Clinical Evaluation Format BSC JIMSH

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Clinical Evaluation Format

Name of the student: Clinical field:

Experience started: Experience ended:

Total marks: 100 : Marks obtained:

Sl Criteria Poor Average Good Very Excellent


no Good
1 2 3 4 5
I Objective:
Evidence of ability in planning
comprehensive patient care based on
assessment of patient need:

1. Make Nursing assessment (Head to Toe


assessment / pain assessment / system wise /
psychosocial / spiritual)

2. Identify the patient problem by considering


patient as a whole.
3. Recognize the nature of illness
4. Plan and organizes daily work priority wise
5. Consider economy of time, material and
energy.
6. Use knowledge of available resources.
II
Objective II:
Evidence of ability to implement
appropriate nursing interventions based on
Scientific Principles and concepts of
Nursing Care.

7. Explains the nursing action before


implementation.

8. Knowledge in carrying out the treatment.

9. Provide problem based Nursing care.

10. Applies scientific principles – that justify


nursing action.
11.
Carries out Nursing procedure effectively

12. Taking care of the equipment

13. Taking care of the patient’s unit


III Objective III
Evidence of teaching skill in patient
situation:

14. Identify the learning need of the patient and


the families.

15. Teach according to the level of


understanding of the patient and the
families.
IV Objective :IV
Evidence of recording and reporting
information essential for the continuity of
care.

Complete charts, Reports and record of


16. patient’s conditions and Nursing action
accurately.

Receives / reports pertinent information


17.
when reporting on and off duty

Objective: V
V
Evidence of behavioral aspects

Collaborate with other team member as


18.
needed

19. Professional behavior & Punctuality.

20. Emotional stability.


Signature of the evaluator Signature of the students

Evaluation format for Health Talk

NAME : DATE :

TOPIC : Total Marks : 25


Sl.No Total
. Criteria Marks Marks obtained
Organization of the
1 presentation 4  
2 Depth and understanding 5  
Arrangement of the unit /
3 classroom 1  
4 Appearance 1  
5 Confidence level 1  
6 Voice and tone 2  
7 Communication skill 5  
8 Handling question 2  
9 Use of A V aids 2  
10 Time 2  

Signature of the evaluator Signature of the students

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