NURS 2020H Community Based Nursing Practice

Clinical Evaluation Process for the Trent/Fleming School of Nursing

Instructions for use:

The Evaluation Form-Midterm will be completed at the midpoint of the clinical placement to assist the student in taking inventory of their
development and help them make plans for future development. Reflection will be used to assist the student in measuring their progress against
their established program and course objectives. This is to be submitted to the clinical faculty prior to the formal mid-term evaluation.

After receiving the student’s self-evaluation form, the clinical instructor will complete the comments sections providing feedback and evaluation
for the student’s progress. Clinical faculty will provide evidence of learning and suggestions for improvements. 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 Evaluation Form-Final is to be completed be the student to archive their achievements and areas for future
development. It will assist the clinical faculty in their assessment of the student. The clinical faculty will also complete the student evaluation
form to provide feedback to the student.

The clinical faculty will collect evidences in the form of student self-assessment, comments of the health care team members, patient input,
student submissions (including portfolio) and observations to complete the Evaluation Form-Faculty-Final. A summary of achievements as well
as implications for future learning forms the base of this form. The attendance section and record of completed hours is to be filled in
completely. The completed form is to be shared with the student and signed. The signed copy must be returned to the TFSON by the date
indicated by the Year Lead. The Year Lead will assess the completion of the Learning Center Component if applicable. An electronic copy of the
students completed final evaluation must be uploaded by both the student and by the clinical faculty to them within 48 hours of the final
evaluation delivery.

The Student Evaluation Form-Preceptor is to be completed in rotation where the students are working with a preceptor. It must be reviewed by
the student and submitted to the clinical faculty before the final evaluation is completed.

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Clinical Course Evaluation

Program Goals
Students graduating from this program are prepared as generalists entering a self-regulating profession in situations of health and
illness.
Students graduating from this program are prepared to work with people of all ages and genders (individuals, families, groups,
communities, and populations) in a variety of settings.
Graduated will learn to continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing
knowledge in their practice.
Students graduating from this program will be prepared to demonstrate leadership in professional nursing practice in diverse
heath care contexts.
Graduates will be 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.
Students will demonstrate the ability to establish and maintain therapeutic, caring and culturally safe relationships with clients
and health care team members based upon relational boundaries and respect.
Graduated of this program will be able to enact advocacy in their work based on the philosophy of social justice.

Graduates will effectively utilize communications and informational technologies to improve client outcomes.

Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed
interventions and outcome measures.

** these forms are for reference use only and do not need to be submitted with evaluation*

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Trent/Fleming School of Nursing

Trent University-Peterborough Site
Semester ______________

NURS 2020H Clinical Course Evaluation

Mid-term Evaluation

Student: Leah Will

Preceptor: Priscilla Holden
Clinical Instructor: Ann MacLeod

Placement: Christian Horizons (Whitby)

Total Clinical Hours: _________
*Signed log must be attached
Grade: satisfactory unsatisfactory

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Student – Preceptor- Instructor Evaluation (midterm):

Progress
Satisfactory/Unsatisfactory
Evidence/Indicators
Course Objective (drop down box for Clinical
(The student has...)
Instructor only)
1. Demonstrated professional
responsibility and accountability to Student comment:
collaboratively plan, implement and/or
evaluate a health promotion project My partner and I spent the first few weeks at
relevant to the community population placement getting to know the persons supported in
served, using element of the course the home, as well as their daily routine. I have
website such as the learning system and demonstrated professional accountability by asking
regular, punctual communication with many questions to the staff to gain a better Choose an item.
preceptor and faculty. understanding of the policies and procedures they
have in place for each person in the home.

I have also demonstrated this skill by communicating

to both my instructor and preceptor about our plans
to work collaboratively outside of the home, due to
the commute. This holds both of us accountable as
we use the time we are given as effectively as
possible. By working away from home, I was able to
demonstrate time management, initiative and
responsibility and accountability for the work that I
said would get done.

Preceptor comment:

Instructor comment:

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2. Applied their knowledge to support

population assessment, collaborative Student comment:
and evidence informed health
promotion project development, I have demonstrated this skill by successfully being
implementation and process and able to complete our windshield survey. We were
outcome evaluation. able to get a variety of information about the group
home, surrounding area and support systems in the
community that the persons supported have access Choose an item.
to.

