Clinical Competencies Program Evaluation

Tara Peters

Boise State University

2
Summary
Mountainland Applied Technology College (MATC) Practical Nursing program conducted an
evaluation of their clinical competency program, which is one aspect of the nursing program. The
survey results found that the clinical competency program is generally effective, though some specific
findings warrant further attention. Students and instructors alike found the clinical competencies to be
effective in providing structure and direction to students, demonstrating student progress and in
helping students meet program outcomes. The program will continue as it is in the near term, but will
undergo some revisions based on the evaluation findings during 2014. The target date for rolling out
the revised clinical competencies is August, 2014.
Program Description
MATCs Practical Nursing (PN) Program is two semesters in length and is comprised of several
separate but closely linked elements each designed to address and specific aspect of the novice
practical nurses essential educations and training. The clinical competencies program is one such
essential element designed to provide practical nursing students with a tool intended to help them
develop their clinical skills, critical thinking skills, and to synthesize their didactic and clinical
education. Thus, the clinical competency program was designed to provide students with the
foundations they will need to be safe, competent nurses upon completion of the PN program.
Program Objectives
The clinical competencies program objective is to provide PN students the knowledge, skills
and experience they need to function as novice nurses after graduation. By the end of the two semester
Practical Nursing program students should be able to:
Demonstrate critical thinking in the use of the nursing process
Demonstrate use of management and leadership principles in the delivery of patient care
Perform nursing interventions in a safe and effective manner
Use therapeutic communication while providing nursing care to patients and their families
Demonstrate professional behaviors
Each of these clinical competencies are further broken down into specific elements that detail what
students need to do in order to fulfill the competencies, and the complete clinical competencies are
included as an attachment for reference. Students are also shown how to complete skills such as nurses
notes, medication administration and sterile technique, for example, during skills lab for nine weeks
prior to attending clinicals. This is to help ensure that students possess the skills they need to be
successful at clinical and that they understand what will be expected of them. Students are also
expected to pass off on each skill prior to attending clinicals, and they will not be allowed to attend
clinicals until they can demonstrate basic competency in each skill.
Program Components
Prior to attending clinicals all nursing students must attend several weeks of labs where they
will learn basic nursing skills and begin to apply what they have learned in their didactic classes to
their clinical practice. Once students have completed the requisite number of labs and have
demonstrated basic proficiency of the learned skills they will move from lab to their clinical
placements in one of three long-term care facilities. Students attend clinicals once per week at the same
site each week for the rest of their first semester and they will work closely with a nurse while also
being supervised by their clinical instructor. Instructors have eight students to monitor and assist, and
this is an average student to instructor ratio.
While in clinicals the students will be expected to demonstrate their ability to perform
previously learned skills and they will have the opportunity to develop their critical thinking skills by
applying what they learn in their didactic classes to the clinical setting. In order to keep track of

