Clinical Evaluation Process for the Trent Fleming School of Nursing

Instructions for use

The Mid-Term Evaluation document will be completed at the mid-point of the clinical
placement to assist the student in taking inventory of their current development and assist
them to make plans for future clinical practice. Reflection will be used to assist the student in
measuring their progress against the established program and course objectives, with
specific examples from clinical practice identified as evidence of learning. The broad
indicators listed in the accompanying document entitled NURS 2021 Program and Course
Objectives may be used to support student reflection, although the list of indicators is not
exhaustive and should not be used to cut and paste as evidence of learning. Specific
examples of progress must be provided that are unique to each student. The student will
submit the Mid-Term Evaluation document to the clinical instructor prior to the formal mid-
term student evaluation.

After receiving the student’s Self Mid-Term Evaluation, the clinical instructor will add to the
evidence of progress and complete the comment section providing feedback and evaluation
of the student’s progress. The clinical instructor will provide suggestions for improvement. If
a student is in a failing position at mid-term, the student and instructor will develop a
Learning Plan outlining strategies the student will engage in, along with clear expectations
that must be met, for the successful completion of this clinical course.

At the end of the rotation, the Final Evaluation document is to be completed by the student
to archive their achievements and areas for future development. It will assist the clinical
instructor in their assessment of the student. The clinical instructor will add to the evidence
of progress and complete the comment section providing feedback and evaluation of the
student’s progress.

The clinical instructor will collect evidence in the form of the student self-assessment,
comments of the health care team members, patient input, student submissions (including
portfolio) and observations to complete Final Evaluation. A summary of achievement as well
as implications for future learning shapes the outcome of this document. The attendance
section and record of completed hours is to be filled in completely. The completed document
is to be shared with the student and signed. The signed copy must be returned to the TFSON
within 10 days. The Course Instructor will assess the completion of the Learning Center
Component, if applicable. An electronic copy of the student’s completed final evaluation
must be uploaded by both the student and by the clinical instructor within 48 hours of the
final evaluation delivery.

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 NURS 2021 – Program and 2nd Year Outcomes
Program Outcomes
Students graduating from this program:
1. Prepared as generalists entering a
self-regulating profession in
situations of health and illness.
2. Prepared to work with people of all ages
and genders (individuals, families,
groups, communities and populations)
in a variety of settings.
3. Expected to have an enhanced
knowledge of the program foci:
indigenous and women's health, aging,
mental health, and rural populations.
4. Prepared to learn to continuously use
critical and scientific inquiry and other
ways of knowing to develop and apply
nursing knowledge in their practice.
5. Prepared to demonstrate leadership in
professional nursing practice in diverse
health care contexts.
6. Prepared to contribute to a culture of
safety by demonstrating safety in their
own practice, and by identifying, and
mitigating risk for patients and other
health care providers.
7. Able to establish and maintain
therapeutic, caring and culturally safe
relationships with clients and health
care team members based upon
relational boundaries and respect.
8. Able to enact advocacy in their work
based on the philosophy of social
justice.
9. Able to effectively utilize
communications and informational
technologies to improve client
outcomes.
10.Prepared to provide nursing care that
includes comprehensive, collaborative
assessment, evidence-informed
interventions and outcome measures.
On completion of 2000 level courses
students will be able to:
Begin to practice and experience self-
regulation in a variety of health care
settings.
Explore the broader role for nursing in a
variety of communities and populations.
Understand and appreciate the contextual
components of working with families,
groups, communities, and populations.
Demonstrate an understanding the
relevance of five foci in relation to
individual and communities experience of
health.
Begin to apply critical and scientific inquiry
to nursing knowledge and practice.
Understand health experiences using a
variety of ways of knowing.
Discover leadership in self and others when
working with individuals, families and
communities.
Understand the context and attributes of
the culture of patient safety.
Establish an engaged, caring, and culturally
safe relationship with families and
communities.
Explore the influence of determinants of
health on health and wellness of
individuals, families and communities.
Identify situations where advocacy is
indicated.
Effectively utilize information and
technology skills to promote positive
outcomes.
Perform an assessment of a community.
Collaborate with group to identify priority
health goals and create evidence informed
plans of care
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 NURS 2021H Clinical Course Evaluation
Mid-Term Evaluation

Student: Leah Will

Clinical Instructor: Anne Falconer

Placement: Ontario Shores Facility for Mental Health

Missed Clinical Hours: ______ Missed Lab Hours: ______

Satisfactory Progress (SP): The student demonstrates sufficient knowledge, and skill and ability to safely practice or achieve a competency with an average
level of teaching support and guidance; or the level of performance is what the instructor would expect of an average student at that level and point in time;
and the instructor reasonably anticipates that if the student continues at the current pace of practice and achievement, the student should be able to fully
meet the objective at the end of the course.

