Multi Rater Competency Assessment

2015 - 2016 - NURS 253 Practical Nursing Pre-graduate Experience MRA Final (201508)
NURS 253 Practical Nursing Pregraduate experience (PN, 18-Jan-2016 - 07-May-2016)
Student :
Clinical Teacher/Preceptor :
Advisor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Elina Yaskovich
Sophia Donalds
Mala Tiwari-Hosein
Judy Martin
Sunnybrook Health Sciences Centre
Agency
D2
18-Jan-2016 To 07-May-2016
448
448
424

Teacher comment for validated hours:

Elina met the required 448 hours[424 clinical hours 24 hospital/college orientation}
I declare that this is my original work and the sources used are acknowledged.

Abilities and Outcomes / Learning Outcomes

Student Rating

Teacher Rating

1. Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies and procedures of the
practice setting.

1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies and

Satisfactory

Satisfactory

procedures.
E.Y. : Respect preceptor and other nurses on the unit, get on time to clinicals, work safely and responsibly with equipment

1. 2 Act in a professional, responsible, ethical and accountable manner.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

E.Y. : Responsible for one's work, always complete preparatory work, work independently

1. 3 Use the three factor and decision making frameworks to determine strengths and limitations and
when to collaborate and consult with other professionals.

E.Y. : Reflect on experience from clinical practice, try to apply it next time better, use theoretical knowledge, try to see the holistic picture of the care
and prioritize properly

1. 4 Integrate evidence-informed practice and a theory based approach into nursing care.

Satisfactory

Satisfactory

E.Y. : Reflect on experience from clinical practice, try to apply skills next time better, use theoretical knowledge, review textbooks

1. 5 Assess practices and risk management principles and take action to ensure safety of clients,

Satisfactory

self, and others.

E.Y. : Always set a patient's safety as priority, for example, lowering the bed or check breaks of a wheelchair.

Satisfactory

1. 6 Question and clarify unclear orders or directions and when uncertain.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

E.Y. : When uncertain always clarify each point with my preceptor or health team professionals.

1. 7 Question, clarify or challenge questionable orders, decisions or actions by others.

E.Y. : If uncertain, always clarify orders

1. 8 Respond in a professional manner to situations in which there is unsafe, unacceptable or

unprofessional behavior.

E.Y. : Recognize unsafe situations and seek assistance from the clinical teacher or nurse in charge to avoid negative outcomes

1. 9 Demonstrate understanding about the role of the nurse within health care.

Satisfactory

Satisfactory

E.Y. : Understand role of the nurse as first line worker, eager to learn and implement the skills and knowlege in a right way, ask relevant questions
when seeking clarification and/or new knowledge.

Teacher comments for Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies
and procedures of the practice setting. :
Elina continues to deliver safe patient care.She knows her limitation and seeks assistance and guidance when required .Elina demonstrates a strong
work ethics she is present at work in a reliable and timely manner.

2. Communicate using strategies and technology to effect accurate and timely information sharing including data, research, and other
information.

2. 1 Contribute to team sharing and discussions.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

E.Y. : Work effectively reporting medical information to other nurses, or doctors when needed

2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic methods.
E.Y. : Produce documentation in clear and accurate manner.

2. 3 Use effective communication techniques when reporting relevant information and providing
feedback to the appropriate members of the interprofessional heath care team.
E.Y. : Reports relevant client information to appropriate personal , when practicing in a clinical setting.

2. 4 Evaluate and refine techniques used to communicate and share information with clients and the
interprofessional health care team.

E.Y. : Respectfully communicated with all clinical patients by addressing patients by name and giving patients instructions/explanation when
providing care. Offer help to others when clarification or assistance is needed. More practice with health teaching is needed

2. 5 Ensure privacy and confidentiality.

E.Y. : When practicing show respect of patient's privacy by using curtains and all of the right equipment.

Satisfactory

Satisfactory

2. 6 Use technology to retrieve information including research and other date and to obtain and

Satisfactory

Satisfactory

forward information both within and outside the practice setting.

E.Y. : Use variety of resources to farther my understanding of the material and to clear up every uncertainty.

Teacher comments for Communicate using strategies and technology to effect accurate and timely information sharing including data,
research, and other information. :
Elina charting is complete and concise .Elina demonstrates good interaction with others and is an active listener.

3. Engage in relational practice that is caring, compassionate and respectful.

3. 1 Establish therapeutic caring, compassionate, and culturally safe relationships with clients and

Satisfactory

Satisfactory

health care team members.

