55
Hong Kong College of Surgical Nursing Post Membership Program for Ordinary Member Specialty – Ophthalmological Nursing
Hong Kong College of Surgical Nursing
Post Membership Program for Ordinary Member
Specialty – Ophthalmological Nursing
Name of Mentee: ____________________
TABLE OF CONTENTS
No. Content Page
1. Particulars of Mentor and Mentee Training Period 1
2. Introduction 2- Mentee & Responsibilities 2- Mentor & Responsibilities 3
3. Reference 4
4. Appendices4.1 Ophthalmological Care Specialty Competency Skill
Log - Caring patient with Corneal Graft Transplant
5
4.2 Ophthalmological Care Specialty Competency Skill Log - Caring patient with Angle Closure Glaucoma
6
4.3 Ophthalmological Care Specialty Competency Skill Log - Caring patient with Cataract Extraction
7
4.4 Ophthalmological Care Specialty Competency Skill Log- Caring patient with Retinal Detachment
8
4.5 Comprehensive Case Study 94.6 Marking Scheme for Post Membership Programme –
Case Study11
4.7 Project Learning Agreement 144.8 Marking Scheme for Post Membership Programme –
Project20
4.9 Assessment Form for Ordinary Member 244.10 Record of Recognized Significant Contribution Scoring
System30
1. PARTICULARS OF MENTOR AND MENTEE TRAINING PERIOD
Name of Mentee:
Rank: _________________ HKCSN Ordinary Membership No.:
No. Training Site Period of Supervision
1 Clinical Department: General / Specialty: ________
Ward: Hospital: _______________
From: To:
Name of Mentor: __________________________
Fellowship No.: ____________________________
2 Clinical Department: General / Specialty:
Ward: Hospital: _______________
From: To:
Name of Mentor: ____________________________
Fellowship No.: _____________________________
3 Clinical Department: General / Specialty:
Ward: Hospital: _______________
From: To:
Name of Mentor: ____________________________
Fellowship No.: _____________________________
4 Clinical Department: General / Specialty:
Ward: Hospital: ______________
From: To:
Name of Mentor: ____________________________
Fellowship No.: _____________________________
5 Clinical Department: General / Specialty:
Ward: Hospital: ______________
From: To:
Name of Mentor: ____________________________
Fellowship No.: _____________________________
1
2. INTRODUCTION
Mentee
Mentee is expected to sit for Fellowship exit examination within 3 years after being an
Ordinary Member. During this period, mentee is encouraged to attend conferences
and specialized courses locally or internationally to update his / her knowledge and
skill on the trends of development in the specialty. The learning in clinical practice will
increase relative to didactic teaching and to wider multidisciplinary team approach.
The clinical practice will be mainly in work placement with mentor guiding and
supervising mentee to further consolidate experience and competencies gained as an
Ordinary Member in the first year; to widen spectrum of practice through taking part in
hospital-wide / specialty projects in the second year; and to be recognized as a role
model or consultant of the specialty field in the final year (Skills for Health, 2010).
Mentee should discuss and agree with the mentor how he / she can best achieve his
or her learning objectives within the set time frame. This learning agreement forms
the basis of a learning partnership between the mentor and the mentee.
Responsibilities of Mentee:
Mentee is expected to take a proactive approach in learning and development
Make full use of learning opportunities during training
Identify areas for observation and feedback
Initiate regular meetings with mentor once every 6 months
Maintain up to date learning portfolio
Regular reflective practice
2
During the three year’s period, the mentee is expected to
1. Complete the Specialty Competency Skill Log (Appendix 4.1, 4.2, 4.3, 4.4)
2. Submit two comprehensive case study (Appendix 4.5 )
3. Conduct one learning agreement project (Appendix 4.7)
4. Meet with mentor once every 6 months using the Assessment Form (Appendix
4.9)
5. Achieve a total of 100 score for the recognized significant contributions (Appendix
4.10)
Mentor(s)
Mentor(s) must be Fellow(s) of the Hong Kong College of Surgical Nursing and is/are
in current practice in Surgical Nursing. Mentee must be assigned to a designated
mentor at the training site. One mentor should supervise no more than 2 mentees at
one time.
For a hospital / institution where there is no fellow of the specialty / subspecialty
on-site:
- A specialist doctor who is in charge of the service can be invited as the
mentor of the mentee approved for training
- A nurse supervisor, who meets the criteria set out by the College, can be
invited as the mentor
These mentors are to be appointed by the College prior to the start of training.
The College is responsible to appoint a Visiting Mentor to meet with the specialist
doctor / nurse supervisor regularly to discuss the progress of the mentee.
