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Meet Our Faculty
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Tour Campus
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Transient Admissions
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Application
Tuition & Financial Aid
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Student Accounts
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Financial Aid & Loans
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Student Life
Student Life Overview
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How to Register for Classes
Academic Support & Outreach (TRIO)
ACTIVATE
Counseling Services
Childcare
Campus Services
Dining Options
Bookstore
Palmer Memorial Library
Perot Leadership Museum
Pinkerton Fitness Center
Clubs & Organizations
Student Government Association
Community & Business
Community & Business Education Overview
Allied Health
CPR Classes
Certified Nurse Aide
Clinical Medical Assistant
Dental Assisting
Medical Billing & Coding
Medication Aide
Pharmacy Technician
Phlebotomy Technician
Personal Enrichment
Upcoming Classes
Bladesmithing
Kids' College
Online Learning
AI at Texarkana College
Online Health Care
Online Career Training
Online Personal Skills
About
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Leadership, Faculty & Staff
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Nursing Preceptor Program
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Nursing Preceptor Program Student Feedback form
TC Health Sciences Nursing Program Nursing Preceptor Student Feedback
"
*
" indicates required fields
Are you currently registered as a Texarkana College Preceptor?
*
Yes
No
Is your agreement updated within the last two years?
*
Yes
No
Please click here to
register as a preceptor
.
Enter the Full Name of Student
*
Which type of student?
VN
ADN
Texarkana College Clinical Instructor Name
*
Enter Clinical Site Location / Department
*
Assessment
*
Data gathering and analysis.
Satisfactory
Unsatisfactory
Not Observed
Planning
*
Prior to care, discusses with preceptor interventions necessary to achieve expected outcomes.
Satisfactory
Unsatisfactory
Not Observed
Implementation
*
Implements the plan of care to meet the patient’s psychosocial and physiological​ needs.
Satisfactory
Unsatisfactory
Not Observed
Interpersonal Relations
*
Written, verbal, and non-verbal communication.
Satisfactory
Unsatisfactory
Not Observed
Evaluation
*
Evaluates self and patient, revises plan appropriately.
Satisfactory
Unsatisfactory
Not Observed
Professional Growth and Ethics
*
Shows professional growth and practices ethical behavior.
Satisfactory
Unsatisfactory
Not Observed
Safety
*
Practices techniques that promote physiological and psychological safety.
Satisfactory
Unsatisfactory
Not Observed
Skills observed / Other Comments
*
Preceptor Full Name with Credentials
*
Preceptor Email address
What is 3 + 3?
*
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Email
This field is for validation purposes and should be left unchanged.
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