FIRST YEAR

MSc. NURSING
 NURSING
EDUCATION
 INTERNAL ASSESSMENT CRITERIA FOR
NURSING EDUCATION (THEORY)
1st YEAR M.SC. NURSING

SR. CRITERIA NO TOTAL

NO MARKS

1 Assignment 2 2x50=100

2 Unit test 4 2x25=100

3 Mid – term exam 1 75

4 Pre- university exam 1 75

Total 350

Remaining Requirement as per Log Book And INC

 EVALUATION FORMAT FOR WRITTEN ASSIGNMENTS
M. Sc NURSING FIRST YEAR
NURSING EDUCATION
Name of the college:
Name/ Seat Number of the student:
Topic: Date/ Time:
SR. CRITERIA TOTAL MARKS MARKS
NO. OBTAINED

1 Relevancy of content: 10
 Clarity (3)
 Concise (3)
 Simplicity of language(4)

2 Depth of content: 20
 Simple to complex(3)
 Key points emphasized(7)
 Description of important
points with
illustration(10)
3 Organization of content 10
 Sequential (5)
 Grammar , punctuation(2)
 Clean, neat , tidy(3)
4 A.V.Aids/Diagram/Tables 05

5 Bibliography /references 03

6 Submission on time 02

Total 50

Comment of Evaluator:-

Signature of student: Signature of Evaluator:

 NURSING EDUCATION
I YEAR M. Sc. NURSING
(PRACTICAL ASSIGNMENT)

Sr. Criteria No Total Marks

no
1 Different method of 10 10x50=500
Practice Teaching
 Lecture cum discussion
 Seminar
 Panel discussion
 Role play
 Simulation
 Demonstration
 Nursing rounds
 Bedside clinic
 Case analysis
 Nursing conference
2 Micro teaching 2 2x50=100

3 Course Plan 1 25

4 Unit plan 1 25

5 Blue Print 1 25

6 A.V.Aids 2 2x50=100

7 Master rotation plan 1 25

8 Clinical rotation plan 1 25

9 Mid- term exam 1 50

10 Pre- university exam 1 50

Total 21 925

Remaining Requirement as per Log Book And INC

 FIRST YEAR M. Sc NURSING, NURSING EDUCATION
CRITERIA FOR THE EVALUATION OF PRACTICE TEACHING
Name of the Student………….. Group………………..

Place………… Topic…………………

Name of the Evaluator: Date and Time:

S No CRITERIA Marks Obtained

1 LESSON PLAN
 Selection of topic, research evidence based on the topic 2
selected
 Statement of aims and objectives 2
 Organization of subject matter 2
(Sequence, continuity and
adequacy) 2
 Appropriate Bibliography
2 LEARNING ENVIRONMENT
 Physical arrangement of the classroom 2
 Light and ventilation adequate 3
3 PRESENTATION
 Introduction( clear, interesting, related to topic) 3
 Coverage of the subject matter 2
 In depth knowledge of the topic 4
 Explanation and clarification 3
 Teaching learning atmosphere 2
 Command over language. 2
4 A V AIDS
 Appropriate, self prepared and planned well 2
 Arrangements of A. V. Aids 2
 Used effectively at right time 2
 Creative and Innovative 2
5 QUESTIONING TECHNIQUE
 Correct technique of questioning 2
(Clear, stimulating, well 2
developed,) 2
 Well worded, No ambiguity
 Sufficient time allowed to answer
6 ASSIGNMENT
 Appropriate to the lesson 1
 Motivating 2
 Scope for further study 2
7 SUMMARY AND CONCLUSION 2
Total 50

Commment……………………………………………………………………………………
…………

Signature of Student Signature of Evaluator

 NURSING EDUCATION
EVALUATION CRITERIA FOR MICRO-TEACHING
Name: Topic:
Group: Date and Time:
Evaluator’s Name: Total Marks: 50 Marks
Sr.No Criteria Marks Obtained

1 Set induction 5
 Attractive introduction 2
 Objectives - Pre-teaching Teaching: Post-Teaching 2
 Assessing of previous knowledge
1
2 Planning : 10
 organization of material 2.5
 relevant and appropriateness 2.5
 Proper selection of Audio-Visual aids
 Time limits 2.5
2.5
3 Presentation: 20
 coverage of subject matter 5
 language: fluency, audibility, quality pronunciation 3
 changed the pace of presentation by shifting emphasis,
jokes etc. 2
 Use of specific examples 3
 Use of non verbalques 2
 Thought Provoking questions 3
 Recognizing attending behaviour
2
4 Student Teachers personality 5
 Eye Contact 2
 Dress Code 1.5
 Enthusiasm / Energy/ Gestures
1.5
5 Use of AV Aids 5
 Relevant , clear and visible 2
 Creativity 2
 Used effectively at the right time
1
6 Closure 5
 summarization 1
 Assignment given for the student 2
 Evaluation of students against objectives
 Conclusion 1
1
Total 50

Signature of Evaluator Signature of Student

 FIRST YEAR M. Sc NURSING
NURSING EDUCATION
CRITERIA FOR THE EVALUATION OF COURSE PLAN
Name of the Student…………..

Place………… Topic…………………

Name of the Evaluator Date and Time

S No Criteria Max Marks

Marks Obtained
1 Course description & Objectives 5

2 Course Content 10

3 Bibliography 7

4 Submission on time 3

Total 25

Comments:
…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
……………………

Signature of Student Signature of Evaluator

 FIRST YEAR M. Sc NURSING
NURSING EDUCATION
CRITERIA FOR THE EVALUATION OF UNIT PLAN
Name of the Student…………..

Place………… Topic…………………

Name of the Evaluator: Date and Time:

SrNo Criteria Max Marks

Marks Obtained
1 Objectives 5
2 Division of units & time 3
3 Content 5
4 Teaching & learning 5
5 Bibliography 5
6 Submission on time 2
Total 25

Comments:
…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
……………………

Signature of Student Signature of Evaluator

 FIRST YEAR M. Sc NURSING
NURSING EDUCATION
EVALUATION CRITERIA FOR CONSTRUCTION OF A WRITTEN

OBJECTIVE TYPE TEST(Blue Print)

S.No Criteria Maximum Marks Obtained Marks

1. Relevancy 2

2. Clarity 3

3. Coverage of the topic 3

4. Preparation 5

5. Correct method adopted and 5

followed

6. Item analysis 5

7. Terminology 2

Total 25

Remarks:

Signature of Evaluator Signature of Student

 FIRST YEAR M. Sc NURSING
NURSING EDUCATION
EVALUATION CRITERIA FOR A.V AID PREPARATION

Name of the college:-

Name of the student:-
Class: - Date:-Place:-
Name of Evaluator: -

S. No Content Marks allotted Marks obtained

1 Applicability to the topic 5

2 Accurate in every aspect 5

3 Self-prepared/ readymade. 5
4 Materials used: 5
economical/(local
availability)
5 Attractiveness & motivates 5
the learners
6 Principles followed in 5
preparation and presentation

7 Display / visibility 5
8 Message conveyed 5
9 Relevance 5
10 Effectiveness 5
TOTAL 50
Remark:
…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
……………………

Students signature Evaluators Signature

 FIRST YEAR M. Sc NURSING
NURSING EDUCATION
EVALUATION CRITERIA FOR ROTATIONAL PLAN(Master/Clinical)

Name of the college:-

Name of the student:-

Class: - Date:-

Sr. No Content Marks allotted Marks obtained

1. Organization and adequacy 02
2. Applicability 02
3. Followed the Principles of learning 02
4. Completion of Theory and clinical hours 03
5. Chance for students overall development 02
6. Colour combination 02
7. Indexing 01
8. Appropriate Calculation 03
9. Material used: economical/ cost 02
10. Chance for Continued learning 01
11. Effectiveness of presentation 05
Total 25

Signature of Evaluator Signature of Student

 FIRST YEAR M. Sc NURSING
NURSING EDUCATION
EVALUATION CRITERIA FOR THE UNIVERSITY PRACTICAL & VIVA
EXAMINATION
Name of the college:-

Seat of the student:-

Time: Date:-
SI.No Criteria Max
marks
A Lesson plan (8)
1 Statement of objectives 2
2 Content 2
3 Teaching-learning activities 1
4 Recapitulation 1
5 Assignments 1
6 References 1
B Class room environment (2) 2
C Teacher( 8)
1 Personality 2
2 Eye contact 1
3 Language 2
4 Confidence 2
5 Voice 1
D Teaching (16)
1 Introduction 1
2 Mastery over subject matter 2
3 Explanation 3
4 Illustration & correlations 1
5 Questioning technique 1
6 A.V.Aids 2
7 Teacher & student interaction 1
8 Summary & conclusion 1
9 Recapitulation 1
10 Assignment 1
11 References 1
E Time management (1) 1
F CRP (5) 5
G Viva (10) 10
TOTAL 50

Internal examiner………………………. External examiner ………………………..

ADVANCE
NURSING
PRACTICE
 INTERNAL ASSESSMENT CRITERIA
ADVANCED NURSING PRACTICE

M.SC. NURSING FIRST YEAR

SR.NO EVALUATION CRITERIA NUMBERS MARKS

1 Seminar 2 2x100=200

2 Unit test 4 25x4=100

3 Written Assignment 3 3X50=150

5 Case study with Theory Application 1 100

6 Presentation on comparative theory 1 100

application
7 Family case study 1 100

8 Health Education 2 2x50=100

9 Procedure demonstration 1 50

10 Anecdotal bibliography 1 25

11 Report of Field Visit 5 5 X 25 = 125

13 Mid term Exam 1 75

14 Pre university Exam 1 75

15 TOTAL 1200
 ADVANCED NURSING PRACTICE
M.SC. NURSING FIRST YEAR
EVALUATION FORMAT FOR SEMINAR
Name of the college:

Name of the student : Date :

Topic / unit : Time :
Course Placement :

S.NO CRITERIA 5 4 3 2 1
I Plan For Seminar
1. Description of the master plan on the topic
2. Introduction relevant & motivating
3. Subject matter extensively selected
4. Sequentially organized
5. Application of allied sciences
6. Incorporation of theories , concepts and related
research studies
7. Reference of books and journals
II Educational media
8. Observed principles in preparation and use of A.V.Aids
9. Innovative ideas in preparation of A.V Aids
III Presentation
10. Subject matter – interesting , valid, accurate, complete
11. Mastery of content
12. Sequencing information
13. Correlation of previous knowledge
14. Relevant handouts
15. Group participation
16. Time limit
17. Submission of written manuscript on time
18. Conclusion
19. Responds to others point of view
20. Communication skill
TOTAL

Key: 5 - Excellent ; 4 - V. Good.; 3 -Good.; 2 Fair.; 1 - Poor.

Remarks:

Signature of the student with date Signature of the evaluator with date
 M.Sc NURSING FIRST YEAR

ADVANCED NURSING PRACTICE

EVALUATION FORMAT FOR WRITTEN ASSIGNMENT

Name of the college:

Name of the student : Date :

Topic / unit : Course Placement :

S.NO CRITERIA 5 4 3 2 1
I Relevancy of content:
1 Promptness & Neatness
2 Clarity
3 Concise
4 Current information
II Depth of content:
5 Key points emphasized
6 Sequential
7 Recent research studies
8 A.V.Aids/Diagram/Tables/ Figure

9 Bibliography /references
10 Submission on time
TOTAL

Key: 5 - Excellent ; 4 - V. Good.; 3 -Good.; 2 Fair.; 1 - Poor.

Remarks:

Signature of the evaluator with date

 M.Sc NURSING FIRST YEAR
ADVANCED NURSING PRACTICE
EVALUATION FORMAT FORCASE STUDY WITH THEORY APPLICATION

Name of the college:

Name of the student : Date of presentation :
Topic / unit : Course Placement :
Diagnosis: Ward:

S.NO EVALUATIVE ASPECTS 4 3 2 1

1 History collection
2. Physical examination
3. Investigation
4 Medication
5 Theory application:
- List out theories appropriate to condition

- Explain the concepts of the theory

- Apply patient conditions to the concepts
- Plan the care of patients with theory
- Prepare modified conceptual frame work

5. Nursing care plan

- Assessment

- Diagnosis
- Goal
- Expected outcome
- Planning with evidence based practice
- Implementation
- Evaluation

6 Health education and diet plan

7 Conclusion
8 Summary
9 Bibliography
Total

Key: 5 - Excellent ; 4 – Excellent 3 - V. Good.; 2 -Good.; 1 - Poor.

Remarks:

Signature of the student with date Signature of the evaluator with date
 EVALUATION FORMAT FOR COMPREHENSIVE FAMILY CASE STUDY
Ist YEAR M.SC NURSING
ADVANCED NURSING PRACTICE
COLLEGE NAME:

STUDENT NAME:

TOPIC: DATE & TIME:

Sl.No CRITERIA MARKS MARKS

ALLOTTED OBTAINED

1 Introduction 2
2 General Information About Family 2
3 Demographic Characteristics 6
4 Environmental Conditions 8
5 Economic Condition 4
6 Transport And Communication 4
7 Nutritional Status 8
8 Mch 8
9 Physical Examination & Investigation 8
10 List Of Health Problems Identified 6
11 Nursing Care Plan with 16
theory application
12 Health Education 8
13 Conclusion 4
14 Bibliography 6
15 Tidiness 10
TOTAL 100

REMARKS:................................................................................................................................
......................................................................................................................................................

STUDENT SIGNATURE: EVALUATOR SIGNATURE:

 M.Sc NURSING FIRST YEAR
ADVANCED NURSING PRACTICE
EVALUATION CRITERIA FOR HEALTH TALK
Name:………… …………………….
Course Placement:
Date & Time:………………… Topic:…………………

Marks Obtained Remarks

S.No Content marks
I. GENERAL 08
 Grooming
 Punctuality
 Self introduction
 Introducing the topic
II. CONTENT 10
 Selection of topic
 Arrangement of
content
 Continuation
 Reinforcement
 References
III. Physical set up 02
IV. Method of presentation 10
V. A.V. AIDS 06
 Appropriate
 Neat
 Clarity
 Color contrast
 Understandable
VI. LANGUAGE 05
 Using local language
as per the client
 Pronunciation
 Voice and modulation
VII. COMMUNICATION 4
 Initiative
 Interactive
 Enthusiastic
 Adherence to time
VIII. SUMMARY & 02
CONCLUSION
IX. GROUP 03
PARTICIPATION
TOTAL:

Remarks: Signature of the Teacher

 PROCEDURE EVALUATION FORMAT
M.Sc NURSING FIRST YEAR
ADVANCED NURSING PRACTICE

Name of the college:

Name/ seat number of the student:
Procedure:
Marks
Sl No Particulars Marks Obtained
Allotted
A Planning and organization
1 Theoretical knowledge and content 05
2 Preparation of patient and unit 03
3 Safety measures of the patient 02
B Tray Setup
4 Collection of articles 03
5 Arrangement of articles 04
6 Use of available resources 03
C Skill and technique
7 Following scientific principles 04
8 Steps of procedures 07
9 Handling of instruments 03
10 Confidence 02
11 Time management 02
12 Communication skill 02
D After care
13 After care of patient 04
14 After care of the articles 03
15 Recording and reporting 03
TOTAL 50

Signature of Student Name & Signature of

Supervisor Date : Date:
 ASSESSMENT RUBRIC FOR ANNOTATED BIBLIOGRAPHY
Ist YEAR M.SC NURSING
ADVANCED NURSING PRACTICE

COLLEGE OF NAME
NAME OF THE STUDENT DATE
YEAR
Sr.
No. Criterion 5 4 3 2 1
1.
Quantity of sources

2.
Quality /Reliability of
Sources

3.
Annotations

4.
Documentation

5.
Language

6. Total

Key: 5- 8 sources, 4- 7 sources, 3- 6 sources, 2-5 sources 1- 4 or less sources

Signature of student : Signature of Evaluator

 EVALUATION FORMAT FOR FIELD VISIT REPORT
1ST YEAR M.SC NURSING
ADVANCE NURSING PRACTICE
COLLEGE NAME:
STUDENT NAME: ROLL NO:
TOPIC: DATE & TIME:
SR.NO CRITERIA MARKS MARKS
OBTAINED

1 Introduction 2

2 Objectives Of Visit 2

3 Selection Of visit Area 2

4 Organization Structure 2

5 Physical Facility 5

6 Functions 5

7 Staffing 3

8 Learning Objective Met 2

9 Summary & Conclusion 2

10 Total 25

REMARKS
STUDENT’S SIGNATURE EVALUATOR’S SIGNATURE
RESEARCH
&
STATISTIC
 INTERNAL ASSESSMEN CRITERIA
M.Sc. Nursing I Year
Nursing Research
SNO Evaluation criteria NUMBERS MARKS

1 Seminar 1 100

2 Assignment 1 50

1 PROPOSAL 1 25
PRESENTATION

2 REVIEW OF 1 50
LITERATURE

3 TOOL PREPARATION 1 25

4 ANNOTATED 1 25
BIBLIOGRAPHY

5 JOURNAL CLUB 1 50
PRESENTATION

6 RESEARCH CRITICS 1 50

7 RESEARCH PROJECT 1 50

8 UNIT TEST 25X4 100

9 MID TERM EXAM 50

11 PREUNIVERSITY 50

Total 625

Remaining Requirement as per Log Book And INC

 FIRST YEAR M. SC NURSING
NURSING RESEARCH
EVALUATION CRITERIA FOR SEMINAR

College Name:
Name of student: Date:
Subject : Group:
Topic : Maximum Marks: 100

Sr. Criteria Max Marks Marks Remarks

No. Obtained

1 Physical Setup 5
2 Grooming 5
3 Introduction 5
Content
4 Lesson plan 5
5 Objectives 5
6 Relevant 5
7 Adequate 5
8 Organization of content 5
9 Research evidence 5
Presentation
10 Communication Skill 5
11 In depth knowledge 5
12 Time management 5
13 Group involvement 5
14 Control of group 5
AV Aids
15 Relevant to the topic 5
16 Innovation and creativity 5
17 Effective use of AV Aids 5
18 Follows Principles of AV 5
Aids
19 Summary/ conclusion 5
20 Reference 5
TOTAL 100

Remarks
Signature of student Signature of supervisor
 FIRST YEAR M. SC NURSING
NURSING RESEARCH
EVALUATION FORMAT FOR WRITTEN ASSIGNMENTS

Name of the college:

Name/ Seat Number of the student:
Topic:
Sr. Criteria Total marks Marks obtained
No.
1 Relevancy of content: 10
 Clarity (3)
 Concise (3)
 Simplicity of language(4)

2 Depth of content: 20
 Simple to complex(3)
 Key points emphasized(7)
 Description of important
points with
illustration(10)
3 Organization of content 10
 Sequential (5)
 Grammar , punctuation(2)
 Clean, neat , tidy(3)
4 A.V.Aids/Diagram/Tables 05

5 Bibliography /references 03

6 Submission on time 02

Total 50

Comment of Evaluator:-

Signature of student: Signature of Evaluator:

 FIRST YEAR M. SC NURSING
NURSING RESEARCH
EVALUATION CRITERIA FOR RESEARCH PROPOSAL

NAME OF STUDENT DATE

YEAR

Item Evaluation Criteria 5 4 3 2 1

Introduction
1. (Background information, problem statements,
aims/objectives)

Literature Review
2. (Relevant literatures, reasonable review parameter,
recent development, organization of issues etc.)

