Part C: Clinical Education Objectives and ANMC Domain Booklet

Transcription

1 HCNUR 1141 Clinical Practice in Australia Clinical Practice Documentation Part C: Clinical Education Objectives and ANMC Domain Booklet RETURN TO PRACTICE/RE-ENTRY PROGRAM FOR DIVISION 1 REGISTERED NURSES (RTP/RPRN) and INITIAL REGISTRATION FOR OVERSEAS NURSES/PRE- REGISTRATION PROGRAM FOR OVERSEAS QUALIFIED NURSES (IRON/PPOQN) 1 (Non Award Program) ACCREDITED UNIVERSITY FOR DELIVERY School of Nursing University of Ballarat University Drive Mt Helen Vic August 2010 CRICOS CODE: F/069548E/071353J 1 These Programs may be identified by the NBV as Return to Practice & Initial Registration for Overseas Nurses

2 Students please note: This Clinical Education Objectives and ANMC Domain Booklet (Booklet) is to be read in conjunction with other documents relating to HCNUR 1141 Clinical Practice in Australia: Part A: Course Descriptor Part B: Student Information and Guidelines Governing Clinical Education At the end of this Course, the completed Clinical Education Objectives and ANMC Domain Booklet is to be photocopied. Both the original and photocopy submitted to the Course Coordinator, as directed or no later than 0900 on the last day of the Program. The original Clinical Education Objectives and ANMC Domain Booklet will be returned to the student, for use in their Curriculum Vitae when applying for employment. It is the responsibility of the student to safely maintain the Clinical Education Objectives and ANMC Domain Booklet both during the clinical placement, and when completed. Copies of Booklets (including the Appraisals) from the Partner Provider/University records will not be released to students. ii

3 TABLE OF CONTENTS 1. Introduction and Overview of Assessment and Evaluation Methods Introduction Assessing Clinical Competence ANMC Competencies Bondy Rating Scale Example of application of the Bondy Rating Scale (elements and ratings) Minimum Competency Rating Tools used to assist achievement of competency Personal Professional Reflective Journal (PPRJ) Development of Teaching and Learning Objectives Record of Clinical Educator / Preceptor / Division 1 Nurse who has supervised the student on clinical placement Guidelines for Facilitators/Preceptors/Clinical Educators in Health Care Agencies 8 2. Overview of Monitoring Student Progress, Assessment Procedures 9 and associated information. 2.1 Brief Overview Detailed Overview Confidentiality Agreement Specific Clinical Placement Learning Objectives Teaching and Learning Plan Psychomotor Psychosocial Skills/Interventions Clinical Feedback Summary Weekly Clinical Feedback summary Process if US (Unsatisfactory) rating is achieved Weekly Clinical Feedback Guidelines Clinical At Risk Report At Risk due to deficit in clinical skills/provision of care At Risk due to unprofessional conduct Teaching Assistance Request Clinical Appraisal Tools (Midway and Completion) Midway Clinical Appraisal Final/Completion Clinical Appraisal Anecdotal Notes Reflection/Evaluation of Clinical Experience Summary of the Process of Monitoring Student Progress. 17 iii

4 3. Clinical Placement Documentation Summary (Flowchart) of 19 monitoring student Progress Weekly, Midway and Completion Weekly Clinical Feedback Summary Guidelines ANMC Competency Domains Minimum Competency Rating for University of Ballarat Programs leading to NBV Division 1 Nurse in Victoria Example of application of the Bondy Rating Scale Clinical Placement Documentation Confidentiality Agreement Clinical Placement Overview Aim Specific Objectives Part A: Psychomotor and Psychosocial Knowledge/Skills/ 43 Interventions Outcome Objective Frequent specific Knowledge/Skills/Interventions 44 Part B: Psychomotor and Psychosocial Knowledge/Skills 48 Interventions.. Week 1-4 Documentation and Assessment Tools Teaching and Learning Plan Clinical Feedback Summaries Clinical Appraisal Tool: Midway Assessment Week 5-8 Documentation and Assessment Tools Teaching and Learning Plan 52 - Clinical Feedback Summaries Clinical Appraisal Tool: Final/Completion Assessment Record of the Registered Nurse Division Reflection/Evaluation of Clinical Experience Additional documentation 57 Anecdotal Note.. 58 Clinical At Risk Report Teaching Assistance Request. 62 Figures 1 Summary Flowchart of Monitoring of Student Progress 11 2 Process and Outcomes for Midway Assessment and Completion of Assessment 12 Tables 1 ANMC Competency Domains 4 2 Adapted Bondy Rating Scale 4 3 Example of application of the Bondy Rating Scale 5 4 Minimum competency Rating for University of Ballarat Programs leading to NBV Division nurse in Victoria 6 5 Overview of location of documentation relating to monitoring of student progress 10 6 Clinical Feedback Summary Guidelines 21 7 Example of the Bondy Rating Scale 26 iv

5 SECTION 1 INTRODUCTION AND OVERVIEW OF ASSESSMENT AND EVALUATION METHODS

6 1.1 Introduction Central themes This final course provides concentrated clinical practice learning experiences that prepare for entry level practice in the role of Division 1 registered nurse. The course contributes to the integration of theoretical and clinical concepts and their application in a health care environment. Students are required to demonstrate competency as per the ANMC (2006) National Competency Standards for the Registered Nurse: Professional and Ethical Practice; Critical Thinking and Analysis; Provision and Coordination of Care; and Collaborative and Therapeutic Practices. A particular focus of this course is for students to focus on their role as a safe and competent beginning practitioner. Objectives Following completion of this course the student will be expected to: Knowledge 1. Describe the scope of practice for a graduate/entry level practitioner as a Division 1 Nurse in Australia; 2. Synthesise information accessed from a range of sources; and 3. Describe the care and management of clients/patients with a range of conditions in a variety of settings. Skills 4. Demonstrate overall competency as per ANMC (2006) National Competency Standards for the Registered Nurse: Professional and Ethical Practice; Critical Thinking and Analysis; Provision and Coordination of Care; and Collaborative and Therapeutic Practices. Specifically: 5. Practice safety in the selected clinical agency; 6. Practice within a culturally competent, legal and ethical framework; 7. Develop a nursing care plan for a clients for whom they are allocated to provide care; 8. Demonstrate the ability to professionally document care appropriate both client and context; 9. Provide competent, holistic nursing care, appropriate to their level of preparation to clients in the selected clinical agency; 10. Demonstrate appropriate assessment of clients in their care; 11. Apply a problem solving approach to the care of the clients; 12. Apply pathophysiological, psychosocial and nursing skills/nursing practice knowledge in their nursing practice at the level of their preparation; 13. Demonstrate a complete and accurate handover of clients condition and care to oncoming staff; 14. Practice and use effective and professional communication skills with clients, their families, colleagues and other health professionals; 15. Demonstrate integration of knowledge, skills and attitudes through appropriate professional behaviour; 16. Identify situations that are beyond the limit of their level of preparation and experience and seek appropriate assistance; 17. Evaluate their own learning needs and identify their strengths and weaknesses; Course Graduate Outcomes 2 Continuous learning - they will be equipped with the skills, motivation and confidence to engage in continuous learning to meet the personal, professional and vocational challenges of an ever changing world; Self-reliance - they will possess the confidence, capability, assurance, independence and enterprise to enable them to fulfill their personal and career aspirations; Engaged citizenship - they will add to the productive capacity of the economy and be in demand and will be attuned to, and engage with, contemporary social and cultural issues and aspire to make meaningful and helpful contributions to local, national and global communities; Social responsibility - they will be aware of generally accepted norms of ethical 2 1

7 18. Demonstrate effective time management skills, flexibility, accountability, team work and ability to prioritise care; and 19. Demonstrates critical thinking and reflective practice skills Values 20. Reflect on the professional characteristics and attributes required by students completing a course leading to a Division 1 professional nurse behaviour and be encouraged to act in a socially responsible manner both in the work place and other settings. Content Relates to knowledge skills and values required of a beginning practitioner and enabling the meeting of the ANMC (2006) National Competency Standards for the Registered Nurse: Professional and Ethical Practice; Critical Thinking and Analysis; Provision and Coordination of Care; and Collaborative and Therapeutic Practices. o o 256 hours (32 hours per week x 8 weeks) of clinical placement, of which 75-80% is undertaken in an acute care setting (acute medical care and acute surgical setting) % may be undertaken in a range of other practice areas that will meet ANMC (2006) National Standards Competency for the Registered Nurses and have NBV recognition; and A minimum of 240 hour practicum (re entry program) and 280 hour practicum (initial registration program) focused on meeting ANMC competencies and standards to an independent level and enable registration as a Division 1 Registered Nurse in selected clinical agency(s). Direct contribution to ANMC (2006) competence development 3 Professional Practice 1. Practises in accordance with legislation affecting nursing practice and healthcare (Clinical Learning Objectives: 1,4,5,6). 2. Practices within a professional and ethical nursing framework (Clinical Learning Objectives: 14,15,19, 20). Critical Thinking and Analysis 1. Practices within an evidence-based framework. (Clinical Learning Objectives: 1,12). 2. Participates in ongoing professional development of self and others (Clinical Learning Objectives: 16, 17, 19, 20). Provision and Coordination of Care 1. Conducts a comprehensive and systematic nursing assessment (Clinical Learning Objectives: 7, 8,10). 2. Plans nursing care in consultation with individuals/groups, significant others and the interdisciplinary health care team (Clinical Learning Objectives: 7, 18). 3. Provides comprehensive, safe and effective evidence-based nursing care to achieve identified individual/group health outcomes (Clinical Learning Objectives: 2, 3). 4. Evaluates progress towards expected individual/group health outcomes in consultation with individuals/groups, significant others and the interdisciplinary health care team (Clinical Learning Objectives: 11,12,19,20). Collaborative and Therapeutic Practice 1. Establishes, maintains and appropriately concludes therapeutic relationships (Clinical Learning Objective: 14). 2. Collaborates with the interdisciplinary health care team to provide comprehensive nursing Care (Clinical Learning Objectives: 13,14,18)

8 Teaching Methods Specific clinical practice objectives, reflective practice, critical analysis of practice, demonstration of competency as per ANMC (2006) National Competency Standards for the Registered Nurse, use of evidenced based practice, clinical guidelines and policies and clinical teacher 1:8 and preceptor 1:1. Learning tasks and assessment Learning Tasks 1 Demonstrate appropriate assessment, planning, implementation and evaluation of safe nursing practice to a proficient level 2 Demonstrate appropriate assessment, planning, implementation and evaluation of safe nursing practice to the level prescribed Key: * Assessment tasks Clinical assessment Pass/fail Minimum ANMC competency* standards rating: Proficient **in all ANMC Competency Domains Clinical assessment Pass/fail Minimum ANMC competency* standards rating: Independent ** for ANMC Professional Practice; and Proficient ** for all other ANMC Competency Domains Course objective(s) addressed by this assessment task (AT) Addresses all course objectives (1 20) Addresses all course objectives (1-20) Weighting % 100% Competence (competency) is defined by the ANMC (2006) National Competency Standards for the Registered Nurse as the combination of skills, knowledge attitudes, values and abilities that underpin effective and/or superior performance in a professional/occupational area 4 ** Bondy Rating Scale 5 : contributes to objectivity of clinical competence and encompasses the (i)professional standards and procedures for the behaviour, (ii)qualitative aspects of the performance, and (iii) the assistance needed to perform the behaviour. 4 NBV, EXE POL021 AX 001 Standards for Course Accreditation 15 March, 2009, p.20 5 Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation Journal of Nursing Education, 22(9),

9 1.2 Assessing Clinical Competence The importance of objectively assessed clinical competence is paramount to the success of the student. The assessment tool used in this course is based on two separate mechanisms competencies, and a rating scale ANMC Competencies 6 The overall assessment tool used is the ANMC National Competency Standards for the Registered Nurse (2006). These Standards comprise four (4) core areas or domains of practice upon which each student is assess to obtain and retain registration, and provides the framework within which each nurse is expected to practice. Table 1: ANMC Competency Domains Number ANMC Competency Domains 1 Professional Practice 2 Critical Thinking and Analysis 3 Provision and Coordination of Care 4 Collaborative and Therapeutic Practice Source: Bondy Rating Scale 7 The second tool utilises the Bondy Rating Scale, a structured assessment tool for clinical practice. This tool outlines Five (5) levels of competence: independent, proficient, advanced beginner, beginner unsatisfactory; and Three (3) specific areas assessed for each level of competence: professional standards,quality of performance and assistance required. Further, the scales encompasses the following elements (i) Professional standards and procedures for the behaviour (ii) Qualitative aspects of the performance, and (iii) Assistance needed to perform the behaviour. Competency Rating Table 2: Adapted Bondy Rating Scale Overview of Bondy Elements: Note: Each level is assessed considering 3 areas*: Professional Standards (ii) Quality of Performance (iii) Assistance required 5 Independent Practices in a safe, accurate, co-ordinated and effective manner with little need for guiding cues 4 Proficient Practices in a safe, accurate, co-ordinated and effective manner with some need for guiding cues 3 Advanced Beginner Practices in a safe, accurate, co-ordinated manner most of the time with frequent cues required 2 Beginner Practices in a safe manner when continuous guiding cues are given 1 Unsatisfactory Unable to demonstrate safe practice, adequate knowledge base and/or professional behaviour X Not Applicable Not observed or not applicable Source: Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation Journal of Nursing Education, 22(9), Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation Journal of Nursing Education, 22(9),

