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Purpose
Time
Outline
Materials Needed
Opening
PPT 6-1
Introduce yourself and your role. Share some background
information on your expertise with clinical evaluation.
The purpose of this session is to review with you, the
participants, the types of clinical evaluation tools that
might be encountered when evaluating students in clinical
practice. The decision as to which evaluation tools are to
be used is often made by the full-time or permanent
faculty in the clinical course. As adjunct clinical
instructors, you are obligated to follow the evaluation
methods established by the course faculty and offer
suggestions for change when needed to the course faculty.
More than likely, you will not use all of these methods in a
semester. However, having an understanding of the
various methods is important.
Objectives
Objectives
PPT 6-2
Highlight the objectives for this session. Explain that after
discussing the major evaluation methods and tools,
participants will work in small groups to practice using a
clinical performance rubric.
6-2
Direct Observation
Preceptor Observation
Anecdotal Notes
6-3
Tools
Journaling/Reflection Papers
Process Recordings
Portfolios
Patient Assessment Tools
Nursing Care Plans
Concept Maps
Student Self-Evaluation
6-4
Observation
Observation Guides
Checklists
Simulation Lab
Direct Clinical Observation
Anecdotal Notes
Clinical Rubrics
Preceptor Observation
Observation
PPT 6-5
Observation is the main method faculty members use in
the student evaluation process. Observation occurs in the
skills lab using observation guides in the form of
checklists during skill demonstrations. There is direct
clinical observation in the clinical setting by the faculty
member, the preceptor, or even the staff member.
After observing students, faculty members often keep
anecdotal notes to remember specific information about
their observations. According to OConnor (2001),
anecdotal notes should include a description of:
Care the patient received
What the student did or failed to do in providing care
Any situational or environmental factors that
contributed to the observed situation
In addition to anecdotal notes, faculty may choose to use a
clinical performance rubric to record student performance,
which will be presented next.
6-5
Predetermined behaviors/criteria
Delineates safe and satisfactory student
performance
Derived from course outcomes
Describes different levels of quality such as:
Satisfactory
Needs Improvement
Unsatisfactory
6-6
6-7
Clinical Competence
Rating Scale
Independent
Supervised
Assisted
Marginal
Dependent
Not Applicable
Not Observed
6-8
6-9
6-10
Satisfactory
Needs
Improvement
Unsatisfactory
Patient Assessment
Graded weekly
6-12
Patient Assessment
Patient Demographics
Chief Complaint
IV Information
Physician Orders
Pathophysiology Review
6-13
Patient Assessment
PPT 6-12
The patient assessment form or tool is one of the most
common evaluative methods used to evaluate student
understanding, accuracy, and comprehensiveness. The
assessment form usually is accompanied by a medication
profile, a nursing care plan, or a concept care map. The
patient assessment form is typically graded by the clinical
faculty member with feedback. There is a place on the
clinical performance rubric to indicate the quality of the
students work. Typically, one assessment tool is required
for each assigned patient.
Patient Assessment
PPT 6-13
The patient assessment form often contains the following
sections patient demographics; chief complaint; history
current/past medical and surgical; allergies and current
medications; IV information; laboratory, diagnostic tests
and procedures; physician orders; and pathophysiology
review. How the patient assessment tool is configured
depends on course faculty preference.
Standardized format
Formative evaluation
Graded
6-14
Advantages
Standard approach or format
Thought to show critical thinking
Helpful in learning to think like a nurse
Disadvantages
Standardized care plans
Use of critical thinking skills
Linear approach
Real nurses do not write care plans
6-15
Concept Maps
CLINICAL EVALUATION TOOLS
By: Joric M. Magusara, RN, RPT
Concept Maps
Diagrammatic strategy
Demonstrates relationships
Organizes data
Formative evaluation
Graded
6-16
Concept Maps
Advantages
Synthesis of knowledge
Less writing
Shows student understanding
Disadvantages
Map may be large
No two will be alike in format
Attractiveness may influence
assessment
PPT 6-16
A new and competing method of demonstrating
understanding of the nursing process and student
understanding of the whole patient is the concept care
map. The concept map is a diagrammatic teaching
strategy that helps students to demonstrate how the patient
assessment tool is configured, depending on course faculty
preference and the relationships between data. The
concept care map shows a students ability to organize a
large amount of data. It takes the place of a traditional
NCP. It also is a part of students formative evaluative
process and is graded with feedback.