3
student progress and to provide structure to the clinical experience, the faculty has devised a set of
clinical competencies (attached) that the students must complete successfully each semester. The
clinical competencies were designed to allow for more assistance during the first semester and more
independence and personal responsibility in the second semester with the goal of providing support for
their learning early on and encouraging steady progression of their skills, critical thinking and
confidence by the end of the two semester program.
The clinical competencies (Appendix A) are mapped to the PN programs Student Learning
Outcomes (Appendix B) and QSEN quality measures (Appendix C). Each objective contains a number
of individual items the student must complete successfully in order to meet the objective and to be
considered competent. It is understood that students are new to nursing and possibly to the clinical
setting; therefore, students are allowed multiple submissions of each element if needed. While clinical
instructors do expect to see progress as each semester unfolds, the weekly clinical competency
submissions are considered formative (no points attached) until the final due date at the end of the
semester when they become the summative evidence of clinical success or failure.
The faculty intends that every element of the PN program be relevant and linked to a specific
learning outcome or competency. In addition, each class, lab, simulation, or clinical experience is not
to be considered a discreet unit but they are all linked and based on the same curriculum. Students
should be able to move from didactic to lab to clinicals and know that vocabulary such as objective and
subjective data, skills such as nurses notes and physical assessments and so forth are consistent. The
clinical competency program is intended to link didactic to clinicals, to provide a consistent clinical
experience for students and to provide all students a consistent learning experience where they can
develop their nursing skills and demonstrate their competence in key areas.
Evaluation Method
The evaluation followed a goal-based model, and quantitative and qualitative data was
collected using surveys and interviews to answer the following questions:
Do the clinical competencies help students use and demonstrate critical thinking in the use of
the nursing process?
Do the clinical competencies help students use and demonstrate management and leadership
principles in the delivery of patient care?
Do the clinical competencies help students use and demonstrate their ability to perform nursing
interventions in a safe and effective manner?
Do the clinical competencies help students use and demonstrate their ability to use therapeutic
communication while providing nursing care to patients and their families?
Do the clinical competencies help students use and demonstrate professional behaviors?
Do the clinical competencies help students and instructors focus their efforts during clinicals?
Do students and instructors have enough time to complete the clinical competencies?
Do students and instructors have enough time to ask and answer questions during clinical and
post-clinical conferences?
Were students and instructors oriented to the clinical competency program and do they feel they
understand expectations.
Are instructors recognizing student progression from one semester to the next?
Are students able to integrate classroom learning into their patient care?
Finally, Nursing Advisory Board members were asked about our students and graduates performance
at clinicals, after hire, or both if applicable.

4
The surveys addressed the objectives given earlier though the questions were somewhat
different for students than for instructors. The survey questions with results are attached as Appendix
D. The evaluation is aimed at examining the efficiency, effectiveness and impact of the clinical
competency program. The program will be considered successful if it is easy to use, helps students and
instructors gauge student performance in clinicals, and if our community partners report positive
outcomes for and perceptions of our students after graduation. The results will be used to inform the
facultys decisions about adjustments to the program at this time, though the program will be
monitored at least every semester or as needed to ensure student learning is taking place and program
goals are being met.
Participants
The program participants include all first and second semester PN students, clinical and
didactic instructors, and our Advisory Board Members. All four part-time clinical instructors were
given the opportunity to complete the survey. One instructor completed the survey but all four
provided detailed narratives in person. No need for sampling exists because the population of
instructors is small, and the same is true of students. Currently, 24 first semester and 21 second
semester students are enrolled in the Practical Nursing program, and with such a small population all
second semester students will be included in the study, although participation is completely voluntary.
First semester students were not surveyed due to the fact they have had only one week in
clinicals and have not had enough time to become familiar with the program. Of the 21 students asked
to participate in the survey, 15 responded. In addition to the instructors and students, all 10 Advisory
Board Members present at the March 20, 2014 meeting were asked to provide input into the process
participated, making this a non-random, self-selecting convenience sample.
Procedures
The clinical competencies program was fully operational and ran normally while the evaluation
was being conducted. Survey questions were developed for each objective and these were reviewed by
the full-time faculty prior to use. Once the questions were finalized surveys were created in Survey
Monkey and made available to staff and students from March 17, 2014 until March 24, 2014. All
faculty members were invited to interview no later than March 22, 2014, and all clinical instructors did
so. All current students were sent a link to the survey and were offered an in-class pizza party as a
thank you for their participation, with proof being a printed or electronic copy of the thank you for
participating page at the end of the survey. Advisory Board members were asked for their input at the
Advisory Board Meeting on March 20, 2014 and their comments were recorded for review.
Data Sources
The two sources of data in this evaluation were student surveys and clinical instructor surveys.
The student and instructor survey questions and answers, along with the questions asked of the
advisory board members are included in Appendix D. Students and instructors were surveyed from
March 15, 2014 through March 22, 2014. In addition, the Nursing Advisory Board members present at
the March 20, 2014 Advisory Board Meeting were asked about their perceptions of our students
preparedness both at clinicals and as new employees.
Once the surveys were closed the data was compiled and comments examined, a table was
created to make the results more accessible for all stakeholders. Appendix D lists the questions from
the student survey and the results, plus the open text comments students wrote in after each question. If
the same comment was made multiple times, one representative comment is provided followed by the
number (#) of times it was mentioned as a response to that question. In addition, demographics were
collected to correlate student answers to age or hours worked per week, for example.

