NURS322C, NURS422C and NURS410C Clinical Evaluation Tools (January 2016)

Student: __Courtney Eades___ Date: _10/23/17___

Clinical Instructor: ___Brother Atwood___
Student Self Evaluation
Clinical Judgment Component
Clinical Site: ___State Hospital South______ Clinical Week___10/23/17______
Award Complete a self-assessment in the section of the Clinical Evaluation Tool based on your clinical
1-4 points in each experience, and meet with your assigned clinical or simulation faculty to discuss. Use the next page
of components to determine your self-rating and explain specifically your rationale if you gave yourself a B
(Beginning) or E (Exemplary) rating in the rows below.

NOTICING
Focused Observation B D A E D
Recognizing deviations from D
expected patterns B D A E
Information Seeking B D A E D
INTERPRETING
Prioritizing Data: B D A E D
Making sense out of data: B D A E D
RESPONDING
Calm, Confident Manner B D A E D
Clear Communication B D A E D
Well-Planned Intervention/ D
Flexibility B D A E
Being Skillful B D A E D
REFLECTING
Evaluation/Self-Analysis B D A E D
Commitment to Improvement B D A E D

Minimum requirements J1 (NURS 310C) J2 (NURS 322C & NURS 323C) S1 (NURS 410C & NURS 422C) S2 (NURS433C & NURS490C
Noticing B D A E
Interpreting B D A A
Responding B D A E
Reflecting B D A A
Daily Progress
Copy permission obtained from Lasater (U:\SON\Diane\Bussard\Lasater Clinical Judgment Rubric Scoring Sheet.doc) Final document adapted from Lasater (2007a)
NURS322C, NURS422C and NURS410C Clinical Evaluation Tools (January 2016)
Table 1
Adapted Lasater Clinical Judgment Rubric
Dimension
Effective noticing involves:
Focused observation
Recognizing deviations
from expected patterns
Information seeking
Effective interpreting involves:
Prioritizing data
Exemplary
Focuses observation appropriately
without assistance; regularly
observes and monitors a wide
variety of objective and subjective
data to uncover any useful
information and makes changes to
assessments as needed.
Recognizes subtle patterns and
deviations from expected patterns
in data and uses these to guide the
assessment. Makes association
between deviations to patient
disease processes.
Assertively seeks information to
plan intervention: carefully collects
useful subjective data from
observing and interacting with the
patient and family. Determines if
more information is needed.
Focuses on and prioritizes the most
relevant and important data useful
for explaining the patients
condition.
Accomplished
Focuses observation
appropriately; regularly observes
and monitors a wide variety of
objective and subjective data to
uncover any useful information.
Recognizes subtle patterns and
deviations from expected patterns
in data and uses these to guide
the assessment.
Assertively seeks information to
plan intervention: carefully
collects useful subjective data
from observing and interacting
with the patient and family.
Focuses on the most relevant and
important data useful for
explaining the patients condition.
Developing
Regularly observes and monitors
a variety of data, including both
subjective and objective; most
useful information is noticed;
may miss the most subtle signs.
Recognizes most obvious patterns
and deviations in data and uses
these to continually assess.
Actively seeks subjective
information about
the patients situation from the
patient and family to support
planning interventions;
occasionally does not pursue
important leads.
Generally, focuses on the most
important data and seeks further
relevant information but also
attempts to attend to less
pertinent data.
Beginning
Attempts to monitor a variety of
subjective and objective data
but is overwhelmed by the array
of data; focuses on the most
obvious data, missing some
important information.
Identifies obvious patterns and
deviations, missing some
important information; unsure
how to continue the assessment.
Makes limited efforts to seek
additional information from
the patient and family; often
seems not to know what
information to seek and/or
pursues unrelated
information.
Makes an effort to prioritize and
focus on the most important
data, but also attends to less
relevant or useful data.
Unsatisfactory
Confused by the clinical
situation and the amount and
kind of data; observation is not
organized and important data
are missed, and/or assessment
errors are made
Focuses on one thing at a time
and misses most patterns and
deviations from expectations;
misses opportunities to refine the
assessment
Is ineffective in seeking
information; relies mostly on
objective data; has difficulty
interacting with the patient and
family and fails to collect
important subjective data
Has difficulty focusing and
appears not to know which
data are most important to the
diagnosis; attempts to attend to
all available data
NURS322C, NURS422C and NURS410C Clinical Evaluation Tools (January 2016)
Table 1
Adapted Lasater Clinical Judgment Rubric
Dimension
Making sense of data
Effective responding involves:
Calm, confident manner
Clear communication
Well-planned
intervention/flexibility
Being skillful
Exemplary
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 new
data as needed.
Assumes responsibility 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.
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;
Interventions are tailored for the
individual patient; monitors
patient progress closely and is able
to adjust treatment as indicated
by patient response and by
worsen patient condition.
Shows confidence and co-
ordination of necessary nursing
skills with minimal supportive
cues from staff or faculty.
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 data patterns and
compares with known patterns to
develop an 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 support
persons.
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 familiar
situations, is able to compare
the patients data patterns with
those known and to develop or
explain intervention plans; has
difficulty, however, with even
moderately difficult data or
situations that are within the
expectations of students;
inappropriately requires advice
or assistance.
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 trouble distinguishing
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
NURS322C, NURS422C and NURS410C Clinical Evaluation Tools (January 2016)
Table 1
Adapted Lasater Clinical Judgment Rubric
Dimension Exemplary
Effective reflecting involves:
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 to Demonstrates commitment to
improvement ongoing 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.
Accomplished
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.
Developing
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.
Beginning
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.
Unsatisfactory
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
NURS322C, NURS422C and NURS410C Clinical Evaluation Tools (January 2016)

Table 2
Resource for Faculty: Examples of questions from the Lasater Clinical Judgment Rubric (LCJR) that simulate deep thinking and learning so student think like a nurse.

Tanner Model Phase LCJR Dimension Example of Question

Noticing Focused observations What did you first notice about the patient?
Recognizing deviations from expected patterns What was different than what you expected? Have you seen this 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 interventions/flexibility What factors, including patient feedback, impacted the treatment plan?
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