R.E. : Have upheld the practices and systems that support the diversity of clients and the health care team

3. 8 Provide effective client education.

Satisfactory

Satisfactory

R.E. : Provided effective client education especially regarding medication, testing and rationals on nursing interventions

Teacher comments for Engage in relational practice that is caring, compassionate and respectful. :
Student spends time with patients. Compassionate and caring. Hearing out Family/Patient's concerns

Advisor comments for Engage in relational practice that is caring, compassionate and respectful. :
agreed

4. Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the profession.

4. 1 Evaluate and refine leadership skills to develop solutions, resolve conflict, create a positive work

Satisfactory

Satisfactory

environment and organizational culture, and to strengthen advocacy role.

R.E. : Have used leadership skills to develop solutions, resolve conflict and help promote and create a positive work environment

4. 2 Provide feedback to peers and accept feedback from peers and members of the

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

interprofessional health care team.

R.E. : have accepted feedback from members of the health care team

4. 3 Advocate for clients, self, others, and quality practice environment.

R.E. : Advocated for clients, self, others and quality practice environment

4. 4 Support clients rights for self-determination and choice.

R.E. : Support clients rights for self determination and choice as much as possible

4. 5 Respond appropriately to unsafe, unacceptable, and unprofessional behaviors.

R.E. : appropriately responded to unsafe, unacceptable and unprofessional behaviors

4. 6 Demonstrate public protection and acting in the interests of the public through collaboration and
consultation with other members of the interprofessional health care teams.

R.E. : Demonstrated public protection and acted in the interests of the public through collaboration and consultation with other members of the health
care team

4. 7 Contribute to the creation of quality practice strategies and solutions.

R.E. : contributed to the creation of quality practice and strategies and solutions

Satisfactory

Satisfactory

4. 8 Assign, supervise, teach as appropriate, and provide feedback to unregulated care providers

Satisfactory

Satisfactory

(UCPs) in collaboration with the interprofessional health care team.

R.E. : Have taken lead in supervising, taught when appropriate and provided feedback to UCPs in the collaboration with the health care team

Teacher comments for Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the
profession. :
Need improvement leading the care.

5. Integrate the nursing process into all aspects of nursing care and across diverse practice settings.

5. 1 Formulates clinical judgments that meet clients unique and changing health needs and priorities,

Satisfactory

Satisfactory

outcomes, and overall condition and incorporates these into evolving plans of care.
R.E. : With evolving care plans regarding clients, I have formulated clinical judgements to meet those unique needs of clients to achieve their goal of
plan of care

5. 2 Devise evidence-informed plans of care that are holistic and client-centred.

Satisfactory

Satisfactory

R.E. : Provided and helped establish evidence-informed plans of care which are holistic and client centred

5. 3 Use clinical judgment to assess clients, prioritize needs, outcomes, and nursing interventions.

Satisfactory

Satisfactory

R.E. : Used my clinical judgement to assess clients, prioritize needs while on the floor, outcomes and took action on nursing interventions backed up
with rational

5. 4 Collaborate in the evaluation, refinement and modification of plans of care.

Satisfactory

Satisfactory

R.E. : Collaborated with the evaluation, refinement and modification of plans of care for the clients on Neurology

5. 5 Safely and competently perform treatments and use techniques, and technology autonomously

Satisfactory

Satisfactory

and in collaboration with clients and members of the interprofessional health care team.
R.E. : Performed treatments, techniques and used technology in a safe and competent manner in cooperation and collaboration with clients and the
health care team

5. 6 Collaborate with the clients across the lifespan and with members of the interprofessional health

Satisfactory

Satisfactory

care team to create a client centered plan of care that is articulated with competence both in writing
and orally.
R.E. : aided in creating a client centered care plan with the collaboration of the healthcare team and clients with competence in writing and verbally

5. 7 Use awareness of own knowledge and skills, the three factors of nurse, client and environment

Satisfactory

Satisfactory

and the practice decision-making framework to guide practice.

R.E. : Have guided my practice while at Neurology by using my awareness of my own knowledge and skill,s three factors of nurse, environment and
practice decision making

5. 8 Manage workload, time, and physical resources to provide effective, efficient and ethical care.

Satisfactory

Satisfactory

R.E. : Have provided effective and ethical care by managing workload, time , resources and prioritization

Teacher comments for Integrate the nursing process into all aspects of nursing care and across diverse practice settings. :
Student plans his day and evaluate it for changes for better efficiency.

Advisor comments for Integrate the nursing process into all aspects of nursing care and across diverse practice settings. :
agreed.

6. Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and holistic health care in a
complex and changing environment.

6. 1 Collaborate with clients to determine needs, mutually agreed health outcomes, approaches to

Satisfactory

Satisfactory

care, and to evaluate care.

R.E. : In order to determine needs, agreed health outcomes, approaches to care (considering cultural and religious backgrounds), and evaluating
care, I have determined and collaborated these needs with the client in order to achieve them

6. 2 Contribute as a member of the interprofessional and health care teams to respond to changing

Satisfactory

Satisfactory

client needs and outcomes.

R.E. : Have contributed to the health care team to accommodate and respond to the changing client needs and outcomes

6. 3 Consult with and seek out assistance from members of the interprofessional health care team.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

R.E. : Have sought out assistance and consulted with members of the healthcare team

6. 4 Use teamwork, consensus building, and conflict resolution and leadership skills to meet
expected client outcomes.
R.E. : Used teamwork, conflict resolution and leadership skills to meet expected outcomes of clients

6. 5 Integrate effective, collaborative, and consultative strategies to meet clients needs within a
changing environment.
R.E. : Integrated effective, collaborative and consultative strategies to meet clients needs within

6. 6 Respect the unique role and competencies of all members of the interprofessional health care
team.

