Practice setting: For the MSN student who is focusing on nurse professional development, the
learner’s clinical competencies are being evaluated as part of a performance improvement plan.
For the MSN student who is focusing on an academic setting, the learner is a student in a
fundamental nursing class who requires successful completion of the didactic and clinical
Be specific here. If an academic setting, identify the level of the learner, the course (didactic) and the
clinical unit you are evaluating the student on. If a hospital setting, be sure and identify the level of
the learner (new hire with experience vs. new graduate RN) and the unit.
Fictional example identifying the behaviors of the successful learner. Note: One competency needs
improvement. (The remainder are satisfactory) This section is a brief narrative of the scenario you are
evaluating your learner on. Describe the scenario to provide context to the reader for your
evaluation. Set the general picture of the care situation. (student might be one patient with
procedures/medications, nurse might be care of multiple patients or one with complex needs…)
What are the behaviors (knowledge, skill and attitude) you expect to see with your identified level
of learner to be evaluated as “successful”?