3
Responsibilities of Mentor:
Provide learning opportunities to the mentee in practicing advanced
Ophthalmological care to an independent and leadership role;
Facilitate the mentee to be innovative and change practice when providing care
to patients and families with complex and unpredictable Ophthalmological care
conditions;
Facilitate and guide the mentee to research and analyse evidences in improving
and developing the advanced practice skills in patient care;
Provide on-going feedback on the mentee’s clinical performance and advice on
areas for improvement;
Facilitate the mentee to take up responsibility and exercise professional
autonomy in service delivery;
Facilitate and guide the mentee to prepare for Fellow Exit Assessment.
3. References
Skills for Health (2010). Key Elements of the Career Framework. United Kingdom. [cited on 2017 June 08]. Available from:http://www.skillsforhealth.org.uk/index.php?option=com_mtree&task=att_download&link_id=163&cf_id=24
4
4. Appendices Appendix 4.1
Ophthalmological Care Specialty Competency Skill LogCaring patient with Corneal Graft Transplant
No. of Independent
PracticeDate
Patient’s Name(Surname + initials)
Episode No.*Mentor’s
signature with Full Name
1
2
3
4
5
*Mentor’s signature on each independent practice denotes that each practice is performed in an independent, accurate, complete and safe manner.
5
Appendix 4.2Ophthalmological Care Specialty Competency Skill Log
Caring patient with Angle Closure Glaucoma
No. of Independent
PracticeDate
Patient’s Name(Surname + initials)
Episode No.*Mentor’s
signature with Full Name
1
2
3
4
5
6
7
8
9
10
*Mentor’s signature on each independent practice denotes that each practice is performed in an independent, accurate, complete and safe manner.
6
Appendix 4.3Ophthalmological Care Specialty Competency Skill Log
Caring patient with Cataract Extraction
No. of Independent
PracticeDate
Patient’s Name(Surname + initials)
Episode No.*Mentor’s
signature with Full Name
1
2
3
4
5
6
7
8
9
10
*Mentor’s signature on each independent practice denotes that each practice is performed in an independent, accurate, complete and safe manner.
7
Appendix 4.4Ophthalmological Care Specialty Competency Skill Log
Caring patient with Retinal Detachment
No. of Independent
PracticeDate
Patient’s Name(Surname + initials)
Episode No.*Mentor’s
signature with Full Name
1
2
3
4
5
6
7
8
9
10
*Mentor’s signature on each independent practice denotes that each practice is performed in an independent, accurate, complete and safe manner.
8
Appendix 4.5
COMPREHENSIVE CASE STUDY
i. The case study should reflect advanced ophthalmological care specialty nursing
practice related to the key domains of competency framework* of an Advanced
Practice Surgical Nurse
ii. The case study should be type-written on A4-size paper with Times New Roman 12
font size and 1.5 line spacing within the word limit of 2000 – 3000 words
iii. There should be a cover page with the candidate’s name, Ordinary membership
number, report title, date of submission, total number of words and a self-declaration
of original work
iv. Mentor should mark the case study using the marking scheme for post membership
programme - case study (Appendix 4.6), with 60 as a passing mark
Suggested Format
- Patient data with present chief complaint, health and social history
- Physical health assessment with findings
- Laboratory examination and investigations
- What is / are the differential diagnosis of this patient?
- What investigations / laboratory examination you would like to order for diagnostic
evaluation with rationale?
- What is the most likely diagnosis of this patient?
