McMaster Mohawk
Conestoga BScN Program
STUDENT: Level 4 Professional Practice Evaluation Tool
Student:
Course:
Tutor:
Midterm
Final
Preceptor:
Date:
Agency/Area:
Evaluation Rating Scale – Level 4
U - Unsatisfactory
NI - Needs Improvement
S – Satisfactory
E – Exemplary
NA – Not Applicable
The student is deficient in awareness, knowledge, and/or skill
associated with the characteristic being rated and the student needs
significant further learning and effort to achieve an acceptable
standard. Lacks accountability for actions. Places patients at risk.
The student has shown some evidence of the awareness,
knowledge, and/or skill associated with the characteristic being
rated, but performance is inconsistent or there may be examples of
poor motivation or minor irresponsibility. It is anticipated that the
rating will improve with some further learning, supervision, and
student effort.
The student has consistently demonstrated the awareness,
knowledge, and/or skill associated with the characteristic being
rated. Accountable for actions.
The student has exceeded the awareness, knowledge, and/or skill
associated with the characteristic being rated and is performing at
the advanced level.
The student did not have the opportunity to demonstrate
competency for this characteristic being rated and/or the evaluator
did not have the opportunity to observe this area.
Please provide comments if the score given is U or NI and negotiate with the student and document a
remedial plan for success.
Adapted from Indiana University Department of Counseling and Educational Psychology, Center for
Human Growth
Personhood and Caring
Communication & Relational Skills
Consistently engages in meaningful dialogue with patients to establish mutuality considering
patients story, preferences, physiological, psychosocial and spiritual needs [while maintaining
confidentiality]. Uses a wide range of communication and interpersonal skills to establish and
maintain effective collegial relationships. Provides frequent patient updates in a timely, organized
concise manner to preceptor other nursing staff and inter-professional (IP) team members.
Accurately documents patient care utilizing clinical reasoning framework, detailing relevant
nursing judgement. Assumes effective role within IP team to accomplish patient care goals.
Adheres to relevant standards and guidelines/policies of clinical agency/practice setting.
Demonstrates awareness of personal communication style and impact of self on patients and
health team members. Articulates thoughtful perceptions of professional observations
including rationale for his/her professional stance. Comes prepared to student-tutor meetings with
agenda to discuss patient care issues, interventions with evidence of integrating theory, ways of
knowing and evidence informed practice.
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Caring
Develops therapeutic, caring, culturally safe , nurse patient relationship providing nonjudgmental nursing care while respecting patients story, cultural norms, values and beliefs
Establishes positive, caring inter-professional relationships with health care team members
based on appropriate relational boundaries and respect. Is developing and demonstrating
emotionally intelligent behaviours [self-awareness, self-regulation, motivation, empathy and
social skill]. Demonstrates consistent evidence of scientific and humanistic caring.
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Person-centred Care
Consistently engages in meaningful dialogue with clients to establish mutuality considering
client story, preference , involvement, cultural diversity, physiological, psychosocial and
spiritual needs while maintaining confidentiality. Individualizes care plan based on clinical
reasoning and sound judgment, and on patient’s values, beliefs and preferences. Demonstrates
accountability and responsibility for consistent, safe, compassionate, competent ethical nursing
care. Understands the patient’s narrative/story reflecting multiple ways of knowing.
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Professionalism
Evidence of increasing autonomy and independent safe practices in accordance with legislation,
agency policy standards guidelines and the CNO standards. Recognizes limitations of practice
and seeks guidance when necessary. Models professional comportment behaviours and a
professional presence. Demonstrates punctuality and reliability in clinical setting and tutorstudent meetings. Prepared and intellectually ready for professional practice. Is honest,
accountable and accepts responsibilities for own actions, decisions, and errors. Is developing and
refining a more authentic personalized professional identity. Beginning to demonstrate self
confidence in articulating nursing actions/issues, and speaking as a nursing voice [ongoing
formation of
identity]. Demonstrates respect for professional practice, its values, knowledge and
achievements.
Evidence of role transition from community of learning to community of professional practice
and professional life. Demonstrates commitment to professional development and
competency/capabilities through critical inquiry relative to research of new knowledge and
technologies that change, enhance, and inform clinical reasoning and professional actions.
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Context, Health, and Healing
Professional Practice Skill Development
Knowing and Acting:
Performs skills competently and confidently by end of term, while maintaining personal and
patient safety and optimizing care quality. Embeds skill performance within the broader
context of patient centred care and effective clinical reasoning. Recognizes limitations and
seeks assistance when skill is beyond own capabilities. Demonstrates understanding of
underlying principles and rationale supporting nursing actions. Follows nursing standards,
practice guidelines, and agency policies and procedures.
