Graduate Program / Student Evaluation: Advanced Practice in Psychiatric / Mental Health

STUDENT EVALUATION
ADVANCED PRACTICE IN PSYCHIATRIC AND MENTAL HEALTH NURSING PRACTICUMS
26:705:515 ; 26:705:553 ; 26:705:517

Student's Name: ______

(Last) (First) (Middle)

Preceptor’s Name:______

(Last) (First) (Middle)

RUID: ______

Course Title: ______

Student’s Clinical Specialty: ______

Course Semester and Year: ______

Clinical Agency: ______

EVALUATION FOR (Select One):

۝ Mid-Term ۝Final

PERSON COMPLETING FORM (Select One):

۝Student: ______

(Signature)

۝Preceptor: ______

(Signature)

Date: ______

PERSON REVIEWING FORM (Select One):

 Student: ______

(Signature)

 Preceptor: ______

(Signature)

Date: ______

This form should be completed twice during the semester: once at midterm by the student with a review by the preceptor and again around the final week of the semester by the student and preceptor.

Mid-term: The main purpose of the mid-term evaluation is to identify the student's strengths and weaknesses so that experiences can be provided to help the student meet the course objectives. The student should complete the form and make arrangements with the preceptor to discuss the ratings and plan future experiences. The mid-term self-evaluation by the student will not be used in calculating the final course grade because it is a formative evaluation. However, it is a required activity. The student should return the completed form to the course faculty after the conference with the preceptor.

Final:The main purpose of the final evaluation is to determine the extent to which the

student achieved the course objectives (summative evaluation). Before the last week of the course, the student and preceptor should independently complete the form, discuss their respective evaluations, and sign both forms. The signatures only indicate that each has seen the evaluation — not that each agrees or disagrees with the ratings. The student's and preceptor's ratings will be used by the faculty member in determining the student's final course grade as specified in the course syllabus.

Performance indicators are located under each course objective. Please place a 

mark in the column to indicate the student's achievement of each course objective as evidenced by the following performance indicators. Please use the following scale. Space is provided for comments. Comments can be directed to performance on one or more performance indicators. Refer to the letters to save space.

4 = Excellent: Consistently functions above the expected level. Demonstrates outstanding ability to apply theoretical knowledge to the clinical setting and superior clinical performance.

3 = Satisfactory: Consistently functions at the expected level. Demonstrates expected ability to apply theoretical knowledge to the clinical setting and average clinical performance.

2 = Marginal: Inconsistently functions at the expected level. Frequently requires assistance in applying theoretical knowledge to the clinical setting and in clinical performance.

1 = Unsatisfactory: Consistently functions below the expected level. Unable to apply theoretical knowledge to clinical setting and to perform safely and/or effectively.

NA = Not Applicable

NO = No opportunity to observe

Advanced Practice Nurse (APN)
Competencies Expected at End of Program

Evaluation of competencies in the HUMAN BEHAVIOR PRACTICUMS I & II and Family Intervention (Circle relevant semester)

OBJECTIVES:

1. Diagnose and manage acute health care needs of adult clients.

Performance Indicators:

The student:

  1. obtains a complete health history including an evaluation of the client's developmental level, physical maturation, psychosocial status, coping abilities, and ability to perform activities of daily living;
  1. collects data.using appropriate assessment techniques and relevant supporting diagnostic information;
  1. prioritizes data collection according to the client's immediate condition and needs;
  2. integrates data from relevant sources and utilizes data findings to make clinical judgments and decisions about appropriate recommendations and treatments;
  3. analyzes the assessment data in determining diagnoses;
  4. identifies expected outcomes individualized to meet client needs;
  5. formulates a database which is synthesized, prioritized and documented in a retrievable form;
  6. develops a plan of care that specifies diagnostic strategies and therapeutic interventions, and addresses the continuing needs of the client; •

1. implements the interventions identified in the plan of care;

j. evaluates client progress toward the attainment Of expected outcomes using quality indicators and a multidisciplinary collaborative approach to care.

The APN student has performed in the following manner during the (1m) (2m) (3rd) (4th) semester of clinical experience: Circle one

PERFORMANCE INDICATORS / SEMESTER / 4 / 3 / 2 / 1 / N/A / NO
INDICATORS FOR OBJECTIVE #1

Semester 1, 2, 3, for all specialties except FNP has 4. Students should be rated on progress toward the competency until the final semester. At end of final semester , actual achievement should be rated. Please note that students can be scored from 4 to 1 for the semester they are in (i.e. you need not reserve 3's & 4's only for 3rd or 4th semester students).