Research Methodology
3.
(Description of method, experimental design, etc.)

Feasibility of Study and Preliminary Results

(in terms of scope, time, resources & practicality;
4.
observation to date, presentation – statistical analysis,
graphs, tables, etc)

Overall Performance
(Presentation skills, shows confidence during Q&A
5.
session, etc.)

Total

* Note: Excellent: 5 Very Good: 4 Good: 3

Fair: 2 Poor: 1

Signature of Student Signature of Evaluator

 FIRST YEAR M. SC NURSING
NURSING RESEARCH
ASSESSMENT CRITERIA FOR REVIEW OF LITERATURE
NAME OF COLLEGE

NAME OF THE STUDENT DATE

YEAR

Sr.

No. Factors to consider Most reliable 5 4 3 2 1

1. Type of source Official websites,

Institutional websites,
Academic journals

2. Authors background Expert in the field

3. Date published Recently revised

4. Depth of review Peer reviewed by reliable sources

5. Sources cited Citations referencing

Other well cited works
6. Objectivity Balanced, neutral

7. Number of reviews Maximum reviews used

8. Organization

9 Relevant Relevant to study variables

10 Writing style Correct format

TOTAL

Signature of student : Signature of Evaluator

 FIRST YEAR M. SC NURSING
NURSING RESEARCH
TOOL PREPARATION

S.No Criteria Maximum Marks Obtained Marks

1. Relevancy 2

2. Clarity 3

3. Coverage of the topic 3

4. Preparation 5

5. Correct method adopted and 5

followed

6. Item analysis 5

7. Terminology 2

Total 25

Remarks:

Signature of Evaluator Signature of Student

 FIRST YEAR M. SC NURSING
NURSING RESEARCH
ASSESSMENT RUBRIC FOR ANNOTATED BIBLIOGRAPHY

COLLEGE OF NAME

NAME OF THE STUDENT DATE

YEAR

Sr.
Criterion 5 4 3 2 1
No.

1.
Quantity of sources 8 sources 7 sources 6 sources 5 sources 4 or fewer

2.
Quality /Reliability of
Sources
3.
Annotations

4.
Documentation

5.
Language

6. Total

Signature of student : Signature of Evaluator

 FIRST YEAR M. SC NURSING
NURSING RESEARCH
RESEARCH JOURNAL CLUB PRESENTATION
NAME OF COLLEGE NAME OF THE STUDENT

DATE YEAR

Sr. Particulars Excellent Poor N/A

no

OVERVIEW 5 4 3 2 1 0

1 What is your overall rating of this activity?

2 Were the sessions well organized?

3 Did they start on time?

CONTENT

4 Were the article / topics chosen interesting?

5 Were the appropriate critical tools used?

6 Did the activity meet your learning objectives?

DID THE FACILITATOR( S )

7 Offer a well organized presentation?

8 Display good subject knowledge?

9 Use appropriate style of presentation?

10 Provide adequate opportunities for questions and

discussions?

Remarks:
Signature of Evaluator Signature of Student
 FIRST YEAR M. SC NURSING ( NURSING RESEARCH )
EVALUATION FORMAT OF CRITICS
NAME OF COLLEGE NAME OF THE
STUDENT
SR. Criteria Maximum Obtained
No Marks Marks
1 Identifying information to include 5
 Where and was the article published? who wrote the article ?
 What was the purpose of the study? What was the nature of the study (
e.g. a case study, ethnography, a content analysis, or an experimental
study ?
 What is the analytical approach or theoretical framework? ( e.g. a
feminist analysis, a critical analysis, and application of a specific
theoretical model ?
2 Research design and methodology 15
 How does the method reflect or augment other studies of the same
topic?
 What makes this method feasible? How realistic is it?
 Why will this method produce data that will answer the research
question?
 How does the method address questions of validity?
 How does the researcher overcome the limitations of the method? Are
there large limitations or minor ones? How will these limitations affect
your ability to use this data to answer your research question?
 Was the research conducted ethically and following tri – council
guidelines?
3 Interpretation of findings 10
 Did the researcher find a correlation or a cause?
 Are the alternative interpretations of the findings?
 How “ generalizable “ are the findings ? Can the findings be applied to
other populations or situations?
4. Writing quality, clarity & style, and the organization of information 15
 Does the source reflect the genre of the source’s discipline?
 Does the source offer sufficient detail Are there gaps in the description
or places with unnecessary description ?
 Does the source present the information logically
 Does the sources present an objective view point? Does the author
seem to have a bias or blind spot?
5. The value of the study 5
 Is the research problem significant?
 What contribution does the study make to advancement of knowledge,
theory, or practice?
TOTAL 50
Signature of Evaluator Signature of Student
 FIRST YEAR M. SC NURSING
NURSING RESEARCH
EVALUATION CRITERIA FOR RESEARCH PROJECT

COLLEGE OF NAME

NAME OF THE STUDENT DATE

YEAR

Criteria for Evaluation Marks

Sl.

No.

1 Problem identified:
Significance

Clarity of problem
Clarity of operational definitions 6
Clarity of objectives
Hypothesis /Assumptions
Conceptual framework

2 Review of literature:
Inclusion of current references

Citation of primary sources 5

Systematic flow of writing
Relevance of literature

3 Methodology:
Population,
sampling technique,
size, criteria for
selection
 Ethical consideration 10
Data collection procedure
Validity and reliability of tools used
Statistical methods chosen

4 Analysis and interpretation of data:

Analytical methods – appropriate &

Accurate 14
Interpretation in the light of objectives

and hypothesis testing

5 Summary and discussion:
Summary of findings

Discussion with relation to relevant

Studies
37
Limitation of the study
Implications
Recommendations – relevant and
Practical

6 Abstract References and Appendix 4

7 Style of writing research report 3
Total 50

Name Of Evaluator : Total Marks :

Signature : Comments
:

Student Signature
 Internal Assessment criteria for Statistics

M.Sc Nursing Ist year

College Name: Date/Time

Name of Student:

Sno Criteria Numbers Marks

1 Unit Test 4 25x4= 100

2 Midterm exam 1 25

3 Preuniversity exam 1 25

TOTAL 150
 INTERNAL ASSESSMENT CRITERIA FOR THEORY

M.Sc. Nursing First Year MEDICAL SURGICAL NURSING I

SR.NO EVALUATION CRITERIA NUMBERS MARKS

1 Seminar 3 100x3=300

2 Unit test 4 25x4=100

3 Written Assignment 2 2X50=100

4 Practice Teaching 3 3x50= 150

5 Drug Presentation 1 50

6 Design of Medical surgical Dept 1 25

7 Field Visit 1 25

8 Project/ workshop 1 25

9 Mid term Exam 1 75

10 Preuniversity Exam 1 75

TOTAL 925
 EVALUATION FORMAT FOR SEMINAR
M.Sc NURSING FIRST YEAR
CLINICAL SPECIALITY- I (MEDICAL SURGICAL NURSING)
Name of the college:
Name/ Seat Number of the student:
Topic
Sl No Basic of evaluation 5 4 3 2 1 Remarks
1 Content
a) Introduction
b) Relevancy content
c) Adequacy of content
d) Organization of the topic
e) Submission in time
2 Organization and management of
class
a) Arrangement of class
b) Budgeting of time
c) Group participation
d) Control of Group
3 AV aids
a) Appropriate to subject
b) Selection and adequacy
c) Following Principles
4 Presentation
a) Mastery over content
b) Overall presentation & explanation
5 Personal appearance
a) Neatness and professional
appearance
b) Degree of self confidence
c) Voice and clarity
d) Mannerism
6 Summery &Conclusion
7 Bibliography
Total marks out of 100

Signature of Student Name & Signature of Supervisor

 EVALUATION FORMAT FOR WRITTEN ASSIGNMENTS
M.Sc NURSING FIRST YEAR
CLINICAL SPECIALITY-1 (MEDICAL SURGICAL NURSING)

Name of the college:

Name/ Seat Number of the student:
Topic:

Sr. Criteria Total marks Marks obtained

No.
1 Relevancy of content: 10
 Clarity (3)
 Concise (3)
 Simplicity of language(4)

2 Depth of content: 20
 Simple to complex(3)
 Key points emphasized(7)
 Description of important
points with
illustration(10)
3 Organization of content 10
 Sequential (5)
 Grammar , punctuation(2)
 Clean, neat , tidy(3)
4 A.V.Aids/Diagram/Tables 05

5 Bibliography /references 03

6 Submission on time 02

Total 50

Comment of Evaluator:-

Signature of student: Signature of Evaluator

 M.Sc Nursing First Year
Medical Surgical Nursing- I
Performa for evaluation- practice teaching
College Name Name of the student ……………………….
Topic ………………………
Name of evaluator …………………………. Date & time ………………….
Sr.No Criteria Maximum – Marks
marks (50 mks) obtained
1 Lesson plan
 General objectives stated clearly
 Specific objectives stated in behavioural term 10
 Lesson plan followed in sequence
 Bibliography up to date and complete
2 Learning environment
 Physical setup of class room
 Class room light is adequate 05
 Well ventilated
 Motivates student
3 Presentation
 Coverage of subject content
 Depth of knowledge
 Integration of subject matter 10
 Explanation and clarification
 Use of current literature
 Time limit
4 Use of Audio visual aid
 Relevant ,clear and visible 10
 Creativity
 Used effectively at the right time
5 Questioning technique
 Questions equally addressed to all
 Well worded questions and no ambiguity 05
 Thought provoking questions
 Sufficient time allowed for answering
 Relevant to topic
6 Student teacher appearance
 Appearance
 Grooming 05
 Confidence
 Mannerism
7 Assignment
 Appropriate to lesson
 Clear 05
 Motivating
 Explained to students
 Feed back given to students
Signature of evaluator Remarks
 EVALUATION FORMAT FOR DRUG PRESENTATION
M.Sc NURSING FIRST YEAR
CLINICAL SPECIALITY-1 (MEDICAL SURGICAL NURSING)
Name of the college:
Name/ Seat Number of the student:

Sr. Parameters Mark Mark

no. allotted obtained
1 Introduction 2
2 Drug class, Available form 4
3 Mode of action 6
4 Indication, Dosage, Route 4
5 Side Effect & 4
Contraindication
6 Nursing consideration & 8
Patient Education
7 Eye Contact 2
8 Appearance 2
9 Classroom Management 2
10 Use of A. V. Aids 4
11 Language Fluency 2
12 Mastery over content 4
13 Group Participation 4
14 Bibliography 2
Total 50

Remarks:

Sign of the student: Name & Sign of the Evaluator:

 Blue Print Of Design Of Medical Surgical Nursing Department
M.Sc Nursing First Year

Name Of College :
Date &Time :

SR.NO CRITERIA MARKS

1 Introduction 2

2 Unit / Bed Arrangement 2

3 Physical Facility 4

4 Equipment 6

5 Infection Control Measures 3

6 Staffing 5

7 Facility For Family 2

8 Design For Future 1

9 Total 25
 M.Sc Nursing First Year
Medical Surgical Nursing- I
Evaluation Form For Field Visit
Name Of College
: Year :
Date &Time :
SR.NO CRITERIA MARKS

1 Introduction 2

2 Objectives Of Visit 2

3 Selection Of visit Area 2

4 Organization Structure 2

5 Physical Facility 5

6 Functions 5

7 Staffing 3

8 Learning Objective Met 2

9 Summary & Conclusion 2

10 Total 25
 M.Sc Nursing First Year
Medical Surgical Nursing- I

Evaluation Form For Project/ workshop Evaluation

Name Of College :
Name/ Seat No of Student :
Date & Time :

Please rate the following items on a scale from 1 to 5 by circling the appropriate number:
1=Strongly Agree (SD); 2 = Disagree (D); 3 = Not Sure (NS); 4 = Agree (A); 5 = Strongly
Agree(SA).
SD D NS A SA

1. Workshop was well organized and the main

1 2 3 4 5
points were well covered and clarified.

2. Facilitator demonstrated comprehensive

1 2 3 4 5
knowledge of the subject matter.

3. Facilitator helped students to understand how the

1 2 3 4 5
workshop material related to subject

4. Facilitator conveyed ideas effectively and

clearly and the material was informative and easy 1 2 3 4 5
to understand.

5. Usable skills and student will be able to apply

1 2 3 4 5
them to their academic or personal life.

6. What was the most valuable aspect of the workshop?

7. What could have been done to improve the workshop?

8. Additional Comments or suggestions:

Sign of Evaluator Remarks

 PRACTICAL ASSESSMENT CRITERIA
M.Sc. Nursing First Year( Medical Surgical Nursing – I )

SR.NO PRACTICAL ASSIGNMENT NUMBERS MARKS

(EACH)

1 Case Study 2 100x2= 200

2 Care Plan with theory Application 3 50x3=150

3 History taking &Health Assessment 5 (GI, Respi, 1000x5= 500

Cardiac, Neuro&
Genitourinary
Assessment)
4 Clinical Evaluation 4 100x4=400

5 Procedure Demonstration 5 50x5= 250

6 Case presentation 2 50x2=100

7 Health Education 2 25x2= 50

8 Nutritional Assessment 3 25x3=75

9 Daily Dairy 1 50

10 Mid Term Practical 1 100

10 PreUniversity Exam 1 100

TOTAL 1975

Note- Remaining Assignments as per the log book and INC

 EVALUATION FORMAT FOR CASE STUDY
M.Sc NURSING FIRST YEAR
CLINICAL SPECIALITY-1 (MEDICAL SURGICAL NURSING)

Name of the college:

Name/ seat number of the student: Year :
Patient’s Diagnosis : Ward:
Sl Marks
Particulars Marks
No Obtained
1 Introduction 02
2 Patient Profile 02
3 History Collection 08
4 Physical Examination 08
5 Investigation 02
6 Medication 04
7 Nursing Process 10
8 Anatomy And Physiology 05
9 Disease Condition 06
10 Comparative Study 06
11 IV Plan 06
12 Intake - Output Chart 08
13 Nurses Record 10
14 Diet Plan 08
15 Health Education 06
16 Patient Prognosis. 04
17 Summary & Conclusion 03
18 Bibliography 02
TOTAL 100

Signature of Student Name & Signature of Supervisor

Date : Date:
 M.Sc. Nursing First Year
CLINICAL SPECIALITY-1 (MEDICAL SURGICAL NURSING)
Performa for evaluation- Care plan with Theory application
Name of the student ………………………. College……………………
Topic ………………………
Name of evaluator ……………………. Date & time ………………….

