UNDERGRADUATE NURSING PRECEPTORSHIP INSTRUCTOR EVALUATION

Purpose: To identify compliance with the instructor preceptor expectations to ensure a positive precepted experience.
Directions: Please complete this survey based on your experience with Senior Precepted Students for this most recent semester/time-period. All surveys should be completed by May 26, 2014
Name: 


A red asterisk (*) indicates required questions.

  1. In what location did this Senior Precepted Student(s) clinical experience take place (e.g. CSM-M; CSM-O; Outpatient Clinic, etc) *


  1. In what department did this Senior Precepted Student(s) clinical experience take place (e.g. 7E; AAU/ICU; ED; Burn Unit; etc)?*


  1. Please enter the school this Precepted Senior Student attends, if known.


  1. Please enter the student's name, if known.


  1. 6. Did the instructor establish initial contact with the RN preceptor or unit leadership two weeks prior to the preceptorship? *
    Yes
    No
    Unknown


  1. 7. Did the student contact the RN preceptor and/or unit leadership to establish a schedule of clinical hours at least one week prior to clinical start? *
    Yes
    No
    Unknown


  1. 8. Did you and the preceptor receive a packet of information regarding the preceptorship from either the student or the instructor prior to or on the first day of the clinical? *
    Yes
    No
    Unknown


  1. 9. Did the instructor make at least one site visit to the unit? *
    Yes
    No
    Unknown


  1. 10. Was there communication from the instructor to the RN preceptor every two weeks during the preceptorship? *
    Yes
    No
    Unknown


  1. Please describe the type of communication from the instructor to the RN preceptor and how often it actually occurred in order to provide comments/feedback regarding this communication.*


  1. 11. Was instructor contact information made available to the RN preceptor and/or nursing leadership? *
    Yes
    No
    Unknown


  1. 12. Was the instructor accountable for the evaluation/grading of the student’s clinical performance? Please note: The preceptor is expected to provide feedback on student performance, but is not responsible for grading. *
    Yes
    No
    Unknown


  1. Please explain any comments you may have regarding your experience with feedback asked of you from the student's instructor.


  1. Please provide any other comments or feedback regarding your experiences with Senior Precepted students.