COMMENTS:

______

______

______

______

2. Use current research findings to provide advanced nursing care for acutely ill adult clients.

Performance Indicators:

The student

  1. applies a theory-based conceptual framework to guide practice;
  2. evaluates and applies research findings pertinent to client care management and outcomes of care;
  3. uses interventions substantiated by relevant research data as appropriate for the client and the practice setting;
  4. incorporates research findings into clinical practice;
  5. participates in the research process to discover, examine, and test knowledge and theories;
  6. uses epidemiological, social, and environmental data to draw inferences about the health status of individuals, families, and the community

The APN student has performed in the following manner during the (1m) (2m) (3rd) (4th) semester of clinical experience: Circle one

PERFORMANCE INDICATORS / SEMESTER / 4 / 3 / 2 / 1 / N/A / NO
INDICATORS FOR OBJECTIVE #2

COMMENTS:

______

______

______

______

Semester 1, 2, 3, for all specialties except FNP has 4. Students should be rated on progress toward the competency until the final semester. At end of final semester , actual achievement should be rated. Please note that students can be scored from 4 to 1 for the semester they are in (i.e. you need not reserve 3's & 4's only for 3rd or 4th semester students).

3. Consult and collaborate with other health professionals in the planning, implementation, and evaluation of advanced nursing care to acutely ill adult clients.

Performance Indicators:

The student:

  1. consults and collaborates with client, significant others, and other members of the healthcare team to provide a coordinated multidisciplinary approach to acute care delivery;
  2. collaborates with other disciplines in teaching, consultation, and management of client health care;
  3. makes appropriate referrals to other systems and health care providers

The APN student has performed in the following manner during the (1m) (2m) (3rd) (4th) semester of clinical experience: Circle one

PERFORMANCE INDICATORS / SEMESTER / 4 / 3 / 2 / 1 / N/A / NO
INDICATORS FOR OBJECTIVE #3

COMMENTS:

______

______

______

______

Semester 1, 2, 3, for all specialties except FNP has 4. Students should be rated on progress toward the competency until the final semester. At end of final semester , actual achievement should be rated. Please note that students can be scored from 4 to 1 for the semester they are in (i.e. you need not reserve 3's & 4's only for 3rd or 4th semester students).

4. Incorporate and evaluate innovative strategies that include the use of information technology, patient classification systems, and other technology in the delivery of advanced nursing care to acutely ill adult clients through advanced practice roles of educator, consultant, and expert practitioner.

Performance Indicators:

The student:

Educator Role:

  1. determines client's/family's readiness to learn;
  2. identifies client's/family's learning needs;
  3. develops and/or utilizes existing technologies and information resources to instruct clients/family members in the provision of care;
  4. selects teaching strategies and evaluation techniques with consideration of objectives and client/family characteristics (age, learning style, sensory deficit, language skills, pathophysiological alteration, developmental and reading levels);

e. measures client's/family's ability to achieve learning objectives and modifies the plan as needed

Consultant Rqle

  1. utilizes information systems to transmit, store, retrieve, import and export electronic data in consultation with other disciplines;
  2. engages in on-line synchronous or asynchronous telehealth, telemedicine, teleconferencing and other technologies to disseminate/obtain information;

c. analyzes electronic/digital information transmitted by consulting health professionals

Expert Practitioner

  1. incorporates use of information systems in the provision of primary care to men and women;
  2. utilizes telecommunication technologies and information systems to classify client levels of acuity,

manage clinical data, communicate clinical findings, and modify physiological alterations

  1. evaluates the effectiveness/accuracy of electronic data transmissions

The APN student has performed in the following manner during the (1st ) (2nd ) (3rd ) (4th ) semester of clinical experience: Circle one

PERFORMANCE INDICATORS / SEMESTER / 4 / 3 / 2 / 1 / N/A / NO
INDICATORS FOR OBJECTIVE #4

COMMENTS:

______

______

______

______

Semester 1, 2, 3, for all specialties except FNP has 4. Students should be rated on progress toward the competency until the final semester. At end of final semester , actual achievement should be rated. Please note that students can be scored from 4 to 1 for the semester they are in (i.e. you need not reserve 3's & 4's only for 3rd or 4th semester students).

