College of Nursing COURSE COORDINATOR … of Nursing COURSE COORDINATOR HANDBOOK Compiled by the CON Workload Group - January 2013 Reviewed/Revised Summer 2013 Conversion to Georgia

College of Nursing

COURSE COORDINATOR HANDBOOK

Compiled by the CON Workload Group - January 2013 Reviewed/Revised Summer 2013

Conversion to Georgia Regents University is underway so some links and documents may still contain the Georgia Health Sciences University (GHSU) logo. These documents will be updated

as links and documents become available.

Table of Contents

1. Purpose Statement ................................................................................... 01

2. Mission, Vision, and Values .................................................................... 02

3. Course Preparation Timeline ................................................................... 03

4. Checklist: Coordinator Timeline ............................................................ 12

5. Appendix A: Course Offering Form ....................................................... 13

6. Appendix B: Responsibilities Related to Clinical Site Request ............. 14

7. Appendix C: Clinical Site Survey Form for New Contract .................... 17

8. Appendix D: Clinical Forms ................................................................... 19

a. BSN Program Clinical Forms ............................................................ 19

b. CNL Program Clinical Forms ............................................................ 21

c. Nursing Anesthesia Program Clinical Forms .................................... 23

d. Nurse Practitioner Program Clinical Forms ...................................... 25

9. Appendix E: Midterm Letter Examples .................................................. 34

10. Appendix F: Student Course Evaluation Forms ..................................... 38

11. Appendix G: Course Summary ............................................................... 44

12. Appendix H: Coordinator Response to Student Evaluations .................. 45

1

Purpose Statement

This Handbook serves as a resource for faculty for implementing the role of Course Coordinator for the College of Nursing (CON). The CON Philosophy, Organizing Framework, Program Objectives, Course Sequencing, and Course Objectives guide the implementation of the curriculum. Course Coordinators operationalize the theoretical and clinical learning experiences associated with each course. Course Coordinators collaborate with faculty who are assigned to the teaching team as active participate in course implementation

2

Georgia Regents University Mission Our mission is to provide leadership and excellence in teaching, discovery, clinical care, and service as a student-centered comprehensive research university and academic health center with a wide range of programs from learning assistance through postdoctoral studies. Vision Our vision is to be a top-tier university that is a destination of choice for education, health care, discovery, creativity, and innovation. Our Values Collegiality – reflected in collaboration, partnership, sense of community, and teamwork. Compassion – reflected in caring, empathy, and social responsibility. Excellence – reflected in distinction, effectiveness, efficiency, enthusiasm, passion, and quality. Inclusivity – reflected in diversity, equality, fairness, impartiality, and respect. Integrity – reflected in accountability, ethical behavior, honesty, and reliability. Leadership – reflected in courage, honor, professionalism, transparency, and vision.

College of Nursing Our Mission To improve health & wellness in individuals, families, and communities through the discovery and dissemination of nursing knowledge and the translation of science into practice. Our Vision The CON will be an exemplar of excellence among academic health sciences colleges of nursing. Our Values The CON Values are aligned with those of the University: leadership, social responsibility, compassion, diversity, professionalism, partnership, and excellence.

3

Course Preparation Timeline

I. Twelve (12) Weeks PRIOR to the Semester Start A. Course Coordinator Team Meeting: The Program Director and Course

Coordinators meet to collaborate concerning the course schedule, evaluation methodologies and resources for the courses. Program Directors provide the semester schedules for the courses. Refer to Georgia Regents University Augusta Academic Calendar for semester start and end dates, midterm dates: http://www.gru.edu/registrar/

B. Prepare the Course Calendar: Using the Program Director’s approved semester schedule, prepare your course calendar and exam dates.

C. Complete Course Offering Form (COF): Program Managers send COF to Course Coordinators to complete the following: 1. Course name and number 2. Classroom size and type 3. Dates and times for class and/or conference 4. AV needs 5. Exam Testing dates/times needed for Computer Lab (NOTE: Refer to

accommodations for additional considerations with testing request) 6. Textbook: (Title, publishing company, author, edition, ISBN, cost)

Refer to Appendix A: COF example D. Order Textbook Desk Copies: Submit information for ordering desk copies to

the Program Manager. Typically it is acceptable to request one text per 10 students enrolled in the course.

E. Request Clinical Sites, Simulation Time or LRC Time: 1. Clinical Sites: Refer to Appendix B for Responsibilities related to Clinical

Sites. 2. Simulation Center: Communicate needs with Program Director. Once the

Program Director has discussed with other Program Directors and confirmed that there are no schedule conflicts, contact the simulation center to submit the request.

3. Learning Resource Center (LRC) Lab: Communicate needs to the LRC Coordinator and submit schedule request to the LRC.

II. Six (6) Weeks PRIOR to the Semester Start A. Prepare Syllabus: Course Syllabi are developed by the Program Committees.

Depending on curriculum needs, the Faculty will develop, revise, and submit for approval.

B. The syllabus consists of standard topic areas: Topic areas are to be reviewed and updated by the Course Coordinator in collaboration with the teaching team and Program Director each semester. Exceptions: areas designated with a * cannot be changed without Program Committee and CON Faculty Senate approval. 1. Course Title and Credit Hours* 2. Placement* 3. Prerequisites*

4

4. Co-requisites* 5. Faculty

Example of Information to be Included: Name of Faculty and Credentials Faculty Rank Department Email Address Phone Number; Office Location Role: Course Coordinator, Lecture, Clinical, Simulation

6. Course Description* 7. Learning Outcomes* 8. Topical Outline* 9. Teaching/Learning Methods* 10. Criteria for Selection of Teaching/Learning Methods* 11. Evaluation Methods (include the numerical grading scale) 12. Criteria for Selection of Evaluation Method 13. Grading Scale* 14. Clinical Activities (if course has a clinical component) 15. Required and Recommend Texts 16. Pertinent/General Course Information 17. CON and Institution mission, vision, and values statements* 18. Program terminal objectives* Additional Pertinent/General Information that may be added to the Syllabus based on Program preferences includes: 1. Integrated Learning System (e.g., ATI) 2. Class Attendance Policy 3. Exam Attendance Policy 4. Accommodations Due to Disability Policy 5. Academic Honesty 6. Classroom Civility 7. Learning Management System (e.g., Desire2Learn) expectations 8. Lecture Capture (e.g., ECHO) 9. Preferred methods for student/faculty communication ( e.g., email, phone) 10. Student Course Evaluations (e.g., One45)

NOTE: In existing courses, changes in a course title, credit hours, placement, prerequisites, course description, learning outcomes or topical outline/content must be approved by the Program Committee, the CON Faculty Senate (for pre-licensure), and the Graduate School (for graduate programs). Any recommended changes in these areas and rationale for the changes should be documented and presented to appropriate Program Committee for approval. The Program Committee then sends a recommendation forward for approval. This process can take several months.

C. Classroom Confirmation: Once the classroom requests have been confirmed, CON Student Affairs will notify Coordinators of the classroom assignments.

5

Distant education connections are scheduled in coordination with classroom request. Any request for classroom changes must be approved by Department Chair and then communicated with the CON Student Affairs.

D. Integrated Learning System: For the Integrated Learning System (e.g., ATI) System, obtain assigned exams and tests for course from the Program Director and complete the information process for students. The following information about the system requirements needs to be clearly provided in each course syllabus: 1. The list of the required activities 2. Minimum passing requirement 3. Access Code (if needed) 4. Suggested timeline for test completion 5. A clear statement of expectations

Example Statement: This learning system is a systematic approach developed to help students be successful on NCLEX-RN. The practice tests and finals are designed to help students learn how to read test questions, identify and analyze critical elements of questions, and apply didactic and clinical knowledge to correctly answer questions. There are # Topic Practice Tests and # Topic Final(s) assigned to NURS XXXX. Completion of all assignment by date before last class, at 2359 is a requirement of NURS XXXX. A minimum score of 90% on all Practice Tests and the Final is required. Failure to complete and/or meet the passing score of 90% on all Practice Tests will result in the loss of five (5) points from the final calculated grade.

