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.





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.


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.


5.       Implement patient care decisions based on evidence-based practice.


6.       Utilize patient care technology and information management systems.


7.       Communicate therapeutically with patients.


8.       Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care.


9.       Understand the human experience across the health-illness continuum.


10.    Provide culturally sensitive care.


11.    Preserve the integrity and human dignity in the care of all patients.


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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