- Discuss the advanced nursing practice you give throughout the patient’s hospital stay
- Reflect on your nursing practice and its outcomes
- What are the implications to the impact of the surgical advanced nursing practice in
the local and / or international context
9
*Key Domains of Competency Framework for Advanced Practice Nurse
Domain 1 Managing clients with complex health conditions
Domain 2 Enhancing therapeutic nurse-client relationship
Domain 3 Demonstrating effective leadership and team work
Domain 4 Enhancing quality assurance and improvement
Domain 5 Managing and negotiating innovative and effective approaches to care delivery
Domain 6 Enhancing professional attributes of general and advanced practice
Domain 7 Enhancing personal attribute
10
Appendix 4.6
Hong Kong College of Surgical NursingMarking Scheme for Post Membership Programme
CASE STUDY Candidate Ordinary Membership No.:Title of Case Study:
MARKING RUBRICS
Excellent Proficient Average PoorMarks
allocated
Marks
1. Understand and apply the theory
Showed a thorough understanding of the theory; able to concisely assess the case to apply the theoretical concept of 7 domains of generic framework at a deep level
Showed a working understanding of the theory; able to satisfactorily assess the case but applied the theoretical concept at a surface level
Showed basic understanding of the theory; attempted to assess the case and apply the theoretical concept in a very limited level
Showed little understanding of the theory; poorly assessed the case and applied the theoretical concept
15
( 12.7 - 15 marks ) ( 12.6 - 10.36 marks ) ( 10.35 - 7.5 marks ) ( <7.5 marks )2. Problem
solving skillsAble to suggest and bring out appropriate solutions to manage complex health condition of the
Able to bring out some solutions; logical flow was still observed but there was a
Still able to bring out a few solutions on time; logical flow was hardly observed
Failed to bring out any solution to the case; logical flow was not
30
case; many solutions were provided; logical approach to seek for solutions was observed
lack of relevance of the flow observed
( 25.3 - 30 marks) ( 25.2 - 20.8 marks) ( 20.7 - 15 marks) ( <15 marks)
11
CASE STUDY
MARKING RUBRICS
Excellent Proficient Average PoorMarks
allocated
Marks
3. Creative opinions and solutions
Able to come up with some innovative opinions; solutions were not those mentioned on textbook and lesson
Attempted to look for a few innovative opinions, some solutions were those not mentioned on textbook and lesson
Attempted to look for any innovative opinions; solutions were those mentioned on textbook and lesson
Failed to show or did not attempt to give any innovative opinions; ideas were those on textbook
10
( 8.5 - 10 marks ) ( 8.4 - 7 marks ) ( 6.9 - 5 marks ) ( <5 marks )4. Case
analysisA deep and critical analysis was made based on a wild range of inter-disciplinary perspectives
A satisfactory analysis was made; showed the attempt to analyze the case from a wild perspective but not deep and critical enough
Analysis was made based on the subject discipline at a surface level
Failed to make an analysis of the case with the context of the subject
30
( 25.3 - 30 marks ) ( 25.2 - 20.8 marks ) ( 20.7 - 15 marks ) ( <15 marks )5. Reference Referencing and citation style
was correct and consistent Referencing citation style was consistent between the
Some references were inconsistent between text
Many references were inconsistent between
5
between the list and the text; reference list was completely concise without errors
text and the list; reference list with only a few minor mistakes
and list; reference list with some mistakes
the text and the list; a number of mistakes in the reference list
( 4.3- 5 marks ) ( 4.2 - 3.46 marks ) ( 3.45 - 2.5 marks ) ( <2.5 marks )
12
CASE STUDY
MARKING RUBRICS
Excellent Proficient Average PoorMarks
allocated
Marks
6. Presentation Writing was well organized and followed the specific report format; clear and concise explanations of the technical terms; number, specific symbols and units of measurements were accurately presented
Writing was organized and mostly followed the specific report format with a few minor mistakes; clear explanations of the technical terms; specific symbols, number and units of measurements were presented with a few minor mistakes
Writing lacked of an organized flow and not followed the specific report format; only described the technical terms without explanations; number and units measurements were presented not accurately presented
Chaotic in organization and presentation of technical terms, numbers and units of measurements
10
( 8.5 - 10 marks) ( 8.4 - 7 marks) ( 6.9 - 5 marks) ( <5 marks)
Total marks 100
* Delete as appropriate
Name of Marker: _________________________ Signature: ________________________ Date: ___________________
13
Appendix 4.7
PROJECT LEARNING AGREEMENT
Hospital / Department __________________________________
Period __________________________________
Year of Ordinary Member 1 st / 2 nd / 3 rd ______________________
Assigned Mentor __________________________________
Initial Period
Part 1. Topic of Interest
