clinical placement appraisal tool

FederationUNIVERSITY-AUSTRALIA

Clinical PlacementAppraisal Tool

Faculty of Health - Nursing

Bachelor of Nursing

Student Name

Student ID

Course Code:

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CRICOS Provider No. 00103D

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Clinical Placement Appraisal ToolThis appraisal tool is based upon the Nursing and Midwifery Board Australia National CompetencyStandards for the Registered Nurse in four domains:

Professional Practice,Critical thinking & Analysis,Provision & Coordination of Care,Collaborative & Therapeutic practice

The Bondy Scale is used for assessment of performance in all clinical courses in theBachelor of Nursing. Five levels are used and are descriptively labelled: Independent (I),Supervised (S), Assisted (A), Marginal (M) and Dependent (D). Each level is defined bythe description of characteristics in three areas: Professional standard, Quality ofperformance and Assistance required. To successfully complete clinical placement, thestudent must achieve the required levels as described in the relevant clinical placementcourse descriptor or clinical objective books

At the completion of clinical placement, your completed Clinical Appraisal Tool is to besubmitted online via moodle to your course coordinator as outlined in your coursedescriptor. Please ensure that evidence of missed clinical placement days are submitteddirectly to the clinical office. We do not require a copy of your attendance record.

Student Name (Please print clearly)

Student ID Number

Course Code

Course Coordinator

Health Agency

Placement Dates

CompletedDays/Hours:

Number of absentdays:

Assessment Result(please circle) x-"

Clinical Assessor/s*Name and Signature

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*A Clinical Assessor must be a Nursing and Midwifery Board Australia (NMBA), AustralianHealth Practitioner Regulation Agency (AHPRA), registered division one nurse or midwife.

CRICOS Provider No. 00103D Insert file name here of 14

FederationU N I V E R S I T Y - A U S T R A L I A

Clinical Placement Appraisal ToolThis appraisal tool is based upon the Nursing and Midwifery Board Australia National CompetencyStandards for the Registered Nurse in four domains:

Professional Practice,Critical thinking & Analysis,Provision & Coordination of Care,Collaborative & Therapeutic practice

The Bondy Scale is used for assessment of performance in all clinical courses in theBachelor of Nursing. Five levels are used and are descriptively labelled: Independent (I),Supervised (S), Assisted (A), Marginal (M) and Dependent (D). Each level is defined bythe description of characteristics in three areas: Professional standard, Quality ofperformance and Assistance required. To successfully complete clinical placement, thestudent must achieve the required levels as described in the relevant clinical placementcourse descriptor or clinical objective books

At the completion of clinical placement, your completed Clinical Appraisal Tool is to besubmitted online via moodle to your course coordinator as outlined in your coursedescriptor. Please ensure that evidence of missed clinical placement days are submitteddirectly to the clinical office. We do not require a copy of your attendance record.

Student Name (Please print clearly)

Student ID Number

Course Code

Course Coordinator

Health Agency

Placement Dates

CompletedDays/Hours:

Number of absentdays:

Assessment Result(please circle)

Clinical Assessor/s*Name and Signature

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*A Clinical Assessor must be a Nursing and Midwifery Board Australia (NMBA), AustraliaHealth Practitioner Regulation Agency (AHPRA), registered division one nurse or midwife.

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CRICOS Provider No. 00103D Insert file name here Page 2 of 14


Confidentiality Agreement

BETWEEN: Federation University, of University Drive, Mt Helen, Victoria

("the University") and

The Student * . . « n . U *~ ("the Student")(Print Name)

RECITALS:

A. The Student is a student of the University who is undertaking external clinical placement that willform part of their course work with the University.B. To protect Confidential Information which may be disclosed to the Student in relation to theclinical placement, the Student has agreed to the following terms and conditions.AGREEMENT:

Definitions:

1. "Agency" means the external Hospital or Health Care Centre where the clinical placementis being conducted; "Confidential Information" means any information whether written ororal provided by one party to another party on or after the date of this agreement inconnection with the clinical placement including without limitation any clinical information onpatients 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 shallnot 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 clinicalplacement is conducted particularly relating to their duty of confidentiality under Section 141of the Health Services Act.

4. In the event the Student requires access to current and archival patient medical records forthe purposes of formal research the Student will seek approval from Agency's EthicsCommittee before commencing such research.

5. This agreement shall be governed by and construed in accordance with the laws of theState of Victoria.

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EXECUTED AS AN AGREEMENT.

