CLINICAL SPECIALTY I

CHILD HEALTH (PAEDIATRIC) NURSING

Placement : 1st Year
Hours of Instruction Theory 150 Hours Practical 650 Hours Total : 800 Hours

Course Description This course is designed to assist students in developing e pertise and in!depth understanding in the filed of Pediatric "ursing# It $ill help students to appreciate the child as a holistic individual and develop s%ill to function as neonatal and pediatric nurse specialist# It $ill further ena&le the student to function as educator' manager and researcher in the filed of Pediatric nursing# Ob ecti!es " (t the end of the course the students $ill &e a&le to : 1# (ppreciate the history and developments in the filed of pediatrics and pediatric nursing as a specialty )# (pply the concepts of gro$th and development in providing care to the pediatric clients and their families# *# (ppreciate the child as a holistic individual +# Perform physical' development' and nutritional assessment of pediatric clients 5# (pply nursing process in providing nursing care to neonates and children# 6# Integrate the concept of family centered pediatric nursing care $ith related areas such as genetic disorders' congenital malformations and long term illness# ,# -ecogni.e and manage emergencies in neonates# 8# /escri&e various recent technologies and treatment modalities in the management of high ris% neonates 0# (ppreciate the legal and ethical issues pertaining to pediatric and neonatal nursing 10# Prepare a design for layout and management of neonatal units 11# Incorporate evidence &ased nursing practice and identify the areas of research in the filed of pediatric 1 neonatal nursing 1)# -ecogni.e the role of pediatric nurse practitioner and as a mem&er of the pediatric and neonatal health team 1*# Teach pediatric nursing to undergraduate students and in!service nurses#

Course Content Unit I Hours 10 Content Intro#uction Historical development of Pediatrics and Pediatric "ursing /ifference &et$een child and adult care Philosophy of paediatric care 2hanging trends in Pediatric "ursing -ole of family in child care 2ommunity!&ased nursing of the child and family 3thical and cultural issues in pediatric care -ole of paediatric nurse -ights of children and special la$s and ordinance relating to children# 2urrent status of child health in India4 "ational goals' 5ive year plans "ational health programs related to child health# Assess$ent o% pe#i&tric c'ients History ta%ing /evelopmental assessment Physical assessment "utritional assessment 5amily assessment "ursing process in care of children Nursin( $&n&(e$ent o% t)e sic*+ )ospit&'i,e# c)i'# 6eaning of hospitali.ation of the child' preparation for hospitali.ation' effects of hospitali.ation on the child and family 7tressors and reactions related to developmental stages' play activities for ill 1 hospitali.ed child# "ursing care of hospitali.ed child and family ! principles and practices# Pre-n&t&' Pe#i&trics 3m&ryological and fetal development' Prenatal factors influencing gro$th and development of fetus' 9enetic patterns of common pediatric disorders' chromosomal a&errations' genetic assessment and counseling legal and ethical aspects of genetic' screening and counseling -ole of nurse in genetic counseling' Importance of prenatal care and role of pediatric nurse# Gro.t) &n# De!e'op$ent o% c)i'#ren Principles of gro$th and development' 5actors affecting gro$th and development 2oncepts and theories of gro$th : development ;iophysical Psycho!social theories Psychose ual theories 6oral development theories 2ognitive development theories 7piritual theories /evelopment tas%s and special needs from infancy to adolescence' developmental milestones' (ssessment of gro$th and development of pediatric clients' 9ro$th 6onitoring