Part 2. Proposed Learning Opportunities to Meet Learning Objective(s)
Workplace Learning:
Formal Learning:
Self-directed Learning:
Part 3. Proposed Assessment Method to Meet Learning Objective(s): “Project based assessment” or “written test or examination” or “Audit”
14
Part 4. Comments
Mentee:
Mentor:
Mentee’s Name and Signature Date (dd/mm/yy)
Mentor’s Name and Signature Date (dd/mm/yy)
Interim Review
Part 1. Review and Update on Topic of Interest
Part 2. Progress on Learning Opportunities to Meet Learning Objective(s)
Workplace Learning:
Formal Learning:
Self-directed Learning:
15
Part 3. Progress on Assessment Method to Meet Learning Objective(s): “Project based assessment” or “written test or examination” or “Audit”
Part 4. Comments
Mentee:
Mentor:
Mentee’s Name and Signature Date (dd/mm/yy)
Mentor’s Name and Signature Date (dd/mm/yy)
Final Review
Part 1. Achieve Objective(s) on Topic of Interest
Part 2. Complete Learning Opportunities
Workplace Learning:
16
Formal Learning:
Self-directed Learning:
Part 3. Completion Assessment
Part 4. Mentee Reflection on Overall Learning Opportunities and Results (if no, write reason)
1. Mentor discussed and provided feedbacks on my progress Yes No
Reason:
2. Mentor provided me with information on learning opportunities for this project Yes No
Reason:
3. There are no unresolved issue or adverse effect Yes No
Reason:
4. Self- perceived Overall Performance
5. Self-perceived Strengths
6. Self-perceived Areas for Improvement
17
Part 5. Comments from Mentor
1. Mentee’s reflective practice was satisfactory Yes No
Reason:
2. Mentee followed an agreed timeframe to complete the project Yes No
Reason:
3. There are no unresolved issue or adverse effect Yes No
Reason:
4. Overall Performance
5. Strengths
6. Areas for Improvement
Mentee’s Name and Signature Date (dd/mm/yy)
Mentor’s Name and Signature Date (dd/mm/yy)
18
PROJECT
i. The project should be a surgical-related work related to the key domains of
competency framework* of an Advanced Practice Surgical Nurse
ii. The project should be type-written on A4-size paper with Times New Roman 12 font
size and 1.5 line spacing within the word limit of 2000 – 3000 words
iii. There should be a cover page with the candidate’s name, Ordinary membership
number, report title, date of submission, total number of words and a self-declaration
of original work
iv. Mentor should mark the project using the marking scheme for project (Appendix 4.8) ,
with 60 as a passing mark
Suggested Format
- Background with update literature search
- Significance of the project / research
- Aims and objectives / hypothesis
- Methodology: design, sample, study tool, data collection, data analysis
- Findings / results
- Discussion
- Implications to the impact of the surgical advanced nursing practice in local and / or
international context
*Key Domains of Competency Framework for Advanced Practice Nurse
Domain 1 Managing clients with complex health conditions
Domain 2 Enhancing therapeutic nurse-client relationship
Domain 3 Demonstrating effective leadership and team work
Domain 4 Enhancing quality assurance and improvement
Domain 5 Managing and negotiating innovative and effective approaches to care delivery
Domain 6 Enhancing professional attributes of general and advanced practice
Domain 7 Enhancing personal attribute 19
Appendix 4.8
Hong Kong College of Surgical NursingMarking Scheme for Post Membership Programme
PROJECTCandidate Ordinary Membership No.:Title of Project:
MARKING RUBRICS
Excellent Proficient Average PoorMarks
allocated
Marks
1. Introduction The purposes and aim of the project / study were clearly stated; an in-depth coverage of the background; showed the previous and recent knowledge of the topic to support the aims of the project / study; hypothesis was clearly stated in a testable form with detailed explanation
The purposes and aim of the project / study were clearly stated; some in-depth background was shown; previous and recent knowledge was showed in a descriptive way with little support to the aims of the project / study; hypothesis
The purposes and aim of the project / study were briefly stated; only covered the background at a basic level; only described the previous and recent knowledge; hypothesis was only described without explanation
The purpose and aim were not stated; briefly mentioned the background information and knowledge of the project / study; hypothesis was stated without explanation
10
was clearly stated with basic explanation
( 8.5 - 10 marks ) ( 8.4 – 7 marks ) ( 6.9 – 5 marks ) ( <5 marks )
20
PROJECT
MARKING RUBRICS
Excellent Proficient Average PoorMarks
allocated
Marks
2. Materials and Methods
Precisely and clearly outlined the method; reported the detailed procedures of the project / study / experiment; specified the use of particular materials and equipment in details; diagram was clear, simple, accurate, titled and labeled
Clearly outlined the method; reported the procedures of the project / study / experiment but a few points were not detailed enough; mentioned most of the materials and equipment; diagram was simple and clear but some labels were missed