5
Results
This section analyzes the data associated with each program objective or question being evaluated. The
results indicate that the objectives are being met but the survey results and the comments indicate there
is room for improvement.
Clinical Objective 1: Demonstrate critical thinking in the use of the nursing process
Student questions eight and ten ask students about the students perceptions of their ability to
apply what they have learned in the classroom to their clinical experiences and whether they find that
the clinical competencies provide them a way to demonstrate their ability to critically think through the
nursing care they provide their patients. Over 90% of the students agree that the clinical competencies
provide they can apply what they have learned and that the clinical competencies help them
demonstrate this ability, one student disagreed. The one free text response entered stated, They really
helped me apply my critical thinking skills and recognize what I learned in the clinical setting.
Instructor responses to questions to questions 9, 11 and 12 indicate that first semester students
are still developing their critical thinking skills but that by the middle of the second semester they have
made definite improvement in their critical thinking skills as indicated by the instructor responses.
Instructors also agree that the clinical competencies mostly or always provide the students a way to
demonstrate their critical thinking skills. One instructor stated, By the end of the clinical rotation it is
apparent the students know where to find the information if they don't know. Especially with
medications and the related labs and how it can affect the patient.
Nursing Advisory Board members are not in a position to speak to the clinical competencies
specifically, but they are able to give the PN Program an indication of what kind of impact the clinical
competencies are having once students graduate. Three Nursing Advisory Board members stated that
they prefer to hire MATC PN program graduates because, in the words of one member,
Your students are ready to hit the floor when we hire them, and we hire them
over BYU 4 year grads when possible because while the BYU grads are book
smart, your students have actual clinical experience and can think like nurses.
They are not afraid to make decisions and provide direct patient care.
One advisory board member approached the Program Director after the meeting and asked to
have more students placed in their clinical site so they would be able to evaluate and potentially hire
more MATC graduates. The results appear to indicate that the clinical competencies are effective in
helping students meet Clinical Objective 1.
Clinical Objective 2: Demonstrate use of management and leadership principles in the delivery
of patient care
Student survey results were mixed for questions 10 and 11 which covered prioritization and
time management issues. This is one area that students generally score low on when they take their
licensing exam, the NCLEX-PN, even though these issues are covered at length in multiple classes and
the concepts are woven throughout the program. While 80% of the students surveyed felt the
competencies did help them learn and demonstrate organization, time management and prioritization
skills, 20% did not. Clinical instructors indicate that student skills improve in these areas from first to
second semester, but the results are not overwhelmingly positive. The clinical competencies related to
these areas could be strengthened.
Advisory Board members also had a lukewarm reaction to the students abilities to prioritize,
manage time and be organized but all agreed that these skills take time to learn and that it is not really
reasonable to expect novice nurses to be adept at these skills without a significant amount of daily
clinical practice. Their general consensus was that the students are about where they are expected to be
for newly graduated, inexperienced nurses. Therefore, it appears that Clinical Objective 2 is partially

