HUMBER ITAL

PRACTICAL NURSING DIPLOMA PROGRAM

NURS 161 Faculty/Student Feedback Tool

STUDENT: Davinder Bassi
(Examples of Specific Learning Outcomes
provided below. For more learning outcomes
please look to Appendix A of NURS 161)

STUDENT #: xxx xxx xxx

Sa
t

N
D

Uns
at

Faculty:

Faculty Comments

DATE: July 12, 2013

Student Comments

Professional Responsibility
and Accountability

Adheres to dress code

Punctual and present each week
Organizes time and workload to
meet weekly learning objectives
Acts in a respectful manner by
being courteous, polite, and
honest
Demonstrates evidence of review
of past learning and preparation
prior to each class.
Increases knowledge of
anatomy/physiology and nursing
theory as it is applied to practice
in the clinical setting
Demonstrates problem solving
skills

Ethical Practice
Respects diversity
Maintains a caring and
therapeutic environment in the
classroom and clinical lab
Maintains confidentiality
Provides privacy during
clinical lab activities

S
S
S
S
S
S
S

S
S
S
S

Punctual and present for each class, prepared

and in full dress code.
Pre-lab quiz always complete, material
reviewed and videos observed multiple times
prior to class.
Knowledge of A&P expanding with theory
and practice of vital signs (BP and pulse as it
relates to cardiac system, respiration rate as it
relates to respiratory system, etc.)
Problem solving skills developing through
working with variety of partners.
Respectful of peers, teachers and self at all
times. Enjoys learning about other cultures.
Always maintains friendly, therapeutic
relationship in classroom and lab to facilitate
learning.
Maintains privacy and confidentiality in all
lab activities.
1

HUMBER ITAL
PRACTICAL NURSING DIPLOMA PROGRAM

NURS 161 Faculty/Student Feedback Tool

STUDENT: Davinder Bassi
(Examples of Specific Learning Outcomes
provided below. For more learning outcomes
please look to Appendix A of NURS 161)

Service To The Public

Begins to advocates for self,

peers, and the nursing profession

Respect the rights of others
Resolves conflict positively

Identifies own limitations in

practice
Seeks out consultation as
required
Promotes safety in the clinical
lab
Self-Regulation

Models professional behaviour

Recognizes impact of behaviour
on others.
Evaluates the effectiveness of
nursing care provided
Listens to peers and faculty
feedback and uses this effectively
Invests time and effort to improve
clinical practice
Adheres to CNO Standards of
Practice discuss during NURS
161
Adheres to Humber ITAL Policies
and PN Handbook

STUDENT #: xxx xxx xxx

Sa
t

S
S
S
S

N
D

Uns
at

Faculty:

Faculty Comments

DATE: July 12, 2013

Student Comments

Advocates for self, peers and nursing

profession
Very respectful of others rights.
Resolves conflicts

Able to identify own limitations and seek out

assistance as required.

Always promotes patient safety in the lab.

S
S

Models professional behaviour at all times

and promotes same in peers.

Good understanding of evaluating

effectiveness of nursing care provided
Always ready for feedback to improve
nursing care.
Improves clinical practice with consultation
and repetition with peers at home prior to
testing.
Adheres to all CNO standards, Humber ITAL
policies, and PN Handbook.

S
S
S
S

HUMBER ITAL
PRACTICAL NURSING DIPLOMA PROGRAM

NURS 161 Faculty/Student Feedback Tool

STUDENT: Davinder Bassi
(Examples of Specific Learning Outcomes
provided below. For more learning outcomes
please look to Appendix A of NURS 161)

STUDENT #: xxx xxx xxx

Sa
t

N
D

Uns
at

Faculty:

Faculty Comments

DATE: July 12, 2013

Student Comments

Additional Faculty/Student Comments:

I have very much enjoyed my first Clinical Lab experience as I prepare for my future career in nursing.
Thank you for all your guidance.

Future Recommendations/Strategies for Success:

Student Signature ________________________

Faculty / Clinical Teacher Signature____________________________________

Date ___________________________________

Date __________________________

Satisfactory: Student is meeting course outcome.

Needs Development: Student needs development in particular course outcome
Unsatisfactory: The student is not meeting requirements in specific course outcome
Please note that CNO Teacher/Student Clinical Feedback tool may be used for PN PAT purposes.
MC/CNOClinicalFeedbackToolNov22/10
Revised JH Aug 2012