Briefly outlined the method; briefly described the procedures; only mentioned some materials and equipment; diagram was not labeled in details
Briefly outlined the method; procedures of the project / study / experiment were described ambiguously; materials and equipment were briefly mentioned and some were missed
25
( 21.1- 25 marks ) ( 21 - 17.3 marks ) ( 17.25 - 12.5 marks ) ( <12.5 marks )3. Results Data were illustrated in a concise,
clear and systematic way; clearly showed the formula and details of
Data were showed in a clear way; showed most of the key steps of the calculations but a
Data were shown in an ambiguous way with some non-significant findings
Data, calculations and tables were hard to follow; poor
20
the calculations; tables and graphs were presented appropriately (including title, headings and units)
few steps missed; tables and graphs were presented with minor errors
included; calculations were not clear and detailed; tables and graphs were poorly presented
presentation of the results
( 16.9-20 marks ) ( 16.8 - 13.9 marks ) ( 13.8 - 10 marks ) ( <10 marks )
21
PROJECT
MARKING RUBRICS
Excellent Proficient Average PoorMarks
allocated
Marks
4. Discussion A detailed interpretation and evaluation of the data; identified and discussed the significance and relationship among data and the aim of the project / study; recognized and discussed the limitations of the data and methods; provided practical suggestions for future studies
An basic interpretation and evaluation of the data; identified and discussed some of the relationship among data and the aim of the project / study; identified a few limitations of the data and method; attempted to make a few suggestions but not practical enough
Only described the data with a little explanation and evaluation; the relationship among data and the aim of the project / study was discussed at a general level; limitations and suggestions for future studies were not stated
Only described the data without explanation
30
( 25.3-30 marks ) ( 25.2 – 20.8 marks ) ( 20.7 – 15 marks ) ( <15 marks )5. Reference Referencing and citation style
was correct and consistent between the list and the text; reference list was completely concise without errors
Referencing citation style was consistent between the text and the list; reference list with only a few minor mistakes
Some references were inconsistent between text and list; reference list with some mistakes
Many references were inconsistent between the text and the list; a number of mistakes in the reference list
5
( 4.3 -5 marks ) ( 4.2 – 3.46 marks ) ( 3.45 – 2.5 marks ) ( <2.5 marks )
22
PROJECT
MARKING RUBRICS
Excellent Proficient Average PoorMarks
allocated
Marks
6. Presentation Writing was well organized and followed the specific report format; clear and concise explanations of the technical terms; number, specific symbols and units of measurements were accurately presented
Writing was organized and mostly followed the specific report format with a few minor mistakes; clear explanations of the technical terms; specific symbols, number and units of measurements were presented with a few minor mistakes
Writing lacked of an organized flow and not followed the specific report format; only described the technical terms without explanations; number and units measurements were presented not accurately presented
Chaotic in organization and presentation of technical terms, numbers and units of measurements
10
( 8.5- 10 marks) (8.4 – 7 marks) (6.9 – 5 marks) (<5 marks)
Total marks 100
* Delete as appropriate
Name of Marker: _________________________ Signature: ________________________ Date: ___________________
23
Appendix 4.9
HONG KONG COLLEGE OF SURGICAL NURSINGHONG KONG COLLEGE OF SURGICAL NURSINGASSESSMENTASSESSMENT FORM FOR FORM FOR ORDINARY MEMBER (6 MONTHLY) ORDINARY MEMBER (6 MONTHLY)
Name of Mentee : Training Period From : To :
Hospital : Specialty in Training :
No. of Days absent Reason for absence (e.g. holiday / study leave / others)
Guidelines for Mentors : It is expected that the majority of mentees will fall into in the “satisfactory” category for most
competencies. Mentors are asked to write in the right hand column that best reflects the mentee’s performance during the
training period for each specified competency. Please note that explanatory comments would be required to submit and
attach to this assessment form for less than satisfactory performance or excellent rating.
UNSATISFACTORY = 1 SATISFACTORY = 2 ABOVE AVERAGE = 3 EXCELLENT =4
UNSATISFACTORY = 1 SATISFACTORY = 2 ABOVE
AVERAGE
= 3
EXCELLENT =4 RATING
CLINICAL EXPERTISE – access and apply relevant knowledge to clinical practice
Poor knowledge base
Significant deficiencies or poor
perspective
Needs direction to study
Allows deficiencies to persist
Maintains currency of knowledge
Applies scientific knowledge to patient
care
Reads appropriately, asks for
information and follows-up
Recognizes and solves real-life
problems
Generally
performs
above the
expected
standard
Outstanding knowledge
Knows common areas in depth
Aware of the unusual
Excellent application of
knowledge in clinical situation
TECHNICAL EXPERTISE – safely and effectively perform appropriate surgical procedures