6
met but that rewriting the competencies or explaining them better may help students see the connection
between the concepts, the competencies and their clinical experiences.
Clinical Objective 3: Perform nursing interventions in a safe and effective manner
Student survey questions 9 and 13 address student perceptions about how well prepared they
think they are to work as a nurse, and if they feel they can perform the required skills in a safe and
effective manner. In other words, can students see a direct connection between what they are asked to
do as part of their clinical education and the job for which they are training? One-hundred percent of
the students felt that their clinical experiences are mostly or always preparing them for the workplace,
and 86% of the students felt that the competencies provide them a way to demonstrate their ability to
perform safe and effective nursing care.
The negative comments all seem to stem from the students perceptions that they are not getting
adequate experiences in some areas and this perception is causing them some anxiety. This is a
common issue with nursing students and is an expected result. More thorough explanations about what
can reasonably be expected from any clinical experience in any setting plus supportive encouragement
surrounding simulation lab use may help ameliorate some of the anxiety these students experience.
Instructors indicated in questions 9 and 11 that students are meeting expectations regarding physical
assessments, medication administration and sterile technique (all necessary and common skills) and
that students are making progress from first to second semester. Advisory Board members agreed that
MATC PN students are safe and possess the basic skills they would expect of first year nurses. They
had no recommendations for any improvements in this area.
Clinical Objective 4: Use therapeutic communication while providing nursing care to patients
and their families
Student survey question 14 asks about therapeutic communication, which is an essential skill
for anyone working with patients, many of whom can be depressed, frightened, angry or confused.
Students learn about therapeutic communication techniques and the importance of patient-centered
interactions in the classroom and in the skills lab. The clinical experience provides students a way to
put what they have learned into practice and to try out their beginning level skills with the guidance
and support of their instructors and the nurses with whom they work. Seventy-three percent of the
students agree that the clinical competencies help them learn how to use therapeutic communication
while 27% feel that they help in this area only somewhat or a little. Further examination of this result
is warranted to determine if the students feel they already know the concepts and techniques well
enough that the competencies do not help, if they do not understand how to apply the competencies or
if the competency itself needs to be rewritten. The survey question wording may also have influenced
the results.
Instructors again saw progression from first to second semester, with 100% agreement that the
students can perform this at the expected levels by the second semester. Advisory Board members were
not asked about this issue directly, but all agreed that student-patient interactions were positive and
professional and that they have not had any issues with MATC PN students or new graduate hires.
From these results it appears that Clinical Objective 4 may only be partially met, but that further
investigation and clarification is in order before rewriting the competency.
Objective 5: Demonstrate professional behaviors
Students were mixed about the clinical competencies helping them be aware of their own
professional behaviors, yet clinical instructors were generally favorable about this and they indicated
the students are progressing in their professionalism from first to second semester. One student stated,
Clinical is a great way to apply what we are learning. Most telling about the impact of the program
are the comments made by Advisory Board members, all of whom agreed that MATC PN students
were professional, compassionate and that they make a good impression on and are well like by the

7
patients and their families. While 80% of the students felt the clinical competencies helped them be
more aware of their professional behaviors, 20% did not. It is not clear from the results if that is
because these students were already aware of the need to maintain a certain level of professionalism or
if the competencies simply did not help them in this regard. Further examination of this point is
warranted prior to changing this competency, though the issue should be discussed.
In addition to the questions directly related to the clinical competencies directly related to the
clinical objectives, more general information about the clinical competency program was gathered.
Clinical instructors and students were asked a series of questions about their perceptions of the
program, and the questions and results of those questions follow.
Question 1: Do the clinical competencies help students and instructors focus their efforts during
clinicals?
The clinical instructors indicate that the competencies provide guidance and structure most of
the time (66.7%) or all of the time (33.3%). No comments were made regarding where the
competencies may be falling short in providing guidance and structure, but clearly there is room for
improvement.
Question 2: Do students and instructors have enough time to complete the clinical competencies?
Regarding time to complete competencies, one student commented that I have time to get the
information for the competencies but not enough time to actually work on them and another student
commented I think we should have more time to sit and look at charts. Instructors felt that they
mostly (67%) or always (33%) have time to address student concerns during clinicals. It would be
interesting to know what students wanted to learn from charts (required information or curiosity).
Question 3: Do students and instructors have enough time to ask and answer questions during
clinical and post-clinical conferences?
Students largely felt that they were able to get assistance from their instructors and that they
had enough time to get their questions answered during post-clinical conferences. While the clinical
competencies are designed in part to give all students a similar clinical experience regardless of their
site placement or instructor, it was still easy to see that the instructor makes a real difference in the
success and perception of the clinical competency program.
Question 4: Were students and instructors oriented to the clinical competency program and do
they feel they understand expectations.
Eighty-six percent of the students felt that they understood what was expected of them at
clinicals all of the time and the remainder agreed that they understood expectations most of the time.
Two of the three instructors who responded to the question stated that they were very well oriented to
the clinical competencies and one felt that they were mostly oriented to the clinical competencies.
While it would be ideal to have 100% of instructors and students feel they fully understand
expectations and the clinical competencies, a more realistic percentage would be 90%. Thus, the
orientation portion of the clinical program overall and the clinical competencies could be strengthened.
Question 5: Are instructors recognizing student progression from one semester to the next?
Clinical instructors indicate that the students are showing progression from the first semester to
the second. The same areas of concern on the NCLEX-PN such as prioritization and patient-specific
care also show up as areas that the instructors rate as less than ideal though still in the mostly or most
of the time category. Progression seems clear and student skills at or above expected levels for PN
students.