Dated this eAlgjynPv day

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Signed by the Student (Print

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In the presence of: (Print Name)

Signature Wij^f****,^ (Name of Fed Uni Staff Member)


Federation 32U N I V E R S I T Y - A U S T R A L I A *^

CLINICAL LEARNING PLAN 1:Prior to the commencement of your clinical placement you need to identify your clinical learning objectivesand write these in the space provided below. On the first day of placement, you need to discuss yourobjectives with your clinical Teacher/ Preceptor/ Supervisor and document how together you will achieveyour clinical learning objectives.

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CLINICAL LEARNING PLAN 2:At the beginning of the second week of your clinical placement, identify and record your clinical learningobjectives and write these in the space provided below. You need to discuss these with your clinicalTeacher/ Preceptor/ Supervisor and document how together will achieve your clinical learning objectives.

Student Learning Objectives:

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Federation 3":SUNIVERSITY 'AUSTRALIA ™*

Mid-Point Assessment (Formative)Initial appropriate rating for each standardSee Appendix B or clinical objectives book for required level.

Domain 1: Professional PracticeRelates to the professional. Legal and ethical responsibilities which requiredemonstration of a satisfactory knowledge base, accountability for practice,functioning in accordance with legislation affecting nursing and health care,and the protection of individual and group rights.

Practises in accordance with legislation affectingpractice and health care

nursing

Practises within a professional and ethical nursing framework

Domain 2: Critical Thinking and Analysis

Relates to self-appraisal, professional development and the value ofevidence and research for practice. Reflecting on practice, feelings andbeliefs and the consequences of these for individual groups is an importantprofessional benchmark

Practises within an evidence-based framework

Participates in the ongoing professional development of selfand others

Domain 3: Provision & coordination of care

Relates to the coordination, organisation and provision of nursing care thatincludes the assessment of individuals/ groups, planning, implementationand evaluation of care

Conducts a comprehensive and systematic nursingassessment

Plans nursing care in consultation with individuals or groups,significant others and the interdisciplinary health care team

Provides comprehensive, safe and effective evidence-basednursing care to achieve identified individual or groups healthoutcomes

Evaluates progress towards expected individual/group healthoutcomes in consultation with individuals/groups, significantothers and interdisciplinary health care team

Domain 4: Collaborative & therapeutic practice

Relates to establishing, sustaining and concluding professional relationshipswith individuals/groups. This also contains those competencies that relate tothe nurse understanding their contribution to the interdisciplinary health careteam

Establishes, maintains and appropriately concludestherapeutic relationships

Collaborates with the interdisciplinary health care team toprovide comprehensive nursing care

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Mid-Point (Formative) Feedback Summary

Clinical Supervisor: additional comments and strategies for improvement(Please make general comment on the four main areas of the appraisal tool - professional practice, critical thinking &analysis, provision & coordination of care, collaborative & therapeutic practice)

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Student: response to feedback and identification of learning outcomes.

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FederationU N I V E R S I T Y ' A U S T R A L I A

CLINICAL LEARNING PLAN 3:At the beginning of the third week of your clinical placement, identify and record your clinical learningobjectives and write these in the space provided below. You need to discuss these with your clinicalTeacher/ Preceptor/ Supervisor and document how you will achieve your clinical learning objectives.


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CLINICAL LEARNING PLAN 4:At the beginning of the fourth week of your clinical placement, identify and record your clinical learningobjectives and write these in the space provided below. You need to discuss these with your clinicalTeacher/ Preceptor/ Supervisor and document how you will achieve your clinical learning objectives.


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Federation 2":U N I V E R S I T Y - A U S T R A L I A

Final Assessment (Summative)Please ensure page 2 signed off at end of placement. To be completed by clinical teacher/preceptor/ Supervisor

Domain 1: Professional PracticeRelates to the professional. Legal and ethical responsibilities which requiredemonstration of a satisfactory knowledge base, accountability for practice,functioning in accordance with legislation affecting nursing and health care,and the protection of individual and group rights.

Practises in accordance with legislation affecting nursingpractice and health care

Practises within a professional and ethical nursing framework

Domain 2: Critical Thinking and Analysis

Relates to self appraisal, professional development and the value ofevidence and research fro practice. Reflecting on practice, feelings andbeliefs and the consequences of these for individual groups is an importantprofessional benchmark

Practises within an evidence-based framework

Participates in the ongoing professional development of selfand others

Domain 3: Provision & coordination of care

Relates to the coordination, organisation and provision of nursing care thatincludes the assessment of individuals/ groups, planning, implementationand evaluation of care

Conducts a comprehensive and systematic nursingassessment

Plans nursing care in consultation with individuals or groups,significant others and the interdisciplinary health care team

Provides comprehensive, safe and effective evidence-basednursing care to achieve identified individual or groups healthoutcomes

Evaluates progress towards expected individual/group healthoutcomes in consultation with individuals/groups, significantothers and interdisciplinary health care team

Domain 4: Collaborative & therapeutic practice

Relates to establishing, sustaining and concluding professional relationshipswith individuals/groups. This a/so contains those competencies that relate tothe nurse understanding their contribution to the interdisciplinary health careteam

Establishes, maintains and appropriately concludestherapeutic relationships

Collaborates with the interdisciplinary health care team toprovide comprehensive nursing care

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FederationUNIVERSITY-AUSTRAL IA

Final (Summative) Feedback Summary.

