Specialty Area Clinical – Preceptor Evaluation of the Adult I Student Date(Required) MM slash DD slash YYYY Student Name(Required) First Last Preceptor Name(Required) First Last Specialty Area(Required)Wound CareRespiratoryVascular AccessRural HealthOther1.1 Arrives on time, ready to learn and completes clinical hours scheduled.(Required) Unsatisfactory Satisfactory Not Applicable 1.2 Adheres to NOC and facility uniform guidelines.(Required) Unsatisfactory Satisfactory Not Applicable 1.3 Communicates therapeutically with clients and family.(Required) Unsatisfactory Satisfactory Not Applicable 1.4 Demonstrates knowledge appropriate for this specialty area.(Required) Unsatisfactory Satisfactory Not Applicable 1.5 Actively engaged and expresses interest throughout clinical experience.(Required) Unsatisfactory Satisfactory Not Applicable 1.6 Asks appropriate questions for this specialty area.(Required) Unsatisfactory Satisfactory Not Applicable 1.7 Collaborates effectively with multidisciplinary healthcare team members.(Required) Unsatisfactory Satisfactory Not Applicable 1.8 Exhibits professional behavior.(Required) Unsatisfactory Satisfactory Not Applicable 1.9 Seeks out learning activities with enthusiasm.(Required) Unsatisfactory Satisfactory Not Applicable 1.10 Overall, impression of my student’s clinical performance today.(Required) Unsatisfactory Satisfactory Not Applicable Please include any positive feedback and areas for improvement. Also include an explanation of any unsatisfactory areas.(Required)
