Brigham Young University Idaho Nursing Program Clinical Evaluation Tool

To be completed by Student:
Student Name:
Cassity Clay
I#: 13-802-6671

Course code:

Facility Name:
Sister Cannon
Clinical Area:
Aston Living Center
Dates Attended:
2/24/2017

To be complete by Clinical facilitator/preceptor:

Clinical facilitator/preceptor name:

Number of hours completed:

Number of hours absent:
Mid-term assessment: Satisfactory
Unsatisfactory
Final assessment: Satisfactory
Unsatisfactory
Clinical facilitator/preceptors signature:

Date:

I acknowledge that I have made a duplicate of this document and other documents that I have submitted which I will retain for
the duration of my course.
Students signature:_____________________________Cassity Clay________________ Date:_____2/24/17___________________

Revised 7/18/16
Brigham Young University Idaho Nursing Program Clinical Evaluation Tool

Student Self Evaluation Complete a self-assessment in the section of the Clinical Evaluation Tool based on your clinical
experience, and meet with your assigned clinical faculty to discuss. Use the next page to
determine your self-rating and explain specifically your rationale or give examples if you gave
yourself a rating below or above the minimum requirements for your semester level.
Clinical Judgment Component
NOTICING
Focused Observation E A Over the course of our clinicals I have become more comfortable with the patients and
D B U able to recognize deviations from regular patterns especially since I know the patients
better.
Recognizing deviations from By having the confidence with better focused observation I am improving on this.
expected patterns E A
D B U
Information Seeking E A I have become better at talking to the patients and found different ways to ask questions
D B U when they are incoherent.
INTERPRETING
Prioritizing Data: E A I have become better at looking at the different data and finding what I need to attend to
D B U first.
Making sense out of data: E A With my growing base line of data through my studies I have been able to interpret data
D B U better.
RESPONDING
Calm, Confident Manner E A I feel a lot better about being around patients and jumping in to help with things.
D B U
Clear Communication E A I have found different ways to communicate with patients who require different forms of
D B U communication.
Well-Planned Intervention/ I have been able to vocalize interventions to the patients.
Flexibility E
A D B U
Being Skillful E A Once again by having my baseline knowledge of skills I have been able to apply those
D B U skills.
REFLECTING
Evaluation/Self-Analysis E A I am completely willing and ready to continue on to further clinicals.
D B U
Commitment to Improvement E A I am committed to becoming better and ready for further instruction.
D B U

Daily: Mid-term: Final:

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Brigham Young University Idaho Nursing Program Clinical Evaluation Tool

Copy permission obtained from Lasater (U:\SON\Diane\Bussard\Lasater Clinical Judgment Rubric Scoring Sheet.doc) Final document adapted from Lasater (2007a)

Table 1: Adapted Lasater Clinical Judgment Rubric

Dimension Exemplary Accomplished Developing Beginning Unsatisfactory

Effective noticing involves:

Focused observation Focuses observation Focuses observation Regularly observes and Attempts to monitor a Confused by the clinical
appropriately without appropriately; regularly monitors a variety of variety of subjective and situation and the amount
assistance; regularly observes and monitors a wide data, including both objective data but is and kind of data;
observes and monitors a variety of objective and subjective and objective; overwhelmed by the observation is not
wide variety of objective and subjective data to uncover most useful information array of data; focuses on organized and important
subjective data to uncover any useful information. is noticed; may miss the the most obvious data, data are missed, and/or
any useful information and most subtle signs. missing some important assessment errors are
makes changes to information. made
assessments as needed.
Recognizing Recognizes subtle patterns Recognizes subtle patterns Recognizes most obvious Identifies obvious patterns Focuses on one thing at a
deviations from and deviations from and deviations from expected patterns and deviations in and deviations, missing time and misses most
expected patterns expected patterns in data patterns in data and uses data and uses these to some important patterns and deviations
and uses these to guide the these to guide the continually assess. information; unsure how to from expectations; misses
assessment. Makes assessment. continue the assessment. opportunities to refine the
Minimum requirements Jnr 1 (NURS
association between
Jnr 2 (NURS 322C & NURS Snr 1 (NURS 410C & NURS 422C) Snr 2 (NURS433C
assessment
&
per semester 310C)
deviations to patient disease 323C) NURS490C
Information seeking Assertively seeks information Assertively seeks information Actively seeks subjective Makes limited efforts to Is ineffective in seeking
Noticing B D A A
to plan intervention: carefully to plan intervention: carefully information about the seek additional information; relies mostly
Interpreting collectsBuseful subjective Dcollects useful subjective data A situation from the
patients information from theA on objective data; has
Responding B observing and
data from Dfrom observing and Aand family to
patient patient and family; A difficulty interacting with
Reflecting interacting
B with the patient Dinteracting with the patient support
A planning often seems not to A the patient and family and
and family. Determines if and family. interventions; occasionally know what information fails to collect important
more information is needed. does not pursue important to seek and/or pursues subjective data
leads. unrelated information.

