PRACTICUM EVALUATION TOOL TEMPLATE

DEPARTMENT OF NURSING
JAMES MADISON UNIVERSITY
Student:

Emily Lawler

Name of Preparer:

Hilda Taylor RN MSN CNS

Practicum Site:

Rockingham Memorial Hospital

Course# NSG 356L

Section #: 8

Date:

May 2, 2015

Criteria: Students must achieve a passing rating in every outcome in order to pass a practicum course

Grade
Pass

Demonstrates satisfactory development of knowledge and skills. Objectives are met consistently and comprehensively, with progressive
independence and self-direction. Shows insight into strengths and areas for growth.

Fail

Mastery of skills and objectives inconsistent. Conduct is unsafe, unprofessional, offensive, or fails to maintain therapeutic alliance with clients
or resource personnel. Fails to construct or submit documentation in a professional or timely manner.
Outcomes/Objectives

Rating
Pass/Fail

Health Promotion/Illness Care: Provide health protection and promotion, risk reduction, disease prevention, illness
care, rehabilitation, and end of life care to diverse populations within a holistic framework in a variety of settings.
1.

Course Objectives:

Incorporate health promotion and prevention that considers each patients continuum of health and illness
Behaviors:

Pass

Teaches patient/family about prevention/health concerns/discharge. Performs care to rehabilitate the patient. Provides grief care to
patient/family/friends. Provide nursing interventions appropriate to diagnosis.

2. Critical Thinking: Synthesize knowledge, skills, and technology from the established practice and science of nursing,
the biological and psychosocial sciences, and the humanities to engage in critical thinking and the nursing process in the
care of clients.
Course Objectives:

Examine the nursing process as a clinical reasoning and decision making framework
Demonstrate knowledge of physiologic and pathophysiologic processes associated with health alterations
Behaviors:

Able to analyze/interpret data. Able to write, verbally present, and link pathophysiology, diagnostic tests, medications, labs results,
and nursing interventions. Able to prioritize and format NANDA DX with a corresponding SMART goal and interventions. Evaluates
the effectiveness of interventions in meeting goal.

Pass

Student Name: ___________________________________________

NSG Section ____

Page 2 of 4

3. Therapeutic Relationships: Develop caring culturally competent relationships with clients that are sensitive to diverse
personal, socio-cultural, and environmental characteristics, which encourage clients to assume primary responsibility for
health care decisions, and in which the nurse functions as advocate and advisor.
Course Objectives:

Utilize the nursing process and knowledge of human responses to illness to plan culturally competent nursing
interventions for adults and families experiencing health alterations

Pass

Behaviors:

Initiates care anticipating patient/familys needs. Finds ways to communicate with diverse patients. Is culturally sensitive. Respects
and values patients/families decisions/beliefs. Conveys a caring demeanor.

4. Communication: Use effective communication and information technology to communicate interpersonal and health
care information.
Course Objectives:

Integrate communications and collaboration within the interprofessional team in providing care .
Behaviors:

Pass

Keeps the nurse updated on activities performed/problems with patient. Talks &/or listens to patient/familys concerns. Answers
questions effectively. Interacts professionally and positively with faculty, staff, patient, family. Uses technology effectively and
professionally only when required for patient care &/or family emergencies. Completes and documents patient assessment in a
timely fashion. Able to perform/interact/communicate in simulated experiences in a professional manner using available resources.

5. Professional Role Development: Enhance professional role development.

Course Objectives:

Independently demonstrate competence, safety, ethical, and evidence based practice in the application of nursing skills
and technologies in care of adults with acute and chronic illness, and their families
Behaviors:
Prioritizes care. Completes administering medications/tasks in a safe and timely manner. Able to organize self to care for 1-2
patients. Accepts responsibility for RN role development. Can perform skills and understands their underlying concepts on the unit
and in simulated scenarios.

Pass

Student Name: ___________________________________________

NSG Section ____

Page 3 of 4

6. Ethical and Professional Values: Engage in activities to promote self-awareness, self-growth, ethical accountability,
and legal responsibility in the practice of nursing.
Course Objectives:

Independently demonstrate competence, safety, ethical, and evidence based practice in the application of nursing skills
and technologies in care of adults with acute and chronic illness, and their families.
Behaviors:

Pass

Demonstrates respect/confidentiality. Is prepared prior to the clinical experience. Assists staff and others when needed. Is
motivated and takes responsibility for completing all patient care. Documents in a legal, ethically sound, professional manner. Is
accountable for mistakes. Accepts constructive feedback. Follows dress code. Is punctual and cooperative. Follows agencies
policies.

7. Scholarship: Contribute to excellence in nursing care by scholarly contributions through discovery, integration,
application, and teaching.
Course Objectives:

Independently demonstrate competence, safety, ethical, and evidence based practice in the application of nursing skills
and technologies in care of adults with acute and chronic illness, and their families
Behaviors:

Uses resources to promote learning and seeks out new learning opportunities. Brings information to clinical for patient/student/staff
dissemination. Evidence based research presented in practice.

Pass

Student Name: ___________________________________________

NSG Section ____

Page 4 of 4

Areas of strength:
Emily devotes appropriate attention to all responsibilities in the clinical setting. She is conscientious and productive.
Without exception she maintains client confidentiality.
Emilys graded data sheet charts were 99, 100 and 90.
Areas for growth:
Emily is quietly assertive without being aggressive. She consistently uses proper oral and written communication skills in
an efficient and timely manner. She will improve with the benefit of additional clinical experience opportunities.

Skills performed (if applicable):

Hilda A. Taylor
MSN RN CNS
___________________________________
Faculty Signature

5/2/2015
Date

Final Grade: