Providence Care Quality Clinical Placements Evaluation Tool

Question Title

* 1. What is the name of your educational institution?

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* 2. What is the code for the clinical course you have just completed?

Question Title

* 3. What level of education are you completing?

Certificate

Diploma

Undergraduate Degree

Master's Degree

PhD

Doctorate

Question Title

* 4. In which year of a program are you enrolled? (if a combination, list highest year)

First year

Second year

Third year

Fourth year

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* 5. Where was your most recent clinical placement?

Providence Care Community Program

Providence Transitional Care Centre

Providence Care Hospital

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* 6. In which specialty/field was your most recent clinical placement?

Rehabilitation service

Aged care

Mental Health

Complex Care

Other

(Specify location)

Question Title

* 7. Using the scale below, please respond to the following statements about your placement experience:

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
I was fully orientated to the clinical area	I was fully orientated to the clinical area Strongly disagree	I was fully orientated to the clinical area Disagree	I was fully orientated to the clinical area Neither agree nor disagree	I was fully orientated to the clinical area Agree	I was fully orientated to the clinical area Strongly agree
Staff were willing to work with students	Staff were willing to work with students Strongly disagree	Staff were willing to work with students Disagree	Staff were willing to work with students Neither agree nor disagree	Staff were willing to work with students Agree	Staff were willing to work with students Strongly agree
Staff were positive role models	Staff were positive role models Strongly disagree	Staff were positive role models Disagree	Staff were positive role models Neither agree nor disagree	Staff were positive role models Agree	Staff were positive role models Strongly agree
Staff were ethical and professional	Staff were ethical and professional Strongly disagree	Staff were ethical and professional Disagree	Staff were ethical and professional Neither agree nor disagree	Staff were ethical and professional Agree	Staff were ethical and professional Strongly agree
Staff demonstrated respect and empathy towards patients/clients	Staff demonstrated respect and empathy towards patients/clients Strongly disagree	Staff demonstrated respect and empathy towards patients/clients Disagree	Staff demonstrated respect and empathy towards patients/clients Neither agree nor disagree	Staff demonstrated respect and empathy towards patients/clients Agree	Staff demonstrated respect and empathy towards patients/clients Strongly agree
Patient safety was fundamental to the work of the unit(s)	Patient safety was fundamental to the work of the unit(s) Strongly disagree	Patient safety was fundamental to the work of the unit(s) Disagree	Patient safety was fundamental to the work of the unit(s) Neither agree nor disagree	Patient safety was fundamental to the work of the unit(s) Agree	Patient safety was fundamental to the work of the unit(s) Strongly agree
I felt valued during this placement	I felt valued during this placement Strongly disagree	I felt valued during this placement Disagree	I felt valued during this placement Neither agree nor disagree	I felt valued during this placement Agree	I felt valued during this placement Strongly agree
I felt safe in the clinical environment (e.g. physically, emotionally, culturally)	I felt safe in the clinical environment (e.g. physically, emotionally, culturally) Strongly disagree	I felt safe in the clinical environment (e.g. physically, emotionally, culturally) Disagree	I felt safe in the clinical environment (e.g. physically, emotionally, culturally) Neither agree nor disagree	I felt safe in the clinical environment (e.g. physically, emotionally, culturally) Agree	I felt safe in the clinical environment (e.g. physically, emotionally, culturally) Strongly agree
This placement was a good learning environment	This placement was a good learning environment Strongly disagree	This placement was a good learning environment Disagree	This placement was a good learning environment Neither agree nor disagree	This placement was a good learning environment Agree	This placement was a good learning environment Strongly agree
My supervisor(s) helped me identify my learning objectives/needs	My supervisor(s) helped me identify my learning objectives/needs Strongly disagree	My supervisor(s) helped me identify my learning objectives/needs Disagree	My supervisor(s) helped me identify my learning objectives/needs Neither agree nor disagree	My supervisor(s) helped me identify my learning objectives/needs Agree	My supervisor(s) helped me identify my learning objectives/needs Strongly agree
I was adequately supervised in the clinical environment	I was adequately supervised in the clinical environment Strongly disagree	I was adequately supervised in the clinical environment Disagree	I was adequately supervised in the clinical environment Neither agree nor disagree	I was adequately supervised in the clinical environment Agree	I was adequately supervised in the clinical environment Strongly agree
I received regular and constructive feedback	I received regular and constructive feedback Strongly disagree	I received regular and constructive feedback Disagree	I received regular and constructive feedback Neither agree nor disagree	I received regular and constructive feedback Agree	I received regular and constructive feedback Strongly agree
I was supported to work within my scope of practice	I was supported to work within my scope of practice Strongly disagree	I was supported to work within my scope of practice Disagree	I was supported to work within my scope of practice Neither agree nor disagree	I was supported to work within my scope of practice Agree	I was supported to work within my scope of practice Strongly agree
My supervisor(s) understood how to assess my clinical abilities	My supervisor(s) understood how to assess my clinical abilities Strongly disagree	My supervisor(s) understood how to assess my clinical abilities Disagree	My supervisor(s) understood how to assess my clinical abilities Neither agree nor disagree	My supervisor(s) understood how to assess my clinical abilities Agree	My supervisor(s) understood how to assess my clinical abilities Strongly agree
I had opportunities to enhance my skills and knowledge	I had opportunities to enhance my skills and knowledge Strongly disagree	I had opportunities to enhance my skills and knowledge Disagree	I had opportunities to enhance my skills and knowledge Neither agree nor disagree	I had opportunities to enhance my skills and knowledge Agree	I had opportunities to enhance my skills and knowledge Strongly agree
I had opportunities to interact and learn with the multi-disciplinary team	I had opportunities to interact and learn with the multi-disciplinary team Strongly disagree	I had opportunities to interact and learn with the multi-disciplinary team Disagree	I had opportunities to interact and learn with the multi-disciplinary team Neither agree nor disagree	I had opportunities to interact and learn with the multi-disciplinary team Agree	I had opportunities to interact and learn with the multi-disciplinary team Strongly agree
I achieved my learning objectives	I achieved my learning objectives Strongly disagree	I achieved my learning objectives Disagree	I achieved my learning objectives Neither agree nor disagree	I achieved my learning objectives Agree	I achieved my learning objectives Strongly agree
I have gained the skills and knowledge to further my practice	I have gained the skills and knowledge to further my practice Strongly disagree	I have gained the skills and knowledge to further my practice Disagree	I have gained the skills and knowledge to further my practice Neither agree nor disagree	I have gained the skills and knowledge to further my practice Agree	I have gained the skills and knowledge to further my practice Strongly agree
I anticipate being able to apply my learning from this placement	I anticipate being able to apply my learning from this placement Strongly disagree	I anticipate being able to apply my learning from this placement Disagree	I anticipate being able to apply my learning from this placement Neither agree nor disagree	I anticipate being able to apply my learning from this placement Agree	I anticipate being able to apply my learning from this placement Strongly agree

Question Title

* 8. On a scale of 1 - 10, with 1 being very dissatisfied and 10 being extremely satisfied, how satisfied were you with this placement experience?

Clear

i We adjusted the number you entered based on the slider’s scale.

Providence Care Quality Clinical Placements Evaluation Tool - Students

Introduction

Question Title

* 1. What is the name of your educational institution?

Question Title

* 2. What is the code for the clinical course you have just completed?

Question Title

* 3. What level of education are you completing?

Question Title

* 4. In which year of a program are you enrolled? (if a combination, list highest year)

Question Title

* 5. Where was your most recent clinical placement?

Question Title

* 6. In which specialty/field was your most recent clinical placement?

Question Title

* 7. Using the scale below, please respond to the following statements about your placement experience:

Question Title

* 8. On a scale of 1 - 10, with 1 being very dissatisfied and 10 being extremely satisfied, how satisfied were you with this placement experience?

Question Title

* 9. Please provide any additional comments about your placement experience.