U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Bureau of Health Professions
Division of Nursing
Advanced Education Nursing Traineeship (AENT) Program
HRSA-12-062
July 9-11 , 2012
REVIEWER WORKSHEET TEMPLATE
This worksheet is provided as a guide/template to complete your assigned applications. It serves
as a working document to record an overview of the application and initial strengths and
weaknesses. The overview is used by you as talking points during the application discussion
it is neither submitted nor used for scoring of the application. A strength is a response that
clearly meets and/or substantially exceeds requirements set forth in a review criterion. A
weakness is a response that falls short of meeting requirements set forth in a review criterion. To
assist you in assigning points to each criterion and in developing your strengths and weaknesses
for each application, please refer to the application materials.
PLEASE NOTE This worksheet is NOT to be returned to DIR or <contractor name> it is
solely for your use. The information must still be entered into ARM.
OVERVIEW PRESENTATION INFORMATION:
The overview should briefly focus on the "big picture" of who the applicant is, what is being
proposed, how it will be accomplished in view of the published program guidance and review
criteria, and the most significant strength and/or weakness found in the application.
Applicant information:
Target population, service area, appropriateness of budget, etc.:
Proposed project/program description:
Major goals and objectives:
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Any significant strength and/or weakness:
Any other pertinent information:
Comments on Application Based on Published Review Criteria: For each criterion, list
strengths and weaknesses to support your criterion score. (Your responses should generally
be limited to no more than 5 statements.)
CRITERION 1: NEED NARRATIVE (20 Points)
The need for the project will be evaluated based on the extent to which the
applicant addresses the criteria below:
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The institution’s need for traineeship support and the benefit that the traineeship program
is expected to have for the institution and students;
How the AENT traineeships will support the preparation, graduation and employment of
trainees in primary care, rural or underserved areas/populations, or public health practice
settings;
The community needs and the populations served by the primary care NP and nursemidwifery students and graduates;
The number of primary care NP and nurse-midwifery students expected to receive
traineeship support;
Evidence of an increasing number of graduates serving in rural or underserved
areas/populations or public health practice settings;
Evidence of an increasing number of trainees who have clinical experiences in medically
underserved communities; and
The integration of the goals of Healthy People 2020 into the programs receiving
traineeship support.
Strengths (Please enter all comments ARM)
Weaknesses (Please enter all comments ARM)
Criterion 2: Response (25 Points)- up to 4 of the 25 points will be awarded to applicants that
demonstrate outreach for the Helping Veterans Transition to Careers in Nursing Initiative.
The responsiveness of the project will be evaluated based on the extent to which the applicant
addresses the criteria below:
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A clear plan is provided to meet the project objectives;
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The recruitment plan will increase the number of underrepresented or disadvantaged
minority trainees supported with AENT funding;
Pass rates on Specialty Certification Exams among prior graduates;
The plan to assist trainees from educationally disadvantaged backgrounds to achieve and
maintain the predetermined academic standards of the institutions;
Outreach for Helping Veterans To Transition To Careers In Nursing Initiative is
provided;
The plan to track student employment after graduation;
The facilities where clinical experiences occur are in medically underserved
areas/populations; and
The challenges/barriers that may be encountered and the solutions to overcome.
Criterion 3: Evaluative Measures (20 Points)
The evaluation plan must demonstrate the effectiveness of the method proposed to monitor and
evaluate the project results. The evaluation measures must assess: 1) to what extent the program
objectives (i.e. to prepare graduates to work in primary care settings) have been met; and, 2) to
what extent these can be attributed to the traineeship program. The proposed method for
evaluating the project will be evaluated based on the extent to which the applicant addresses the
criteria below:
 The procedures to collect, analyze, and report on the number of students to be enrolled
and graduated over the next 2 years, the number of full-time and part-time trainees, and
the number of traineeship graduates to serve in rural and underserved areas/populations;
 The rigor of the methodology to evaluate the proposed project;
 The process to validate data collection and results including a description of evaluation
activities, expected results and challenges;
 The salience of indicators that will be used to evaluate project objectives;
 The linkage of the outcome measures to the Need statement; and
 The overall quality of the evaluation plan.
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Criterion 4: Impact (15 Points)
The impact of the project will be evaluated based on the extent to which the applicant demonstrates
the effectiveness of the proposed project to carry out the intent of the AENT Program and project
objectives:
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Increasing the number of primary care providers serving in medically underserved
communities; and
Increasing the number, distribution and diversity of primary care NPs and nursemidwives
Criterion 5: Resources/Capabilities (10 Points)
The resources and capability of the applicant to conduct the project will be evaluated based on the
extent to which the applicant addresses the criteria below:
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The capabilities of the Project Director for the AENT Program;
The capabilities of the applicant organization, and the quality and availability of facilities
and personnel to fulfill the needs and requirements of the proposed project;
The institution’s commitment, experience, and success in enrolling and graduating
primary care NPs and/or nurse-midwives;
The academic and clinical learning resources and learning opportunities for trainees; and
The institutional resources and community support for the project.
Criterion 6: Support Requested (10 Points)
The support requested for the project will be evaluated based on the extent to which the applicant
addresses the criteria below:
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The adequacy of the budget to meet the stated project objectives;
The consistency of the budget request with the enrollment and graduation history and
projections; and
A plan for awarding traineeships among eligible students.
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