Student Name: Simulation/Clinical #____ Date:

✔ Clinical Lab Midterm ✔ Final

NURS 310C Clinical Evaluation Tool

1. Demonstrate beginning competence in nursing skills associated with identified physiological and psychological concepts.
2. Administer medications safely according to legal and practice guidelines and reason clinically to evaluate medication orders, assess client
response, and take remedial actions when appropriate.
3. Provide safe, evidence-based, patient-centered care for stable patients with common heath alterations.
4. Provide effective patient education and support for patients with simple needs and stable conditions.
5. Communicate effectively with patients, significant others, and members of the interdisciplinary team.
6. Document nursing care and basic clinical decisions using an Electronic Health Record (EHR) or other means of communication.
7. Assume responsibility for one’s own professional growth evidenced by preparation for simulation/clinical.

Check the box that matches the student performance in the rubric below for each objective.

Student assessment check green box. Peer assessment check blue box. Faculty assessment check yellow box.

Unsatisfactory/ Developing Proficient Distinguished

Beginning 2 3 4
1
Student failed to follow Student demonstrated basic Student demonstrated Student demonstrated
Nursing Skills
1.

recommended guidelines for
beginning nursing skill(s)
Missed critical steps or
performed skill incorrectly
with potential to cause harm
knowledge of skill and
guidelines but requires
significant assistance from
faculty or peer. Unable to
articulate rationale for each
step in preforming skill.
knowledge of the skill and beginning competence in
was able to perform the skill nursing skill(s).
with minimal assistance from Procedural steps were
faculty or peer. Performed organized using correct
skill steps in order and techniques. No assistance
verbalized rationale for each was needed. Student
step. demonstrated depth and
✔ understanding of the skill.
 Unsatisfactory/
Beginning
1
Student missed one or more
Medications
2. of the 6 rights of medication
administration and/or had a
medication error. Unable to
articulate indication, side
effects and contraindications
of medication. Left
medication unattended.
Student did not provide safe,
Care
Evidence Based
Provide Safe,
3.
evidence-based or patient-
centered care for stable
patient with common health
alterations. Student
performance had potential to
cause patient harm.
Student did not provide or
Effective Patient Education
4.
provided incorrect patient
education or support for
patients with simple needs
and stable conditions.
Developing
2 3
Student missed one or more
of the 6 rights of medication
administration. Able to
verbalize at least one of the
following: indication of use
for this patient, side effects
or contraindications. Did not
leave the medication
unattended.
Student provides patient
care that lacked the
understanding of patient
safety, evidence-based
practice, and/or patient-
centered cares.
Student provided partial or
incomplete patient
education.
Student demonstrated
insufficient knowledge about
patient condition, lacked
confidence and was unsure
about what or how to teach
or instruct patient and/or
family. Did not use teach
back method.
Proficient
Student demonstrated safe
medication administration
using the 6 right. Unable to
articulate medication
indication of use, side effects,
and contraindications. Did
not leave the medication
unattended.
✔ contraindications of the
Student provided safe,
evidence-based, and patient-
centered care for a stable
patient. Student lacked the
ability to articulate rationale
for evidence-based and/or
patient centered care.
✔ concepts used.
Student provided teaching to
patient, including basic
concepts and teaching
methods. Lacked depth and
adequate knowledge base to
provide patient and family
with all information needed
related to current condition.
Distinguished
4
Student demonstrated
appropriate knowledge of
medication(s).
Student demonstrated safe
medication administration by
using the 6 rights. Able to
articulate indication of use,
side effects and
medication before
administration. Did not leave
the medication unattended
Student provided safe,
evidence-based, and patient-
centered care for a stable
patient with common health
alterations.
Student demonstrated and
verbalizes understanding of
Student provided patient
education and support.
Recognized and included
family when appropriate in
teaching. Showed confidence
when teaching patient.
Able to teach patient and
family about conditions, self-
care and utilized evidence
based teaching methods.
Used teach back method to
assess knowledge of
information provided to the
patient/family.
✔
 Unsatisfactory/
Beginning
1
Communication was very
Communicate Effectively
5.
limited, awkward, and lacked
flow, unable to effectively
relay information to patient,
family members, or
interdisciplinary team.
Student appears anxious
and/or lacks organization
Student failed to chart per
Documentation
6.
instruction, charted on the
wrong patient, charted
wrong information. Violated
HIPAA by leaving computer
screen, charting, and or
medical records visible to
patient or visitors
Student did not assume
Growth
Professional
7.
responsibility for own
professional growth.
Student was not prepared for
simulation/clinical.
Clinical Faculty Initial:
Developing
2 3
Communication was
attempted, but lacked depth
and direction. Student
appeared reluctant to
communicate with the
patient, family members, or
interdisciplinary team.
Limited documentation
completed. Student missed
or omitted important
subjective or objective
information. APIE was
incorrect.
Student failed to understand
the connection between
decisions made, cares given,
and what needed to be
documented.
N/A
Proficient
Communication was
appropriate but lacked depth
and detail.
Nurse appeared calm and
confident but had difficulty
with clear communication
with the patient, family
members, and
interdisciplinary team.
Student completed
documentation. APIE was
correct.
However, student lacked
understanding of connection
between decisions made,
cares given, and what was
documented.
N/A
Distinguished
4
Student used effective
communication with the
patient, family members, and
interdisciplinary team.
Student appeared calm and
confident with clear
communication. Uses SBAR
when communicating patient
information to physician.
✔
Student demonstrated
appropriate documentation
based upon the ability to
make basic clinical decisions.
Student utilized APIE when
documenting nurse notes.
✔
Student assumed
responsibility for own
professional growth.
Student was prepared for
simulation/clinical.
✔
Score:
 Peer comments* (2 compliments and 2 recommendations)

Student comments (2 strengths and 2 opportunities for improvement) Midterm Final

Faculty comments Midterm Final

*Peer comments not needed in clinical setting

Faculty Signature:

Student Signature:

Satisfactory Unsatisfactory Needs Remediation/Statement of Concern