Inst
ruct
ions
Thi
s
doc
um
ent
mu
st
be
co
mp
let
ed
at
the
end
of
eac
h
clin
ical placement. The Registered Nurse will complete the ‘Employee’ rating and comments
section for each Performance Indicator. Each rating must be accompanied by a couple of
examples providing evidence of how the rating is justified (bullet points are fine).
The Preceptor or Manager then initials the ‘Preceptor or Manager’ section to confirm the
rating. If the Preceptor does not agree with the RNs self-rating they must right their
rating in the ‘Preceptor or Managers’ section and initial to indicate that the amended
rating has been discussed with the RN.
At the completion of the document the RN then arranges time with the NUM or Team
Leader to go through the form and summarise their progress. At this time the NUM or
Team Leader would then complete the checklist at the bottom of the last page. Finally
the document must be scanned and an email a copy of the document to the Nurse
Manager – Workforce / Delegate for filing.
Rating
The purpose of the Interim Performance Assessment is to ascertain whether or not the
Employee is on track to meet the relevant performance indicator by the end of their
transition year, as will be evidenced by a full Registered Nurse Performance
Management Review at the end of the third placement. The Registered nurse is
required to rate themselves against each performance indicator and provide an
example. The manager will also need to rate the Registered Nurse against the
performance indicators and provide feedback.
Rating Scale
1 – Considerable improvement required
Rating ‘3 or 4’
No further action is required. Complete the document, sign it and forward a scanned
copy to the Nurse Manager, Workforce.
Rating ‘1 or 2’
The Participant’s Learning Development Plan must be updated to evidence that the
Employee has a SMART Goal to improve the rating in the next placement.
The Process
Performance
Manager reviews Participant
Professional
Knowledge Skills
Development
Completion Report.
Interim
completed at
scored 1 or 2. Development
Plan Reviewed
Feedback provided
by NUM/Manager Progress
Review
Transition to Professional Practice Program-Mental Health (TPPPMH) Interim Performance Review
Name of Participant:
Employee Number:
Name of Manager:
Date of Assessment:
Location of Placement:
4 – Outstanding Progress
2. Teamwork/Collaboration
The Nurse demonstrates an
understanding of how
appropriate.
4. Work Practice
5. Problem-Solving
Assesses effectiveness of
interventions and acts
6. Communication-Verbal
Page 2 of 4
4 – Outstanding Progress
Employee Manager D
Yes/No/N/A Previous Learning Development Plan goals met (Check previous Performance Review
Yes/No/N/A Learning Development Plan amended to include any new goals (if applicable).
Yes/No Attendance at Block Training during placement (CEWD report non attendance)