BON SECOURS MEMORIAL COLLEGE OF NURSING

BSN PRACTICUM EVALUATION TOOL

NUR 2103P: Competencies for Nursing Practice I

Student Name Semester/Year Faculty
Gina Varacalli Fall 2018
DC/A DC/C DC/S Obs. Alt. Exp. Other TOTAL
33 10 2 30 75
Total Practicum Hours Missed Midterm 0 Final 0

The purpose of the BSN Practicum Evaluation Tool at Bon Secours Memorial College of Nursing is to facilitate the process of student
evaluation in each practicum courses. The student will have multiple opportunities to meet these objectives throughout the semester.
Students are to complete a self-evaluation prior to meeting with faculty at midterm and final. The self-evaluation includes a self-rating for
each category (if not applicable: mark n/a) utilizing the rating scale below and a reflection that elaborates on strengths and opportunities for
growth. Faculty will provide a rating in each category and an overall evaluation at midterm and final. A 3 is required in all categories to
successfully pass practicum. If a student is not achieving the level of performance needed to pass the course at midterm (3), the student
and faculty will collaborate to create a plan of success. If the student is not achieving the level of performance need to pass the course at
final, the student will receive a grade of F in the course.

Expected Levels of Performance

4 - Above Expectations
● Demonstrates all the attributes of “3” meets expectations
● Functions consistently with minimum guidance in the practicum situation
● Recognized by staff, peers, patients, families or community as practicing above and beyond expectations for course objectives
● Engages consistently in self-direction in approach to learning
3 - Meets Expectations
● Functions satisfactorily with minimum to moderate guidance in the practicum situation
● Demonstrates accurate and appropriate knowledge and integrates knowledge with skills and attitudes among interdisciplinary team
members
● Occasional prompting for engaging in self-direction in approach to learning
● Provides evidence of preparation for all practicum learning experiences
● Follows directions and performs safely
● Identifies own learning needs and seeks appropriate assistance
● Demonstrates continued improvement during the semester
● Uses nursing process and applies scientific rationale
2 - Below Expectations
● Functions safely with moderate to extensive amount of guidance in the practicum situation
● Demonstrates adequate knowledge and requires moderate assistance in integrating knowledge with skills
● Requires some direction in recognizing and utilizing learning opportunities
1 - Does Not Meet Expectations
 Requires intense guidance for the performance of activities at a safe level
 Practicum performance reflects difficulty in the provision of nursing care

***Prior to placement of the student in a specific practicum environment, the practicum lead faculty ensures that the practicum site is an
effective learning environment that will allow students to demonstrate the required competencies of the pre-licensure nursing program.***

Curriculum Approval_08/03/17
 Bon Secours Memorial College of Nursing
BSN Practicum Evaluation Tool
Students will be evaluated in both the laboratory and practicum settings. Midterm Final
Student Faculty Student Faculty

1. Utilizes basic communication and collaboration skills in working with patients, their families, and other Rate 1-4
healthcare providers.
Basic communication with patients, families, and other healthcare providers is clear and complete in simple situations 4 3 4 4
Responds confidently when working with patients, families and team members in very simple situations 4 4 4 4
Completes documentation using EMR in an accurate, timely and legal manner 4 3 4 4
Provides a basic handoff report to staff members when leaving patient care assignments 4 3 4 4
Protects patient privacy and confidentiality of patient (HIPAA) at all times 4 3 4 4
2. Demonstrates caring behaviors in all nursing interactions according to the Catholic Healthcare Ministry. Rate 1-4
Focuses on the patient while providing nursing care 4 4 4 4
Encourages patient, significant others, and family participation in care 4 4 4 4
Responsive to patient needs 4 4 4 4
Maintains a non-judgmental attitude 4 4 4 4
3. Identifies principles of servant leadership and global health. Rate 1-4
Identifies and respects patient values, preferences, and needs 4 4 4 4
Recognize the importance of being a steward of resources 3 3 4 4
Explore cultural differences and preferences when providing patient care 4 3 4 4
Recognizes socio-economic, environmental, educational, cultural, and developmental factors that may influence care 4 3 4 4
4. Delivers safe, quality, patient-centered, evidence-based nursing care. Rate 1-4
Identifies obvious changes in patient assessment in simple situations 4 3 4 4
Prioritizes routine patient care within a designated time frame 4 3 4 4
Sorts simple data to develop appropriate evidence-based interventions for routine patient care 4 3 4 4
Able to perform basic nursing skills safely and accurately with minimal coaching 4 3 4 4
Satisfactory participation and/or performance in simulation 4 N/A 4 4
5. Demonstrates professionalism and readiness to learn. Rate 1-4
Demonstrate initiative in seeking learning opportunities 4 4 4 4
Independently performs basic self-reflection 4 4 4 4
Maintains professional attitude, behavior and appearance. 4 4 4 4
Demonstrates on time and satisfactory completion of written assignments 4 4 4 4
Demonstrates on time attendance to laboratory and practicum experience 4 4 4 4
Follows healthcare system and BSMCON policies and procedures 4 4 4 4

