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* 1. Student Information 

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* 2. Where your course objectives for clinical application met in the patient care setting (Please chose the best response)

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* 3. Were you given opportunities to implement nursing care in your daily assignments (i.e., at the bedside, participating at report or conferences, nursing rounds, patient teaching, and documentation on the chart)

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* 4. Did you have a chance to meet and interact with any of the following? (Please check all that apply)

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* 5. What types of patients did you most care for in your clinical rotation? (Please rank the following options)

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* 6. Are the clinical resources at the University of Louisville Hospital adequate and appropriate for meeting your course objectives?(please circle)?

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* 7. Did the staff nurses reflect a role model for you to emulate? (Please choose the best response)

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* 8. Would you like to recognize any staff members for making your clinical rotation a positive learning experience.

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* 9. Please choose the best response for each of the following statements

  Most nursing staff exhibited this behavior Most nursing staff DID NOT exhibit this behavior
The nursing staff provided good customer service
The nursing staff provided good organizational/prioritization skills
The nursing staff used collaboration and teamwork
The nursing staff displaced personal responsibility and accountability
The nursing staff provided respect for patients and staff
The nursing staff provided leadership qualities
The nursing staff were willing to provide a variety of useful clinical learning experiences 
The nursing staff were supportive of your deliver of patient care 

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* 10. Please provide the best experience during the clinical rotation 

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* 11. Please provide areas/items that could improve the clinical rotation 

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