8
Question 6: Are students able to integrate classroom learning into their patient care?
Students and instructors alike agree that they are able to apply what they have learned in class
to the clinical setting most of the time. This result is expected and reasonable.
Question 7: Are the clinical sites providing the necessary experiences?
Students seem to be concerned that they are not getting the clinical experiences they need while
clinical instructors tend the think that the clinical sites are providing the types of experiences the PN
students need at this level. The fact is that students are eager to do as much as they can whether they
are ready for it or not, and this is a function of the excitement they feel as they progress through the
program and begin gaining confidence. Students do not realize that although the long-term care centers
may not offer opportunities for them to practice certain skills, being place in a hospital setting is no
guarantee of the opportunity either. As many experienced nurse can attest, many nursing students can
go through a two-year program and never have an opportunity for tracheostomy suctioning, placing a
Foley catheter, or changing a PICC line dressing. While the program teaches these skills in the lab so
students will have some knowledge of them should they ever have the need, it is far more likely that
they will perform the common skills they experience at the long-term care center most often. These
facts should be conveyed to students more strongly and then reinforced throughout the PN program.
Question 8: Do clinical instructors provide or refer students for remediation when needed?
Clinical instructors do refer students for remediation on occasion but not often. This is only an
issue if clinical instructors want to fail a student in clinicals for poor performance but they have not
brought the issues to the students attention or given them the opportunity for remediation. Since this
has been a problem in the past, instructors are encouraged to send students for lab or classroom
assistance not as a punishment but as an opportunity for improvement.
Question 9: Do our students possess the skills needed to function as a novice nurse in the
workplace?
Both the instructors rating of the second semester students skills and the comments from the
Nursing Advisory Board members indicate that the students do possess the skills needed to function in
a safe and effective manner as a novice nurse.
Discussion
According to the results it appears that the clinical competency program is generally effective
at meeting the objectives it was designed to meet, though some areas for clarification and improvement
were identified. Overall the student responses indicate that they feel the clinical competencies are
helping them demonstrate that they have met the clinical course objectives, though they do have some
valid suggestions for improvement. Students mentioned that they felt some competencies were
repetitive or that they were concentrating on the competencies rather than other activities such as
reviewing charts or assisting the nurse with whom they are working.
Instructors are generally happy with the clinical competencies and recognize that they represent
a significant reduction in paperwork and time from the more traditional clinical paperwork associated
with nursing. Instructors also comment that this program requires that students stop and think about
what they are doing and reflect on what they and or do not know. Without some mechanism to force
reflective thinking they feel many students would still be in a task-oriented mode and focused on
completing tasks rather than critically thinking though their nursing care. Some suggestions for
changes have been made which will be examined in the Discussion section of this report.
MATCs Practical Nursing (PN) Program utilizes a clinical competencies program designed to
provide PN students with the means to demonstrate that they have met program goals and objectives.
The clinical competency program is new, therefore; evaluation was needed to determine if the program
is effective and what, if any, changes need to be made in order to improve student outcomes. While

9
most of the program appears to be effective some modifications should be considered. First, students
may not be fully oriented to the intent of the clinical experiences and the clinical competencies. Clear,
consistent messaging concerning these may reduce some uncertainty and misunderstandings. For
example, students question the need to repeat the same skills such as physical assessment. This may be
an indication of their difficulty transitioning from a task oriented mode to a critical thinking mode, and
additional support in this regard may increase student satisfaction and positive engagement with the
clinical competency process. Further analysis is also warranted to determine if there is any correlation
between students who work or have other significant demands on their time and students who feel the
competencies are time consuming.
Overall, it appears the clinical competency program is effective and has lasting impact on the
students behaviors and attitudes, based on Nursing Advisory Board member statement. However, the
program could be more efficient (easier to use) if the orientation and ongoing messaging regarding the
importance of the program in helping students meet program outcomes were strengthened.
Project Cost
Included below is the invoice for the evaluation services rendered.
Tara, Inc.
75 S 1300 E
Pleasant Grove, UT 84062
801-787-5436
To:
MATC
2301 W. Ashton Blvd.
Lehi, UT 84043
801-753-2826
Item Description
Design and Implement Online Surveys
Design and Conduct Face-to-Face Interviews
Post-survey Data Evaluation
Write Evaluation Report
Office Supplies and Printing
Make all checks payable to Tara, Inc.

