LANE COMMUNITY
COLLEGE
RESPIRATORY CARE
PROGRAM
The Goal of this preceptor handbook is to assist the
respiratory care preceptor in arranging
appropriate clinical experiences that are designed
to provide learning opportunities that will meet
the clinical objectives of Lane Community College’s
Respiratory Care Program.
Preceptor
Handbook
Section Table
Faculty Information
Introduction
Roles/Responsibilities
Evaluation
Clinical Competency Requirements
Forms
Glossary
LANE COMMUNITY COLLEGE
RESPIRATORY CARE PROGRAM
FACULTY
Norma Driscoll, BS, RRT
Program Director
Respiratory Care Program
Lane Community College
Phone: 541.463.3176
driscolln@lanecc.edu
Kellee Rickerl, B.A., RRT
Director of Clinical Education
Respiratory Care Program
Lane Community College
541.463.5624
rickerlk@lanecc.edu
Mailing Address-
Respiratory Care Program ATTN:
Lane Community College
4000 E.30th Ave
Eugene, OR 97405
(Health Professions)
Main Campus, Building #4 Phone: 541-463-5617 Division Number | Fax: 541-463-4151
Introduction
Dear Respiratory Care Clinical Preceptor:
First, we would like to thank you for your participation in this extremely important phase of a
respiratory care student’s education. Our students often remember their clinical hours as the
highlight of their Respiratory Care training.
This handbook is designed to provide information about the Lane Community College
Respiratory Care Program and to offer guidance and educational objectives for supervising
and evaluating students during their clinical hours.
The Respiratory Care Program at Lane Community College (LCC) was established in 1969.
With the start of the 2009 academic year, our program has transitioned from an “on campus,
lecture program” to a hybrid program. Theory and concepts are provided through highly
interactive online delivery. Laboratory activities are managed in small groups during oncampus sessions. Clinical rotations are managed and arranged by the program’s Director of
Clinical Education in co-operation with fifteen clinical affiliates. The LCC Respiratory Care
Program is a limited-entry two year program and accepts up to thirty new students each year.
During this two year period, students have the clinical requirement of obtaining competency in
approx. twenty five different skills in order to graduate. The program is fully accredited by the
Commission on Accreditation for Respiratory Care (CoARC).
We appreciate your interest in our students and wish to make your task in mentoring them as
easy as possible. It is with that purpose in mind that this handbook was created. Our clinical
preceptors and clinical sites are an integral part of our success as an advanced practitioner
respiratory care program and we could not serve our students without you. We have attempted
to answer common questions you may have; however, please feel free to call our Clinical
Coordinator, Kellee Rickerl at 541.463.5624
Thank you for your commitment to Respiratory Care Education.
Lane Community College Respiratory Care Program
PURPOSE OF THE CLINICAL PRECEPTOR PROGRAM
The clinical preceptor program is designed to assist the RT student succeed in gaining handson experience in patient care and competency in clinical skills under the supervision of an
experienced Respiratory Therapist. Upon graduation the student will then be able to move
from student role to the entry-level respiratory therapist role seamlessly. With the preceptors
guidance the student can work on improving patient care skills and well as learn what it means
to work and interact in a professional manner. In order to accomplish this, it is necessary to
provide the student with a realistic clinical experience and allow the student to:

Care for various types of patients in the Clinical/Home Care setting
Geriatric
Adult
Pediatric
Neonatal

Conduct care to include but not limited to
1.
2.
3.
4.
5.
6.
7.
8.
Oxygen Therapy
Humidity and Aerosol Therapy
Bronchial Hygiene Therapy
Volume Expansion Therapy
Non-invasive and Invasive Ventilation
Cardiopulmonary Resuscitation
Arterial Blood Gases
Pulmonary Function Testing

Critical Thinking and Research Skill development through
1.
2.
3.
4.
5.
Planning and organization of daily clinical activities
Hone decision making and priority-setting skills
Patient Assessment
Disease Process Research
Treatment Assessment

