Nursing Student Clinical Evaluation Survey Form
Rate clinical performance across key practice areas.
Demonstrates sound clinical judgment
*
Needs improvement
1
2
3
4
Excellent
5
1 is Needs improvement, 5 is Excellent
Applies nursing knowledge in clinical practice
*
Needs improvement
1
2
3
4
Excellent
5
1 is Needs improvement, 5 is Excellent
Communicates clearly with patients and the care team
*
Needs improvement
1
2
3
4
Excellent
5
1 is Needs improvement, 5 is Excellent
Maintains professional and respectful conduct
*
Needs improvement
1
2
3
4
Excellent
5
1 is Needs improvement, 5 is Excellent
Follows clinical procedures and safety practices
*
Needs improvement
1
2
3
4
Excellent
5
1 is Needs improvement, 5 is Excellent
Prioritizes tasks effectively
*
Needs improvement
1
2
3
4
Excellent
5
1 is Needs improvement, 5 is Excellent
Shows empathy and respect in interactions
*
Needs improvement
1
2
3
4
Excellent
5
1 is Needs improvement, 5 is Excellent
Works collaboratively with the clinical team
*
Needs improvement
1
2
3
4
Excellent
5
1 is Needs improvement, 5 is Excellent
Responds constructively to feedback
*
Needs improvement
1
2
3
4
Excellent
5
1 is Needs improvement, 5 is Excellent
Overall clinical performance
*
Needs improvement
1
2
3
4
Excellent
5
1 is Needs improvement, 5 is Excellent
Submit Evaluation
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