S.no Evaluative aspects Points Points Remarks

allotted obtained
1 History collection 5
2. Physical examination 5
3. Investigation & medication 5
4. Theory application:
- List out theories appropriate to 15
condition
- Selection of theory apply to
the condition
- Explain the concepts of the theory
- Apply patient conditions to
the concepts
- Plan the care of patients with theory
- Prepare modified conceptual frame
work
5. Nursing care plan
- Concepts used to diagnose 10
the condition
- Assessment
- Diagnosis
- Goal
- Expected outcome
- Planning with evidence based
- Implementation
- evaluation

6 Health education and diet plan 5

7 Conclusion 3
8 Summary 2
Total 50

Signature of evaluator: Signature of

student:
Comments:

M.Sc. Nursing First Year

CLINICAL SPECIALITY-1 (MEDICAL SURGICAL NURSING)
HEALTH ASSESSMENT EVALUATION FORMAT

NAME OF THE STUDENT: YEAR: Topic:

TOPIC: DATE:

SR. PROCEDUR MARKS MARKS

NO ALLOTED OBTAINED
1 PLANNING AND ORGANIZATION 30
Lesson plan preparation 10
Theoretical knowledge 10
Preparation of patient and unit 5
Safety measures for patient 5
2 TRAY SETUP 18
Collection of articles 6
Arrangement of articles 6
Use of available resources 6
3 SKILLES AND TECHNOLOGIS 28
Use of scientific principles 5
Steps of procedure 5
Handling of instrument 4
Use of articles 5
Confidence 3
Time management 3
Communication skills 3
4 AFTER CARE 12
After care of patients 4
After care of Articles 3
Recording and reporting 5
5 PERSONAL QUALITIES 12
Appearance 3
Mannerism 3
Interest 3
Punctuality 3
TOTAL 100

Signature of Student Signature of Teacher

 CLINICAL EVALUATION FORMAT M.Sc NURSING FIRST YEAR
CLINICAL SPECIALITY-1 (MEDICAL SURGICAL NURSING)
Name of the college:
Name/ seat number of the student: Ward:
Date:
MARKS
S.NO ABILITY & SKILLS TO BE EVALUATED 1 2 3 4
I ASSESSMENT
1 Use suitable method to collect relevant data
2 Make interview with patient and relatives
3 Make clinical observation and physical examination
4 Accurately identifies the problem of the patient with the use of
nursing theory
5 Accept the patient and maintain good rapport
6 Co-operate with health team members
7 Maintain good IPR and accept supervision by nursing personnel
8 Create an atmosphere of mutual trust and respect
II PLANNING
9 State problem on scientific rationale on the basis of subjective and
objective data
10 Formulates the objectives relevant to problem on priority
11 Involve the client , other key persons and evidence based
planning of care
III IMPLEMENTATION
12 Determine the appropriate nursing action of the problem on
priority basis
13 Demonstrate the clinical skill necessary to carry out nursing
intervention
14 Utilize the opportunity to teach health care concepts to clients
15 Apply evidence based practice & scientific principle
IV EVALUATION
16 Routinely evaluate the effect of nursing care
17 Utilize current data to review nursing care plan
18 Use advance technology for recording data
V RECORDING & REPORTING
19 Maintain adequate records accurately
20 Communicate ideas information and health message effectively
21 Follow legal principles on records and reports
VI PERSONAL QUALIFICATION
22 Punctuality,grooming,maintain own health
23 Initiative and responsibility
24 Follow professional ethics ,leadership skills
25 Confidence
Total score

Signature of student: Name &Signature of evaluator:

 PROCEDURE EVALUATION FORMAT
M.Sc NURSING FIRST YEAR
CLINICAL SPECIALITY-1 (MEDICAL SURGICAL NURSING)
Name of the college:
Name/ seat number of the student:
Procedure:
Marks Marks
Sl No Particulars
Allotted Obtained
A Planning and organization
Theoretical knowledge and content 05
Preparation of patient and unit 03
Safety measures of the patient 02
B Tray Setup
Collection of articles 03
Arrangement of articles 04
Use of available resources 03
C Skill and technique
Specific principles 04
Steps of procedures 07
Handling of instruments 03
Confidence 02
Time management 02
Communication skill 02
D After care
After care of patient 04
After care of the articles 03
Recording and reporting 03
TOTAL 50

Signature of Student Name & Signature of Supervisor

Date : Date:
 EVALUATION FORMAT FOR CASE PRESENTATION
M.Sc NURSING FIRST YEAR
CLINICAL SPECIALITY-1 (MEDICAL SURGICAL NURSING)

Name of the college:

Name/ seat number of the student: Year :
Patient’s Diagnosis: Ward:
Sl Marks
Particulars Marks
No Obtained
1 Introduction 02
2 Patient Profile 02
3 History Collection 08
4 Physical Examination 10
5 Investigation 03
6 Medication 04
7 Anatomy And Physiology 04
8 Disease Condition 06
9 Comparative Study 06
10 Nursing Process 10
11 Diet Plan 05
12 Health Education 05
13 Nurses Record 05
14 Presentation
a- Appearance & confidence 03
b- Knowledge about the patient& case 06
c- Use of AV aids 04
d- Language & Fluency 03
e- Group involvement 06
15 Summary & Conclusion 04
16 Bibliography 04
TOTAL 50

Signature of Student Name & Signature of Supervisor

Date : Date:
 EVALUATION FORMAT FOR HEALTH EDUCATION
M.Sc NURSING FIRST YEAR
CLINICAL SPECIALITY-1 (MEDICAL SURGICAL NURSING)
Name of the college:
Name/ Seat Number of the student:

Sr. Parameters Mark Mark

no. allotted obtained
1 Introduction 1
2 Drug class, Available form 2
3 Mode of action 3
4 Indication, Dosage, Route 2
5 Side Effect & 2
Contraindication
6 Nursing consideration & 4
Patient Education
7 Eye Contact 1
8 Appearance 1
9 Classroom Management 1
10 Use of A. V. Aids 2
11 Language Fluency 1
12 Mastery over content 2
13 Group Participation 2
14 Bibliography 1
Total 25

Remarks:

Sign of the student: Name & Sign of the

Evaluator:
 Evaluation Form For Nutritional Assessment
M.Sc. Nursing First Year ( Medical Surgical Nursing )

Name of College :
Name/ Seat No of Student :
Diagnosis :
Date &Time :

SR.NO CRITERIA MARKS MARKS

OBTAINED

1 Patient Information and Detail 2

2 Diet Pattern / History of Patient 2

3 Calorie Calculation as Per Patient Need 5

4 Diet Education 4

6 100 Gm Value of Food Stuff (Required For Menu ) 2

7 Menu Planning ( 24 Hours ) 10

8 Total 25

Name Of Evaluator : Total Marks :

Signature : Comments :

Student Signature :
 EVALUATION FORMAT FOR DAILY DIARY
M.Sc. Nursing First Year ( Medical Surgical Nursing )

Name of the student ……………………….

Topic ………………………
Name of evaluator ……………………. Date & time ………………….

S.no Evaluative aspects Points Points Remarks

allotted obtained
1. Patient Profile 2
2. History collection 4
3. Physical examination 4
4. Investigation 3
5. Medication 3
6. Theory application:
a. List out theories appropriate 2
to condition
b. Selection of theory apply to 5
the condition
c. Explain the concepts of the theory
d. Plan the care of patients with theory 4
e. Prepare modified conceptual 4
frame work
5. Nursing care plan
a. Assessment 2
b. Diagnosis 2
c. Goal 2
d. Planning &Implementation 2
e. evaluation 2

6 Submission on time 3
7. Neatness 2
8. Revision of Plan as per Patient Need 3
9. Completeness 2
Total 50

Signature of evaluator: Signature of student:

Comments:
 VEER NARMAD SOUTH GUJARAT UNIVERSITY, SURAT
MSC NURSING IST YEAR
PRACTICAL EVALUATION FORM
( Medical Surgical Nursing- I )
College Name- Subject - Seat
No-
Year Date/ Time-
I Criteria Max Roll no Roll No Roll No Roll Roll Roll No
Mark No No
s

ASSESSMENT – THEORY
BASED
1 History Relevant & adequate 2
2 Equipment- adequate 2
3 Technique- appropriate 4
4 Data- relevant, Complete 7
& organized
CARE PLANNING
(PRIORITY BASED)
5 Defining characteristics 3
appropriate
6 Nursing Diagnosis 4
7 Objective- Measurable, 4
achievable
8 Interventions – Specific 6
INMPLEMENTATION

9 Patient Preparation 4
10 Scientific Principles 7
11 Skills 7
12 Communication 4
13 Patient Instruction 5
14 Documentations 3
15 Evaluation of Care 3
16 Completeness of care 3
PROFESSIONALISM

17 Grooming, Pleasant & sensitive 2

to patient Need
VIVA 30

TOTAL 100
 Signature of Internal Examiner Signature of External Examiner

MIDWIFERY AND OBSTETRICAL NURSING

M.Sc. Nursing First Year INTERNAL ASSESSMENT CRITERIA

S.No EVALUATION CRITERIA MARKS

1 Seminar 1 x 100 = 100

2 Assignments 2 x 25 = 50

3 Unit Test 4 x 25 =100

4 Mid term Examination 1 x 75 =75

5 Pre university Examination 1 x 75 =75

TOTAL 400
EVALUATION FORMAT FOR SEMINAR M.Sc NURSING FIRST YEAR
CLINICAL SPECIALITY- I (MIDWIFERY AND OBSTETRICAL NURSING)

Name of the college:

Name/ Seat Number of the student:
Topic
Sl No Basic of evaluation 5 4 3 2 1 Remarks
1 Content
f) Introduction
g) Relevancy content
h) Adequacy of content
i) Organization of the topic
j) Submission in time
2 Organization and management of
class
e) Arrangement of class
f) Budgeting of time
g) Group participation
h) Control of Group
3 AV aids
d) Appropriate to subject
e) Selection and adequacy
f) Following Principles
4 Presentation
c) Mastery over content
d) Overall presentation & explanation
5 Personal appearance
e) Neatness and professional
appearance
f) Degree of self confidence
g) Voice and clarity
h) Mannerism
6 Summery & Conclusion
7 Bibliography
Total marks out of 100

Signature of Student Name & Signature of Supervisor

 EVALUATION FORMAT FOR WRITTEN ASSIGNMENT

Ist YEAR M.SC NURSING

MIDWIFERY AND OBSTETRICAL NURSING

Name of the college:

Name/ Seat Number of the student:
Topic: Date:

Sr. Criteria Total marks Marks obtained

No.
1 Relevancy of content: 4
 Clarity (3)
 Concise (3)
 Simplicity of language(4)

2 Depth of content: 10
 Simple to complex(3)
 Key points emphasized(7)
 Description of important
points with
illustration(10)
3 Organization of content 5
 Sequential (5)
 Grammar , punctuation(2)
 Clean, neat , tidy(3)
4 A.V.Aids/Diagram/Tables 3

5 Bibliography /references 2

6 Submission on time 1

Total 25

Comment of Evaluator:

Signature of student: Signature of Evaluator:

INTERNAL ASSESSMENTT CRITERIA FOR MSc. NURSING FIRST YEAR

MIDWIFERY & OBSTETRICAL NURSING -I

PRACTICAL REQUIREMENTS

S.No REQUIREMENTS MARKS

1. CASE PRESENTATION
 ANTENATAL-1 100x3=300
 POSTNATAL-1
 NEWBORN-1
2 CASE STUDY 100x3=300
 ANTE NATAL-1
 POSTNATAL-1
 NEONATAL-1
3 DRUG BOOK 50x1=50
4 DRUG PRESENTATION 50x1=50
5 INSTRUMENT BOOK 100x1=100
6 CASE BOOK 50x1=50
7 50x1=50
DAILY DAIRY
8 100x1=100
EVALUATORY PROCEDURE
9 25x2=50
HEALTH EDUCATION
10 100
MID TERM
11 100
PREUNIVERSITY EXAM
TOTAL 1250
 MIDWIFERY & OBSTETRICAL NURSING -I

Case presentation - EVALUATION FORM

MSc. NURSING FIRST YEAR
COLLEGE NAME:

STUDENT NAME:

YEAR: I YR M.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRIC NURSING
TOPIC: DATE & TIME:
S.No Abilities to be evaluated 1 2 3 4 Remarks
1 Personal attitude
 Grooming & Appearance
 Posture
 Manners
 Alertness
2 Organizational abilities
 Preparation of unit
 Selection of patient & Preparation of patient
 Preparation of group
3 Teaching abilities & material
 Leadership quality
 Selection of appropriate AV aids
 Principle followed in AV aids
 Group Involvement
 Accept constructive criticism
 Feed back
4 Application of nursing theories
 Selection of appropriate theory
 Clearly explained the concepts
 Application of patient condition in to theory
 Modify conceptual framework based on condition
5 Health Assessment
 History collection
 Physical examination
 Investigation & drug study
 Comparison of disease condition
 Prioritize health needs & nursing diagnosis
 Implementation & evaluation of care given
 Health Education
Discharge Plan
6 Bibliography
Total (out of 100)

REMARKS

Signature of Evaluator
 MIDWIFERY & OBSTETRICAL NURSING -I
CASE STUDY - EVALUATION FORM

MSc. NURSING FIRST YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: IV YR B.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRICAL NURSING

TOPIC: DATE & TIME:

Sr.No Item Max.Marks Obt.Marks

1 Demographic data 5
2 Chief complaints at the time of admission 4
3 History collection
3.1 Present History 4
3.2 Past History 4
3.3 Obstetrical/Gynaecological History 5
3.4 Personal History & Menstrual History 4
3.5 Socioeconomic History 5
3.6 Marital & Contraceptive History 5
3.7 Physical examination 5
4 Obstetrical examination 5
4.1 General Examination 5
5 Investigations & Drug Study 4
6 Treatment 5
7 Anatomy & physiology of relevant system 5
8 Disease condition 10
9 Assessment – priority need 7
10 Nursing process 5
11 Health education & Diet Plan 5
12 Discharge Plan 4
13 Bibliography 4

TOTAL 100

REMARKS:
SIGNATURE OF STUDENT SIGNATURE OF EVALUATOR

MIDWIFERY & OBSTETRICAL NURSING -I

DRUG BOOK - EVALUATION FORM

MSc. NURSING FIRST YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: IV YR B.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRICAL NURSING

TOPIC: DATE & TIME:

Max Marks
SL.No Criteria
Marks Obtained

01 Content 10

02 Nursing Responsibility 10

Organization of content, creativity, neatness &

03 10
legibility

04 New trends, researches or critical analysis 10

05 Bibliography / References 10

Total 50

REMARKS:

SIGNATURE OF STUDENT SIGNATURE OF EVALUATOR

 MIDWIFERY & OBSTETRICAL NURSING -I
DRUG PRESENTATION - EVALUATION FORM

MSc. NURSING FIRST YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: I YR M.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRICAL NURSING

TOPIC: DATE & TIME:

SR.NO ITEM MAX.MARKS Marks obtained

A Drug Study
1 Introduction 2
2 Trade & Pharmaceutical name 2
3 Preparation, strength & dose 4
4 Action 4
5 Indication 4
6 Contraindication 4
7 Adverse Effect & Drug Interaction 4
8 Nsg Responsibility 4
9 Patient Education 2
10 Bibliography 2
B Material
11 Technical Adequacy Content 2
12 Organisation of content 3
13 Latest trends & research studies 5
C A.V Aids
14 Follow Principles of AV aids 2
15 Attractive & Self Explanatory 2
16 Innovative & Creative 2
D Personal Appearance & Mannerism 2
TOTAL 50

REMARKS:

SIGNATURE OF STUDENT SIGNATURE OF EVALUATOR

 MIDWIFERY & OBSTETRICAL NURSING -I
EVALUATION FORMAT - INSTRUMENT BOOK
MSc. NURSING FIRST YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: I YR M.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRICAL NURSING

TOPIC: DATE & TIME:

SR. CRITERIA MARKS MARKS

NO. ALLOTTED OBTAINED

1 Student Profile & Index 4

2 Content
 Uses/indications 12
 Description of an instrument 12
 Limitations 12
 Contraindications 10
 Neatness & Clarity 12
 Use of pictures/diagrams or tables 10
 After care of an instrument 10
10
 New Trend/Researches/Critical
Analysis
3 Bibliography 4

4 Punctuality in submission 4

TOTAL 100

Signature of Student Name & Signature of Teacher

Date : Date:
 MIDWIFERY & OBSTETRICAL NURSING -I

CASE BOOK- EVALUATION FORM

MSc. NURSING FIRST YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: ROLL NO:SUBJECT:

TOPIC:DATE & TIME:

SR. CRITERIA MARKS MARKS

NO. ALLOTTED OBTAINED

1. Patient Profile & Index 2

2. Content

 Adequacy 6

 Relevancy 6

 Organization of content 4

 Legibility 4

 Accuracy of data 6

 Completed as per requirement 6

3. Technical Knowledge 4

4. Technical Skill 4

5. Attitude towards patient & health personals 4

6. Punctuality in submission 4

TOTAL 50

Remarks:

Signature of Student Signature of Teacher:

 MIDWIFERY & OBSTETRICAL NURSING -I

EVALUATION FORMAT FOR DAILY DIARY

MSc. NURSING FIRST YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: I YR M.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRICAL NURSING

TOPIC: DATE & TIME:

S.no Evaluative aspects Points Points Remarks

allotted obtained
1. Patient Profile 2
2. History collection 2
3. Physical examination 3
4. Investigation 2
5. Treatment 2
6. Theory application:
f. List out theories appropriate to 2
condition
g. Selection of theory apply to 5
the condition
h. Explain the concepts of the theory
i. Plan the care of patients with theory 2
j. Prepare modified conceptual 2
frame work
5. Nursing care plan
f. Assessment 3
g. Diagnosis 3
h. Goal 3
i. Planning & Implementation 3
j. Evaluation 3

6 Learning Experience 4
7. Submission on time 3
8. Neatness & Complete 3
9. Revision of Plan as per Patient Need 3
Total 50
Signature of Evaluator: Signature of student
 MIDWIFERY & OBSTETRICAL NURSING -I
Procedure evaluation form MSc. NURSING FIRST YEAR
COLLEGE NAME:

STUDENT NAME:

YEAR: I YR M.SC NSG ROLL NO: SUBJECT: MIDWIFERY AND

OBSTETRICAL NURSING

SR. PROCEDURE MARKS MARKS

NO ALLOTED OBTAINED
1 PLANNING AND ORGANIZATION 30

Lesson plan preparation 10

Theoretical knowledge 10
Preparation of patient and unit 5
Safety measures for patient 5
2 TRAY SET UP 18

Collection of articles 6
Arrangement of articles 6
Use of available resources 6
3 SKILS AND TECHNOLOGIES 25

Use of scientific principles 5

Steps of procedure 5
Handling of instrument/articles 5
Confidence 4
Time management 3
Communication skills 3
4 AFTER CARE 13
After care of patients 3

After care of articles 5

Recording and reporting 5
5 PERSONAL QUALITIES 12

Appearance 3
Mannerism 3
Interest 3
Punctuality 3
6 Bibliography/References 2
TOTAL 100
SIGNATURE OF STUDENT SIGNATURE OF TEACHER
 MIDWIFERY & OBSTETRICAL NURSING -I

EVALUATION FORMAT FOR HEALTH EDUCATION

MSc. NURSING FIRST YEAR

COLLEGE NAME:

STUDENT NAME: ROLL NO:

TOPIC: DATE & TIME:

SR CRITERIA MARKS MARKS

.NO ALLOTTED OBTAINED
1 Introduction 2

2 Preparation of physical environment 2

3 Preparation of participant 2

4 Preparation of content 5
5 A V aids 5
6 Communication skills 2
7 Written material 3
8 Advanced information 2

9 Response from participants 2

Total 25

REMARKS:

SIGNATURE OF EVALUATOR: SIGNATURE OF STUDENT :

 VEER NARMAD SOUTH GUJARAT UNIVERSITY, SURAT

MIDWIFERY & OBSTETRICAL NURSING -I

PRACTICAL EXAM EVALUATION CRITERIA
Demograph VIVA
Hallic data History Collection & Examination
Physical Nursing Process (5) Health Education (5)
Nursing procedure & Practical Tot m
ticket(5) Num. Bed side viva (10) TOTA Requirements (10)
(5) L ( 50

Obstetrical Examination & Investigation

/medication (10)
AD P I E

SIGNATURE OF INTERNAL EXAMINER

SIGNATURE OF EXTERNAL EXAMINER

 THEORY ASSESSMENT CRITERIA
M. Sc NURSING FIRST YEAR
MENTAL HEALTH NURSING- I

EVALUATION:

Scheme of Internal Assessment of theory - out of 25marks

Sr.No Theory Assignment Marks

1. Seminar 100 marks

2. Project 100 marks

3. Unit test4 25X4=100 marks

4. Mid TermExam 75 marks

5. Priuniversity Exam 75 Marks

6. Preparation of A.V. aids (Flash cards or 50

any A.V aid on particular topics) No’s- 2
Total 500

Practical – External Assessment 100 Marks

Theory – External Assessment 75 Marks

 M.Sc. Nursing First Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR SEMINAR

Name of student Date
Subject Group
Topic Maximum Marks: 100
Sr. Criteria Max Marks Marks Remarks
No. Obtained

1 Physical Setup 5
2 Grooming 5
3 Introduction 5
Content
4 Lesson plan 5
5 Objectives 5
6 Relevant 5
7 Adequate 5
8 Organization of content 5
9 Research evidence 5
Presentation
10 Communication Skill 5
11 In depth knowledge 5
12 Time management 5
13 Group involvement 5
14 Control of group 5
AV Aids
15 Relevant to the topic 5
16 Innovation and creativity 5
17 Effective use of AV Aids 5
18 Follows Principles of AV 5
Aids
19 Summary/ conclusion 5
20 Reference 5
TOTAL 100

Remarks:
Signature of student Signature of supervisor
 M.Sc. Nursing First Year

CLINICAL SPECIALTY- I (MENTAL HEALTH NURSING)

EVALUATION FORMAT: PROJECT

Subject
Topic Date
Name of student Time
Group Maximum Marks: 100
CRITERIA MAX MARKS Remarks
MARKS OBTAINED
1 Physical Setup 5
2 Grooming 5
3 Introduction 5

Content
4 Relevant 10
5 Adequate 20
6 In sequence 5
Presentation
7 Communication Skill 10
8 In depth knowledge 10
AV Aids
9 Relevant to the topic 5
10 Innovation and creativity 5
11 Effective use of AV Aids 5
12 Follows Principles of AV 5
Aids
13 Summary/ conclusion 5
14 Reference 5
Total 100

Remarks:

Signature of student Signature of supervisor

 MENTAL HEALTH NURSING
EVALUATION CRITERIA FOR A.V AID PREPARATION
Name of the college:-
Name of the student:-
Class: - Date:-Place:-
Name of Evaluator: -
S. No Content Marks allotted Marks obtained

1 Applicability to the topic 5

2 curate in every aspect 5

3 Self prepared/ readymade. 5

4 Materials used: economical 5

5 Attractiveness 5
6 Principles 5

7 Display / visibility 5
8 Message conveyed 5
9 Relevance 5
10 Effectiveness 5
TOTAL 50
Remarks:

Signature of student Signature of supervisor

 Scheme of Internal Assessment of Practical - out of 100marks
MENTAL HEALTH NURSING I (PRACTICAL
ASSESSMENT CRITERIA )

S.No Area Quantity Marks

1 Midterm Exam 100

2 Pre university Exam 100

3. Case presentation 2x100 200

4. Case studies 2x100 200

5. History taking 5x25 125

6. MSE 5x25 125

7. Process recording 5x25 125

9. Counselling 2x50 100

10. Assisted ECT 2x25 50

11 Socio and psycho drama 2x50 100

12 Field visit 2x10 20

13 Clinical Evaluation 1x100 100

14 Observation report 2x10 20

15 Psychometric assessment 3x50 150
16 Personality assessment 3x50 150
17 Work book 2x50 100
18 Neurological examination 4x100 400
19 Care plan 5x25 125
20 Psychoeducation 3x50 150
21 Drug presentation 1x50 50
22 Mini mental status examination 5x10 50
23 Drug Study 1x100 100

Total 2540
 FIRST YEAR M. Sc NURSING

M.Sc. Nursing First Year

CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR NURSING CASE PRESENTATION

MARKS MARKS
S. NO. CONTENT
OBTAINED
Knowledge assessment
1 Orientation of History 05

2 M.S.E.with Diagnosis 06
Co-relation with patient and
3 03
Book
Nursing care plan and Nurses’
4 08
Notes
5 Drug Study 03

6 Research evidence 03

7 Health Education 03

8 Bibliography 02

Presentation skill
9 Use of A. V. Aids 05

10 Physical arrangement 02

11 Group participation 05

12 Effectiveness of Presentation 03
Implementation of psycho
13 02
therapies
50

Remarks:
Signature of Student Signature of Superviso

M.Sc. Nursing First Year

CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR NURSING CASE

STUDY

Sl. No Content Marks Marks Obtained

1 Patient’s History 03
2 MSE 03
3 Anatomy and Physiology 05
4 Incidence, Etiology 05
5 Psycho pathology 05
6 Clinical manifestations 06
7 Investigations 04
8 Complication and Prognosis 05
Management –
 Medical
9 10
 Psychotherapies
 Physical therapies
10 Drug study 10
11 Nursing care plan 15
12 Nurses’ Notes/ prognosis 08
13 Health Education 06
14 Discharge planning 05
15 Research evidence 04
16 Conclusion 03
17 Bibliography 03
Total 100

Remarks:

Signature of Student Signature of Supervisor

 M.Sc. Nursing First Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR PSYCHIATRIC CASE HISTORY TAKING

Marks Marks
Sr. No. Criteria Allotted Obtained
1 Demographic of Patient 1
2 Chief Complaints 3
3 Present psychiatric history 4
4 Past Psychiatric history 3
5 Non-Psychiatric History 1
6 Family History 2
7 Personal History 5
8 Pre-morbid personality 5
9 Summary & Clinical Diagnosis 1
10 Total 25

Remark

Signature of Student Signature of Supervisor

 M.Sc. Nursing First Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING
EVALUATION CRITERIA FOR MENTAL STATUS EXAMINATION
Marks Marks
Sr. No. Criteria Allotted Obtained
1 Demographic Data 1
2 General appearance and behavior 3
3 Psychomotor Activity 1
4 Speech 3
5 Thought 3
6 Mood 2
7 Perception 2
8 Cognitive functions 1
9 Attention and concentration 1
10 Memory 1
11 Orientation 1
12 Abstraction 1
13 Intelligence & General Information 1
14 Judgment 1
15 Insight 1
16 General Observations 1
17 Summary & Clinical Diagnosis 1
Total 25

Remarks:

Signature of Student Signature of Supervisor

 M.Sc. Nursing First Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR PROCESS RECORDING

Marks Marks
Sr. No. Criteria Allotted Obtained
1 Base line data 1
List of Nursing p
2 4
roblems identified
3 List of objectives of interactions 4
4 Conservation Pattern 5
5 Communication Techniques Used 5
6 Nature of termination 3
7 Evaluation by students 3
Total 25

Remarks:

Signature of student Signature of Supervisor

 M.Sc. Nursing First Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING
EVALUATION FORMAT: COUNSELLING

Name of the college:

ALLOTTED MARKS
SR NO CRITERIA
MARKS OBTAINED

1. Introduction with the patient 4

2. Objectives 3

3. Therapeutic Environmental Set up 5

4. Communication skills 5

5. Therapeutic techniques used 5

6. Grooming 5

7. Topic relatedness 5

8. Punctuality 5

9. Attitude 5

10. Innovation and creativity 5

11. Summary and Conclusion 3

TOTAL 50
Name/ seat number of the student:
Diagnosis: Ward:

Remarks:
Signature of the Candidate Signature of supervisor
 M.Sc. Nursing First Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR ECT CARE STUDY

Sl. CRITERIA MARKS MARKS

NO. ALLOTTED OBTAINED
1 Introduction 03
2 Preparation of article and patient 04
3 Care before therapy 04
4 Care during therapy 05
5 Care after therapy 05
6 Recording 04
Total 25

Remarks:

Signature of Student Signature of Supervisor

 M.Sc. Nursing First Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING EVALUATION FORMAT:

SOCIO AND PSYCHO DRAMA

CRITERIA ALLOTTED MARKS
SR NO MARKS OBTAINED

1. Introduction of the theme 3

2. Objectives 3

3. Environmental Set up 5

4. Information provided by the students 5

5. A.V aids 5

6. Grooming 5

7. Topic relatedness 2

8. Time management 3

8. Attitude 3

9. Communication Skill 5

10. Innovation and creativity 5

11. Coordination with team members 3

12. Summary and Conclusion 3

TOTAL 50

Remarks:
Signature of the Candidate Signature of supervisor

M.Sc. Nursing First Year

CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION PROFORMA OBSERVATIONAL FIELD VISIT

S.No Content Marks Marks Obtained

1 Introduction 1

2 Objectives 1

3. Organization pattern 1

4. Staffing pattern 1

5 Physical set up 1

6 Description 3

7 Submission of report on time 1

8 Conclusion 1

Total 10

Remarks:

Signature of student Signature of Supervisor

 M.Sc. Nursing First Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

GUIDELINE FOR CLINICAL PERFORMANCE EVALUATION PROFORMA

Area: Max. Marks- 100

Student’s Name: Year:
Duration: Hospital:
Ward: Date:
S. NO CONTENT 4 3 2 1
1 KNOWLEDGE, SKILL AND APPLICATION

1 Demonstrates, sound scientific knowledge and understanding in her dealings

with the patient.
2 Demonstrates ability in history taking.
3 Examine the MSE
4 . Demonstration of communication skill
5 Demonstrates ability to analyze and interpret the data collected for nursing care
planning.
6 Demonstrates ability to identify the needs of patients.
7 Demonstrate ability to implement the planned care to patients.
8 Attends to psycho social needs
9 Able to perform and assist in diagnostic and treatment modalities
10 Implements the procedure with skill, speed and completeness.
11 Makes relevant observations and record and reports them promptly and
effectively
12 Identifies risk factors and manages emergency situations effectively and
promptly
13 Works independently and makes prompt, relevant decisions in all situations
14 Able to carry out health talks and incidental health teachings effectively
15 Demonstrates sound knowledge of drug used in psychiatric ward.
16 Utilizes therapeutic communication techniques while interacting with patients &
family members.
II. PERSONALITY ASPECTS

17 Professional grooming and turn-out in uniform

18 Patient, keen and attentive listener

19 Punctuality

20 Courteous, tactful and considerate in all her dealings with colleagues, seniors,
patients and family
21 Maintains professional relationship
with health team members.
22 Enthusiastic and interested, takes interest in clinical setting
23 Follows instructions and exhibits positive behavioural changes as and when
required
24 Displays emotional maturity in all her dealings in the clinical setting
25 Demonstrates evidence of self learning by additional reading of current literature
Total Marks obtained:
Remarks:

Signature of Student Signature of Clinical supervisor

EVALUATION CRITERIA FOR OBSERVATION REPORT

DEPARTMENT OF PSYCHIATRY

Name: Roll No:

Course and Batch: Date & time:

Unit Posted:

Sr. No. Area of Evaluation Marks Obtained Marks

1 Introduction & Objective 1

2. Physical Set- up 1

3. Staffing Patterning 1

4. Function/Activity carried out 4

5. New Learning 2

6 Conclusion 1

Total 10

Remarks:
 Signature of student Signature of Teacher

GUIDELINES FOR OBSERVATION OF PERSONALITY/PSYCHOMETRIC ASSESSMENT

Activities:

1. Students will write the objectives of personality/psychometric assessment.

2. Setting of environment and premorbid personality of client.
3. Students will identify and describe the tools/scales and articles used in
personality/psychometric assessment.
4. Students will write the observational study on assisting personality/psychometric
assessment.
5. Students will write the activities carried out in personality/psychometric assessment.
6. New learning.

FORMAT FOR OBSERVATIONAL REPORT

1. Introduction
a. Basic information, demographics, relevant background history and details, source
and reason for referral and report. Some statements regarding sources of
information used.
b. The person in his/her environment Activities, daily living, work, leisure, social
networks, interpersonal functioning, family relationships, academic training and
employment history, offending history and Index offence, current functioning, skills
and deficits, resources.
2. Objectives of personality/psychometric assessment.
3. Premorbid personality of the client.
4. Describe the tools/scales and articles used
5. List of Procedures and Activities carried out
6. New Learning
7. Summary
 EVALUATION CRITERIA FOR OBSERVATIONAL REPORT OF PERSONALITY/PSYCHOMETRIC
ASSESSMENT

Name: Roll no.

Course and Batch: Date & time:

S.No. Criteria Max Marks Marks

Obtained

1. Objectives 4

2. Introduction
8

3. Premorbid personality 8

4. Procedures and activities performed 8

5. Investigations done. 8

6. States various tools/scales required for

8
personality/psychometric assessment.

7. Conclusion 5

8. References 1

Total 50

Remarks:

Signature of student Signature of Teacher

 EVALUATION FORM FOR WORK BOOK

Student Name:

Course and Batch: Roll no:

Date &time: Topic:

SR. CRITERIA MARKS MARKS

NO. ALLOTTED OBTAINED
1. Focus for specific data 3
2. Content
 Adequacy 5
 Relevancy 5
 organization 5
 Feasibility 5
3. Pictures, Diagrams & Tables
 Attractiveness 5
 Color Combination 5
 Neatness 5
 Creativity 5
4. Legibility and Completeness 3
5. Bibliography 2
6. Punctuality in submission 2
TOTAL 50
Remarks:

Signature of Student Name & Signature of Teache

 EVALUATION CRITERIA FOR NURSING CARE
PLAN 3RD YEAR BSC NURSING
MENTAL HEALTH NURSING
Name of the college:
Name/ seat number of the student:
Diagnosis: Ward:

SR. CONTENT MARKS MARKS

NO. OBTAINED
1. Introduction 1

2. History collection 4

3. MSE & Diagnosis 7

4. Investigations and treatment 2

5. Nursing care plan 7

6. Summary and conclusion 2

7. Bibliography 2

TOTAL 25

Remarks:

Signature of Student Signature of Clinical supervisor

 EVALUATION FORMAT FOR DRUG PRESENTATION
Ist YEAR MSC NURSING
MENTAL HEALTH NURSING

Name of the college:

Name/ seat number of the student:
Diagnosis: Ward:

SR. MARK MARK

PARAMETERS
NO. ALLOTTED OBTAINED
Knowledge assessment
1 Introduction 2
2 Drug class, Available form 4
3 Mode of action 6
4 Indication, Dosage, Route 4
5 Side Effect & Contraindication 4
Nursing consideration & Patient
6 8
Education
Presentation skill
7 Eye Contact 2
8 Appearance 2
9 Classroom Management 2
10 Use of A. V. Aids 4
11 Language Fluency 2
12 Mastery over content 4
13 Group Participation 4
14 Bibliography 2
TOTAL 50

Remarks:

Signature of Student Signature of Clinical supervisor

 EVALUATION FORMAT FOR MINI MSE

M.Sc NURSING

Student Name:

Course and Batch: Roll no: _

Date & time: Diagnosis:

MAX MARKS
SR.NO CRITERIA
MARKS OBTAINED

1. Identification data 1

2. Orientation 2

Registration 2
3.
Attention and Calculation 2
4.

5. Memory 2

Language 1
6.
Total 10

Sign of the student: Name & Sign of the Supervisor:

Date: Date
 EVALUATION CRITERIA FOR DRUG STUDY

M.Sc NURSING

Student Name:

Course and Batch: Roll no: _

Date & time: Topic:

MAX MARKS
SR.NO CRITERIA
MARKS OBTAINED

1. Planning and Organization of content 04

Content

 Introduction
 Drug class,
 Available form
 Pharmacokinetics
 Mode of action 30
2.
 Indication,
 Contraindication
 Dosage & Route
 Special precautions
 Side Effect
 Family and client education

3. Nursing Responsibility 05

4. Mastery over the content 03

5. Research input 04

6. Summary & Conclusion 02

7. Bibliography 02

Total 50

Remarks:

Sign of the student: Name & Sign of the Supervisor:

 UNIVERSITY PRACTICAL EVALUATION CRITERIA
FIRST YEAR M.SC NURSING

MENTAL HEALTH NURSING

R.N Hall History Mental Process Care Therapy Counseling Health Grooming & Viva Total
Ticket Collection Status Recording Plan (10) (10) Education Professionalism (20) (100)
No (10) Examination (10) (20) (05) (05)
(10)

INTERNAL EXAMINER
TOTAL
EXTERNAL EXAMINER
 M.Sc. Nursing I Year

Theory Assessment

Theory requirement for I Year M.sc.Nursing(PEDIATRICS)

SNO Evaluation criteria NUMBERS MARKS

1 Seminar 3 100x3=300

2 Unit Test 25 25x4= 100

3 Mid term Exam 1 75

4 Pre university Exam 1 75

 TOTAL 550

FIRST YEAR M.Sc NURSING

CHILD HEALTH NURSING
EVALUATION CRITERIA FOR SEMINAR

Name of student: Date:

Subject : Group:
Topic : Maximum Marks: 100

Sr. Criteria Max Marks Marks Remarks

No. Obtained

1 Physical Setup 5
2 Grooming 5
 3 Introduction 5
Content
4 Lesson plan 5
5 Objectives 5
6 Relevant 5
7 Adequate 5
8 Organization of content 5
9 Research evidence 5
Presentation
10 Communication Skill 5
11 In depth knowledge 5
12 Time management 5
13 Group involvement 5
14 Control of group 5
AV Aids
15 Relevant to the topic 5
16 Innovation and creativity 5
17 Effective use of AV Aids 5
18 Follows Principles of AV 5
Aids
19 Summary/ conclusion 5
20 Reference 5
TOTAL 100

Remarks

Signature of student Signature of supervisor

INTERNAL ASSESSMENT CRITERIA FOR PRACTICAL REQUIREMENTS

M.SC 1ST YEAR SPECIALITY

CHILD HEALTH NURSING-I

Sl. No. Requirements Marks

1 Case presentation-3 300

2 Case study-1 100

3 Nursing process-3 150

4 Clinical Evaluation – 3 300

5 Health education-3 150

6 Project-1 50

7 Mild Term-1 100

8 Pre-University-1 100

Assessment of growth and development-

9 125
(5X25)

Assessment of Normal Newborn and

10 50
Preterm Neonate (2X25)

11 Observation report (3) 150

Total 1575

Other requirements as per the Log book.