Development of Independence
1.
2.
3.
4.
Independently suggest implementation of respiratory care procedures
Develop patient management skills
Time management skills.
Goal of becoming fully functioning therapist with RRT skill set.
GOALS OF CLINICAL PRECEPTOR PROGRAM
To prepare graduates with demonstrated competence in the cognitive (knowledge),
psychomotor (skills), and affective (behavior) learning domains of respiratory care practice as
performed by registered respiratory therapists (RRTs).
The CLINICAL SITE ROLE:
The Clinical Sites are essential partners of any successful respiratory care program.
The clinical site contributes to the learning process of Lane’s Respiratory Care Program
students by helping develop the professional and technical skill sets needed to become a
respiratory therapist.
This helps ensure the preparation of competent entry level respiratory therapists. A win-win
situation for when these students become entry level therapist entering the job market.
By electing to have students at your site participating faculty will have the opportunity for
selected staff respiratory therapists to gain experience and competency in the role of
preceptor/educator.
Provide clinical experience for selected students in the LCC Respiratory Care Program in
accordance with contractual agreement between clinical site and LCC.
Collaborate with LCC in appointing the preceptors. Appoint alternate preceptor when
needed, e.g. due to absence of assigned preceptor.
Orientation of student to the department and shift responsibilities.
Notify College program faculty within 24 hours of incidents/injuries that occur to either a patient
and/or student a result of the student’s participation in a clinical activity. An incident in which a
student may sustain some injury may require hospital treatment; however student health
insurance will be billed for care.
THE LANE COMMUNITY COLLEGE CLINICAL PRECEPTOR:
DEFINITION OF RESPIRATORY PRECEPTORSHIP
A respiratory preceptorship is a defined period of time in which two people (respiratory student
and experienced respiratory therapist) work together so that student can learn and apply
knowledge and skills in the clinical setting with supervision and guidance from the experienced
therapist. This therapist acts as role model for skills as well as professionalism. A preceptor
must have the ability to help with the growth and progression of the student/s into that of a
professional therapist.
The RT must be willing to work with a student in this capacity. If the therapist is unwilling, it
makes for an adversarial relationship and leads to a negative experience for both the student
as well as the RT in question. This does not foster a nurturing learning environment.
PRECEPTOR SKILLS
The RT is assigned a preceptor role has demonstrated expertise in the delivery of respiratory
care (as determined by the Hospital and in collaboration with the College Clinical Education
Coordinator and or college representative). The Preceptor must be a CRT credentialed
licensed practitioner. RRT credential and licensure is preferred.
The RT has demonstrated ability to communicate effectively and professionally with patients,
faculty, students, staff, and physicians.
The RT can demonstrate student assessment skills. This is verified through the completion of
the clinical preceptor modules developed by the college to maintain inter-rater reliability.
The RT demonstrates the ability to document student observation and skills in a timely
manner.
The RT demonstrates that they are staying current on issues related to nationally standardized
practices of care.
He/She makes a conscious effort to develop relationships with students that are:
-Conducive to a positive learning environment;
-mutually respectful;
-collaborative and supportive.
Preceptor Responsibilities
1. Directs student to clinical situations, which would provide student with opportunity to
meet goals and objectives, increase skills and pass competency evaluations.
2. Act as a clinical resource person for the student.
3. Be a role model demonstrating responsible RT behavior.
4. Provide feedback concerning the student’s professional behavior through use of forms
provided by LCC (Clinical proficiencies and evaluation forms).
5. Provide ongoing feedback to student regarding patient care and equipment use utilizing
daily activity forms.
6. Be available to meet with RC program Clinical Education Coordinator and other LCC
staff about students’ experience and progress during clinical educator’s site visit/s.
7. Facilitates the student’s progress towards accepting more and more of the patient care
assignment and the development of good time-management skills to facilitate the
education of capable graduate therapists.
8. Will treat the student as an adult learner in an educator-learner relationship.
9. Must review all students charting for accuracy and completeness.
10. Follows FERPA (See Glossary) Rules regarding student rights to privacy.
11. Communicate with Lane Community College clinical educator regarding observed
student behaviors that are unacceptable for staff Respiratory Therapists such as:
A. -Content or skill weakness in a given area
B. -Inability to perform patient care procedures
C. -Lack of knowledge or inability to gain knowledge necessary for the
implementation of patient care
D. -Lack of technical competence
E. -Any behavior, which is in the opinion of the clinical preceptor, is
counterproductive to the Respiratory Care Program process. I.e.
personal hygiene, tardiness being argumentative etc.
THE LANE COMMUNITY COLLEGE STUDENT:
Learning Outcomes
The graduate will:

provide age-specific treatment, management, control, and care of patients with
deficiencies and abnormalities associated with respiration.

provide patients with therapeutic use of medical gases, air and oxygen administering
apparatus.

appropriately use environmental control systems, humidification and aerosols,
medications, ventilatory control.

