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Seton Hall University College of Nursing

NUTC 3916AA Child and Family Nursing: Spring 2012

Child and Family Nursing Formative and Summative Clinical Evaluation: Criterion Referenced Tool

Course Competency #3: Provides care that demonstrates knowledge of developmental and cultural influences.

NAME______SEMESTER______

Mid-Term Clinical Evaluation FINAL Clinical Evaluation

Self-Evaluation Instructor Self-evaluation Instructor

4 / 3 / 2 / 1 / 4 / 3 / 2 / 1 / 4 / 3 / 2 / 1 / 4 / 3 / 2 / 1
Reflects on personal culture, expectations, beliefs, attitudes, self-awareness, and cultural biases formulating a plan to address identified deficient areas (reflective journal).
Utilizes effective age-appropriate therapeutic communication with patient (child), family, nurse, and interdisciplinary team.
Adapts approach to child’s care to reflect an understanding of the child’s developmental needs as reflected in care and written NCP.
Analyzes child/family’s cultural value system and beliefs gathering information from parental-child interviews and review of the chart (paper and EMR).
Utilizes the nursing process to develop an individual plan of care incorporating cultural values and age-appropriate developmental level and needs to prioritize care.

Mid-Term Clinical Evaluation FINAL Clinical Evaluation

Self-Evaluation Instructor Self-evaluation Instructor

4 / 3 / 2 / 1 / 4 / 3 / 2 / 1 / 4 / 3 / 2 / 1 / 4 / 3 / 2 / 1
Collaborates with the family and other members of the health care team.
Provides safe, culturally sensitive care.
Performs clinical skills accurately and independently.
Succinctly documents care using the nursing process.
Reports abnormal findings to appropriate staff within an appropriate period of time.

Legend:

4= Above expectations: Consistently excels in performance of behavior, independent; above average knowledge

3= Meets expectations: Demonstrates adequate knowledge to perform skill competently, independent

2= Below expectations: Performs with minimal knowledge for safe practice; requires close supervision and assistance

1= Unacceptable: Demonstrates inadequate knowledge and skill for safe practice; unable to perform; requires guidance at all times

Students are required to score a minimum of 3 in all areas on the final evaluation to pass this course.

Mid-Term Evaluation: Student’s self-evaluation: Reflect on your clinical experiences to date in this course. Identify your strengths and weakness. Develop a plan to address your identified weak areas. Identify at least 1 goal for the remaining weeks.

Areas of strength:

Areas of Weakness:

Plan to address weak areas:

Goal:

Clinical instructor’s evaluation of strengths and weakness; identified collaborative plan to address weak areas.

Student’s Signature:______Date:______

Instructor’s Signature:______Date:______

FINAL Evaluation: Student’s self-evaluation: Reflect on your clinical experiences throughout this course. Evaluate the effectiveness of your plan to address your identified weak areas. Identify strategies to utilize in your next clinical experience to facilitate a successful experience.

Evaluation of the effectiveness of plan:

Strategies for future success:

Student comments:

Clinical instructor’s evaluation and recommendations:

Student’s Signature:______Date:______

Instructor’s Signature:______Date:______

Couper CRT peds clinical 2012