Clinical Evaluation Tool

NSG-320C
Semester/Year: ___Fall 2020________________________

Evaluation Day and Date: ___Dec. 6, 2019____________________

Student First Name Last Name: ____Ahsan Arca________

Clinical Faculty First Name Last Name: __Kelly Schaefer____________

Course Objectives
1. Create a nursing plan of care that prioritizes safe, evidence-based, holistic client-centered care for the adult client in a variety of
settings.
2. Interpret assessment, lab, and diagnostic data to detect changes in condition and plan and prioritize appropriate care of the
adult client.
3. Delegate care to interdisciplinary team members based on knowledge of their role and scope of practice.
4. Implement a collaborative client-centered transitional plan of care that includes medication education, self-care strategies
and follow-up care for the adult client.
5. Demonstrate the use of effective communication strategies with clients, family and interdisciplinary team members.
6. Demonstrate increasing proficiency in the performance of psychomotor nursing skills with the adult client.
7. Demonstrate appropriate safety protocols and standards of care while working in the client-care setting.
8. Exhibit professional nursing behaviors based upon the standards and scope of nursing practice.

Midterm Final

NSG-320C Clinical Competencies

Student

Student
Faculty

Faculty
© 2018. Grand Canyon University. All Rights Reserved.
 Assign a score of 1 to 3 for each
competency in the boxes below.
Client-Centered Care See the Clinical Scoring
Guidelines below for additional
detail.
Develop an individualized plan of care with a focus on assessment and planning, utilizing the
nursing process while respecting the diversity of clients. 3  2   3 3 
Demonstrate caring behaviors, including assessing for the presence and extent of pain and
suffering.* 3   3  3  3
Interpret assessment, lab, and diagnostic data to detect changes in condition and prioritization of
interventions in the care of the adult client. 2   2  3  2
Develop a collaborative, client-centered transitional plan of care that includes medication
education, self-care strategies, and follow-up care for the adult client.
 2  2  2  2
Demonstrate increasing proficiency in the performance of psychomotor nursing skills with the
adult client.
3 3 3 3
Safety, Informatics, and Quality Improvement 
Demonstrate standardized infection control practices (hand washing and PPE) that support
safety and quality, and implement strategies to reduce risk of harm to self or others.* 3   3  3  3
Identify two client identifiers, six rights for medication administration, and verification of care
orders for the client prior to implementation as encountered in the clinical environment.*  3  3  3  3
Demonstrate appropriate safety protocols and standards of care while working in the client-care
setting.
3 3 3 3
Document clear and concise responses to care, as appropriate for clinical setting (i.e., EHR,
paper documentation, care plan).  3  2  3  3
Protect confidentiality of all client data and promote the ethical use of electronic health
information.*  3  3  3  3
Identify methods to deliver care in a timely and cost-effective manner. 3   3  3  3
Teamwork and Collaboration
Develop effective verbal and written communication skills with clients, team members, and
family. 3   2  3  2
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 Identify relevant data for communication in preconferences and postconferences. 3   3  3  3
Identify intraprofessional and interprofessional team member roles and scopes of practice, and
establish collaborative relationships with team members. 3   2  2  2
Delegate care to interdisciplinary team members based on knowledge of their role and scope of
practice. 3 2 3 3
Identify the need for help when appropriate to situation. 3   3  3  3
Professional Role
Demonstrate core professional values (such as caring, altruism, autonomy, integrity, human
dignity, and social justice) while complying with the ANA Code of Ethics and Standards of
Practice, and policies and procedures of Grand Canyon University, College of Nursing and
2   3  3  3
Health Care Professions, and clinical agencies.*
Maintain a positive attitude and interact with interprofessional team members, faculty, and
fellow students in a positive, professional manner, including accepting constructive feedback 3  3  3  3
and developing a plan of action for improvement.*
Arrive punctually, demonstrate expected behaviors, complete tasks in a timely manner, and
maintain professional behavior and appearance.*
3   3  3  3
Accept individual responsibility and accountability for nursing interventions, outcomes, and
other actions; engage in self-evaluation; and assume responsibility for learning.*
3   2  3  3
Critical competencies are highlighted in yellow. Students who score a 1 (Does Not Meet) on any of these competencies at final evaluation will fail the clinical
course. Target performance is a Score of 3 (Independent) on the competencies marked with an asterisk* by final evaluation.
Content of this checklist is based on Quality and Safety Education for Nurses (QSEN) competencies and knowledge, skills, and attitudes (KSAs):
Quality and Safety Education for Nurses Institute. (2017). QSEN competencies. Retrieved from http://qsen.org/competencies/pre-licensure-ksas/

Midterm Evaluation Comments

Faculty Comments (Include strengths and areas for improvement):

Ahsan, you are doing very well in clinical. As we have discussed, take report on all of the patients that the nurse is caring for and
watch the way they prioritize. Ask if you are not sure on why they see one patient before the other. This can help with your own
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critical thinking and decision making. If someone plays and instrument or is part of a sports team, their skill and comfort level
improve with the more practice they have. Your nursing skills are similar to this. The more you do, the more you practice, the more
exposure you have in the clinical setting, the more comfortable you will become and the easier the skills will be for you. Continue to
take advantage of every opportunity. Make the most of every clinical day.

Student Comments (Identify three areas for development):

I wish to improve my ability to prioritize client care, be able to adjust to stressful shifts, and have more confidence when performing
care on clients (such as inserting an IV, for example).