 M.Sc NURSING I YEAR
PEDIATRIC NURSING
EVALUATION CRITERIA FOR CASE PRESENTATION

NAME OF THE COLLEGE

Name of the student: Year :
Patient’s Diagnosis : Ward:
Date of care given:
Sl Marks
Particulars Marks
No Obtained
Introduction of the child( Biodata, presenting
1 complaints, personal data , socioeconomic 10
status and play needs)
2 History and Assessment 20
Present, past history and family history 5
Physical examination 5
Growth and Development (Milestones &
Theories) 5
Immunization 2
Nutritional status 3
3 Disease Condition 10
4 Co-relation of patient with Book 5
5 Care plan, Priority & theory based 15
Theory application 8
Nursing process 7
6 Diet plan 10
7 Health education 5
8 Progress report 5
10 Summary and conclusion 3
 11 Effectiveness of Presentation 14
Personal attitude –Grooming, confidence 5
Teaching abilities 4
Use of AV Aids 5
12 Bibliography 3
TOTAL 100

Name Of Evaluator : Total Marks :

Comments :
M.Sc. NURSING I YEAR
Student Signature : PEDIATRICSignature
NURSING by the Teacher:
EVALUATION CRITERIA FOR CASE STUDY

NAME OF THE COLLEGE Name of the student: Year :

Patient’s Diagnosis : Ward:
Date of care given:
Marks
Sl No Particulars Marks
Obtained
Introduction of the child( Bio data, presenting
1 complaints, personal data & socioeconomic 10
status, Meeting play needs)
2 History and Assessment 20
Present, past history and family history 5
Physical examination 5
Growth and Development (Milestones &
Theories) 5
Immunization 2
Nutritional status 3
3 Disease Condition 10
4 Co-relation of patient with Book 5
5 Care plan, Priority & theory based 15
Theory application 8
 Nursing process 7
6 Diet plan 5
7 Health education 5
8 Progress report 5
9 Follow up 5
10 Summary and conclusion 3
11 Effectiveness of Presentation 14
Personal attitude –Grooming, confidence 5
Teaching abilities 4
Use of AV Aids 5
12 Bibliography 3
TOTAL 100

Name Of Evaluator : Total Marks :

Signature of Evaluator: M.Sc NURSING I Comments

YEAR :
PEDIATRIC NURSING -I
Student Signature :
EVALUATION FORMAT FOR NURSING CARE PLAN

Name Of The College

Name of the student: Year :
Diagnosis: Date:
Ward:

Sl Marks
Particulars Marks
No Obtained

Introduction of the child( Biodata, presenting

1 complaints, personal data & socioeconomic 10
status, Meeting play needs)

2 History and Assessment 15

 Present, past history and family history 5

Physical examination 5

Growth and Development (Milestones &

Theories) 5

Immunization 2

Nutritional status 3

3 Care plan, Priority & theory based 15

Theory application 5

Nursing process 10

07 Health education 5

10 Summary and conclusion 5

TOTAL 50

Name Of Evaluator : Total Marks :

Signature : Comments : Student Signature :

M.Sc NURSING I YEAR

PEDIATRIC NURSING
FORMAT FOR CLINICAL EVALUATION

NAME OF THE COLLEGE

Name of the student:
Year:
Area of clinical experience:
Duration of posting in weeks:
Name of the supervisor:
 Total marks: 100 marks

4 = Very good, 3 = Good, 2 = Satisfactory / fair, 1 = Poor

Sr. No Evaluation Criteria Grades

4 3 2 1

I Personal & Professional behavior

a. Wears clean & neat uniform and well groomed.
b. Arrives and leaves punctually
c. Demonstrates understanding of the need for
quietness in speech & manner & protects the patient from
undue notice.
d. Is notably poised and effective even in situations of
stress
e. Influential & displaced persuasive
assertive leadership behaviour

II Attitude to Co-workers and patients

a. Works well with member of nursing team
b. Gives assistance to others in clinical situations
c. Understands the child as an individual
d. Shows skills in gaining the confidence & co-operation
of child and relatives, tactful and considerate.

III Application of knowledge

a. Possess sound knowledge of pediatric conditions.
b. Has sound knowledge of scientific principles
c. Has knowledge of normal growth and
development of children
d. Has knowledge of current treatment modalities
inclusive medicine, surgery, pharmacology and dietetics.
e. Takes interest in new learning from current
literature & seeks help from resourceful people
IV Quality of clinical skill
a. Able to elicit health history of child and family
accurately.
b. Skillful in carrying out physical examination,
developmental screening and detecting deviations
from normal
c. Identifies problem& sets priorities and grasps essentials
while performing duties
 d. Able to plan and implement care both preoperatively
and post operatively.
e. Applies principles in carrying out procedures & carries
out duties promptly.
f. Has technical competence in performing nursing
procedures.
g. Able to calculate and administer medicines accurately
h. Resourceful and practices economy of time material
and energy.
i. Recognizes the role of play in children and
facilitates play therapy in hospitalized children

j. Observes carefully, reports & records signs &

symptoms & other relevant information
k. Uses opportunities to give health education to
patients & relatives

Total

Grade

Very good = 70 % and above

Good = 60 – 69 %

Satisfactory = 50- 59 %

Poor = Below 50 %

Remarks for improvement:

Student’s Remark:

SIGNATURE OF THE STUDENT SIGNATURE OF THE TEACHER

 M.Sc NURSING I YEAR
PEDIATRIC NURSING
EVALUATION FORMAT FOR HEALTH EDUCATION
NAME OF THE COLLEGE
Name of the student: Year:
Topic: Date:
Group: Place:

Sl No Particulars Marks Marks Obtained

1 Planning and organization 10
Formulation of attainable objectives 2
Adequacy of content 3
Organization of subject matter 2
Current knowledge related to subject matter 3
2 Selection and arrangement of group 02
3 Presentation 10
Interesting 2
Voice 2
Adequate explanation 2
Group involvement 2
Time limit 2
4 Personal qualities 03
Self confidence 01
Language 01
Self awareness of strong and weak points 01
5 AV aids 10
 Adequacy 03
Relevance 03
Appropriateness 02
Effective use of A.V Aids 02
6 Discussion and Questioning 05
7 Group response 05
8 Recapitulation 05
TOTAL 50

Signature of evaluator: Signature of student:

Comments:

FIRST YEAR M. SC NURSING

PEDIATRIC NURSING
EVALUATION CRITERIA FOR PROJECT

NAME OF THE COLLEGE

Name Of College :
Year :
Date &Time:

Criteria for Evaluation Marks

Sl.

No.

2Problem identified:
Significance
 Clarity of problem
Clarity of operational definitions 6
Clarity of objectives
Hypothesis /Assumptions
Conceptual framework

3 Review of literature:
Inclusion of current references

Citation of primary sources 5

Systematic flow of writing

Relevance of literature

4 Methodology:
Population, sampling technique, size, criteria for selection

Ethical consideration 10
Data collection procedure

Validity and reliability of tools used

Statistical methods chosen

4 Analysis and interpretation of data:

Analytical methods – appropriate &

Accurate 14
Interpretation in the light of objectives
and hypothesis testing
5 Summary and discussion:
 Summary of findings

Discussion with relation to relevant

Studies
37
Limitation of the study
Implications
Recommendations – relevant and
Practical

6 Abstract References and Appendix 4

7 Style of writing research report 3
Total 50

Name Of Evaluator : Total Marks :

Signature : Comments :

Student Signature :

EVALUATION PROFORMA FOR ASSESSMENT OF GROWTH & DEVELOPMENT

REPORT FIRST YEAR M.Sc. NURSING
CHILD HEALTH NURSING

(Age group: birth to 5 yrs.)

I. Identification Data:
Name of the child :

Age :

Sex :

Date of admission :

Diagnosis :

Type of delivery : Normal/ Instrumental/ LSCS

Place of delivery : Hospital/ Home

Any problem during birth : Yes/ No

If yes, give details :

Order of birth :

II. Growth & development of child & comparison with normal:

Anthropometry In the child Normal

Weight
Height
Chest circumference
Head circumference
Mid arm circumference

Dentition
III. Milestones of development:
IV. Social, Emotional & Language Development:

V. Play habits
• Child favorite toy and play:
• Does he play alone or with other children?
VI. Toilet Training
- Is the child trained for bowel movement & if yes, at what age:
- Has the child attained bladder control & if yes, at what age:
- Does the child use the toilet?
VII. Nutrition
• Breast feeding (as relevant to age)
• Weaning has weaning started for the child: Yes/No If yes, at what age & specify the weaning
diet. Any problems observed during weaning:
Meal pattern at home
Sample of a day’s meal: Daily requirements of chief nutrients:
Breakfast: Lunch: Dinner Snacks:

VIII. Immunization status & schedule of completion of immunization.

IX. Sleep pattern

How many hours does the child sleep during day and night?
Any sleep problems observed & how it is handled:
X. Schooling
Does the child attend school?
If yes, which grade and report of school performance:
XI. Parent child relationship
How much time do the parents spend with the child?
Observation of parent-child interaction:
XII. Explain parental reaction to illness and hospitalization
XIII. Child’s reaction to the illness & hospital team
XIV. Identification of needs on priority
XV. Conclusion
XVI. Bibliography

Evaluation Criteria: Assessment of Growth &Development (birth to 5 year)

(Maximum Marks: 25)
Sr. No. Item Ma rks
 1. Adherence to format 02
2. Skill in Physical examination & assessment 10
3. Relevance and accuracy of data recorded 05
4. Interpretation Identification of Needs 05
5. Bibliography 03
Total 25

Note: - Same format to be used for assessment of infant, Toddler & Preschooler child.
Name Of Evaluator : Total Marks :

Signature : Comments

M.Sc NURSING I YEAR

PEDIATRIC NURSING
EVALUATION FORMAT FOR OBSERVATIONAL REPORT
NAME OF THE COLLEGE
Name Of College : Place of Visit:
Year :
Date &Time :
FIELD VISIT REPORT

SR.NO CRITERIA MARKS

1 Introduction 2

2 Objectives Of Visit 5

4 Organization Structure 5
 5 Physical Facility 10

6 Functions 8

7 Staffing 7

8 Learning Objective Met 5

9 Critical analysis 4

10 Summary & Conclusion 4

11 Total 50

Name Of Evaluator : Total Marks : Signature :

Comments :

VEER NARMAD SOUTH GUJARAT UNIVERSITY, SURAT

EVALUATION CRITERIA FOR THE UNIVERSITY PRACTICAL & VIVA EXAMINATION
M.Sc NURSING I YEARPEDIATRIC NURSING
Name Of College : Seat No:
Year :Date &Time
SI.No Criteria Max. Marks
1
Assessment ( 20)
History 3
Physical examination 4
Growth and development 7
 Immunization Nutritional status 3
Care plan, priority & theory based. ( 20 ) 3

Assessment 4
Nursing diagnoses Objectives 4
Plan of care 4
Implementation ( 35 ) Skill in care 8
Application of scientific principles Meeting Play needs
Health education Establishing IPR Recording and reporting Evaluation ( 5 )
3 Viva ( 20 )
10
8
4
5
3
5
5
20

4
5

TOTAL 100

INTERNAL EVALUATOR SIGN: EXTERNAL EVALUATOR

 INTERNAL ASSESSMENT CRITERIA FOR

COMMUNITY HEALTH NURSING-I (Theory)

I YEAR M.Sc. Nursing

Sr. Criteria No Total Marks

no

1 Assignment 2 2x50=100

2 Unit test 4 4x25=100

3 Seminar 4 4x100=400

4 Mid – term exam 1 75

5 Pre- university exam 1 75

Total 750
 FIRST YEAR M. Sc NURSING
COMMUNITY HEALTH NURSING-I
EVALUATION CRITERIA FOR
SEMINAR
Name of student Date:
Subject College:
Topic Maximum Marks: 100
Sl No Basic of evaluation 5 4 3 2 1 Remarks
1 Content
k) Introduction
l) Relevancy content
m) Adequacy of content
n) Organization of the topic
o) Submission in time
2 Organization and management of
class
i) Arrangement of class
j) Budgeting of time
k) Group participation
l) Control of Group
3 AV aids
g) Appropriate to subject
h) Selection and adequacy
i) Following Principles
4 Presentation
e) Mastery over content
f) Overall presentation & explanation
5 Personal appearance
i) Neatness and
professional appearance
j) Degree of self confidence
k) Voice and clarity
l) Mannerism
6 Summery &Conclusion
7 Bibliography
Total marks out of 100

Signature of Student Name & Signature of Supervisor

 FIRST YEAR M. Sc NURSING
EVALUATION FORMAT FOR WRITTEN ASSIGNMENTS
COMMUNITY HEALTH NURSING-I
Name of the college:
Name/ Seat Number of the student:
Topic: Date/ Time:

Sr. Criteria Total marks Marks obtained

No.
1 Relevancy of content: 10
 Clarity (3)
 Concise (3)
 Simplicity of language(4)

2 Depth of content: 20
 Simple to complex(3)
 Key points emphasized(7)
 Description of important
points with
illustration(10)
3 Organization of content 10
 Sequential (5)
 Grammar , punctuation(2)
 Clean, neat , tidy(3)

4 A.V.Aids/Diagram/Tables 05

5 Bibliography /references 03

6 Submission on time 02

Total 50

Comment of Evaluator:-

Signature of student: Signature of Evaluator:

 PRACTICAL ASSESSMENT
CRITERIA M.SC. NURSING FIRST
YEAR COMMUNITY HEALTH
NURSING – I

SR. PRACTICAL NUMBE MARKS Remarks

NO ASSIGNMENT RS (EACH)

1 Family Care Study (Urban 4 4x50=200

,Rural)

2 Health Talk (Urban ,Rural) 10 10x50=500

1. Individual-4
2. Family -4
3. community-2
(urban,rural

3 Procedure evaluation (Urban 4 4x50=200

,Rural)

4 Clinical evaluation 2 50x2=100

5 Observational Visit 3 3x25=75

6 Nutritional assessment 1 25

7 Mid Term Practical 1 50

8 PreUniversity Exam 1 50

TOTAL 1200

Remaining requirement as per the INC syllabus & log book

 FIRST YEAR M. Sc NURSING
COMMUNITY HEALTH NURSING
EVALUATION CRITERIA FOR FAMILY CARE STUDY
Name of the student: Year
Field placement: Period

S .NO CRITERIA MARKS MARKS REMARK

ALLOTTED OBTAINED
1 Personal and professional Grooming 02
2 Initial data : 05
Subjective data and objective data
3 Family health (Assessment of Family 05
members physical mental & social)
Health of each member
Gynae & Obstetric health
Nutritional data
Rest & sleep
Use of health resources
Family planning status
Health practices of each member
Family life style
4 Identification of vulnerable groups 03
and high risk individual
5 Health needs / problems identified 03
6 Planning for family health nursing care 06
(including short term & long term
plan)
7 Implementation of home nursing care 06
plan with scientific rationale
8 Health education planning & 05
implementation
9 Planning for diet menu 03
10 Evaluation : 03
Out come of family health care
11 Evaluation : Self learning as a Nurse 04
12 Future plan 02
13 Conclusion & suggestion 03
Total 50

Signature of student Signature of supervisor

 FIRST YEAR M. Sc NURSING
COMMUNITY HEALTH NURSING
EVALUATION CRITERIA FOR HEALTH TEACHING

Name of the Institution:

Name of the student:
Language:
Topic:
Audience:
Ward / Field:
Name of the Supervisor / teacher: Date :

S. NO CRITERIA MARKS MARKS

ALLOTTED OBTAINED
Content
1 Lesson planning 05
2. Appropriateness, relevancy & 08
adequacy of content
3 Organization 04
4 Up to date and evidence based 03
Presentation
1. Physical arrangement 03
2 Communication skill 05
3. Confidence 03
4 Group involvement 03
A.V. Aids
1 Selection & Preparation 04
2 Effective use of A. V. Aids 03
Other
1 Time Management 03
2 Acceptance of guidance 03
3 Reference 03
Total 50

Signature of Student Signature of Supervisor

 FIRST YEAR M. Sc NURSING
COMMUNITY HEALTH NURSING
EVALUATION CRITERIA FOR PROCEDURE EVALUATION USING BAG
TECHNIQUE
Name of the student:
Field placement:
Period: Year:

S. NO CONTENT MAXIMUM OBTAINED

MARKS MARKS

1 Approach to the family 02

2 Selection of procedures based on 05
family needs
3 Preparation of the bag for the 05
procedure
4 Hand washing 05
5 Caring out all the steps of 10
procedure correctly
6 Scientific principles followed 05
while doing procedure
7 Involvement of family while 03
doing procedure
8 Health education during the 05
procedure
9 Termination of procedure ( after 05
care of bag and equipment &
disposal of waste)
10 Recording and reporting 05
Total 50