II

10 hrs

III

I8

10

)0

Unit 8I

Hours 5

8II

*0

8III

*5

-ole of play in gro$th and development of children# Content /e)&!ior&' + Soci&' Pe#i&trics &n# Pe#i&tric Nursin( Parent child relationship' ;asic &ehavioral pediatric principles and specific &ehavioral pediatric concepts1 disorders < maternal deprivation' failure to thrive' child a&use' the &attered child# 2ommon &ehavioral and social pro&lem and their management# 2hild guidance clinic# Pre!enti!e Pe#i&trics &n# Pe#i&tric Nursin(0 2oncept' aims and scope of preventive pediatrics' 5ive year plans : "ational health policy for children "ational health programs related to child health# 6aternal health and its influence on child health antenatal aspects of preventive pediatrics# 6ortality among children' 62H indicators# -ecent trends in 62H services Immuni.ation' e panded program on immunication 1 universal immuni.ation program and cold chain# "utrition and "utritional re=uirements of children' 5luid and electrolyte &alance in children Pattern of feeding' &reast feeding' &a&y!friendly hospital initiative' (rtificial feeding >eaning "utritional Programs and $elfare services# "ational and international organi.ations related to child health -ole of pediatric nurse in the hospital and community# Health education' nutritional education for children# Neon&t&' Nursin( "eonatal resuscitation "e$ &orn &a&y!profile and characteristics of the ne$ &orn (ssessment of the ne$ &orn "ursing care of the ne$ &orn at &irth' care of the ne$ &orn and family' Planning and organi.ation of level I'II and III neonatal care units "I2? and environment 3=uipment and personnel management High ris% neonate < pre term and term neonate and gro$th retarded &a&ies# @o$ &irth $eight &a&ies# Transport of the high ris% neonate to "I2? "eonatal infections prevention and management Identification and classification of neonates $ith infection HI8 and (I/7' Aphthalmia neonatorum' congenital syphilis# High ris% ne$ &orn < Identification' classification and nursing management# Arga.ation of neonatal care' services B@evelsC' transport' neonatal intensive care unit' organi.ation and management of nursing services in "I2?# 6anagement of "eonatal pro&lems -espiratory distress syndrome : H6/ "eonatal Hypoglycemia "eonatal Hyper&iliru&enemia 2ommon meta&olic pro&lems "utritional re=uirements

 Unit ID Hours )5

"eonatal sei.ures "eonatal mechanical ventilation Thermo regulation 5ollo$ up care and assessment of high ris% infants

Content I1NCI (Inte(r&te# 1&n&(e$ent o% Neon&t&' &n# c)i'#)oo# i''nesses) 2oncept -ationale for an evidence &ased syndromic approach 2omponents Principles of I6"2I 2ase management process Autpatient management of young infants age up to ) months Autpatient management of children age ) months up to 5 years Principles of management of sic% children in small hospital "ational Population policy )000 -e productive and child health#

PRACTICAL SN Deptt0 + Unit 1 Pediatric 6edicine >ard ) Pediatric 7urgery >ard * @a&or -oom 1 6aternity >ard + Pediatric AP/ 5 "I2? 6 2reche 1 /ay care 2entre , 2hild 9uidance 2linic 8 2ommunity Tot&' Stu#ent Acti!ities 2linical presentations (ssessment of "e$ ;orn ;a&y1Preterm 9ro$th : developmental assessment "ursing care plan ProFect $or% 5ield 8isits#

No0 o% .ee* + + )1) ) + 1 1 ) 22 .ee*s 455 50 E 100 E 50 )0 E 100 )5 E 50 50

Tot&' Hours 1)0 Hours 1)0 Hours 1)0 Hours 60 Hours 110 Hours *0 Hours *0 Hours 60 Hours 345

) 5 )

)5 )

