1

NURS 253 PRECEPTOR FEEDBACK

WRITTEN PERFORMANCE FEEDBACK OCCURS AT WEEK 7 AND WEEK 15
NOTE: Preceptors complete this written feedback form in Week 7 (Mid-term Evaluation) and Week 15 (Final

Evaluation). In Week 4 a discussion of student learning to date occurs; students who Need Development or
are Unsatisfactory in Week 4, 11 or as required, receive written feedback using this form which is submitted to
the Professor/Clinical Teacher.

LEARNING
INDICATORS THAT LEARNING HAS OCCURRED:
OUTCOME
Students will be able
to:
COMPETENT AND SAFE PRACTICE WITHIN A LEGAL AND ETHICAL
FRAMEWORK
i.
1. Model safe,
competent,
and ethical
practice in
compliance
with legal
and
regulatory
frameworks
and the
policies and
procedures
of the
practice
setting.

ii.
iii.

iv.
v.

vi.
vii.
viii.

ix.

Comment

Comply with regulatory standards, relevant

legislation and the practice settings policies and
procedures.
Act in a professional, responsible, ethical and
accountable manner.
Use the three factor and decision making
frameworks to determine strengths and limitations
and when to collaborate and consult with other
professionals.
Integrate evidence-informed practice and a theory
based approach into nursing care.
Assess practices and risk management principles
and take action to ensure safety of clients, self,
and others.
Question and clarify unclear orders or directions
and when uncertain.
Question, clarify or challenge questionable orders,
decisions or actions by others.
Respond in a professional manner to situations in
which there is unsafe, unacceptable or
unprofessional behavior.
Demonstrate understanding about the role of the
nurse within health care.

S = SATISFACTORY
ND = NEEDS DEVELOPMENT
U = UNSATISFACTORY
WEE
K
4

WEE
K
7
S

WEE
K
11

WEE
K 14

S
S

S
S
S
S
S
S

Vanessa follows VPD policy and procedures. She asks questions and refers to these
documents on regular basis.

2
LEARNING
OUTCOME
Students will be able
to:

INDICATORS THAT LEARNING HAS OCCURRED:

ACCURATE AND RELEVANT COMMUNICATION

i.
2. Communicate
ii.
using strategies
and technology iii.
to effect
accurate and
timely
information
iv.
sharing
including data,
research, and
v.
other
vi.
information.

Contribute to team sharing and discussions.

Document clearly, accurately, concisely in a timely
manner using written and electronic methods.
Use effective communication techniques when
reporting relevant information and providing
feedback to the appropriate members of the
interprofessional heath care team.
Evaluate and refine techniques used to
communicate and share information with clients and
the interprofessional health care team.
Ensure privacy and confidentiality.
Use technology to retrieve information including
research and other date and to obtain and forward
information both within and outside the practice
setting.

Comments

Vanessa continuously provides feedback to team members.

S = SATISFACTORY
ND = NEEDS DEVELOPMENT
U = UNSATISFACTORY
WEEK WEE
WEE
WEEK
4
K
K
14
7
11
S
S
S

S
S
S

3
LEARNING
OUTCOME
Students will be
able to:

INDICATORS THAT LEARNING HAS OCCURRED:

CARING RELATIONAL PRACTICE

i.
Establish therapeutic caring, compassionate, and
3. Engage in
culturally safe relationships with clients and health
relational
care team members.
ii.
Establish a caring environment that supports
practice that is
clients in meeting their needs and outcomes,
caring,
managing their illness, or experiencing a peaceful
compassionate
death
and respectful.
iii.
Demonstrate therapeutic use of self to foster client
well-being.
iv.
Utilize relational knowledge and skills, and ethical
principles to support clients and to interact with
health care providers
v.
Use self-awareness to identify the effects that
beliefs, values, and personal experiences have on
relational practice.
vi.
Collaborate with clients, members of the
interprofessional and health care teams; and,
consult appropriately.
vii.
Uphold practices and systems that support the
diversity of clients and of the interprofessional
health care team.
viii.
Provide effective client education.
Comments

S = SATISFACTORY
ND = NEEDS DEVELOPMENT
U = UNSATISFACTORY
WEEK
WEEK WEEK WEEK
4
7
11
14
S
S
S
S

S
S
S
S

Vanessa is very caring and compassionate individual. She takes time with each client to ensure they are
comfortable during immunization process. She is very knowledgeable on immunization we provide in VPD and is
able to provide client education to clients.

4
LEARNING
OUTCOME
Students will be able
to:

INDICATORS THAT LEARNING HAS OCCURRED:

LEADERSHIP AND ADVOCACY

i.
Evaluate and refine leadership skills to develop
4. Act as a leader
solutions, resolve conflict, create a positive work
and an advocate
environment and organizational culture, and to
to empower
strengthen advocacy role.
ii.
Provide feedback to peers and accept feedback
clients, self, the
from peers and members of the interprofessional
interprofessiona
health care team.
l health care
iii.
Advocate for clients, self, others, and quality
team and to
practice environment.
further the
iv.
Support clients rights for self-determination and
profession.
choice.
v.
Respond appropriately to unsafe, unacceptable,
and unprofessional behaviors.
vi.
Demonstrate public protection and acting in the
interests of the public through collaboration and
consultation with other members of the
interprofessional health care teams.
vii.
Contribute to the creation of quality practice
strategies and solutions.
viii.
Assign, supervise, teach as appropriate, and
provide feedback to unregulated care providers
(UCPs) in collaboration with the interprofessional
health care team.
Comments

