“We are delighted to introduce this book to a new generation of readers. The challenges in nursing, as well as in health care, have never been greater. The need for resources such as this text is profound.”
–from the foreword by Joanne Disch, PhD, RN, FAAN, Professor and Lillehei Chair in Nursing Leadership and Director, Katharine J. Densford International Center for Nursing Leadership, School of Nursing, University of Minnesota, and Kathleen Dracup, DNSc, FNP, RN, FAAN, Dean and Chair of Nursing Education, School of Nursing, University of California, San Francisco

The Concise Encyclopedia of Nursing Leadership is a manageable, one-volume reference that describes and defines the field of nursing leadership. The Encyclopedia will provide students, faculty, nurse managers, executives, and others with a comprehensive resource for information about the range of knowledge and roles encompassed by the term “nursing leadership.” It details the contributions of key nursing leaders, the knowledge base and traits of leadership, skills and models on which leadership is based, the regulatory environment of health care, the range of practice settings and roles, and the design of quality outcomes.

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The painless way to master medical-surgical nursing

Need to learn the complexities of medical-surgical nursing but find yourself looking for some anesthesia after perusing thick textbooks? HereAnd#39;s your remedy! This easy-to-follow guide delivers the material with surgical precision.

Medical-Surgical Nursing Demystified features a full chapter for each system–cardiovascular, respiratory, immune, hematologic, nervous, musculoskeletal, gastrointestinal, endocrine, genitourinary, and integumentary. YouAnd#39;ll find a description of how the system functions, signs and symptoms of diseases and conditions, diagnostic tests, and treatment options. Perioperative preparation and pain management are also covered. Filled with key terms to help you to remember important concepts, and complete with end-of-chapter NCLEX-style quizzes to test your knowledge, this book will teach you the fundamentals of medical-surgical nursing in no time at all.

This fast and easy guide offers:
Learning objectives at the beginning of each chapter
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A time-saving approach to performing better on an exam or at work

Simple enough for a beginner, but challenging enough for an advanced student, Medical-Surgical Nursing Demystified is your shortcut to mastering this essential nursing topic.

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This completely updated and revised new edition of a popular textbook is specially written for qualified nurses working in intensive care nursing units. Fully comprehensive and developed to be as user-friendly as possible it contains four new chapters and valuable updated and new clinical scenarios to aid learning.

The book is structured in user-friendly sections, with each chapter containing “fundamental knowledge” needed to understand the chapter, a chapter introduction, “implications for practice,” a chapter summary, completely up-to-date further reading, “time out” sections for consideration and revision and a clinical scenario written by Jane Roe with questions included.

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Registered Nurse Magazine provides news of organizational activities and reports on developments of concern to all registered nurses across the nation. It also carries general coverage and commentary on matters of nursing practice, community and public health, and healthcare policy. It is publishedmonthly except for combined issues in January and February, and July and August.

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By the 1990s, it became clear to many in the nursing community that certification for respiratory nursing practice was desirable, even necessary, but that this could not take place without a carefully designed CORE Curriculum. This book, nearly a decade in the making, sets out such a curriculum. Put together by an expert team of respiratory nurse practitioners, the book includes 42 chapters, each blindly peer reviewed by at least 3 people for clinical content and timeliness. The book will therefore be essential for all nurses seeking the expertise needed to care for persons with respiratory disease or compromised function. Respiratory Nursing should be read by all respiratory and intensive care specialists, related health care professionals, and teachers and students in graduate and undergraduate nursing programs.

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New studies in Critical Care are finding that lack of sleep in the ICU can slow recovery. Disrupted sleep can cause problems with the immune system, resistance to infection, and wound healing. This timely new issue of Critical Care Clinics Guest Edited by Nancy Collop explores the affects of the ICU of normal sleep patterns. Topics such as Adverse Effects of Sleep Deprivation, Common Sleep Disorders in ICU Patients, and the Sleep Friendly ICU make this an up-to-date reference for all Emergency and Critical Care clinicians.

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This is a comprehensive guide to cervical cancer for nurses. It is a practically-based text for clinical nurses who wish to consolidate and update their knowledge of cervical cancer. It is concise, containing comprehensive information for general practice together with useful references to facilitate more in-depth study. Thus it provides an invaluable resource for both the registered nurse with a general interest in cervical cancer and for the nurse specialist working in primary health, gynaecology, oncology and palliative care.

As well as containing the essential chapters about the pathophysiology and treatment of cervical abnormalities and cervical cancer, the book also addresses specific nursing issues such as sexuality, fertility, and symptom control. Moreover it examines the bigger, global picture of the disease. Full appreciation of global impact of cervical cancer on women involves an appreciation of the social, political and public health aspects of the disease – not only in the developed world but also in developing countries.

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Much has changed since the first book Paediatric Oncology: Acute Nursing Care (1999), therefore, this new edition encompasses these changes in relation to the practice itself and the evidence that underpins it. Emphasis is placed on ensuring terminology is accurate, in keeping with the language of the current day.

The book is divided into six sections: Chemotherapy, Haematopoetic Stem Cell Transplantation, General Surgery, Radiotherapy, Late Effects of cancer therapies, and Palliative Care. There is a brief commentary at the end of each section/chapter by a ‘novice’ author but experienced practitioner, highlighting to the reader what is already known and what the section/chapter adds to their current knowledge and practice.

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Case Western Reserve Univ., Cleveland, OH. Text includes 320 articles by 200 expert contributors on topics such as nursing services, education, care, specialties, organizations and publications, cancer survivorship, middle range theories, taxonomy, HIV risk behavior, depression in cardiac disease, and more.

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Registered Nurse magazine
January/February 2008 | English | 28 pages | PDF | 3.2 MB

Registered Nurse magazine not only covers the activities of the California Nurses Association and National Nurses Organizing Committee, but also strives to produce hard-hitting news features and thoughtful analyses about nursing and the real ills plaguing the U.S. healthcare system.

You’ll find true stories from the front lines of care given by the nation’s 2.5 million registered nurses, as well as articles about nursing practice, public health, healthcare policy, and the healthcare industry. Through our reporting, we hope to inspire a movement toward a humane and just healthcare system for all. The magazine is published 10 times per year by CNA/NNOC, with combined issues in summer and winter.

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Registered Nurse magazine not only covers the activities of the California Nurses Association and National Nurses Organizing Committee, but also strives to produce hard-hitting news features and thoughtful analyses about nursing and the real ills plaguing the U.S. healthcare system.

You’ll find true stories from the front lines of care given by the nation’s 2.5 million registered nurses, as well as articles about nursing practice, public health, healthcare policy, and the healthcare industry. Through our reporting, we hope to inspire a movement toward a humane and just healthcare system for all. The magazine is published 10 times per year by CNA/NNOC, with combined issues in summer and winter.

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Barbara A. Vitale “NCLEX-RN Notes: Core Review & Exam Prep”
F. A. Davis Company | 2007-04-08 | ISBN: 0803615701 | 272 pages | PDF | 1,4 MB

A Davis’s Notes book. Prepare for the NCLEX wherever you are-at home, the library, on the bus or in line at the movie theater. The publishers of RNotesr and Davis’s NCLEX-RNr Success and the co-author of Test Success and Fundamentals Success present the most portable reference ever for preparing for your licensure exam. The pocket-sized NCLEX-RNr Notes weighs little but it’s no lightweight. It contains studying and test-taking tips, strategies, techniques, and nursing content in quick snippets to allow you to maximize your time to review. In addition to the tips and review within its pages, there’s a NCLEX-RNr Notes mini CD-ROM enclosed with the book providing 1,000 multiple-choice and alternate format questions and answers with rationales for test review, with a focus on common test-taking errors with strategic tips on how to avoid them.

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Clinical practice related to sleep problems and sleep disorders has been expanding rapidly in the last few years, but scientific research is not keeping pace. Sleep apnea, insomnia, and restless legs syndrome are three examples of very common disorders for which we have little biological information. This new book cuts across a variety of medical disciplines such as neurology, pulmonology, pediatrics, internal medicine, psychiatry, psychology, otolaryngology, and nursing, as well as other medical practices with an interest in the management of sleep pathology. This area of research is not limited to very young and old patients – sleep disorders reach across all ages and ethnicities. “Sleep Disorders and Sleep Deprivation” presents a structured analysis that explores the following: improving awareness among the general public and health care professionals; increasing investment in interdisciplinary somnology and sleep medicine research training and mentoring activities; and validating and developing new and existing technologies for diagnosis and treatment. This book will be of interest to those looking to learn more about the enormous public health burden of sleep disorders and sleep deprivation and the strikingly limited capacity of the health care enterprise to identify and treat the majority of individuals suffering from sleep problems.
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Incentives in health systems: developing theory, investigating practice

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Medical Aspects of Disability is a true interdisciplinary textbook, representing collaboration between experts from many professions and specialties. An overview of themes and principles of rehabilitation is provided. Numerous disabling conditions and disorders are covered not only from clinical but also functional, psychological, and vocational perspectives. Special topic chapters address important new trends and processes within the field of rehabilitation and health care at large. The book is designed as a resource for rehabilitation professionals across many disciplines. Each chapter provides concise but significant coverage of topics, and extensive references to facilitate further exploration. The book can be used as a textbook and as a reference tool for the practitioner.
With the field’s increasing move toward evidence-based practice, a need for information in the areas of accreditation and outcome measurement has arisen. In response, the editors have added an essential special topics chapter detailing the importance of the accreditation process as a fundamental component of the quality assurance and improvement process.
This is an excellent resource as both a textbook and reference guide, to inform and assist graduate and undergraduate students (physical therapy, occupational therapy, speech therapy, social work, psychology, nursing, vocational counseling, therapeutic recreation, hospital administration), as well as practitioners, about the most current information on the etiology, and clinical symptoms of a wide variety of medical and disabling conditions.

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This book is designed for all renal nurses and for general nurses who care for patients with impaired renal function. Renal disease is on the increase in western society and as a result there is a growing need for well educated renal nurses. This practical book will assist in the development of high quality renal nurses and nurse practitioners. This book offers a practical approach to guide nurses in the art and science of renal care. It is holistic as well as technical, therapeutic and compassionate in its approach. Acute and chronic renal failure, renal osteodystrophy and other selected diseases are comprehensively discussed. The nurse’s role with regard to specific treatments such as peritoneal dialysis, haemodialysis, plasma exchange and haemoperfusion as well as organ transplantation procedures are discussed in detail. There is also a section that relates specifically to paediatric care. The final section of the book is devoted to the use of complementary therapies and alternative medicine in renal disease.
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This unique and practical book introduces the reader to the concept of blood management and explains how to improve patient outcomes by avoiding undue blood loss, enhancing the patient’s own blood, effective management of anemia and coagulopathy. Basics of Blood Management is the first book dedicated to blood management, a multidisciplinary and multimodality concept that focuses on patient outcome.

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Rebecca Neno, Debby Price, “The Handbook for Advanced Primary Care Nurses”
Open University Press | 2008-10-01 | ISBN: 0335223532 | 224 pages | PDF | 1,6 MB

“This handbook provides comprehensive information relevant to community and district nurses and new community matrons. It incorpoprates discussions on legal and ethical issues, case management, interprofessional working, commissioning and leadership. This book is an excellent resource for nurses who want to broaden knowledge of their role and who may be undertaking community matron university modules.”

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Pain, and particularly chronic pain, is one of the most common problems among the elderly, who represent 13% of the U.S. population and the largest group of individuals seeking health care. Controlling pain in this population is more challenging for health care providers because the elderly often have multiple health problems and take many medications in addition to the physiologic changes of aging.

Pharmaceutical agents are not generally tested in this population, leaving health care providers to “start low and go slow,” in order to avoid adverse reactions when prescribing new medications, particularly pain medications.

From her experience in critical care and neuroscience nursing and work as a GNP, Dr. Jansen will focus on the assessment, diagnosis, and treatment of acute and chronic pain among older adults with interventional, noninterventional, pharmacotherapeutic, and nonpharmacotherapeutic methods.

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Evidence-Based Geriatric Nursing Protocols for Best Practice: Third Edition (Springer Series on Geriatric Nursing)
Springer Publishing Company | ISBN: 0826111033 | 2007-11-16 | PDF | 736 pages | 2 Mb

This is the third edition of the book formerly entitled Geriatric Nursing Protocols for Best Practice. The original project grew from the efforts of these authors and editors, national leaders in geriatric nursing, and the John A. Hartford Foundation Institute for Geriatric Nursing, to improve the quality, outcomes, and cost-effectiveness of health care for the elderly in hospitals, long-term care facilities, and the community. These efforts include influencing both the skills of individual nurses and the quality of the systems in which they are educated and work. This focus on improving geriatric care is driven by the growth in the over-65 population and its impact on the health care system.

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Winner of an AJN Book of the Year Award! ” Who has a right to health care? ” What is the government’s role? ” How are corporations, insurance companies, and health care providers affecting the quality of health care? ” Can we reform the U.S. health care system?
In this innovative text, Gunnar Almgren provides all the tools necessary to understand and critique a health care policy in dire need of change. With its comprehensive coverage of U.S. health care, this unique text is accessible to all those in public health, nursing, social work, public policy, or public administration. No other book addresses the underlying issues of the U.S. health care system alongside a variety of social justice models that we can use to evaluate, and perhaps eventually, change it.

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Univ. of California, Los Angeles. Outline of psychosocial information for nurses and nursing students. Discusses interventions for dealing with psychosocial responses to the stresses of illness, how to respond to patients from different cultures, how to recognize which interventions are effective in end-of-life situations, and more.

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Cardiothoracic Surgical Nursing: Current Trends in Adult Care: Carl Margerson, Jillian Riley
Wiley-Blackwell | ISBN: 0632059044 | October 17, 2003 | PDF (OCR) | 248 pages | 1136 KB
Thames Valley Univ., UK. Written from the nursing perspective, text offers practical advice and information on all aspects of cardiothoracic surgical nursing with particular focus on the continuing developments and challenges. Discusses Discusses the development of the speciality, pre-operative preparation, and post-operative Softcover DNLM: Perioperative Nursing–trends.

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With over 10% of the elderly suffering from diabetes, this new edition provides up-to-date and comprehensive information about the key aspects of managing older people with diabetes, predominantly Type 2 diabetes
An overview of the field of diabetes in the elderly, covering standard problems such as diagnosis and topics specific to the elderly such as falls, dementia and nursing home care
Features new material on diabetes-related cognitive dysfunction, diabetes-related disability, the association between diabetes and depressive illness, diabetes education and nutritional impairment in the elderly
Provides guidance, best practice points and key learning outcomes in each area covered, and identifies the published evidence base for each major conclusion.

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Health Promotion in Practice is a practice-driven text that translates theories of health promotion into a step-by-step clinical approach for engaging with clients. The book covers the theoretical frameworks of health promotion, clinical approaches to the eleven healthy behaviors—eating well, physical activity, sexual health, oral health, smoking cessation, substance safety, injury prevention, violence prevention, disaster preparedness, organizational wellness, and enhancing development—as well as critical factors shaping the present and the future of the field. Written by the leading practitioners and researchers in the field of health promotion, Health Promotion in Practice is a key text and reference for students, faculty, researchers, and practitioners.

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Mood and Anxiety Disorders During Pregnancy and Postpartum earns its important place in the literature by detailing our current understanding of the course, diagnosis, and treatment of psychiatric illness during pregnancy and postpartum, including breast-feeding—a top priority today because we now know that active maternal psychiatric illness during pregnancy and postpartum can exert long-term negative effects on child development and cause significant morbidity for the mother.

