INFORMATION FOR INSTRUCTOR SKILLS INVENTORY CHECKLIST
RNSG 1140
1. The first six blank columns are for use in the skills lab.
Columns1 and 2 should have the initials of two peers who have observed you
performing the skill correctly.
Column 3 should have the letter indicating your role in the group checkoff:
D-Demonstrator
Person #1
P-Prompter
or
Person #2
R-Reviewer
Person #3
Not Applicable (N/A) in the role column indicates an individual checkoff.
Column 4 and 5 will be initialed and dated by the instructor at satisfactory
checkoff. If you will not be required to demonstrate the skill due to job
performance, this will be signed by the Provost or an instructor. Only selected
skills will be approved so that demonstrations will not be required.
Column 6 will have an R placed in the column if a recheck of the skill is
necessary.
The next four blank columns will be used in the clinical setting.
Column 7 and 8 should be initialed and dated by the clinical instructor who
observed you performing the skill in the clinical setting.
Columns 9 and 10 will be initialed by the clinical instructor when you are allowed
to perform the skill independently. The IVP & Blood Transfusion clinical
Independent columns indicate that these skills must always be done with an
instructor present and the skill must never be done independently.
Column 11 will be used by the instructor to make pertinent comments.
2. This sheet must be checked and signed by the skills lab coordinator for credit in
RNSG 1140. The sheet will then be returned to you to take to your clinical rotations.
You should make a copy and keep for your personal records as proof of completion.
3. You may not exchange role check-off cards. This is considered a breach of the
honesty policy.
N:ADN Syllabus/Transition/Info for Instructor RNSG 1140
Reviewed 04/13