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Kingdom of Saudi Arabia Ministry of Higher Education University of Hail College Of Nursing

STUDENT CLINICAL EVALUATION FORM (WORK YEAR)

Evaluation Guideline
The following specific evaluation guidelines are used to determine the students clinical performance. They indicate how well the student has met the outcomes for clinical practice and overall judgment on competencies. These guidelines are based on several aspects of nursing practice as stated below. The degree of supervision required for the expected level of clinical practice. The competence of nursing care, such as priority setting, problem solving, astuteness in noticing cues, appropriateness in designing nursing care strategies, dexterity and interactions with clients, health care providers and peers. The ability to apply theory and skills in the clinical setting. Motivation and readiness of the student for clinical practice with the expectation that interest and selfdirection for learning will be demonstrated.

General Directions: 1. Check the boxes that best represents the students performance on each of the following Ha'il Universitys Nursing Program Outcomes. 2. This evaluation tool uses the 5-point Likert scale as shown below.

A RATING OF 5 (OUTSTANDING) MEANS THE STUDENT:


Generally functions satisfactorily with minimum guidance in the usual clinical situation. Demonstrates excellence with multiple clients or one complex client in performance of nursing care. Demonstrates accurate and appropriate knowledge and usually integrates knowledge with skills. Engages in self direction in approach to learning consistently.

A RATING OF 4 (VERY SATISFACTORY) MEANS THE STUDENT:


Generally functions with minimum guidance in the usual clinical situation with one client. Demonstrates above average performance of nursing care. Demonstrates adequate knowledge and requires moderate assistance in integrating knowledge with skills. Recognizes learning opportunities but may require assistance in utilizing them.

A RATING OF 3 (SATISFACTORY) MEANS THE STUDENT:


Functions safely with moderate amount of guidance in the usual clinical situation. Demonstrates average performance of nursing care for this level student. Demonstrates adequate knowledge and requires moderate assistance in integrating knowledge with skills. Requires some direction in recognizing and utilizing learning opportunities.

A RATING OF 2 (NEEDS IMPROVEMENT) MEANS THE STUDENT:


Requires occasional intense guidance for the performance of activities at a safe level. Clinical performance reflects difficulty in the provision of nursing care. Demonstrates gaps in necessary knowledge and requires frequent or almost constant assistance in integrating knowledge and skills. Requires frequent and detailed instructions regarding learning opportunities.

A RATING OF 1 (UNSATISFACTORY) MEANS THE STUDENT:


Requires consistent intense guidance for the performance of activities at a safe level. Is unsafe to practice without constant, intense guidance. Frequently lacks necessary knowledge and skills and is unable to integrate these into practice. Requires constant, detailed instruction regarding learning opportunities and is often unable to utilize them.

Kingdom of Saudi Arabia Ministry of Higher Education University of Hail College Of Nursing

STUDENT CLINICAL EVALUATION FORM (WORK YEAR) Name of Student : _________________________________________ UoH ID #: ________________ : ________________ : ________________

Area of Assignment : __________________________________________ Level Inclusive Date(s)


General Instructions: 1. 2. Please check the box that best describes the students performance. Calculate the evaluation grade using the formula below. Cumulative Score X 100% Total Score Scale: 5 4 3 2 1 Outstanding Very Satisfactory Satisfactory Needs Improvement Unsatisfactory 5 X Weight Value (%) =

: __________________________________________ Mark

Average Score (%)

A. PHYSICAL APPEARANCE (5%)

1. 2. 3. 4. 5.

Wears prescribed uniform neat and clean. Hair is well-groomed. Maintains good hygiene in client care (e.g. free from cigarette smoke odor). Physicaly and mentally alert. Facial expression is pleasant.
Average Score (%): __________

B. ATTITUDE (10%)

1. 2. 3. 4. 5. 6.

Participates in group conferences on client care actively. Accepts criticisms constructively. Manifests initiative in taking the assigned tasks. Accepts varied assignments willingly. Adjusts to working environments positively. Displays good working relationship with hospital staff, preceptors/clinical
3

instructors, and peers.


C. TRAITS (5%) Average Score (%): __________ 5 4 3 2 1

1. Dependable and reliable even with minimum supervision. 2. Honest, courteous and respectful to hospital staff, clients, guests, and preceptors/clinical instructors. 3. Maintains composure under stressful situations.
Average Score (%): __________ D. HABITS (10%) 5 4 3 2 1

1. Reports and leaves with permission on time in the assigned area. 2. Submits and completes course requirements on time. 3. Utilizes learning resources to increase knowledge about the clients care. 4. Sets priorities in handling clients problems. 5. Gathers the necessary equipment before performing procedures. 6. Assists with after care of equipment. 7. Maintains clients privacy, safety and comfort. 8. Adheres to standard hospital protocols. 9. Organizes assigned tasks systematically. 10. Conducts bedside health teaching to the client and their significant others.
Average Score (%): __________ D. KNOWLEDGE Scheduled Individual Student Conference (30%)
Note: Evaluate the student from prepared questionnaires on the items enlisted below through bedside discussion. Schedule the pre- and postconference sessions to validate knowledge based on the care plan formulated by the student. Refer to the clinical focus on the plan of activities to accommodate reinforcement of knowledge.

1. 2. 3. 4.

Medical Abbreviations and Terminologies Anatomy and Pathophysiology (patient case) Dosage Calculations (oral, subcutaneous, intramuscular, intravenous routes) Nursing Interventions (bedside care)
Average Score (%): __________

E. SKILLS Nursing Procedures (40%)


Note: Evaluate the student on two (2) procedures per day according to rotation plan as applicable in the assigned area. Indicate the title of each procedure performed by the student below. 1 2 3 4 5 6 7 8

Total Score (%)

Average Score (%): __________ 4

Total Grade/Marks in Work Year

_______ (100%)

_______ (20%)

Please describe the student's strong points and areas for improvement. Whenever possible, please provide examples.

A. Kindly describe what the student did well.

B. Kindly describe what the student needs to work on.

Submitted by:
/ 5

Submitted to:
/

Preceptor

/Date

Clinical Instructor

/Date

Kingdom of Saudi Arabia Ministry of Higher Education University of Hail College Of Nursing

GRADING SYSTEM
Attendance Work Year (Student Clinical Evaluation Total Grade) Case Study Nursing Care Plan Midterm Exam Final Exam 5% 20% 10% 5% 20% 40%

GRADE POINT AVERAGE (GPA)

100%