In just five concise richly informative chapters, the nine distinguished contributors to Mood and Anxiety Disorders During Pregnancy and Postpartum dispel prevailing beliefs and offer invaluable guidance in treating women during pregnancy and postpartum:
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The shifting demographic toward a “graying” population—coupled with today’s reality of managed care—makes the need for high-quality, cost-effective psychiatric services within the nursing care setting more urgent than ever. As we increase the number of our years, it is also imperative that we enhance the quality of those years.

The product of the American Psychiatric Association’s (APA’s) Council on Aging and its Committee on Long-Term Care and of the Elderly, the Manual of Nursing Home Practice for Psychiatrists stands out because it focuses on the “how”—not the “why”—of nursing home care. Of exceptional importance is its detailed discussion of the Minimum Data Set (MDS), a structured assessment required by both Medicare and Medicaid for all residents of skilled nursing facilities.

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Clinical Evaluation
Moh. Afandi)*

Concep of Evaluation

Evaluation is the process of obtaining information for making judgments about learners. Evaluation as the systematic collection of evidence to determine wheter in fact certain change are taking place in the learner as well as to determine the amount or degree of change in individual students (Bloom, 19971 in Reilly, Dorothy E, 1985).

Evalution is a dynamic, continuous process intervowen with the teaching-learning process. This view of evaluation emphasizes its relationship to growth learner, for the judgment made facilitate the learners own further development of knowledge, skills, and potential essential for professional practice.

Evaluation serves three major purposes:
1. Selection of students for a given nursing program
2. Assessment of student learning in varied setting: classroom, learning laboratory and clinical field
3. Program revision and determination of program success.

Evans and Larson (1978) in Reilly, Dorothy E (1985) identified nine trends concerning evaluation of clinical skills:
1. Greater emphasis on relating objectives to evaluation
2. More focus on student learning as the function of clinical evaluation
3. Increased attention to the clinical evaluation process as a vehicle for instructional improvement.
4. More involvement of student in clinical evaluation
5. Provision for observer training to improve reliability among faculty evaluators
6. Increased use of simulation techniques
7. Use of patient records as instruments for clinical evaluation
8. Renewed efforts toward dealing effectively with the issue of grades and clinical evaluation
9. Combined clinical evaluation methods for more comprehensive evaluation

Purposes of Evaluation

Evaluation serves many purposes. The instructor needs to remain attuned to the purposes for which evaluation data are being collected so that the data are used appropriately. Assessment of individual learner is likely to involve
• Indentification of existin ability and aptitude, which provides a base upon which futher learning can be built
• Indentification of learning needs, or observed deficits or missed opportunities that should be addressed during the clinical experience
• Assessment of progress toward achievement of course objectives, and
• Judgment concerning students achievement of a satisfactory level of performance at the conclusion of the clinical experience

Types of Evaluation
There are two major types of evaluative processes:
1. Formative Evaluation
Formative evaluation represents feedback to the learner regarding the learner progress in meeting objectives.
Evaluation that is formative enables the teacher and student to identify areas in which further learning is needed and plan relevant learning experiences.
2. Summative Evaluation
Summative evaluation, end of instruction evaluation, provides information as to the extent to which the learner has achieved the behavioral objectives.
Summative evaluation is Final, stating what has been accomplished rather than what can be.

