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Midterm & Clinical Evaluation Form

                              Clinical Competencies                  Mid      Final    Instructor Comments


                                                                    (S,U)     (S,U)

                 1. Safety: Provides safe care

                 (learning outcomes 1,2,3)

                    •  Protects self and patient from injury


                    •  Adheres to hospital policy/procedure

                    •  Complies with standard
                        precautions/infection control procedures
                    •  Utilizes safety measures such as
                        independent double check and BCMA

                 2. Communication: oral & documentation

                 (learning outcomes 4,6,7)


                    •  Communicates in a respectful manner

                    •  Delivers accurate/thorough bedside
                        handoff
                    •  Builds rapport with patients and families


                    •  Advocates for patient/family needs

                    •  Documents thoroughly, accurately, timely

                 3. Nursing Practice/Process:

                 (learning outcomes 1,6,5,7)


                    •  Performs age appropriate assessments

                    •  Delivers patient and family-centered care

                    •  Identifies nursing diagnoses/interventions


                    •  Assesses educational needs

                    •  Evaluates patient care outcomes
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