Practice Immersion Clinical Evaluation Tool

Practice Immersion Clinical Evaluation Tool

Practice Immersion Clinical Evaluation Tool – Agency/Site

Agency/Site Criteria

Student Evaluation

 
Faculty Evaluation
Comments

Does Not Meet
Meets
Excels*
Does Not Meet
Meets
Excels*

1.       Agency/site was able to provide the opportunities for the student to meet practice immersion clinical objectives.
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☐
☒
☐
☐
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2.       Agency/site was able to establish a comfortable, yet stimulating, practice environment.
☐
☐
☒
☐
☐
☒
Practice Immersion Clinical Evaluation Tool

Criteria:
Does Not Meet:  Elements are missing.
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Meets:  Agency/site meets this criterion.
Excels:  Agency/site meets this criterion and further a teaching point opportunity or expanded information, guidance, or other element to further enhance student learning.
Agency/site – strengths:

Student Evaluation
Faculty Evaluation

Practice Immersion Clinical Evaluation Tool

 
 
Agency/site – areas of improvement needed:                                                                                                                         
 

Student Evaluation
Faculty Evaluation

 
Agency/site – Suggestions to incorporate more responsiveness to student learning needs:

Student Evaluation
Faculty Evaluation

 
 
 
 
 
Practice Immersion Clinical Evaluation Tool – Mentor

Clinical Criteria

Student Feedback of Mentor Experience

Comments

Does Not Meet
Meets
Excels*

3.       Exemplify professionalism in diverse health care settings.
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☐
☒

4.       Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents.
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☐
☒

5.       Implement patient care decisions based on evidence-based practice.
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☐
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6.       Utilize patient care technology and information management systems.
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7.       Communicate therapeutically with patients.
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8.       Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care.
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9.       Understand the human experience across the health-illness continuum.
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10.    Provide culturally sensitive care.
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11.    Preserve the integrity and human dignity in the care of all patients.
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☒

Criteria:
Does Not Meet:  Elements are missing; mentor did not achieve.
Meets:  Mentor meets this criterion.
Excels:  Mentor meets this criterion and further incorporates a teaching point scenario or expanded information, guidance, or other element to further enhance student learning. Practice Immersion Clinical Evaluation Tool
 
Practice Immersion Clinical Evaluation Tool – Student

Clinical Criteria
Mentor
Sign Off

Faculty Sign Off

Comments

Does Not Meet
Meets
Excels*

12.    Exemplify professionalism in diverse health care settings.
☐
☐
☐
☒

13.    Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents.
☐
☐
☐
☒

14.    Implement patient care decisions based on evidence-based practice.
☐
☐
☐
☒

15.    Utilize patient care technology and information management systems.
☐
☐
☐
☒

16.    Communicate therapeutically with patients.
☐
☐
☐
☒

17.    Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care.
☐
☐
☐
☒

18.    Understand the human experience across the health-illness continuum.
☐
☐
☐
☒

19.    Provide culturally sensitive care.
☐
☐
☐
☒

20.    Preserve the integrity and human dignity in the care of all patients.
☐
☐
☐
☒

Criteria:
Does Not Meet:  Elements are missing; student is required to remediate this element to pass the course
Meets:  Student meets this criterion.
Excels:  Student meets this criterion and further incorporates a teaching point scenario.
Practice_Immersion_Clinical_Evaluation_Tool
Practice Immersion Clinical Evaluation Tool
 

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