Practicing Clinical Instructor (PCI) Evaluation Form: College of Nursing

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This document is an evaluation form for a Practicing Clinical Instructor (PCI) at Xavier University-Ateneo de Cagayan College of Nursing. It contains sections to rate the PCI's knowledge, skills, and attitude on a scale of 1 to 5. There are also sections for comments and recommendations to improve the PCI's performance.

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Practicing Clinical Instructor (PCI) Evaluation Form: College of Nursing

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PCI-EVAL-V2

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Practicing Clinical Instructor (PCI) Evaluation Form: College of Nursing

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Joe Real

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Xavier University-Ateneo de Cagayan

COLLEGE OF NURSING
Corrales Avenue, Cagayan de Oro City

Practicing Clinical Instructor (PCI) Evaluation Form

PCI Name:
Rotation: SN Name (optional):
Hospital/Area:
Area ClinicaI Instructor:

Please rate and evaluate the following PCI with regards to the following criterion, kindly rate
using a (1-5) scale; 1 being the lowest and 5 the highest:

Knowledge:__/_5
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Skills:__/_5
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Attitude:__/_5
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Suggestions/Recommendations:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

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