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Final Evaluation Comments

Faculty Comments (Include strengths and areas for improvement):

Ashan, you did a great job in clinical. I love how you really wanted to get all you could out of your clinical time. It was
refreshing to have students who truly valued the time on the unit. Continue to have such passion about learning and growing and it
will all pay off. Remember that all of the skills are important to practice, including “CNA” skills. Keep pushing forward, Ashan.
Nursing school will be over before you know it.

Student Comments (Identify three areas for development):

Areas of improvement for the future: improving on prioritization of client care, recognizing patterns of abnormal findings and
identifying needed interventions to address the problem, and work on critical thinking.

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Student and Clinical Faculty Signatures

Signatures indicate student and clinical faculty have reviewed and discussed the Clinical Evaluation Tool.

Student Signature at Midterm: Ahsan Arca Date: 11/1/19

Student Signature at Final: Ahsan Arca Date: 12/6/19

Clinical Faculty Signature at Midterm: Kelly Schaefer MSN-Ed, RN Date: 11/1/19

Clinical Faculty Signature at Final: Kelly Schaefer MSN-Ed, RN Date: 12/6/19

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Remediation for Unsatisfactory Areas
If a student earns a score of 1 on any competency at either the midterm or final evaluation, the clinical faculty and student must
complete the following documentation for remediation of unsatisfactory areas. Didactic faculty are required to sign off on this plan as
well.

Unsatisfactory Student-Centered Strategy for Success

Include Situation (dates and behaviors), Background, Assessment,
Indicate applicable competencies
and Recommendation (including timeframe)

   

   

   

   

   

I have reviewed the content with the clinical faculty and agree with the remediation plan for the student.

Didactic Faculty Signature at Final: Date:

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Clinical Scoring Guidelines
The Clinical Evaluation Tool (CET) is used in all clinical nursing courses across the BSN Pre-Licensure program. Each clinical
nursing course aligns with its co-requisite didactic course and builds on prior knowledge, skills, and attitudes from other courses and
levels within the program, as appropriate. Faculty members will perform either a final clinical evaluation, or both a midterm and final
clinical evaluation depending on the length of the clinical rotation, using the CET for each student. Faculty will discuss the evaluation
with students, and both students and faculty must sign and date the form acknowledging the evaluation was completed and discussed.
A copy of the signed CET should be uploaded into the LoudCloud classroom. Faculty will also complete the corresponding rubric in
LoudCloud for each student.
General Criteria:
When observing students in the clinical setting and assigning a score, faculty will consider the following general criteria:
 Supervision: The degree of supervision required for the expected level of clinical practice.
 Clinical Judgment: The competence of nursing care based on the application of the nursing process, nursing diagnoses, and
clinical reasoning to make informed decisions that provide safe, quality client care.
 Professionalism: The nature of the interactions and communication with clients and the interdisciplinary team, professional
demeanor, and appearance.
 Application of Skills and Knowledge: The ability to apply nursing knowledge, theory, and skills in the clinical setting.
 Self-Direction: The ability to address one's own learning goals and needs.

Scoring Guidelines:
Faculty will assign a score of 1 to 3 for each clinical competency listed on the CET. When observing students in the clinical setting,
faculty will apply the following sets of criteria holistically when assigning a score for each clinical competency. If a student scores a 1
in any category, the clinical faculty should complete an Early Alert and meet with the student to discuss the student's performance and
plans to improve. The clinical faculty also need to complete the remediation portion on the CET. The remediation portion will then
need to be shared with the didactic faculty for review and signature.
Score = 3 (Independent)
To achieve a score of 3, the student:
 Functions independently, appropriately, and safely in the clinical setting.

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  Demonstrates frequent, informed clinical judgment and ensures safe, quality client care.
 Demonstrates consistent professionalism and effective communication with clients, families, and the interdisciplinary team
while maintaining professional demeanor and appearance at all times. 
 Demonstrates consistent, accurate integration of nursing knowledge, skills, and attitudes in the clinical setting. 
 Engages consistently in a self-directed approach to learning, independently seeks appropriate guidance and resources.

Score = 2 (With Assistance or Supervised)

To achieve a score of 2, the student:
 Functions appropriately and safely with occasional guidance and/or supervision in the clinical setting.
 Demonstrates average clinical judgment and ensures safe, quality client care.
 Demonstrates sufficient professionalism and effective communication with clients, families, and the interdisciplinary team
while maintaining professional demeanor and appearance most of the time. 
 Demonstrates reasonable integration of nursing knowledge, skills, and attitudes in the clinical setting. 
 Attempts a self-directed approach to learning, but needs help recognizing resources and learning opportunities.

Score = 1 (Does Not Meet)

To achieve a score of 1, the student:
 Does not function safely in the clinical setting, even with persistent guidance.
 Rarely demonstrates appropriate clinical judgment and struggles to rationalize measures for safe, quality client care.
 Demonstrates a consistent lack of professionalism and effective communication skills with clients, families, and the
interdisciplinary team while failing to maintain a professional demeanor and appearance.
 Demonstrates a significant lack of integration of nursing knowledge, skills, and attitudes in the clinical setting. 
 Does not attempt a self-directed approach to learning and requires persistent, detailed instructions regarding learning
opportunities and resources and is unable to utilize them without support.