Form G (BSN Programs) Policy C-04Clinical Site/Preceptor Assessment by StudentsSemester*SpringSummerFallDate Faculty Name* First Last Faculty Email* Preceptor Name* First Last Name of Site*Clinical Unit*Student Name* First Last Course Number*Instructions: Use the drop down boxes to select your assessment for each statement. Space is provided below each statement if you choose to add any comments.Clinical Site1. Number of clients is sufficient*YesNoN/AComments2. There are opportunities to follow up with clients and/or clinical problems.*YesNoN/AComments3. Staff are available to help.*YesNoN/AComments4. Community resources, other agencies, and professional disciplines are involved with clients.*YesNoN/ACommentsPreceptor(s)1. Assist in identifying student objectives for experience.*YesNoN/AComments2. Level of expectations is consistent with course objectives.*YesNoN/AComments3. Provides timely written/verbal feedback.*YesNoN/AComments4. Provides student rationale for own decisions.*YesNoN/AComments5. Reviews diagnoses with student.*YesNoN/AComments6. Discusses alternative management plan.*YesNoN/AComments7. Challenges the student to utilize critical thinking skills.*YesNoN/ACommentsGeneral CommentsList ways this agency/individual provides quality clinical experience for students. RecommendationsList other areas in which this agency/individual could provide optimal student learning.