E. Course Planning Team Meeting: Meet with teaching team and clinical faculty (as applicable) to plan and communicate role expectations and schedules for the course. A review of the Course Summary from the last course offering are shared and discussed to aid in the planning. Content teaching and evaluation responsibility assignments for the teaching team faculty are made at these team meetings. Communicate course and exam schedules with the Program Director so consideration of student workload and due dates can be made.

F. Clinical Courses: Communicate with the Academic Clinical Liaison (pre-licensure) or designated program faculty (Nurse Anesthesia, Nurse Practitioner) concerning clinical agency contracts, placement forms and orientation requirements for students and faculty that are specific to the course clinical sites. The CON Clinical Faculty Handbook provides guidance on coordinating the clinical experience for courses.

G. Other: As appropriate, prepare class materials, handouts, exams, and online materials prior to first day of class (refer to the Learning Management System, e.g., Desire2Learn, and other resources for tutorials and classes to assist with this preparation).

6

III. PRIOR to the First Class Day A. Prepare Course Orientation B. Upload Course material in Learning Management System (e.g.,

Desire2Learn) Refer to tutorials and attend classes for assistance as needed.

C. REQUIRED Information to be provided to students on the first class day: 1. Syllabus 2. Course faculty (and if applicable, clinical faculty) names, teaching role,

office location, and phone contact information. Example of Information to be Included:

Name of Faculty and Credentials Faculty Rank Department Email Address Phone Number; Office Location Role: Course Coordinator, Lecture, Clinical, Simulation

3. Approved grading scale Note: Students must make a “C” or higher in all nursing courses to progress in the program. Rounding Policy: During the semester, all grades will be recorded to two (2) decimal places. At the end of the semester, the final grade will be calculated to two decimal places and rounded mathematically as follows: a. <0.50 round down to next whole number (82.49 rounded to 82) b. >0.50 round up to next whole number (91.95 rounded to 92)

4. Evaluation Methodology (grade weighing and specific grading criteria/rubric)

5. Statement for due dates and missed/late assignments Examples: a. Due dates are expected to be met. If extenuating circumstances occur

and a student is unable to meet a due date, notification of appropriate faculty prior to the due date is required. Late exams or assignments are not accepted unless a prior arrangement with the Course Coordinator has been made.

b. Submission by due date is expected. Points may be deducted if projects/papers are not submitted by established due dates. In case of emergencies, exceptions may be granted.

6. Course Schedule/Calendar Include class dates/times, reading assignments, test dates, and other scheduled activities. For Clinical, Sim or Lab Courses: a. Clinical Descriptions and Schedule to include location, faculty, dates

and times, and expectations. b. Clinical/Sim Evaluation tool.

7. Handouts Other materials/handouts may be distributed throughout the semester as appropriate or placed on Learning Management System (e.g.,

7

Desire2Learn) for access by students. Handouts should be posted 24 hours in advance. This allows sufficient time for student access, especially in the event of electronic transmission problems.

IV. Course Orientation – First Class Day

A. Review syllabus in detail B. Review Class Attendance policy C. Introduction to all course faculty (and clinical faculty if applicable) D. Faculty Office Hours E. Communication Process overview F. Etiquette, civility, professionalism, and expectations G. Distance Technology (IP): TV, Audio, and how to ask questions H. All evaluation criteria for the didactic, clinical, and Sim or Lab (if applicable)

components of the course should be clearly explained to all students as part of their orientation to the course.

I. Classroom Management Resources LINK: http://policy.georgiahealth.edu/2010/09/22/classroom-services-policies-and-procedures/ NOTE: Faculty are expected to provide a 10 minute ‘break’ after each 50 minutes of class time. Classes must end 10 minutes early to allow for transition of students in/out of classroom. For example: Classes scheduled 9am – 11am must end at 10:50am. If during class, you need assistance with :

• Audiovisual Equipment, IP Links, classroom conflicts, heat/air conditioning

i. Augusta campus call Classroom Services (706-721-3061/3062) ii. Athens campus contact the Office Associate (706-389-6825)

• Computer Testing Rooms i. Contact: IT Help desk (706-721-4000) or the IT support for

Nursing.

V. First Few Weeks of the Semester A. Confirm Roster: CON Student Affairs sends an email with instructions to

Confirm the Roster in Student Records/Information System (i.e. POUNCE). To access POUNCE, visit portal.georgiahealth.edu and choose the POUNCE icon. Use your NetID and password you use for Email to access. Please check over the POUNCE roster in detail as it must be accurate and account for every student enrolled in your course. POUNCE Instructions: http://www.gru.edu/registrar/classroster.php If the roster is incomplete, students who are not correct on the roster are notified by the Course Coordinator via phone or email to contact the Registrar’s office (in person or by phone).

B. Submit Course Materials: During the first few weeks of the semester, you will receive a request to submit the following course materials: • Course Syllabus

8

• Course Calendar • Rotation Schedules (clinical, simulation, lab) with list of student groups

assigned to faculty Since these materials have been prepared for the first day of class, there should not be a delay in responding to this request. Please respond to the email by the assigned deadline and attach the requested documents. The requested documents are essential records for the CON Academic Affairs Office and are required for accreditation.

C. Complete CIR: CON Student Affairs sends an email with instructions for POUNCE access for completion of Curriculum Inventory Report (CIR) Every semester, a curriculum inventory report must be submitted that lists the names of faculty assigned to teach the course and the teaching hour information. A link and instructions for completion of this form online is emailed to Coordinators by the Registrar’s Office and CON Student Affairs about two weeks into the semester. CIR must be validated by the Course Coordinator and returned by the specified date. CIR Instructions: http://www.gru.edu/registrar/cir.php

D. Exam Construction: Writing an exam requires preparation and following guidelines for valid test item construction. Valid test questions helps develop students' critical thinking skills, reinforce the nursing process and test students' abilities to use their nursing knowledge. Several resources are available for faculty assistance. This includes faculty mentoring, faculty development class, the use of tutorials or other resources.

1. Plan a timeline for completing your exam, peer review of exam questions, and uploading online for computer testing.

2. Exams must be proctored by a faculty member. Staff Associates are not permitted to proctor exams. It is recommended that a statistical analysis of all exam items be conducted prior to releasing grades.

3. Grades should not be released until all students have been tested. However, in instances where there is a great delay (longer than a few days), grades/scores may be released with the exam closed until all students have been tested.

E. Exam Grading: Learning Management System offers a Calculation Grade Book. Refer to Learning Management System (e.g., Desire2Learn) tutorial for guidelines on setting up these calculations of evaluation methodologies.

F. Team Meeting: Consult or meet with course faculty to communicate or discuss issues/progress in the course. Recommended that at a minimum, there should be 1 team meeting during the semester.

G. Special Considerations: The Assistant Dean for Student Affairs/Program Director will communicate with Course Coordinators if students in the course have documented need for special accommodations. These are documented in the Office of Disability Services. Contact Office of Testing and Disability Services at 706-737-1469 or visit online at http://www.gru.edu/admin/tds/

H. Withdrawal Passing Information: Information concerning policy on WP is available in the CON Student Handbook. The timeline for WP is noted on the GRU academic calendar http://www.gru.edu/registrar/calendar.php

9

VI. Midterm of the Semester

A. Submit Additional Course Materials: You will receive a request to submit the following course materials: • One Course Handout • One Course Test/Examination Since these materials have been prepared for class periods prior to midterm, there should not be a delay in responding to this request. Please respond to the email by the assigned deadline and attach the requested documents. The requested documents are essential records for the CON Academic Affairs Office and are required for accreditation.

B. Formative Feedback from Students: Consider taking class time or the use of a survey through the Learning Management System (e.g., Desire2Learn) to obtain formative feedback from students. This should occur 4-6 weeks into the semester. Consult with other Coordinators for creative ideas for seeking this feedback and other classroom assessment techniques.

C. Formative Feedback from Faculty: Consult or conduct a team meeting with course faculty to discuss issues/progress in the course. Check with Affiliate, Clinical and/or Sim/Lab faculty for any student passing concerns.

D. Check student status for completion of the Integrated Learning System (e.g., ATI) requirements: Check each student’s overall course grade status for passing the requirements for the course. Identify issues and meet with students who are not satisfactory at midterm. (Note: Unsatisfactory at midterm will require a written contract with student.)

