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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

