CLINICAL SKILLS ASSESSMENT FORM

PRAC 6665/6675 Clinical Skills

Self-Assessment Form

Desired Clinical Skills for Students to Achieve	Confident (Can complete independently)	Mostly confident (Can complete with supervision)	Beginning (Have performed with supervision or needs supervision to feel confident)	New (Have never performed or does not apply)
Comprehensive psychiatric evaluation skills in:
Recognizing clinical signs and symptoms of psychiatric illness across the lifespan	X
Differentiating between pathophysiological and psychopathological conditions	X
Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)	X
Performing and interpreting a mental status examination	X
Performing and interpreting a psychosocial assessment and family psychiatric history	X
Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).	X
Diagnostic reasoning skill in:
Developing and prioritizing a differential diagnoses list	X
Formulating diagnoses according to DSM 5-TR based on assessment data	X
Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes	X
Pharmacotherapeutic skills in:
Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management)		X
Evaluating patient response and modify plan as necessary	X
Documenting (e.g., adverse reaction, the patient response, changes to the plan of care)	X
Psychotherapeutic Treatment Planning:
Recognizes concepts of therapeutic modalities across the lifespan	X
Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation)	X
Applies age appropriate psychotherapeutic counseling techniques with individuals and/or any caregivers		X
Develop an age appropriate individualized plan of care	X
Provide psychoeducation to individuals and/or any caregivers	X
Promote health and disease prevention techniques
Self-assessment skill:
Develop SMART goals for practicum experiences	X
Evaluating outcomes of practicum goals and modify plan as necessary	X
Documenting and reflecting on learning experiences	X
Professional skills:
Maintains professional boundaries and therapeutic relationship with clients and staff	X
Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings	X
Identifies ethical and legal dilemmas with possible resolutions	X
Demonstrates non-judgmental practice approach and empathy	X
Practices within scope of practice	X
Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals:
Demonstrates selecting the correct screening instrument appropriate for the clinical situation	X
Implements the screening instrument efficiently and effectively with the clients	X
Interprets results for screening instruments accurately	X
Develops an appropriate plan of care based upon screening instruments response	X
Identifies the need to refer to another specialty provider when applicable		X
Accurately documents recommendations for psychiatric consultations when applicable	X

Summary of strengths:

Opportunities for growth:

Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.

1. Goal:

a. Objective:

b. Objective:

c. Objective:

2. Goal:

a. Objective:

b. Objective:

c. Objective:

3. Goal:

a. Objective:

b. Objective:

c. Objective:

4. Goal:

a. Objective:

b. Objective:

c. Objective:

Signature:

Date:

Course/Section: NRNP 6675/FALL

NR 500 Evidenced-Based Practice Discussion 3

Mental Health Factors

CLINICAL SKILLS ASSESSMENT FORM