NURS 2020H Community Based Nursing Practice

Clinical Evaluation Process for the Trent/Fleming School of Nursing

Instructions for use
The Evaluation Form-Midterm will be completed at the mid point of the clinical placement to assist the student in taking inventory of their
development and help them to make plans for future development. Reflection will be used to assist the student in measuring their progress against
their established program and course objectives. This is to be submitted to the clinical faculty prior to the formal mid-term evaluation.
After receiving the students self evaluation form, the clinical instructor will complete the comments section providing feedback and evaluation for
the students progress. Clinical faculty will provide evidence of learning and suggestions for improvements. If a student is in a failing position at midterm, the student and instructor will develop a Learning Plan outlining strategies the student will engage in along with clear expectations that must be
met for the successful completion of this clinical course.
At the end of the rotation, the Evaluation Form-Final is to be completed by the student to archive their achievements and areas for future
development. It will assist the clinical faculty in their assessment of the student. The clinical faculty will also complete the student evaluation form to
provide feedback to the student.
The clinical faculty will collect evidences in the form of student self assessment, comments of the health care team members, patient input, student
submissions (including portfolio) and observations to complete the Evaluation Form-Faculty-Final. A summary of achievement as well as
implications for future learning forms the base of this form. The attendance section and record of completed hours is to be filled in completely. The
completed form is to be shared with the student and signed. The signed copy must be returned to the TFSON by the date indicated by the Year Lead.
The Year Lead will assess the completion of the Learning Center Component if applicable. An electronic copy of the students completed final
evaluation must be uploaded by both the student and by the clinical faculty to them within 48 hours of the final evaluation delivery.
The Student Evaluation Form-Preceptor is to be completed in rotations where the students are working with a preceptor. It must be reviewed by
the student and submitted to the clinical faculty before the final evaluation is completed.

NURS 2020H Community Based Nursing Practice

Clinical Course Evaluation
Program Goals
Students graduating from this program are prepared as generalists entering a self-regulating profession in situations of health and illness.
Students graduating from this program are prepared to work with people of all ages and genders (individuals, families, groups, communities
and populations) in a variety of settings.
Students graduating from this program are prepared to work with people of all ages and genders (individuals, families, groups, communities
and populations) in a variety of settings.
Graduates will learn to continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge
in their practice.
Students graduating from this program will be prepared to demonstrate leadership in professional nursing practice in diverse health care
contexts.
Graduates will be prepared to contribute to a culture of safety by demonstrating safety in their own practice, and by identifying, and
mitigating risk for patients and other health care providers.
Students will demonstrate the ability to establish and maintain therapeutic, caring and culturally safe relationships with clients and health
care team members based upon relational boundaries and respect.
Graduates of this program will be able to enact advocacy in their work based on the philosophy of social justice.
Graduates will effectively utilize communications and informational technologies to improve client outcomes.
Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed interventions
and outcome measures.

*these forms are for reference use only and do not need to be submitted with evaluation*
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Trent/Fleming School of Nursing

Trent University-Peterborough Site
Fall Semester 2015

NURS 2020H Clinical Course Evaluation

Mid-term Evaluation
Student: Nicole Warren
Clinical Instructor: Ann MacLeod
Preceptor: Merrill
Placement: Telecare
Total Clinical Hours: 88
*Signed log must be attached

NURS 2020H Community Based Nursing Practice

Grade: satisfactory

unsatisfactory

Student Self-Evaluation (midterm):

Course Objective
Demonstrated professional responsibility and
accountability to collaboratively plan, implement
and/or evaluate a health promotion project relevant to
the community population served, using elements of
the course website such as the learning system and
regular, punctual communication with preceptor and
faculty.

Applied their knowledge to support population

assessment, collaborative and evidence informed
health promotion project development,
implementation and process and outcome evaluation.

Progress
Evidence/Indicators: (The student has ...)