Effective interpreting involves:

Prioritizing data Focuses on and prioritizes the
most relevant and important
data useful for explaining the
patients condition.
Focuses on the most relevant
and important data useful for
explaining the patients
condition.
Generally, focuses on the Makes an effort to Has difficulty focusing
most important data and prioritize and focus on the and appears not to
seeks further relevant most important data, but know which data are
information but also also attends to less most important to the
attempts to attend to less relevant or useful data. diagnosis; attempts to
pertinent data. attend to all available
data

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Brigham Young University Idaho Nursing Program Clinical Evaluation Tool
Table 1: Adapted Lasater Clinical Judgment Rubric
Dimension Exemplary
Making sense of data Even when facing complex,
conflicting, or confusing data,
is able to (a) note and make
sense of patterns in the
patients data, (b) compare
these with known patterns
(from the nursing knowledge
base, research, personal
experience, and intuition),
and (c) develop plans for
interventions that can be
justified in terms of their
likelihood of success. Seeks
Effective responding involves:
Calm, confident Assumes responsibility
manner within current scope of
practice; assesses patients
efficiently and effectively.
Reassures patient and any
support persons, adjust
priorities of care based on
changes to patient condition.
Clear communication Communicates effectively;
checks for understanding
and adjusts communication
as needed; explains
interventions in a manner
that all involved are able to
understand; calms and
reassures patients and any
support persons;
Well-planned Interventions are tailored for
intervention/flexibi the individual patient;
lity monitors patient progress
closely and is able to adjust
treatment as indicated by
patient response and by
worsen patient condition.
Being skillful Shows confidence and co-
ordination of necessary
nursing skills with minimal
supportive cues from staff or
faculty.
Effective reflecting involves:
Revised 7/18/16
Accomplished
Even when facing complex,
conflicting, or confusing data,
is able to (a) note and make
sense of patterns in the
patients data, (b) compare
these with known patterns
(from the nursing knowledge
base, research, personal
experience, and intuition),
and (c) develop plans for
interventions that can be
justified in terms of their
likelihood of success.
Assumes responsibility within
current scope of practice;
delegates team assignments;
appropriately assesses
patients and reassures
reassure the patient and any
support persons.
Communicates effectively;
explains interventions;
checks for understanding
calms and reassures patients
and any support persons.
Interventions are tailored for
the individual patient;
monitors patient progress
closely and is able to adjust
treatment as indicated by
patient response.
Shows confidence and
capability of necessary
nursing skills, requires
infrequent supportive cues
from staff or faculty.
Developing
In most situations,
interprets the patients familiar situations, is able
data patterns and
compares with known
patterns to develop an known and to develop or
intervention plan and
accompanying rationale;
the exceptions are rare or
in complicated cases
where it is appropriate to
seek the guidance of a
specialist or a more
experienced nurse.
Needs to be prompted to
take responsibility.
Appears to be unsure of
appropriate co-ordination
of care. Is able to assess
the patient, requires
assistance to priorities
care but is able to
appropriately reassure
the patient and any
Generally, communicates
well; explains carefully to
patients and any support
persons; could be more
effective in establishing
rapport.
Develops interventions on
the basis of relevant
patient data; monitors
progress regularly but
does not expect to have
to change treatments.
Displays proficiency in the
use of most nursing skills;
could improve speed or
accuracy, requires
frequent verbal and/or
physical cues.
Beginning
In simple, common, or
to compare the patients
data patterns with those
trouble distinguishing
explain intervention
plans; has difficulty,
however, with even
moderately difficult data
or situations that are
within the expectations of
students; inappropriately
requires advice or
Is reluctant to take on
responsibility; reassures
patients and families in
routine and relatively
simple situations, but
becomes disorganized
easily, unable to adjust to
changes in patients
conditions.
Shows some
communication ability
(e.g., giving directions);
communication with
patients, and any support
persons is only partly
successful; displays some
empathy.
Develops interventions on
the basis of the most
obvious data; monitors
progress but is unable to
make adjustments as
indicated by the patients
response.
Is hesitant or ineffective in
using nursing skills,
requires continuous verbal
and frequent physical
cues.
Unsatisfactory
Even in simple, common,
or familiar situations, has
difficulty interpreting or
making sense of data; has
among competing
explanations and
appropriate interventions,
requiring assistance both
in diagnosing the problem
and developing an
intervention
Except in simple and
routine situations, is
stressed and
disorganized, lacks
control, makes patients
and families anxious or
less able to cooperate
Has difficulty
communicating;
explanations are
confusing; directions
are unclear or
contradictory; patients
and families are made
confused or anxious
and are not reassured
Focuses on developing a
single intervention,
addressing a likely
solution, but it may be
vague, confusing, and/or
incomplete; some
monitoring may occur
Is unable to select and/
or perform nursing
skills
Brigham Young University Idaho Nursing Program Clinical Evaluation Tool
Table 1: Adapted Lasater Clinical Judgment Rubric
Dimension Exemplary Accomplished Developing Beginning Unsatisfactory

