Nursing Student in Critical Care Evaluation

1. Student

Name
Date(s) of Clinical Experience

2. Student's College of Nursing
3. Critical Care Unit
4. Was this student part of clinical rotation of students with faculty member or was this a senior practicum precepted experience

Clinical Rotation
Senior Practicum

5. Preceptor or Evaluator

Name

6. The Student was able to:

	4 Strongly Agree	3 Agree	2 Disagree	1 Strongly Disagree
Use nursing process to deliver nursing care
Perform selected skills under supervision safely
Utilize therapeutic communication with patient
Utilized AIDET to introduce self to patient, family and others
Able to integrate knowledge and critical thinking
Demonstrate caring behaviors in the nurse patient relationship
Interact effectively with members of the healthcare team
Report changes in patients' condition timely, accurately, and concise
Utilize SBAR type of communication when needed
Demonstrate appropriate level of self learning
Organize nursing care related to patients' acuity, stability, treatment plan.
Contributed to the patients' plan of care
Perform appropriate physical assessments
Be open to guidance and feedback on behavior/performance

7. Professional Accountability

	Yes	No
Maintain confidentiality within all aspects of compliance with HIPAA
Is on time for clinical experience
Notifies preceptor or charge nurse if unable to meet scheduled clinical experience
Arranges in advance with preceptor for any appropriate clinical experiences
Attends clinical experiences only when previously arranged
Attends shift report as appropriate
Demonstrates a sense of professional responsibility for own behaviors and attitude
Is collegial in relationships with other students and nursing staff

8. Strengths of Student:

9. Areas for improvement:

10. Additional Comments

Provide any other information for this evaluation:

Modified from The University of Iowa College of Nursing Evaluation of Student Performance in "Beyond the High-Tech Mystique: Preparing ICU Nurses to Precept Novice Students in Intensive Skill Immersion Practica" Chapter 21; ANNU REV NURS EDUC 2006; 4:393-404