Satisfactor
y

Unsatisfactory

- Worked within the group and with Preceptor to

identify areas of the agency that need attention,
what the agency would like from us, prioritized the
discussed jobs
- Reviewed with Clinical Instructor and Preceptor
where the group was going with their project, what
the expectations of us were, and what we had
accomplished so far, everyone left the meeting
understanding the work outstanding, and the
general outline of the project at hand
- Showed up on time to all scheduled meetings,
and worked as a group to complete the statistics
coding of caller profiles, completed both 2014 and
2015 to date, as per expectations
- Looked at pamphlets made by the MERAP by the
University of Waterloo, discussed other group
projects to determine cross over so as not to
reinvent the wheel, and found common ground
between Trents expectations and what the
preceptor would like to see
- Beginning of literature review, work is in progress
around issues of Aging (Smale & Dupuis, 2004)
and making a comprehensible training package for
Telecare to provide their volunteers with during the
volunteer orientation
- Complete Praxis note with partner, which worked
to further expand our knowledge of demographic of
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NURS 2020H Community Based Nursing Practice

population of Peterborough, and of those that
utilize Telecare services, research content
specifically regarding SDOH, to further enhance
our basis to being our training module off of for
Issues of Aging from the caregiver perspective,
the elderly individuals perspective, and the
supporting volunteers perspective
Demonstrated ethical respectful and professional
practice when working with community organizations
and the population with whom they work.

Demonstrated knowledge of relational practice in

project development, respectful of group process,
leadership/followership, and collaborative practice to
meet the needs and build capacity of the population in
the given context.

- Conscientiously asked Preceptor every step of

the way questions regarding what she expected of
us, what we were and were not allowed to discuss
of the agency, and had her clarify anything I was
uncertain of
- Maintaining confidentiality of the location of the
Telecare office
- Developed an understanding and appreciation of
the relation between this placement and nursing
despite not working with a community nurse
- Am gaining an appreciation of the difficulties
people are facing, particularly within a life
subjected to low income and poverty, and am
moving to better educate myself as to how to
better help that person, and develop a training to
tool to help others help this population that
routinely seems to use Telecares agency for
emotional support
- Meeting each member of the group and the
Preceptor, developing relationships with each of
the group members and taking the initiative to offer
to drive the rest of the group to the CMHA
conference in Oshawa
- Scanned to pdf a hard copy of a Statistics Manual
that Telecare uses for coding calls and emailed to
Merrill
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NURS 2020H Community Based Nursing Practice

Demonstrated self-regulation by engaging in selfreflective practice and identifying learning needs

through self-assessment that align with the SONs
program goals and the Community Health Nursing
Standards of Practice in Canada.

- Working collaboratively as a group in a small

space to complete the statistics task assigned
- Pairing up and volunteering to take on Coping
with Issues of Aging research project which will
ultimately generate a pamphlet to reflect the
literature review we perform
- Continuing to work collectively as a group to
complete the major task of statistics coding for
2014 and 2015, continue contact with preceptor
outside of when she is not within the agency with
us, and together are gaining an appreciation for
the population of Peterborough that needs
Telecare, and are all becoming keenly interested in
educating ourselves so as to better serve this
population going forward
- Can work as group independent of Preceptor, but
still completing tasks, putting in ours and meeting
expectations
- Attended a CMHA conference on Thursday Sept
24 regarding a suicide survivors journey from
which I then have looked into further research
regarding on my own accord
- Have met group at time as planned at Telecare
office, and outside of clinical hours to further work
on projects and praxis note submissions, logic
model building and complete further project
development criteria
- Continuing research to further supplement
training pamphlet, regarding SODH, mental health
and Peterborough and County statistics

Student Self Evaluation Comments (Any area marked unsatisfactory need to be commented on).

NURS 2020H Community Based Nursing Practice

Identify 3 personal strengths developed in this placement.

1. An appreciation for agencies in the community that are working
to help individuals, beyond what the clinical setting can offer them
2. A knowledge for the difficulties individuals face that are living
on low income, and the lack of social supports they have
3. Developing a grasp of the process of research, and the importance
of studying the demographics of the population the agency works
with to identify how to better support them and how to utilize the
information for grants, and monetary support from governments, etc.

Identify 3 areas requiring further development.

1. Need to further my knowledge around project planning, which
will presumably come as we continue working through the steps
during the second half of our placement and as we get further along
with our project
2. Need to address the time management issue of completing the
statistical analysis within Telecare, and developing my annotated
bibliography and pamphlet, by the end of term
3. My literature review needs to be further extended to better address my
topic of the Issues of Aging so that the most comprehensive training
pamphlet can be made for Telecare to utilize in their next volunteer
training session

Signature of Student_____________________________________________________

Date________________________

Signature of Clinical Instructor____________________________________________

*Signatures must not be typed in

Date_________________________

NURS 2020H Community Based Nursing Practice

Preceptors Evaluation (midterm):

Course Objective

Progress
Evidence/Indicators: (The student has ...)