provide pulmonary hygiene appropriate to patient’s condition

perform cardiopulmonary resuscitation, and measures and maintenance of natural,
artificial, and mechanical airways.

use clinical decision skills to create appropriate patient care plans

use appropriate library and information resources to research professional issues and
support lifelong learning.

formulate questions that can be addressed with data, and collect, organize and present
relevant data to answer them.
STUDENT RESPONSIBILITIES
1. Perform patient care under the supervision of a preceptor assuming an increasing
level of responsibility on a daily basis.
2. Monitor their competency/skill list, discuss competency/skill list with clinical
preceptor.
3. Identify competencies/skills yet to be completed and discuss with clinical preceptor.
4. Notify clinical affiliate and LCC clinical coordinator if going to be late or absent in a
timely and appropriate manner as stated in the Student Handbook.
5. Adhere to the Lane Community College Respiratory Care student dress /
identification guidelines when in a clinical facility.
6. Review necessary theory and clinical content to maximize safety and performance.
7. Meet with Lane Community College Coordinator of Clinical Education for review
meetings and/or symposiums and as needed to discuss experiences and concerns.
8. Participate in the evaluation of the preceptor program and clinical site.
9. Conform to all policies and procedures particular to the clinical facility, including;
10. On time for the start of shifts and end of breaks.
11. Follows all HIPPA rules with respect to patient confidentially and not use patient
names or ID numbers if writing notes or preparing for a case presentation.
12. In addition, students will be very careful not to discuss specifics about patients or
their care in public places where they can be overheard by third parties.
The student must make a conscious effort to develop a relationship with the Clinical Preceptor
that is:
-formal
-mutually respectful;
-collaborative and supportive.
The student is responsible for entering observations and competency data into the clinical care
notebook. Patient care tasks, observations and or care will never be declined in order to enter
information in clinical notebook or to work on class assignments while the student is at the
clinical site for a patient care shift.
Students MAY NOT make any changes in the prearranged clinical schedule without the
approval of the LCC Clinical Coordinator.
The students need to be proactive at the clinical site and need to make contact with their
assigned preceptor or the clinical lead before the start of the shift and introduce themselves.
The student, with the guidance of the preceptor, will complete appropriate hospital incident
reports documenting incidents/injuries that occur to either patients and/or student as a result of
the student’s participation in a clinical activity. An incident in which a student may sustain some
injury may require hospital treatment; however student health insurance will be billed for care.
EVALUATION
Philosophy and Rationale: The clinical evaluation methodology employed at Lane
Community College to assess students’ procedural proficiency and behavior has been
formulated to reflect a competency-based, student centered philosophy of the Program; the
faculty maintain that it is only through the implementation of reliable and valid measures of
students’ clinical performance and proficiency that the ultimate goal of the program of learning,
i.e., the training and provision of competent clinical practitioners capable of successfully
assuming the roles and functions requisite to the delivery of quality respiratory care, can be
realistically achieved.
Bases for Implementation: The policies and procedures upon which the evaluative system
is built are consistent with the philosophy, goals, and grading policies of the College and are
based upon the principle of equivalent clinical experience within the Program curriculum. The
criteria utilized to assess learning outcomes have been derived from the current delineation of
the roles and functions of the entry-level respiratory therapist.
Integration of the Evaluative System within the Curriculum: The evaluative system
has been designed to provide documentation, assessment, feedback and remediation, which
are relevant to the three key phases of the students’ clinical education.