Clinical Supervisor: additional comments and strategies for improvement(Please make general comment on the four main areas of the appraisal tool - professional practice, critical thinking &analysis, provision & coordination of care, collaborative & therapeutic practice)

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Student Comments

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FederationU N I V E R S I T Y ' A U S T R A L I A

Appendix 1: Bondy ScaleThe Bondy Scale* is used for assessment of performance in all clinical courses in theBachelor of Nursing. Five levels are used and are descriptively labelled: Independent (I),Supervised (S), Assisted (A), Marginal (M) and Dependent (D). Each level is defined by thedescription of characteristics in three areas; these being, Professional standard, Quality ofperformance and Assistance required.

It is important to remember that students are not master practitioners. The aim is to prepare themto be beginning level practitioners. Differing levels of skills are to be expected.

SCALE

INDEPENDENT(1)

SUPERVISED(S)

ASSISTED (A)

MARGINAL (M)

DEPENDENT(D)

PROFESSIONALSTANDARD

Safe; accurate; achievesthe intended purposeeach time; performs in anappropriate manner eachtime

Safe; accurate; achievesthe intended purposeeach time; performs in anappropriate manner eachtime

Safe; accurate; achievesthe intended purposemost of the time;performs in anappropriate manner mostof the time

Safe, but not alone,performs at risk; notalways accurate:Occasionally achievesthe intended purpose;Occasionally performs inan appropriate manner

Unsafe; unable todemonstrate intendedbehaviour

QUALITY OFPERFORMANCE

Proficient; coordinated;confident; occasionalexpenditure of excessenergy; performs withinan expedient time period

Efficient; coordinated;confident; occasionalexpenditure of excessenergy; performs withinan reasonable timeperiod

Skilful in parts of thebehaviour; inefficient andun-coordinated; expendsexcess energy; performswithin a delayed timeperiod

Unskilled; inefficient,considerable expenditureof excess energy;performs within aprolonged time period

Unable to demonstrateprocedure or behaviour;lacks confidence; lackscoordination, lacksefficiency

ASSISTANCEREQUIRED

Without supportingcues

Occasional supportivecues (e.g. commentssuch as 'that's right','keep going 'aresupportive cues)

Frequent verbal andoccasional physicaldirective cues (in anattempt to correctactivity or indicate whatis required next) inaddition to supportiveones.

Continuous verbaldirective, and frequentphysical directive cues

The cues are sodirective andcontinuous that it is asif the supervisor isperforming thebehaviour or skill

* This criterion - referenced rating scale was constructed or validated by K.N. Bondy (1983, 1984). It has also been utilisedand validated by Hawly & Lee (1991) and Tower & Majowski (1987). The scale has been adapted for use in the Bachelor ofNursing program at the Federation University


FederationUNIVERSITY 'AUSTRALIA

Appendix 2: Minimum Competency Level

Minimum Competency Rating

ANMC DOMAINS

ProfessionalPractice

Critical Thinking &Analysis

Provision andCoordination ofCare

Collaborative andTherapeuticPractice

Year 1

Marginal

Marginal

Marginal

Marginal

Year 2Semester 1

Assisted

Assisted

Assisted

Assisted

Year 2Semester 2

Supervised

Assisted

Assisted

Assisted

Year3Semester 1

Supervised

Supervised

Supervised

Supervised

Year 3Semester 2

Independent

Supervised

Supervised

Supervised

Bondy Rating Scale

I

s

A

M

D

PerformanceAssessment

Independent

Supervised

Assisted

Marginal

Dependent

Overview of Bondy Elements

Practices in a safe, accurate, co-ordinated and effective manner withlittle need for guiding cuss

Practices in a safe, accurate, co-ordinated and effective manner withsome need for guiding cues

Practices in a safe, accurate, co-ordinated manner most of the timewith frequent cues required

Practices in a safe manner when continuous guiding cues are given

Unable to demonstrate safe practice, adequate knowledge baseand/or professional behaviour



Appendix 3

RECORD OF HEALTH PROFESSIONALS SIGNATURES/INITIALS

Name Institution Signature Initial


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