E. Midterm Student Reports – Academic Jeopardy: The Course Coordinator reviews each student’s academic and clinical progress at midterm. If applicable, the Coordinator makes contact with the didactic, clinical and simulation faculty to determine if any students are in jeopardy of not passing. 1. At midterm, letters are sent to inform students if they are in academic

jeopardy. This letter should include the grade status and the existing grades for the course. It also must include specific recommendations for successful course completion such as meeting with Course Coordinator, extra time in the LRC, study habits, tutors, etc.

2. The Learning Management System (D2L) is acceptable for sending letter to the student with a copy to CON Student Affairs, the Program Director and student’s Advisor. This is placed in the student file in Student Affairs office

3. Example: midterm Student sample letters- Appendix E F. Preparation for Final Course Evaluations: An email request from the Office

of Academic Affairs will arrive after midterm requesting confirmation of the faculty teaching in the course as well as clinical, lab or sim faculty with specific student groups as indicated. Please check to ensure accuracy of the information and submit any changes necessary. This is to ensure that students received the correct list of faculty for the course/clinical for evaluation.

10

VII. End of Semester & Course Wrap Up A. Course Evaluation: Facilitate student access and completion of Course

Evaluation with reminders of dates for Student Evaluation access in the correct format (e.g., One45). View the Course Evaluation Form—Appendix F

B. Submit Final Grades 1. POUNCE is used to input final grades. See Instructions:

http://www.gru.edu/registrar/gradesub.php 2. Print, sign and date a hard copy of student grades to CON Student Affairs by

the assigned deadline. 3. Student may access their grades through POUNCE. No grades are mailed to

students. Final Grade can be posted and released through the Learning Management System (e.g., Desire2Learn).

C. Incomplete Grades: The “I”- incomplete grade is defined as “indicates that a student was doing satisfactory work but, for non-academic reasons beyond his/her control, was unable to meet the full requirements of the course”. The ‘I” is not available to select as a grade in POUNCE. The “Justification of Incomplete Grade Form” will need to be completed and turned into CON Office of Student Affairs to assign a grade of “I”-incomplete. http://policy.gru.edu/3-4-3-incomplete-grade-policy/ NOTE: Any “I”- incomplete grade reason that does not comply with the Institutional Policy will not be accepted and a final grade of “A, B, C, D, F, S or U” will have to be assigned. Please do not send the student a memo. If approved, this form will be distributed to the student, the department and the Dean’s Office/Office of Student Affairs.

D. Additional Course Material Documentation for Academic Affairs: Clinical Course material is maintained in the Office for Academic Affairs for our accreditation documentation. Course Coordinators will be prompted by email communication to submit the following information by an assigned deadline. See Appendix B for specific forms. 1. Prelicensure

a) Clinical Placement form (one per agency or nursing unit) b) Clinical Agency Evaluation c) Individual Student Clinical Evaluation form

2. Nursing Anesthesia a) Clinical Placement form b) Clinical Rotation Evaluation form c) Individual Student Self-Evaluation form d) Individual Student Clinical Evaluation form

3. Nurse Practitioner a) APN Clinical Preceptor Agreement form b) APN Clinical Time Sheet c) Individual Student Evaluation form d) Preceptor’s Evaluation of APRN Student Performance form e) Student Clinical Site Evaluation form f) Student Evaluation of Preceptor form g) Preceptorship Documentation form

11

G. Complete Course Summary: Schedule a summative wrap-up meeting with teaching team to provide input into next course offering planning. Complete and submit Course Summary and note suggested course improvements while fresh in your mind (see Appendix G).

H. Peer-Review for faculty teaching: For faculty development, it is important to seek input from colleagues. Peer review process is being developed within the CON.

VIII. Several Weeks after Course Completion

A. Coordinator Written Response to Student Evaluations: The Office of Academic Affairs will email Course Coordinators the responses from their student evaluations approximately 3-4 weeks after grades are sent to the registrar. Coordinators submit a formal reply via email form to Academic Affairs and Department Chair within reasonable time period as indicated in the email communication. The purpose is to demonstrate accountability for the course outcomes, student input, and to assist with the next year planning. Example: Appendix H.

12

Coordinator Timeline Checklist

Date Task Comments Completed 12 weeks prior to semester start Course Coordinator Team Meeting Prepare Course Calendar Complete Course Offering Form (COF) Order Textbook Desk Copies Request Clinical Sites, Simulation Time or LRC

Time Required for course

Six (6) Weeks PRIOR to the Semester Starts Prepare Syllabus Classroom Confirmation Identify needed assignments for the Integrated

Learning System (if applicable)

Course Planning Team Meeting Clinical Course- confirm placements/ forms Prepare class lectures, etc PRIOR to the First Class Day Prepare Course Orientation Upload Course material in Learning

Management System (e.g., Desire2Learn)

First Few Weeks of the Semester Confirm Roster in POUNCE Submit requested Course Materials (syllabus,

calendar, rotation schedules)

Complete CIR Seek assistance with this form Exam Construction Team Meeting for communication Midterm of the Semester Submit Additional Requested Course Materials

(handout, test/examination)

Formative Feedback from Students Formative Feedback from Faculty Check student status for completion of the

Integrated Learning System (e.g., ATI) requirements

Midterm Student Reports – Academic Jeopardy Communicate with Program Director the

midterm status in your course

Preparation for Final Course Evaluations End of Semester & Course Wrap Up Facilitate Course Evaluation Complete and Submit Student Clinical

Evaluations

Submit Final Grades in POUNCE Wrap-up Meeting with Teaching Team Coordinator Written Response to Student

Evaluations

13

Appendix A Course Offering Information Form (COF)

EXAMPLE

Thank you for your assistance.

Please send form to NAME Program Manager at [email protected] Due May 28, 20XX

Course Title NURS 3107: Health Assessment CRN XXXXX Date form completed 5/22/XX Course Coordinator: Faculty Name Expected enrollment 40 Is this course cross-listed? no If yes, with which course Credit hours 3 Is this course 100% online? No Technology requirements Support for online modules Additional Comments Learning Management System (e.g., Desire2Learn) support

and computer testing support Classroom AV equipment(using PPT, internet access, ECHO capability)

Days for face-to-face lecture Mondays Times for Lecture 1300-1500 If days and times are variable, please provide the specifics

Room preference for lecture Classroom lecture style seating

Room preference for exams EC 2216 for total of 41 computers Specific Instructions

Required textbooks Include author(s), title, edition, publisher, ISBN, and cost.

Jarvis, C. (2011). Physical Examination & Health Assessment. Saunders/Elsevier. 6th edition. • ISBN-10: 1437701515 • ISBN-13: 978-1437701517 • Cost- $93

Recommended textbooks

NA

Does this course have a clinical component?

No, but there is a lab LRC on Tuesdays 11:30 - 1430

If yes, days/times of clinical LRC on Tuesdays 11:30 – 2:30 Will you need a classroom reserved for clinical orientation or other dates?

No.

If yes, room preference(s)

14

Appendix B Responsibilities Related to Clinical Site Request

1. Clinical Coordination:

a. Pre-licensure: All clinical placements are made in collaboration with the Academic Clinical Liaison, who assumes responsibility for establishing and maintaining clinical partnerships for student clinical placement reservation on clinical units in acute care agencies and hospital-based community organizations. The Course Coordinator manages student placement for non-hospital community sites.

b. Nursing Anesthesia: All clinical placements are made in collaboration with the Nursing Anesthesia Program Director and program faculty. The Program Manager provides the administrative oversight of the clinical placements.

c. Nurse Practitioner: All clinical placement are made in collaboration with campus designated NP Clinical Liaison’s. Administrative oversight is provided by designated Staff Associates.