Peer Reviewed

Lab/ Instructor Reviewed

Clinical Site Reviewed
Clinical Education Evaluative Mechanism Used in the LCC Respiratory Care
Program
During the learning and reinforcement phases of the LCC Respiratory Care Program, the
clinical skill mastery sequence is actually initiated. Competence is assessed in the College
Laboratory Sections by skills evaluations utilizing a “workbook” of skills checklists and
observation. The checklist/rating scale approach is utilized to track practice, lab and finally
clinical performance competencies. All performance elements, whether performed in the
College laboratory or at the clinical affiliate site, are maintained on file in the LCC Respiratory
Care Program student files at the end of each term. This process is computerized and tracked
electronically. Depending upon the student’s performance of the skill and comprehension of
the procedure, a status recommendation is made by the evaluator and recorded. Review of the
student’s clinical skills notebook will be done at the end of each quarter by the Director of
Clinical Education and as needed by the program faculty.
CLINICAL COMPETENCY REQUIREMENTS
Clinical skills are divided into the syllabi of the clinical terms of the program such that
they are presented in an ascending order of complexity. These skills are divided into two
categories. First year skills focus on basic cardiopulmonary assessment and treatment
modalities. Second year skills focus on advanced emergency and critical care modalities. Due
to the fact that it is impossible to predict when certain therapies will be available for practice, it
is possible for first-year students to work ahead on therapies that are scheduled for first year winter through summer terms. The intention of this policy is that the students must attain a
degree of mastery over the basic skills before moving on into the advanced skills presented in
the second year of the program. The final portion of this list identifies those skills that the
students is encouraged to observe and assist staff in their performance, but are not required to
demonstrate independent competency.
First Year - Spring through Summer Terms:
Breath Sounds
Oxygen Supply Systems
Oxygen Administration
Small Volume Nebulizer Therapy
MDI Administration
DPI Administration
Incentive Spirometry
Documentation and Goals Assessment
Pulse Oximeter Monitoring
Humidity and Aerosol Therapy
Vest Airway Clearance System (HFCWO)
Pep/Flutter Therapy
Second Year - Fall through Winter Terms
Manual Resuscitation
End Tidal CO2 Monitoring (EtCO2)
Endotracheal Suctioning
Monitoring Cuff Pressures
Tracheostomy and Stoma Care
Pressure Support
Chest X-ray Interpretation
Extubation
Initiation of NIPPV
Initiation of Continuous Mechanical Ventilation (Adult)
Monitoring of Continuous Mechanical Ventilation (Adult)
Spontaneous Ventilation Parameters
Skills for Observation/Assisting
Oxygen Concentrator
Equipment Processing
Beside PFT (FVC & PF)
Chest Percussion / Postural Drainage
Adjunct Breathing Techniques
IPPB
Nasotracheal Suctioning
Basic Spirometry
Electrocardiographs
Arterial Puncture
Arterial Line Sampling
Intubation
Extended Mandatory Minute Ventilation
Changing a Ventilator Circuit
Initiation of Newborn Mechanical Ventilation
Monitoring of Newborn Mechanical Ventilation
Arterial Line Monitoring
Bronchoscopy Assisting
HHNP
Evaluation Tools and Student Clinical Records
A successful student not only demonstrates skill acquisition and mastery, but also presents an
appropriate professional demeanor as evidenced by their interpersonal skills. The college has
developed tools to help foster the student’s professional growth, as well as evaluate their
professional behavior and skill competency. These tools are listed and described below.
Examples of each of these tools is included in this section.
Performance Evaluation Record (Yellow form)
This form provides a quick reference for staff and students to view student progress on
completing required skill Performance Evaluations. The skills are arranged in order of
presentation during the program. The student is expected to complete skills during the term
presented and this will be documented in the Professional Performance Assessment. The last
page of the record lists skills that students should observe and assist with during their clinical
experience, but are not required to demonstrate competency through the formal skill
Performance Evaluation. Observation or assistance must be supported by documentation in
the Daily Clinical Activity Record.
The Performance Evaluation Record is to be placed in the front of the student’s clinical
notebook. It will be retained in the clinical notebook throughout their clinical experiences.
STUDENT NAME:_____________________________
CLASS YEAR:_________________
Student must demonstrate the ability to independently perform the following skills by the end of the term
under which they are listed. If the student has had sufficient practice they may have their ability to
independently perform skill evaluated prior to term listed. If staff or instructor must intervene or direct student
performance during the procedure the student has not demonstrated competency.
SPRING TERM / FIRST YEAR