2hild care center' (ngan$adi' play school' 2reche' >HA1?"I235' 7A7 8illage

"eonatal resuscitation Health education

E!&'u&tion Internal 3 ternal Internal assessment BTheoryC 7eminar ;I;@IA9-(PHY

T)eor6 )5 ,5 ) 50E100

Pr&ctic&' 100 100

1# (char 7T and 8is$anathan 4 GTe t &oo% of Paediatrics4 ( 2linical (pproach GArient @ongman' 6um&ai )# (le ander "6';ro$n 674 G Paediatric Physical /iagnosis for "ursesH 6c9re$ Hill ;oo% 2o' "e$ Yor% *# ;all4 G Paediatric "ursing caring for childrenH Prenticehall' 1000 +# ;ehrman' -ichard I : 8aughan4 H"elson's Te t&oo% of PaediatricsH 4 >; 7aunders 2ompany 5# ;la%e 9' 5lorence : >right4 G 3ssentials of Paediatric "ursingH 6# ;ar&ara 3>4 G 9uidelines in the care of the lo$ &irth $eightH Arient @ongman ,# ;o$den 9reen&erg4 G Paediatric "ursing ProcedureH @ippincott '>illiams: >il%ins 8# ;ro$der J J4 G "ursing care og childrenH 5(/avis 0# 2ameron' Jeline% et al4 G Te t ;oo% of 3mergency Paediatric 6edicineH 10# 2loherty' John P : 7tar%' (nn -4 G 6anual "eonatal careH @ippincott 11# /avid Hull : Johnstan /4 G 3ssentials Af PaediatricsH 2hurchill @ivingstone 1)# 3li.a&eth Hurloc%4 G 2hild /evelopmentH 1*# 9hai A P4 G 3ssential Te t ;oo% Af PaediatricsH Jaypee ;rothers 1+# 9hosh 7hanti4 G "utrition and child careH Jaypee ;rothers 15# 9hosh 7hanti4 G Ino$ your childH Jaypee ;rothers 16# 9upte 7uraF4 G "eonatal 3mergenciesH Jaypee ;rothers 1,# 9upte 7uraF4 G ( 7hort Te t &oo% of PaediatricsH Jaypee ;rothers 18# 9uha /I4 G "eonatologyH Jaypee ;rothers 10# 9uha /I4 G 6anual of Practical ne$&orn 2areH Jaypee ;rothers )0# Hathfield "4 G Introductory Paediatric "ursingH @ippincott' )00* )1# Helens 2@ : -o&erts4 G Paediatric "ursingH 28 6os&y : 2o ))# Ihilnany4 G Practical approach to Paediatric Intensive 2areH Jaypee ;rothers )*# Iul%arni 624 G 6anual of "eonatologyH Jaypee ;rothers )+# Ilosner : "ancy Hathfield4 G Introductory 6aternity and Paediatric "ursingH @ippincott '>illiams: >il%ins )5# 6erenstein : 9ardner4 G Hand&oo% of neonatal intensive careH 28 6os&y 2o )6# 6cmillan'5ergin et al4 G As%iKs Paediatrics!Principle : practiceH @ippincott '>illiams: >il%ins ),# 6arlo$ /orothy 4 G Te t&oo% of Paediatric "ursingH> ; 7aunders 2o )8# Parthasarthy et al4 G I(P Te t&oo% of PaediatricsH Jaypee ;rothers )0# Par%Ks GTe t &oo% of Preventive and 7ocial medicineH 18 edn' ;anarasi das *0# -o&erts I/ 3d$ards J64 GPaediatric Intensive 2areH ;lac%$ell 7cientific Pu&lications' A ford' *1# -ichard Polin4 G Paediatric 7ecretsH 6os&y 2o *)# 7ele%man4 G Paediatric "ursingH 7pringhouse' )00+ **# 7ingh 6eher&an4 G2are of "e$&ornH 7agar Pu&lications "e$ /elhi *+# 7ingh 6eher&an4 G/rugs ?sed in 2hildrenH 7agar Pu&lications "e$ /elhi *5# 7lota4 G 2ore curriculum for Paediatric 2ritical 2are "ursingH >; 7aunders 2o *6# 7peer4 G Paediatric 2are planningH 7pringhouse'1000 *,# 8idhyasagar : 7arnai%4 G "eonatal : Paediatric Intensive 2areH Jaypee ;rothers *8# >agle 274 G7hort Te t ;oo% of PaediatricsH 8ohra ;oo% 2entre' 6um&ai *0# >haley : >ong4 G"ursing care of Infants and 2hildrenH 28 6os&y 2ompany +0# >haley' @ucilla 5 /onna @4 G 3ssentials of Paediatric "ursingH 286os&y 2A ' 7t @ouis +1# ?dani -H4 G "eonatal -esuscitationH I36 Hosp

CHILD HEALTH NURSING

PROFORMA & GUIDELINE FOR EXAMINATION AND ASSESSMENT OF NEW BORN

I] Biodata of baby and mother 05 Marks Name of the baby (if any) : Age: Birth weight : Present weight: Mothers name : Period of gestation: Date of delivery : Identification band a lied : !y e of delivery : Normal" Instr#mental" $ eration Place of delivery : %os ital" %ome Any roblems d#ring birth : &es" No If &es e' lain : Antenatal history : Mothers age : %eight: (eight: N#tritional stat#s of mother : )ocio*economic bac+gro#nd : II] Examination of the baby : 05 Marks ,haracteristics In the Baby ,om arison with the normal -. (eight /. 0ength 1. %ead circ#mference 2. ,hest circ#mference 3. Mid*arm circ#mference 4. !em erat#re 5. heart rate 6. 7es iration III] General behavior and observations ,olor : )+in" 0an#go : 8erni' caseosa : 9a#ndice : ,yanosis : 7ashes : Mongolian s ot : Birth mar+s : %ead : * Anterior fontanel : 05 Marks

! Posterior fontanel : * Any ce halhematoma" ca #t s#ccedane#m * :orce s mar+s (If any) : ;yes : :ace: ,left li " alate ;ar ,artilage : !r#n+: * Breast nod#le * <mbilical cord * %ands : :eet")ole creases : 0egs : =enitalia : M#scle tone :