2. Requests for Clinical Sites: The College of Nursing must have a “Memorandum of

Understanding”, or contract with the agency in order to place students in clinical experiences. The Administrative Coordinator in the Office of the Associate Dean of Academic Affairs keeps an updated list of agencies with which GRU College of Nursing has a contract. The Clinical Agency List is also located on the CON Intranet and is located under Faculty Resources within the Office of Academic and Student Affairs tab. Process: a. Determine if existing contract is in place. b. Clinical requests for the next Academic Year are to be submitted in Spring semester each year

(February): 1) Pre-licensure: submit request to the Academic Clinical Liaison (pre-licensure) and the

Office of CON Academic Affairs. 2) Nursing Anesthesia: submit final request to the Nursing Anesthesia Program Manager. 3) Nurse Practitioner: submit final request to the Staff Associate assigned for administrative

oversight. c. To request a new clinical site, complete a Clinical Site Request Form (See Appendix C). d. If you are requesting the use of an agency that the CON does not have a contract with, then the

Clinical Coordinator (or designated faculty member) must first visit the agency, complete a “Clinical Site Survey” form and send to the Academic Programs Office. The Administrative Coordinator will then initiate a contract with the agency. The agency representative and either the Dean of the College of Nursing or the President of GRU must sign this form.

NOTE: Students cannot be placed in the clinical site until all parties sign the contract. The time line for processing a contract can take 2-6 weeks so it is important to plan ahead.

3. Forms for Clinical Courses (Appendix D)

a. Baccalaureate (BSN) Program: 1) Clinical Placement Form: Circulate a form titled “Undergraduate Program Clinical

Placement” to all clinical faculty for completion. This form confirms the names of students assigned to each clinical group, the unit to which they are assigned, the dates and times of clinical and student absences. (These forms are distributed to the Course and Clinical Coordinators from the Office of the Associate Dean of Academic Affairs and are required by the State Board of Nursing and the hospital agencies). One per agency or nursing unit.

2) Clinical Agency Evaluation Form: Have clinical instructors submit the “Clinical Agency Evaluation of Learning Activities” to appropriate person in the clinical site to complete and

15

return to the Office of the Associate Dean. Collect data regarding evaluation of the clinical agency from the completed clinical forms. Use this information for future clinical placements.

3) Individual Student Clinical Evaluation Form: Clinical faculty complete on each student and submit to the Clinical Coordinator. These are reviewed and then sent to the office of Student Affairs to file in students record.

b. Clinical Nurse Leader (CNL) Program: 1) Clinical Placement Form: Circulate a form titled “CNL Clinical Placement” to all clinical

faculty for completion. This form confirms the names of students assigned to each clinical group, the unit to which they are assigned, the dates and times of clinical and student absences. (These forms are distributed to the Course and Clinical Coordinators from the Office of the Associate Dean of Academic Affairs and are required by the State Board of Nursing and the hospital agencies). One per agency or nursing unit.

2) Clinical Agency Evaluation Form: Have clinical instructors submit the “Clinical Nurse Leader Clinical Agency Evaluation of Learning Activities” to appropriate person in the clinical site to complete and return to the Office of the Associate Dean. Collect data regarding evaluation of the clinical agency from the completed clinical forms. Use this information for future clinical placements.

3) Individual Student Clinical Evaluation Form: Clinical faculty complete on each student and submit to the Clinical Coordinator. These are reviewed and then sent to the office of Student Affairs to file in students record.

c. Nursing Anesthesia Program: 1) Clinical Placement Form: This form confirms the names of students assigned to each

clinical group, the unit to which they are assigned, the dates and times of clinical and student absences. The completed forms are submitted and kept in the program files.

2) Clinical Site Visit Evaluation Form: Faculty completes this form upon visit to a clinical site. The completion of this information is essential and provides information for future clinical placements.

d. Nurse Practitioner Programs: 1) APN Clinical Preceptor Agreement Form: This form confirms the preceptor agreement

to work with the student for the semester assigned. A form must be completed and on file for each preceptor arrangement.

2) APN Clinical Time Sheet: This form confirms the clinical time of the students assigned to clinical courses. One per agency or nursing unit.

3) NP Faculty Evaluation of Student Performance: Clinical faculty complete on each student. These are reviewed and then sent to the office of Student Affairs to file in students record.

4) Preceptor’s Evaluation of APRN Student Performance Form: Preceptors complete on each student and submit to the Clinical Coordinator. These are reviewed and then sent to the office of Student Affairs to file in students record.

5) Student Clinical Site Evaluation Form: Each student completes this evaluation on each clinical site that they have encountered. Information gathered from the students experience with the clinical site will be useful when considering future clinical placements.

6) NP Student Evaluation of Preceptor Form: Each student complete this evaluation on the preceptor they worked with during the semester. Information gathered from the students experience with the preceptor will be useful when considering utilizing the preceptor in the future.

7) Preceptorship Documentation Form: Completion of this form will be done when requested by preceptor. Form is used to document precepting by the preceptor for certification renewal.

16

4. Thank you letters for preceptors and agencies: A letter to each agency/preceptors is prepared by Course Coordinator (or clinical faculty as indicated) and sent within a few weeks of the course completion. Maintaining good relationship with clinical sites is essential. Course Coordinators for the practicum course typically send Certificates of Appreciation for preceptors.

17

Appendix C

Clinical Site Survey Form for new Contract with Agency COLLEGE OF NURSING

Clinical Agency Site Survey/Description Agency Name ___________________________________________________ Address ____________________________________________________________

Telephone Number ____________________________________________________________

Administrator __________________________________________________________ Nurse Administrator __________________________________________________________________ (if applicable) license number Liaison Person ________________________________________________________ Name of Accrediting Organization __________________________________________________________________ Approved by Department of Human Resources Standards & Licensure __________________________________________________________________ Classification (e.g., general acute care setting, skilled _________________________________________________________________ nursing home, community site, institution) Number of Licensed Beds ________________________ Number of Open Beds______________________ Census on Date of Site Visit ________________________ Average # of Clients _______________________

Faculty Site Visitor ________________________________________________________________________ DATE Describe: (1) Description of the process used to schedule students (e.g., days, times, other schools): (2) Course specific learning activities (e.g., services provided, clinical population): (3) Agency Resources which facilitate the planning, implementation, and evaluation of clinical learning activities: (4) Agency personnel who facilitate the learning goals of the clinical experience. (e.g., Chief RN’s, other health care workers): (5) Description of the process used by facility, agency, staff, and students to select learning activities collaboratively. (6) Evaluation of clinical activities by students, faculty, and agency staff (e.g., evaluation forms used by College of Nursing, conference): (7) Identify the best aspect of this practice setting: (8) Identify the least desirable aspect of this practice setting:

18

GEORGIA REGENTS UNIVERSITY COLLEGE OF NURSING – GRADUATE PROGRAMS

Clinical Agency Site Evaluation Form

Agency Name:

Address: City/State/Zip: Telephone Number: Facsimile Number:

Administrator/Manager With Signature Authority For Contract: Name

Student/s Evaluated: Name

Preceptor(s): Name & Credentials as appropriate License # Name & Credentials as appropriate License # Organization Accredited Yes No by JCAHO or Equivalent: Facility Type (RE: Primary Care/ER, etc):

Type of patients seen: Facility conducive to support Yes No support student learning outcomes? (sufficient resources/equipment/ space, etc.) Comments: Level of knowledge & experience Yes No of preceptor/s adequate to support student learning outcomes? Comments: Level of collaboration Yes No with preceptor adequate to support student learning outcomes? Comments: Level of depth & scope of Yes No clinical experience adequate to support student learning outcomes?: Comments: Faculty Site Visitor

SIGNATURE DATE

19

Appendix D Clinical Placement Form

GEORGIA REGENTS UNIVERSITY COLLEGE OF NURSING

UNDERGRADUATE PROGRAM Course: NURS 3210 Adult Nursing Coordinator: Faculty Name Agency: XXXX Home Health - Augusta Clinical Faculty: Faculty Name_____ Semester/Year: SPRING 2012

Please rate the clinical agency for effectiveness as a learning resource for undergraduate students: Poor: _____ Average: _______ Above Average: X ___ Superior: ____ Additional Comments: Excellent placement for students to work with Preceptor in provision of home health assessments and care for pt and families with acute and chronic conditions.

