SCHOOL OF NURSING

BETTY WHITE HEALTH CENTER

Graduate Nursing Program

Graduate Nursing Program Advanced Adult/Gerontology Primary Care Nursing I, II, III Practicum Clinical Competency Evaluation

By completing the following form, preceptors evaluate the student's current achievement of the DNP Program Outcomes.

Semester/Year ___

Course ___

Student Name ___

Clinical Practicum Preceptor___

Faculty_____

Agency ___

Number of Clinical Hours with Preceptor

Evaluation Please Circle Midterm Final

PLEASE EVALUATE THE STUDENT'S PERFORMANCE BY SCORING EACH ITEM USING THE FOLLOWING CRITERIA:

Highly Competent Accurate performance without supervision. Utilizes appropriate consultation.

Competent Accurate performance with minimal supervision. Utilizes appropriate consultation.

Competent but Infrequently inaccurate. Requires direct

Needs Practice supervision. Utilizes appropriate consultation.

Unsatisfactory Inaccurate most of the time. Requires direct Most of the time supervision. Depends on consultation.

*Asterisks indicate the expected performance level at the end of the clinical experience.