Reflexes * ,linging : * 0a#ghing"snee>ing : * )#c+ing : * 7ooting : * =agging : * =ras : * Moro : * !onic nec+ refle' : Cry: Good/ week AP=A7 scoring at birth : :irst feed given : !y e of feed given : !otal re?#irements of fl#id @ calories: Amo#nt of feed acce ted :
) ecial observations made d#ring feed:

,are of s+in : ,are of eyesA noseA earA mo#th : ,are of #mbilic#s and genitalia : Meconi#m assed" not assed : <rine assed" not assed : IV] Identification of Health eeds in Baby ! Mother" V] Health ed#cation to mother abo#t Breast feedin$ : Care of skin, eye, and umbilicus ect. V ]Bibliogra !y

05 Marks 54 1&r*s

PROFORMA & GUIDELINE FOR ASSESSMENT OF GROWTH & DEVELOPMENT

%&$e $ro#': birth to 5 yrs(

I] Identification )ata Name of the child : Age : )e' : Date of admission : Diagnosis : !y e of delivery : Normal" Instr#mental"0),) Place of delivery : %os ital" %ome Any roblem d#ring birth : &es" No If yesA give details : $rder of birth : II] Gro*th ! develo'ment of child ! com'arison *ith normal:
"nt!ro ometry #n t!e C!ild $ormal %& 'arks

(eight %eight ,hest circ#mference %ead circ#mference Mid arm circ#mference Dentition III] Milestones of develo'ment: 0+ Marks Develo mental milestones In ,hild ,om arison with the normal -. 7es onsive smile /. 7es onds to )o#nd 1. %ead control 2. =ras s obBect 3. 7olls over

4. 5. 6. C. -D. --. -/. -1. -2.

)its alone ,rawls or cree s !h#mb*finger co*ordination (Prehension) )tands with s# ort )tands alone (al+s with s# ort (al+s alone ,limbs ste s 7#ns

IV] ,ocial- Emotional ! .an$#a$e )evelo'ment: 0+ Marks )ocial @ emotional develo ment In 2hild 2omparison $ith the normal 7es onds to closeness when held )miles in recognition 7ecogni>es mother ,oos and g#rgles )eated before a mirrorA regards image Discriminates strangers (ants more than one to lay )ays MammaA Pa a 7es onds to nameA no or give it to me Increasingly demanding $ffers chee+ to be +issed ,an s ea+ single word <se rono#ns li+e IA MeA &o# As+s for foodA drin+sA toiletA Plays with doll =ives f#ll name ,an hel #t things away <nderstands difference between boy @ girl (ashes hands :eeds himself"herself 7e eats with n#mber <nderstands #nderA behindA insideA o#tside Dresses and #ndresses V] /lay habits 0+ Marks ,hilds favo#rite toy and lay: Does he lay alone or with other childrenE VI] 0oilet trainin$ 0+ Marks Is the child trained for bowel movement @ if yesA at what age: %as the child attained bladder control @ if yesA at what age: Does the child #se the toiletE VII] #trition 0+ Marks Breast feeding (as relevant to age) (eaning %as weaning started for the child: &es"No If yesA at what age @ s ecify the weaning diet. Any roblems observed d#ring weaning:

'eal attern at !ome %& 'arks )am le of a days meal: Daily re?#irements of chief n#trients : Brea+fast: 0#nch: Dinner: )nac+s: VIII] Imm#ni1ation stat#s ! sched#le of com'letion of imm#ni1ation" 0+ Marks I2] ,lee' /attern 0+ Marks %ow many ho#rs does the child slee d#ring day and nightE Any slee roblems observed @ how it is handled: 2] ,choolin$ 0+ Marks Does the child attend schoolE If &esA which grade and re ort of school erformance: 2I] /arent child relationshi' %ow m#ch time do the arents s end with the childE $bservation of arent*child interaction: 2II] Ex'lain 'arental reaction to illness and hos'itali1ation 2III] 3hild4s reaction to the illness ! hos'ital team 2IV] Identification of needs on 'riority 2V] 3oncl#sion

(V#] Bibliogra !y
Eval#ation 3riteria :&ssessment of Gro*th

PROFORMA & GUIDELINE FOR CASE STUDY I] /atient4s Biodata

$ame, "ge, )ex, Religion, 'arital status, *ccu ation, )ource of !ealt! care, +ate of admission, ,ro-isional +iagnosis, +ate of surgery if any.
##] ,resenting com laints

Describe the com laints with which the child has been admitted to the ward.