R.E. : Shown and demonstrated respect to the unique roles and competencies of all members of the health care team

6. 7 Collaborate as a member of the interprofessional health care team to respond to changes in

Satisfactory

Satisfactory

nursing knowledge and practice and in the health care environment.

R.E. : As a member, I have collaborated with the health care team to respond to changes and nursing knowledge and practice in the health care
environment of Neurology

Teacher comments for Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and
holistic health care in a complex and changing environment. :
Communicates with otehr disciplinary. Pharmacy, Doctors, Allied health.

Advisor comments for Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and
holistic health care in a complex and changing environment. :
agreed

7. Engage in Quality Assurance consistent with the regulatory framework.

7. 1 Act in the best interests of clients and protect clients from harm through collaboration and

Satisfactory

Satisfactory

consultation with other members of the interprofessional and health care teams and by through
competent and safe practice.
R.E. : Acted in the best interest of clients from harm by working with consults and the health care team by competent and safe practice

7. 2 Commit to Quality Assurance practice to identify strengths and areas for professional growth and

Satisfactory

Satisfactory

in accordance with the regulatory framework (CNO).

R.E. : Have commited to QA practice to pinpoint my strengths and areas of professional growth in accordance with the regulatory framework

7. 3 Create, implement, and evaluate a learning plan consistent with the Quality Assurance program

Satisfactory

Satisfactory

Satisfactory

Satisfactory

(CNO).
R.E. : Have created, implemented and evaluated a learning plan that is consistent with the QA program

7. 4 Assume responsibility to seek out feedback for colleagues and peers and learning opportunities
that foster professional development.

R.E. : Have assumed the responsibility to seek out feedback for colleagues and peers learning opportunities that foster professional development.

7. 5 Consistently review nursing research and information about health care to improve competence

Satisfactory

Satisfactory

and to support clients.

R.E. : Reviewed nursing research and information about healthcare to improve my competence and support clients in their health goals

7. 6 Develop professional responses to health care system changes resulting from advances in

Satisfactory

Satisfactory

research, technology, and changes in societal and political forces.

R.E. : Have developed professional responses to health care system changes resulting from advances in research, technology, and changes in
societal and political forces.

Teacher comments for Engage in Quality Assurance consistent with the regulatory framework. :
Accept feedbacks well from preceptor and other staff.

Advisor comments for Engage in Quality Assurance consistent with the regulatory framework. :
agreed

8. Use critical thinking, problem solving and decision making skills to meet the health care needs and expected outcomes of clients.

8. 1 Use critical thinking to inform decision making in all aspects of nursing care.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

R.E. : Have used critical thinking to inform decision making in all aspects of nursing care

8. 2 Use clinical judgment to assess and refine assessments in collaboration with the
interprofessional health care team, formulate nursing diagnoses, plan nursing interventions, and
outline evaluative criteria.

R.E. : Used clinical judgement and assessments with the health care team to distinguish and formulate a nursing diagnosis, plan interventions and
outline the evaluative criteria

8. 3 Evaluate and refine critical thinking, problem solving, and decision-making skills.

Satisfactory

Satisfactory

R.E. : Evaluated, refined and implemented my critical thinking, problem solving and decision making skills

8. 4 Integrate knowledge from variety of nursing, health, and other theory into nursing practice to

Satisfactory

Satisfactory

provide safe and competent care.

R.E. : Integrated knowledge from variety of nursing, health and other theory into nursing practice to provide safe and competent care

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

R.E. : Have demonstrated prioritization effectively when establishing the priority of what needs to be done on the nursing floor

8. 6 Demonstrate professionalism, responsibility, and accountability.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

R.E. : Have consistently demonstrated professionalism, responsibility and accountability

8. 7 Use critical thinking, the practice decision-making framework and the nurse-client-environment
framework to inform clinical judgments and practice.

R.E. : Used critical thinking, practice decision-making framework and nurse-client-environment framework to inform my clinical judgement and
practice

Teacher comments for Use critical thinking, problem solving and decision making skills to meet the health care needs and expected
outcomes of clients. :
Uses critical thinking when a concern arises.

Advisor comments for Use critical thinking, problem solving and decision making skills to meet the health care needs and expected
outcomes of clients. :
agreed

Student Midway Summary with Strategies for Continued Growth

Have learned, refined and obtain many more experiences in Neurology and plan to ask questions to clarify rationals, skills and so on. Will also look to
be more effective and efficient in my skills while at the same time improving my critical thinking on the unit in order to provide therapeutic and holistic
care to clients and demonstrate my competency.

Teacher Midway Summary with Strategies for Continued Growth

Will put student under stress. Floor's full workload. Will assess Student's ability to manage his time and use critical thinking to prioritize his work.

Advisor Midway Summary with Strategies for Continued Growth

continue to review theory before each clinical day. student works well with staff and preceptor. Review communication using SBAR.

Student's References
CNO, Neurology Brampton Civic

Refer to Clinical Excellence Committee (CEC)

Grade

Satisfactory

Grade

Needs Development

Satisfactory

Program Coordinator Feedback

The Program Coordinator has reviewed the evaluation

Yes

No

Student Sign Off

I met with my Clinical Teacher/Preceptor and discussed my evaluation

Yes

No

In general this evaluation accurately reflects my performance

Yes

No

Submitted Date: 01-Mar-2016 13:47

Unsatisfactory