10 1.2.3 Example of application of the Bondy 8 Rating Scale (elements and ratings) Five (5) levels of competence: independent, proficient, advanced beginner, beginner unsatisfactory; and Three (3) specific areas assessed for each level of competence: professional standards, quality of performance and assistance required. Table 3: Example of the Bondy Rating Scale 1. Professional Standards Independent = 5 Proficient = 4 Advanced beginner = 3 Beginner = 2 Unsatisfactory = 1 Safe client, nurse & others Safe Safe Not always safe Unsafe Accurate Accurate Accurate Not always accurate Inaccurate - knowledge base - professional vocabulary - communication, (verbal, non-verbal and written) - approach to various situations - psychomotor skills Appropriate effect* Appropriate effect* Effect &/or affect Effect &/or affect Effect &/or affect Appropriate affect* Appropriate affect* Difficulties at times Difficulties at times Poor *The students effect = achievement of intended purpose *The students affect = manner in which the behaviour is performed / demeanour 2. Quality of Performance Independent = 5 Proficient = 4 Advanced beginner = 3 Beginner = 2 Unsatisfactory = 1 - Exceptional coordination - Efficient & coordinated - Lacking efficiency and/or uncoordinated - Comprehension of - Comprehension of - Comprehension of knowledge evident knowledge beginning knowledge insufficient - Confident and relaxed - Confident - Anxious, appears confident - Time taken (proficient) - Time taken (acceptable) - Client Focused (always) - Client Focused (not on skill or task) (mostly) (can be distracted) 3. Assistance Required (Cues*) - Inefficient/ uncoordinated - Inefficient/ uncoordinated - Comprehension of - Comprehension of knowledge poor knowledge NIL - Not confident - Not confident - Time taken (slow) - Time taken (poor) - Time taken (unable to complete) - Focus more on the behaviour/self than client - Not client focused at all - No client focus Independent = 5 Proficient = 4 Advanced beginner = 3 Beginner = 2 Unsatisfactory = 1 - NO Cues required - Occasional supportive cues /an infrequent directive cue - Continuous directive cues are required Key: - Frequent directive cues are required in addition to supportive cues - Cues are so directive/continuous that the staff is now performing the task/skill CUES* Directive Cues refer to assistance/cues that give direction or correct the students performance / expression of knowledge. Directive cues can be verbal or physical. Supportive Cues - refer to cues that only reinforce or encourage a student s performance / expression of knowledge, but do not change or direct the performance. The LOWEST level of achievement in any of the three areas is the final score/rating. Accurately, confidently, with sound comprehension of knowledge (independent) but required one directive cue (proficient). Then the final score = Proficient 8 Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation Journal of Nursing Education, 22(9),

11 1.3 Minimum Competency Rating This interrelationship of ANMC Domains and Bondy Rating Scale is outlined in the following table and provides the minimum competency rating for this Program, which is the same required for final year students enrolled in the Bachelor of Nursing program, University of Ballarat. These minimum competency ratings enable consistency and quality between outcomes of Programs that lead to registration as a Division 1 Nurse in Victoria. ANMC (2006) DOMAINS* 1. Professional Practice 2. Critical Thinking & Analysis 3. Provision and Coordination of Care 4. Collaborative and Therapeutic Practice Table 4: Minimum Competency Rating for University of Ballarat Programs leading to NBV Division nurse in Victoria RPRN/POQN Bondy Rating Scale midway assessment (by end of week 4) RPRN/PPOQN final assessment (by end of week 8) BN** Yr 1 BN Y 2 BN Y 3 Semester 1 BN Y 3 Semester 2 Advanced Proficient Proficient Independent Beginner Beginner Advanced Beginner Proficient Proficient Beginner Advanced Beginner Proficient Proficient Beginner Advanced Beginner Proficient Proficient Key: * ANMC = Australian Nursing and Midwifery Council National Competency Standards for the Registered Nurse (2005) ** BN= Bachelor of Nursing RPRN/PPOQN midway and final assessment times and outcome to be achieved - Standard is equivalent to that of the Bachelor of Nursing (BN) for Year 3 Semester 1 and Semester Tools used to assist achievement of competency Personal Professional Reflective Journal (PPRJ) The PPRJ is a personal record maintained by the student and will not be viewed, or corrected, however feedback regarding thematic direction will be provided by the Preceptor/Clinical Educator/Course Coordinator. Maintaining a PPRJ enables the participant to Reflect on the experiences of the clinical placement; Critically analyse the experience; Develop teaching and learning plans to meet competencies; and Develop professionally, by considering how aspects/situations encountered may be managed differently in the future. Instructions: Continue using the Notebook commenced in HCNUR 1131 Contextual Nursing Practice in Australia each week of clinical practice to enable integration of theory and practice; Commence writing on the right page only; Leave the left page free for comments, based on ongoing reflection; Write responses to the following critical reflection and discussion topics and discuss responses with your Preceptor/Clinical Educator; With the support of the Preceptor/Clinical Educator, develop objectives and strategies for areas identified requiring further development; and Submit your Teaching and Learning Plan for the next week, to the Course Coordinator (each Friday in class). Critical reflection and discussion topics 6

12 1. Discuss the areas of professional practice where you think you are doing well and the areas you would like to improve (knowledge, skills and values/attitudes), with your Preceptor/Clinical Educator. 2. Critically reflect and review your practice in the clinical area and note areas for improvement, and develop appropriate objective and strategies to improve performance. 3. Critically reflect on interactions in the clinical setting and discuss how you approached/resolved any issue/s that may have occurred. 4. Summary question: If you were the Preceptor/Clinical Educator, how would you assess yourself, in relation to the four ANMC Domains this week? 1.5 Development of Teaching and Learning Objectives Concepts relating to writing objectives and strategies to ensure learning outcomes are discussed in HCNUR 1131 Contextual Nursing Practice in Australia. Objectives and relative strategies for the weekly HCNUR 1141 Clinical Practice in Australia Teaching and Learning Plan will be developed by the student, normally in consultation with the Preceptor/Clinical Teacher. The following Steps in developing the Teaching and Learning Plan are recommended. Students will work closely with the Preceptor/Clinical Educator, each step of the way. Step 1 Based on student reflections and outcome of weekly assessments, topic/areas to be improved are identified, and associated teaching, learning and resource needs; Step 2 Students specify the learning objectives they will need to achieve in order to meet the identified learning needs; Step 3 Participants will identify and outline the resources and strategies required to achieve the learning objectives; Step 4 Once steps one to three have been completed and agreed on by the student and Preceptor, evidence of accomplishment of objectives will need to be specified; Step 5 Criteria determining how evidence will be validated will need to be stated, including timelines for completion of objective(s); Step 6 The Teaching and Learning Plan is agreed to by the Preceptor and student, and subsequently signed and dated; Step 7 Implementation of the Teaching and Learning Plan; and Step 8 Evaluation of the Teaching and Learning Plan. Review and examination of supporting evidence is undertaken between the Preceptor and student. 7

13 1.6 Record of Clinical Educator/Preceptor/Division 1 Nurse who has supervised the student on clinical placement This Record of Supervision form is to be signed by the Clinical Educator, Preceptor, Division 1 Nurse who has supervised the student on any one day, throughout the clinical placement. 1.7 Guidelines for Facilitators/Preceptors/Clinical Educators in Health Care Agencies Guidance in the supervision and/or assessment of students in HCNUR 1141 can be obtained from the Course Coordinator of the Program, completion of Preceptorship Programs and health care agency Policies, Procedures and Guidelines. Clinical Educators/Preceptors should: View Part A: Course Descriptor (which contains references that may be useful) View Part B: Student Information and Guidelines Governing Clinical Education View Part C: Clinical Education Objectives and ANMC Domain Booklet; and further Access specific guidance regarding supervision and assessment of nursing students and associated professional responsibilities and accountability at the NBV website Specific documentation includes: ANMC Code of Ethics for Nurses in Australia; ( ANMC Code of Professional Conduct for Nurses in Australia; ( ANMC National Competency Standards for the Registered Nurse (2005) Guidelines: Delegation and Supervision for Registered Nurses and Midwives (2007); ( and Guidelines: Scope of Nursing and Midwifery Practice (2007); ( 8

14 SECTION 2 OVERVIEW OF: MONITORING STUDENT PROGRESS ASSESSMENT PROCEDURES AND ASSOCIATED INFORMATION 9

15 2. Overview of monitoring student progress, assessment procedures and associated information This area provides Information surrounding documentation required to commence clinical placement and monitoring of student progress, assessment procedures and associated information; Locations of associated documentation and additional copies are initially provided for quick reference; and Detail regarding each area identified. 2.1 Brief Overview Table 5: Overview of location of documentation relating to monitoring of student progress Area Location of associated Documentation Location of additional copies Summary (flowchart) of monitoring Section 2, 3 None Required student progress (Fig 1 and Fig 2) Confidentiality Agreement Section 4 Section 5 Specific Clinical Placement Learning Section 4 Section 5 Objectives Teaching and Learning Plan Section 4 Section 5 Psychomotor and Psychosocial Section 4 None required Skills/Interventions Weekly Clinical Feedback Summary Section 4 None Required (contains Performance Criteria) Weekly Clinical Feedback Summary Section 3 None Required Guidelines Students At Risk of not Section 4 Section 5 progressing/completing the course Teaching Assistance Section 4 Section 5 Clinical Appraisal tools Section 4 None Required Anecdotal Notes Section 4 Section 5 Record of staff supervising students Section 4 None Required Student Reflection/Evaluation of Clinical Experience Section 4 None Required 10

16 HCNUR 1141 CLINICAL PRACTICE IN AUSTRALIA Summary (Flowchart) of Monitoring Student Progress - WEEKLY Fig 1: Process and Outcomes of Normal Weekly Monitoring of Student Progress: Weeks 1 8 Develop and implement weekly objectives & strategies as per Teaching & Learning Plan ST/PR/CE Undertake Clinical Placement Demonstrate: Psychomotor & Psychosocial Knowledge/Skill/ Intervention Weekly Clinical Outcome= Satisfactory (S) Signed Confidentiality Document Feedback PR/CE/ST Continue process & refer to Overall & Specific Objectives ST (PR/CE) Outcome = Unsatisfactory (US) Key: PR = Preceptor CE = Clinical Educator CC = Course Coordinator ST=Student Normal progression in course Weeks 1-4 write an Anecdotal Note documenting each criterion rated US and develop a Teaching and Learning Plan (objectives, strategies, activities, resources, review date) in relation to the area assessed as US. Forward documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg. theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary. Weeks 5-8 write Complete Clinical At Risk Document noting each criterion rated US and develop a Teaching and Learning Plan (objectives, strategies, activities, resources, review date) in relation to the area assessed as US. Forward documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg. theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary. ST/PR/CE Note: If a student demonstrates unsafe practice or unprofessional conduct at any time, they must be immediately removed from the practice area, counselled and CC informed without delay. An at risk form must be completed as per requirements:, the matter must be described in relation to ANMC Competencies and specific examples provided. Students must not return to the clinical area until CC has met with the student, and full consideration given to progress in Course. CC will consult with UB Program Coordinator throughout this time. PR/CE/CC Outcome = Satisfactory (S) Outcome = Unsatisfactory (US) Complete Clinical at Risk Form & refer to CC immediately & at any time during 1-8 PR/CE CC will inform UB Program Co-ordinator PR/CE WEEKLY Monitoring 11

17 HCNUR 1141 CLINICALPRACTICE IN AUSTRALIA: Summary (Flowchart) of Monitoring Student Progress MIDWAY & COMPLETION Fig 2: Process and Outcomes for Midway Assessment and Completion of Assessment HCNUR 1141 Week 4 & By Week 8 Formal Assessment Complete: Midway Clinical Appraisal Tool (Week 4) & Final/Completion Clinical Appraisal Tool (by Week 8) PR/CE ANMC Competencies met at required level? YES ANMC Competencies met at required level? Continue Normal Weekly Monitoring (at Week 4) or Complete Course (by Week 8) PR/CE NO Course Coordinator may request a meeting with the student to discuss progress in Course PR/CE Key: PR = Preceptor CE = Clinical Teacher CC = Course Coordinator Normal progression in course Complete Clinical At Risk Document for achieving any rating less than required. Forwards documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary PR/CE MIDWAY AND COMPLETION MONITORING Continue Weekly Monitoring (Weeks 5-8) PR/CE If Final/Completion Assessment is US (by week 8) refer to UB Programs Manager for consideration of Academic Progress CC 12