S = SATISFACTORY
ND = NEEDS DEVELOPMENT
U = UNSATISFACTORY
WEEK
4

WEEK
7
S

S
S
S
S
S
S
S

WEEK
11

WEEK
14

5
LEARNING
OUTCOME
INDICATORS THAT LEARNING HAS OCCURRED:
Students will be
able to:
PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED
EXPECTED OUTCOMES
i.
Formulates clinical judgments that meet clients
5. Integrate the
unique and changing health needs and
nursing process
priorities, outcomes, and overall condition and
into all aspects
incorporates these into evolving plans of care.
ii.
Devise evidence-informed plans of care that are
of nursing care
holistic and client-centred.
and across
iii.
Use clinical judgment to assess clients, prioritize
diverse practice
needs, outcomes, and nursing interventions.
settings.
iv.
Collaborate in the evaluation, refinement and
modification of plans of care.
v.
Safely and competently perform treatments and
use techniques, and technology autonomously
and in collaboration with clients and members of
the interprofessional health care team.
vi.
Collaborate with the clients across the lifespan
and with members of the interprofessional
health care team to create a client centered plan
of care that is articulated with competence both
in writing and orally.
vii.
Use awareness of own knowledge and skills,
the three factors of nurse, client and
environment and the practice decision-making
framework to guide practice.
viii.
Manage workload, time, and physical resources
to provide effective, efficient and ethical care.

S = SATISFACTORY
ND = NEEDS DEVELOPMENT
U = UNSATISFACTORY
WEEK
WEEK WEEK WEEK
4
7
11
14
S

S
S
S
S
S

Comments
Due to the fact that VPD provides mass immunization efficiency is very important and Vanessa has shown that she
has all the skills in providing safe and efficient immunization.

6
LEARNING
OUTCOME
INDICATORS THAT LEARNING HAS OCCURRED:
Students will be
able to:
COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE
TEAMS
i.
Collaborate with clients to determine needs,
6. Collaborate and
mutually agreed health outcomes, approaches to
consult with
care, and to evaluate care.
ii.
Contribute as a member of the interprofessional
clients and the
and health care teams to respond to changing
interprofessiona
client needs and outcomes.
l health care
Consult with and seek out assistance from
team to provide iii.
members of the interprofessional health care
comprehensive
team.
and holistic
iv.
Use teamwork, consensus building, and conflict
health care in a
resolution and leadership skills to meet expected
complex and
client outcomes.
changing
v.
Integrate effective, collaborative, and consultative
environment.
strategies to meet clients needs within a changing
environment.
vi.
Respect the unique role and competencies of all
members of the interprofessional health care
team.
vii.
Collaborate as a member of the interprofessional
health care team to respond to changes in nursing
knowledge and practice and in the health care
environment.
Comments

S = SATISFACTORY
ND = NEEDS DEVELOPMENT
U = UNSATISFACTORY
WEEK
WEEK WEEK WEEK
4
7
11
14
S
S
S
S
S
S
S

In Vaccine Preventable Disease Program our school based clinics settings change daily. Vanessa has shown ability to
adjust and provide safe, competent immunization in variety of settings. She has had opportunity to work at Measles
outbreak clinic where she was providing care to number of infants.

7
LEARNING
OUTCOME
Students will be
able to:

INDICATORS THAT LEARNING HAS OCCURRED:

WEEK
4

QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

i.
7. Engage in
Quality
Assurance
consistent with
ii.
the regulatory
framework.
iii.

iv.

v.

vi.

S = SATISFACTORY
ND = NEEDS DEVELOPMENT
U = UNSATISFACTORY

Act in the best interests of clients and protect

clients from harm through collaboration and
consultation with other members of the
interprofessional and health care teams and by
through competent and safe practice.
Commit to Quality Assurance practice to identify
strengths and areas for professional growth and in
accordance with the regulatory framework (CNO).
Create, implement, and evaluate a learning plan
consistent with the Quality Assurance program
(CNO).
Assume responsibility to seek out feedback for
colleagues and peers and learning opportunities
that foster professional development.
Consistently review nursing research and
information about health care to improve
competence and to support clients
Develop professional responses to health care
system changes resulting from advances in
research, technology, and changes in societal and
political forces.

WEEK
7

WEE
K
11

WEE
K 14

S
S
S
S

Comments
Vanessa attended Nursing Practice council at Toronto Public Health and shared feedback with other members
regarding nursing practice issues and Quality Assurance.

LEARNING
INDICATORS THAT LEARNING HAS
OUTCOME
OCCURRED:
Students will be able
to:
USE CRITICAL THINKING, PROBLEM-SOLVING and DECISION-MAKING
EFFECTIVELY
i.
Use critical thinking to inform decision
8. Use critical
making in all aspects of nursing care.
thinking, problem
ii.
Use clinical judgment to assess and refine

S = SATISFACTORY
ND = NEEDS DEVELOPMENT
U = UNSATISFACTORY
WEEK
4

WEEK
7
S
S

WEEK
11

WEEK
14

8
solving and
decision making
skills to meet the
health care needs
and expected
outcomes of
clients.

iii.
iv.

v.
vi.
vii.

assessments in collaboration with the

interprofessional health care team, formulate
nursing diagnoses, plan nursing
interventions, and outline evaluative criteria.
Evaluate and refine critical thinking, problem
solving, and decision-making skills.
Integrate knowledge from variety of nursing,
health, and other theory into nursing practice
to provide safe and competent care.
Prioritize effectively.
Demonstrate professionalism, responsibility,
and accountability.
Use critical thinking, the practice decisionmaking framework and the nurse-clientenvironment framework to inform clinical
judgments and practice.

S
S
S
S
S

Comments
Vanessa continues to use critical thinking and problem solving skills. She is has demonstrated number of times
that she is able to prioritize and provide safe and competent care.
It has been my pleasure to guide Vanessa thru this process. She has done outstanding job at our clinics and
made a difference. Her passion for learning and hard work is going to be an asset everywhere she goes.