Judgment:
Recognizes and utilizes available learning opportunities to practice and develop professional
practice skills. Implements feedback [from peers, tutor, agency], develops learning activities
[includes learning plan], and modifies behaviour to improve performance.
Being and Becoming:
Maintains person centered care recognizing the significance of patient respect, dignity,
informed consent, and alleviation of stress [valuing patient choice and acting on it, evidence of
transitioning from student nurse to practising professional]
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Patient/Nurse Safety and Care Quality
Protects patients through identification and reporting unsafe practices when patient, self, or
team member’s safety and well-being are potentially or actually compromised. Questions
unclear or questionable orders, decisions, or actions made by IP team members. Recognizes,
seeks immediate assistance and helps others in rapidly changing conditions that could affect
patient health or safety. Evidence of accurate, concise, timely reporting to IP team. Is
responsible and accountable for provision of safe patient care. Understands importance of
patient safety, roles of nurse and IP team. Recognizes and reports near misses and errors to
preceptor/tutor (own and others) and takes action to stop and minimize harm arising from
adverse events. Applies safety principles, evidence informed practices, infection control
measures and appropriate protective devices consistently when providing nursing care to
prevent injury to clients, self, other health care workers and the public. Has knowledge and
application of workplace health and safety documents, including ergonomics and safe work
practices.
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Advocacy & Leadership
Identifies, and advocates for concerns/needs of the clients/patients in a timely manner with
appropriate reporting, collaboration and documentation of interventions. Provides relevant
client/patient teaching and information regarding their health, self-care and nursing
interventions. Protects safety, privacy and autonomy respecting client/patient’s right of choice.
Collaborates with preceptor(s), IP team, and patients/families in professional practice activities.
Advocates for self-related to inter and intra professional conflict within the practice
environment. Demonstrates self-direction in the development and implementation of
professional practice activities. Role models professional values, beliefs and attributes.
Demonstrates caring behaviours and engaged in encouraging personal and professional growth
of others. Listens interactively and communicates in an open, honest, clear, direct manner with
IP team, preceptor, tutor and peer group. Begins to challenge status quo and rationally
articulate, influence, advocate for change at a unit/system level when assumptions, values,
structures/practices, and processes are not patient centered. Demonstrates respect for
professional practice. Beginning to readily identify opportunities for leading at point of care.
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Inter-professional Collaboration and Team
Anticipates need for IP participation, collaboration and decision making. Demonstrates
professional and respectful response to conflict situations which could impact patient centered
care and IP relationships/collaboration. Understands and applies advanced communication
strategies [SBAR, RAI-MDS,CUS, ROUNDS,TOA] for effective teamwork and positive patient
centered outcomes. Recognizes, understands and values the expertise and roles of IP team in
providing patient centered care. Has a beginning understanding of organizational/system
issues which impact IP team effort, quality of patient centered care and implementation of safe,
organized, timely nursing interventions. Displays initiative, a beginning confidence, selfawareness, and participates in inter professional collaboration. Values diversity of opinion,
professional stance and argument in advancing care quality.
Unsatisfactory
Needs Improvement
Satisfactory
Exemplary
NA
Comments and Examples:
Energy, Time Management & Organization
Demonstrates increasingly organized, timely, safe and efficient nursing care. Consistently
anticipates and promotes optimal health, healing, and peaceful death by identifying patient energy
needs and nurse’s available energy for an efficient mutually established patient centered plan of
care. Depending on context, demonstrates ability to prioritize care appropriately for more than one
patient or for one patient with complex needs with minimal direction. Evidence of increasing
independent practice and demonstrates appropriate professional/inter-professional collaboration
when situation is beyond knowledge base/students’ scope of practice. Organizes workload and
uses time management skills to meet responsibilities. Recognizes the importance of self-care,
work and personal life balance to enable successful IP working relationships and positive patient
outcomes. Demonstrates increasing flexibility, resilience, coping skills to minimize ethical stress
in a continually changing health care environment. Demonstrates increasing awareness and ability
to balance competing values, priorities, and demands in order to deliver patient/client centred care.
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Learning and Knowing
Clinical Reasoning & Judgment
Knowing
&
Noticing:
Data
Collection,
Relational
Dialogue
Demonstrates knowing [grasping] the patient/client story. Completes accurate,
comprehensive assessments with knowledge of typical, atypical patient
presentation. Demonstrates relational skills and active dialogue with preceptor
[IP team] to interpret patients presenting signs and symptoms. Is able to
anticipate outcomes based on previous experience and professional practice
preparation. Develops a patient centered care plan with continual evaluation
and supporting rationale. Seeks guidance when unsure. Demonstrates
awareness of how contextual system issues can impact self and influence
delivery of care in patients with more complex, increased acuity and multiple
system variables.