Fails to acquire appropriate
skills despite repeated
instruction/ practice. Too hasty
or too slow. Rough, Hesitant,
Lacks attention to detail
Consistently demonstrates acquisition,
practice and retention of sound
procedural knowledge, surgical skills
and techniques for level of training
Generally
performs
above the
expected
standard
Excellent and advanced abilities
in procedures and techniques
Excellent pre-operative
preparation, and post-operative
care
Poor manipulative skills
Poor hand/eye coordination
Fails to learn from experience
Demonstrates manual dexterity required
to carry out procedures
Good hand/eye coordination
Outstanding technician
Fluent and always in control
Meticulous
Unable to adapt skills and
techniques
Adapts their skills in the context of each
patient—each procedure
Extremely good at adapting
skills for varying operative
situations
Excellent clinical judgement
Lacks enthusiasm and/or
initiative to participate and/or
learn
Maintain skills and learn new skills Seeks opportunities to learn new
skills
Lacks care and diligence in
approach
‘Near enough is good enough’
Approaches and carries out procedures
with due attention to safety of patient,
self, and others
Outstanding clinician Constantly
aware and responds to patient,
self and team members
As procedure assistant fails to
follow operation
Follows the operation with guidance
from the operator
Anticipates the needs of the
operator & responds accordingly
Ignores/fails to follow up on
problematic performance
Little or no recognition of
deficiencies in skills/techniques
Analyses their own clinical performance
for continuous improvement
Accurate in self-appraisal,
excellent insight
Seeks and accepts criticism &
responds appropriately
24
UNSATISFACTORY = 1 SATISFACTORY = 2 ABOVE
AVERAGE
= 3
EXCELLENT =4 RATING
JUDGEMENT – clinical decision making/organize diagnostic testing, imaging and consultation as needed
Incomplete or inaccurate
Poor basic skills
Takes a history, performs an
examination, and arrives at a well-
reasoned diagnosis
Efficiently and effectively examines the
patient
Generally
performs
above the
expected
standard
Precise, thorough and
perceptive
Incomplete/inaccurate
recognition of significant
symptoms
Significant errors/omissions/
not concise on history, signs or
diagnosis
Poor discussion of clinical
cases
Recognizes the symptoms of, accurately
diagnose, and manages common
disorders
Differentiates those conditions amenable
to operative and non-operative treatment
Competent, concise and correct on
clinical details Arrives at appropriate
conclusions in case presentations
Accurate and efficient
Considers a wide range of
symptoms and factors
Insightful perspective in case
discussions
Inadequate or Inappropriate,
poor selection and/or
interpretation
Unable to appropriately justify
use of investigations
Disregards patient’s needs or
circumstances
Selects appropriate investigative tools
and monitoring techniques in a cost-
effective manner
Appraises and interprets results of
investigations against patient’s needs in
the planning of treatment
Critically evaluates the advantages and
disadvantages of different investigative
modalities
Always selects optimal
investigations
Excellent interpretation
Safe, efficient and cost effective
approach to use of
investigations
Unable to make a decision
Unable to suggest alternative
interpretations
Presentation unclear,
disorganized
Formulates a differential diagnosis
based on investigative findings
Evaluates the significance of data
Indicates alternatives in the process of
interpreting investigations and in
decision making
Clear & concise presentation of findings
Precise, well organized,
thorough, systematic, focused
- Presentatio
n of findings
- Indicates
relevant alternatives
- Decisions
based on data
Poor record keeping
– incomplete,
disorganized, irrelevant,
illegible
– not up-to date
Contemporaneously maintains accurate
and complete clinical records
Precise and focused
Complies with required organizational
structure
Perceptive of relevant
information / data for
documentation
Records very easily accessible
Disinterested or indifferent
approach to patient problems
Fails to grasp significance or
respond accordingly
Under or overreacts
Manages patients in ways that
demonstrate sensitivity to their physical,
social, cultural, and psychological needs
Considers all issues relevant to the
patient
Excellent and highly developed
ability to manage & interact with
patients and to anticipate and/or
respond to their needs
Copes poorly in situations of
stress and/or complexity
Effectively manages the care of patients
with trauma including multiple system
trauma
Generally maintains controlled approach
& demonstrates sound judgement during
times of stress/complexity – seeks
assistance accordingly
Anticipates possible risks and/or
complications
In stressful situations always
maintains orderly approach and
demonstrates sound judgment
Inadequate planning
Inadequate involvement in pre
& post-operative care
Fails to grasp significance of
symptoms or respond
accordingly
Under or overreacts to
emergencies
Plans, and where necessary implements
a risk management plan.