Curriculum Approval_08/03/17
 Student Midterm Reflection
In the section below, the student will provide a critical reflection on the growth in their knowledge, skills, and attitudes within the practicum to meet course
outcomes (i.e. communication, collaboration, caring, servant leadership, safe/quality care, professionalism). Students will note areas of strengths,
opportunities for growth, and a plan of action for the last portion of the practicum.
Today’s clinical experience (10/03/2018) offered me the experiences of documenting in the EMR , testing a patient’s blood glucose level, and
giving a bed bath to a quadriplegic person. Thus far, all of my clinical experiences have enabled me to strengthen my communication skills as
well as give compassionate care to all of my patients. I have been able to use my communication skills with fellow students, nurses, and my
instructor. This semester I have worked alongside fellow students as a team to care for patients. I feel confident in the skills I learned in the lab
setting. These skills have now been implemented in the clinical setting. I have been punctual and have worn the appropriate uniform in all clinical
and lab scenarios. I have treated all patients and fellow students/nurses/instructors with respect. As the second half of the semester proceeds, I
am hoping to learn and experience as much as I can. This semester has been exciting for me. I hope my positive attitude and enthusiasm will
keep me motivated for the remainder of this semester.

Student Final Reflection

In the section below, the student will provide a critical reflection on the growth in their knowledge, skills, and attitudes within the practicum to meet course
outcomes (i.e communication, collaboration, caring, servant leadership, safe/quality care, professionalism). Students will note areas of strengths and
opportunities for growth.
This semester has been a great learning experience for me. My instructor as well as the majority of the nurses and techs have been helpful
and encouraging. I feel comfortable and confident in the clinical setting. I have had to keep communication lines open to facilitate cooperation in
the clinical environment. I have worked with fellow students this semester as a team. I have assisted techs and nurses in delivering
compassionate care in the hospital. As this semester comes to an end, I feel energized by the skills I have learned this semester. I am confident in
my abilities to make patients feel that they are important and worthy of the quality care they are receiving. I feel confident in my abilities to give
medications according to protocol. I have treated fellow team members with respect. I have been punctual wearing the appropriate badge and
uniform. I am looking forward to next semester with all of the knowledge I will be acquiring.
Faculty Midterm Comments
In this section faculty will provide a response to the student reflection and provide any rationale to a rating that does not meet the level of expectation defined
on page1.
Gina has shown improvement each week in comprehension and execution of skills. She is attentive to each patient she serves and creates an
environment that promotes healing. I look forward to continuing to facilitate Gina’s learning this semester.
Faculty Final Comments
In this section faculty will provide a response to the student reflection and provide any rationale to a rating that does not meet the level of expectation defined
on page 1.
Gina has displayed progressive competence in patient care throughout this semester. She has shown compassion and caring with both patients
and colleagues and has been willing to share in post-conference to help enhance the education of her classmates. It has been a pleasure to be a
part of Gina’s nursing education and I hope to continue to play a part in helping her to continue to develop as a practitioner.
Evaluation
Midterm Grade Pass Final Grade Pass
(Pass or Fail) (Pass or Fail)
Student Electronic Signature/ Date Faculty Electronic Signature/ Date
Midterm Gina Varacalli 10/03/18 Midterm Kaitlin E Chidley MSN, RN 10/05/2018

Final Gina Varacalli 11/14/18 Final Kaitlin E Chidley MSN, RN 11/28/18

Skills checklist update: 11/28/18

Curriculum Approval_08/03/17