Mansoura University

Faculty of Nursing
Medical Surgical Nursing Department
Condensed Nursing Program

Medical – Surgical Nursing Evaluation Sheet

Student's name: Round:
Group number:

Evaluation Item Grade Student's grade

Professional behavior & sense of responsibility: 10

*Uniform 2.5
*punctuality 5
*Sense of responsibility 2.5

Scientific knowledge 10

assessment for patient's needs & problems : 5

Planning & organization of nursing care plane : 15

*Nursing diagnosis 4
*Priority 3
*Out come criteria ( pt's goal) 3
*Nursing intervention 5

Skills 20

Total grade 60

Clinical instructor signature: Student's signature:

………………………. ……. ………………………..
……………………………...

Date:…………………………