PRACTICUM EVALUATION TOOL TEMPLATE

DEPARTMENT OF NURSING
JAMES MADISON UNIVERSITY

Student: Bosley, Bre Name of Preparer: Self and Arlene Kelley, MSN,RN
Practicum Site: Virginia Mennonite Retirement Center- Rehab Course #: NSG 352L Section #: 0009 Date: November 28, 2016

CLINICAL HOURS
Direct Patient Care: 77hrs. Simulation: 4 hrs. Observation: 0 hrs.
Missed Clinical Hours: 0 hrs. Precepted: 0 hrs Other: 9hrs. Total Clinical Contact Hours: 90 hrs

Grade Criteria: Students must achieve a passing rating in every outcome in order to pass a practicum course
Demonstrates satisfactory development of knowledge and skills. Objectives are met consistently and comprehensively, with progressive
Pass independence and self-direction. Shows insight into strengths and areas for growth. Demonstrates a 92% or greater on the Medication
Calculation and Safety Test (MCAST).
Mastery of skills and objectives inconsistent. Conduct is unsafe, unprofessional, offensive, or fails to maintain therapeutic alliance with clients
Fail or resource personnel. Fails to construct or submit documentation in a professional or timely manner. Does not demonstrate a 92% or greater
on the Medication Calculation and Safety Test (MCAST).
Rating
Outcomes/Objectives Pass/Fail
1. 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.
Course Objectives: (course specific)
Incorporate health promotion and prevention that considers each patient’s illness, rehabilitation or end of life in the
application of nursing care PASS
Describe beginning pathophysiological concepts of illness care, disease prevention, rehabilitation, and end of life over
the lifespan
Demonstrate safe, ethical, culturally sensitive and competent performance of nursing skills and professional role
behaviors in the clinical setting

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, clinical reasoning and the
nursing process in the care of clients.
Course Objectives: (course specific)
Articulate theory, rationale, and principles underlying application of selected psychomotor, cognitive, and affective PASS
nursing skills
Describe beginning pathophysiological concepts of illness care, disease prevention, rehabilitation, and end of life over
the lifespan
Student Name: __________Bosley, Bre______________ NSG Section ____0009_______ Page 2 of 3

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. PASS
Course Objectives: (course specific)

Demonstrate safe, ethical, culturally sensitive and competent performance of nursing skills and professional role
behaviors in the clinical setting
4. Communication: Use effective communication and information technology to communicate interpersonal and health
care information.
Course Objectives: (course specific)
PASS
Communicate effectively with members of the inter-professional team, the patient, and their family using verbal, written,
and electronic modalities

5. Professional Role Development: Enhance professional role development.

Course Objectives: (course specific) PASS
Demonstrate safe, ethical, culturally sensitive and competent performance of nursing skills and professional role
behaviors in the clinical setting
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: (course specific)
PASS
Demonstrate safe, ethical, culturally sensitive and competent performance of nursing skills and professional role
behaviors in the clinical setting

7. Scholarship: Contribute to excellence in nursing care by scholarly contributions through discovery, integration,
application, and teaching. Contribute to excellence in nursing practice by identifying and critiquing research evidence
and integrating it with clinical practice, patient preference, cost-benefit, and existing resources.
Course Objectives: (course specific) PASS
Incorporate evidence based practice into patient care
Describe beginning pathophysiological concepts of illness care, disease prevention, rehabilitation, and end of life over
the lifespan

8. MCAST: Demonstrates a 92% or greater on the Medication Calculation and Safety Test (MCAST).
PASS
Student Name: __________Bosley, Bre______________ NSG Section ____0009_______ Page 3 of 3

Areas of strength:
Per Student:
Pt interactions, listening, attending to pt needs in a timely manner, being responsible with tasks I was assigned,conducting myself in a professional
manner, being respectful to the pt , good work ethic, hardworking,demonstrating kindness, nonjudgmental, helping others with their tasks when mine
were complete.

Per Instructor:
Demonstrated progressive growth in levels of thinking, delivery of care, therapeutic communication, and patient safety. Demonstrated growth in
preplanning skills, in time management, and in critical thinking and in linking pathophysiology. Was progressive in developing skills of seeing
details that are important to the plan of care. Was consistently on time, prepared, and totally engaged throughout the clinical. Demonstrated
quality, compassionate care. Sought learning experiences when not directly involved with care of her own patient. Communicated with staff and
peers. Is quite personable, and engaged well with patients and staff. Patients spoke highly of her. Demonstrated leadership skills; assisted peers
and taught them.

Areas for growth:

Per Student:
Better critical thinking skills, being able to accomplish tasks with more confidence, stop constantly worryingabout making a mistake, responding to
situations where the pt expresses sadness from the death of a lovedone, diagnosis, etc.

Per Instructor:
Is willing to perform new tasks, but is developing confidence. Sees the big picture, and is attempting to connect the details. Demonstrate growth
in writing and implementing a plan of care. Continues to develop her professional role. Was not offered medication administration at this facility,
although she did observe medication nurse one shift and when possible. Needs to mentally prepare for challenges in medical-surgical care as vs.
rehab care.

Skills performed:
Transfers, vitals, watched medication administration, head to toe assessment, watched wound dressing change, assisted pt in feeding, watched I and O
catheter, bed baths, whirlpool, changed brief, perineal care, made bed, helped with use of bedside commode, dressed pt, shower, traction device, helped
pt put on TED hose, assisted with toileting, checked blood glucose, delivered hall trays, helped pt put in dentures, oral care, comb hair, helped pt
ambulate in wheelchair, walker, cane, and with gait belt.

Final Grade:
PASS