III] 3hild4s /ersonal data:

IV] ,ocio5economic stat#s of the family: V] History of Illness

i) ii) iii)

$bstetrical history of mother Prenatal @ natal history =rowth @ Develo ment (com are with normal) Imm#ni>ation stat#s Dietary attern incl#ding weaning N#tritional stat#s Play habits !oilet training habits )lee attern )chooling

Monthly incomeA e' endit#re on healthA foodA ed#cation %istory of resent illness F onsetA sym tomsA d#rationA reci itating" aggregating factors %istory of ast illness F IllnessesA hos itali>ationsA s#rgeriesA allergies. :amily history F :amily treeA family history of illnessA ris+ factorsA congenital roblemsA sychological roblems.

VI] )ia$nosis :5 Provisional : confirm# VII] +escri tion of disease: Incl#des the followings:
1# /efinition )# -elated anatomy and physiology *# 3tiology : ris% factors +# Path physiology 5# 2linical features

VIII] /hysical Examination of /atient

,linical feat#res resent in the boo+ resent in the atient
#(] #n-estigations:.

Date Investigation done 7es#lt Normal val#e Inference

2] Mana$ement 5 Medical 6 ,#r$ical

Aims of management $bBectives of N#rsing ,are Plan

2I] Medical Mana$ement

).No
Dr#g (Pharmacological name) Dose :re?#ency " !ime Action )ide effects @ dr#g interaction N#rses res onsibility

2II]

#rsin$ mana$ement %7se #rsin$ /rocess( B7hort Term : @ong Term

PlansCAssessment N#rsing Diagnosis $bBective Plan of care 7ationale Im lementation

;val#ation

2III] 3om'lications
Prognosis of the atient 2IV] )ay to day 'ro$ress re'ort of the 'atient 2V] )ischar$e 'lannin$ 2VI] 8eferences: /V"01"2#*$ CR#2/R#" 3*R C")/ )21+4 (Ma'im#m Mar+s F 3D)
7" 01# 0)# 0*# 0+# 05# 06# 0,# 08# Item Introduction History and assessment 2omparative finding $ith patients Theoretical %no$ledge and understanding of diagnosis "ursing Process 5ollo$ up care 7ummary and conclusion ;i&liography 6ar%s 0* 05 10 05 15 05 05 0)

Total 50
Note :- One Medical and One Surgical Pediatrics Case study. 50 Marks each.

CHILD HEALTH NURSING

PROFORMA & GUIDELINE FOR CASE PRESENTATION

I] /atient Biodata $ame, "ge, )ex, Religion, 'arital status, *ccu ation, )ource of !ealt! care, +ate of admission, ,ro-isional +iagnosis, +ate of surgery if any.
##] ,resenting com laints

Describe the com laints with which the child has been bro#ght to the hos ital III] 3hild4s /ersonal data: $bstetrical history of mother Prenatal @ natal history =rowth @ Develo mentA com are with normal (7efer Assessment Proforma). Imm#ni>ation stat#s Dietary attern incl#ding weaning(Breast feeding relevant to age) Play habits !oilet training )lee attern

)chooling

IV] ,ocio5economic stat#s of the family: 6onthly income' e penditure on health' food' education etc#
V] 5istory of #llness

i)

%istory of

resent illness F onsetA sym tomsA d#rationA

reci itating

"aggravating factors ii) %istory of ast illness F IllnessesA s#rgeriesA allergiesA medications iii) :amily history F :amily treeA history of illness in the family membersA ris+ factorsA congenital roblemsA sychological roblems. VI] )ia$nosis: BProvisional : confirmedC# +escri tion of disease: Incl#des the followings /. Definition. 1. 7elated anatomy and hysiology 2. ;tiology @ ris+ factors 3. Path hysiology 4. ,linical feat#res.