18 2.2 Detailed Overview Confidentiality Agreement The Confidentiality Agreement is to be signed by the student, and the Course Coordinator or delegate prior to attending clinical placement. This Agreement is to be retained in this Booklet, as evidence of agreeing to the terms and conditions outlined, as relating to all clinical placements. Clinical Educators and Preceptors should check that the Agreement is signed, and that students are aware of their legal obligations. Students must take this Agreement with them to all clinical placements, along with all components of this Booklet, and any other documentation as directed Specific Clinical Placement Learning Objectives These clinical learning objectives provide the framework for clinical placement for all students. They are to be read in conjunction with the aims and objectives of HCNUR 1141 Clinical Practice in Australia and other Course Descriptors (aim, objectives and content) relating to the Program. Objectives are also to be related to the ANMC (2006) National Competency Standards for the Registered Nurse Teaching & Learning Plan Each student is expected to document their individual learning objectives and strategies to be implemented on the weekly Teaching and Learning Plan. This Plan may be utilised, in relation to weekly assessments or midway/final assessment, in the areas identified as unsatisfactory Psychomotor and Psychosocial Skills/Interventions Whilst undertaking clinical placement students will be expected to perform as many psychomotor skills listed within the Psychomotor and Psychosocial Skills/Interventions section as possible in an effort to meet objectives and consolidate their competence. Opportunities will be provided within the clinical environment to practice these skills and a final ANMC domain score will be allocated by the Preceptor/Clinical Educator, after discussion with the student. Although it is possible that not all skills are achieved, a considerable effort needs to be made to in the clinical environment to achieve a satisfactory level of clinical competence. Students may also undertake skills not covered in the specific objectives, or listed in the Psychomotor and Psychosocial Skills/Interventions. These skills/interventions can be documented in the area titled: Other Psychomotor and Psychosocial Skills/Interventions Clinical Feedback Summary Weekly Clinical Feedback Summary This Weekly Clinical Feedback Summary (contains performance criteria) form is used for monitoring student progress each week, enabling ongoing, documented, and formative assessment of Students, and provides an opportunity for supportive feedback from Clinical Educators, and Course Coordinators. The Weekly Feedback Summary Guidelines assist with determining the rating of Satisfactory (S) or Unsatisfactory (US) against each performance criteria outlined in the Weekly Clinical Feedback Summary. These Guidelines provide a sound foundation to base initial and ongoing assessment of students, and clear guidance to areas in need of improvement. If a particular criteria is not observed, this is indicated by N. 13

19 Process Clinical Educators will discuss progress with students and award either S (Satisfactory), US (Unsatisfactory) or N (Not Observed) to each performance criterion at the end of each week. Based on the outcome of the assessment, the Clinical Educator will provide guidance about the ways in which the student could improve upon their current practice for the coming weeks or demonstrate the practice awarded N. This guidance is to be written as objectives and strategies, on the Teaching and Learning Plan, and an Anecdotal Note written. Outcome It is envisaged that the majority of students will meet satisfactory performance (S) on most of the criteria listed for each weekly summary. The overall aim is for students to meet the required competence level at the formal midway and final/completion assessment. However if students have not been successful in achieving an S rating, the following process is to be followed Process if US (Unsatisfactory) rating is achieved Weeks 1-4 Students receiving an US rating for any performance criteria during Weeks 1-4 must have an Anecdotal Note completed indicating the specific ANMC Domain that relates to the criterion. Weeks 5-8 Students receiving an US rating during weeks 5-8 must have an At Risk form completed. In the event that a discrepancy arises, a discussion may take place that enables the student and Clinical Educator to reach an equitable outcome. However, the Clinical Educator will always make the final assessment based on the discussion, forming the final grade S or U/S to allocate to the student Weekly Clinical Feedback Guidelines The aim of these Guidelines is assist Clinical Educators and Preceptors to interpret the performance criteria outlined in the Weekly Clinical Feedback Summary document (outlined above). The statements listed in the Guidelines are intended as a guide only and should not be used in a prescriptive or encompassing manner. Each criterion is numbered and the information (dot points) may be used for interpretation, grading and to assist student feedback Clinical At Risk Report This form is to be used if a student is considered to be unsatisfactory (US): At the midway/completion assessment, or In any of the performance criterion during Weeks 4-8 Process If the rating of US is awarded: A Clinical at Risk Report is to be completed and specific example(s)/exemplars provided. These exemplars are to be directly related to the Performance Criteria outlined in the Weekly Clinical Summary Guidelines and the specific ANMC domains. The Clinical at Risk Report is to be signed by both the Preceptor/Clinical Educator, and the student and forwarded (faxed) to the Course Coordinator; and 14

20 The Clinical Educator must immediately inform the Course Coordinator by telephone regarding the matter identified at risk At Risk due a deficit in clinical skills/provision of care The Clinical at Risk Report enables the Clinical Educator to expand upon those areas where the student is deemed unsatisfactory and in need of improvement. In the event that a student is deemed at risk relating to clinical skills the student must be Counselled, and appropriate the area of unsatisfactory practice documented and a Teaching Assistance Request can be implemented (see below); and Following discussion with the Course Coordinator, the Clinical Educator will develop teaching and learning strategies with the student, utilising an additional Teaching and Learning Plan or a specific learning contract provided by the Course Coordinator, with the aim for the student to improve in the area identified as unsatisfactory At Risk Due To Unprofessional Conduct If unsafe or unprofessional conduct is demonstrated at any time during the clinical practice placement, the Student must immediately be removed from the practice area and a Clinical At Risk Report completed by the Preceptor/Clinical Educator and the Course Coordinator contacted for progress advice; and Student must not return to the clinical area until authorised by the Course Coordinator to do so; and the Course Coordinator will meet with the student, and progress will be determined Teaching Assistance Request It is expected that students will practice /demonstrate clinical skills/interventions in the clinical area under the supervision of the Clinical Educator/Preceptor. However, if the Clinical Educator/Preceptor deems that the student requires additional support other than what they can provide in the clinical area, a Teaching Assistance Request is to be completed, and forwarded to the Course Coordinator. Whilst the laboratory is available for student use throughout the course, students are encouraged to practice their skills in context under the supervision of the Preceptor/Clinical Teacher, in the clinical area Clinical Appraisal Tools (Midway and Completion) The Clinical Appraisal Tools used in this course has been outlined in Section 1. The bold numbers on the Clinical Appraisal Tools (mid-way assessment and the completion assessment) indicate the expected level of competency performance for each ANMC Domain Midway Clinical Appraisal Clinical Educators and Students will discuss the competency criteria listed, and both allocate the perceived rating achieved. Including student self assessment enables discussion of discrepancies and perceptions at the time of assessment. The outcome of student and Clinical Teacher s assessment also provides the basis for the completion of an At Risk Report and development of a teaching and learning plan. Process if a rating less than required is achieved in any ANMC Domain If a student is assessed as achieving a rating less than required for any ANMC domain the Clinical Educator will: Complete a Clinical at Risk Report indicating the area/domain/specific criteria that student is not yet achieving to the required level, and provide an exemplar. 15

21 Contact the Course Coordinator regarding students who do not meet the expected level in any of the ANMC Domains to ensure objectivity, and a base line for implementing any subsequent required strategies and interventions; and Develop appropriate strategies and interventions to achieve expected outcomes (including counselling of student), and confirm with the Course Coordinator Final/Completion Clinical Appraisal Clinical Educators and Students will discuss the competency criteria listed, and both allocate the perceived rating achieved. However, the rating awarded by the Clinical Educator is the final rating for the domain assessed. The Course Coordinator will award the overall rating for HCNUR 1141 based on overall assessment outcomes. The overall rating achieved will be either C (Competent achievement of required level in all ANMC Domains) or NC (Not Competent achieved less that the required level, in any ANMC Domain). The final rating (C or NC) is required to be ratified by the University of Ballarat, Academic Programs Committee before the final grade is confirmed/awarded for the course. Process if US (Unsatisfactory) is awarded in final/completion assessment If a student is assessed as NC (that is, one or more ANMC Domains have been assessed as less than the level of achievement required) the Clinical Educator will: Complete a Clinical at Risk Report indicating the area/domain/specific criteria not yet competent and provide an exemplar; Contact the Course Coordinator regarding any students who do not meet the expected level in any of the ANMC Domains to ensure objectivity, and a base line for implementing an subsequent required strategies and interventions; and Suggest recommendations, and confirm with Course Coordinator. Develop appropriate strategies and interventions to achieve expected outcomes (including counselling of student). The Course Coordinator will Meet with the student, provide counselling and continually monitor student progress; and Inform the University Program Manager of progress in the area NC, who will provide input and supervision where required, and ensure University processes in relation to monitoring students at risk are implemented. The University Program Manager will also inform the NBV regarding outcome of final assessment, and recommendations Anecdotal Notes An Anecdotal Note is to be completed at any time during the course, and in particular, during Weeks 1-4 to highlight areas of difficulty, or unsatisfactory practice, and ensure timely interventions. A particular example/exemplar of the issue/problem must be documented, and how this example relates specifically to the ANMC Domains. This ensures objectivity, and a base line for implementing required strategies. 16

22 These Anecdotal Notes may also be used by clinical educators/preceptors/ward staff to provide positive feedback on students who are performing in the clinical area to a level beyond expectation, or in a particular instance that indicates an exceptional demonstration of professionalism. This feedback may contribute to determining if a student is eligible to be considered for undertaking clinical placement in a speciality area. To ensure privacy Anecdotal notes written of a confidential nature (for example counselling relating to a person issue/nature) must be written on an additional form and forwarded in a sealed envelope to the Course Co-ordinator. These type of confidential notes must not be retained in this Clinical Education Objectives and ANMC Domain Booklet. 2.3 Reflection/Evaluation of Clinical Experience Students complete this evaluation form and reflect on their experiences in the clinical area in relation to the knowledge, skills, values, confidence and competence acquired, and discuss with the Clinical Teacher. 2.4 Summary of the Process of Monitoring Student Progress A visual representation (flowchart) of the process of monitoring student progress, possible outcomes, associated documentation and reporting mechanisms is provided in Fig 1 and Fig 2 (following). 17

23 SECTION 3 QUICK REFERENCE: MONITORING OF STUDENT PROGRESS FOR USE BY STUDENTS AND CLINICAL EDUCATORS/PRECEPTORS 18

24 3.1 Summary (Flowchart) of Monitoring Student Progress - Weekly Summary (Flowchart) of Monitoring Student Progress - WEEKLY Fig 1: Process and Outcomes of Normal Weekly Monitoring of Student Progress: Weeks 1 8 Develop and implement weekly objectives & Undertake Clinical Placement Weekly Clinical Outcome= Satisfactory (S) Signed Confidentiality Document strategies as per Teaching & Learning Plan ST/PR/CE Demonstrate: Psychomotor & Psychosocial Feedback PR/CE/ST Continue process & refer to Overall & Specific Objectives Knowledge/Skill/ Intervention ST (PR/CE) Outcome = Unsatisfactory (US) Key: PR = Preceptor CE = Clinical Educator CC = Course Coordinator ST=Student Normal progression in course Weeks 1-4 write an Anecdotal Note documenting each criterion rated US and develop a Teaching and Learning Plan (objectives, strategies, activities, resources, review date) in relation to the area assessed as US. Forward documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary. Weeks 5-8 write Complete Clinical At Risk Document noting each criterion rated US and develop a Teaching and Learning Plan (objectives, strategies, activities, resources, review date) in relation to the area assessed as US. Forward documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary. ST/PR/CE Note: If a student demonstrates unsafe practice or unprofessional conduct at any time, they must be immediately removed from the practice area, counselled and CC informed without delay. An at risk form must be completed as per requirements:, the matter must be described in relation to ANMC Competencies and specific examples provided. Students must not return to the clinical area until CC has met with the student, and full consideration given to progress in Course. CC will consult with UB Program Coordinator throughout this time. PR/CE/CC Outcome = Satisfactory (S) Outcome = Unsatisfactory (US) Complete Clinical at Risk Form & refer to CC immediately & at any time during 1-8 PR/CE CC will inform UB Program Co-ordinator PR/CE WEEKLY Monitoring 19

25 Summary (Flowchart) of Monitoring Student Progress MIDWAY AND COMPLETION Fig 2: Process and Outcomes for Midway Assessment and Completion of Assessment HCNUR 1141 Week 4 & By Week 8 Formal Assessment Complete: Midway Clinical Appraisal Tool (Week 4) & Final/Completion Clinical Appraisal Tool (by Week 8) PR/CE ANMC Competencies met at required level? YES ANMC Competencies met at required level? Continue Normal Weekly Monitoring (at Week 4) or Complete Course (by Week 8) PR/CE NO Course Coordinator may request a meeting with the student to discuss progress in Course PR/CE Key: PR = Preceptor CE = Clinical Teacher CC = Course Coordinator Normal progression in course Complete Clinical At Risk Document for achieving any rating less than required. Forwards documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary PR/CE MIDWAY AND COMPLETION MONITORING Continue Weekly Monitoring (Weeks 5-8) PR/CE If Final/Completion Assessment is US (by week 8) refer to UB Programs Manager for consideration of Academic Progress CC 20

