Providence Care Quality Clinical Placements Evaluation Tool

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* 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?

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* 3. Where was your most recent clinical placement?

Providence Care Community Program

Providence Transitional Care Centre

Providence Care Hospital

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* 4. Which area was your placement?

Heritage 0 - Forensics

Heritage 1 - Rehabilitation

Heritage 2 - Complex Medical/Palliative Care

Lakeview 0 - Adult Mental Health

Lakeview 1 - Rehabilitation

Lakeview 2 - Complex Medical

Parkside 0 - Adult Mental Health

Parkside 1 - Seniors Rehabilitation

Parkside 2 - Seniors Mental Health

PTCC - Level 2

PTCC - Level 3

Clinics (please specify in Comments below)

Community (please specify in Comments below)

Comments:

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

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
The in-class orientation answered my questions.	The in-class orientation answered my questions. Strongly disagree	The in-class orientation answered my questions. Disagree	The in-class orientation answered my questions. Neither agree nor disagree	The in-class orientation answered my questions. Agree	The in-class orientation answered my questions. Strongly agree
I know what to do if I'm injured or ill while on placement.	I know what to do if I'm injured or ill while on placement. Strongly disagree	I know what to do if I'm injured or ill while on placement. Disagree	I know what to do if I'm injured or ill while on placement. Neither agree nor disagree	I know what to do if I'm injured or ill while on placement. Agree	I know what to do if I'm injured or ill while on placement. 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
My learning needs were supported in this placement.	My learning needs were supported in this placement. Strongly disagree	My learning needs were supported in this placement. Disagree	My learning needs were supported in this placement. Neither agree nor disagree	My learning needs were supported in this placement. Agree	My learning needs were supported in this placement. Strongly agree
I felt comfortable asking staff questions when I wasn't sure about something.	I felt comfortable asking staff questions when I wasn't sure about something. Strongly disagree	I felt comfortable asking staff questions when I wasn't sure about something. Disagree	I felt comfortable asking staff questions when I wasn't sure about something. Neither agree nor disagree	I felt comfortable asking staff questions when I wasn't sure about something. Agree	I felt comfortable asking staff questions when I wasn't sure about something. Strongly agree
Staff were collaborative with students.	Staff were collaborative with students. Strongly disagree	Staff were collaborative with students. Disagree	Staff were collaborative with students. Neither agree nor disagree	Staff were collaborative with students. Agree	Staff were collaborative with students. 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

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* 6. Staff demonstrated:

	Never	Rarely	Sometimes	Frequently	Always
Respect towards patients/clients	Respect towards patients/clients Never	Respect towards patients/clients Rarely	Respect towards patients/clients Sometimes	Respect towards patients/clients Frequently	Respect towards patients/clients Always
Respect towards students	Respect towards students Never	Respect towards students Rarely	Respect towards students Sometimes	Respect towards students Frequently	Respect towards students Always
Empathy towards patients/clients	Empathy towards patients/clients Never	Empathy towards patients/clients Rarely	Empathy towards patients/clients Sometimes	Empathy towards patients/clients Frequently	Empathy towards patients/clients Always
Empathy towards students	Empathy towards students Never	Empathy towards students Rarely	Empathy towards students Sometimes	Empathy towards students Frequently	Empathy towards students Always

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* 7. Our goal is to promote a positive learning environment in the future for you and others. If you indicated "Never" or "Rarely" to any of the statements in Question 6 above, please provide details to help us improve this placement opportunity.

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* 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?

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

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* 3. Where was your most recent clinical placement?

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* 4. Which area was your placement?

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

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* 6. Staff demonstrated:

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* 7. Our goal is to promote a positive learning environment in the future for you and others. If you indicated "Never" or "Rarely" to any of the statements in Question 6 above, please provide details to help us improve this placement opportunity.

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* 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?

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