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NURS 427 L Nursing Leadership Summer 2022
CLINCAL TIME LOG SUMM ARY
NURS 427L
Instructions: Indicate date, hours spent and the summary of the activities (1-2 line) for
each clinical day spent at the assigned facility by each student. Activities performed
must be confirmed and initialed by the preceptor.
DO NOT WRITE: spent time with preceptor or change project. That does not describe your
functions.
After competing 30 hours of clinical rotation, type the time log (without initial) and attach to
the handwritten version and then submit to instructor.
Date Hrs Cum Activity Preceptor
hrs Initials
06/02 1 1
Post Conference
06/09 1 2
Post Conference
06/16 1 3
Post Conference
06/02- 12 15
08/06 Shadow Health: Dynamics of Nursing Leadership
(12 hours)
7/16 2.5 17.5 Group zoom meeting for Change Project
7/23 2.5 20 Group zoom meeting for Change Project
7/30 2 22 Group zoom meeting for Change Project
08/01 15 37
diploma in Nursing Leadership and Care
Management
08/01 8 45
FEMA
08/01 2 47
Six Sigma
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NURS 427 L Nursing Leadership Summer 2022
Grading Rubric
Change Project: Power Point Presentation
Student/s Name/s: ____________________________ Date: __________
Presentation Topic: _______________________________________________
Content/Criteria Possible Earned Comments
Points Points
1. Problem identification 1
and documentation
Goal/Purpose
2. Review of Literature
Background (3-4 articles)
▪ Current literature 1
▪ Gaps in literature 1
▪ Current Evidence Based 1
Practice (EBP)
3. Development and 2
Implementation of plan
Methodology
4. Change theory 2
framework and how it
relates/fits the project
Theoretical Framework
5. Evaluation of change 1
process
Results
[Link] 0.5
Conclusion
7. APA format for 0.5
reference
Total 10
*All literature referenced in any written assignment should be from a textbook or refereed (peer-
reviewed) journal published within the past five (5) years unless it qualifies as a "classic” or
landmark research. Information about how to identify a refereed journal is available.
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NURS 427 L Nursing Leadership Summer 2022
CALIFORNIA STATE UNIVERSITY
NORTHRIDGE
NURS 427L Leadership in Nursing
TO BE COMPLETED BY PRECEPTOR
Student Name:
Preceptor Name: Credentials &
Title:
Clinical Agency:
Clinical Faculty/Instructor
Name:
Date:
Check One: □ Midterm evaluation □ Final evaluation
CLINICAL PERFORMANCE EVALUATION TOOL
The clinical preceptor will use Clinical Evaluation Tool to evaluate the student’s
clinical leadership performance at the end of the semester.
The clinical faculty will use the completed evaluations to grade the student’s overall
clinical leadership performance. It is the responsibility of the student to make sure that
both completed pages are completed by the preceptor and submitted to their clinical
faculty by the due date.
FAILURE TO MEET A MINIMUM OF ONE OF THE DESIGNATED CRITICAL
BEHAVIORS CONSTITUTES A FAILING GRADE FOR THE COURSE.
Critical Behaviors Pass Fail
These objectives must be met
Will determine Pass/Fail status
1. Maintains professional confidentiality, objectivity and accountability for
nursing functions
2. Demonstrates legal/ethical aspects of patient advocacy
3. Demonstrates responsibility for self within the legal, ethical and
professional role appropriate to the setting or situation
4. Demonstrates professional behavior and the ability to work effectively
with others
Preceptor comments on observations of student’s performance:
___________________________________________________________________________
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NURS 427 L Nursing Leadership Summer 2022
___________________________________________________________________________
____________________________________________________________________
CLINICAL PERFORMANCE EVALUATION TOOL: (continued page 2 of 2)
Please rate each objective and give comments as appropriate Pass Fail
1. Identifies and meets own leadership learning objectives that are based
on analysis of personal strengths and weaknesses.
2. Identifies the need for guidance and seeks it from appropriate resources.
3. Follows recommendations from constructive criticism.
4. Seeks opportunities to meet learning objectives.
5. Works effectively with individuals and groups.
6. Thinks critically about multiple variables when making clinical decisions.
7. Evaluates and seeks to improve own verbal, nonverbal and written communication
skills.
8. Analyzes clinical situations using nursing theories and models.
9. Serve as an advocate for patients or colleagues.
10. Applies a working knowledge of nursing informatics in the clinical setting.
11. Applies administrative strategies (including scope and standards) to:
• Organizing quality nursing leadership project
• Directing quality nursing care, and/or
• Controlling quality nursing care
12. Makes a significant contribution to the clinical agency by collaborating on a planned
change project.
13. Evaluates nursing care management in terms of:
• Structures
• Processes
• Outcomes
14. Demonstrates professional approach to conflict resolution.
15. Applies research findings from the literature to recommend health care system
changes (evidenced-based practice).
