NURS 601 Student Evaluation

Thank you for serving as a clinical preceptor for Gonzaga University School of Nursing and Human Physiology. We recognize and appreciate your vital role in shaping exceptional future nurse practitioners.

Preceptors use this form to evaluate students completing a clinical practice experience during Nursing 601. Gonzaga University faculty members review this form to learn about the level of student performance in clinical rotations and to monitor the standards of performance. Students enrolled in Nursing 601 are expected to demonstrate:

  • Developing independence in collecting subjective and objective data.
  • Health assessments that integrate clinical and research based knowledge with individualized knowledge of patients and their family.

Students are required to obtain feedback from each preceptor with whom they work. Please record your evaluation and review it with the student. Gonzaga University Faculty review this form to learn about the level of student performance in clinical rotations and monitor the standards of performance.

**The form is successfully submitted when completed in one sitting and a banner will pop up after the successful submission to let you know that it has been received.**

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N/A = Unable to evaluate
1 = Unsatisfactory
2 = Needs Improvement
3 = Average
4 = Above average
5 = Excellent
History Taking Skills
  • Obtains health and medical history appropriate to client population
  • Identifies problem areas
  • Adapts to special patient and clinical situations
  • Directs interview appropriately

Physical Exam Skills
  • Handles equipment
  • Organizes exam process
  • Demonstrates confidence with patient
  • Identifies variations from normal findings
  • Performs a physical examination based on age and history

Differential Diagnoses—novice level
  • Formulates three differentials relative to the history
  • Selects the most likely diagnosis and provides rationale, based on pertinent positives/negatives
  • Reports to preceptor about assessment findings and identified problems.
  • Documents history and physical examination findings in a manner appropriate to the clinical setting.
  • Provides patient with information regarding decisions and choices about health promotion and maintenance.

  • Promotes a safe environment
  • Participates as a team member in the provision of health care.