Evaluation/self-analysis Independently evaluates and
analyzes personal clinical
performance, noting decision
points, elaborating
alternatives, and accurately
evaluating choices against
alternatives. Assesses if
goals are being met.
Commitment Demonstrates commitment
to to ongoing improvement;
improvement reflects on and critically
evaluates nursing
experiences; accurately
identifies strengths and
weaknesses and develops
specific plans to eliminate
weaknesses. Uses reflective
nursing practice effectively.
Independently evaluates and
analyzes personal clinical
performance, noting decision
points, elaborating
alternatives, and accurately
evaluating choices against
alternatives.
Demonstrates commitment
to ongoing improvement;
reflects on and critically
evaluates nursing
experiences; accurately
identifies strengths and
weaknesses and develops
specific plans to eliminate
weaknesses.
Evaluates and analyzes
personal clinical
performance with minimal
prompting, primarily about
major events or decisions;
key decision points are
identified, and alternatives
are considered.
Demonstrates a desire to
improve nursing
performance; reflects on
and evaluates
experiences; identifies
strengths and
weaknesses; could be
more systematic in
evaluating weaknesses.
Even when prompted,
briefly verbalizes the
most obvious
evaluations; has difficulty
imagining alternative
choices; is self-protective
in evaluating personal
choices.
Demonstrates awareness of
the need for ongoing
improvement and makes
some effort to learn from
experience and improve
performance but tends to
state the obvious and
needs external evaluation.
Even prompted
evaluations are brief,
cursory, and not used to
improve performance;
justifies personal
decisions and choices
without evaluating them
Appears uninterested in
improving performance or
is unable to do
so; rarely reflects; is
uncritical of himself or
herself or overly
critical (given level of
development); is
unable to see flaws or
need for improvement

Table 2
Resource for Students: Examples of questions from the Lasater Clinical Judgment Rubric (LCJR) that simulate deep thinking and learning so
student think like a nurse.
Tanner Model LCJR Dimension Example of Question
Phase
Noticing Focused observations What did you first notice about the patient?
Recognizing deviations from What was different than what you expected? Have you seen this
expected patterns before in other patients?
Information seeking What other information would be helpful? How can you get that
information?
Interpreting Prioritizing data How did you prioritize the patient information/data? In other words,
what was most important for this patient now?
Making sense of the data On what did you base choice of intervention? If intuition, what kinds of
data might offer evidence to support your gut feeling?
Responding Calm, confident manner What was your approach with the patient? How comfortable did you
feel?
Clear communication How did you think you gained the patients trust? What did you say to
the patient? To the family?
Well-planned What factors, including patient feedback, impacted the treatment
interventions/flexibility plan?

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Brigham Young University Idaho Nursing Program Clinical Evaluation Tool
Being skillful How did your skill compare to nursing standards of care?
Reflecting Evaluation/self-analysis What went well? What didnt go so smoothly as your planned? Why or
why not?
Commitment to improvement What would you do differently if you had the opportunity?
K. Lasater / Nurse Education in Practice 11 (2011) 86e92

Students and facilitators are expected to complete an interim and a final reflection on the clinical placement.

Mid-term reflection by student: Mid-term reflection by facilitator/clinical preceptor

Students name:_______________________ Students signature ___________________________ Date:____________________________

Clinical facilitator/preceptor name:_______________________ Clinical facilitator/preceptor signature:_______________________
Date:________________

Final reflection by student: Final reflection by facilitator/preceptor:

I have been able to practice many skills that we have learned Student is able to practice at expected level.
throughout the semester, which has been good practice
performing them on live people.

Learning different communication styles for patients who have Recognizes need for improvement and constant reflection of
dementia or are unable to verbally communicate. It has been self and practice
a great learning experience for me to also implement
therapeutic communication techniques that I have learned in
class.
Willing to participate.
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Brigham Young University Idaho Nursing Program Clinical Evaluation Tool
I have also been able to see some situations in the nursing
home that I have decided that I will never do in my practice.
Ready for next step.

Students name:______________Cassity Clay_________ Students signature _____Cassity Clay______________________

Date:__________________2/24/17__________
Clinical facilitator/preceptor name:_______________L. Cannon RN________ Clinical facilitator/preceptor signature:______________L.
Cannon RN_________ Date:____________2/24/17____

Revised 7/18/16