Invoice
#42
Date: 5/1/2014
For: Clinical
Competency
Evaluation

Hours/Unit Rate
s
5
10
5
8
0.5

Amount
$500
$500
$500
$500
$100
Subtotal
Deposit
Total

$2500.00
$5000.00
$2500.00
$4000.00
$50.00
$14050.00
0.00
$14050.00

10
Appendix A
Student Survey Questions and Responses
Question

Not
at
All
(0)

A little,
Some
of Time
(2)

Mostly,
Most of
Time
(3)

Always,
Very
Well
(4)

Total

Average
Rating

Q 1. I was oriented to the clinical competencies.

0
0%

0
0%

9
60%

6
40%

15

3.4

Q 1. Comments:

Q 2. I have enough time during clinicals to complete my

clinical competencies.
Q 2. Comments:

Q 3. I have enough time to write my clinical competencies

and submit them to my instructor each week.
Q 3. Comments:

First semester was a little bit unclear, but after going over them in post
conference several times, the expectations were understood. Second
semester I didn't have a problem and really enjoyed the competencies.

0
0%

0
0%

5
33.3%

15

3.27

3
20%

4
66.7%

8
33.3%

15

3.33

It depends on the week, if I have three tests in one week I don't do very
many competencies because there isn't enough time to do it all.
(3 instances)

0
0%

Q 5. My clinical instructor is available to answer questions

and assist me during clinicals.

0
0%

1
66.7%

11
33.3%

3
20%

15

3.13

1. It seems like there aren't a lot of labs that are run at my clinical site.
2. There's always a situation you can apply to the competencies, but we
didn't have much opportunity to practice dressing changes, trach care, IM
injections, etc. in the long term center.
3. The more complicated procedures (such as changing a catheter, IV
dressing change, etc) were rarely opportunities, but the simple things
(such as insulin injections) were frequent opportunities.

0
0%

4
66.7%

11
33.3%

15

3.73

1. Tom has been very helpful and great instructor!

2. The first semester my instructor wasn't, but this semester he is.
(Students have different instructors each semester whenever possible.)

Q 6. I am able to get my questions answered during postclinical conferences.

0
0%

Q 6. Comments:
Q 7. I understand what is expected of me in clinicals.

None

Q 7. Comments:
Q 8. I am able to apply what I have learned in the classroom
to my clinical experiences.

None

Q 8. Comments:
Q 9. I feel confident that I am gaining the clinical skills and
knowledge I need to work as a practical nurse when I
graduate.

None

Q 9. Comments:

9
60%

1. I have time to get the information for the competencies but not enough
time to actually work on them.
2. I think we should have more time to sit and look at charts.
Sometimes it was hard to get everything done, especially when there are
some days that it was slow, with PT, or with Respiratory.

Q4. The experiences provided by my clinical site allow me to

complete my clinical competencies.
Q4. Comments:

Q 5. Comments:

1
66.7%

0
0%
0
0%
0
0%

0
0%

3
20%

12
80%

15

3.8

0
0%

2
33.3%

13
66.7%

15

3.87

0
0%

8
33.3%

7
66.7%

15

3.47

0
0%

9
60%

6
40%

15

3.4

1. Sometimes I have gotten a nurse who won't allow me to do very much.

I only get to do CNA things like vital signs and blood sugars.

11
2. I'm just nervous about not having much experience with catheters,
dressing changes, traches, etc. because not much in the long term center.