STUDENT UNIT DATES OF CLINICAL TIMES OF CLINICAL

ABSENCES

Name

Home Health

Wed & Thursdays (6 days) Jan 11- Jan 26

8-4:30pm

None

Name Feb 1- Feb 16 Name Feb 22- March 8 Name March 14- 29

20

CLINICAL AGENCY EVALUATION OF CLINICAL LEARNING ACTIVITIES Instructions to Clinical Instructor: Please attach clinical course outcomes to this form and have clinical agency employee (Head Nurse, Clinical Director, etc.) complete form at end of clinical rotation and return to you. Course Number & Title: Instructor: Agency: Agency Employee Completing Form: Employee Title: Date: Instructions to Agency Employee: Please help us evaluate clinical learning activities by providing the following information: Great Moderate Small Not At Don't All Know 1. Degree to which unit provided learning experiences which helped meet course outcomes (attached): ____ ____ ____ ____ ____ 2. Degree to which needs of students and instructor were made known to you: ____ ____ ____ ____ ____ 3. Quality of communication among staff/instructor/students: ____ ____ ____ ____ ____ 4. Extent to which students contributed to providing quality patient care on unit: ____ ____ ____ ____ ____ 5. Comments:


MSN CLINICAL NURSE LEADER PROGRAM

CLINICAL PLACEMENT FORM Course: Course Coordinator: Agency: Clinical Faculty: Semester/Year: STUDENT UNIT DATES OF CLINICAL TIMES OF CLINICAL ABSENCES Lucy Richardson Marquetta Dobson Elizabeth Awad Marissa Liebscher Kathryn Gallivan Kim Weber Katie Hill Brittany Raborn Please rate the clinical agency for effectiveness as a learning resource for pre-licensure students: Poor: Average: Above Average: Superior: Additional Comments (Use the back if needed):

21

22

Georgia Regents University Clinical Nurse Leader Program

College of Nursing

CLINICAL AGENCY EVALUATION OF CLINICAL LEARNING ACTIVITIES

Instructions to Clinical Instructor: Please ask a nurse leader (i.e. manager, charge nurse) at the clinical agency to evaluate your clinical group at the end of the rotation. Provide a copy of the course goals from the syllabus. Course Number & Title: Instructor: Clinical Agency and unit: Instructions to Agency Employee: Please help us evaluate clinical learning activities by providing the following information: Title: Date: Strongly

Agree Agree Not Sure Disagree Strongly

Disagree 1. Clinical unit provided

appropriate learning experiences (see course goals)

2. Needs of students and instructor were made known to the nursing staff

3. Communication among staff, instructor, & students was appropriate

4. Students contributed to quality patient care on the unit

5. Comments:

Nursing Anesthesia Program Clinical Placement Form

Student Aug 19-‐Sept 13 Sept 16-‐Oct 11 Oct 14-‐Nov 9 Nov 11-‐Dec 6 CMC GRMC Summitt St. Mary’s CMC GRMC Doctor’s Doctor’s St. Mary’s Habersham Northside Piedmont Atl MCCG MCCG WGMC OB St. Joe’s GRMC Piedmont Atl MCCG MCCG Doctor’s WGMC CMC WGMC OB WGMC OB Doctor’s CMC GRMC GRMC WGMC OB GRMC CMC Summitt St. Joe’s EGRMC Doctor’s Phoebe Putney Summitt WGMC OB Houston EGRMC Doctor’s St. Mary’s GRMC Piedmont Atl Phoebe Putney Doctor’s GRMC Doctor’s Doctor’s GRMC CMC MCCG MCCG St. Mary’s Northside Northside St. Mary’s Piedmont Atl WGMC OB WGMC CMC ARMC ARMC St. Joe’s CMC Habersham Summitt WGMC OB EGRMC Houston Habersham ARMC ARMC GRMC EGRMC Habersham WGMC OB MCCG MCCG Specialty rotations= Doctor’s combined general & burns, ARMC & St. Joseph hearts, GRMC neuro & gen, CMC peds, Habersham & Summitt regional, and MCCG are 5 days per week. Each clinical site can determine if you are called in for cases. If you work past 2300 you cannot do cases next day per COA. OB is 24-‐hour/7days per week coverage get with Barry Cranfill to work out schedule. Macon is 5 days a week. While there the site coordinator will move you into specialty rotations. *2 of 5 try and get hearts*

23

24

Georgia Regents University Nursing Anesthesia Program

Clinical Site Visit Evaluation Form Clinical Site: Date of Visit: Site Visitor: Student(s) seen: Preceptor(s) seen:

Accrediting Agency: Date of last review:

Students’ time commitment is reasonable Yes No Students receive an orientation to the facility Yes No An anesthesia library is available Yes No Study facilities are available Yes No Equipment is adequate, up to date and well Yes No maintained Depth and breadth of cases are adequate Yes No Case assignments are fair and equitable Yes No The students’ experience and patients’ PS are Yes No considered in making assignments Students participate in all aspects of anesthetic Yes No management Adequate supervision is always present and Yes No available Preceptors allow students to function within the Yes No limits of the students’ knowledge and experience Preceptors engage students in meaningful Yes No discussion Housing is available Yes No Housing is safe Yes No Opportunities available for:

Invasive monitoring Yes No Regional Anesthesia Yes No Call Yes No Out of OR cases (radiology, CT scanner, et) Yes No

Preceptor credentials are current Yes No Additional Comments:

Comments

Clinical Site Eval Rev.: 01/07 mbb

GEORGIA REGENTS UNIVERSITY

School of Graduate Studies/ School of Nursing APN Clinical Preceptor Agreement Form

Student Semester/Date

Thank you for agreeing to precept one of our graduate students in the nurse practitioner program this

semester. Your participation as a preceptor for the nurse practitioner program is an essential component of

their educational curriculum. Clinical rotations with a preceptor offer a unique opportunity for students to

observe and practice the art of managing patient care in primary care. The student will contact you to arrange

specific clinical schedules, but this semester clinical begins and ends . The

student will complete a minimum of hours with you. Students are covered under the University’s

liability policy as long as they are functioning within the course objectives. They are HIPAA trained, CPR

certified, and are up to date on the following immunizations: TB, Hepatitis B, Td, MMR. Students will

supply preceptors with copies of course documentation including: course syllabus, agreement form, clinical

evaluation tool, daily log & time sheet. Please contact course coordinator for any questions of concerns:

Course Coordinator: Phone:

Preceptor Information

Preceptor License #

Preceptor E-Mail

Name of Clinic

Address Phone

Brief Summary of site (Practice Specialty, Population Served (age range), and facility description):

The preceptor agrees to the best of his/her abilities to facilitate student learning accordance with course

objectives. The preceptor agrees to provide clinical supervision and support over the semester. All students

are required to keep and submit to faculty a Daily clinical log. All logs include only patient initials, no

personal ID information and are used solely as a learning tool for students.

Please check ONE of the following below and sign

_______ Preceptor is aware of Daily Log and sample chart requirement. Student is able to copy a weekly

sample of their charting (with all patient identifying information removed and confidentiality assured).

_______ Preceptor is aware of Daily log but would prefer student to write rather than copy note.

_______ Preceptor has concerns about Daily log and charting sample (contact coordinator above)

____________________________________________ (Signature) Date: ____________________

Please submit a copy of your current Resume or Curriculum Vitae by e-mail to [email protected] Or

fax it to Dorie Krapf, 706-568-2073

DKrapf 1/13

25

mailto:[email protected]

GEORGIA REGENTS UNIVERSITY

School of Graduate Studies/ School of Nursing

APN Clinical Time Sheet

Course Number:________________________ Semester/Campus:______________________________

This log accurately reflects time spent in the clinical setting.