Nature of Clinical Evaluation Process
Clinical evaluation is a judgmental process, reflecting the values and beliefs of the participants. Value is part of the word and since values are personally chosen, there is subjective involvement in all aspect of the process.
Schweer and gebbie (1976) in Reilly (1985) write: The very nature of evaluating clinical nursing performance means that the evaluators, the students, and the setting in which the evaluation occurs deal with human being. As such, one can hardly eliminate subjectivity in evaluation.
Quality of Fairness in Clinical Evaluation
Whereas clinical evaluation cannot be objective, it can be fair, and this quality of fairness in the evaluative process should be the goal of the faculty.
Fairness has two requisites:
1. Clarity of objectives identified for the field practice experience
2. Supportive climate within which the evaluation take place
Clinical Objectives
The clinical objectives communicate to the learner the expected behaviors to be developed and in turn, the focus of evaluation. These behaviors need to be adhered to in the evaluation process so the learner is aware of the behavioral competencies to be evaluated and can be direct his or her own learning toward them.
The clinical objectives also direct the teacher as to the specific behaviors to be evaluated in the field, rather than allowing the teachers personal desires and beliefs to become the focus of the evaluation.
The clinical objectives represent a contract between learner and teacher.
Psychosocial Climate of Clinical Evaluation
The climate within which the evaluation takes place is critical determinant of the way the learner perceives the evaluation process. A supportive climate denoting trust and respect between teacher and student is essential if evaluation is to be viewed by the learner as a learning experience, providing needed feedback for improvement in learning.
Learning in the clinical field is a difficult process for it places students in vulnerable position. Learning, especially that which requires a demonstrated performance, occurs as a public event in front of the teacher, clients and sometimes even staff and peers, often resulting in the student experiencing feeling of anxiety and stress.

Relationship of Clinical Evaluation to Objectives
Clinical evaluation is based on the objectives established for field practice, which are those course objective and behaviors for which clinical practice is required for attainment.
These objectives address competencies in the cognitive, psychomotor and affective domains at different taxonomic level.
Cognitive Domain
Evaluation of cognitive learning relates to the learner’s acquisition of the knowledge base needed for problem solving and decision making and the ability to use these skill practice. Level of the coginitive taxonomy: Knowledge and understanding level, Application level, Analysis level, Synthesis level, Evaluation level.

Affective Domain
Evaluation of affective learning in the field relates to two aspect:
1. The experiencing behaviors of the learner which may be evidenced in practice
2. The Critical thinking behaviors vital to the element of choice in value development
Psychomotor Domain
Evaluation of psychomotor performance competency relates to judgements of the learner’s accuracy, coordination, and speed in performance. Evaluation of psychomotor learning at the upper level of taxonomy is intended to ascertain the integration of the act in nursing practice. Performance should be reflect a consistently high level of coordination and competence.
Multidomain Performance
This is evident in performance evaluation situations where the student is involved in administering care to a client, thus requiring an assessment of the integration of cognitive, psychomotor and affective skills. Criteria for assuring fairness are described by lenburg (1979):
1. The test must be uniform and equivalent for all students and judged by the same criteria, by all of the faculty
2. It must be administered at a designated time and place with specific and prescribed conditions that are known and accepted by both student and faculty
3. The expected performance behaviors are clearly and explicitly stated and known in advance by student and faculty
4. Students are responsible for learning the entire array of performance behaviors prior to the examination, but are tested on a sample of those that have been systematically derived according to stated criteria and are consistent with the program objectives.

Methods of Evaluation Clinical Practice
Clinical practice is complex and as such cannot be evaluated by one method. Since nursing practice encompasses behaviors in the cognitive, psychomotor and affective domain, it requires an evaluation protocol that contains multiple strategies for appraising the learner’s practice competence in all three domains as appropriate.
Reilly (1980) identifies five reasons for providing diversity in evaluation strategies:
1. Complexity of human behavior
2. Individual differences in responses to learning
3. Suitability of specific evaluation approaches to specific types of learning behavior
4. Motivational factor of evaluation
5. Creative dimension to the evaluation process