E.Y. : Show respect to health care team members, take to account cultural preferences, and continuously monitor my own communication techniques
during various situations.

3. 2 Establish a caring environment that supports clients in meeting their needs and outcomes,

Satisfactory

Satisfactory

managing their illness, or experiencing a peaceful death.

E.Y. : When practicing try to practice therapeutic relationships and effective communication techniques with my patients to the best that I can.

3. 3 Demonstrate therapeutic use of self to foster client well-being.

Satisfactory

Satisfactory

E.Y. : Use different therapeutic communication skills and evaluate client response to improve care. Recognize the impact of my own behavior on
others. Try always communicate with polite and calm manner.

3. 4 Utilize relational knowledge and skills, and ethical principles to support clients and to interact

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

with health care providers.

E.Y. : Try to take in consideration client's beliefs and experience to establish trust relationship.

3. 5 Use self-awareness to identify the effects that beliefs, values, and personal experiences have on
relational practice.
E.Y. : Always try to identify my beliefs and relate properly on patients beliefs and practices

3. 6 Collaborate with clients, members of the interprofessional and health care teams; and, consult
appropriately.
E.Y. : Try to take in consideration client's beliefs and experience to establish trust relationship.

3. 7 Uphold practices and systems that support the diversity of clients and of the interprofessional
health care team.

E.Y. : Recognize cultural, religious and other beliefs of clients and show respect for them, I have interacted well with clients by asking their
preferences and having patience with them.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

E.Y. : Provide some education for clients, however, still have room for improvement.

Teacher comments for Engage in relational practice that is caring, compassionate and respectful. :
Elina demostrates positive interactions with others and is respectful to individual differences.

4. Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the profession.

4. 1 Evaluate and refine leadership skills to develop solutions, resolve conflict, create a positive work

Satisfactory

Satisfactory

environment and organizational culture, and to strengthen advocacy role.

E.Y. : Working as a team helps us use time in the clinical setting more efficiently. Try to utilize my leadership skills to the best I can. Offer help to my
peers as needed

4. 2 Provide feedback to peers and accept feedback from peers and members of the

Satisfactory

Satisfactory

Satisfactory

Satisfactory

interprofessional health care team.

E.Y. : Always take feedback in a positive manner. Provide feedback to peers in respectful manner.

4. 3 Advocate for clients, self, others, and quality practice environment.

E.Y. : Trying to see the whole picture, prioritize, help others and advocate when needed, for example, explaining family what is important for patient.

4. 4 Support clients rights for self-determination and choice.

Satisfactory

Satisfactory

E.Y. : Recognize that client problems need to be prioritized according to his/her particular needs, and client's choice must be respected by the nurse

4. 5 Respond appropriately to unsafe, unacceptable, and unprofessional behaviors.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

E.Y. : React appropriately to unsafe behavior. Let know if someone's actions or behavior is unsafe.

4. 6 Demonstrate public protection and acting in the interests of the public through collaboration and
consultation with other members of the interprofessional health care teams.

E.Y. : Consistenly consult and collaborate with peers, preceptor and professional team members to improve care.

4. 7 Contribute to the creation of quality practice strategies and solutions.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

E.Y. : Collaborate with peers, teacher and health care team to create effective practice learning.

4. 8 Assign, supervise, teach as appropriate, and provide feedback to unregulated care providers
(UCPs) in collaboration with the interprofessional health care team.
E.Y. : Seek help of UCP when needed, instruct them what I need appropriately.

Teacher comments for Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the
profession. :

Elina is cooperative and proactively seeks to improve working relationship with members of the health team.

5. Integrate the nursing process into all aspects of nursing care and across diverse practice settings.

5. 1 Formulates clinical judgments that meet clients unique and changing health needs and priorities,

Satisfactory

Satisfactory

outcomes, and overall condition and incorporates these into evolving plans of care.
E.Y. : Carefully studying client's unique needs and preferences, a medical history to adjust a care plan effectively.

5. 2 Devise evidence-informed plans of care that are holistic and client-centred.

Satisfactory

Satisfactory

E.Y. : See a client in a holistic way, and develop plan of care based on theory and a client's unique needs, more experience is needed to improve
these abilities.

5. 3 Use clinical judgment to assess clients, prioritize needs, outcomes, and nursing interventions.

Satisfactory

Satisfactory

E.Y. : Try to apply my skills when assesing clients using knowlege about his/ her health problems, medications, and potential outcomes.

5. 4 Collaborate in the evaluation, refinement and modification of plans of care.