16. Identifies problems amenable to future nursing research.
17. Meets deadlines.
REQUIRED SIGNATURES:
Student: ___________________________________________________________________
Preceptor __________________________________________________________________
Date:______________________________________________________________________
FACULTY EVALUATION of Student Performance:
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NURS 427 L Nursing Leadership Summer 2022
REQUIRED SIGNATURES:
Student: __________________________________________________________________
Clinical Faculty/Instructor:_____________________ ______________________Date:____
Change Project: Contract
By the end of (target date)---------------------, I (student
name)---------------------------------------------a nursing student at CSUN will be working with
my leadership preceptor (name, title, unit and
agency)----------------------------------------------------------------------------------------------------to
conduct a change project that involves the following:
(Topic of the Project)---------------------------------------------------------------------------------------
Activity Description Target Outcome (Met / Not met) / Delayed
completion date Justification/Recommendation
Initial investigation/
review/assessment
Data collection
Planning
Implementation
Evaluation
Additional
Activities:
Preceptor Name: Student Name:
__________________________ _______________________________
Preceptor Signature: Student Signature:
___________________________ _______________________________
Date:_______________________ Date:___________________________
Final Change Project outcome with recommendations and future implications
□ Completed ____________________________________________________________
________________________________________________________________________
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NURS 427 L Nursing Leadership Summer 2022
________________________________________________________________________
□ Not-Completed __________________________________________________________
________________________________________________________________________
________________________________________________________________________
Make a xerox copy of the signed contract before handing in to your clinical faculty at the
beginning of the semester. Use the xerox copy to have the functions completed by the preceptor
and hand in to clinical faculty at the end of the semester.
Poster Evaluation Rubric
Criteria Description Points Points
Assigned Earned
Concept explained Clear and concise discussion of important 1
points of the concept
Impact summary of Clear and concise discussion of all the concept 2
concept on impacting leadership
Leadership
Nursing implications Clear and complete discussion of the leadership 2
of the concept on implications
Leadership
Summary of the main Clear and complete summary of the main points 2
points
Presentation style Articulates well when presenting. Demonstrates 2
confidence. Well prepared and rehearsed (30
minutes or less) shows deep understanding of
the topic, good eye contact, easy to hear, WOW
factor present, audience highly engaged.
Professional Professional dress and demeanor. Appropriately NA
appearance groomed virtual
Demonstrates logical Clear demonstration of information, the poster 1
progression of is easy to read with graphic representations to
thoughts and support the information
information
Total 10
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NURS 427 L Nursing Leadership Summer 2022
Student Evaluation of Preceptor
Preceptor Name: ______________________________________________________________
Agency: CSU Northridge_______________________________________________________
Clinical Faculty/Instructor Name:_________________________________________________
Course Dates: __________________________________ _____________________________
Course Session #: _________________NURS: 427 L Dynamics of Nursing Leadership Lab
To what extent does the clinical preceptor?
Never Consistently
1. Demonstrate strong interpersonal skills 1 2 3 4 5
2. Provide agency orientation 1 2 3 4 5
3. Provide opportunities to complete course 1 2 3 4 5
objectives
4. Coordinate learning experiences within the 1 2 3 4 5
agency
5. Arrange for alternate preceptor as needed 1 2 3 4 5
6. Assist in student integration into agency. 1 2 3 4 5
7. Monitor student progress 1 2 3 4 5
8. Provide a balance of positive and negative 1 2 3 4 5
verbal feedback to student on progress
9. Provide written feedback to student on 1 2 3 4 5
progress
10. Seek ongoing student input related to 1 2 3 4 5
experience
Other comments:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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NURS 427 L Nursing Leadership Summer 2022
Student Name:_________________________________________________________________
Student Signature: ______________________________________________________________
Date_________________________________________________________________________
Campus resources that you might find it helpful:
🍎 Food Pantry at CSUN: Anybody who faces challenges securing food or housing and believes
this impacts course performance, should contact CSUN's Food Pantry website and the
corresponding contacts.
💰 Emergency MataCare grants, one-time grants to prevent evictions, urgent child care issues, etc.
👥 University Counseling Center (USU): Part of your tuition covers a certain number of free
counseling sessions each year.
☎️Help lines (after hours when the USU is closed) for numerous topics/needs (e.g., suicide,
drug, rape, LGBQT, military, or any crisis). You don't have to handle intense feelings alone!
🔴 Sexual Assault & Violence: CSUN offers the support you or a friend may need.
👮🏾 Matador Escort: You don't have to walk alone on campus- call an escort.
📚 Learning Resource Center offers tutoring, a writing center, & more.
🖥 Campus computer labs
🏝 To de-stress, go to the spa-like Oasis for relaxation or our 🏊🏿 Student Recreation Center
(SRC).
🔐 Disabilities Resource Educational Services (DRES). If you had an IEP in the past, you can
receive assistance in college too. OR, maybe you are still curious to know if you have
undiagnosed learning challenge; get tested and start using DRES assistance before you graduate.
🏥 Student Health
🎓 Career Center for resume writing & interviewing
🚦Clubs & Organizations: Hopefully a dozen people have already advised you to ""get involved"
at CSUN in something that interests you.
Final version: updated 1-16-21 zn