Remarks

Signature of Students Signature of Supervisor

 FIRST YEAR M. Sc NURSING
COMMUNITY HEALTH NURSING-II
CLINICAL EVALUATION PROFORMA

Name: Year:
Areas of community health nursing
Period under Evaluation From to Max. Marks: 100
S. Areas Rating Scale*
No 1 2 3 4 5
I Knowledge and understanding about family
Assesses family health in detail and collects relevant and significant
1 data of each individual in the family
2 Interprets significant findings appropriately
II Home visit
3 Planning and organization of home visits based on the health
needs of the family and identified goals
4 Establishes rapport with the family and is able to
communicate effectively and tactfully with different
individual / group
III Health assessment and observation
5 Does physical health assessment of family members
6 Identifies deviation from normal and set priorities in home
care activities
7 Plans home care based on identified health needs and health
problems
8 Implements simple home nursi
ng procedure based on plans
IV Nursing activities carried out
9 Application of scientific principles
10 Technical skills with necessary modification and
completeness of the procedure
11 Involvement and participating of the family members
12 Interpretation, reporting, recording of results
13 Takes corrective action , follow standing orders and selects
appropriate referral agencies
14 Evaluates outcome of family health care rendered
V Health education
15 Uses every opportunities for incidental / planned health
teaching for individual and group
16 Uses appropriate teaching learning principles
VI Post visit
17 Reports significant information
18 Completes record, promptly, precisely, accurately
VII Professional qualities
19 Professional in dealing with family
20 Is resourceful and has leadership qualities

Total 100

Signature of student Signature of Supervisor

 EVALUATION FORMAT FOR OBSERVATIONAL VISIT REPORT

FIRST YEAR M.SC NURSING

COMMUNITY HEALTH NURSING - I

COLLEGE NAME:

STUDENT NAME: ROLL NO:

TOPIC: DATE & TIME:

SR.NO CRITERIA MARKS MARKS

OBTAINED

1 Introduction 2

2 Objectives Of Visit 2

3 Selection Of visit Area 2

4 Organization Structure 2

5 Physical Facility 5

6 Functions 5

7 Staffing 3

8 Learning Objective Met 2

9 Summary & Conclusion 2

10 Total 25

REMARK
STUDENT’S SIGNATURE EVALUATOR’S SIGNATURE
 EVALUATION FORM FOR NUTRITIONAL ASSESSMENT
M.SC. NURSING FIRST YEAR
COMMUNITY HEALTH NURSING-I

Name of College :
Name/ Seat No of Student :
Date &Time :
Address :

SR.NO CRITERIA MARKS MARKS

OBTAINED

1 Family Information and Detail (24 recall) 7

2 Diet Pattern / History of family 2

3 Calorie Calculation as Per family members Need 5

4 Diet Education 4

6 100 Gm Value of Food Stuff (Required For Menu ) 2

7 Menu Planning ( 24 Hours ) 5

8 Total 25

Name Of Evaluator : Total Marks :

Signature : Comments :

Student Signature :
 PRACTICAL EXAMINATION SCHEME OF EVALUATION
FIRST YEAR MSC NURSING
SUBJECT: COMMUNITY HEALTH NURSING-I

S.no Criteria Max

Theory/Nursing process marks(100)
1 Approaches to the family 6
 Professional appearance 2
 Concern to family members 2
 Interviewing technique 2
II Family health assessment 20
 Health history of all members 7
 Physical asessment 5
 Nutritional Assessment 4
 Socioeconomic assessment 2
 Environmental assessment 2
III Nursing Diagnosis 10
 Individual 7
 family 3
IV Family care plan 15
 Comprehensive plan 8
 Priority 2
 Theory application 5
V Implementation 30
 Procedure based on scientific 10
principle
 Effective use of community bag 4
 Making use of family resources 3
 Need based health education 8
 Appropriate use of AV aids 5
VI Evaluation 4
 Recording and Reporting

VII Viva 15
Total 100

EXTERNAL EXAMINER INTERNAL EXAMINER

SIGN: SIGN :
SECOND YEAR
M.SC NURSING
 INTERNAL ASSESSMENT FOR THEORY REQUIREMENT

M.Sc NURSING II YEAR

NURSING MANAGEMENT

SR.NO EVALUATION CRITERIA TOTAL

MARKS
1 Seminar -1x100marks 100

2 Assignment -2X50marks 100

3 Unit test-4X25marks 100

4 Mid- term exam1X75marks 75

5 Pre-university exam-1x75 75

TOTAL 450

Other requirements as per the Log book And INC Syllabus

 EVALUATION FORMAT FOR SEMINAR
M.Sc NURSING SECOND YEAR
NURSING MANAGEMENT
Name of the
college:
Name/ Seat Number of the student:
Topic Date/ Time:

Sl No Basic of evaluation 5 4 3 2 1 Remarks

1 Content
p) Introduction
q) Relevancy content
r) Adequacy of content
s) Organization of the topic
t) Submission in time
2 Organization and management of
class
m) Arrangement of class
n) Budgeting of time
o) Group participation
p) Control of Group
3 AV aids
j) Appropriate to subject
k) Selection and adequacy
l) Following Principles
4 Presentation
g) Mastery over content
h) Overall presentation & explanation
5 Personal appearance
m) Neatness and professional
appearance
n) Degree of self confidence
o) Voice and clarity
p) Mannerism
6 Summery &Conclusion
7 Bibliography
Total marks out of 100

Signature of Student Name & Signature of Supervisor

 EVALUATION FORMAT FOR WRITTEN ASSIGNMENTS
M.Sc NURSING SECOND YEAR
NURSING MANGEMENT
Name of the college:
Name/ Seat Number of the student:
Topic: Date/ Time:

Sr. Criteria Total marks Marks obtained

No.
1 Relevancy of content: 10
 Clarity (3)
 Concise (3)
 Simplicity of language(4)

2 Depth of content: 20
 Simple to complex(3)
 Key points emphasized(7)
 Description of important
points with illustration(10)
3 Organization of content 10
 Sequential (5)
 Grammar , punctuation(2)
 Clean, neat , tidy(3)
4 A.V.Aids/Diagram/Tables 05

5 Bibliography /references 03

6 Submission on time 02

Total 50

Comment of Evaluator:-

Signature of student: Signature of Evaluator:

DISSERTATION
 INTERNAL ASSESSMENT CRITERIA FOR MSC NURSING IInd YEAR

DISSERTATION

SN CONTENT Number Marks

1 Proposal Defense Evaluation 1 25

2 Synopsis Presentation 1 50

3 Report writing 1 50

TOTAL 125
 EVALUATION CRITERIA FOR PROPOSAL DEFENSE

M.Sc. Nursing 2ND year

DISSERTATION

College Name
NAME OF STUDENT DATE

YEAR

Item Evaluation Criteria 5 4 3 2 1

Introduction
1. (Background information, problem statements,
aims/objectives)
Literature Review
2. (Relevant literatures, reasonable review parameter,
recent development, organization of issues etc.)
Research Methodology
3. (Description of method, experimental design, tools
etc.)
Feasibility of Study and Preliminary Results
(in terms of scope, time, resources & practicality;
4.
observation to date, presentation – statistical analysis,
graphs, tables, etc)
Overall Performance
5. (Presentation skills, shows confidence during Q&A
session, etc.)

Total

* Note: Excellent: 5 Very Good: 4 Good: 3

Fair: 2 Poor: 1

Signature of Student Signature of Evaluator

 EVALUATION CRITERIA FOR SYNOPSIS PRESENTATION
M.Sc. Nursing 2ND year
DISSERTATION
COLLEGE NAME
NAME OF STUDENT DATE
YEAR

Item Evaluation Criteria 5 4 3 2 1

1. Evidence of originality and creativity

Resourcefulness, alertness to significance of
2.
findings.

3. Diligence, care, technical skill in the research.

Usefulness of the results to other workers in the

4.
field; value as a contribution to knowledge

Usefulness of the results to other workers in the

5.
field

6 Results clear and concise(analysis)

7 Discussion( Supporting reviews)

8 Question answers session/ clearing doubts

Statement of Problem faced during data

9
collections

Quality of presentation (coherence, lucidity,

10 grammar, style, freedom from typographical
errors).

Total

* Note: Excellent: 5 Very Good: 4 Good: 3

Fair: 2 Poor: 1

Signature of Student Signature of Evaluator

 EVALUATION CRITERIA FOR REPORT WRITING

M.Sc. Nursing 2ND year

DISSERTATION
COLLEGE NAME

NAME OF STUDENT DATE

YEAR

Item Evaluation Criteria 5 4 3 2 1

1 Introduction
2 Need of study
3 Review of Literature
4 Research Topic& Objectives
5 Methodology
6 Analysis and discussion
7 Conclusion
8 Recommandations
9 Content organization
Quality of presentation( Grammar, style
10
&typological error)
TOTAL
Note: Excellent: 5 Very Good: 4 Good: 3
Fair: 2 Poor: 1

Signature of Student Signature of Evaluator

 VEER NARMAD SOUTH GUJRAT UNIVERSITY, SURAT
Dissertation ( viva) Evaluation Criteria For MSc Nursing 2 nd Year
College Name- Subject/ Specialty-
Roll no of student Date/ Time
SN EVALUATION CRITERIA 5 4 3 2 1

1 Introduction

2 Need of Study.

3 Review of Literature( relevant, recent development)

4 Research methodology

5 Feasibility of study

6 Result

7 Summary &Discussion

8 Nursing Implication & Recommendations

9 Limitations of study

10 Bibliography

11. Presentation skill

12 Abstract

13 Confidence
14 Mannerisms

15 Grooming

TOTAL (75 MARKS)

VIVA – 25 MARKS
TOTAL- 100

Signature of Internal Examiner Signature of External Examiner

 MEDICAL
SURGICAL
NURSING -II
 INTERNAL ASSESSMENT CRITERIA FOR THEORY

M.Sc. Nursing Second Year MEDICAL SURGICAL NURSING II

SR.NO EVALUATION CRITERIA NUMBERS MARKS

1 Seminar 3 100x3=300

2 Unit test 4 25x4=100

3 Written Assignment 2 2X50=100

4 Practice Teaching 2 2x50= 100

5 Drug Presentation 1 50

6 Design of Medical surgical Dept 1 25

7 Field Visit 1 25

8 Project/ workshop 1 25

9 Mid term Exam 1 75

10 Preuniversity Exam 1 75

TOTAL 875
 EVALUATION FORMAT FOR SEMINAR
M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY- II (MEDICAL SURGICAL NURSING)
Name of the college:
Name/ Seat Number of the student:
Topic
Sl No Basic of evaluation 5 4 3 2 1 Remarks
1 Content
u) Introduction
v) Relevancy content
w) Adequacy of content
x) Organization of the topic
y) Submission in time
2 Organization and management of
class
q) Arrangement of class
r) Budgeting of time
s) Group participation
t) Control of Group
3 AV aids
m) Appropriate to subject
n) Selection and adequacy
o) Following Principles
4 Presentation
i) Mastery over content
j) Overall presentation & explanation
5 Personal appearance
q) Neatness and professional
appearance
r) Degree of self confidence
s) Voice and clarity
t) Mannerism
6 Summery &Conclusion
7 Bibliography
Total marks out of 100

Signature of Student Name & Signature of Supervisor

 EVALUATION FORMAT FOR WRITTEN ASSIGNMENTS
M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY-II (MEDICAL SURGICAL NURSING)

Name of the college:

Name/ Seat Number of the student:
Topic: Date:

Sr. Criteria Total marks Marks obtained

No.
1 Relevancy of content: 10
 Clarity (3)
 Concise (3)
 Simplicity of language(4)

2 Depth of content: 20
 Simple to complex(3)
 Key points emphasized(7)
 Description of important
points with illustration(10)
3 Organization of content 10
 Sequential (5)
 Grammar , punctuation(2)
 Clean, neat , tidy(3)
4 A.V.Aids/Diagram/Tables 05

5 Bibliography /references 03

6 Submission on time 02

Total 50

Comment of Evaluator:

Signature of student: Signature of Evaluator:

M.Sc NURSING SECOND YEAR,Clinical Speciality-II (Medical Surgical Nursing)
Performa for evaluation- practice teaching ( MSN)
College Name Name of the student ……………………….
Topic ……………………… Date & time ………………….
Sr.No Criteria marks (50 mks) obtained
1 Lesson plan
 General objectives stated clearly
 Specific objectives stated in behavioural term 10
 Lesson plan followed in sequence
 Bibliography up to date and complete
2 Learning environment
 Physical setup of class room
 Class room light is adequate 05
 Well ventilated
 Motivates student
3 Presentation
 Coverage of subject content
 Depth of knowledge
 Integration of subject matter 10
 Explanation and clarification
 Use of current literature
 Time limit
4 Use of Audio visual aid
 Relevant ,clear and visible 10
 Creativity
 Used effectively at the right time
5 Questioning technique
 Questions equally addressed to all
 Well worded questions and no ambiguity 05
 Thought provoking questions
 Sufficient time allowed for answering
 Relevant to topic
6 Student teacher appearance
 Appearance
 Grooming 05
 Confidence
 Mannerism
7 Assignment
 Appropriate to lesson
 Clear 05
 Motivating
 Explained to students
 Feed back given to students
Signature of evaluator Remarks
 EVALUATION FORMAT FOR DRUG PRESENTATION
M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY- II (MEDICAL SURGICAL NURSING)
Name of the college:
Name/ Seat Number of the student:

Sr. Parameters Mark Mark

no. allotted obtained
1 Introduction 1
2 Drug class, Available form 2
3 Mode of action 3
4 Indication, Dosage, Route 2
5 Side Effect & 2
Contraindication
6 Nursing consideration & 4
Patient Education
7 Eye Contact 1
8 Appearance 1
9 Classroom Management 1
10 Use of A. V. Aids 2
11 Language Fluency 1
12 Mastery over content 2
13 Group Participation 2
14 Bibliography 1
Total 25

Remarks:

Sign of the student: Name & Sign of the Evaluator:

 M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY- II (MEDICAL SURGICAL NURSING)

Blue Print Of Design Of Medical Surgical Nursing Department

Name Of College : Name of student

Date &Time :

BLUE PRINT OF DESIGN OF CRITICAL CARE UNIT

SR.NO CRITERIA MARKS

1 Introduction 2

2 Unit / Bed Arrangement 2

3 Physical Facility 4

4 Equipment 6

5 Infection Control Measures 3

6 Staffing 5

7 Facility For Family 2

8 Design For Future 1

9 Total 25
 M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY- II (MEDICAL SURGICAL NURSING)

Evaluation Form For Field Visit

Name Of College :
Year :
Date &Time :

FIELD VISIT REPORT

SR.NO CRITERIA MARKS

1 Introduction 2

2 Objectives Of Visit 2

3 Selection Of visit Area 2

4 Organization Structure 2

5 Physical Facility 5

6 Functions 5

7 Staffing 3

8 Learning Objective Met 2

9 Summary & Conclusion 2

10 Total 25

Students Sign Supervisors Sign

 M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY- II (MEDICAL SURGICAL NURSING)
Evaluation Form For Project/ workshop Evaluation
Name Of College :
Name/ Seat No of Student :
Date & Time :

PROJECT EVALUATION

Please rate the following items on a scale from 1 to 5 by circling the appropriate number:
1=Strongly Agree (SD); 2 = Disagree (D); 3 = Not Sure (NS); 4 = Agree (A); 5 = Strongly
Agree(SA).
SD D NS A SA

1. Workshop was well organized and the main

1 2 3 4 5
points were well covered and clarified.

2. Facilitator demonstrated comprehensive

1 2 3 4 5
knowledge of the subject matter.

3. Facilitator helped students to understand how the

1 2 3 4 5
workshop material related to subject

4. Facilitator conveyed ideas effectively and clearly

and the material was informative and easy to 1 2 3 4 5
understand.

5. Usable skills and student will be able to apply

them to their academic or personal life. 1 2 3 4 5

6. What was the most valuable aspect of the workshop?

7. What could have been done to improve the workshop?

8. Additional Comments or suggestions:

 PRACTICAL ASSESSMENT CRITERIA

M.Sc. Nursing Second Year( Medical Surgical Nursing – II )

SR.NO PRACTICAL ASSIGNMENT NUMBERS MARKS

(EACH)

1 Case Study 2 100x2= 200

2 Care Plan with theory Application 3 50x3=150

3 History taking &Health Assessment 5 (GI, Respi, 100x5=500

Cardiac, Neuro&
Genitourinary
Assessment)
4 Clinical Evaluation 4 100x4=400

5 Procedure Demonstration 5 50x5= 250

6 Case presentation 2 50x2=100

7 Health Education 2 25x2= 50

8 Nutritional Assessment 3 25x3=75

9 Daily Dairy 50

10 Mid Term Practical 1 100

10 PreUniversity Exam 1 100

TOTAL 1975
 EVALUATION FORMAT FOR CASE STUDY
M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY-II (MEDICAL SURGICAL NURSING)

Name of the college:

Name/ seat number of the student: Year :
Patient’s Diagnosis : Ward:
Sl Marks
Particulars Marks
No Obtained
19 Introduction 02
20 Patient Profile 02
21 History Collection 08
22 Physical Examination 08
23 Investigation 02
24 Medication 04
25 Nursing Process 10
26 Anatomy And Physiology 05
27 Disease Condition 06
28 Comparative Study 06
29 IV Plan 06
30 Intake - Output Chart 08
31 Nurses Record 10
32 Diet Plan 08
33 Health Education 06
34 Patient Prognosis. 04
35 Summary & Conclusion 03
36 Bibliography 02
TOTAL 100

Signature of Student Name & Signature of Supervisor

Date : Date:
 M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY- II (MEDICAL SURGICAL NURSING)
Performa for evaluation- Care plan with Theory application
Name of the student ……………………….

Topic ……………………… Ward……………..

Name of evaluator ……………………. Date & time ………………….

