MAEER COLLEGE OF NURSING

Talegaon Dabhade, Pune

CLINICAL EVALUATION PERFORMA

NURSING FOUNDATION II (Semester – II)

Name of the Student : - _ ________________________Year : -

Duration of posting in weeks : - ________________________Area of Clinical experience : -
Name of the Supervisor : -
(Scores:- 5 = Excellent, 4 = Very good, 3 = Good, 2 = Satisfactory / fair, 1 = Poor)
Total Marks: - 10 Marks

SN PERFORMANCE CRITERIA (5) (4) (3) (2) (1)

Personal & Professional behavior

1. Wears clean & neat uniform and well groomed.
2. Arrives and leaves punctually.
3. Demonstrates understanding of the need for quietness in speech &
manner & protects the patient from undue notice.
4. Influential & displaced persuasive assertive leadership behavior.
Attitude to Co-workers and patients
5. Works well as member of Nursing team.
6. Gives assistance to other in clinical situations.
7. Understands the patient as an individual.
8. Shows skills in gaining the confidence & cooperation of patients and
relatives. Tactful and considerate.
Application of knowledge
9. Possess sound knowledge of Medical Surgical conditions/ Patient condition.
10. Has sound knowledge of Scientific principles.
11. Able to correlate theory with practice.
12. Has knowledge of current treatment modalities and progress of the patient.
13. Takes interest in new learning from current literature & seeks help from
resourceful people.
14. Records and reports patient information accurately.
Quality of clinical skill
15. Identifies problems & sets priorities and grasps essentials while performing
duties.
16. Applies principles in carrying out procedures & carries out duties promptly.
17. Has technical competence in performing Nursing procedures
18. Resourceful and practices economy of time material and energy.
19. Observes carefully, reports & records signs-symptoms & other relevant
information.
20. Uses opportunities to give Health education to patients & relatives.
Total
Round up /10
Grant Total /100

Remarks for Improvement:

Signature of the Student Signature of the Teacher