26 3.2 Weekly Clinical Feedback Summary Guidelines (To be consulted when determining weekly feedback for specific items listed on the Clinical Feedback Summary form) Clinical Educators / Preceptors/Registered Nurses are to complete a Weekly Clinical Feedback Summary at the end of each week the student is on a clinical placement; Anecdotal Notes are used for providing students with positive feedback and areas of improvement including an unsatisfactory (US) grade in the student s weekly report. All unsatisfactory grades must be supported by outlining a specific example as to why the U score was achieved. This example is to be directly related to the ANMC (2006) Competencies. When an US grade is awarded, the Weekly Clinical Feedback Summary is to be photocopied and sent to the Course Coordinator immediately with the attached Anecdotal Note and Teaching Learning Plan which outlines the objectives and strategies to be implemented to convert the score from U to S (Satisfactory). In the event that the student is demonstrating unsafe practice or unprofessional conduct, the student is to be immediately removed from the clinical area, The Course Coordinator is to be notified immediately of the counselling undertaken, and a Clinical At Risk Report completed, in addition to the documentation outlined above. The student will not return to clinical practice until approved to do so by the Course Coordinator or/and the University Program Manager. The following statements are provided to help educators interpret the Performance Criteria on the Weekly Clinical Feedback Summary form. The statements are intended as a guide only and should not be used in a prescriptive or all encompassing manner. It is envisaged that the majority of students would meet satisfactory performance on clinical placement. A small number of students may receive an unsatisfactory grading for one or more criteria. Each criterion is numbered and the following dot points may be used for interpretation, grading and to assist student feedback. Table 6: Weekly Clinical Feedback Summary Guidelines 1 Adheres to School of Nursing Attendance Policy ie. Attends for required clinical hours, notifies appropriate person regarding absence: Student is on time for aspects of NCHUR0031 Meets at appropriate place; If absent: o Informs the Course Coordinator if absent from theoretical class o Informs Clinical Educator and RN prior to the commencement of the shift or the Course Coordinator on a Friday prior to the commencement of class. o Absence is valid (i.e Supported by medical certificate or other appropriate, documentation) and same is forwarded to the Course Coordinator. o Completes the University absentee form and forwards same to the Course Coordinator. 2 Adheres to University and School policy (excludes Criteria 1 - Attendance Policy). Individual clinical placement objectives developed and brought to the clinical placement from Day 1 onwards and each theoretical class Objective and Domain booklet maintained, available for sighting and use on clinical placement and theoretical classes. Wears correct uniform and adhered to dress code as per School of Nursing Handbook, ID requirements met (ID card and name badge worn); Has current Police Check available for sighting on request both on clinical placement, and theoretical class. 21

27 3 Demonstrates appropriate professional conduct: Conducts self in accordance with professional requirements; i.e. Professional Code of Conduct; Adheres to the University Student Confidentiality Policy; Demonstrates respect for others; Boundaries of professional practice maintained; and Appropriate clinical language used including the use of English. 5 Accepts and integrates constructive criticism: Accepts information/criticism provided by Clinical Educator/Registered Nurse; Works to integrate information/criticism into practice; Listens to the issues presented, is not argumentative or defensive to constructive criticism; and Demonstrates self perception and focuses on the issues identified and works to implement strategies. 7 Provides appropriate support to peers and colleagues: Participates as a member of the team; Demonstrates respect to others; Acknowledges the rights of others - individuality; Is non-judgmental of others; Shows support to others as required; Allows others to speak in turn; and Actively listens. 4 Practices within own abilities/ knowledge level and recognises own limitations: Practices nursing at the level of student enrolment; Seeks help when care is beyond limitations; Requests RN supplementation to care requirements; and Excuses self from requested care requirements if they exceed the student level of learning. Demonstrates being resourceful by identifying strategies to overcome the limitation in skill or knowledge. 6 Demonstrates effective interpersonal skills: Discusses client care with RN/Clinical Educator; Demonstrates the ability to work as part of a team; Integrates confidentiality and privacy concepts into relationships; Questions practice using a positive approach; Shows courtesy to others, respects others in group meetings; Demonstrates appropriate behaviours in for example, group counselling sessions, debrief sessions, team meetings, etc; Proactive in establishing a therapeutic relationship; and Proactive in establishing a professional relationship. 8 Participates in ward/health service activities e.g. handover, ward rounds: Provides/receives handover for allocated clients; Notates care requirements from handover; Practices according to facility requirements; and Engages in activities as designated by the RN/Clinical Educator. 22

28 9 Cares for client in a holistic manner. Takes responsibility for allocated client/s to level of student enrolment; Bases practice on holistic care of client; Undertakes plan of care for allocated client; Incorporates care within a multidisciplinary framework; and Delegates care appropriately, seeking assistance from RN/Clinical Educator for additional care of client. Demonstrates cultural sensitivity and cultural competence 11 Bases practice on current knowledge and skill level. Practices according to level of student enrolment; Identifies deficits & strategies to meet skill requirements; Seeks assistance/guidance as required; and Applies theoretical knowledge to the clinical setting Resourceful and practices in accord with evidence based practice Critically analysis information and identifies gaps in clinical practice and considers/researches best practice and discusses with CE/RN in a positive manner. 13 Provides safe nursing practice consistent with client needs and plan of care. Nursing practice is consistent with client needs; Nursing practice meets goals of nursing as identified for client; Nursing practice meets ANMC standards of practice; Practices with supervision Considers and implements OH&S requirements; Recognizes an unsafe environment/practice and acts accordingly; Discusses unsafe practices in a positive way and excuses self from requested unsafe care practices, for example the non use of gloves in specific situations and seeks to gain evidenced based clarification Advocates for the client, and Considers the clients health care issues and potential needs. 10 Demonstrates an ability to apply and integrate knowledge in the practice setting. Incorporates prior learning into practice i.e. Previous knowledge/skills are cumulative in the care process eg. asepsis knowledge, medication knowledge, anatomy and physiology, etc; Demonstrates an ability to undertake nursing skills; and Able to apply theoretical concepts/best practice principles to practice. 12 Demonstrates effective time management. Prioritises care; Organises self-care requirements; Nursing care undertaken is accomplished in a timely manner; Acknowledges client time frame requirements; and Shows evidence of having practiced the clinical skills and Delegates care appropriately. 14 Consistently demonstrates effective oral and written communication: Student demonstrates satisfactory communication processes with clients, staff, colleagues, clinical educator, other personnel; Oral communication results in: Student being understood; Student undertaking verbal/written requirements; and Student undertakes instructions from the professional. 23

29 15 Consistently demonstrates appropriate professional documentation skills: Student documents all client care as per organisational policies; Documentation adheres to nursing professional standards; Care is documented accurately and immediately following the nursing activity; Documentation is legible, objective and accurate and complete; Utilises correct nursing forms and charts; and Adheres to confidentiality requirements and Privacy Act (2004). 16 Consistently practices within ethic/legal boundaries: Practice is ethically based as per Nurses Code of Ethics; Student safeguards the rights of individuals; Practice meets legal requirements; Practice conforms to: - Professional Code of Conduct; - Boundaries of professional practice; and ANMC standards. - Medication management is in accord with safe practice criterion. 17 Consistently demonstrates critical thinking skills, analytical skills and reflective practice skills Resourceful and practices in accord with evidence based practice Critically analysis information and identifies gaps in clinical practice and considers/researches best practice and discusses with CE/RN in a positive manner. Discusses strategies with the CE/PR to overcome identified gaps in clinical practice 24

30 3.3 ANMC Competency Domains: Quick Reference for Assessing Competencies Number ANMC Competency Domains 1 Professional Practice 2 Critical Thinking and Analysis 3 Provision and Coordination of Care 4 Collaborative and Therapeutic Practice Source: Minimum Competency Rating for University of Ballarat Programs leading to NBV Division Nurse in Victoria ANMC (2006) DOMAINS 5. Professional Practice 6. Critical Thinking & Analysis 7. Provision and Coordination of Care 8. Collaborative and Therapeutic Practice Bondy Rating Scale RPRN/POQN midway assessment (by end of week 4) RPRN/PPOQN final assessment (by end of week 8) BN Yr 1 BN Yr 2 BN Y 3 Semester 1 BN Y 3 Semester 2 Advanced Proficient Proficient Independent Beginner Beginner Advanced Beginner Proficient Proficient Beginner Advanced Beginner Proficient Proficient Beginner Advanced Beginner Proficient Proficient Key: * ANMC = Australian Nursing and Midwifery Council National Competency Standards for the Registered Nurse (2005) * BN= Bachelor of Nursing RPRN/PPOQN midway and final assessment times and outcome to be achieved - Standard is equivalent to that of the Bachelor of Nursing (BN) for Year 3 Semester 1 and Semester 2. Adapted Bondy Rating Scale Competency Rating Overview of Bondy Elements: Note: Each level is assessed considering 3 areas*: Professional Standards (ii) Quality of Performance (iii) Assistance required 5 Independent Practices in a safe, accurate, co-ordinated and effective manner with little need for guiding cues 4 Proficient Practices in a safe, accurate, co-ordinated and effective manner with some need for guiding cues 3 Advanced Beginner Practices in a safe, accurate, co-ordinated manner most of the time with frequent cues required 2 Beginner Practices in a safe manner when continuous guiding cues are given 1 Unsatisfactory Unable to demonstrate safe practice, adequate knowledge base and/or professional behaviour X Not Applicable Not observed or not applicable Source: Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation Journal of Nursing Education, 22(9), Example of application of the Bondy 9 Rating Scale (elements and ratings) Five (5) levels of competence: independent, proficient, advanced beginner, beginner unsatisfactory; and Three (3) specific areas assessed for each level of competence: professional standards, quality of performance and assistance required. 9 Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation Journal of Nursing Education, 22(9),

31 Table 7: Example of the Bondy Rating Scale 1. Professional Standards Independent = 5 Proficient = 4 Advanced beginner = 3 Beginner = 2 Unsatisfactory = 1 Safe client, nurse & others Safe Safe Not always safe Unsafe Accurate Accurate Accurate Not always accurate Inaccurate - knowledge base - professional vocabulary - communication, (verbal, non-verbal and written) - approach to various situations - psychomotor skills Appropriate effect* Appropriate effect* Effect &/or affect Effect &/or affect Effect &/or affect Appropriate affect* Appropriate affect* Difficulties at times Difficulties at times Poor *The students effect = achievement of intended purpose *The students affect = manner in which the behaviour is performed / demeanour 2. Quality of Performance Independent = 5 Proficient = 4 Advanced beginner = 3 Beginner = 2 Unsatisfactory = 1 - Exceptional coordination - Efficient & coordinated - Lacking efficiency and/or uncoordinated - Comprehension of - Comprehension of - Comprehension of knowledge evident knowledge beginning knowledge insufficient - Confident and relaxed - Confident - Anxious, appears confident - Time taken (proficient) - Time taken (acceptable) - Client Focused (always) - Client Focused (not on skill or task) (mostly) (can be distracted) 3. Assistance Required (Cues*) - Inefficient/ uncoordinated - Inefficient/ uncoordinated - Comprehension of - Comprehension of knowledge poor knowledge NIL - Not confident - Not confident - Time taken (slow) - Time taken (poor) - Time taken (unable to complete) - Focus more on the behaviour/self than client - Not client focused at all - No client focus Independent = 5 Proficient = 4 Advanced beginner = 3 Beginner = 2 Unsatisfactory = 1 - NO Cues required - Occasional supportive cues /an infrequent directive cue - Frequent directive cues are required in addition to supportive cues - Continuous directive cues are required - Cues are so directive/continuous that the staff is now performing the task/skill Key: CUES* Directive Cues refer to assistance/cues that give direction or correct the students performance / expression of knowledge. Directive cues can be verbal or physical. Supportive Cues - refer to cues that only reinforce or encourage a student s performance / expression of knowledge, but do not change or direct the performance. The LOWEST level of achievement in any of the three areas is the final score/rating. Accurately, confidently, with sound Comprehension of knowledge (independent) but required one directive cue (proficient). Then the final score = Proficient. 26

32 SECTION 4 CLINICAL PLACEMENT ASSESSMENT DOCUMENTATION Acknowledgement The documentation contained in this section is a combination of documentation specifically developed for the RPRN/PPOQN, and that used by the existing (BN) (currently accredited with the NBV). 1. Documentation specifically developed for students enrolled in the PPOQN/RPRN, undertaking HCNUR 1141 Clinical Practice in Australia: a. Specific Objectives relating to clinical practice; and b. Student Evaluation of their learning in the clinical area 2. Some documentation used in the Bachelor of Nursing, has been adopted in total, or with slight modification, for example, the Clinical Appraisal Tools (midway and final/completion). 27

33 Please note: On completion of this Section (along with any additional documentation used) is to be photocopied, and submitted to the Course Coordinator. The photocopied documents will be retained on the student file, for Nurses Board Victoria (NBV) reference. Students are to complete the following before photocopying the document: Name of Student: Student ID Number: Intake Number: Signature: Date: 28

