Agency Evaluation of Students

Directions: The goal of the UH Hilo Baccalaureate Nursing Program is to educate students that can perform at the beginning/novice practice level. Please use the dropdown boxes for each statement to indicate your response and enter any comments into the textbox at the end of the survey. Then submit your survey. Thank you for your input. All answers will be for program evaluation and will be held confidentially.

Please enter the following information.

1.	Name of Clinical Agency:

2.	Unit/Specialty:

3.	Course Instructor:

Please provide your answers to the questions below. (Select from the dropdown boxes.)

4.	Provider of Care--Students were knowledgeable in the clinical area.

5.	Provider of Care--Students were competent in clinical skills.

6.	Communicator--Students communicated well with staff members and clients/families.

7.	Teacher--Students consistently conducted client teaching.

8.	Manager of Care--Students participated in comprehensive nursing plans of care.

9.	Investigator--Students gathered focused data to prioritize client care.

10.	Member of Profession--Students displayed caring attitudes toward clients, families, and staff members.

11.	Member of the Profession--Students acted in a manner that reflected high levels of professional nursing standards.

12.	Promoter of Transcultural Care--Students demonstrated culturally congruent care.

13.	Elaborate on the criteria regarding the students' performance. Additional comments are welcomed.