Evaluation strategies applicable for use in the clinical field may be classified:
1. Observation
Observation of learner performance is a major means of evaluating student in clinical practice. Through observation, judgments may be made regarding cognitive, psychomotor, and affective performance behaviors.
Difficulties in the use of observation methods lie with:
- The influence of teacher variables on the observation and resulting judgments
- Focus of observation
- Sampling of behaviors observed which may or may not be representative of the usual level performance of the student.
Anecdotal Note is narrative description of an observed behavior recorded in relation to a specified clinical objectives. Effective use of anecdotal notes can be increased by devoleloping a systematic approach to their collection. Reilly (1980) recommends that at the times certain clinical behaviors are identified for evaluation by anecdotal note, the number of notes to be recorded for each also be specified and the student so notified.
Critical Incident. Schweer and Gebbi (1976) define critical incident as “ ..a sample of observable human behavior in a given situation that clearly demonstrates either positive or negative factors contributing to the effective or ineffective completion of the activity.
Critical incidents are an effective strategy for formative evaluation since they include a record of observations made regarding performance in the field and allow for analysis of behavior in terms of its influence on the outcomes of the activity.
Rating Scale, used to a great extent for evaluation in the clinical field, provide a means of recording qualitative and quantitative judgement regarding the learner’s performance in practice.
Rating scale contains two major parts: (1) a set of defined clinical behaviors on which students are judged. (2) an accompanying graduated scale to rate the degree of competence with which the behavior has been performed.
Most of the rating scales used in nursing programs represent five point scales: Letter A, B, C, D, E or number 5, 4, 3, 2, 1; qualitative label, such as excellent, very good, good, fair nad poor.
Videotape, one additional means of recording observation of learner performance is trough videotape.
2. Written communication methods
Evaluation strategies classified as written communication methods provide data on the ability of the learner to communicate in writing and on quality of the content communicated.
Evaluation of the substance of the written material provides data relevant to the objectives. Strategies for clinical evaluation include:
a. Nursing care plan
b. Case study
c. Teaching plan
d. Process recording
e. Log
f. Nursing notes
g. Other written assignment

3. Oral communication methods
- Clinical conference
- Issue conference
- Nursing and multidisciplinary conference

4. Simulation
Simulations are a valuable strategy for clinical evaluation, offering a readily available means of judging performance. Simulation is a new method of performance testing for the cognitive, affective and psychomotor domains.

5. Self-evaluation
Fuhrmann and weissburg (1978) emphazise that “ just as skill in evaluation are not inherent in human beings but must be learned, so too must self evaluation skills be learned.
The focus of self evaluation in clinical practice is determined by the objectives of the experience and individual learner goals.

Evaluation Strategies for The Laboratory and Clinical Practice Settings
Nursing educators recognize that not all experience are educative, and that not all learning requires practical experience with its subject matter. But sometimes student identify their clinical experience as a major contributor to their eventual success in the profession. Given the difficulty in articulating how learning occurs, in the clinical practice setting.
Offering the student opportunities to improve performance (the goal of clinical instruction) must be balanced with the need to remove the student from the clinical area if her performance continues to jeopardize patient safety.
Diagnostic evaluation also is essential to ensuring due process in evaluation practices. Providing guidelines for improvement gives the student a chance to overcome deficits. While feedback is essential, the instructor should avoid labeling a student’s performance with an interim grade, unless this required by nursing program policies at a point midway through the experience.
Grading is the final outcome of the evaluation process, and represents the results of summative evaluation.

Clarifying the Standards for Evaluation
There are two professional judgments about the students performance: whether the student has met course objectives and whether the student can safely provide care. While students can not expect equivalency of evaluation procedures across clinical areas and with different instructors, they should know the “ground” below which problems occur, as well as what marks a superior level of performance.
Reliability in the application of standards is facilitated by the use of rating scales. Certain elements critical to minimally safe practice may be identified as overriders. These are elements that must be present whenever a skill is performed.

Summary
Evaluation in the clinical field provides data for making judgments of the learner’s performance in all domains of learning.
There is no such process as objective evaluation. Evaluation is always subjective, fo it is influenced by the values and beliefs of the participants.
Clinical practice is complex and as such, cannot be evaluated by one method alone. Multiple strategies are needed for appraising the learner’s performance in practice.

References
O’Connor, Andrea B (2001). Clinical Instruction and Evaluation: Teaching Resource. United State of America. Jones and Bartlett Publishers
Reilly, Dorothy E (1985). The Clinical Field: Its use in Nursing Education. United States of Amerika, prentice-Hall