VII] /hysical Examination of /atient %)ate ! 0ime(

Physical e'amination: with date and time. ,linical feat#res resent in the boo+ Present in the atient

V###] #n-estigations
Date Investigation done 7es#lts Normal val#e Inference

I2] Mana$ement 5 %Medical 6,#r$ical(

Aims of management $bBectives of N#rsing ,are Plan

2] 0reatment:
) No Dr#g (Pharmacological name) Dose :re?#ency" !ime Action )ide effects @ dr#g interaction N#rses res onsibility )#rgical management N#rsing management

2I] #rsin$ 3are /lan: 7hort Term : @ong Term plan#

Assessment N#rsing Diagnosis $bBective Plan of care 7ationale Im lementation ;val#ation

2II] )ischar$e 'lannin$: It sho#ld incl#de health ed#cation and discharge lanning given to the atient. 2III] /ro$nosis of the 'atient: 2IV] ,#mmary of the case: 2V] 8eferences: ;8A0<A!I$N ,7I!;7IA :$7 ,A); P7;);N!A!I$N (Ma'im#m Mar+s F 3D) 3riteria 0otal Marks 9" 3ontent ,#b:ective ! ob:ective data" 0; +" /roblems ! need Identified ! s$" 3are /lan" 95 <" Effectiveness of 'resentation" 05 =" 3o5relation *ith 'atient ! book" 90 5" 7se of &" V" &ids" 05 >" /hysical arran$ement" 0+ ?" Gro#' 'artici'ation" 0< ;" Biblio$ra'hy ! references"0+ 0otal 50 CLINICAL EVALUA ION! C"IL# "EAL " NU$SIN% Area :- Paed. Medical & Surgical Nursing. Maximum Marks 100

Na&e '( the Student )ear! Nursing #urati'n '( E*+erience S.No Criteria 1 2 ! "N#$%&'(&) S"*%% & APP%*CA+*#N ,. P'ssess s'und kn'-ledge '( +rinci+les '( Paed Nsg .. "as an understanding '( the &'dern trends and current issues in +aed nsg +ractice /. "as kn'-ledge '( n'r&al gr'-th and de0el'+&ent '( children 1. "as ade2uate kn'-ledge '( +aed nutriti'n and a++lies +rinci+les '( n'r&al thera+eutic diet 5. A3le t' elicit health hist'ry '( child and (a&ily accurately 4. Identi(ies need5+r'3le&s '( Children -ith Medical & Surgical +r'3le&s 6. A3le t' +lan7 i&+le&ent and e0aluate care 3'th +re'+erati0ely and +'st '+erati0ely 8. A3le t' calculate and ad&inister &edicati'ns t' children accurately 9. $ec'gni:es the r'le '( +lay in children ; (acilitates +lay thera+y ('r h's+itali:ed children ,0. Acts +r'&+tly in +aediatric e&ergencies ,,. Makes rele0ant '3ser0ati'ns7 &aintain rec'rds ; re+'rts +r'&+tly ; e((ecti0ely. ,.. Skil(ul in carrying 'ut +hysical e*a&inati'n7 de0el'+&ental screening and detecting de0iati'ns (r'& n'r&al

,/.

A3le t' carry 'ut thera+eutic regi&e related t' children in acc'rdance -ith +rinci+les '( +aediatric Nsg ,1. Identi(ies '++'rtunities ('r health educati'n ; reha3ilitati'n and enc'urages +arent +artici+ati'n in the care '( the child ,5. #e&'nstrates e0idence '( sel( learning 3y reading '( current literature5seeking hel+ (r'& e*+erts. Personalit, as-ects ,4. Pr'(essi'nal gr''&ing ; turn<'ut ,6. A3le t' think l'gically7 alert7 attenti0e and -ell in('r&ed ,8. C'&&unicates e((ecti0ely ,9. Enthusiastic ; takes interest in clinical setting .0. rust -'rthy and relia3le .,. C'urte'us7 tact(ul ; c'nsiderate in all her dealings -ith c'lleagues7 seni'rs7 +atients ; (a&ily ... #is+lays e&'ti'nal &aturity and leader shi+ 2ualities. ./. ='ll'-s instructi'ns ; e*hi3its +'siti0e 3eha0i'ral changes as and -hen re2uired .1. Practices ec'n'&y in relati'n t' ti&e7 e(('rt ; &aterial in all as+ects '( care .5. C'&+lete assign&ents in ti&e -ith sel( &'ti0ati'n and e(('rts.

P'siti0e ; Negati0e as+ects. Signature '( Student Signature '( Clinical su+er0is'r
P$O=O$MA ; %UI#ELINE =O$ "EA L" EAC"IN%. '+ic Selected !< 1# "ame of the 7tudent Teacher# )# "ame of the 7upervisor# *# 8enue# +# /ate# 5# Time 6# 9roup# ,# Previous %no$ledge group# 8# 9eneral o&Fectives# 0# 7pecific o&Fectives# 10# (# 8# (ids# used#