Nursing Practical Exam Evaluation Form
Please complete this form to assess the candidate's performance during the nursing practical exam. Use the provided scales and input fields to ensure a thorough and objective evaluation. All responses are confidential and should focus on observed skills and behaviors.
Candidate Name
*
First Name
Last Name
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Clinical Skill Performance
*
Rows
Needs Improvement
Satisfactory
Excellent
Hand Hygiene
1
2
3
Patient Identification
4
5
6
Vital Signs Measurement
7
8
9
Medication Administration
10
11
12
Aseptic Technique
13
14
15
Communication with Patient
*
1
2
3
4
5
Professionalism & Attitude
*
1
2
3
4
5
Adherence to Safety Protocols
*
1
2
3
4
5
Documentation Accuracy
*
1
2
3
4
5
Critical Thinking & Problem Solving
*
1
2
3
4
5
Overall Performance
*
Poor
1
2
3
4
5
6
7
8
9
Outstanding
10
1 is Poor, 10 is Outstanding
Evaluator Comments / Recommendations
Submit Evaluation
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