Conscientious and reliable follow-up
Effectively manages complications of
operative procedures and the underlying
disease process
Identifies and manages risk
Manages complexity and uncertainty
Outstanding clinician who
- anticipates possible
risks/complications
- identifies problems early
- follows-up meticulously
- coordinates and uses other
personnel effectively
- aware of own limitations
25
UNSATISFACTORY = 1 SATISFACTORY = 2 ABOVE
AVERAGE
= 3
EXCELLENT =4 RATING
COMMUNICATION – communicate effectively
Disliked by patients because of
poor interpersonal skills
Bad listener
Poor communicator
Increases patient anxieties
Patients remain confused or
unclear and/or unable to follow
instructions
Trusted by patients. Listens well
Communicates information to patients
(and their family) about procedures,
potentialities, and risks associated with
surgery in ways that encourage their
participation in informed decision making
Communicates with the patient (and their
family) the treatment options, potentials,
complications, and risks associated with
all treatment modalities
Recognizes what constitutes ‘bad news’
for patients and relatives &
communicates accordingly,
demonstrates empathy at appropriate
times
Generally
performs
above the
expected
standard
Possesses excellent
interpersonal skills
Develops excellent rapport
with patients & team
members
Inspires confidence
Patients delighted to be looked
after by this mentee
Ignores or fails to recognize
misunderstandings
Causes disruption/problems
Initiates the resolution of
misunderstandings or disputes with
peers, colleagues, and others
Effectively diffuses any problems
in the surgical team
Unaware of patient’s needs
Unable to communicate under
varying conditions/situations
Appropriately adjusts the way they
communicate with patients & relatives to
accommodate cultural and linguistic
differences and emotional status
Always interacts effectively with
patients according to their social
& health needs
COLLABORATION - work in collaboration with members of an interdisciplinary team where appropriate
Refuses to facilitate function of
team
Poor relationship with peers
and other professionals
Does not adequately
acknowledge the contributions
of others
May undermine team members
or function
Good rapport with nursing and other
medical staff. Willing to help
Employs a consultative approach with
colleagues and other professionals
Communicates effectively with and co-
ordinate surgical teams to achieve an
optimal surgical environment
Generally
performs
above the
expected
standard
Always willing to help even if
personally inconvenient
Excellent working relationship
with other professionals
Always supports colleagues and
junior staff
Reluctant/unable to work as a
team member
Self-focused
Unreliable
Fails to seek timely assistance
with issues of patient care
Ignores or is unaware of their
own limitations
Respectful of & appreciates the different
kinds of knowledge and expertise which
contribute to the effective functioning of
a clinical team
Develops a patient care plan in
collaboration with members of an
interdisciplinary team
Collaborates with other professionals in
the selection and use of various
treatment modalities assessing the
effectiveness of each management
option
Recognizes and facilitates the need to
refer patients to other professionals
Excellent team member
Extremely knowledgeable about
the contribution of different fields
of care
Aware of and seeks the
contribution of different fields
and refers patients in a timely
and appropriate manner
MANAGEMENT and LEADERSHIP – effectively use resources to balance patient care and system demands
Unaware of management
constraints and/or expectations
Reluctant to take on any
management responsibility
Wasteful of resources
Poor interaction with and/or
supervision and management
of junior staff
Identifies and differentiates between
resources of the health care delivery
system and individual patient needs.
Effectively assesses and manages
systemic risk factors
Applies a wide range of information to
prioritize needs and demands
Directs and supervises junior staff
effectively
Generally
performs
above the
expected
standard
Willing to contribute to health
services management
Uses resources very effectively
for patient care balanced with
patient need
Excellent role model for junior
medical staff, all ways offers
support for junior staff
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UNSATISFACTORY = 1 SATISFACTORY = 2 ABOVE
AVERAGE
= 3
EXCELLENT =4 RATING
HEALTH ADVOCACY
Ignores/jeopardizes own or
colleagues health or well-being
Promotes health maintenance of
colleagues
Looks after own health
Generally
performs
above the
expected
standard
Maintains high level of fitness
and encourages others
Takes little interest in patient
health beyond surgery
Advocates patient health Very knowledgeable and active
in advocating patient health
including preventative measures
SCHOLAR and TEACHER – recognize the value of knowledge and research and its application to clinical practice
Little evidence of reading texts
or journals
Needs direction to study
Assumes responsibility for own on-going
learning
Draws on different kinds of knowledge in
order to weigh up patient’s problems in
terms of context, issues, needs, and
consequences
Critically appraises new trends in
Surgical Nursing
Generally
performs
above the
expected
standard
Always keen to discover new
knowledge
Takes extra courses & learning
opportunities
Avoids teaching if possible.