PERFORMANCE EVALUATION
Breath Sounds
Oxygen Supply Systems
Oxygen Administration
Small Volume Nebulizer Therapy
MDI Administration
DPI Administration
Incentive Spirometry
Documentation and Goals Assessment
Pulse Oximeter Monitoring
SUMMER TERM / FIRST YEAR
Humidity and Aerosol Therapy
Vest Airway Clearance System (HFCWO)
PEP / Flutter Therapy
Tracheostomy and Stoma Care
FALL TERM / SECOND YEAR
Manual Resuscitation
End Tidal CO2 Monitoring
Endotracheal Suctioning
Monitoring Cuff Pressures
Pressure Support
Date
Site
STUDENT NAME:_______________________________ CLASS YEAR:_________________
WINTER TERM / SECOND YEAR
PERFORMANCE EVALUATION
Chest X-Ray Interpretation
Extubation
Initiation of NIPPV (BiPap)
Initiation Cont. Mechanical Ventilation(Adult)
Monitoring of Cont. Mech. Ventilation (Adult)
Spontaneous Ventilation Parameters
Date
Site
STUDENT NAME:_______________________________ CLASS YEAR:_________________
Students are not required to complete the checklists for the skills listed below but should observe and
eventually assist staff in the performance of the techniques, according to the policy and procedures of the
clinical site. Student may be able to perform some skills under direct supervision of clinical staff.
PERFORMANCE EVALUATION
Oxygen Concentrator
Equipment Processing
Liquid Oxygen Systems
Bedside PFT (VC & PF)
Chest Percussion / Postural Drainage
Adjunct Breathing Techniques
IPPB
Nasotracheal Suctioning
Basic Spirometry
Electrocardiographs
Arterial Puncture
Arterial Line Sampling
Intubation
Extended Mandatory Minute Ventilation
Changing a Ventilator Circuit
Initiation of Newborn Mechanical Ventilation
Monitoring of Newborn Mechanical Ventilation
CVP/Pulmonary Artery Catheter Monitoring
Arterial Line Monitoring
Bronchoscopy Assisting
Date / Site
Date / Site
OBSERVED
ASSISTED/ OR
PERFORMED WITH
SUPERVISON
The Daily Activity Record/Preceptor Feedback Form (White form)
The student will complete this form for each clinical day. It must include their name, clinical
site, date, and the times they arrived and departed the clinical site. This includes any shift that
was missed (with an explanation), and any make-up shift. These sheets provide an area for
them to track the activities of the shift, list other learning experiences or discussions they had
with their preceptor. The back side of the form is for your preceptor to complete. It provides
clinical preceptors the opportunity to evaluate the student in several categories (Coming
Prepared, Professional Behavior, Technical Performance, and Communication Skills) and to
provide feedback directly to program faculty. There are yes/no questions and an area for
detailed comments on the students’ strengths and areas to work on. There is also a check box
to indicate if the preceptor discussed their feedback with the student. The preceptor’s signature
is required. It is important that these are completed PRIOR to leaving the clinical site for the
day. This ensures a correct record of the events of the day as well as the site documentation
that is necessary for this to be a valid record.
Daily Clinical Activity Record
Student is required to complete the following information and to present to instructor/preceptor at
conclusion of day for review and verification.
Name: ___________________________ Clinical Site: ____________________________
Date: ________________
Time In: _________
Indicate how many times you participated in the following
technical skills/activities/procedures. The (Term) indicates when
skill needs to be completed & checked off. Once completed these
skills should be performed regularly with minimal supervision.
Time Out: _________
#
of Times
Observed
#
Assisted with
supervision
Oxygen Supply Systems (Spring Term)
Oxygen Administration (Spring Term)
Small Volume Nebulizer Therapy (Spring Term)
MDI Administration (Spring Term)
DPI Administration (Spring Term)
Incentive Spirometry (Spring Term)
Documentation and Goals Assessment (Spring Term)
Pulse Oximeter Monitoring (Spring Term)
Humidity and Aerosol Therapy (Summer Term)
Vest Airway Clearance System (HFCWO) (Summer Term)
Pep/Flutter Therapy (Summer Term)
Manual Resuscitation (Summer/Fall Term)
Initiation of NIPPV (BIPAP) (Summer Term)
End Tidal CO2 Monitoring (EtCO2) (Fall Term)
Endotracheal Suctioning (Fall Term)
Monitoring Cuff Pressures (Fall Term)
Tracheostomy and Stoma Care (Fall Term)
Pressure Support (Fall Term)
Chest X-ray Interpretation (Fall Term)
Extubation (Fall/Winter Term)
Initiation of Cont. Mech.Ventilation (Adult) (Neo)
(Fall/Winter Term)
Monitoring of Cont. Mech. Vent. (Adult) (Neo)
(Fall/Winter Term)
Spontaneous Ventilation Parameters (Fall/Winter Term)
Other Learning Experiences:
What Questions arose during your shift and what discussions did this spark with your preceptor?
Comes Prepared:
YES
NO
YES
NO
YES
NO
Complied with hospital, college dress
codes, used appropriate identification.
Arrived prepared to carry out assigned
tasks with necessary equipment &
paperwork.
Appropriately applied / integrated theory,
principles to clinical practice.
Professional
Behavior:
YES
NO
YES
NO
YES
NO
Took direction, instruction, suggestions
and ideas in a cooperative manner.
Appropriately sought assistance when