______________________________________ (Student Signature) _____________________Date

______________________________________ (Preceptor Signature) _____________________ Date

D. Krapf 2013

Week of Dates of clinical Time to nearest

15 minutes

Total hours for day Cumulative hours Preceptor Initials

(weekly)

Comments

example 1/13/08 0900-1645 7H 45 M 13H 45 M JB Rounds at hospital

26

Faculty Evaluation of APRN Student Performance

Student: _________________________________________ Faculty___________________________________________ Date: ___________________________ Clinical Site: ________________________________________________________________ Course Name/Semester/required clinical hours :___________________________________________________________________ Hours of Contact required__________________ Site Visit(s) Date__________________________________________________

Evaluation Scoring: 1= Inadequate: unsafe/ requires significant or constant guidance or interaction 2= Unsatisfactory: inconsistent performance/ requires frequent guidance or interaction 3= Satisfactory: requires verbal coaching/ moderate interaction to perform / functions not carried out thoroughly 4= Very Good: relatively independent/ requires intermittent coaching or interaction/direction/ generally accurate and competent in most situations 5= Excellent: independent with validation/ accurate and competent in all types of situations n/a= not applicable/not observed PASS: rating of 3 or above in each behavior of each category NO PASS: rating of 2 or below in any behavior of each category

Performance Site visit 1 Site Visit 2 (if needed)

INTERPERSONAL/COMMUNICATIONS SKILLS

Establishes rapport and communicates effectively with patients and their families

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Uses communication skills adapted to the patient’s and family’s health literacy, cultural background, and learning style

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Maintains confidentiality, dignity and privacy of patient. Creates climate of trust 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Effectively focuses communications to garner and share clinical information in an organized and succinct manner

1 2 3 4 5 n/a 1 2 3 4 5 n/a

ASSESSMENT

History Taking

Obtains relevant comprehensive and problem focused health histories using collateral sources as necessary

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Evaluates signs and symptoms, including age appropriate changes, noting pertinent positives and negatives

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Prioritizes data collection appropriately 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Physical Examination

Performs a pertinent, comprehensive physical assessment 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Performs a pertinent, comprehensive mental health and cognitive assessment 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Uses correct examination techniques 1 2 3 4 5 n/a 1 2 3 4 5 n/a

27

DIAGNOSIS

Utilizes assessment findings to develop appropriate plan for lab and diagnostic procedures

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Develops prioritized list of differential diagnosis based on history, physical and diagnostic data

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Synthesizes data to make clinical decisions regarding appropriate collaboration, consultation and referral

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Develops problem list including medical problems, health needs for health promotion, counseling and disease prevention(screening) relevant to age

1 2 3 4 5 n/a 1 2 3 4 5 n/a

PLAN OF CARE

Formulates actions, diagnostic testing and interventions based on scientific rationale, evidence based standards and practice guidelines

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Prepares a plan of management for patient’s problems including appropriate pharmacologic and non-pharmacologic treatment interventions

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Initiates referrals and consultations as indicated 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Promotes quality, safety and risk reduction in plan of care 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Documents accurately and according to legal standards 1 2 3 4 5 n/a 1 2 3 4 5 n/a

PROFESSIONAL ROLE DEVELOPMENT

Demonstrates interest in continued learning outside clinical setting 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Works collaboratively with other health care professionals as part of an interdisciplinary team

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Is always punctual, professionally dressed and gives preceptor appropriate notification if unable to attend clinical day. Attends clinical as scheduled with minimal changes

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Maintains clinical logs every two weeks and keeps updated 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Additional Faculty Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Faculty Signature_________________________ Date:_______________ Please print name:_______________________________________________________________

Student Signature__________________________ Date:_______________

Please print name:________________________________________________________________

28

Preceptor's Evaluation of APRN Student Performance

Student: __________________________________ Preceptor (include credentials) ______________________________________ Course Name/Semester/Required clinical hours____________________________________________________________________ Date Completed:___________________________ (Check one) Midterm___ or Final____ Hours of Contact______________ Clinical Site: ________________________________________________________________ Evaluation Scoring: 1= Inadequate: unsafe/ requires significant or constant guidance or interaction 2= Unsatisfactory: inconsistent performance/ requires frequent guidance or interaction 3= Satisfactory: requires verbal coaching/ moderate interaction to perform / functions not carried out thoroughly 4= Very Good: relatively independent/ requires intermittent coaching or interaction/direction/ generally accurate and competent in most situations 5= Excellent: independent with validation/ accurate and competent in all types of situations n/a= not applicable/not observed PASS: rating of 3 or above in each behavior of each category NO PASS: rating of 2 or below in any behavior of each category

Performance Midterm Final

INTERPERSONAL/COMMUNICATIONS SKILLS

Establishes rapport and communicates effectively with patients and their families

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Uses communication skills adapted to the patient’s and family’s health literacy, cultural background, and learning style

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Maintains confidentiality, dignity and privacy of patient. Creates climate of trust 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Effectively focuses communications to garner and share clinical information in an organized and succinct manner

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Provides appropriate communication during crisis/ times of change in health status for patient

1 2 3 4 5 n/a 1 2 3 4 5 n/a

ASSESSMENT

History Taking

Obtains relevant comprehensive and problem focused health histories using collateral sources as necessary

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Evaluates signs and symptoms, including age appropriate changes, noting pertinent positives and negatives

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Prioritizes data collection appropriately 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Physical Examination

29

Performs a pertinent, comprehensive physical assessment 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Performs a pertinent, comprehensive mental health and cognitive assessment 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Uses correct examination techniques 1 2 3 4 5 n/a 1 2 3 4 5 n/a

DIAGNOSIS

Utilizes assessment findings to develop appropriate plan for lab and diagnostic procedures

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Develops prioritized list of differential diagnosis based on history, physical and diagnostic data

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Synthesizes data to make clinical decisions regarding appropriate collaboration, consultation and referral

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Develops problem list including medical problems, health needs for health promotion, counseling and disease prevention(screening) relevant to age

1 2 3 4 5 n/a 1 2 3 4 5 n/a

PLAN OF CARE

Formulates actions, diagnostic testing and interventions based on scientific rationale, evidence based standards and practice guidelines

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Prepares a plan of management for patient’s problems including appropriate pharmacologic and non pharmacologic treatment interventions

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Evaluates results of interventions and modifies plan of care after evaluating patient’s response to therapeutic interventions

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Assesses client’s need for teaching and provides appropriate counseling regarding management/condition. Accounts for cultural influences and learning styles.

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Initiates referrals and consultations as indicated 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Promotes quality, safety and risk reduction in plan of care 1 2 3 4 5 n/a 1 2 3 4 5 n/a

Documents accurately and according to legal standards 1 2 3 4 5 n/a 1 2 3 4 5 n/a

PROFESSIONAL ROLE DEVELOPMENT

Evaluates and revises objectives with preceptor/demonstrates interest in continued learning

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Works collaboratively with other health care professionals as part of an interdisciplinary team

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Is always punctual, professionally dressed and gives preceptor appropriate notification if unable to attend clinical day. Attends clinical as scheduled with minimal changes

1 2 3 4 5 n/a 1 2 3 4 5 n/a

Additional Preceptor Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Preceptor Signature_________________________ Date:_______________ Please print name:_______________________________________________________________

Student Signature__________________________ Date:_______________

Please print name:________________________________________________________________

30

Georgia Regents University Graduate College of Nursing

STUDENT CLINICAL SITE EVALUATION Clinical Site Name: Address: Semester used: Completed by Date Answer by checking the appropriate response.

1. Is adequate space provided? YES NO 2. Is adequate time given to see clients? YES NO 3. Are there sufficient numbers of clients? YES NO 4. Are the types of clients varied (age, problem, socioeconomic status, etc) YES NO 5. Are students allowed to select clients according to their learning needs? YES NO 6. Are student given the opportunity to follow-up with clients? YES NO 7. Are reports from lab and x-ray accessible to students? YES NO 8. Is support staff appropriately helpful to students? YES NO 9. Does site provide health promotion and disease prevention? YES NO 10. Does site provide disease diagnosis and management? YES NO 11. Are community resources, other agencies, and professional disciplines involved with client welfare? YES NO 12. Do you recommend this site for other NP students? YES NO Additional comments:

31

Georgia Regents University Graduate College of Nursing

STUDENT EVALUATION OF PRECEPTOR Preceptor: Clinic Name: Student: ____________________________________ Semester __________________ Check the appropriate number that corresponds to each statement according to the following scale 0- Not applicable 1- Never 2- Seldom 3- Sometimes 4- Frequently 5- Always Use back for additional comments. 1 2 3 4 5 1. Is available to student

2. Demonstrates understanding of the NP role

3. Utilizes student's strengths & knowledge

4. Serves as good role model

5. Demonstrates effective rapport with clients

6. Encourages student to assume increasing responsibility during the semester

7. Assists student in identifying goals and needs for experiences

8. Considers student's limits according to level of training

9. Provides immediate and adequate feedback

10. Leads student through decision making rather than giving own impressions

11. Reviews and signs each clinic note

12. Offers constructive comments about chart notes

13. Encourages questions

14. Thoughtfully reviews differential diagnosis with student

15. Discusses alternative management

16. Allows student opportunities to suggest drug of choice, calculate dosages, suggest lab & x-ray to be ordered

17. Communicates clinical knowledge well

18. Utilizes other members of the health care team

19. Suggests and provides additional learning experiences

20. Provides alternative experiences when there are no clients

21. Reviews evaluations with student and provides immediate and constructive feedback

32

ANCC Certification Renewal 35

Certification Renewal Category 5: Preceptorship Documentation

Directions: To fulfill Professional Development Category 5, have the educational institution complete this document to confirm your role as a preceptor. All information must be written legibly in either blue or black ink. This form must be included with your application.