Satisfactor
y

Unsatisfactory

Demonstrated professional responsibility and

accountability to collaboratively plan, implement
and/or evaluate a health promotion project relevant to
the community population served, using elements of
the course website such as the learning system and
regular, punctual communication with preceptor and
faculty.

Applied their knowledge to support population

assessment, collaborative and evidence informed
health promotion project development,
implementation and process and outcome evaluation.

Demonstrated ethical respectful and professional

practice when working with community organizations
and the population with whom they work.

NURS 2020H Community Based Nursing Practice

Demonstrated knowledge of relational practice in

project development, respectful of group process,
leadership/followership, and collaborative practice to
meet the needs and build capacity of the population in
the given context.

Demonstrated self-regulation by engaging in selfreflective practice and identifying learning needs

through self-assessment that align with the SONs
program goals and the Community Health Nursing
Standards of Practice in Canada.

Preceptors Comments (Any area marked unsatisfactory need to be commented on).

Signature of Preceptor___________________________________________________

Date____________________

Signature of Instructor___________________________________________________

Date____________________

Signature of Student_____________________________________________________
*all signatures must be in writing not typed

Date____________________

NURS 2020H Community Based Nursing Practice

Clinical Instructors Evaluation (midterm):

Course Objective
Demonstrated professional responsibility and
accountability to collaboratively plan, implement
and/or evaluate a health promotion project relevant to
the community population served, using elements of
the course website such as the learning system and
regular, punctual communication with preceptor and
faculty.

Applied their knowledge to support population

assessment, collaborative and evidence informed
health promotion project development,
implementation and process and outcome evaluation.

Progress
Evidence/Indicators: (The student has ...)
Nicole is progressing towards meeting this
objective through increasing responsibility
and independent practice. She has only
occasionally been late submitting weekly logs
and has attended and participated in all
seminars. She has completed her project
requirements to date outlined above,
(collating statistics of call users of Telecare)
and is commencing training and development
of a volunteer guide regarding aging.

Satisfactor
y
Progressing

Unsatisfactory

Nicole is progressing towards meeting this

Progressing
objective. Like many of her peers, the critical
analysis of the population served needed more
in depth research to meet the level of a second
year students capacity. This detailed context
(plus the information from the user statistics),
should have been referenced in more detail to
support their program plan/logic model.
Revisions are under progress and I anticipate
a solid product (the volunteer guide on aging)
supported by evidence.
I know Nicole will benefit from the training
offered.
Nicole is meeting the expected level of
Meeting
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NURS 2020H Community Based Nursing Practice

Demonstrated ethical respectful and professional
practice when working with community organizations
and the population with whom they work
Demonstrated knowledge of relational practice in
project development, respectful of group process,
leadership/followership, and collaborative practice to
meet the needs and build capacity of the population in
the given context.

Demonstrated self-regulation by engaging in selfreflective practice and identifying learning needs

through self-assessment that align with the SONs
program goals and the Community Health Nursing
Standards of Practice in Canada.

ethical, professional practice at midterm as

evidenced by:
maintaining confidentiality of clients and
communicating with her preceptor and faculty
in a professional, respectful manner.
Nicole is meeting the expected level of
relational practice at midterm as evidenced
by:
-working colleagially with her peers
-attending to feedback from faculty and her
preceptor
-participating in the telecare training which
focuses on relating with vulnerable callers

expectations
at midterm

Nicole is meeting the expected kevel of self

regulation at midterm;
She is submitting her weekly logs and has
identified her learning strengths and areas of
growth with insight.
I anticipate she will reach out for support to
the librarian and myself for assistance with
the literature search and evidence to support
her work on aging.

Meeting
expectations
at midterm

Meeting
expectations
at midterm

Clinical Instructors Comments (Any area marked unsatisfactory need to be commented on).
Nicole is progressing towards meeting expectations at midterm. A basic assessment of the population and plan to address some needs of the
agency has begun. As correctly identified, using evidence to support practice, project planning and evaluation of a final product that the agency will
find useful is an appropriate expectation to meet the course objectives. See the librarian or me to help you with the literature search strategies to
support development of the aging resource for volunteers.

Signature of Instructor___________________________________________________

Date____________________
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NURS 2020H Community Based Nursing Practice

Signature of Student_____________________________________________________
Date____________________
*all signatures must be in writing and not typed

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