This document provides guidance on clinical placements and portfolios for nursing students. It discusses setting learning objectives using the RAMA framework (realistic, achievable, measurable, assessable). Students are expected to write two clinical objectives per week that meet unit and ANMC competency standards. The portfolio format requires objectives, self-evaluation, strategies for improvement, and preceptor sign-off. Mid-placement and final assessments are to achieve minimum "assisted" competency levels. Reflective practice is emphasized using models like Gibbs. Changes to roster or placement need approval, and missed time must be made up.
2. By the end of this session the participant should be
able to:
Demonstrate an understanding of the acronym
RAMA
Be familiar with new clinical portfolio format.
Be able to set clear learning objectives for clinical
placement within 1st year scope of practice
Be able to utilise ANMC competencies to define
practice domains
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4. For each clinical placement– you need to write TWO
clinical objectives per week.
Should be site-specific and meet unit objectives.
If an objective is clear and meets the ‘RAMA’ test
competence will be easier to demonstrate.
Your objectives should reflect the ANMC Competency
Standards Codes of Practice.
Formulating of 1st year objectives – 125 CTB
timetable and 1st year scope of practice
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5. Realistic - Is the objective realistic in relation to the
student’s level of skill and scope of practice?
Achievable - Is the objective appropriate and
achievable within the time frame, demands and
resources of the placement site.
Measurable - Is there a way to clearly identify if the
student did or did not successfully meet this
objective and at what level of competence?
Assessable - does the objective make sense? Is the
objective clearly written and is the meaning clear?
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6. Objective: What you want to achieve. This must be RAMA. Do
not use abbreviations.
Domain: Which domain of practice does your objective relate
to? (ANMC competency for registered nurses). Please
indicate the number of the domain.
Resources: What resources you will use to aid your mastery
of the clinical skill e.g. practice manuals, textbooks,
observation, preceptors, other health professionals.
Student Self Evaluation: self-assessment of performance.
What was good – what could be improved.
Strategies to Improve/ patient outcomes: identified by
student. Link strategy to patient outcome.
Completed: Signed and dated by preceptor / clinical
supervisor.
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7. Objective: By the end of week 1, under supervision I will be able to accurately
measure vital signs including temperature, pulse, respirations, blood pressure and
pulse oximetry. I will demonstrate knowledge of the normal parameters for these
vital signs. I will document my findings and report any abnormal measurements to
my preceptor.
Domain/Standards: 1.1, 1.2, 1.3, 2.1, 2.3, 2.5, 2.6, 5.1, 5.2, 9.5, 7.1, 7.3, 9.1,
9.2, 10.2
Resources: Clinical Psychomotor Skills–Assessment tools for nursing students
(Tollefson, J), Potter & Perry’s Fundamentals of Nursing (Crisp, J & Taylor, C),
Preceptor, self-directed learning.
Student Self Evaluation – I performed the procedure under supervision. I was very
intent on monitoring the patient’s vital signs and was a little too task focussed.
While my measurements were accurate I need to improve my knowledge of the
variations in vital signs and the associated clinical manifestations.
Strategies to Improve performance / patient outcomes – I will continue self-
directed learning activities about the clinical relevance of variations in vital signs.
Being task focussed is important when mastering a clinical skill but it should not
be at the expense of patient interactions. In coming weeks I need to incorporate
greater therapeutic communication into my interactions with my patients.
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8. Interim – completed midway through
placement (page 10-11)
Final – completed at end of placement (page 18-
19)
Must include student reflection (Gibbs Model)
Must achieve minimum level of ‘Assisted’ in
all ANMC categories.
Core competency x 1 (wound management – must also
include student reflection. See page 26-28)
Learning Agreement – if not progressing at
interim assessment.
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9. 9
* Need to state what Reflective Model
used – suggest using headings.
10. This reflection uses the Gibbs Model
Description: I have enjoyed the first two weeks of placement on medical ward. The
ward has 24 beds and is an acute care facility.
Feelings: The workload has at times overwhelmed me and I feel a little daunted by
how much I need to learn.
Evaluation: I have had the opportunity to observe and practice a number of clinical
skills. But I recognise my knowledge is deficient in a number of areas, particularly
pharmacology.
Analysis: Clinical placement presents multiple learning opportunities and I need to
maximise this experience in order to gain the most benefit from my clinical
placement.
Conclusion: I need to find time during working hours to seek out additional
information as required. I decided to learn from each of the patients I encountered
on the ward. This meant researching their medical conditions and the treatments
they were receiving. This proved a good way of both learning and retaining
information.
Action Plan: For future clinical placements I will be better prepared particularly for
the clinical area I will be working in and the type of patient I am likely to encounter.
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11. Roster changes – must be approved by
placement office.
Placement deferral – advise unit coordinator
and placement office.
Exams on placement – negotiate with
placement office.
Missed time (sickness) needs to be made up.
Clinical experience (observed and performed)
recorded in Tollefson.
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When a student has multiple preceptors during their placement it may be difficult to establish a record of clinical experience. In such instances students may wish to use their Tollefson to keep a record of their clinical experience. The student’s copy of Tollefson will have clinical skills stamped in CTB as ‘demonstrated’. Students will then be able to record observed and performed clinical skills in their Tollefson to obtain a record of their experience. Not a legally binding document and not compulsory.