Unsatisfactory Progress(UP): The student does not demonstrate sufficient knowledge, or skill, or ability to safely practice or achieve a competency, even with
constant, intensive teaching support and guidance; or the level of performance is far below what the instructor would expect of the average student at that
level and point in time; and the instructor reasonably anticipates that if the student continues at the current pace of practice and achievement, the student is
not likely to meet the objective at the end of the course.

Needs Development(ND): The student demonstrates sufficient knowledge and ability to safely practice or achieve a competency, but requires more than
average teaching support and guidance; or the student demonstrates knowledge but needs more practice to achieve the competency; or the level of
performance is below what the instructor would expect of the average student at that level and point in time; and the instructor reasonably anticipates that if
the student focuses his/her learning in the required area, and gains sufficient practice, the student has the potential to meet the objective at the end of the
course.

Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)
 NURS 2021H Clinical Course Mid-Term Evaluation
Progress
Course Objective Evidence/Indicators
MIDTERM
Recognize and begin to navigate Student:
the complexities of family nursing.
I have learned to develop a therapeutic
relationship with members of the patient’s family
Progress Progress Final and the importance of including the family in the
Midterm patients plan of care where applicable. By sitting in
on conferences, I can see that an emphasis is put
 SP  SP on making sure the patient has good support
 ND  ND systems put in place.
 UP  UP
In placement, I have appreciated how complex the
plan of care can be and how many people it
actually involves. I also actively focus on my
emotions as I am reading family histories and I
have to be mindful of passing judgments.
I look forward to future opportunities in this
placement to perhaps work with a family member
in regard to care for their loved one as a patient at
the facility.
Clinical Instructor:
Evidence/Indicators
FINAL
Student:
I have seen how family members can have an
impact on the patients, both in a positive and
negative way.
I have seen how a mother can play a massive
role in the patients’ recovery, and she was
always so excited to see her every Friday when
she came and visited her and brought her
food. This made the patient more motivated to
get up, dressed, have breakfast and display
good behaviours.
Also, I have learned that sometimes as nurses
we need to be aware of how the patient feels
about their relationship with family members,
as this can often be a negative experience for
them and possibly trigger harmful or
emotional memories.
Clinical Instructor:
Integrate knowledge from Student:
previous courses to support This is a very different population than long term
diverse populations. care. The forensic unit consists mainly of younger
adults, so the personal care is much different.
Progress Progress Final There are more therapeutic communication
Midterm opportunities and mental assessments. I used
communication techniques from my last
 SP  SP placement, such as prompting and redirecting
 ND  ND conversation while talking to forensic patients with
 UP  UP various mental illnesses.
I took PHIL 2390 (Biomedical ethics) and this
course provided me with information regarding
morals and ethics when working with a diverse and
vulnerable population. I use this knowledge and
experience from this course to think ethically at all
times and gain perspective into the various belief
systems that I may encounter.
The several knowledge based concepts that we
learned in the 1000 courses in first year were great
building blocks that I will continue to expand on in
my upcoming practice.
Clinical Instructor:
Student:
In NURS 2001, we spent the majority of the
semester talking and learning about relational
inquiry. I have used this several times in my
practice on the unit, especially when working
with forensic patients. Rather than just quickly
making judgements or assumptions about a
patients situation, I take the time to get to
know their story and see everything as a bigger
picture. This allows me to build a therapeutic
relationship with the patient and develop a
good rapport.
In NURS 1002 we were briefly introduced to
the Mental Health Act, and with my experience
on the forensic unit I feel as if I have a good
understanding of it. I also feel as if I know
much more about the Ontario Review board
and how the legal and the medical systems
interconnect and what benefits this has for the
patients.
I look forward to using my experience in this
course to better my practice in future courses.
Clinical Instructor:
Critically appraise relational Student:
inquiry processes and begin to
develop meaningful relationships On one of my placement days, I was shadowing a
with health care providers and nurse who was working with a difficult and
family members. aggressive patient. I developed a meaningful
relationship with this patient, establishing trust
Progress Progress Final with my presence in a “learning situation” such as
Midterm his. This also strengthen the relationship I had with
that nurse because she could see that I was
 SP  SP working well with a difficult patient.
 ND  ND
 UP  UP
There have also been several occurrences during a
slower period of time during the day where we will
go onto the unit and play a game of “Snakes and
Ladders” with one of the patients who we met on
the first day. He is very kind and seems to enjoy
our company on the unit.
By critically appraising relational inquiry processes I whole situation and understand how family