Q10. The clinical competencies provide me a way to

demonstrate that I can think critically and apply the nursing
process to direct patient care.
Q 10. Comments:
Q 11. The clinical competencies help me learn to prioritize
patient care.
Q 11. Comments:

0
0%

0
0%

Q 12. Comments:
Q 13. The clinical competencies provide me a way to
demonstrate that I can perform nursing interventions in a
safe and effective manner.

None

Q 14. Comments:

6
40%

15

3.33

3
20%

6
40%

6
40%

15

3.2

1. I felt like a lot of each clinical was worrying about doing things that I
could apply to the competencies. I think if there were less competencies I
could really focus more on the patients' needs and doing what the nurse
ask of me.
2. I feel like I already knew from other experiences how to prioritize care,
not so much from the competencies.

0
0%

Q 14. The clinical competencies help me learn how to use

therapeutic communication during patient care.

8
33.3%

They really helped me apply my critical thinking skills and recognize

what I learned in the clinical setting.

Q 12. The clinical competencies help me learn organization

and time management.

Q 13. Comments:

1
66.7%

0
0%

3
20%

6
40%

6
40%

15

3.2

2
33.3%

7
66.7%

6
40%

15

3.27

I would still feel nervous about performing certain procedures (such as a

catheter change) because we didn't get much opportunity to do it outside
of the lab.

0
0%

4
66.7%

5
33.3%

6
40%

15

3.13

I think it's good to evaluate yourself in this area, and the competencies
allowed us to do this.

Q 15. The clinical competencies help me to be aware of my

own professional behaviors.

0
0%

Q 15. Comments:
Q 16. If there was one thing I could change about the clinical
competencies it would be:

1. Clinical is a great way to apply what we are learning.

1. The only thing I would say to change is having it be even between the
clinical instructors. Some seem to require more work than others.
2. More variety. I would love some more hospital experience.
3. Just making sure that the clinical instructor is invested in the teaching
and improvement of there student my second semester with Tom was so
much more productive and I learned so much more having him as my
instructor than in my first semester with a different instructor.
4. Being able to leave the clinical site for lunch.
5. More clarification/examples during orientation.
6. I feel like there isn't enough time to do competencies and sit down and
actually look through charts to be able to get the information for our
charts. I also think that instead of extra lab time required we should have
more clinical hours
7. One thing I would change is to not require repeats of certain
competencies that take longer to record. There is adequate time to
accomplish all the competencies, but with so many repeats of certain
competencies, it becomes more busy work than it does a learning
experience.

3
20%

5
33.3%

7
66.7%

15

3.27

12
Instructor Survey Questions and Responses
Question

Not
at
All
(0)

A little,
Some
of Time
(2)

Mostly,
Most of
Time
(3)

Always,
Very
Well
(4)

Total

Average
Rating

Q 1. I was oriented to the clinical competencies.

0
0%

0
0%

1
33.3%

2
66.7%

3.66

Q 1. Comments:

Q 2. I have enough time during clinicals to address

student concerns.
Q 2. Comments:

First semester was a little bit unclear, but after going over them in post
conference several times, the expectations were understood. Second semester I
didn't have a problem and really enjoyed the competencies.

0
0%

0
0%

Q 3. Comments:
Q4. The competencies provide guidance and structure for
both instructors and students during clinicals.
Q4. Comments:
Q 5. I send written competencies back to students for
revision.

None

0
0%

1
33.3%

3.33

0
0%

3
100%

0
0%

3.00

0
0%

2
66.7%

1
33.3%

3.33

2
66.7%

0
0%

1
33.3%

2.67

None

0
0%

With a sample competency, I find it helps the students understand what is

expected from them on the competency. This made it easier to not only grade
the work but helps guide the students understanding.

Q 6. I send students to the skills lab for remediation.

0
0%

Q 6. Comments:
Q 7. I send students to their classroom instructor for
remediation.

None

Q 7. Comments:

2
66.7%

1. I have time to get the information for the competencies but not enough time
to actually work on them.
2. I think we should have more time to sit and look at charts.
Sometimes it was hard to get everything done, especially when there are some
days that it was slow, with PT, or with Respiratory.