34 4.1 Confidentiality Agreement BETWEEN: SCHOOL OF NURSING, University of Ballarat, of University Drive, Mt Helen Victoria ( the University ) and THE STUDENT... ( the Student ) Print Name RECITALS: A. The Student is a student of the University who is undertaking external clinical placement that will form part of their course work with the University. B. To protect Confidential Information which may be disclosed to the Student in relation to the clinical placement, the Student has agreed to the following terms and conditions. AGREEMENT: 1. Definitions: Agency means the external Hospital or Health Care Centre where the clinical placement is being conducted; Confidential Information means any information whether written or oral provided by one party to another party on or after the date of this agreement in connection with the clinical placement including without limitation any clinical information on patients and of other information concerning the Agency which is deemed confidential. 2. All information submitted by the Agency to the Student, shall be kept confidential and shall not be disclosed to any other party without the prior written consent of the Agency. 3. The Student agrees to comply with any terms and conditions under which the clinical placement is conducted particularly relating to their duty of confidentiality under Section 141 of the Health Services Act. 4. In the event the Student requires access to current and archival patient medical records for the purposes of formal research the Student will seek approval from Agency s Ethics Committee before commencing such research. 5. This agreement shall be governed by and construed in accordance with the laws of the State of Victoria. Executed as an Agreement. Dated this...day of Signed by the Student... Signature In the presence of: Name of Academic Staff Member teaching in Designated Course and Signature 29

35 4.2 Clinical Placement Overview The specific objectives in this section build on the overall course objectives for HCNUR 1141 Nursing Practice in Australia. These specific objectives are targeted to the care and management of patients/clients in acute medical settings and acute surgical settings in accordance with the 2008 Nurses Board Victoria Standards for Course Accreditation for this Course. These objectives also provide the framework for completion of the identified psychomotor and psychosocial knowledge/skills/interventions outlined in this Booklet, and the opportunity to integrate all content related to the Program being undertaken, for example the Australian health care system and services provided. The use of a reflective journal is required, and demonstration of critical thinking and analytical skills in the provision of evidenced based, professional care. Objectives relate to aspects of the following areas: 1. Orientation at health care facilities 2. Principles of resuscitation 3. Basic cardiac monitoring 4. Disease/trauma processes and provision of care 5. Care in context Peri-operative care, prominent surgical conditions and provision of care Prominent medical conditions and provision of care 8. Prominent chronic illness and provision of care Mental health and provision of care 10. Aged care, residential care and provision of care 11. End stage illness and provision of care 12. Quality improvement and associated concepts As patients in acute medical settings and acute surgical settings often have diagnosed medical conditions other than those admitted for, objectives and subsequent knowledge/skills/interventions should be viewed in this light. For example, a patient diagnosed with an acute medical condition, may also have a chronic medical condition(s), or a diagnosed mental health condition that needs to be managed whilst in hospital. Likewise, a patient from a non English speaking background, admitted for minor surgery, may have been transferred from a residential aged care facility, and require rehabilitation on discharge. The combinations of situations are endless. Whilst the objectives listed (and the associated knowledge/skills/interventions) relate to nursing care and management of a patient(s) with acute medical and surgical conditions, much of this is applicable in other nursing practice areas, such as community care, rehabilitation, sub-acute and geriatric assessment and evaluation courses, mental health facilities and aged care residential facilities. The School of Nursing recommends that students maximise their learning opportunities in all theoretical and clinical environments, to provide comprehensive professional care to a range of situations, and across the life span. 10 Includes cultural competency (indigenous, multicultural) 11 Includes rehabilitation 12 Includes community (as well as objectives relating to aged care, end of life care and mental health) 30

36 Objectives may be met in a group or individual situation, normally in the clinical area. However, some objectives may be met in the classroom. For example, discussion surrounding nursing care and nursing management of certain conditions or concepts surrounding end of life care may be met in a classroom situation. The following objectives are to be met, and signed off accordingly prior to submission of documents on completion of the course, or as directed Aim The overall aim of the clinical placement is for students to demonstrate competency in the Australian Nursing and Midwifery Council National Standards for the Registered Nurse (2006), to the required level outlined in the Course Descriptor and Clinical Assessment Tools, to enable eligibility for registration as a Division 1 Nurse in Victoria Specific Objectives Objective 1 During the Course, students will complete a hospital orientation at the commencement of clinical placement in each organisation. Thereafter, students will demonstrate an understanding of aspects listed. To include: Health and Safety protocols (including infection control, manual handling equipment, fire) Hospital/Nursing care policy procedure, guidelines and documentation Information technology requirements Function of the specific unit/ward/hospital in which they are undertaking Clinical Placement Role of the staff in assessing and meeting patient needs Other orientation/induction procedures/protocols/equipment including that relating to emergency situations (eg bomb) and cardio pulmonary resuscitation situations Satisfactory Unsatisfactory Comments:. Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date

37 Objective 2 Students will discuss principles related to patient resuscitation with the Clinical Educator/Preceptor To include: Principles related to the DRABC algorithm of resuscitation within an acute / sub-acute care setting, including all aspects of the algorithm as well as principles and practice of fluid resuscitation. Satisfactory Unsatisfactory Comments:..... Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date Objective 3 Students will develop an understanding of basic cardiac monitoring and develop skills in recognising common ECG anomalies. Students will discuss with the Clinical Educator/Preceptor, relating to ECGs To include: Preparing a patient for ECG monitoring (correct placements of electrodes) Recognition of normal sinus rhythm and factors that might impact on the accuracy of the ECG recording. Recognition of some of the common abnormalities including: Atrial fibrillation Ventricular ectopics Ventricular tachycardia; Ventricular fibrillation. Signs of myocardial infarction Satisfactory Unsatisfactory Comments:... Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date

38 Objective 4 Students will discuss with the Clinical Educator/Preceptor disease/trauma processes and relevant nursing and medical management. To include: Acute respiratory failure Shock Myocardial infarction Multiple trauma patient Burns Management of the person with altered conscious state Epilepsy / seizures Satisfactory Unsatisfactory Comments:.. Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date

39 Objective 5 Students will participate in patient care, and under supervision (Preceptor/Clinical Educator) undertake comprehensive assessment, nursing care and nursing management of patients allocated during clinical placement. Students will demonstrate the ability to provide nursing care and management of 4 patients on any one shift allocated to the level required. During this time, students will complete the evidenced based, Psychomotor and Psychosocial knowledge/skills/intervention activities listed. To include: Cultural sensitivity and cultural competence. Skills utilised in patient assessment. Obtaining a nursing history. Assessment of patient/family physical and psychosocial needs. Use of patient flow observation charts and other documentation, nursing including progress notes. Specific nursing care and management appropriate to patients/clients being cared for. Knowledge of continuity of care, including discharge planning and community services. Roles of the interdisciplinary team members. Participating in handovers and ward rounds. Demonstrates understanding of medical terminology and the relationship between the patient s medication and his/her condition. Identifies and performs specific nursing care with regard to specific medication. Accurately administers medication to each patient, and documents same in accordance with legal and professional requirements. Consistently demonstrates the use of infection control practices, including hand hygiene. In undertaking the above, the student will consistently demonstrate professionalism including: Reference to organisational policy, procedures. Critical, analytical and reflective practice skills. Cultural sensitive care (indigenous and multicultural), including the use of the interpreter service where required. Ethical, legal and accountability (including that related to documentation). Knowledge of and works within scope of practice. Identifies situations that are beyond the limit of their level of preparation and experience and seeks appropriate assistance. Time management skills including the ability to prioritise care, use of a written work plan, organisation of workload to be effective. Satisfactory Unsatisfactory Comments:. Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date

40 Objective 6 Students will observe, discuss and demonstrate knowledge in relation to peri operative care and some prominent surgical conditions. Students will discuss with the clinical educator, or staff if appropriate, disease processes and relevant nursing and medical management. Select surgical conditions Eye Surgery Orthopaedic surgery: Fractures, Knee Replacement, hip replacement Gynaecological surgery Urology Neurosurgery Cardiovascular surgery Renal surgery Gastro intestinal surgery Plastic Surgery Ear Nose and Throat Surgery Plus Any surgical conditions/procedures routinely performed in the health care facility where clinical placement is undertaken To include: Peri operative phase preadmission investigations, preparation and consent Assessment and plan of care Psychosocial support Post operatively, handover, reporting, monitoring, communication with family Acute pain assessment and management Patient and family education Use of appropriate resources including equipment Wound management Rehabilitation Continuity of care, including discharge planning Specific nursing care with regard to specific medication; and Medical terminology and the relationship between the patient s medication and his/her condition. Satisfactory Unsatisfactory Comments:.. Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date

41 Objective 7 Students will observe, discuss and demonstrate knowledge in relation to some prominent medical conditions. Students will discuss with the clinical educator, or staff if appropriate, disease processes and relevant nursing and medical management. Specific conditions Unconscious patient Renal disease: acute and chronic renal failure Reproductive changes: uterine prolapse / menopause / cancer Prostatic enlargement Angina / Myocardial infarction Plus Any medical conditions/procedures routinely performed in the health care facility where clinical placement is undertaken To include: Assessment and plan of care. Psychosocial support. Handover, reporting, monitoring, communication with family. Acute pain assessment and management. Patient and family education. Use of appropriate resources including equipment. Rehabilitation. Continuity of care, including discharge planning, community care. Specific nursing care with regard to specific medication; and Medical terminology and the relationship between the patient s medication and his/ her condition. Satisfactory Unsatisfactory Comments:.. Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date

42 Objective 8 Students will demonstrate knowledge in relation to the management of prominent chronic illnesses. Students will discuss with the clinical educator, or staff if appropriate, disease processes and relevant nursing and medical management. Specific conditions: Diabetes Osteo arthritis Chronic Pulmonary Disease Asthma To include: Obtaining a nursing history Nursing assessment and planning care Rehabilitation, mobility, ADL, referral to appropriate team members Nutritional status Skin integrity Poly pharmacy Sleep Cognitive status Hygiene needs Elimination Chronic pain assessment and management Patient family education Community/support services Aids/resources Specific nursing care with regard to specific medication; and Medical terminology and the relationship between the patient s medication and his/her condition. Plus Any chronic conditions and related procedures/interventions routinely performed in the health care facility where clinical placement is undertaken Satisfactory Unsatisfactory Comments:.. Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date

43 Objective 9 Students will discuss and demonstrate knowledge in relation to the care of the person with mental health conditions. Students will discuss with the clinical educator, or staff if appropriate, disease processes and relevant nursing and medical management. Specific conditions Substance abuse leading to mental health conditions Aggression - prevention and management Affective Disorders (depression, bipolar, suicide, psychosis and schizophrenia) To include: Philosophy attitudes and misconceptions Assessment - mental health status Family and nurse in partnership Therapeutic communication Impact of mental health condition on the client and family Continuity of care, including discharge planning, community care Purpose of community resources available or required to support individuals Critical, analytical and reflective practice skills Ethical, legal and accountability (including that related to documentation) Knowledge of and working within scope of practice Mental Health Act Psychopharmacology Plus Any mental health conditions and related procedures/interventions routinely managed in the health care facility where clinical placement is undertaken Satisfactory Unsatisfactory Comments:. Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date

44 Objective 10 Students will discuss and demonstrate knowledge in relation to aspects of aged care and residential care. Students will discuss with the Preceptor/Clinical Educator or staff if appropriate prominent care requirements. Specific areas Dementia Alzheimer s Disease To include: Philosophy, attitudes and misconceptions Communication and interview techniques Assessment/documentation Polypharmacy Functional decline including nutrition, falls, mobility, continence Ageism Continuity of care, including discharge planning to the community or residential care Ethical, legal and accountability (including that related to documentation) Knowledge of and working within scope of practice and with other nursing professionals (Division 2 and Division 3) and unregulated workers such as Personal Care Attendants Specific nursing care with regard to specific medication; and Medical terminology and the relationship between the patient s medication and his/her condition Legislative requirements specifically restrain and elder abuse Plus Any aspects relating to aged care routinely managed in the health care facility where clinical placement is undertaken Satisfactory Unsatisfactory Comments:.. Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date

45 Objective 11 Students will demonstrate knowledge in relation to the management of a person with an end stage illness and in particular, the grieving process. Students will discuss with the Course Coordinator, clinical educator, or staff if appropriate, disease processes and relevant nursing and medical management. Students will also explore their own feelings and beliefs regarding this area, and their nursing responsibilities in relation to patient s different cultural beliefs and attitudes, and expectations surrounding concepts of death and dying. Specific conditions and management Incurable Cancer Progressive non curable illnesses eg Motor Neurone Disease, Multiple Sclerosis Palliation and Hospice Care Including Philosophical approach, Enduring Power of Attorney, Guardianship, Advanced Directives Grieving Process Cultural sensitive care- - end of life beliefs Respite care Barriers to pain management Pain assessment and management Specific nursing care with regard to specific medication Non drug therapies Medical terminology and the relationship between the patient s medication and his/her condition and Models of care eg community, hospice, residential care, acute care And a discussion surrounding the following Nurses interact almost daily with clients and families experiencing loss. They care for dying clients and their families and they support families and friends after the client has died. Nurses responses and interactions in these situations are important for they assist clients and families create the climate for coping with loss and expressing grief. It is also important to note that nurses experience losses in their own lives, and that their response to these may shape their reactions to clients and families in the clinical setting. Issues surrounding the care of clients with chronic illness will be discussed, to deepen nursing knowledge in the management of these clients, and to provide an opportunity to confront personal issues in relation to the care of clients with chronic or terminal illness and their families, in a supportive environment. Discussion of experiences and feelings about dying, death and grieving. If students have concerns regarding caring for the dying client or coping with a situation where a client has just died, it is important to discuss this with Clinical Educators/Preceptors and colleagues Plus Any other aspect of terminal illness/grieving process that are relevant To be discussed with the Course Coordinator/Clinical Educator Discussed: Yes No Course Co-ordinator/Clinical Educator: Signature/Date:... Student: Signature/Date