5. Manage the care of acutely ill clients within current acceptable practice guidelines/standards of care.

Performance Indicators:

The student:

a.participates in a quality management program which addresses collection and analysis of quality data indicators, patient safety/satisfaction, symptom management/control, appropriateness of levels and acuity of care, and analysis of risk/benefits associated with quality and effectiveness;

b.participates in quality of care improvement mechanisms in evaluation of clinical practice;

c.analyzes data generated through quality of care activities to identify opportunities to improve care;

d.formulates recommendations to improve clinical practice based on data obtained from quality of care activities;

  1. engages in collaborative appraisal of professional practice by peers, clients, colleagues and others;

f.collaborates in the development, evaluation and update of clinical guidelines/standards/pathways consistent with current science;

g.demonstrates awareness of legal and regulatory constraints or opportunities that affect care delivery

The APN student has performed in the following manner during the (1st ) (2nd ) (3rd ) (4th ) semester of clinical experience: Circle one

PERFORMANCE INDICATORS / SEMESTER / 4 / 3 / 2 / 1 / N/A / NO
INDICATORS FOR OBJECTIVE #5

COMMENTS:

______

______

______

______

Semester 1, 2, 3, for all specialties except FNP has 4. Students should be rated on progress toward the competency until the final semester. At end of final semester , actual achievement should be rated. Please note that students can be scored from 4 to 1 for the semester they are in (i.e. you need not reserve 3's & 4's only for 3rd or 4th semester students).

6. Provide culturally competent care to diverse groups of acutely ill clients and families.

Performance Indicators:

The student:

  1. performs a culturological assessment of the client;
  2. obtains data that reflects sensitivity to cultural diversity, ethnicity, gender and life style choices from multiple sources, including the client, significant others, and medical records;
  3. contributes to the establishment of a culturally receptive environment that supports the rights of all participants;
  4. contributes to the creation of an individual and systems response to resolution of cultural dilemmas

The APN student has performed in the following manner during the (1st ) (2nd ) (3rd ) (4th ) semester of clinical experience: Circle one

PERFORMANCE INDICATORS / SEMESTER / 4 / 3 / 2 / 1 / N/A / NO
INDICATORS FOR OBJECTIVE #6

COMMENTS:

______

______

______

______

Semester 1, 2, 3, for all specialties except FNP has 4. Students should be rated on progress toward the competency until the final semester. At end of final semester , actual achievement should be rated. Please note that students can be scored from 4 to 1 for the semester they are in (i.e. you need not reserve 3's & 4's only for 3rd or 4th semester students).

7. Evaluate efficacy, effectiveness, cost and health policy in providing care acutely ill adult clientsin a variety of settings.

Performance Indicators:

The student:

  1. performs risk/benefit analysis of the treatment process;
  2. analyzes organizational system enhancement and barriers which have an impact on client care;
  3. assists clients and families to access appropriate health care services;
  4. integrates current understandings of cost and benefits in caring for clients;

e.assists multidisciplinary team members, clients, families in selecting therapies that integrate perspectives of cost and quality benefits;

  1. serves as resource to various publics for the purpose of influencing health care delivery and policy formation;
  2. advocates for the client in matters of health policy and services;
  3. provides age-appropriate and gender relevant health promotion and disease prevention information

The APN student has performed in the following manner during the (1st ) (2nd ) (3rd ) (4th ) semester of clinical experience: Circle one

PERFORMANCE INDICATORS / SEMESTER / 4 / 3 / 2 / 1 / N/A / NO
INDICATORS FOR OBJECTIVE #7

COMMENTS:

______

______

______

______

Semester 1, 2, 3, for all specialties except FNP has 4. Students should be rated on progress toward the competency until the final semester. At end of final semester , actual achievement should be rated. Please note that students can be scored from 4 to 1 for the semester they are in (i.e. you need not reserve 3's & 4's only for 3rd or 4th semester students).

If a student is judged to be marginal or unsatisfactory for any performance indicator, comments should be made to explain the basis for the rating. In addition, the faculty member of the course should be notified.

COMMENTS:

______

______

______

______

FOR COURSE INSTRUCTOR’S USE ONLY:

The grade point should be computed as follows:

1.

2.

3.

Revised 6/10 Page 1