Saint Louis University School of Nursing

NURS 5110

Student Clinical Evaluation

Student: ______Preceptor: ______

Site:______Date: ______

A.  Attendance

1.  Punctuality
2.  Availability

B.  Professionalism

1.  Exhibits NP or APN behaviors
2.  Seeks out/follows through on learning situations
3.  Considers pt need for privacy
4.  Keeps pt info confidential
5.  Relates well with staff
6.  Relates well with preceptor

C.  Skills

1.  Is able to perform appropriate, systematic, organized, physical exam
2.  Exam focused as pertinent to presenting complaint
3.  Handles equipment properly
4.  Complete H&PE in reasonable time for level of student
5.  Uses appropriate interviewing techniques
6.  Describe findings accurately
7.  Uses medical terminology accurately
8.  Readily identifies abnormal findings
9.  Develops differential diagnosis
10.  Communicates data to preceptor in a logical systematic fashion / Satisfactory / Marginal / Unsatisfactory / If unsatisfactory explain or comment

D.  Therapeutic Planning

1.  Formulates appropriate plan with rationale appropriate to dx
2.  Identifies appropriate indications for specific problem/diagnosis
3.  Identifies appropriate diagnostic measures for problem/diagnoses
4.  Identifies therapeutic measures: pharmacologic therapy Supportive nursing
Health promotion/ed Appropriate follow-up

E.  Other

Demonstrates culturally appropriate care and techniques
Demonstrates developmentally appropriate care and techniques
Refers appropriately
Demonstrates beginning knowledge of NP scope of practice
Demonstrates progress in ability to interview, diagnose, plan pharmacologic and non-pharmacologic therapies for an advanced student / satisfactory / Marginal / Unsatisfactory / If unsatisfactory explain or comment

In your opinion, did this student appropriately apply advanced knowledge and skills during this clinical experience/ preceptorship? Yes No

Comments to be shared with student