Final Evaluation

Student: __Gabrielle Gagnon___

Clinical Instructor: ___Sandy White____
Preceptor: __Gwen Mannings______
Placement: ___Roger Neilson Public School___
Total Clinical Hours: __176_

Satisfactory
Unsatisfactory
To be completed by clinical instructor

Students Self-Evaluation (final):

Progress
Course Objective
Evidence/Indicators: (The
Satisfactor
student has ...)
y
-Always come to the agency on *
Demonstrated professional
time, prepared for the work day,
responsibility and accountability to
and dressed appropriately with
collaboratively plan, implement
professional attire and my
and/or evaluate a health promotion
nursing identification badge.
project relevant to the community
-Have carried out assigned tasks
population served, using elements of (assignments, project duties and
the course website such as the
supplemental presentations such
learning system and regular,
as Halloween and hygiene) in a
punctual communication with
timely manner that meets
preceptor and faculty.
expectations and needs
-Have notified preceptor and
clinical instructor well ahead of
time about unforeseen absences
(illness, working from alternate
location, etc.)
-Have made good use of my
time at the agency.
-My partner and I have
*
collaborated on the
Applied their knowledge to support
population assessment, collaborative development, creation and
implementation of the nutrition
and evidence informed health
education program, as well as
promotion project development,
recorded evaluations and
implementation and process and
process outcomes collectively
outcome evaluation.
following education sessions.
-Utilized knowledge from
course work (Nursing 2000) and
various sources such as Ontario
curriculum, dieticians of Canada
and scholarly journals to ensure
information incorporated into
education sessions was informed
and reliable.
-Addressed students, teachers
*
Demonstrated ethical respectful and
and other staff at the school with
professional practice when working
respect and maintained
with community organizations and
appropriate professional
the population with whom they work. boundaries with others in the
agency.
-I do not demonstrate any
favoritism amongst any of the
students I am educating or even
amongst the teachers.
-All information concerning
project evaluation and/or
information provided by
teachers regarding students or
the school are kept confidential
-Support students by not putting
down and completely
disregarding any answers they
may provide during lessons but
rather encourage them to

Unsatisfactory

Signature of Student: ___________________________________________________

Date____________________
Signature of Instructor___________________________________________________
Date____________________

Identify 3 personal strengths developed in this placement.

1.
2.
3.

Developed additional skills in creating therapeutic relationships, specifically amongst the pediatric
population (age 4-13).
Developed the skills to plan, create, implement and evaluate a community health project.
Developed skills on how to effectively teach children of varying ages and capacities health matters,
while keeping them interested and involved.

Identify 3 areas requiring further development.

1. Prior to implementation and planning, do even more extensive research on the community and other
methods of effectively influencing nutritional choices in this socioeconomic group to ensure nutrition
education for children was the most effective method of promoting long-lasting change.
2. Have a more extensive knowledge of materials taught, specifically vitamins and minerals, so to be able
to correctly and with confidence answer every single question asked by the students and teachers.
3. This semester, because of the agency I was in and the project I was assigned, several aspects of more
typical community projects were not involved such as project budgeting and policy making. I believe
that as a future nurse, developing these skills would be beneficial.

Attendance
Week 1
Week 4

Week 2
Week 5

Week 3
Week 6

Week 7

Week 8

Week 9

Week 10

Week 11

Week 12

Total number of clinical hours completed__176___

Signature of Instructor___________________________________________________
Date____________________
Signature of Student_____________________________________________________
Date____________________