46 Objective 12 Students will discuss with the Preceptor/Clinical Educator, and describe the role of the professional nursing in relation to quality improvement and associated activities. Specific quality improvement areas Quality improvement concepts Reporting techniques and accountability Including Demonstrates knowledge and appropriate skills in the following areas: Minimising risks eg. falls prevention and medication errors Reporting near misses and incidents Customer service and complaints management Completing a formal audit eg. environmental audit or medication chart audit and short report Plus Any aspects relating to quality improvement routinely undertaken in the health care facility where clinical placement is undertaken Satisfactory Unsatisfactory Comments:. Clinical Educator/Preceptor: Signature/Date:... Student: Signature/Date

47 PSYCHOMOTOR AND PSYCHOSOCIAL KNOWLEDGE, SKILLS AND INTERVENTIONS 42

48 4.3 Part A: Psychomotor and Psychosocial Knowledge/Skills/Interventions* (Mandatory or frequently related to Nursing Care and Management in Health Care Facilities) The following provides an outline of required (normal) nursing knowledge/skills/interventions relating to nursing care and management in the health care facility where clinical placement is undertaken, and those that must be achieved to a Proficient (4) level Outcome objective: Students will demonstrate* the following knowledge/skills /interventions to the level required The preparation, implementation and assessment of outcomes of the documented Psychomotor and Psychosocial knowledge and skills/interventions should be related to/guided by the objectives of this course, and all content discussed in the Program. * Knowledge/Skills/interventions may be achieved at ward/unit level or in post clinical discussions In completing the following knowledge/skills/interventions the following is to be demonstrated: 43

49 4.3.2 Frequent specific knowledge/skills/interventions Evidenced Based knowledge of: Demonstration* of evidenced based knowledge including: 1 Professional Critical, analytical and reflective skills Ethical, legal and accountability Professionalism Scope of Practice 2 Time Management Skills Utilises time management tools (eg. written work plan). Practice 1** Practice 2** ANMC Domain(s)* CE/PR Initial/Date Comments Organises work load to ensure planned care is effective Prioritises care of 4 patient 3 Documentation Displays an understanding of the legal implications Use of organisational policy and procedures, including approved abbreviation Demonstrate an understanding of commonly used medical terminology 4 Nursing Assessment (eg. admitting a patient) Health assessment skills across the life span. Psychosocial, cultural. Physical: inspection, auscultation, percussion, palpitation, interpretation of laboratory information & Accurate assessment and variations of vital signs and interpretation of other assessment information (including select laboratory information) Falls risk, continence, pain, pressure ulcer. Urinalysis ECG - preparation of patient, placing electrodes etc 5 Nursing Documentation Nursing history Assessment tools eg falls risk, pressure ulcer nursing progress notes fluid balance observation charts nursing care plan/pathways discharge continuous improvement/formal audit 44

50 6 Hygiene/Safety Principles and methods of infection control Hand hygiene Disposal of equipment Emergency procedures including fire and safety 7 Total patient care & bed sponge/shower Activities of daily living attention to all aspects of personal hygiene (ADL) maintaining a safe environment communication throughout the procedure Confidentiality, privacy and dignity, ADL s eg feeding Confidentiality, privacy and dignity maintained Safe transferring and ambulation of client, demonstrating minimal Lift techniques. 8 Medication knowledge Demonstrates understanding of the relationship between the patient s medication and his/her condition. Identifies and performs specific nursing care with regard to specific medication. Demonstrates safe administration of medication including knowledge 7 r s in accord with Hospital policies Patient education Documentation in accord with legal requirements and hospital policy 9 Injection administration subcutaneous intramuscular intravenous Uses appropriate sources to ensure evidence based practice eg compatibility and dilution drugs Utilised 7 rs to ensure safe practice 10 Management and maintenance of intravenous Setting up, priming of IV line/pump and maintaining IV infusion. therapy and blood Accurate monitoring of drip/pump rates transfusion: Discontinuation of IV Infusion removal of cannula. Documentation including fluid balance charts Blood transfusions: procedure for checking/changing/setting up/maintenance and potential risks 45

51 11 Management of diabetes Knowledge of hypoglycaemia management Proficiency in capillary blood glucose test and reportable levels Accurate drawing up/administration of insulin Knowledge of sites for administration of insulin Documentation and patient education 12 Oxygen, nebuliser administration and suctioning Displays knowledge of oxygen flow rates, equipment required administration of medications via a nebuliser Safety aspects 13 Peri-operative nursing Pre-operative nursing care of the client including physical/ psychological care Legal implications prior to procedure Preparation of environment for post-operative reception of client 14 Specimen collection Preparation of equipment and assist with venepuncture Urine, faeces, sputum Collection of swabs/samples and storage of same Lab notification and documentation 15 Pain assessment and Assesses pain as per the protocol management Documentation accurate Identifies appropriate interventions as required Reassess pain following intervention in a timely manner 16 Wound Management Preparation of the patient, equipment and environment Standard precautions Removal of drain tube Removal of wound closures Stomal care Simple wound dressings Documentation 17 Disease/Trauma processes Relevant nursing and medical management of: Acute respiratory failure, shock, myocardial infarction, multiple trauma patient, burns, patient with altered conscious state, epilepsy/seizures, nutritional support, eye disorders/surgery 46

52 18 Cardiac monitoring and ECG abnormalities 19 Basic Life Support (Cardiopulmonary resuscitation) 20 Mandatory knowledge and skills Preparing a patient for ECG monitoring (correct placement of electrodes) Recognition of normal sinus rhythm and factors that might impact on the accuracy of the ECG recording Recognition of some of the common abnormalities and signs of myocardial infarction. Principles related to the DRABC algorithm of resuscitation within an acute/sub-acute care setting, including all aspects of the algorithm as well as principles and practice of fluid resuscitation Care and management of acute respiratory failure, shock, myocardial infarction Infection control principles and hand hygiene Blood safe precautions Basic Life Support (BLS) Medication calculations and administration Safe manual handling techniques (No Lift/Smart Lift systems) Fire and safety procedures and protocols Key : CE/PR/RN Division 1 = Clinical Educator/Preceptor/Registered Nurse Division 1 * Students will determine the appropriate ANMC Domain, in conjunction with the PR/CE ** Students may not need practice and may complete competency at first attempt. If practice is undertaken, Student or Clinical Educator/Preceptor can sign this area. 47

53 4.3 Part B: Psychomotor and Psychosocial Knowledge/Skills/Interventions* (Implemented infrequently or are peculiar to specific Health Care Facilities). Nursing skills/interventions peculiar to your selected area of practice or those that are implemented on an infrequent basis and procedures/activities that may arise during your placement in which you can assist or participate in. These must be achieved to a Proficient (4) level remembering that knowledge and skills outlined relate to the ability to demonstrate or assist or discuss only* * Knowledge/Skills/interventions may be achieved at ward/unit level or in post clinical discussions Knowledge/Skill/Intervention Practice 1** Practice 2** 1.. Demonstrate correct procedure for checking/changing/setting up a blood transfusion and associated documentation 2. Discuss and display knowledge of blood transfusions including maintenance and potential risks 3. Assistance in maintenance of opioid infusion/pcas/ epidural and demonstrated knowledge of appropriate nursing care. 4. Assisted with invasive procedures eg(, LP, PICC line, NGT etc.).trachy, UWSD 5. Assists with performs complex wound dressings Discusses and displays knowledge of chronic wound management, including product knowledge. 6. Assists with/performs ECG, Recognition of life threatening abnormalities Ventricular Ectopic Ventricular Tachycardia Ventricular Fibrillation Signs of Myocardial Infarction 7. Bladder Management: Discusses and displays knowledge of: Bladder scan, female, urinary cathether Insertion, care of urinary catheter Management of bladder irrigation. 8. Stoma Care colostomy, gastrostomy & PEG feeds ANMC Domains* CE/PR Initial/Date 9. Other Key : CE/PR/RN Div 1 = Clinical Educator/Preceptor/Registered Nurse Division 1 * Students will determine the appropriate ANMC Domain, in conjunction with the PR/CE ** Students may not need practice and may complete competency at first attempt. If practice is undertaken, Student or Clinical Educator/Preceptor can sign this area. 48

54 Weeks 1 4 Documentation and Assessment Tools: Teaching and Learning Plan: Students to Develop one or more of these Plans for each week of Clinical Placement (Based on Feedback and Reflections) Student Name:.Student ID INTAKE: Week Number and Date Student Learning Objectives Teaching /Learning Strategies Domain Review or Completion Date* Outcome Outcome CE Signature/date: CE signature/ date: Student signature/date: Please sign and date all entries. Student signature/date: Please sign and date all entries. * Circle either Review or Completion. Review means that the outcome of Teaching and Learning is undertaken on this date. Completion means that the student has met the competency required and/or satisfactory outcome achieved. 49

55 Weeks 1 4 Documentation and Assessment Tools: Teaching and Learning Plan: Students to Develop one or more of these Plans for each week of Clinical Placement (Based on Feedback and Reflections) Student Name:.Student ID INTAKE: Week Number and Date Student Learning Objectives Teaching /Learning Strategies Domain Review or Completion Date* Outcome Outcome CE Signature/date: CE signature/ date: Student signature/date: Please sign and date all entries. Student signature/date: Please sign and date all entries. * Circle either Review or Completion. Review means that the outcome of Teaching and Learning is undertaken on this date. Completion means that the student has met the competency required and/or satisfactory outcome achieved. 50

56 Week 1 Documentation and Assessment Tools: Clinical Feedback Summaries (One form each for weeks 1-4) Section 1: Student Details (Student to complete section 1, CE/RN to complete sections 2 5) Surname: First name: Student ID No: Campus/ Partner Provider: Ward: From: / / to : / / CE/PR/RN Section 2: Attendance Record as per roster. (PR/CE initial each day attended. Attach documentation for absences* Week Monday Tuesday Wednesday Thursday Friday Days Absent* Section 3: State health requirements for clinical placements (Course Coordinator must complete) A. Domestic Students: Police Check/Working with Children Check YES /NO International Students: Student Visa or similar visa YES /NO B. Adult Vaccination Record: YES/NO Section 4: Performance Criteria (Refer the Clinical Feedback Guidelines) Professional Practice 1. Adheres to University Attendance Policy i.e. attends for required clinical hours, notifies appropriate person regarding absences 2. Adheres to University and School policies (excludes Criteria 1 Attendance Policy) 3. Demonstrates professional conduct and appearance. 4. Practices within own abilities/knowledge and skill level and recognises own limitations. Critical thinking and Analysis 5. Accepts and integrates constructive criticism. 6. Demonstrates effective interpersonal skills. 7. Provides appropriate support to peers and colleagues. 8. Participates in ward/health service activities eg. Handover, ward rounds. Provision and Coordination of Care 9. Cares for client in a holistic manner. 10. Demonstrates an ability to apply and integrate knowledge in the practice setting. 11. Bases practice on current knowledge and skill level. 12. Demonstrates effective time management. Collaborative and Therapeutic Practice Rating: S/US/N 13. Provides safe nursing practice consistent with client needs and plan of care. 14. Consistently demonstrates effective oral communication and written communication skills 15. Consistently demonstrates appropriate professional documentation skills. 16. Consistently practices within ethic/legal boundaries; and 17. Consistently demonstrates critical thinking skills, analytical skills and reflective practice skills Section 5: Overall performance rating (CIRCLE appropriate grade according to Performance Criteria) S=Satisfactory N = Not observed US= Unsatisfactory An Anecdotal note/at Risk form for any US grade, identifying a specific example for the US grading and a Teaching and Learning objective and strategies implemented Section 6: Preceptor/Clinical Educator Comments (if insufficient room, please continue on back of form) Student Signature Date: Preceptor/Clinical Educator Signature Date: A copy of this formative Clinical Feedback Summary is to be placed on the Student File (including any attachments). 51