have learned that developing relationships is
crucial and is a skill that will challenge me. This will regards to the patients on the unit.
contribute to my growth as a nurse and improve
my patient care.
Clinical Instructor:
Student:
After getting to know the nurses better on the
unit, I was able to use relational inquiry more
and ask them questions about nursing, what
they liked and didn’t like about working in
mental health, and general tips on getting
through nursing school. By the end of the
semester, I was able to develop good
relationships with a few of the nurses who I
commonly saw week to week.
Although I have not personally had the
opportunity to interact with a family member, I
have been in conferences and meetings where
the family member is often discussed in
relevance to the patient care. By using
relational inquiry, I am able to look at the
members play such an important role in
Clinical Instructor:
Collaboratively formulate a plan Student:
of care based on knowledge of
family nursing, related theories At placement, I contribute to many aspects of the
and scholarly literature. plan of care. During the morning safety meetings,
the nurse I am working with will allow me to give
Progress Progress Final report on the patient I have been assigned. This
Midterm makes me feel part of the team, and that I am
trusted to give report.
 SP  SP
 ND  ND The patient I am working with is a T-30, meaning
 UP  UP someone needs to check in on him every 30
minutes. This is part of his plan of care due to his
illness and by doing this I am ensuring that he, as
well as everyone else on the unit is as safe as
possible.
The patient I am working with also requires daily
vital signs to be assessed and documented as part
of his plan of care due to the specific antipsychotic
he is prescribed. By monitoring his vitals, I can
ensure that the client is consistently healthy and
that the medication is having the desired
therapeutic effect.
Clinical Instructor:
Student:
During the second half of the placement I was
able to continue contributing to the plan of
care by participating in the daily safety
meetings and often reporting on my patient.
The plan of care for my patient was very
interesting throughout the semester. He was
likely the patient on the unit who had the most
rapid change in status, experiencing a very
high, high and a very low, low.
The patient I was working with was still on a T-
30, which became increasingly difficult as he
was starting to phase into a severe depressive
state and was often sleeping or in bed all day. I
had to constantly encourage and prompt him
to shower, get up to eat and to take his
medication and vital signs.
Clinical Instructor:
Develop, implement and evaluate Student: Student:
the effectiveness of health-
promoting, evidence-based On one of our clinical days we got to work with the During my time on the unit, I got to participate
practice, reflecting principles of recreational therapist and participate in an art in several conferences and discussions
family nursing as relational class. This promotes health by engaging the regarding a patients upcoming discharge. The
practice. patients into activities that are social and patient did not necessarily want to leave, so
therapeutic as part of their recovery. This part of the health-promotion and teaching was
Progress Progress Final contributes to holistic health. to print and cut out pictures to hang on her
Midterm wall to give her a more positive image of what
By establishing and implementing health it will be like when she leaves. This provided
 SP  SP promotion and therapeutic relationships, this helps her with reassurance and reminders of her
 ND  ND build trust with the client as well as helping them upcoming discharge date.
 UP  UP with their recovery.
I was also lucky enough to participate in the
I have witnessed conferences with the entire unit BBQ that the recreational staff puts on for
interpersonal team while discussing health the patients. This promotes health by
promotion and teaching plans for the clients who gathering everyone together and getting
are about to be discharged from the unit. This outside to enjoy the nice weather and a BBQ. I
ensures that the patient will be successful with could see how positive and excited the
their recovery even when they have left the unit patients were leading up to it all morning, and
and are reintegrated back into the community. they all seemed to have a better day
afterwards.
Clinical Instructor:

Clinical Instructor:
Demonstrate increasing Student: Student:
competence and confidence in the
application of psychomotor skills I applied psychomotor skills when I was taking My patient was on daily vitals, so I was able to
in practice settings. vitals on the patient that I have been assigned to. get a lot of practice and comfortabilty working
This required me to be efficient and competent in with the vital machine. I was also able to
Progress Progress Final my skills. gather my own way of doing things to be as
Midterm efficient and effective as possible.
This is an area where there has been limited
 SP  SP opportunity so far, as we are not typically able to Even though I was not able to give a lot of
 ND  ND take patients out on walks around the grounds. I’m medications, I was able to give my first
 UP  UP hoping in the upcoming weeks that this could be injection. This was one of the highlights of the
an option if the patient happens to agree that day. placement for me, and I was very confident
before and after the injection.
Clinical Instructor:
This placement has also enabled me to
develop and improve my communication skills
through several interactions with patients in
therapeutic ways.

