Practice Immersion Clinical Evaluation Tool – Agency/Site
Agency/Site Criteria
Student Evaluation
Faculty Evaluation
Comments
Does Not Meet
Meets
Excels*
Does Not Meet
Meets
Excels*
1. Agency/site was able to provide the opportunities for the student to meet practice immersion clinical objectives.
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2. Agency/site was able to establish a comfortable, yet stimulating, practice environment.
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Practice Immersion Clinical Evaluation Tool
Criteria:
Does Not Meet:
Elements are missing.
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Meets:
Agency/site meets this criterion.
Excels:
Agency/site meets this criterion and further a teaching point opportunity or expanded information, guidance, or other element to further enhance student learning.
Agency/site – strengths:
Student Evaluation
Faculty Evaluation
Practice Immersion Clinical Evaluation Tool
Agency/site – areas of improvement needed:
Student Evaluation
Faculty Evaluation
Agency/site – Suggestions to incorporate more responsiveness to student learning needs:
Student Evaluation
Faculty Evaluation
Practice Immersion Clinical Evaluation Tool – Mentor
Clinical Criteria
Student Feedback of Mentor Experience
Comments
Does Not Meet
Meets
Excels*
3. Exemplify professionalism in diverse health care settings.
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4. Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents.
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5. Implement patient care decisions based on evidence-based practice.
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6. Utilize patient care technology and information management systems.
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7. Communicate therapeutically with patients.
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8. Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care.
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9. Understand the human experience across the health-illness continuum.
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10. Provide culturally sensitive care.
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11. Preserve the integrity and human dignity in the care of all patients.
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Criteria:
Does Not Meet:
Elements are missing; mentor did not achieve.
Meets:
Mentor meets this criterion.
Excels:
Mentor meets this criterion and further incorporates a teaching point scenario or expanded information, guidance, or other element to further enhance student learning. Practice Immersion Clinical Evaluation Tool
Practice Immersion Clinical Evaluation Tool – Student
Clinical Criteria
Mentor
Sign Off
Faculty Sign Off
Comments
Does Not Meet
Meets
Excels*
12. Exemplify professionalism in diverse health care settings.
☐
☐
☐
☒
13. Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents.
☐
☐
☐
☒
14. Implement patient care decisions based on evidence-based practice.
☐
☐
☐
☒
15. Utilize patient care technology and information management systems.
☐
☐
☐
☒
16. Communicate therapeutically with patients.
☐
☐
☐
☒
17. Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care.
☐
☐
☐
☒
18. Understand the human experience across the health-illness continuum.
☐
☐
☐
☒
19. Provide culturally sensitive care.
☐
☐
☐
☒
20. Preserve the integrity and human dignity in the care of all patients.
☐
☐
☐
☒
Criteria:
Does Not Meet:
Elements are missing; student is required to remediate this element to pass the course
Meets:
Student meets this criterion.
Excels:
Student meets this criterion and further incorporates a teaching point scenario.
Practice_Immersion_Clinical_Evaluation_Tool
Practice Immersion Clinical Evaluation Tool
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