Section I Candidate information (completed by the candidate):

Social Security Number Last Name First Name MI

Certification Specialty Certification #

Section II Completed by faculty coordinating the Preceptorship:

1. The individual named above has completed _______ hours of preceptorship for

Name of the educational institution and program (e.g. University of xxx, School of Nursing)

2. The dates for the preceptorship were to

3. This preceptorship was conducted with students in a❍ Clinical Nurse Specialist program ❍ Associate or Diploma nursing program

❍ Nurse Practitioner program ❍ Baccalaureate nursing program

❍ Other Graduate Nursing programs (specify)

4. The specialty area or focus of this preceptorship was

5. The preceptorship was held in Name of the hospital/institution/facility

Faculty coordinator name, credentials, and title

Educational institution

Program name

Institution address

Telephone number

Signature Date

My signature on this form attests to the fact that the information provided on this form is accurate. Before signing, please ensurethat the entire form has been completed.

Note: Please return this form to the candidate to include with his/her certification renewal application. Forms sent directly by the school to ANCC will not be accepted and will be returned to the addressee.

Appendix E Midterm Student Academic Jeopardy Letter

Example Midterm Student Letter Dear Student,

According to College of Nursing policy, students must obtain a final course grade of C (75) or higher in order to pass a course and continue in their academic progress. Our policy as stated in your syllabus and your Student Handbook also states: ‘Clinical is graded as Satisfactory or Unsatisfactory. A passing grade must be achieved in both didactic and clinical portions of the course in order to achieve a passing grade.’

It is the policy of the Georgia Regents University, College of Nursing to inform any student in writing at midterm if any student is not passing a course with the minimum of a “C” average and/or if concerns exist that a student might not be satisfactory in clinical evaluation. The purpose of this letter is to inform you of your midterm status in the course NURS 4444: Nursing Course. In this course, you have completed two exams which accounts for 50% of your course grade. On Exam 1, you obtained a grade of 70 and on Exam 2 your grade was 68. Your status at midterm is a course average of 69 which is a D. Your clinical evaluation reveals that there is “Needs Improvement” in two areas on your Clinical Evaluation Tool. The areas in which you need improvement are: Outcome #1: Demonstrates professional behavior and accountability as evidenced by: assuming responsibility for timeliness in the clinical areas

- Feedback- As we discussed in our clinical evaluation meeting, you received “Needs Improvement” as you did not attend your assigned PACU experience. I received no page or phone or email communication from you concering this assignment which was discussed in our clinical orientation on January 10, XXXX and January 31, XXXX.

Outcome # 2: Demonstrates preparedness for assignment - Feedback- You have not submit the pre-clinical paperwork on February 2 or 4 or

notify me of concerns with this assignment. There are several opportunities for you to improve your course grade as we have two (2) exams and the final exam remaining for this semester. I would like to provide you with the following recommendations that may assist you in improving your course average:

• Complete the assigned course readings • Attend each scheduled class. Review the ECHO recording. • Review the power point slides posted the course each week to be sure you have key

concepts from each lecture identified. • Refer to the weekly chapters in the textbook and complete the activities for each

chapter. These activities provide you the opportunity to apply principles you have learned in the class.

• Contact the faculty teaching the content if there are particular concepts that you do not understand

34

• Complete the Integrated Learning System (e.g., ATI) Learning Support tutorials: Nurse Logic and Skill Building which provide hints for success in nursing education- especially test taking skills.

• Review your exams with me in my office (see my office hours for an appointment). • Clinical recommendations include: Be on time for each clinical assignment or

proper notification of the instructor. Complete the paperwork prior to the make-up session that have been arranged for you on March 30, Friday (8-12pm). Review the Clinical Evaluation Tool which outlines all clinical expectations. Prepare for clinical by reviewing you schedule and clinical rotation assignments. Meet with your clinical instructor to review any questions you have about your clinical assignments, feedback and progress.

Please schedule an appointment with me to review these recommendations and discuss your current study habits and identify steps that can be taken to ensure this semester is a successful one for you in this course. I can be reached at ….., etc.

Sincerely, FACULTY Course Coordinator, NURS 4444 Cc: NAME, Assistant Dean, Student Affairs

NAME, Director, BSN Program NAME, Advisor

35

Georgia Regents University 10/15/XX First Last Georgia Regents University College of Nursing BSN Class of 2013

This letter is to serve as a supplement to your NURS 4315 clinical evaluation tool. Your performance related clinical expectations for this course is deemed unsatisfactory at this time. Your specific clinical skills/expectations and the corresponding items on the clinical evaluation tool identified as unsatisfactory (scoring of 2) include the following:

• Communication (1.1, 1.5)

In Week #1, you submitted clinical paperwork using an assessment written by another student. After counseling you about this, you submitted a file with your own name, but no other changes. In Week #2, you submitted paperwork with language from chart and/or numerous factual errors.

• Assessment, Data Collection, and Analysis (2.1, 2.2) Multiple errors noted in Week #2 assessment and in care plan on Week #3 paperwork.

• Evaluation (5.1, 5.2) Unsatisfactory patient outcome and evaluation statements on Week #3 care plan

• Critical Thinking and Decision Making (6.1, 6.5, 6.6) My midterm evaluation of your expected progression and improvement in critical thinking is limited by the fact that paperwork submitted in first two weeks is either not your own work or it contains factual errors. I also notice a significant discrepancy between your self-evaluation scores and mine that suggests you do not recognize areas of needed improvement.

• Role Development and Professionalism (7.5) You stated that your paperwork submission in Week #1 was simply a case of attaching the wrong file. You did not make any acknowledgement in our meeting about viewing this submission as disrespectful of your fellow student, nor did you make any further effort to submit your own assessment of the patient.

Corrective Action: Based on the above areas being “unsatisfactory”, the following remediation and student follow-up is required in order for you to be successful in this course.

1. Submit all clinical paperwork, evaluations, and any other materials assigned for this

36

course by the assigned due date, with evidence that you have completed the work independently of work by any other student, and with all necessary references.

2. If there is an extenuating circumstance interfering with clinical paperwork completion, you must notify the appropriate faculty prior to the due date/time. You may be required to submit documentation of the extenuating circumstance.

3. Make all recommended revisions to all clinical paperwork submitted in Week #4, Week #5, and Week #6

4. Meet with Prof. XXXX 1:1 at least once during each clinical day to discuss specific assessment and care-planning details about your assigned patient. After each clinical day, contact Prof. XXXX by email or in person no later than Friday if you have any additional questions.

Failure to meet these clinical requirements will result in “No Pass” on your clinical evaluation tool. As noted on the Undergraduate Clinical Evaluation Tool—students must achieve a “3” or higher on all behaviors in order to successfully complete clinical. A copy of this letter and corresponding clinical evaluation tool will be placed in your student file. Dr. XXXX (Program Director), Dr. XXXX (Student Advisor); and Dr. XXXX (NURS 4315 Course Coordinator) will be sent a signed copy of this letter with follow-up on the corrective action plan completion.