Poorly prepared, poorly
delivered
Facilitates the learning of others
Competent and well prepared in
teaching others
Enthusiastic teacher
Logical and clear
Can inspire
Excellent teaching skills
PROFESSIONALISM – appreciate the ethical issues associated with Nursing
Behaviour inconsistent with
ethical ideals
Little interest/comprehension of
medico-legal issues
Consistently applies ethical principles
Identifies ethical expectations that
impinge on the most common medico-
legal issues
Generally
performs
above the
expected
standard
Highly conscientious
Anticipates possible areas
where medico-legal issues may
arise
Late, idle, unreliable, forgetful
Off-loads work onto others
Difficult to contact
Acts responsibly
Dependable, conscientious
Efficient use of his/her time
Applies self beyond the ‘call of
duty’
Always completes tasks
Copes poorly under stress
‘Disappears’ when problems
arise
Unwilling or fails to take on
responsibility
Regularly participates in clinical audit
Willing to undergo close scrutiny
Responds appropriately to stress
Anticipates and remains efficient
“when the going gets tough”
Seems to thrive on pressure
Has problems acknowledging/
recognizing mistakes
Unable to accept criticism
Acknowledges and learns from mistakes
Is accountable for their own decisions
and actions
Recognizes & acknowledges their own
limitations
Prompt response to criticism
marked improvement and
positive change
Has inaccurate view of own
performance
Pays little regard to clinical
audit
Employs a critically reflective approach Has great insight into their level
of performance
RESEARCH ACTIVITIES DURING CURRENT TERM: (circle appropriate statement for each research area)
Continuing research No current project Research project in progress Active researcher, demonstrated
flair for research, original ideas
Publications No current project Project in process of being prepared
for submission for publication
Article(s) accepted for publication
and/or published
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REPORT ON CNE PROGRAMME
CNE CYCLE (FROM TO )
Number of CNE points accumulated during this assessment period : points
Number of CNE points accumulated in 1st Year points
2nd Year points
3rd Year points
COMPLIANCE OF CNE REQUIREMENTS: YES / NO
SUMMARY REPORT ON TRAINING PROGRAMME
Assessment Period 1st / 2nd / 3rd / 4th / 5th / 6th / (6 monthly) (circle or write appropriate number)
Submitted 1st comprehensive case study YES / NO Remarks:
Submitted 2nd comprehensive case study YES / NO Remarks:
Conducted learning agreement project YES / NO Remarks:
Achieved a total of / 100 score for the recognized significant contributions
ADDITIONAL/EXPLANATORY COMMENTS (If insufficient space attach separate document)
Any identified area(s) of less than satisfactory performance YES / NO
If Yes it must correlate with ratings given above
Have each of these areas been discussed with the mentee? YES / NO
Have these areas been corrected during the term? YES / NO
Details of area(s) of less than satisfactory performance must be fully documented and attached to
this assessment form
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OVERALL RATING (circle appropriate box)
Unsatisfactory Satisfactory Above Average Excellent
Recommendations regarding f uture t raining (Circle appropriate number(s))
1. Mentee should continue in a Training Position
2. Due to less than satisfactory performance Mentee is likely to require additional time and/or training
3. Due to continuing less than satisfactory performance that has not been rectified, the Mentee should
not continue in the training programme
MENTOR (print name) (signature)
I AGREE WITH THIS ASSESSMENT YES / NO
MENTEE (print name) (signature)
Important Note: Mentees should ensure that this Mentee Assessment Form, together with completed case study / project
are distributed as follows:
1. Original assessment and completed case study / project should be submitted to the Secretariat of the Hong Kong
College of Surgical Nursing at LG1, School of Nursing, Princess Margaret Hospital, 232 Lai King Hill Road, Lai Chi
Kok, Kowloon, Hong Kong. The College Secretariat would be responsible for keeping the original documentation for
mentees.
2. Copies of the above should be made and retained by the mentee for their portfolio records
3. Copies of the above should be made and retained by the assessing mentor
4. A score less than Satisfactory (2) in any category will be discussed by the Specialty Board & Education Committee
of the Hong Kong College of Surgical Nursing
The mentee should ensure that separate assessment forms are filled in by each Mentor. The College must receive
completed assessment forms, case studies and project no later than one month prior to application for fellowship exit
examination.
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Appendix 4.10Record of Recognized Significant Contribution Scoring System
(within past 9 years)Recognized Significant Contribution (provide proof on submission)
Score Remarks Date Achieved
Professional DevelopmentPublishable Nursing Research – Principle Investigator
100
Publishable Nursing Research – Member (active role)
50 Certified by Principle
Investigator
Publishable Nursing Meta-analysis Paper – Principle Investigator
100
Publishable Nursing Meta-analysis Paper – Member (active role)
50 Certified by Principle
Investigator
Project - Leader 50Project – Member (active role) 30 Certified by the
Project Leader
Local Conference – Organizing / Scientific Committee Member
40 Other Committee
Member not
recognized
Local Conference – Abstract Reviewer 40Local Conference – Invited Speaker 40Local Conference – Oral Presenter 30Local Conference – Poster Presenter 20International Conference – Organizer / Scientific Committee Member
60 Other Committee
Member not
recognized
International Conference – Abstract Reviewer
60
International Conference – Invited Speaker 60International Conference – Oral Presenter 40International Conference – Poster Presenter 30
Community ServiceAcademic Institution – Invited Speaker / Mentor
20 Per institution
Professional Organization – Council / Committee Member
20 Per organization
Community Organization - Advisor 10 Per organization
The list above is not exhaustive, any proposed significant contribution will be subject to the endorsement by
the Hong Kong College of Surgical Nursing from time to time.
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