Satisfactory

Satisfactory

E.Y. : Sharing information about a client with health care team about needs and changes in a health status to ensure optimal care, for example, betablocker use when client has heart rate less than 60, or adjusting insulin dose for hypoglicemic client.

5. 5 Safely and competently perform treatments and use techniques, and technology autonomously

Satisfactory

Satisfactory

and in collaboration with clients and members of the interprofessional health care team.
E.Y. : Perform skills and techniques based on learning materials and clinical experience, evaluate the effectiveness of nursing care provided.

5. 6 Collaborate with the clients across the lifespan and with members of the interprofessional health

Satisfactory

Satisfactory

Satisfactory

Satisfactory

care team to create a client centered plan of care that is articulated with competence both in writing
and orally.
E.Y. : Collaborate with clients and health team members to reach optimal care.

5. 7 Use awareness of own knowledge and skills, the three factors of nurse, client and environment
and the practice decision-making framework to guide practice.

E.Y. : Use the Three-Factor and nursing process to identify logical steps for achieving effective nursing care.

5. 8 Manage workload, time, and physical resources to provide effective, efficient and ethical care.

Satisfactory

Satisfactory

E.Y. : Improved confidence in skills that allowed for timely and thorough completion of patient care.

Teacher comments for Integrate the nursing process into all aspects of nursing care and across diverse practice settings. :
Elina responds appropriately to new or stressful situations . She can adjust to changing priorities and circumstances with some guidance required at
times from preceptor.

6. Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and holistic health care in a
complex and changing environment.

6. 1 Collaborate with clients to determine needs, mutually agreed health outcomes, approaches to

Satisfactory

Satisfactory

Satisfactory

Satisfactory

care, and to evaluate care.

E.Y. : Work cooperatively with peers and professionals to achieve good collaborative work.

6. 2 Contribute as a member of the interprofessional and health care teams to respond to changing
client needs and outcomes.

E.Y. : Good team player, ready to respond to client and health team members needs. Ability to adapt and assess the changing needs of clients are
skills that are continuing to develop.

6. 3 Consult with and seek out assistance from members of the interprofessional health care team.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

E.Y. : Seek out assistance when needed.

6. 4 Use teamwork, consensus building, and conflict resolution and leadership skills to meet
expected client outcomes.
E.Y. : Act in a respectful manner by being polite and honest, work collaboratively with all group members.

6. 5 Integrate effective, collaborative, and consultative strategies to meet clients needs within a
changing environment.

E.Y. : Put an effort to learn and implement effective, collaborative, and consultative strategies to meet clients needs

6. 6 Respect the unique role and competencies of all members of the interprofessional health care

Satisfactory

Satisfactory

team.
E.Y. : Alwais interact with health care team member in respectful manner recognizing their important role and experience. Maintain consistent
communication with staff regarding patient plan of care.

6. 7 Collaborate as a member of the interprofessional health care team to respond to changes in

Satisfactory

Satisfactory

nursing knowledge and practice and in the health care environment.

E.Y. : Collaborate with my preceptor about plans for the day. Consistently collaborate around my plans and when to get myrself on break, other
nurses on break giving report, and to manage my care for patients.

Teacher comments for Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and
holistic health care in a complex and changing environment. :
Elina collaborates and consults with various members of the health team.

7. Engage in Quality Assurance consistent with the regulatory framework.

7. 1 Act in the best interests of clients and protect clients from harm through collaboration and

Satisfactory

Satisfactory

consultation with other members of the interprofessional and health care teams and by through
competent and safe practice.
E.Y. : Learn skills using reflective practice and try to apply experience-based knowledge, and act in the best interests of clients consulting with
teacher and professionals.

7. 2 Commit to Quality Assurance practice to identify strengths and areas for professional growth and

Satisfactory

Satisfactory

in accordance with the regulatory framework (CNO).

E.Y. : Identify my limitations and streghts and areas for professional growth and in accordance with the regulatory framework (CNO).

7. 3 Create, implement, and evaluate a learning plan consistent with the Quality Assurance program

Satisfactory

Satisfactory

(CNO).
E.Y. : Use different learning strategies to create, implement and evaluate effective learning plan based on CNO standards and guidlines for best the
practice.

7. 4 Assume responsibility to seek out feedback for colleagues and peers and learning opportunities

Satisfactory

Satisfactory

that foster professional development.

E.Y. : Always trying to participate or perform different procedures, pactice my skills when able, reflect on these experiences and implement in
following practice.

7. 5 Consistently review nursing research and information about health care to improve competence

Satisfactory

Satisfactory

Satisfactory

Satisfactory

and to support clients.

E.Y. : Come prepared reading learning materials and performing online activities.