needed, realizes personal limitations.
Sought out educational opportunities for
professional development.
Technical
Performance:
YES
NO
YES
NO
YES
NO
Planed, organized, fulfilled tasks assigned
by instructor / supervisor.
Provided therapy based on therapist
driven protocols and/or appropriate
physician order
Competently performed assigned tasks &
procedures ensuring safe delivery of
patient care.
Communication
Skills:
YES
NO
YES
NO
YES
NO
Used appropriate communication to relate
effectively to patients, instructors, peers,
staff. Demonstrated appropriate verbal &
nonverbal communication.
Adhered to HIPPA requirements.
Maintained accurate & timely
departmental & patient records.
Please Indicate:
Student Strengths:
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
_________________________________________________________________
Student Needs for Improvement:
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
_________________________________________________________________
______Initial here if: I have reviewed this evaluation with this student.
______Initial here if: I have forwarded this information on to the Director of Clinical Education or my Supervisor.
(Print) Preceptors Name__________________________PreceptorsSignature_____________________________
Physician Interaction Record (Teal Card)
Documentation of time interacting with the physician is necessary to meet program accreditation
standards. Physician interaction could be patient focused, tutorial, or small or large group sessions. The
student is awarded points based on the type of physician interaction. The number of physician
interactions increases as the student advances through each clinical practice sequence:
Clinical Practice 1 . . . minimum of 2 separate physician interactions
Clinical Practice 2 . . . minimum of 4 separate physician interactions
Clinical Practice 3 . . . minimum of 6 separate physician interactions
Clinical Practice 4 . . . minimum of 8 separate physician interactions
Lane Community College
Name
Physician Interaction Form
Respiratory Care Program
Clinical Site
Physician Name________________________________________________________
Topic________________________________________________________________
Type of Interaction:
Patient Focused:
Date___________________
Tutorial:
Time Spent: _____________
Small Group:
Points Awarded: _________
Large Group:
Evaluation of Student – Physician Interaction
Instructions: Please circle the response that reflects your evaluation of this learning experience using the following criteria:
5 = Strongly Agree
4= Agree
3=Disagree
2= Strongly Disagree
1= N/A
Student Evaluation of Physician Interaction
1)
The information was presented at a level appropriate for my experience.
54321
2)
The information was covered completely and at a reasonable pace.
54321
3)
This interaction was a positive experience.
54321
4)
The information was relevant to my clinical work.
54321
5)
The physician took time to explain principles relevant to the practice of
54321
respiratory care.
6)
The physician was receptive to discussion and student participation.
54321
7)
The interaction improved my communication skills with physicians.
54321
Physician Evaluation of Student Interaction
1)
The student has a good understanding of the information presented.
54321
2)
The student provided accurate objective data.
54321
3)
The student used appropriate medical terminology.
54321
4)
The student provided appropriate subjective information.
54321
5)
The student could explain relevant principles of practice.
54321
6)
The student answered directly and appropriately.
54321
7)
The student was able to suggest well-reasoned alternatives.
54321
8)
The student was receptive to feedback.
54321
Students should seek out physician interaction whenever possible in order to learn the
appropriate physician-therapist rapport. A point system has been created to encourage
this behavior. Students must earn a total of 10 points per term. The scoring system is listed below.
Type A: Patient Focused
Individual personal interaction with a physician relating to the management of a particular
Patient as it pertains to respiratory care. Included are actual procedures with a patient (for example, code
blue, bronchoscopy, etc.). Also included are such activities as evaluations, diagnosis, treatment plans,
and prognosis of a singular patient.
Type B: Tutorial
Individual, one-on-one instruction related to clinical medicine or other areas pertinent to
respiratory care. Included are activities such as formal or informal discussions, review of research or
recent advances in respiratory care and practical demonstration of procedures
and equipment without patient interaction.
Type C: Small Group
Formal or informal presentations such as inservice, seminars, continuing education meetings, case
presentations, physicians rounds, etc. It is necessary for the presentations to be small
Enough for the physician conducting the session to be aware of who is in attendance.
Type D: Large Group
Formal education experiences such as lectures papers presented at professional meetings, conferences,
seminars, etc. The size of the meeting would preclude significant audience participation.
Scoring as follows:

Type A :
1 hour = 4 points

Type B :
1 hour = 3 points

Type C :
1 hour = 2 points

Type D:
1 hour = 1 point
Note:
Physician interaction records are to be submitted to the Director of Clinical Education or Program
Coordinator at the time of Personal Performance Assessment.
Performance (Skill) Evaluation Checklists
The Performance Evaluation Checklists from Basic Clinical Lab Competencies for Respiratory
Care are the tools used to evaluate student competency. Ideally, the student should have
practiced the procedures in the laboratory setting. When they feel capable of properly
demonstrating the procedure, they should enlist the help of a peer who will observe and rate
their performance. When they have passed the peer evaluation they should ask the lab
instructor to evaluate their performance.
Clinical skill evaluation should be preceded by observation of staff, assisting staff in performing
the procedure, and close supervision by staff while practicing the procedure. When the student
feels capable of performing procedure without staff assistance they should ask to be formally
evaluated using the Performance Evaluation Checklist for that skill. Student should review
checklist with evaluator so that site-specific procedural differences are addressed before the
skill evaluation. Evaluator should intervene in procedure only if patient safety is compromised.
Criteria for receiving a passing score on the evaluation are given on the checklist. A student
who fails to receive a passing score may request a repeat evaluation after further supervised
practice.
Successful completion of a skill evaluation indicates that the student is competent at
performing that skill and requires minimal supervision. Proficiency in performing the skill is only
achieved through further practice, which must be documented on the Daily Clinical Activity
Record.
Professional Performance Assessment
Respiratory Care students are legally responsible for their own acts, commission and/or
omission. The student, the faculty, and clinical site staff must conscientiously evaluate student
behavior. The Professional Performance Assessment (PPA) evaluation identifies essential
areas of behavior that indicate the successful demonstration of appropriate professional
behavior and interpersonal skills: Attendance, Preparedness, Professional Behavior, Technical
Performance, and Communication Skills.
The PPA serves to reinforce and encourage appropriate student behavior, as well as a means
to document unsafe, unacceptable behaviors. Unsafe, unacceptable behaviors will require the
immediate completion of a PPA by the preceptor. The preceptor must provide written
explanation of any “Needs Improvement” ratings. The student is to review the assessment with
the preceptor or supervisor, and acknowledge this by signing the assessment form. A copy is
to be given to the student for their notebook, and the original is to be forwarded to the Director
of Clinical Education for LCC. Periodically during the term, and at the conclusion of each
clinical course, a PPA will be completed for each student by LCC program faculty utilizing the
input received from the Preceptor’s Daily Feedback forms / PPA’s. Notice of failing behavior
will be forwarded from one instructor to the next instructor to ensure that students will be given
the encouragement, support, and limit-setting to facilitate the learning of these essential
professional behaviors. Any behavior that results in an unsatisfactory rating in any one term, if
repeated in a subsequent term, can result in immediate exclusion from further clinical
experience.
The PPA serves as the written warning prior to suspension from clinical activities as required
by LCC Respiratory Care Program Policy as indicated in the Student Orientation Manual.
Immediate suspension for violations of the student rules of conduct is still possible. The
Director of Clinical Education or Program Director must be notified immediately following
suspension of student privileges by the clinical site.
PROFESSIONAL PERFORMANCE ASSESSMENT
Behaviors relating to responsibility, accountability, and meeting time commitments are essential in the
professional respiratory practitioner. Students who always demonstrate these behaviors should receive
(E)xcellant ratings. Students who usually demonstrate these behaviors should receive (S)atisfactory ratings.
Students who demonstrate unsafe and unprofessional behavior will result in (N)eeds Improvement ratings, and
must have behavior documented on evaluation.
(Evaluation criteria are noted on the back of this form.)
Constructive criticism is a valuable learning tool so please include suggestions for improvement.
Area Evaluated
E
S
N
Suggestions for Improvement
Attendance
Comes Prepared for Clinical
Rotation
Professional Behavior
Technical Performance
Communication Skills
_______________________________________________
Evaluator’s Signature
______________________________
Date of Evaluation
I have reviewed the above evaluation and understand that areas rated as Needs Improvement are to be corrected immediately.
This evaluation constitutes a written warning of unacceptable behavior. Failure to correct this behavior can result in a failing
grade for this course.
_______________________________________________
Student’s Signature
______________________________
Date
Please consider the following criteria when evaluating student performance:
Attendance:



Arrives early enough to start on time
Seeks permission to leave from appropriate supervisor
Gives appropriate and prompt notification regarding absence.
Comes Prepared for Clinical:



Complies with hospital and college dress codes, and use of identification
Arrives at facility prepared to carry out assigned tasks with necessary equipment / paperwork
Appropriately applies / integrates theory and principles to clinical practice
Professional Behavior:





Courteous / considerate with peers, staff, patients and other hospital personnel
Takes direction, instruction, suggestions and ideas made by those in authority in a cooperative
manner
Seeks appropriate assistance when needed, realizes personal limitations
Assumes responsibility for learning by seeking out educational opportunities (self-direction)
Follows rules of conduct listed in student orientation manual
Technical Performance:




Adheres to hospital policies and procedures for safe delivery of patient care
Plans, organizes, and fulfills the tasks assigned by instructor / supervisor
Provides therapy based on therapist driven protocols and/or appropriate physician order
Attains minimal technical competency in assigned skills
 Conserves and safeguards hospital materials and property
Communication Skills:



Uses appropriate communication style to relate effectively to patients, instructors, peers, and staff
Maintains accurate records in a timely fashion
Respects confidential nature of hospital records and patient information. Adheres to HIPA
requirements.
End-of-term Employer Survey
The Director of Clinical Education will request completion of the End-of-term Employer Survey
by the department manager. This survey is reviewed with the student with suggestions for
improvement if needed.
End-of-Term Employer Survey
Lane Community College
Respiratory Care Program
Please help us identify students at risk of not successfully completing the program by answering the following
questions regarding the student named on this form. We will use this information to develop an individual plan
with the student to address areas of needed improvement.
Name of Student:
Date:
1. Is this student welcome back for further clinical experience?
Yes
If no, please explain:
2. How would you rate the employability of this student?
Excellent
Very Good
Good
Fair
What can they work on to improve this rating?
Poor
No
Clinical Site Evaluation
Student completes the clinical site evaluation at the end of each term. Results are shared with
the clinical site manager.
Clinical Site Evaluation
Lane Community College
Respiratory Care Program
TERM:
YEAR:
CLINICAL SITE:
CLASS OF:
SHIFT:
AREA OF ROTATION:
DIRECTIONS: This form should be completed at the end of each clinical rotation. Student evaluations are kept
on file at the College. Program faculty and its advisory committee review this data. Your objective view is very
important to our on-going program evaluation and development. Consider each item separately and rate each
item independently of all others. Circle the rating that indicates the extent to which you agree with each statement.
Please do not skip any rating. Please comment if a score of 4 or 5 is given to help us further identify areas for
improvement.
Strongly
Agree
1
Generally
Agree
Neutral
(Acceptable)
Generally
Disagree
Strongly
Disagree
2
3
4
5
The clinical resources for this rotation were adequate to help me meet course objectives.
1
2
3
4
5
4
5
4
5
Comment:
I felt adequately supervised during the rotation.
1
2
3
Comment:
The quality of clinical instruction was adequate.
1
2
3
Comment:
The staff / preceptor / clinical instructor facilitated experiences that contributed to the completion of
Performance Evaluations required for this course.
1
Comment:
2
3
4
5
Orientation to assigned clinical areas, and procedures was adequate.
1
2
3
4
5
Comment:
Staff / preceptors / clinical instructors are readily available to assist me when needed.
1
2
3
4
5
Comment:
Staff / preceptors / clinical instructors provided consistent, constructive, and timely feedback regarding
my clinical performance.
1
2
3
4
5
Comment:
Points I felt were the strongest in this rotation:
Points I felt were the weakest:
If you could improve your clinical experience in any way, what changes would you make:
THANK YOU!
Glossary
Clinical Preceptors
The utilization of the personnel resources of the College and its clinical affiliates for the clinical
education phases of the Respiratory Care Program is based upon a clear differentiation of the
nature and type of the clinical contact provided to the students. The types of clinical contact
provided are defined thusly:
Clinical Instruction: the organization and implementation of purposeful, planned and
systematic learning experiences based upon specifically identified performance objectives and
including direct one-to-one and group instruction, detailed evaluation and assessment of
clinical performance.
Clinical Supervision: The facilitation of skills acquisition, development and refinement by
supervised work experience selected to correspond with the general performance objectives
detailed for a course unit or clinical rotation. The degree of supervision varies with the
course/rotational sequence and the prerequisite instruction. It includes selection of relevant
work assignments, delegation of work responsibilities, provision of procedural assistance, and
(where necessary) procedural remediation and the observation and reporting of student clinical
performance in basic, advanced or intensive and subspecialty areas.
FERPA: The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR
Part 99) is a Federal law that protects the privacy of student education records. The law
applies to all schools that receive funds under an applicable program of the U.S. Department
of Education.