S.no Evaluative aspects Points Points Remarks

allotted obtained
1 History collection 5
2. Physical examination 5
3. Investigation & medication 5
4. Theory application:
- List out theories appropriate to 15
condition
- Selection of theory apply to
the condition
- Explain the concepts of the theory
- Apply patient conditions to
the concepts
- Plan the care of patients with theory
- Prepare modified conceptual
frame work
5. Nursing care plan
- Concepts used to diagnose 10
the condition
- Assessment
- Diagnosis
- Goal
- Expected outcome
- Planning with evidence based
- Implementation
- evaluation

6 Health education and diet plan 5

7 Conclusion 3
8 Summary 2
Total 50

Signature of evaluator: Signature of

student:

Comments:
 HEALTH ASSESSMENT EVALUATION FORMAT

2ND YEAR M.SC NURSING

MEDICAL SURGICAL NURSING- II

NAME OF THE STUDENT: COLLEGE NAME;

TOPIC:DATE: WARD:

SR. PROCEDUR MARKS MARKS

NO ALLOTED OBTAINED
1 PLANNING AND ORGANIZATION 30
Lesson plan preparation 10
Theoretical knowledge 10
Preparation of patient and unit 5
Safety measures for patient 5
2 TRAY SETUP 18
Collection of articles 6
Arrangement of articles 6
Use of available resources 6
3 SKILLES AND TECHNOLOGIS 28
Use of scientific principles 5
Steps of procedure 5
Handling of instrument 4
Use of articles 5
Confidence 3
Time management 3
Communication skills 3
4 AFTER CARE 12
After care of patients 4
After care of Articles 3
Recording and reporting 5
5 PERSONAL QUALITIES 12
Appearance 3
Mannerism 3
Interest 3
Punctuality 3
TOTAL 100

Signature of Student Signature of Teacher

 EVALUATION FORMAT
M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY-II (MEDICAL SURGICAL NURSING)
Name of the college:
Name/ seat number of the student:
MARKS
S.NO ABILITY & SKILLS TO BE EVALUATED 1 2 3 4
I ASSESSMENT
1 Use suitable method to collect relevant data
2 Make interview with patient and relatives
3 Make clinical observation and physical examination
4 Accurately identifies the problem of the patient with the use of
nursing theory
5 Accept the patient and maintain good rapport
6 Co-operate with health team members
7 Maintain good IPR and accept supervision by nursing personnel
8 Create an atmosphere of mutual trust and respect
II PLANNING
1 State problem on scientific rationale on the basis of subjective and
objective data
2 Formulates the objectives relevant to problem on priority
3 Involve the client , other key persons and evidence based
planning of care
III IMPLEMENTATION
1 Determine the appropriate nursing action of the problem on
priority basis
2 Demonstrate the clinical skill necessary to carry out nursing
intervention
3 Utilize the opportunity to teach health care concepts to clients
4 Apply evidence based practice & scientific principle
IV EVALUATION
1 Routinely evaluate the effect of nursing care
2 Utilize current data to review nursing care plan
3 Use advance technology for recording data
Total score
V RECORDING & REPORTING
1 Maintain adequate records accurately
2 Communicate ideas information and health message effectively
3 Follow legal principles on records and reports
VI PERSONAL QUALIFICATION
1 Punctuality,grooming,maintain own health
2 Initiative and responsibility
3 Follow professional ethics ,leadership skills
4 Confidence
Total score
Signature of student: Name &Signature of evaluator:
 PROCEDURE EVALUATION FORMAT
M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY-II (MEDICAL SURGICAL NURSING)
Name of the college:
Name/ seat number of the student:
Procedure: Ward……………………

Marks Marks
Sl No Particulars
Allotted Obtained
A Planning and organization
Theoretical knowledge and content 05
Preparation of patient and unit 03
Safety measures of the patient 02
B Tray Setup
Collection of articles 03
Arrangement of articles 04
Use of available resources 03
C Skill and technique
Specific principles 04
Steps of procedures 07
Handling of instruments 03
Confidence 02
Time management 02
Communication skill 02
D After care
After care of patient 04
After care of the articles 03
Recording and reporting 03
TOTAL 50

Signature of Student Name & Signature of Supervisor

Date : Date:
 EVALUATION FORMAT FOR CASE PRESENTATION
M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY-II (MEDICAL SURGICAL NURSING)

Name of the college:

Name/ seat number of the student: Year :
Patient’s Diagnosis: Ward:
Sl Marks
Particulars Marks
No Obtained
17 Introduction 02
18 Patient Profile 02
19 History Collection 08
20 Physical Examination 10
21 Investigation 03
22 Medication 04
23 Anatomy And Physiology 04
24 Disease Condition 06
25 Comparative Study 06
26 Nursing Process 10
27 Diet Plan 05
28 Health Education 05
29 Nurses Record 05
30 Presentation
f- Appearance & confidence 03
g- Knowledge about the patient& case 06
h- Use of AV aids 04
i- Language & Fluency 03
j- Group involvement 06
31 Summary & Conclusion 04
32 Bibliography 04
TOTAL 50

Signature of Student Name & Signature of Supervisor

Date : Date:
 EVALUATION FORMAT FOR HEALTH EDUCATION
M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY-II (MEDICAL SURGICAL NURSING)
Name of the college:
Name/ Seat Number of the student:

Sr. Parameters Mark Mark

no. allotted obtained
1 Introduction 1
2 Drug class, Available form 2
3 Mode of action 3
4 Indication, Dosage, Route 2
5 Side Effect & 2
Contraindication
6 Nursing consideration & 4
Patient Education
7 Eye Contact 1
8 Appearance 1
9 Classroom Management 1
10 Use of A. V. Aids 2
11 Language Fluency 1
12 Mastery over content 2
13 Group Participation 2
14 Bibliography 1
Total 25

Remarks:

Sign of the student: Name & Sign of the

Evaluator:
 Evaluation Form For Nutritional Assessment
M.Sc Nursing Second Year ( Medical Surgical Nursing )

Name of College :
Name/ Seat No of Student :
Diagnosis :
Date &Time :

NUTRITIONAL ASSESSMENT

SR.NO CRITERIA MARKS MARKS

OBTAINED
1 Patient Information and Detail 2

2 Diet Pattern / History of Patient 2

3 Calorie Calculation as Per Patient Need 5

4 Diet Education 4

6 100 Gm Value of Food Stuff (Required For Menu ) 2

7 Menu Planning ( 24 Hours ) 10

8 Total 25

Name Of Evaluator : Total Marks :

Signature : Comments :

Student Signature :
 M.Sc NURSING SECOND YEAR
CLINICAL SPECIALITY- II (MEDICAL SURGICAL NURSING)

EVALUATION FORMAT FOR DAILY DIARY

Name of the student ……………………….

Topic ……………………… Ward……………………..
Name of evaluator ……………………. Date & time ………………….

S.no Evaluative aspects Points Points Remarks

allotted obtained
1. Patient Profile 2
2. History collection 4
3. Physical examination 4
4. Investigation 3
5. Medication 3
6. Theory application:
k. List out theories appropriate to 2
condition
l. Selection of theory apply to 5
the condition
m. Explain the concepts of the theory
n. Plan the care of patients with theory 4
o. Prepare modified conceptual 4
frame work
5. Nursing care plan
k. Assessment 2
l. Diagnosis 2
m. Goal 2
n. Planning &Implementation 2
o. evaluation 2

6 Submission on time 3
7. Neatness 2
8. Revision of Plan as per Patient Need 3
9. Completeness 2
Total 50

Signature of evaluator: Signature of student:

Comments:
 MSC NURSING SECOND YEAR
PRACTICAL EVALUATION FORM
MEDICAL SURGICAL NURSING-II
College Name- Subject
Year - Date-
Time-
I Criteria Max Roll no Roll No Roll No Roll Roll Roll
Marks No No No
ASSESSMENT – THEORY
BASED
1 History Relevant & adequate 2
2 Equipment- adequate 2
3 Technique- appropriate 4
4 Data- relevant, Complete 7
& organized
CARE PLANNING (PRIORITY
BASED)
5 Defining characteristics 3
appropriate
6 Nursing Diagnosis 4
7 Objective- Measurable, achievable 4
8 Interventions – Specific 6
INMPLEMENTATION

9 Patient Preparation 4
10 Scientific Principles 7
11 Skills 5
12 Communication 4
13 Patient Instructions 5
14 Documentations 3
15 Evaluation of Care 5
16 Completeness of care 3
PROFESSIONALISM
17 Grooming, Pleasant & sensitive 2
to patient Need
VIVA 30

TOTAL 100

Signature of Internal Examiner Signature of External Examiner

 MIDWIFERY
AND
OBSTETRICAL
NURSING II
 MIDWIFERY AND OBSTETRICAL NURSING

M.Sc. Nursing IInd Year

INTERNAL ASSESSMENT CRITERIA

S.No EVALUATION CRITERIA MARKS

1 Seminar 3 x 100 = 100

2 Assignments 4 x 25 = 50

3 Unit Test 4 x 25 =100

4 Mid term Examination 1 x 75 =75

5 Pre university Examination 1 x 75 =75

TOTAL 400
 EVALUATION FORMAT FOR SEMINAR
M.Sc NURSING IIND YEAR
CLINICAL SPECIALITY- I (MIDWIFERY AND OBSTETRICAL NURSING)

Name of the college:

Name/ Seat Number of the student:
Topic
Sl No Basic of evaluation 5 4 3 2 1 Remarks
1 Content
z) Introduction
aa) Relevancy content
bb) Adequacy of content
cc) Organization of the topic
dd) Submission in time
2 Organization and management of
class
u) Arrangement of class
v) Budgeting of time
w) Group participation
x) Control of Group
3 AV aids
p) Appropriate to subject
q) Selection and adequacy
r) Following Principles
4 Presentation
k) Mastery over content
l) Overall presentation & explanation
5 Personal appearance
u) Neatness and professional
appearance
v) Degree of self confidence
w) Voice and clarity
x) Mannerism
6 Summery & Conclusion
7 Bibliography
Total marks out of 100
Signature of Student Name & Signature of Supervisor

EVALUATION FORMAT FOR WRITTEN ASSIGNMENT

II nd YEAR M.SC NURSING

MIDWIFERY AND OBSTETRICAL NURSING

Name of the college:

Name/ Seat Number of the student:
Topic: Date:

Sr. Criteria Total marks Marks obtained

No.
1 Relevancy of content: 4
 Clarity (3)
 Concise (3)
 Simplicity of language(4)

2 Depth of content: 10
 Simple to complex(3)
 Key points emphasized(7)
 Description of important
points with
illustration(10)
3 Organization of content 5
 Sequential (5)
 Grammar , punctuation(2)
 Clean, neat , tidy(3)
4 A.V.Aids/Diagram/Tables 3

5 Bibliography /references 2

6 Submission on time 1

Total 25

Comment of Evaluator:

Signature of student: Signature of Evaluator:

 MIDWIFERY & OBSTETRICAL NURSING -II

PRACTICAL REQUIREMENTS FOR INTERNAL ASSESSMENT

MSc. 2ND YEAR

S.No REQUIREMENTS MARKS

1. CASE PRESENTATION
 ANTENATAL-1 100x3=300
 POSTNATAL-1
 NEWBORN-1
2 CASE STUDY 100x3=300
 ANTE NATAL-1
 POSTNATAL-1
 NEONATAL-1
3 DRUG BOOK 50x1=50
4 DRUG PRESENTATION 50x1=50
5 INSTRUMENT BOOK 100x1=100
6 CASE BOOK 50x1=50
7 DAILY DAIRY 50x1=50
8 100x1=100
EVALUATORY PROCEDURE
9 25x2=50
HEALTH EDUCATION
10 100
MID TERM EXAM
11 100
PRIUNIVERSITY EXAM
TOTAL 1250
MIDWIFERY & OBSTETRICAL NURSING -II

Case presentation - EVALUATION FORMMSc. 2ND YEAR,

COLLEGE NAME:

STUDENT NAME:

YEAR: I YR M.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRIC NURSING
TOPIC: DATE & TIME:

S.No Abilities to be evaluated 1 2 3 4 Remarks

1 Personal attitude
 Grooming & Appearance
 Posture
 Manners
 Alertness
2 Organizational abilities
 Preparation of unit
 Selection of patient & Preparation of patient
 Preparation of group
3 Teaching abilities & material
 Leadership quality
 Selection of appropriate AV aids
 Principle followed in AV aids
 Group Involvement
 Accept constructive criticism
 Feed back
4 Application of nursing theories
 Selection of appropriate theory
 Clearly explained the concepts
 Application of patient condition in to theory
 Modify conceptual framework based on condition
5 Health Assessment
 History collection
 Physical examination
 Investigation & drug study
 Comparison of disease condition
 Prioritize health needs & nursing diagnosis
 Implementation & evaluation of care given
 Health Education
Discharge Plan
6 Bibliography
Total (out of 100)
REMARKS

Signature of Evaluator
 MIDWIFERY & OBSTETRICAL NURSING -II

CASE STUDY - EVALUATION FORMMSc. 2ND YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: IV YR B.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRICAL NURSING

TOPIC: DATE & TIME:

Sr.No Item Max.Marks Obt.Marks

1 Demographic data 5
2 Chief complaints at the time of admission 4
3 History collection
3.1 Present History 4
3.2 Past History 4
3.3 Obstetrical/Gynaecological History 5
3.4 Personal History & Menstrual History 4
3.5 Socioeconomic History 5
3.6 Marital & Contraceptive History 5
3.7 Physical examination 5
4 Obstetrical examination 5
4.1 General Examination 5
5 Investigations & Drug Study 4
6 Treatment 5
7 Anatomy & physiology of relevant system 5
8 Disease condition 10
9 Assessment – priority need 7
10 Nursing process 5
11 Health education & Diet Plan 5
12 Discharge Plan 4
13 Bibliography 4

TOTAL 100

REMARKS:

SIGNATURE OF STUDENT SIGNATURE OF EVALUATOR

 MIDWIFERY & OBSTETRICAL NURSING -II
DRUG BOOK - EVALUATION FORM

MSc. 2ND YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: IV YR B.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRICAL NURSING

TOPIC: DATE & TIME:

Max Marks
SL.No Criteria
Marks Obtained

Content
01 10

Nursing Responsibility
02 10

Organization of content, creativity, neatness &

03 legibility 10

New trends, researches or critical analysis

04 10

Bibliography / References
05 10

Total 50

REMARKS:

SIGNATURE OF STUDENT SIGNATURE OF EVALUATOR

 MIDWIFERY & OBSTETRICAL NURSING -II
DRUG PRESENTATION - EVALUATION FORM

MSc. 2ND YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: I YR M.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRICAL NURSING

TOPIC: DATE & TIME:

SR.NO ITEM MAX.MARKS Marks obtained

A Drug Study
1 Introduction 2
2 Trade & Pharmaceutical name 2
3 Preparation, strength & dose 4
4 Action 4
5 Indication 4
6 Contraindication 4
7 Adverse Effect & Drug Interaction 4
8 Nsg Responsibility 4
9 Patient Education 2
10 Bibliography 2
B Material
11 Technical Adequacy Content 2
12 Organisation of content 3
13 Latest trends & research studies 5
C A.V Aids
14 Follow Principles of AV aids 2
15 Attractive & Self Explanatory 2
16 Innovative & Creative 2
D Personal Appearance & Mannerism 2
TOTAL 50

REMARKS:

SIGNATURE OF STUDENT SIGNATURE OF EVALUATOR

 MIDWIFERY & OBSTETRICAL NURSING -II
EVALUATION FORMAT - INSTRUMENT BOOK
MSc. 2ND YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: I YR M.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRICAL NURSING

TOPIC: DATE & TIME:

SR. CRITERIA MARKS MARKS

NO. ALLOTTED OBTAINED
1 Student Profile & Index 4
2 Content
 Uses/indications 12
 Description of an instrument 12
 Limitations 12
 Contraindications 10
 Neatness & Clarity 12
 Use of pictures/diagrams or tables 10
10
 After care of an instrument
10
 New
Trend/Researches/Critical
Analysis
3 Bibliography 4
4 Punctuality in submission 4
TOTAL 100

Signature of Student Name & Signature of Teacher

Date : Date:
 MIDWIFERY & OBSTETRICAL NURSING -

II CASE BOOK- EVALUATION FORM

MSc. 2ND YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: ROLL NO:SUBJECT:

TOPIC:DATE & TIME:

SR. CRITERIA MARKS MARKS

NO. ALLOTTED OBTAINED
1. Patient Profile & Index 2
2. Content
 Adequacy 6
 Relevancy 6
 Organization of content 4
 Legibility 4
 Accuracy of data 6
 Completed as per requirement 6
3. Technical Knowledge 4
4. Technical Skill 4
5. Attitude towards patient & health personals 4
6. Punctuality in submission 4
TOTAL 50
Remarks:

Signature of Student Signature of Teacher:

 MIDWIFERY & OBSTETRICAL NURSING -II

EVALUATION FORMAT FOR DAILY DIARY

MSc. 2ND YEAR

COLLEGE NAME:

STUDENT NAME:

YEAR: I YR M.SC NSG ROLL NO: SUBJECT: MIDWIFERY &

OBSTETRICAL NURSING

TOPIC: DATE & TIME:

S.no Evaluative aspects Points Points Remarks

allotted obtained
1. Patient Profile 2
2. History collection 2
3. Physical examination 3
4. Investigation 2
5. Treatment 2
6. Theory application:
p. List out theories appropriate to 2
condition
q. Selection of theory apply to 5
the condition
r. Explain the concepts of the theory
s. Plan the care of patients with theory 2
t. Prepare modified conceptual frame 2
work
5. Nursing care plan
p. Assessment 3
q. Diagnosis 3
r. Goal 3
s. Planning & Implementation 3
t. Evaluation 3