57 Week 2 Documentation and Assessment Tools: Clinical Feedback Summaries (One form each for weeks 1-4) Section 1: Student Details (Student to complete section 1, CE/RN to complete sections 2 5). Surname: First name: Student ID No: Campus/ Partner Provider: Ward: From: / / to : / / CE/PR/RN Section 2: Attendance Record as per roster. (PR/CE initial each day attended. Attach documentation for absences* Week Monday Tuesday Wednesday Thursday Friday Days Absent* Section 3: State health requirements for clinical placements (Course Coordinator must complete) A. Domestic Students: Police Check/Working with Children Check YES /NO International Students: Student Visa or similar visa YES /NO B. Adult Vaccination Record: YES/NO Section 4: Performance Criteria (Refer the Clinical Feedback Guidelines) Professional Practice 1. Adheres to University Attendance Policy i.e. attends for required clinical hours, notifies appropriate person regarding absences 2. Adheres to University and School policies (excludes Criteria 1 Attendance Policy) 3. Demonstrates professional conduct and appearance. 4. Practices within own abilities/knowledge and skill level and recognises own limitations. Critical thinking and Analysis 5. Accepts and integrates constructive criticism. 6. Demonstrates effective interpersonal skills. 7. Provides appropriate support to peers and colleagues. 8. Participates in ward/health service activities eg. Handover, ward rounds. Provision and Coordination of Care 9. Cares for client in a holistic manner. 10. Demonstrates an ability to apply and integrate knowledge in the practice setting. 11. Bases practice on current knowledge and skill level. 12. Demonstrates effective time management. Collaborative and Therapeutic Practice Rating: S/US/N 13. Provides safe nursing practice consistent with client needs and plan of care. 14. Consistently demonstrates effective oral communication and written communication skills 15. Consistently demonstrates appropriate professional documentation skills. 16. Consistently practices within ethic/legal boundaries; and 17. Consistently demonstrates critical thinking skills, analytical skills and reflective practice skills Section 5: Overall performance rating (CIRCLE appropriate grade according to Performance Criteria) S=Satisfactory N = Not observed US= Unsatisfactory An Anecdotal note/at Risk form for any US grade, identifying a specific example for the US grading and a Teaching and Learning objective and strategies implemented Section 6: Preceptor/Clinical Educator Comments (if insufficient room, please continue on back of form) Student Signature Date: Preceptor/Clinical Educator Signature Date: A copy of this formative Clinical Feedback Summary is to be placed on the Student File (including any attachments). 52

58 Week 3 Documentation and Assessment Tools: Clinical Feedback Summaries (One form each for weeks 1-4) Section 1: Student Details (Student to complete section 1, CE/RN to complete sections 2 5). Surname: First name: Student ID No: Campus/ Partner Provider: Ward: From: / / to : / / CE/PR/RN Section 2: Attendance Record as per roster. (PR/CE initial each day attended. Attach documentation for absences* Week Monday Tuesday Wednesday Thursday Friday Days Absent* Section 3: State health requirements for clinical placements (Course Coordinator must complete) A. Domestic Students: Police Check/Working with Children Check YES /NO International Students: Student Visa or similar visa YES /NO B. Adult Vaccination Record: YES/NO Section 4: Performance Criteria (Refer the Clinical Feedback Guidelines) Professional Practice 1. Adheres to University Attendance Policy i.e. attends for required clinical hours, notifies appropriate person regarding absences 2. Adheres to University and School policies (excludes Criteria 1 Attendance Policy) 3. Demonstrates professional conduct and appearance. 4. Practices within own abilities/knowledge and skill level and recognises own limitations. Critical thinking and Analysis 5. Accepts and integrates constructive criticism. 6. Demonstrates effective interpersonal skills. 7. Provides appropriate support to peers and colleagues. 8. Participates in ward/health service activities eg. Handover, ward rounds. Provision and Coordination of Care 9. Cares for client in a holistic manner. 10. Demonstrates an ability to apply and integrate knowledge in the practice setting. 11. Bases practice on current knowledge and skill level. 12. Demonstrates effective time management. Collaborative and Therapeutic Practice Rating: S/US/N 13. Provides safe nursing practice consistent with client needs and plan of care. 14. Consistently demonstrates effective oral communication and written communication skills 15. Consistently demonstrates appropriate professional documentation skills. 16. Consistently practices within ethic/legal boundaries; and 17. Consistently demonstrates critical thinking skills, analytical skills and reflective practice skills Section 5: Overall performance rating (CIRCLE appropriate grade according to Performance Criteria) S=Satisfactory N = Not observed US= Unsatisfactory An Anecdotal note/at Risk form for any US grade, identifying a specific example for the US grading and a Teaching and Learning objective and strategies implemented Section 6: Preceptor/Clinical Educator Comments (if insufficient room, please continue on back of form) Student Signature Date: Preceptor/Clinical Educator Signature Date: A copy of this formative Clinical Feedback Summary is to be placed on the Student File (including any attachments). 53

59 Week 4 Documentation and Assessment Tools: Clinical Feedback Summaries (One form each for weeks 1-4) Section 1: Student Details (Student to complete section 1, CE/RN to complete sections 2 5). Surname: First name: Student ID No: Campus/ Partner Provider: Ward: From: / / to : / / CE/PR/RN Section 2: Attendance Record as per roster. (PR/CE initial each day attended. Attach documentation for absences* Week Monday Tuesday Wednesday Thursday Friday Days Absent* Section 3: State health requirements for clinical placements (Course Coordinator must complete) A. Domestic Students: Police Check/Working with Children Check YES /NO International Students: Student Visa or similar visa YES /NO B. Adult Vaccination Record: YES/NO Section 4: Performance Criteria (Refer the Clinical Feedback Guidelines) Professional Practice 1. Adheres to University Attendance Policy i.e. attends for required clinical hours, notifies appropriate person regarding absences 2. Adheres to University and School policies (excludes Criteria 1 Attendance Policy) 3. Demonstrates professional conduct and appearance. 4. Practices within own abilities/knowledge and skill level and recognises own limitations. Critical thinking and Analysis 5. Accepts and integrates constructive criticism. 6. Demonstrates effective interpersonal skills. 7. Provides appropriate support to peers and colleagues. 8. Participates in ward/health service activities eg. Handover, ward rounds. Provision and Coordination of Care 9. Cares for client in a holistic manner. 10. Demonstrates an ability to apply and integrate knowledge in the practice setting. 11. Bases practice on current knowledge and skill level. 12. Demonstrates effective time management. Collaborative and Therapeutic Practice Rating: S/US/N 13. Provides safe nursing practice consistent with client needs and plan of care. 14. Consistently demonstrates effective oral communication and written communication skills 15. Consistently demonstrates appropriate professional documentation skills. 16. Consistently practices within ethic/legal boundaries; and 17. Consistently demonstrates critical thinking skills, analytical skills and reflective practice skills Section 5: Overall performance rating (CIRCLE appropriate grade according to Performance Criteria) S=Satisfactory N = Not observed US= Unsatisfactory An Anecdotal note/at Risk form for any US grade, identifying a specific example for the US grading and a Teaching and Learning objective and strategies implemented Section 6: Preceptor/Clinical Educator Comments (if insufficient room, please continue on back of form) Student Signature Date: Preceptor/Clinical Educator Signature Date: A copy of this formative Clinical Feedback Summary is to be placed on the Student File (including any attachments). 54

60 Weeks 1 4 Documentation and Assessment Tools: Clinical Appraisal Tool Clinical Appraisal Tool: Midway Assessment 1. Personal Information/Details of Clinical Placement/Outcome of Assessment Student Name (print) First Name: Last Name: Health Care Facility: Clinical Educator: Teaching Assistance required? Student Number: Student Intake: Date from: Date to: No. days absent: Documentation for absence? Yes No Yes No Clinical At Risk Report Yes No Course Yes No Attached? Coordinator Date/Time informed? 2. ANMC (2006) Competency Criteria Bondy (1983) Rating assessed: Professional Practice Student Clinical Ed. Final Rating* 1 Practises in accordance with legislation affecting nursing practice and health care X X X Practises within a professional and ethical nursing X X framework Critical Thinking and Analysis 3 Practices within an evidence based framework X X X Participates in ongoing professional development of self X X and others Provision and Coordination of Care 5 Conducts a comprehensive and systematic nursing X X assessment 6 Plans nursing care in consultation with individuals/groups, X X significant others and the interdisciplinary health care X team 7 Provides comprehensive, safe and effective evidencebased X X nursing care to achieve identified individual/group health outcomes 8 Evaluates progress towards expected individual/group X X health outcomes in consultation with individuals/groups, significant others and interdisciplinary health care team Collaborative and Therapeutic Practice 9 Establishes, maintains and appropriately concludes X X therapeutic relationships X Collaborates with the interdisciplinary health care team to provide comprehensive nursing care X X NB Bold is expected level for successful pass in any one ANMC Domain for the Midway Assessment. Please refer to Course Descriptor and Flowchart related to Midway and Completion of Assessment for further details. * Final rating to each ANMC Domain is allocated by Preceptor/Clinical Educator. Signature: Clinical Educator. Student... Date./ /20.. Competency Rating Overview of Bondy Elements 5 Independent Practices in a safe, accurate, co-ordinated and effective manner with little need for guiding cues 4 Proficient Practices in a safe, accurate, co-ordinated and effective manner with some need for guiding cues 3 Advanced Beginner Practices in a safe, accurate, co-ordinated manner most of the time with frequent cues required 2 Beginner Practices in a safe manner when continuous guiding cues are given 1 Unsatisfactory Unable to demonstrate safe practice, adequate knowledge base and/or professional behaviour X Not Applicable Not observed or not applicable 55

61 Weeks 5 8 Documentation and Assessment Tools: Teaching and Learning Plan: Students to develop one or more of these plans for each week of clinical placement (based on feedback and reflections) Student Name:.Student ID INTAKE: Week Number and Date Student Learning Objectives: Teaching /Learning Strategies Domain Review Date Outcome Outcome CE Signature/date: CE signature/ date: Student signature/date: Please sign and date all entries. Student signature/date: Please sign and date all entries. 56

62 Weeks 5 8 Documentation and Assessment Tools: Teaching and Learning Plan: Students to develop one or more of these plans for each week of clinical placement (based on feedback and reflections) Student Name:.Student ID INTAKE: Week Number and Date Student Learning Objectives: Teaching /Learning Strategies Domain Review Date Outcome Outcome CE Signature/date: CE signature/ date: Student signature/date: Please sign and date all entries. Student signature/date: Please sign and date all entries. 57

63 Weeks 5 8 Documentation and Assessment Tools: Week 5 Clinical Feedback Summaries (One form for each week) Section 1: Student Details (Student to complete section 1, CE/RN to complete sections 2 5. Surname: First name: Student ID No: Campus/ Partner Provider: Ward: From: / / to : / / CE/PR/RN Section 2: Attendance Record as per roster. (PR/CE initial each day attended. Attach documentation for absences* Week Monday Tuesday Wednesday Thursday Friday Days Absent* Section 3: State health requirements for clinical placements (Course Coordinator must complete) A. Domestic Students: Police Check/Working with Children Check YES /NO International Students: Student Visa or similar visa YES /NO B. Adult Vaccination Record: YES/NO Section 4: Performance Criteria (Refer the Clinical Feedback Guidelines) Professional Practice 1. Adheres to University Attendance Policy i.e. attends for required clinical hours, notifies appropriate person regarding absences 2. Adheres to University and School policies (excludes Criteria 1 Attendance Policy) 3. Demonstrates professional conduct and appearance. 4. Practices within own abilities/knowledge and skill level and recognises own limitations. Critical thinking and Analysis 5. Accepts and integrates constructive criticism. 6. Demonstrates effective interpersonal skills. 7. Provides appropriate support to peers and colleagues. 8. Participates in ward/health service activities eg. Handover, ward rounds. Provision and Coordination of Care 9. Cares for client in a holistic manner. 10. Demonstrates an ability to apply and integrate knowledge in the practice setting. 11. Bases practice on current knowledge and skill level. 12. Demonstrates effective time management. Collaborative and Therapeutic Practice 13. Provides safe nursing practice consistent with client needs and plan of care. 14. Consistently demonstrates effective oral communication and written communication skills 15. Consistently demonstrates appropriate professional documentation skills. 16. Consistently practices within ethic/legal boundaries; and 17. Consistently demonstrates critical thinking skills, analytical skills and reflective practice skills Rating: S/US/N Section 5: Overall performance rating (CIRCLE appropriate grade according to Performance Criteria) S=Satisfactory N = Not Observed US= Unsatisfactory An Anecdotal note/at Risk form for any US grade, identifying a specific example for the US grading and a Teaching and Learning objective and strategies implemented Section 6: Preceptor/Clinical Educator Comments (if insufficient room, please continue on back of form) Student Signature Date: Preceptor/Clinical Educator Signature Date: A copy of this formative Clinical Feedback Summary is to be placed on the Student File (including any attachments). HCNUR 1141 Contextual Nursing Practice in Australia CRICOS Provider Number 00103D 58

