MIAMI DADE COLLEGE-MEDICAL CAMPUS
Benjamín León School of Nursing
Clinical Evaluation Tool
LEVEL 2 SEMESTER 3
Community Health Nursing
STUDENT NAME STUDENT NO.
COURSE REFERENCE SEMESTER YEAR
All students are required to adhere to Professional Behaviors throughout the nursing program.
Failure to meet expected behaviors may result in a failing clinical grade or withdrawal from the
program. Faculty will provide written documentation throughout the semester for any behaviors
requiring improvement or designated as unsatisfactory. Students must be satisfactory in all
areas by the end of the semester to pass this course.
SATISFACTORY
A student who earns a grade of satisfactory:
Safely executes psychomotor skills.
Applies previous learning to Community Nursing.
Gathers data about the community systematically.
Uses therapeutic communication with patients, families, staff, peers, and others.
Applies critical thinking to nursing care situations with community nursing.
Is self-directed.
Meets all objectives in Core Components.
UNSATISFACTORY
A student who earns a grade of unsatisfactory:
Fails to transfer previous learning.
Uses communications patterns that are angry, judgmental, disrespectful, familiar,
false, or otherwise inappropriate.
Violates policies of affiliating agency and/or College.
Unsafely executes psychomotor skills.
Fails to act on constructive feedback.
Fails to meet course objectives due to excessive tardiness or absence.
Fails to meet all objectives in Core Component.
1 | P a g e
S=Satisfactory
N/I=Needs Improvement
U=Unsatisfactory
EVALUATION OF CORE COMPONENTS
Midterm
Final
PROFESSIONAL BEHAVIORS
Follows the policies and guidelines of MDC, the School of Nursing and
affiliating agencies.
Treats others with respect.
Demonstrates nonjudgmental behaviors and attitudes.
Maintains personal appearance according to the policies of the School
of Nursing, and affiliating agencies.
Maintains confidentiality.
Reports promptly to reflections and all required classroom sessions.
Attends all assigned service learning activities.
Notifies the instructor and community agency regarding absence or
tardiness prior to the start of activities.
Reports to the instructor and/or assigned community personnel when
entering and leaving the agency/activity.
Receives instructor approval prior to contacting/attending community
activities.
Submits journals by the due dates during the semester and keeps the
community activity log current.
Provides hand on care and physical assessments only when the
instructor is present.
Reports all pertinent information to the instructor and/or community
personnel.
Adheres to legal/ethical guidelines.
Accepts responsibility for own work, organizing activity and maintaining
activity log signature sheet.
Applies knowledge from the physical sciences, previous nursing
courses and concurrent courses (maternity and pediatrics).
Seeks instructor’s guidance for planning activities.
COMMUNICATION
Uses verbal and nonverbal therapeutic communication techniques that
demonstrate respect, understanding and caring. Avoids patronizing or
familiar communication patterns.
Gives and receives relevant information from community personnel.
Maintains journal as a communication tool between faculty and student.
Journal must follow syllabus guidelines.
2 | P a g e
S=Satisfactory
N/I=Needs Improvement
U=Unsatisfactory
EVALUATION OF CORE COMPONENTS
Midterm
Final
S
N/I
S
U
ASSESSMENT
Assess the learning needs of the identified community.
Assess the effectiveness of the community agency/activity in meeting
the needs of the identified community.
Identifies the cultural, cognitive, psychosocial needs of the community.
Identifies community resources available to selected communities.
MANAGING CARE
Demonstrates organization and time management when providing
services to the community.
Demonstrates cost-efficient use of equipment and resources.
Uses equipment in the community setting consistent to the purpose.
Individualizes community activities to meet the needs of the
community.
Provides appropriate services to the community.
Develops priorities for interventions base on community needs.
Uses knowledge and resources of community agencies to promote
the health of community members.
CLINICAL DECISION MAKING
Organizes and prioritizes community activities/education based on an
identified need.
Evaluates the effectiveness of community interventions and suggests
appropriate modifications.
Participates in group critical thinking activities, for example:
Using Healthy People 2020 to evaluate the effectiveness of
community interventions using:
case studies
community education
government/private sponsored community services/support
educational programs
current health care issues found in written/oral media
political responsiveness to community needs (local, state,
National and international.
3 | P a g e
S=Satisfactory
N/I=Needs Improvement
U=Unsatisfactory
EVALUATION OF CORE COMPONENTS
Midterm
Final
S
N/I
S
U
CARING INTERVENTIONS
Supports spiritual and cultural beliefs and practices of the community.
Supports community members when making decisions regarding their
health state.
Collaborates with class mates/community agencies to develop and
provide and activity to resolve an identified community need.
Provides health education and health assessments in the community.
Maintains a safe environment while providing services.
Promotes community cohesion.
Provides safe and effective nursing services in the community.
Consistently adheres to all overriding critical elements regarding
asepsis, communication, safety, professional behaviors, and
universal/standard precautions.
TEACHING LEARNING
Develops an evaluation tool to obtain feedback from the community as
to the value of service received.
Provides appropriate instruction and materials in the following to
women and children.
COLLABORATION
Participates with community agencies in developing and implementing
an activity.
Identifies community services available in the community.
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MIDTERM PROGRESS:
Satisfactory Needs Improvement
Dates of: Absences _Tardiness
Instructor Comments:
Signature Date
Student Comments:
Student Signature Date
5 | P a g e
FINAL COURSE GRADE: (Based on grading criteria)
Dates Of: Absences Tardiness
ACTIVITY
PASSED
FAILED
FACULTY
INITIALS
Satisfactory journal
entries according to
course guidelines.
Attendance and
documentation of
progress toward course
objectives in the journal
and during reflections of
the following:
Orientation and Healthy
People 2020 (2 hours)
Forum on Civic
Responsibility (2 hours)
& Ethics in Healthcare
(1 hour)
Community Health
Lecture (2 hours)
Approved Service
Learning Activities (23
hours)
Attendance and
meaningful participation
during reflections (10
Hours)
6 | P a g e
Instructor Comments
Instructor Signature Date
Student Comments
Student Signature Date
FINAL GRADE: S U
Revised 1/11
7 | P a g e
