PRACTICUM EVALUATION TOOL TEMPLATE

DEPARTMENT OF NURSING
JAMES MADISON UNIVERSITY
Student:

Emily Lawler

Name of Preparer:

Marjorie Scheikl, MSN, RN

Practicum Site:

RMH

Course #: NSG 355L

Section #: 0006

Date:

Spring 2015/Block II

CLINICAL HOURS

Direct Patient Care: 16

Missed Clinical Hours:0
Grade

Simulation:6.5
Precepted:16

Observation: 0
Other: Hospital and Unit Orientation:
6.5

Total Clinical Contact Hours: 45

Criteria: Students must achieve a passing rating in every outcome in order to pass a practicum course

Pass

Demonstrates satisfactory development of knowledge and skills. Objectives are met consistently and comprehensively, with progressive
independence and self-direction. Shows insight into strengths and areas for growth.

Fail

Mastery of skills and objectives inconsistent. Conduct is unsafe, unprofessional, offensive, or fails to maintain therapeutic alliance with clients
or resource personnel. Fails to construct or submit documentation in a professional or timely manner.
Outcomes/Objectives

Health Promotion/Illness Care: Provide health protection and promotion, risk reduction, disease prevention, illness
care, rehabilitation, and end of life care to diverse populations within a holistic framework in a variety of settings.
1.

Rating
Pass/Fail
PASS

Course Objectives: Provide safe and effective nursing care to women/newborn/family units of various cultural/ethnic backgrounds incorporating
health promotion and education necessary to meet the needs of the family.
Behaviors: Provides safe and effective nursing care to all patients with whom there is contact. Provides education during all patient interactions
to enable family to care for infant during hospitalization as well after discharge. Able to identify health care needs, goals and interventions
suitable for healthy outcomes for mother/baby dyad during practicum as well as in written work.

2. Critical Thinking: Synthesize knowledge, skills, and technology from the established practice and science of nursing,
the biological and psychosocial sciences, and the humanities to engage in critical thinking, clinical reasoning and the
nursing process in the care of clients.
Course Objectives: Apply nursing interventions with an understanding of the rationale for those actions supported by evidence based research.
Behaviors: Completes and documents patient assessment in a timely fashion. Able to analyze/interpret data. Able to write, verbally present,
and link pathophysiology, diagnostic tests, medications, lab results, and nursing interventions to patient care. Able to interpret and prioritize
these components during clinical as well as in written work. Able to evaluated effectiveness of interventions and suggest additional measures for
meeting goals.

PASS

Student Name: Emily Lawler NSG Section __0006_

Grade

Page 2 of 3

Criteria: Students must achieve a passing rating in every outcome in order to pass a practicum course

3. Therapeutic Relationships: Develop caring culturally competent relationships with clients that are sensitive to diverse
personal, socio-cultural, and environmental characteristics, which encourage clients to assume primary responsibility for
health care decisions, and in which the nurse functions as advocate and advisor.

PASS

Course Objectives: Integrate health/illness beliefs, values, attitudes, and practices of all the individuals, families, and groups into the care
provided.
Behaviors: Initiates care anticipating mother/infant/ and family needs as well as coordinating efforts to provide time for bonding and privacy.
Provide sensitive care to culturally diverse families while working to communicate with them. Provides safe learning environment for families.
Documents all care in a timely fashion.

4. Communication: Use effective communication and information technology to communicate interpersonal and health
care information.

PASS

Course Objectives: Utilize professional communication and collaborative skills to provide patient/family centered care.

Behaviors: Maintains good communication concerning patient status with faculty and staff during clinical rotation. Interacts professionally and
positively with faculty, staff, patient and family. Receptive to concerns and questions voiced by patient and able to respond appropriately. Uses
technology effectively and professionally only when required for patient care and/or family emergencies

5. Professional Role Development: Enhance professional role development.

PASS

Course Objectives: Examine the role, responsibilities, and scope of practice of nurses within the specialty of womens health.
Behaviors: Demonstrates safe, prepared and professional behavior during all clinical learning experiences. Demonstrates core values while participating in
observational experiences. Prioritizes care. Completes administration of medications/tasks in a safe and timely manner. Able to organize self to provide
comprehensive care for mother/baby dyad. Accepts responsibility for RN role development. Can perform skills and understands their underlying concepts.

6. Ethical and Professional Values: Engage in activities to promote self-awareness, self-growth, ethical accountability,
and legal responsibility in the practice of nursing.

PASS

Course Objectives: Critically analyze ethical dilemmas and policy issues related to women/newborn healthcare.
Behaviors: Demonstrates respect/confidentiality. Is prepared prior to the clinical experience. Assists staff and peers when needed. Is motivated and takes
responsibility for completing all patient care. Documents in a legal, ethically sound, professional manner. Is accountable for mistakes. Accepts constructive
feedback. Follows dress code. Is punctual and cooperative. Follows agencies policies.

7. Scholarship: Contribute to excellence in nursing care by scholarly contributions through discovery, integration,
application, and teaching. Contribute to excellence in nursing practice by identifying and critiquing research evidence
and integrating it with clinical practice, patient preference, cost-benefit, and existing resources.
Course Objectives: Integrate evidence, clinical judgment, inter-professional perspectives, and patient preferences in planning, implementing,
and evaluating outcomes of care.
Behaviors: Uses resources to promote learning and seeks out new learning opportunities. Able to incorporate assessment, outcomes and plan
of care from clinical experience into comprehensive patient care. Able to identify evidence based rational for care provided. Provides evidence
based rationale for interventions used in written work.

PASS

Student Name: Emily Lawler NSG Section __0006_

Grade

Page 3 of 3

Criteria: Students must achieve a passing rating in every outcome in order to pass a practicum course

Areas of strength:
Professionalism: On time, Prepared, Adheres to scope of practice and hospital policies
Communication: Communicates well with peers, faculty, staff, and patients
Team Player: Assists peers and unit staff
Time Management
Areas for growth: Continued practice will allow for expanded skill set and knowledge base. Continue to reflect on clinical
experiences to promote transition to professional practice.
Self-Identified areas for growth: Emily indicated the following areas she would like to strengthen: a.) Knowledge on medications,
b.) Computer documentation, c.) Self-confidence, d.) Teaching patients, and e.) Providing a thorough but concise patient report.
Skills performed:
Medication Administration: Adult: IV, IVpush,
Postpartum Shift Physical Assessment and vital signs
Newborn Shift Physical Assessment and vital signs
Newborn Admission Bathing
Newborn Bottle Feeding
Reviewed Newborn Withdrawal Symptoms and Protocols
Electronic Fetal Heart Rate and Contraction Pattern Analysis
Post operative after c-birth: monitor I&O, IV, pain levels.
Computer documentation of assessments and meds administered
Patient Teaching:
Post Conference: Actively contributes to post conference discussions. Led peer review on sinusoidal fetal heart rate pattern and
causes
Reflective Journal: Reveals an awareness of the importance of teamwork and communication in efficient and safe patient care. Also
displays transfer of classroom knowledge to clinical practice
Observed:
Role of the Newborn Nursery Nurse
Newborn Circumcision
Role of the Labor and Delivery Nurse
Admission process for patient scheduled for labor induction
Artificial Rupture of Membranes
Newborn Delivery via Cesarean Section
Newborn APGAR Scoring