7. 6 Develop professional responses to health care system changes resulting from advances in
research, technology, and changes in societal and political forces.

E.Y. : Trying to be in touch with changes in current health system, technologies, however, more knowlege and experience are needed.

Teacher comments for Engage in Quality Assurance consistent with the regulatory framework. :
Elina accepts feed back from her preceptor then she integrates this into improving her work.

8. Use critical thinking, problem solving and decision making skills to meet the health care needs and expected outcomes of clients.

8. 1 Use critical thinking to inform decision making in all aspects of nursing care.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

E.Y. : Utilize skills and apply it to practice, trying to ask Why?, and prioritize effectively.

8. 2 Use clinical judgment to assess and refine assessments in collaboration with the
interprofessional health care team, formulate nursing diagnoses, plan nursing interventions, and
outline evaluative criteria.

E.Y. : Try to implement problem-solving and decision-making skills to assess clients to determine nursing diagnosis and potential outcomes, however
there is a room for farther improvement.

8. 3 Evaluate and refine critical thinking, problem solving, and decision-making skills.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

E.Y. : Analizing my own practice and outcomes to improve nursing skills.

8. 4 Integrate knowledge from variety of nursing, health, and other theory into nursing practice to
provide safe and competent care.

E.Y. : Trying to use the aquired knowledge of anatomy/ physiology and nursing theory and pharmacology as it is applied to practice in the clinical
setting to provide safe and competent care.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

E.Y. : Try my best to prioritize client's needs to achieve more effective care, especially having multiple clients. Farther development of these skills is
needed.

8. 6 Demonstrate professionalism, responsibility, and accountability.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

E.Y. : Consistently professional and accountable for own learning and completing assigned work on time.

8. 7 Use critical thinking, the practice decision-making framework and the nurse-client-environment
framework to inform clinical judgments and practice.

E.Y. : Always trying make the decisions based on knowlege and evidence, communicate with clients and health care team to achieve optimal care.

Teacher comments for Use critical thinking, problem solving and decision making skills to meet the health care needs and expected
outcomes of clients. :
Elina makes good decisions for the most part however she still needs limited guidance with the more complex situations.

9. Final Exam Results

9. 1 Final Exam Results

Satisfactory

Teacher comments for Final Exam Results :

Overall Elina has had a successful term.She has met her learning plan.She has fostered an effective therapeutic relationship with her clients and
colleagues She had the opportunity to observe many things as well as the opportunity to practice many new skills.

Student Final Summary with Strategies for Continued Growth

In the end of my consolidation I feel that I have wider knowlege about direct patient care, for example, wound care or medication administration. I
have learned some new skills and able to perform them independently, like in and out catheterization, or using insentive spirometer. I know the every
day routine and can plan my tasks better. In addition, I understand better the whole process from admission to reabilitation setting, so I am able more
effectively teach my clients about maintaining their health. I am enthusiastic and positive learner and team member. With more time and experience
with different clients in the clinical setting, I will continue to develop my nursing practice, communication, critical thinking and problem-solving skills
better. I have achieved good results in time management. Now I can better understand the whole picture of care, reqognising my clients needs more
effectively. In addition, I can better understand my strengths and limitation and set goals for farther improvement. I still have several areas for farther
improvement, such as interacting with the inter-professional healthcare team, thetapeutic communication skills, better understanding of diagnosis and
potential outcomes, leadership skills and critical thinking skiils. However, in the end of my practice I feel prepared for independent practice. I would
like to say thank you to my preceptor Sophia Donalds for support and teaching.

Teacher Final Summary with Strategies for Continued Growth

Elina needs to gain more confidence in conversing with patient /patient family and health team members .Elina has a good grasp of the English
language however she must over come her mind set that her ''English is not good enough".Elina has a wealth of knowledge and experience that she
should share.

Advisor Final Summary with Strategies for Continued Growth

Elina has excelled in her clinical practice by increasing her knowledge and skills in direct patient care, procedural care and administrative processes.
She is an eager learner willing to try new processes and procedure within her scope of practice. She is self aware enough to recognize when she
needs assistance. Elina however, is a bit hard on herself about her English speaking capability as English is not her first language. Elina as Sophia
noted needs to overcome this mind set; as her English is good enough and will only get better with practice. Elina should continue on her current path
where she willing accepts and seeks out procedures/tasks that challenge her skills. This will only improve her nursing practice. Elina will be a caring,
compassionate nurse.

Grade

Satisfactory

Submitted Date: 08-Apr-2016 16:41

Unsatisfactory