I was also able to conduct a literature survey

regarding our project. The aim of our project is
digestive health in relation to the population. We
have focused in on a condition called ‘Ogilvie’s
Syndrome’ after learning that a person supported in
the home has this condition. We were able to read
multiple articles about this topic and zone in on what
exactly we wanted the outcome of our community
health project to be. By gaining knowledge from the
staff as well as the literature search, we were able to
come up with a project idea that will effectively
serve this population.

Also, from talking to both persons supported and

staff we are able to get a better understand of the
health effects of the current means in place
regarding digestive health. We are able to see where
there are gaps, and how we may be able to provide
education for the staff to increase the health of the
persons supported in the home.

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Preceptor comment:

Instructor comment:

3. Demonstrated ethical respectful and

professional practice when working with Student comment:
community organizations and the
population with whom they work. I have demonstrated this skill by always treating the
persons in the home in a respectful and non-
judgmental manner. I also make sure to inquire
about any special needs/requirements that anybody
needs in the home, or things to avoid or look out for Choose an item.
in regards to safety. I make sure that the persons
know that I am here to help and support them.

I have demonstrated professional practice by making

sure to treat all staff and workers with respect. The
staff at this home have a great deal of knowledge
and information that I can learn from. They also
always treat the persons supported in the home with
respect, and teach us a lot about how to interact
with this specific population.

I have also made sure to maintain confidentiality of

all persons supported in the home. While looking at
charting or notes, I make sure to keep them private
and to ourselves. If I have notes on my laptop about
specific people, I make sure to use initials only. Also,
during post conference every Monday, I don’t give

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out details about specific people in the home, I just

talk very generally to still get the information across.
This demonstrates that I am acting in a professional
and confidential manner.

Preceptor comment:

Instructor comment:

4. Demonstrated knowledge of
relational practice in project Student comment:
development, respectful of group I have demonstrated this skill by making sure to
process, leadership/followership, and work through all of the necessary steps to ensure a
collaborative practice to meet the needs successful project. Since we have to implement and
and build capacity of the population in evaluate the effectiveness of our project, we figured
the given context. that the best method to use was a simple survey
before and after a presentation/online module on Choose an item.
digestive health for persons with disabilities.

While implementing our project, we have to be

respectful of the policies regarding our organization
of Christian Horizons, and be careful not to work
outside our scope of practice as nursing students.
We also have to be respectful of the organizations
values about being open to all persons, regardless of
disabilities, race, religion, sex, etc.

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Seeing as this is a partner placement/project, we

have learned to effectively communicate and
collaborate on the development of our project. As
we were brainstorming ideas for the project, we
were able to both voice our opinion in order to
figure out the best way to go ahead with the project.
Luckily, my partner and I know each other outside of
school (we worked together in a hospital together),
so we are able to take our already developed
rapport and use that to make an effective
partnership.

Specifically regarding our project, we were able to

realize that there is not enough information on
Ogilvie’s syndrome for people with disabilities. We
are also planning to tailor our project to the
education level of the staff providing primary care
on the persons supported in the group home.

Preceptor comment:

Instructor comment:

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5. Demonstrated self-regulation by
engaging in self-reflective practice and Student comment:
identifying learning needs through self- Prior to this placement, I had very little knowledge
assessment that align with the SON’s on public/community health. I also have never
program goals and the Community worked with this specific population before.
Health Nursing Standards of Practice in Although we are not providing direct patient care, it
Canada. is interesting to have this new perspective on
nursing and how important public health is to the Choose an item.
overall care of the patient. Although we are only
about halfway through the placement, I have
learned a lot about public health nursing and am
looking forward to implementing and evaluating our
project.

Preceptor comment:

Instructor comment:

Student Self Evaluation Comments: (Any area marked “unsatisfactory” needs to be commented on)

Preceptor Comments: (Any area marked “unsatisfactory” needs to be commented on)

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Clinical Instructor’s Comments: (Any area marked “unsatisfactory” needs to be commented on)

Students:
Identify 3 personal strengths developed in this placement Identify 3 areas requiring further development

1. The ability to be open minded to a new area of nursing. 1. Improved efficiency of developing a public health nursing
project.
2. I am able to be non-judgmental and respectful to the 2. Experience and learning about various disabilities and
population. how it affects all aspects of health (biological, emotional,
family etc.)
3. I am eager to learn and I am not afraid to ask questions 3. Use of technology while creating surveys, posters and
if I need clarification or help. infographics for educational purposes.

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Signature: Preceptor_____________________________________________ Date ___________________

Signature: Clinical Instructor ______________________________________ Date ___________________

Signature: Student_______________________________________________Date ____________________

*all signatures must be in writing not typed

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