If you have any additional questions, please feel free to contact me via email [email protected]

Sincerely NAME Augusta Site Campus Coordinator NURS 4315

Cc: Dr. XXXX, Course Coordinator

Dr. XXXX Program Director Dr. XXXX, Student Advisor Dr. XXXX, Assistant Dean for Student Affairs (for the file)

Attachment: Clinical Evaluation Tool dated 10/12/XX

37


Main Coordinator Evaluation for GRU Nursing Students

Directions: Your response provides an opportunity to reflect on your experiences and is helpful with future planning and teaching. Your confidential answers will be most helpful if they are as accurate, objective, and complete as possible. The results will not be shared with faculty until after final grades have been submitted. Please check the most appropriate response with not applicable = 0, strongly disagree = 1, disagree = 2, neutral = 3, agree = 4 and strongly agree = 5. COURSE & MAIN COORDINATOR Please evaluate the following about the course overall: Not

Applicable Strongly Disagree

Disagree Neutral Agree Strongly Agree

1. The course objectives were clearly stated and documented on the syllabus.

2. The course was well organized and logically sequenced. 3. The course assignments (i.e. readings, papers, exams, etc)

were current and relevant to course content.

4. The main course coordinator ensured the course assignments (i.e. readings, papers, exams etc), due dates, and grading criteria were effectively communicated and documented.

5. The main course coordinator ensured the teaching methodologies (lectures, labs, online activities, classroom response system-clickers, small group activities, etc.) contributed positively to overall learning.

6. The main course coordinator was available and helpful in addressing student questions and/or concerns.

7. The main course coordinator provided timely feedback on assignments (i.e. readings, papers, projects, etc) and examinations.

8. The main course coordinator contributed positively to my overall learning and satisfaction with the course.

MEAN SCORE Comments:

38

GEORGIA REGENTS UNIVERSITY SCHOOL OF NURSING

Site Coordinator Evaluation for GRU Nursing Students

Directions: Your response provides an opportunity to reflect on your experiences and is helpful with future planning and teaching. Your confidential answers will be most helpful if they are as accurate, objective, and complete as possible. The results will not be shared with faculty until after final grades have been submitted. Please check the most appropriate response with not applicable = 0, strongly disagree = 1, disagree = 2, neutral = 3, agree = 4 and strongly agree = 5. SITE COORDINATOR for Course Please evaluate the following about the course coordinator: Not



1. The site course coordinator attended all classes and addressed student questions and/or concerns.

2. The site course coordinator facilitated the administration of course exams and/or teaching activities (i.e. readings, papers, projects, etc).

3. The site course coordinator was available, willing, and helpful for student advisement and/or assistance.

4. The site course coordinator ensured timely feedback on assignments (i.e. readings, papers, projects, etc) and examinations.

5. The site course coordinator contributed positively to my overall learning and satisfaction with the course.


39


Faculty Evaluation for GRU Nursing Students

Directions: Your response provides an opportunity to reflect on your experiences and is helpful with future planning and teaching. Your confidential answers will be most helpful if they are as accurate, objective, and complete as possible. The results will not be shared with faculty until after final grades have been submitted. Please check the most appropriate response with not applicable = 0, strongly disagree = 1, disagree = 2, neutral = 3, agree = 4 and strongly agree = 5. COURSE FACULTY Please evaluate the following about the course faculty: Not



1. The faculty member was consistently well prepared for class.

2. The faculty member effectively utilized course time.

3. The faculty member established and maintained quality standards and encouraged optimal performance.

4. The faculty member was available, willing, and helpful in advising and assisting students with timely feedback.

5. The faculty member contributed positively to my overall learning and satisfaction with the course.


40


Clinical Evaluation for GRU Nursing Students

Directions: Your response provides an opportunity to reflect on your experiences and is helpful with future planning and teaching. Your confidential answers will be most helpful if they are as accurate, objective, and complete as possible. The results will not be shared with faculty until after final grades have been submitted. Please check the most appropriate response with not applicable = 0, strongly disagree = 1, disagree = 2, neutral = 3, agree = 4 and strongly agree = 5. CLINICAL FACULTY Please evaluate the following about the course faculty: Not



1. The faculty member was consistently well prepared for clinical.

2. The faculty member effectively utilized clinical time.

3. The faculty member established and maintained quality standards and encouraged optimal performance.

4. The faculty member was available, willing, and helpful in advising and assisting students with timely feedback.

5. The faculty member contributed positively to my overall learning and satisfaction in the clinic(s).


41

GEORGIA REGENTS UNIVERSITY College of Nursing

LEARNING RESOURCE CENTER [LRC] SKILLS LAB QUESTIONS FOR STUDENTS

Directions: To be answered by ALL students (ONLY IF APPLICABLE), one time per semester during program of study. Your response provides an opportunity to reflect on your experiences and is helpful with future planning and teaching. Your confidential answers will be most helpful if they are as accurate, objective, and complete as possible. The results will not be shared with faculty until after final grades have been submitted. Please check the most appropriate response with strongly disagree = 1, disagree = 2, neutral = 3, agree = 4 and strongly agree = 5. Please evaluate aspects of the LRC simulated learning experience: Strongly

Disagree Disagree Neutral Agree Strongly

Agree 1. The faculty teaching the LRC experiences were

consistently well prepared and competent.

2. The LRC experiences stimulated me to use critical thinking skills.

3. The knowledge gained through the LRC experiences can be transferred to the clinical setting.

4. The LRC experience ensured adequate time for instruction, practice, and evaluation and provided essential feedback when necessary.

5. The LRC experiences contributed positively to my overall learning and satisfaction with the course.


42


Simulation Evaluation for GRU Nursing Students

Directions: Your response provides an opportunity to reflect on your experiences and is helpful with future planning and teaching. Your confidential answers will be most helpful if they are as accurate, objective, and complete as possible. The results will not be shared with faculty until after final grades have been submitted. Please check the most appropriate response with not applicable = 0, strongly disagree = 1, disagree = 2, neutral = 3, agree = 4 and strongly agree = 5. Simulation/SIM FACULTY Please evaluate the following about the course faculty: Strongly

Disagree Disagree Neutral Agree Strongly

Agree 1. The faculty teaching Simulation were consistently

well prepared and competent.

2. The Simulation experiences stimulated me to use critical thinking skills.

3. The knowledge gained through the Simulation experiences can be transferred to the clinical setting.

4. The faculty teaching Simulation ensured the incorporation of feedback during the simulation/debriefing experience.

5. The Simulation experiences contributed positively to my overall learning and satisfaction with the course.


43

Appendix G Course Summary

Directions: A Course Summary is a document that is prepared by the Course Coordinator after the completion of the course and should summarize the events of the semester. The Course Coordinator should meet with course faculty for a wrap-up meeting and discussion of course events. The following information is recommended to be included in the Course Summary.

1. Course Title 2. Semester Offered 3. Textbooks Used 4. Course Enrollment 5. Classroom 6. Clinical 7. Critical Thinking/Learning Strategies Utilized 8. Evaluation Methodology 9. Course Evaluation Summary with student comments 10. Recommendations/ Suggestions for Improvement

44

Appendix H Coordinators Response to Student Course Evaluations

Faculty complete the online form based on the feedback from the student evaluation summary received from the Office of Academic Affairs. This comes via email and is confidential. Faculty review the information and respond via email to Office of Academic Affairs and copy to department chair.

Example Response: Provide brief overview of the replies, including the positives, concerns and your recommendations. Example: The final course evaluations were completed by 32 (85%) students who reported high satisfaction with the course organization, workload clarity, and timeliness in communication and a 4.8 overall satisfaction. The majority of the students remarked that the case studies were most helpful in reinforcing the content. About 10% of the responses noted that the criteria for the paper was not clear and requested a point breakdown. Several reported a feeling of ‘being overwhelmed’ initially with these new concepts and three did not like the versatility of the quiz formats (multiple choice, discussion, etc. were utilized). Recommendation: Cleary identify a response to the summary and considerations or a plan for the next course offering. Examples:

1. Continue as online course stressing self-direction and accountability for learning.

2. Continue with the group projects for application and expansion of learning in to the practice setting. Relook at the grading criteria for clarity.

3. For next offering of this course, offer another project example in an audiovisual presentation format for additional clarity to respond to student suggestions. Textbooks update will be considered

45