Clinical Instructor:
Demonstrate accountability and Student: Student:
professionalism that is consistent
with a nurse entering a self- I demonstrate accountability when I am using the I continued to demonstrate accountability
regulating profession. computer in the nurses station. I only look at the when I am charting on the computer. As the
charts of the patients that I am working with that semester went on, I felt more comfortable
Progress Progress Final day, as well as the patient I have been assigned to. taking the lead and charting everything on my
Midterm This ensures confidentiality for the patients at the patient for that day. I was able to create good
facility. I also always make sure to sign out of the SOAPE notes and receive positive feedback on
 SP  SP system when I get up from the computer. them. I am responsible for all the information I
 ND  ND am recording by putting my initials as a
 UP  UP I display accountability when I sign off on rounds or student nurse at the end of all my notes.
am giving the short morning safety report for my
patient. By putting my initials beside documents, I I also make sure that all the staff knows that I
am responsible for the information that I have am a student nurse and I let them know what
recorded. my scope of practice is. This is important when
there are often staff coming in and out of the
I demonstrate professionalism by wearing the unit and do not know who I am.
appropriate dress code while working on the unit,
while also following the dress code policy that Throughout the placement, I also continues to
Trent has put in place. demonstrate professionalism by dressing
appropriately and staying within my scope of
Clinical Instructor: practice, as per Trent policy.

Clinical Instructor:
Select appropriate community Student: Student:
support services for families
needing referral to enhance We have had various talks from guest speakers I have learned about various community
coping with diverse transitional about support services that are available to the resources throughout our placement that can
experiences. patient as well as the family. There is a video help patients in crisis, as well as PHP which is a
conference system that is put in place that we really excellent outpatient program. The
Progress Progress Final learned about so patients families who live farther program that I got to participate in was called
Midterm away from the facility can still receive face to face “Resilience” and it was very therapeutic to the
conversations with a health care provider patients participating.
 SP  SP regarding the care of the patient.
 ND  ND
 UP  UP
We also learned about PHP and the various
programs that they offer to inpatients and
outpatients at the facility.
Clinical Instructor:
Clinical Instructor:

This section to be filled out by Student Areas of Strength
the student.
1. Confidence working with the mental
health population due to familiar and
similar past work experiences.
2. Working well with all members of
the interpersonal team on the unit.
3. Being aware of what I know, and
what I don’t know or are not permitted to
do on the unit.
Student Areas of Strength
1. Fully confident in my ability to
take vital signs effectively and
efficiently. Also ability to perform
MSA’s and chart accordingly.
2. Developing a good rapport
with patients and having an
appropriate sense of humor.
3. Understanding the ORB and
Mental Health Act and how it relates
to my role as a nurse, as well as
patient care.
 Student Areas for Future
Development
1. Confidently performing mental
health assessments on my own.
2. Learning the ADU med system and
giving oral medications.
3. Being confident in charting and
documenting the various assessments
throughout the shift.
MIDTERM:
Signature of Instructor___________________________________________________
Signature of Student_____________________________________________________
Satisfactory Unsatisfactory
Please circle the appropriate outcome
Student Areas for Future
Development
1. Being fully comfortable with
the ADU and Meditech systems (only
due to lack of opportunity).
2. Feeling confident in my
responses to difficult or surprising
topics brought up by patients.
3. Advocating for my own
learning by requesting more
responsibility on the unit. (ex. Taking
on more than one patient earlier in
the semester).
Date _____________________________
Date ______________________________
FINAL:

Signature of Instructor___________________________________________________ Date _____________________________

Signature of Student_____________________________________________________ Date ______________________________

Satisfactory Unsatisfactory
Please circle the appropriate outcome
Attendance

Hrs. Hrs.
Week 1 Week 5
Week 2 Week 6
Week 3 Week 7
Week 4 Week 8

Total number of clinical hours completed_____________

1. Clinical Component

Satisfactory Unsatisfactory
Please circle the appropriate outcome

2. Clinical Learning Center- labs and simulations

Satisfactory Unsatisfactory
Please circle the appropriate outcome

3. Enhanced Learning Days

Mental Health Day ___________
NVCI ____________