Interpretin
g:
Effectivene
ss in
Interpretin
g
Informatio
n
Evidence of adequate understanding and analysis to correctly interpret and
articulate the abnormal patient assessment findings and abnormal laboratory
results. Demonstrates awareness of how contextual system issues can impact
self and influence delivery of care in patients with more complex, increased
acuity and multiple system variables (including determinants of health
variables). Demonstrates complete system assessments with appropriate
interpretation and evaluation of findings. Uses clinical reasoning and judgment
to identify, prioritize and implement nursing interventions which are supported
by best practice. Continually evaluates and adapts interventions recognizing the
patient’s story and resulting care needs and system implications. Involved in
Transfer of Accountability when patient/client/population care needs are
beyond his/her scope of practice e.g. providing referral, appropriate resourcing
of responsible care giver.
Respondin
g to
Informatio
n
Uses clinical reasoning to prioritize actual and anticipated patient issues. Uses
knowledge of system and care team to maximize effective use of resources.
Modifies nursing interventions based on patient specific requirements and
where possible includes patient and family in choices related to care delivery
i.e. considers patient preference. Consistently applies humanistic, scientific
caring and ethical practice to frame nursing actions.
Reflecting:
In action,
On action
In action: begins to “read” or notice how patient is responding to nursing
interventions and adjusts interventions based on the “read” or “noticing”. With
preceptor engages in reflection on practice to evaluate outcomes of
interventions.
On action: reflects on what learning was gained from each patient care
experience. Builds on previous knowledge and reflects how continual
knowledge acquisition and development will contribute to professional practice
judgment in future situations.
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Knowledge Generation, Utilization and Dissemination
Demonstrates professional practice which integrates multiple ways of knowing and course ends
in view. Utilizes evidence informed decision making[EIDM] to utilize appropriate scientific
knowledge within care practices. With preceptor/tutor, engages in self reflection “on and in”
action regarding ideas, inferences, assumptions, issues, beliefs to improve on professional
practice and build personal wisdom base. Retrieves, analyzes, interprets, synthesizes and
applies Best Practice evidence/agency policy which will inform professional practice decision
making.
Demonstrates: intellectual courage and willingness to listen, respect values, ideas beliefs of
others; intellectual humility by knowing/accepting one’s limitations, prejudices, biases and
seeks guidance when unsure; intellectual empathy that acknowledges the reality of others
[patient, families/communities, IP team members] and applies relevant situational
interventions; intellectual integrity in all aspects of professional/academic practice; a spirit of
inquiry in relation to new knowledge, evidences and technologies which will inform decision
making at the bedside; awareness for a dynamic, evolving health care environment. Uses a
variety of relevant knowledge to describe rationale which supports professional reasoning.
Begins to assesses professional practice unit for ways to provide cost effective care in view of
diminishing physical, human, budget resources.
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Learning and Teaching
Actively participates in learning/teaching with preceptor, peers, and health care team members.
Engages in sharing knowledge/resources, providing constructive formative feedback, and
facilitating discussions to enable positive patient outcomes. Participates in health
promotion/prevention with patient/families considering and understanding impact of cultural
diversity and determinants of health [smoking, alcohol and drug abuse] when establishing a
mutually agreed upon care plan. Recognizes community of professional practice as a source of
learning
and ongoing personal and professional development. Accepts constructive feedback with a
view to continual improvement. Uses technologies/informatics effectively in learning and
knowledge dissemination for self and others. Demonstrates self-directed learning. Identifies
learning gaps and follows through for required/new knowledge for application to professional
practice. Through critical reflection has realistic evaluation of self related to novice
competence. Constructs, negotiates, executes and evaluates a Learning Plan which addresses
related personal/ professional practice learning needs. Begins to critique in a constructive
manner both the work environment and care provided by others to enable positive patient care
outcomes [i.e. supported by the literature]
Unsatisfactory
Needs Improvement
Comments and Examples:
Satisfactory
Exemplary
NA
Context for evaluation: (e.g. unexpected occurrences, absences):
Strengths:
Areas for Growth/Suggested Strategies:
Next Steps:
Recommended Level of Performance (to be completed by tutor and student)
Midterm
Progressing towards
meeting course ends in
view
Failing
Final
Pass
Fail
__________________________________
Student Signature/Date
____________________________________
Tutor Signature/Date