Q 3. Students show evidence of applying what they are

learning in the classroom to their clinical practice.

Q 5. Comments:

0
0%

2
66.7%

3
100%

0
0%

0
0%

2.0

1
33.3%

0
0%

0
0%

1.33

I usually speak with the students regarding areas that need remediation. I also
give rationales when possible. (2)

Q 8. Thinking of your first semester students only: My

students came to clinicals with the basic skills and
knowledge needed to safely participate in patient care at a
level expected of a beginning, novice nursing student.

0
0%

Q 8. Comments:
Q 9. Thinking of your first semester students only: Please
rate your students ability to perform the following
nursing skills:

None

0
0%

3
100%

0
0%

3.00

0, 0%

3, 100%

0, 0%

0, 0%

2.00

Critical Thinking

0, 0%

3, 100%

0, 0%

0, 0%

2.00

Therapeutic Communication

0, 0%

1, 33.3%

2, 66.7%

0, 0%

2.67

Medication Administration

0, 0%

1, 33.3%

2, 66.7%

0, 0%

2.67

Basic Physical assessment

13
0, 0%

0, 0%

0, 0%

3, 100%

4.00

0, 0%

0, 0%

1, 33.3%

2, 66.7%

3.67

0, 0%

0, 0%

2, 66.7%

1, 33.3%

3.33

0, 0%

1, 33.3%

2, 66.7%

0, 0%

2.67

0, 0%

2, 66.7%

1, 33.3%

0, 0%

2.33

0, 0%

0, 0%

0, 0%

0, 0%

3.00

0
0%

3
100%

0
0%

3.00

0, 0%

0, 0%

0, 0%

3, 100%

4.00

Critical Thinking

0, 0%

0, 0%

0, 0%

3, 100%

4.00

Therapeutic Communication

0, 0%

0, 0%

0, 0%

3, 100%

4.00

Medication Administration

0, 0%

0, 0%

1, 33.3%

2, 66.7%

3.67

Don and remove PPE

0, 0%

0, 0%

0, 0%

3, 100%

4.00

0, 0%

0, 0%

0, 0%

3, 100%

4.00

Demonstrate professional behaviors

0, 0%

0, 0%

0, 0%

3, 100%

4.00

Provide patient-specific care

0, 0%

0, 0%

2, 66.7%

1, 33.3%

3.33

Prioritization

0, 0%

0, 0%

3, 100%

0, 0%

3.00

Responsibility for their own learning

0, 0%

0, 0%

1, 33.3%

2, 66.7%

3.67

Q 11. Comments:
Q 12. The clinical competencies provide my students a
way to demonstrate that they can think critically and
apply the nursing process to direct patient care.

None

0
0%

1
33.3%

2
66.7%

3.67

Don and remove PPE

Don and remove sterile gloves
Demonstrate professional behaviors
Provide patient-specific care
Prioritization
Responsibility for their own learning
Q 9. Comments:
Q10. Thinking of your first semester students only: My
students came to clinicals with the basic skills and
knowledge needed to safely participate in patient care
with the degree of autonomy indicated in the written
competencies.

None

Q 10. Comments:
Q 9. Thinking of your second semester students only:
Please rate your students ability to perform the following
nursing skills:

None

Basic Physical assessment

Don and remove sterile gloves

Q 12. Comments:
Q 13. M students are able to apply what they have learned

0
0%

0
0%

By the end of the clinical rotation it is apparent the students know where to
find the information if they don't know. Especially with medications and there
related labs and how it can affect the patient.

3.00

14
in the classroom to their clinical experiences.

0%

Q 13. Comments:
Q 14. Have you made any changes to the clinical
competencies?

None

Q 14. Comments:

Q 15. What changes would you like to suggest to improve

the program and why?

Yes-1
33.3%

0%

100%

0%

No-2
66.7%

I have included a SBAR card for the students to fill out and use to give me a
shift hand-off at the end of the clinical rotation. They have definitely become
more comfortable with giving reports and knowing what is pertinent
information to pass on.
Section 5E is still a little fuzzy to the students and it would be helpful to have
examples listed on the competency so the students will understand what is
expected and have time to accomplish the goals.