Unable to demonstrate the ability to practice within the legal and ethical boundaries of the profession. Able to demonstrate the ability to practice within the legal and ethical boundaries of the profession. Comments: Strengths: Development Learning outcome 2 Unable to analyse the role of the OT in the clinical area. Able to analyse the role of the OT in the clinical area. Comments: Strengths: Development needs: Learning outcome 3 Unable to demonstrate the need to Able to demonstrate
practice safely and effectively within their scope of practice. the need to practice safely and effectively within scope of practice. Comments: Strengths: Development needs: Learning outcome 4 Unable to demonstrate the ability to work in partnership with other staff, service users and carers. Able to demonstrate the ability to work in partnership with other staff, service users and carers. Comments: Strengths: Development needs: Learning outcome 5 Unable to demonstrate effective and appropriate communication skills including communication and information technologies. Able to demonstrate effective and appropriate communication skills
Comments: Strengths: Development needs: Learning outcome 8 Unable to apply the underpinning theories and reasoning which impact on treatment decisions. Able to apply the underpinning theories and reasoning which impact on treatment decisions. Comments: Strengths: Development needs: Learning outcome 9 Unable to formulate and demonstrate appropriate interventions under the supervision of the educator. Able to formulate and demonstrate appropriate interventions under the supervision of the educator.
Comments: Strengths: Development needs: Learning outcome 10 Unable to demonstrate the ability to keep accurate comprehensive and comprehensible records in accordance with legislation and guidelines. maintain records appropriately. Able to demonstrate the ability to keep accurate comprehensive and comprehensible records in accordance with legislation and guidelines. maintain records appropriately. Comments: Strengths: Development needs: Learning outcome 11 Unable to demonstrate the need to establish and maintain a safe practice environment. Able to demonstrate the need to establish and maintain a safe practice environment.
Unable to describe the need to establish and maintain a safe practice environment. Able to describe the need to establish and maintain a safe practice environment. This Comments: Strengths: Development needs: Learning outcome 16 Unable to understand the importance of participation in supervision and mentoring. Able to understand the importance of participation in supervision and mentoring Comments: Strengths: Development needs:
Comments: Learning outcome 6 Able to demonstrate the ability to gather appropriate information. Pass Refer Comments: Learning outcome 7 Able to demonstrate and analyse appropriate assessment techniques. Pass Refer Comments: Learning outcome 8 Able to apply the underpinning theories and reasoning which impact on treatment decisions. Pass Refer
Comments: Learning outcome 9 Able to formulate and demonstrate appropriate interventions under the supervision of the educator. Pass Refer Comments: Learning outcome 10 Able to demonstrate the ability to keep accurate comprehensive and comprehensible records in accordance with legislation and guidelines. maintain records appropriately. Pass Refer Comments: Learning outcome 11 Able to demonstrate the need to establish and maintain a safe practice environment. Pass Refer
Please note that you must subtract your meal from the total hours worked column. Hours per week Nursing 37.5 Midwifery 3yr 35 Midwifery 78wk 37.5 Radiography 28 Physiotherapy 36 Occ Therapy 37.5 MSc Rehab 37.5 Dental 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Student Signature ……………………………………………………………………………………. Date ……………………………………………………. Practice Mentor / Educator / Supervisor’s Signature ……………………………………..................................................…………………............... Date ……………………………………………………. The form should be signed by the student and countersigned by the Practice Mentor / Educator / Site Co-ordinator each month. In addition they will be checked by the Academic Mentor at the end of the tripartite meeting (nursing / midwifery) / at the end of the placement (OT) / at the final bipartite meeting (DR).