64 Week 6 Documentation and Assessment Tools: Clinical Feedback Summaries (One form for each week) Section 1: Student Details (Student to complete section 1, CE/RN to complete sections 2 5. Surname: First name: Student ID No: Campus/ Partner Provider: Ward: From: / / to : / / CE/PR/RN Section 2: Attendance Record as per roster. (PR/CE initial each day attended. Attach documentation for absences* Week Monday Tuesday Wednesday Thursday Friday Days Absent* Section 3: State health requirements for clinical placements (Course Coordinator must complete) A. Domestic Students: Police Check/Working with Children Check YES /NO International Students: Student Visa or similar visa YES /NO B. Adult Vaccination Record: YES/NO Section 4: Performance Criteria (Refer the Clinical Feedback Guidelines) Professional Practice 1. Adheres to University Attendance Policy i.e. attends for required clinical hours, notifies appropriate person regarding absences 2. Adheres to University and School policies (excludes Criteria 1 Attendance Policy) 3. Demonstrates professional conduct and appearance. 4. Practices within own abilities/knowledge and skill level and recognises own limitations. Critical thinking and Analysis 5. Accepts and integrates constructive criticism. 6. Demonstrates effective interpersonal skills. 7. Provides appropriate support to peers and colleagues. 8. Participates in ward/health service activities eg. Handover, ward rounds. Provision and Coordination of Care 9. Cares for client in a holistic manner. 10. Demonstrates an ability to apply and integrate knowledge in the practice setting. 11. Bases practice on current knowledge and skill level. 12. Demonstrates effective time management. Collaborative and Therapeutic Practice 13. Provides safe nursing practice consistent with client needs and plan of care. 14. Consistently demonstrates effective oral communication and written communication skills 15. Consistently demonstrates appropriate professional documentation skills. 16. Consistently practices within ethic/legal boundaries; and 17. Consistently demonstrates critical thinking skills, analytical skills and reflective practice skills Rating: S/US/N Section 5: Overall performance rating (CIRCLE appropriate grade according to Performance Criteria) S=Satisfactory N = Not Observed US= Unsatisfactory An Anecdotal note/at Risk form for any US grade, identifying a specific example for the US grading and a Teaching and Learning objective and strategies implemented Section 6: Preceptor/Clinical Educator Comments (if insufficient room, please continue on back of form) Student Signature Date: Preceptor/Clinical Educator Signature Date: A copy of this formative Clinical Feedback Summary is to be placed on the Student File (including any attachments). 59

65 Week 7 Documentation and Assessment Tools: Clinical Feedback Summaries (One form for each week) Section 1: Student Details (Student to complete section 1, CE/RN to complete sections 2 5. Surname: First name: Student ID No: Campus/ Partner Provider: Ward: From: / / to : / / CE/PR/RN Section 2: Attendance Record as per roster. (PR/CE initial each day attended. Attach documentation for absences* Week Monday Tuesday Wednesday Thursday Friday Days Absent* Section 3: State health requirements for clinical placements (Course Coordinator must complete) A. Domestic Students: Police Check/Working with Children Check YES /NO International Students: Student Visa or similar visa YES /NO B. Adult Vaccination Record: YES/NO Section 4: Performance Criteria (Refer the Clinical Feedback Guidelines) Professional Practice 1. Adheres to University Attendance Policy i.e. attends for required clinical hours, notifies appropriate person regarding absences 2. Adheres to University and School policies (excludes Criteria 1 Attendance Policy) 3. Demonstrates professional conduct and appearance. 4. Practices within own abilities/knowledge and skill level and recognises own limitations. Critical thinking and Analysis 5. Accepts and integrates constructive criticism. 6. Demonstrates effective interpersonal skills. 7. Provides appropriate support to peers and colleagues. 8. Participates in ward/health service activities eg. Handover, ward rounds. Provision and Coordination of Care 9. Cares for client in a holistic manner. 10. Demonstrates an ability to apply and integrate knowledge in the practice setting. 11. Bases practice on current knowledge and skill level. 12. Demonstrates effective time management. Collaborative and Therapeutic Practice 13. Provides safe nursing practice consistent with client needs and plan of care. 14. Consistently demonstrates effective oral communication and written communication skills 15. Consistently demonstrates appropriate professional documentation skills. 16. Consistently practices within ethic/legal boundaries; and 17. Consistently demonstrates critical thinking skills, analytical skills and reflective practice skills Rating: S/US/N Section 5: Overall performance rating (CIRCLE appropriate grade according to Performance Criteria) S=Satisfactory N = Not Observed US= Unsatisfactory An Anecdotal note/at Risk form for any US grade, identifying a specific example for the US grading and a Teaching and Learning objective and strategies implemented Section 6: Preceptor/Clinical Educator Comments (if insufficient room, please continue on back of form) Student Signature Date: Preceptor/Clinical Educator Signature Date: A copy of this formative Clinical Feedback Summary is to be placed on the Student File (including any attachments). 60

66 Week 8 Documentation and Assessment Tools: Clinical Feedback Summaries (One form for each week) Section 1: Student Details (Student to complete section 1, CE/RN to complete sections 2 5. Surname: First name: Student ID No: Campus/ Partner Provider: Ward: From: / / to : / / CE/PR/RN Section 2: Attendance Record as per roster. (PR/CE initial each day attended. Attach documentation for absences* Week Monday Tuesday Wednesday Thursday Friday Days Absent* Section 3: State health requirements for clinical placements (Course Coordinator must complete) A. Domestic Students: Police Check/Working with Children Check YES /NO International Students: Student Visa or similar visa YES /NO B. Adult Vaccination Record: YES/NO Section 4: Performance Criteria (Refer the Clinical Feedback Guidelines) Professional Practice 1. Adheres to University Attendance Policy i.e. attends for required clinical hours, notifies appropriate person regarding absences 2. Adheres to University and School policies (excludes Criteria 1 Attendance Policy) 3. Demonstrates professional conduct and appearance. 4. Practices within own abilities/knowledge and skill level and recognises own limitations. Critical thinking and Analysis 5. Accepts and integrates constructive criticism. 6. Demonstrates effective interpersonal skills. 7. Provides appropriate support to peers and colleagues. 8. Participates in ward/health service activities eg. Handover, ward rounds. Provision and Coordination of Care 9. Cares for client in a holistic manner. 10. Demonstrates an ability to apply and integrate knowledge in the practice setting. 11. Bases practice on current knowledge and skill level. 12. Demonstrates effective time management. Collaborative and Therapeutic Practice 13. Provides safe nursing practice consistent with client needs and plan of care. 14. Consistently demonstrates effective oral communication and written communication skills 15. Consistently demonstrates appropriate professional documentation skills. 16. Consistently practices within ethic/legal boundaries; and 17. Consistently demonstrates critical thinking skills, analytical skills and reflective practice skills Rating: S/US/N Section 5: Overall performance rating (CIRCLE appropriate grade according to Performance Criteria) S=Satisfactory N = Not Observed US= Unsatisfactory An Anecdotal note/at Risk form for any US grade, identifying a specific example for the US grading and a Teaching and Learning objective and strategies implemented Section 6: Preceptor/Clinical Educator Comments (if insufficient room, please continue on back of form) Student Signature Date: Preceptor/Clinical Educator Signature Date: A copy of this formative Clinical Feedback Summary is to be placed on the Student File (including any attachments). 61

67 Clinical Appraisal Tool Final/Completion Assessment 1. Personal Information/Details of Clinical Placement/Outcome of Assessment Student Name (print) First Name: Last Name: Health Care Facility: Clinical Educator: Student Number: Student Intake: Date from: Date to: No. days absent: Teaching Assistance Yes No Clinical At Risk Report Yes No Course required? Attached? Coordinator informed? 2. ANMC (2006) Competency Criteria Bondy (1983) Rating assessed: Documentation for absence? Yes No Yes No Date/Time Professional Practice Student Clinical Ed. Final Rating* 1 Practises in accordance with legislation affecting nursing practice and health care X X X Practises within a professional and ethical nursing framework X X Critical Thinking and Analysis 3 Practices within an evidence based framework X X Participates in ongoing professional development of self and others Provision and Coordination of Care 5 Conducts a comprehensive and systematic nursing assessment 6 Plans nursing care in consultation with individuals/groups, significant others and the interdisciplinary health care team 7 Provides comprehensive, safe and effective evidencebased nursing care to achieve identified individual/group health outcomes 8 Evaluates progress towards expected individual/group health outcomes in consultation with individuals/groups, significant others and interdisciplinary health care team Collaborative and Therapeutic Practice 9 Establishes, maintains and appropriately concludes therapeutic relationships X X X X X X X X X X X X Collaborates with the interdisciplinary health care team to provide comprehensive nursing care X X NB Bold is expected level for successful pass in any one ANMC Domain. Please refer to Course Descriptor and Summary (Flowchart) of Monitoring Student Progress Flowchart related to Midway and Completion of Assessment for further details. * Final rating and overall appraisal rating is allocated by Clinical Educator but must be confirmed by Course Coordinator and ratified by Academic Programs Committee. C = Competent NC = Not Competent Signature: Clinical Educator Student..Date.. Competency Rating Overview of Bondy Elements: Note: Each level is assessed considering 3 areas (i) Professional Standards (ii) Quality of Performance (iii) Assistance required 5 Independent Practices in a safe, accurate, co-ordinated and effective manner with little need for guiding cues 4 Proficient Practices in a safe, accurate, co-ordinated and effective manner with some need for guiding cues 3 Advanced Practices in a safe, accurate, co-ordinated manner most of the time with frequent cues required Beginner 2 Beginner Practices in a safe manner when continuous guiding cues are given 1 Unsatisfactory Unable to demonstrate safe practice, adequate knowledge base and/or professional behaviour X Not applicable Not observed or not applicable X X X Overall Appraisal Rating* C NC 62

68 Weeks 5 8 Documentation and Assessment Tools: Record of The Registered Nurse Division 1 Signature/Initials Name Institution Signature Initial 63

69 Reflection/Evaluation of Clinical Experience At the end of the clinical placement, the student should complete this evaluation of their clinical placement reflecting on their knowledge, skills, values, confidence and competence and discuss with the Course Coordinator Signature:. Date:.. 64

70 SECTION 5 ADDITIONAL DOCUMENTATION ASSOCIATED WITH MONITORING OF STUDENT PROGRESS Please photocopy the original provided in this Section. Follow specific instructions as per use of each form normally staple a copy of the completed form to the appropriate area (for example weeks 1-4 or weeks 5-8) and forward a copy to the Course Coordinator without delay. 65

71 5.1 Anecdotal Note Anecdotal Note STUDENT NAME: STUDENT ID: This form is available as an adjunct to, but does not replace, off campus experience evaluation. 2. Its use by Lecturers/Clinical Educators/Preceptors/Registered Nurses is dependant on the clinical practice situation. 3. This form can be used to highlight difficulties that students are experiencing or to commend them for work well done in the theoretical or clinical environment. 4. When used for commenting on unsatisfactory progress or unprofessional conduct for example, comments must relate to the ANMC competencies and specific example/s provided. 5. Anecdotal Notes of a confidential nature (eg. Counselling of a personal nature) must be written on an additional form and forwarded to the Course Co-ordinator. These type of confidential notes must not be retained in this Booklet. COMMENTS: Name (print).. Date:.. Signature:. I have read the above statement Student Signature:.. Date: 66

72 ADDITIONAL COMMENTS:

73 5.2 Clinical At Risk Report Clinical At Risk Report. SECTION 1: STUDENT DETAIL (Please COMPLETE ALL AREAS in Section 1 & 2) SURNAME: FIRST NAME: STUDENT NO: CAMPUS/PARTNER PROVIDER : CE/PR/RN DATE OCCURED: LOCATION: (Hospital & Ward) TIME: DAY & DATE WHEN STUDENT NOTIFIED OF BEING AT RISK : Day: Date: / / Section 2: CE/PR INSTRUCTIONS: Identify reason for unsatisfactory rating -relate to the ANMC (2006) Competency Domains, action taken and outcome. Performance Criterion and Domain U/S Reason (specific example/s must be provided) Action taken and Outcome to be documented on the following page 68

74 Action taken and Outcome Supporting documentation attached? Please outline type: CE/ Name: Signature: Date: / / Student Name: Signature: Date: / / Attach additional pages and/or supporting information and forward to the Course Co-ordinator Office use only Received: / / Copy to student: Yes No 69

75 5.3 Teaching Assistance Request Teaching Assistance Request SECTION 1: STUDENT DETAIL (Please COMPLETE ALL AREAS in Section 1 & 2) SURNAME: FIRST NAME: STUDENT NO: CAMPUS/PARTNER PROVIDER : CE/PR/ DATE OF INCIDENT: LOCATION: (Hospital & Ward) TIME: DAY & DATE WHEN STUDENT NOTIFIED OF BEING AT RISK : Day: Date: / / Section 2: Reasons for referral (skill to be practiced): CE/PR Signature : Date / / Student Signature : Date / / Section 3: Outcome: Educator Comments: Key: CE/PR = Clinical Educator/Preceptor Satisfactory completion: (Please Circle) Yes / No NB: If No. Course Coordinator to be notified and reason stated on an Anecdotal Note NB: The CE/PR/RN may refer the student for additional teaching support or the student may request same. In the event the student is referred by CE/PR the student must attend the training or obtain an unsatisfactory (U) in the weekly feedback report, and may be prohibited from continuing in the clinical placement until The training environment is at the discretion of the referring CE/PR and may be conducted on site at the clinical placement or in the classroom/laboratory. Educator Signature: Date: / / Student Signature: Date: / / 70