"JURS'l22C, NURS323C, NURS410C, NURS422C, NURS433C and NURS490C Clinical Evaluation Tools (January 2016)

To be completed by
Student Name:
1#:
Course code:
Facility Name:
Clinical Area:
Dates Attended:

To be complete by Clinic_al facilitator/p

Clinical facilitator/ preceptor name:
Number of hours completed:
Number of hours absent:
Mid-term assessment: Satisfactory BRIGHA:\I Yot::\"G U~I\-ERSITY - IDAHO
Final assessment: Satisfactory
Clinical facilitator/preceptor's
Date: -:::,a ~d DEPART~IE~T OF NrRSI:\"G

I acknowledge that I have made a duplicate of this document and other documents that I have su mitted which I will retain for the duration of my course.

Student's signature: ~ ~ Date: '2-?:, \~

NU Rsn2c, NURS323C, NURS410C, NURS422C, NURS433C and NURS490C (I; nkal Evaluafon Tools (Janua,y 2016) tDU,W1f ~ fj_des
Daily: D Mid-term: rs/J Final: D
Student Self Evaluation Complete a self-assessment in the section of the Clinical Evaluation Tool based on your clinical experience, and meet w ith
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

. Recognizing deviations from

expected patterns
l
E J

• Information Seeking E

INTERPRETING
. Prioritizing Data: jV\ ~ ""-
;

. Making sense out of data:

.,,._.

~ ~
!:I

RESPONDING 1... f-
. Calm, Confident Manner I;, .C
. Clear Communication
~
$
. Well-Planned Intervention/ ("'

Flexibility ~
. Being Skillful
---
..
i
~
REFLECTING C

. Evaluation/Self-Analysis E ® D B u ~
f

• Commitment to Improvement E@D B u .ft)V-f Y1~ ti 6hS . ~

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

Minimum requirements Jnr I (NURS Jnr 2 (NURS 322C & NURS Sor I (NURS 410C & NURS 422C) Snr 2 (NURS433C &
per semester 310C) 323C) NURS490C
Noticing B D A A
lnteroretin2 B D A A
ResPonding B D A A
Reflecting B D A A
 NURS:i22C, NURS323C, NURS410C, NURS422C, NURS433C and NURS490C Clinical Evaluation Tools (January 2016) C~ &-ks
Da ily: D Mid-term : D Final: ~
Student Self Evaluation Complete a self-assessment in th e section of the Clinical Evaluat ion Tool based on your clinical experience, and meet w ith
your assigned clinical fac ulty to discuss. Use the next page to determine your self-rating and explain specific.ally 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 (e) D

• Recognizing deviations from

l!xpected patterns

• Information Seeking

I: INTERPRETING
I.
•
Prioritizing Data:
Making sense out of data:
~~ U , c u kY~l.~ -~ -s. -~~Ot:t$-1~~ P·1--.~-~~f-.,~..f?o~tl~ ,~~.~J ro~J.

RESPONDING
• Calm, Confident Manner

• Clear Communication

• Well -Planned Intervention/

Flexibility

• Being Skillful

REFLECTING ·
• Evaluation/Self-Analysis ~ lt~
• Commitment to Improvement

Copy permission obta ,ned from l.as~ter (U.\SON\O,ane\Bussard\lasater Clinical Judgment Rubric Scoring Sheet.doc)- Final document adapted from Lasater (2007a)

Minimum requirements Jnr I (NURS . Jnr 2 (NJJRS 322C & NlJRS Snr 1 (NURS 410C & NURS 422C) Sor 2 (NURS433C &
per semester JLOC) 323C) NURS490C
Noticing B D A A
Interpreting B D A A
Responding B D A A
Reflect.in~ B D . A A

'-. ta #
 NURS322C, NURS323C, NURS410C, NURS422C, NURS433C and NURS490C Clinical Evaluation Tools (January 2016)

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

Mid-term reflection by student: Mid-term reflection by facifi~ator/clinicaf preceptor

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

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Student's signat~re _j..~~~....:.;..""7't_-=-..;:_ _
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Student's name. _, ~ ~ ';}- - :t3,--;/f

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J I 11 I\ LK-:1.,-Yinical facilitator/preceptor s1gna ure.