Concept Maps Advantages and Disadvantages
PPT 6-17
The advantages of the concept care map are that it is a
creative process that shows synthesis of information data
and requires less writing. The disadvantages of the
concept map are that it may be large and difficult to
follow, no two maps will be the same, and attractiveness
of the map may influence faculty evaluation of the
students abilities.
6-17
Concept Maps
Types of Maps
Pathophysiologic Focus
Nursing Care Focus
Combination Pathophysiologic and Nursing
Care Focus
6-18
Handouts Needed:
Student Scenario
Clinical Performance Rubric
Patient Assessment Tool
Nursing Care Plan
Concept Care Map
6-19
Issues
Concerns
What if?
PPT 6-19
Divide the participants into groups of two to four,
depending on room configuration. Use the instructions on
page 6 (Tab 6) of the participant notebook to introduce the
activity to the participants. Go through the student
scenario and explain to the participants that they are being
asked to review the patient assessment tool, the nursing
care plan, and the concept care map. Explain they are to
use the portion of the clinical performance rubric to record
their evaluation of the written work and add comments to
the rubric for the student. Give them about 15-20 minutes
for the small group to work and then move to the next
slide to debrief this activity.
Clinical Evaluation Activity Debrief
PPT 6-20
After the activity, offer the participants time to ask
questions and bring up any issues, concerns, their likes
and dislikes. Ask if they have any what if scenarios
they would like to explore.
6-20
Student Self-Evaluation
Clinical performance
Strengths
Areas of improvement
6-21
Student Self-Evaluation
PPT 6-21
Students are now being asked to evaluate their clinical
performance weekly.
Sometimes, faculty members ask the students to evaluate
themselves based on the clinical evaluation tool or the
clinical performance rubric. At other times, faculty want
the students to examine what they learned, what their
strengths were, identify where they want to improve, and
how they plan to improve.
Many students have difficulty with this activity. They
often feel unsure because they dont know what the
faculty member wants to see written. They do not know
how to provide rationale or supportive data when they say
that they demonstrated understanding of the patients
medical diagnosis and surgical procedure. Well, how did
they do that? What supportive information can they offer?
Encourage your students to give details. If they do not
give details, send the evaluation back and indicate you are
unable to evaluate what they have written and you need
more information/examples are needed. According to
Oermann and Gaberson (2006), students in the first
clinical course may need assistance with identifying their
strengths and areas needing improvement. Faculty need to
assist students in the identification of strategies to improve
their performance. The self-evaluation process is only for
formative evaluation and is not graded, according to
Oermann and Gaberson.
Student-Faculty Relationships
6-22
Student-Faculty Relationships
PPT 6-22
According to Gaberson and Oermann (1998), it is the job
of the clinical faculty to foster positive relationships with
their clinical students by displaying confidence in the
students, showing them respect, keeping clinical
expectations realistic (first clinical course behaviors
versus the final clinical course behaviors), being honest
and direct when giving feedback, staying approachable,
displaying caring behaviors, and remaining supportive and
encouraging about their potential for improvement and
growth.
With problem students, you should step back and make
sure you are not the problem. If you decide you might be
part of the problem, be honest with the student and let
them know what you will do to make changes and then
guide them to understand their responsibilities in the
change process. Make a commitment to help this student
to become the best nurse during the time you have them.
Of course, this may be difficult if you have very short
clinical rotations.
If you are sure the student may have difficulty being
successful no matter what you or the student does,
evaluate them weekly using the rubric, and keep them
informed. And, remember to document, document, and
document. Document all student behavior that
demonstrates unsatisfactory performance.
Summary
CLINICAL EVALUATION TOOLS
By: Joric M. Magusara, RN, RPT
10
6-23
PPT 6-23
In conclusion, during this session we:
Introduced various clinical evaluation tools available to
faculty
Discussed the development and use of a clinical
performance rubric
Reviewed guidelines for providing clinical feedback to
students
Compared the traditional nursing care plan with the
concept care map
Discussed how to develop positive student-faculty
relationships
Practiced using the clinical performance rubric based
on a student scenario and paperwork examples
The overall goal of this session was to help familiarize
you with the various methods of clinical evaluation and
introduce the clinical performance rubric and the concept
care map. New clinical faculty are not expected to be
perfect at clinical evaluation, so it is important you keep in
touch with the full-time or permanent course faculty, ask
lots of questions and ask for guidance as you begin your
journey of clinical evaluation. Remember, the students
job is to learn, and the clinical facultys job is to be the
students guide. Good luck to each of you.
FILE: G-CFA Instructor Tab 6 Clinical Eval Tools
11