NRSG 379 Clinical Feedback Form

Review the indicators for each of the five outcomes listed below. For each outcome compare the student’s performance on the indicators to the expected level of performance of a typical novice (new graduate) nurse. Please select only one option for each outcome and include comments to support your selection.

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Outcome 1. Synthesizes core competencies of critical thinking, communication, assessment, and technical skills:

  • Analyzes comprehensive assessment data using all available resources
  • Anticipates changes in health status based on assessments
  • Uses critical thinking and clinical judgment in decision-making and care planning
  • Contributes to the plan of care
  • Modifies care based on evaluation of outcomes.
  • Communicates in a clear and explicit way with patients, preceptor, physicians and other care providers
  • Accurately documents assessment findings and the provision of care 
Compare the student's performance to expected level of performance of a typical novice nurse and select one of the following:



Outcome 2. Models professional values of altruism, autonomy, human dignity, integrity, and social justice:

  • Supports patient autonomy
  • Respects the dignity of others regardless of race, creed, ethnicity, gender, and/or illness.
  • Is trustworthy and honest; reliable
Compare the student's performance to expected level of performance of a typical novice nurse and select one of the following:



Outcome 3: Synthesizing core knowledges across a variety of healthcare situations: health promotion, risk reduction, and disease prevention, illness and disease management, information and health care technologies, ethics, human diversity, global health care, and health care systems and policy:

  • Integrates knowledge of health and illness in determining appropriate nursing interventions
  • Uses teaching and learning principles and process to promote and restore health.
  • Interacts with clients and families with sensitivity to their culture, socioeconomic status, religious beliefs, and lifestyle preferences.
  • Applies principles of patient safety to provide a safe, effective care environment.
  • Uses available health care and information technologies in accordance with agency policies and procedures.
  • Integrates clients’ cultural, racial, socioeconomic, religious, and lifestyle preferences into nursing assessments, interventions (including teaching), and referrals
Compare the student's performance to expected level of performance of a typical novice nurse and select one of the following:



Outcome 4: Upholding the professional standards (ANA, 2010):

  • Implements nursing interventions that improve patient safety and outcomes
  • Completes an effective evidence-based practice project
  • Consistently demonstrates leadership and ethical behavior
  • Takes steps to enhance the therapeutic care environment
Compare the student's performance to expected level of performance of a typical novice nurse and select one of the following:



Outcome 5: Integrates the elements of the professional role: provider, designer/coordinator of care, and member of a profession:

  • Comes to clinical mentally and physically prepared to provide safe and effective care.
  • Delegates and supervises tasks appropriately
  • Demonstrates flexibility in adapting to changing situations.
  • Works collaboratively with others.
  • Contributes to a positive work environment
  • Recognizes the importance of utilization review, continuous quality improvement, and balancing available resources in health care management.
  • Takes initiative to obtain needed knowledge
  • Requests assistance when needed.
  • Integrates constructive feedback for improvement of professional practice
Compare the student's performance to expected level of performance of a typical novice nurse and select one of the following:








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