6 Learning Experience 4
7. Submission on time 3
8. Neatness & Complete 3
9. Revision of Plan as per Patient Need 3
Total 50
Signature of Evaluator: Signature of student
 MIDWIFERY & OBSTETRICAL NURSING -II
Procedure evaluation formMSc. 2ND YEAR
COLLEGE NAME:

STUDENT NAME:

YEAR: I YR M.SC NSG ROLL NO: SUBJECT: MIDWIFERY AND

OBSTETRICAL NURSING
SR. PROCEDURE MARKS MARKS
NO ALLOTED OBTAINED
1 PLANNING AND ORGANIZATION 30

Lesson plan preparation 10

Theoretical knowledge 10
Preparation of patient and unit 5
Safety measures for patient 5
2 TRAY SET UP 18

Collection of articles 6
Arrangement of articles 6
Use of available resources 6
3 SKILS AND TECHNOLOGIES 25

Use of scientific principles 5

Steps of procedure 5
Handling of instrument/articles 5
Confidence 4
Time management 3
Communication skills 3
4 AFTER CARE 13
After care of patients 3

After care of articles 5

Recording and reporting 5
5 PERSONAL QUALITIES 12

Appearance 3
Mannerism 3
Interest 3
Punctuality 3
6 Bibliography/References 2
TOTAL 100

SIGNATURE OF STUDENT SIGNATURE OF TEACHER

MIDWIFERY & OBSTETRICAL NURSING -II

EVALUATION FORMAT FOR HEALTH EDUCATION

MSc. 2ND YEAR

COLLEGE NAME:

STUDENT NAME: ROLL NO:

TOPIC: DATE & TIME:

SR CRITERIA MARKS MARKS

.NO ALLOTTED OBTAINED
1 Introduction 2

2 Preparation of physical environment 2

3 Preparation of participant 2

4 Preparation of content 5
5 A V aids 5
6 Communication skills 2
7 Written material 3
8 Advanced information 2

9 Response from participants 2

Total 25

REMARKS:

SIGNATURE OF EVALUATOR: SIGNATURE OF STUDENT :

 VEER NARMAD SOUTH GUJARAT UNIVERSITY, SURAT

MIDWIFERY & OBSTETRICAL NURSING –II, MSc. 2ND YEAR

PRACTICAL EXAM EVALUATION CRITERIA
S. Demograp VIVA
no Hall hic data Physical Nursing Process Nursing Health & Total
ticke (5) History Examinatio (5) procedur Education TOTA Practical marks
t Collectio n e (5) L Requirement
Num n (10) s ( 50)
. & Obstetrical (10)
Bed Examination
side viva & A D P I E
(5) Investigation
/medication
(10)
1

SIGNATURE OF INTERNAL EXAMINER

SIGNATURE OF EXTERNAL EXAMINER

MENTAL HEALTH
NURSING-II
 THEORY ASSESSMENT CRITERIA
M. Sc NURSING SECOND YEAR
MENTAL HEALTH NURSING II

EVALUATION:

Scheme of Internal Assessment of theory - out of 25marks

Sr.No Theory Assignment Marks

7. Seminar 100 marks

8. Project 100 marks

9. Unit test 25x4= 100 marks

10. Mid term exam 75 marks

11. Preuniversity exam 75 marks

Total 450

(Total marks obtained out of 450 to be converted into out of 25 marks to be

forwarded to the University towards internal assessment Theory)
 M.Sc. Nursing Second Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR SEMINAR

Name of student Date
Subject Group
Topic Maximum Marks: 100
Sr. Criteria Max Marks Marks Remarks
No. Obtained

1 Physical Setup 5
2 Grooming 5
3 Introduction 5
Content
4 Lesson plan 5
5 Objectives 5
6 Relevant 5
7 Adequate 5
8 Organization of content 5
9 Research evidence 5
Presentation
10 Communication Skill 5
11 In depth knowledge 5
12 Time management 5
13 Group involvement 5
14 Control of group 5
AV Aids
15 Relevant to the topic 5
16 Innovation and creativity 5
17 Effective use of AV Aids 5
18 Follows Principles of AV 5
Aids
19 Summary/ conclusion 5
20 Reference 5
TOTAL 100

Remarks:
Signature of student Signature of supervisor
 M.Sc. Nursing Second Year
CLINICAL SPECIALTY- I (MENTAL HEALTH NURSING)

EVALUATION FORMAT: PROJECT

Subject
Topic Date
Name of student Time
Group Maximum Marks: 100
CRITERIA MAX MARKS Remarks
MARKS OBTAINED
1 Physical Setup 5
2 Grooming 5
3 Introduction 5

Content
4 Relevant 10
5 Adequate 20
6 In sequence 5
Presentation
7 Communication Skill 10
8 In depth knowledge 10
AV Aids
9 Relevant to the topic 5
10 Innovation and creativity 5
11 Effective use of AV Aids 5
12 Follows Principles of AV 5
Aids
13 Summary/ conclusion 5
14 Reference 5
Total 100

Remarks:

Signature of student Signature of supervisor

 MSc NURSING –II PRACTICAL ASSESSMENT CRITERIA, MHN-II

Scheme of Internal Assessment of Practical - out of 100marks

S.No Area Quantity Marks
1 Mid term exam 100

2 Preuniversity exam 100

3. Case presentation 2 200

4. Case studies 2 200

5. History taking 4 100

6. MSE 4 100

7. Process recording 2 50

8. Counselling 2 100

9. Assisted ECT 2 50

10. Socio and psycho drama 2 100

11. Field visit 2 20

12. Drug Study 1 50

13. Clinical Evaluation 3 300

Total 1370
(Total marks obtained out of 1370 to be converted into out of 100 marks to be
forwarded to the University towards internal assessment practical)
 M.Sc. Nursing Second Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR NURSING CASE

PRESENTATION

MARKS MARKS
S. NO. CONTENT
OBTAINED
1 Orientation of History 10

2 M.S.E.with Diagnosis 10
Co-relation with patient
3 06
and Book
Nursing care plan and Nurses’
4 20
Notes
5 Drug Study 06

6 Research evidence 04

7 Health Education 06

8 Bibliography 04

Presentation skill
9 Use of A. V. Aids 10

10 Physical arrangement 04

11 Group participation 10

12 Effectiveness of Presentation 06
Implementation of
13 04
psychotherapies
Total 100

Remarks:

Signature of Student Signature of Supervisor

 M.Sc. Nursing Second Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR NURSING CASE

STUDY

Sl. No Content Marks Marks Obtained

1 Patient’s History 03
2 MSE 03
3 Anatomy and Physiology 05
4 Incidence, Etiology 05
5 Psycho pathology 05
6 Clinical manifestations 06
7 Investigations 04
8 Complication and Prognosis 05
9 Management – Medical 10
10 Drug study 10
11 Nursing care plan 15
12 Nurses’ Notes 08
13 Health Education 06
14 Discharge planning 05
15 Research evidence 04
16 Conclusion 03
17 Bibliography 03
Total 100

Remarks:

Signature of Student Signature of Supervisor

 M.Sc. Nursing Second Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR PSYCHIATRIC CASE HISTORY TAKING

S. No. Criteria Marks Allotted Marks Obtained

1 Format 03

2 Present Complaints 03

3 Organization of history 03
of present illness

4 Past history of illness 03

5 Family history of illness 03

6 Personal history 02

7 Pre-morbid personality 04

8 Summary & Clinical 04

Diagnosis
Total 25

Remark

Signature of Student Signature of Supervisor

 M.Sc. Nursing Second Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING
EVALUATION CRITERIA FOR MENTAL STATUS EXAMINATION
SR. CRITERIA ALLOTTED OBTAINED
NO. MARKS MARKS
1 Format 01
2 General appearance 02
3 Psychomotor activity 02
4 Talk & Speech 02
5 Thought 02
6 Affect and mood 02
7 Perception 02
8 Memory 02
9 Attention and Concentration 02
10 Orientation 01
11 Insight & Judgment 02
12 Intelligence and General 02
Information
13 Special points 02
14 Summary 01
Total 25

Remarks:

Signature of Student Signature of Supervisor

 M.Sc. Nursing Second Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR PROCESS RECORDING

S.NO CRITERIA MARKS MARKS

ALLOTTED OBTAINED
1 Format 04
2 Objectives 03
3 Setting 03
4 Therapeutic techniques used 10
5 Evaluation by students 05
Total 25

Remarks:

Signature of student Signature of Supervisor

 M.Sc. Nursing Second Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING
EVALUATION FORMAT: COUNSELLING

CRITERIA ALLOTTED MARKS

SR NO MARKS OBTAINED

1. Introduction with the patient 4

2. Objectives 3

3. Therapeutic Environmental Set up 5

4. Communication skills 5

5. Therapeutic techniques used 5

6. Grooming 5

7. Topic relatedness 5

8. Punctuality 5

9. Attitude 5

10. Innovation and creativity 5

11. Summary and Conclusion 3

TOTAL 50
Remarks:

Signature of the Candidate Signature of supervisor

M.Sc. Nursing Second Year

 CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION CRITERIA FOR ECT CARE STUDY

Sl. CRITERIA MARKS MARKS

NO. ALLOTTED OBTAINED
1 Introduction 03
2 Preparation of article and patient 04
3 Care before therapy 04
4 Care during therapy 05
5 Care after therapy 05
6 Recording 04
Total 25

Remarks:

Signature of Student Signature of Supervisor

M.Sc. Nursing Second Year

 CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION FORMAT: SOCIO AND PSYCHO DRAMA

SR NO CRITERIA MARKS MARKS

ALLOTED OBTAINED

1. Introduction of the theme 3

2. Objectives 3

3. Environmental Set up 5

4. Information provided by the students 5

5. A.V aids 5

6. Grooming 5

7. Topic relatedness 5

8. Time Management 3

9 Attitude 3

10. Communication Skill 5

11. Innovation and creativity 5

12 Coordination with team members 3

13. Summary and Conclusion 3

TOTAL 50

SIGN- REMARK-
 M.Sc. Nursing Second Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

EVALUATION PROFORMA OBSERVATIONAL FIELD VISIT

S.No Content Marks Marks Obtained

1 Introduction 1

2 Objectives 1

3. Organization pattern 1

4. Staffing pattern 1

5 Physical set up 1

6 Description 3

7 Submission of report on time 1

8 Conclusion 1

Total 10

Remarks:

Signature of student Signature of Supervisor

 M.SC NURSING SECOND YEAR
FORMAT FOR DRUG BOOK
MENTAL HEALTH NURSING

Name of the
Student:- Batch:-
Enrolment No:-

INDEX

SL.No Date Category of Drug Page No Sign

General Pharmacology

Definition of
Pharmacology Definition of
Drug
Related Terminology
Abbreviations

Nam Route,
Contra- Side Nsg
SL.N e of Dose, Actio Indication
indication effect Responsibilit
o the Frequenc n s
s s y
Drug y

Conclusion

Reference

Evaluation Criteria

Max Marks
SL.No Criteria Marks Obtained
01 Planning and Organization 10
02 Content 20
03 Nursing Responsibility 10
04 Summery & Conclusion 10
Total 50
 M.Sc. Nursing Second Year
CLINICAL SPECIALTY-MENTAL HEALTH NURSING

GUIDELINE FOR CLINICAL PERFORMANCE EVALUATION PROFORMA

Area: Max. Marks- 100

Student’s Name: Year:
Duration: Hospital:
Ward: Date:
S. NO CONTENT 4 3 2 1
1 KNOWLEDGE, SKILL AND APPLICATION

26 Demonstrates, sound scientific knowledge and understanding in her dealings

with the patient.
27 Demonstrates ability in history taking.
28 Examine the MSE
29 . Demonstration of communication skill.
30 Demonstrates ability to analyze and interpret the data collected for nursing care
planning.
31 Demonstrates ability to identify the needs of patients.
32 Demonstrate ability to implement the planned care to patients.
33 Attends to psycho social needs
34 Able to perform and assist in diagnostic and treatment modalities
35 Implements the procedure with skill, speed and completeness.
36 Makes relevant observations and record and reports them promptly and
effectively
37 Identifies risk factors and manages emergency situations effectively and
promptly
38 Works independently and makes prompt, relevant decisions in all situations
39 Able to carry out health talks and incidental health teachings effectively
40 Demonstrates sound knowledge of drug used in psychiatric ward.
41 Utilizes therapeutic communication techniques while interacting with patients &
family members.
II. PERSONALITY ASPECTS

42 Professional grooming and turn-out in uniform

43 Patient, keen and attentive listener

44 Punctuality

45 Courteous, tactful and considerate in all her dealings with colleagues, seniors,
patients and family
46 Maintains professional relationship
with health team members.
47 Enthusiastic and interested, takes interest in clinical setting
48 Follows instructions and exhibits positive behavioural changes as and when
required
49 Displays emotional maturity in all her dealings in the clinical setting
50 Demonstrates evidence of self learning by additional reading of current literature
Total Marks obtained:

Remarks:
Signature of Student Signature of Clinical supervisor
 UNIVERSITY PRACTICAL EVALUATION CRITERIA
SECOND-YEAR M.SC NURSING-MENTAL HEALTH NURSING

R.N Hall History Mental Process Care Therapy Counseling Health Grooming & Viva
Ticket Collection Status Recording Plan (10) (10) Education Professionalism (20)
No (10) Examination (10) (20) (05) (05)
(10)

INTERNAL EXAMINER
TOTAL
EXTERNAL EXAMINER
CHILD HEALTH
NURSING-II
 M.SC. NURSING II YEAR

THEORY ASSESSMENT

THEORY REQUIREMENT FOR II YEAR M.SC.NURSING(PEDIATRICS)

SNO EVALUATION NUMBERS MARKS

CRITERIA

1 Seminar 3 100x3=300

2 Unit test 4 25x4=100

2 Mid-term Exam 1 75

3 Pre university Exam 1 75

TOTAL 550

SECOND YEAR M.Sc NURSING

 CHILD HEALTH NURSING
EVALUATION CRITERIA FOR SEMINAR

NAME OF STUDENT: DATE :

SUBJECT :GROUP:
TOPIC : MAXIMUM MARKS: 100

Sr. Criteria Max Marks Marks Remarks

No. Obtained

1 Physical Setup 5
2 Grooming 5
3 Introduction 5
Content
4 Lesson plan 5
5 Objectives 5
6 Relevant 5
7 Adequate 5
8 Organization of content 5
9 Research evidence 5
Presentation
10 Communication Skill 5
11 In depth knowledge 5
12 Time management 5
13 Group involvement 5
14 Control of group 5
AV Aids
15 Relevant to the topic 5
16 Innovation and creativity 5
17 Effective use of AV Aids 5
18 Follows Principles of AV 5
Aids
19 Summary/ conclusion 5
20 Reference 5
TOTAL 100

REMARKS

SIGNATURE OF STUDENT SIGNATURE OF SUPERVISOR

 INTERNAL ASSESSMENT FOR PRACTICAL REQUIREMENTS

M.SC IInd YEAR SPECIALITY

CHILD HEALTH NURSING- I

Sl.No. Requirements Marks

1 Case presentation-3 300

2 Case study-2 200

3 Nursing process-3 150

4 Clinical Evaluation - 3 300

7 Demonstration-1 50

8 Health education-5 125

9 Inservice Education - 1 50

10 Field Visit-1 50 Other

requirements
as per 11 Daily Diary 50 the Log book
& INC
12 Mild Term-1 100

13 Pre-University-1 100

TOTAL 1425

M.Sc NURSING II YEAR

PEDIATRIC NURSING
EVALUATION CRITERIA FOR CASE PRESENTATION

Name of College:
Name of the student: Year :
Patient’s Diagnosis : Ward:
Date of care given:

Sl Marks
Particulars Marks
No Obtained
1 Assessment (20) 20
History 3
Physical examination 4
Growth and Development (Milestones &
Theories) 7
Immunization 3
Nutritional status 3
2 Anatomy And Physiology 6
3 Disease Condition 7
4 Co-relation ofpatient with Book& Drug Study 10
5 Care plan, Priority & theory based (20) 20
Theory application 4
Nursing process 9
Meeting play needs 4
Health education 3
6 Diet plan 8
7 Prognosis, Summary & Conclusion 6
8 Effectiveness of Presentation 18
Personal attitude –Grooming, confidence 5
Teaching abilities 6
Use of AV Aids 7
9 Bibliography 5
TOTAL 100

Name Of Evaluator : Total Marks :

Signature : Comments :

Student Signature : M.Sc NURSING II YEAR

PEDIATRIC NURSING
EVALUATION CRITERIA FOR CASE STUDY

Name of College:
Name of the student: Year :
Patient’s Diagnosis : Ward:
Date of care given:

Marks
Sr. No Particulars Marks
Obtained
1 Assessment (20) 20
History 3
Physical examination 4
Growth and Development (Milestones & Theories) 7
Immunization 3
Nutritional status 3
2 Drug Study 9
2 Anatomy And Physiology 7
3 Disease Condition 8
4 Co-relation with patient and Book 15
5 Care plan, Priority & theory based (20) 20
Theory application 4
Nursing process 7
Meeting play needs 2
Health education 2
6 Diet plan 9
7 Prognosis, Summary & Conclusion 6
8 Bibliography 6
TOTAL 100
Name Of Evaluator : Total Marks :
Signature : Comments :

Student Signature : NAME OF COLLEGE

M.Sc NURSING I YEAR

M.SC NURSING II
PEDIATRIC NURSING
EVALUATION FORMAT FOR NURSING CARE PLAN

Name of the student: Year :

Diagnosis: Date:
 Ward:
Sr. Marks
No
Particular Marks
obtained
1. History collection 05

2. Physical examination 05

3. Immunization 03

4. Developmental milestones 03

5. Developmental Theories 06

6. Diet Plan 05

7. Assessment 03

8. Nursing diagnosis 07

9. Goal 02

10. Implementation 05

11. Evaluation 03

12. Health Education 03

TOTAL 50

Name Of Evaluator : Total Marks :

Signature : Comments :

Student Signature :

M.Sc NURSING II YEAR

PEDIATRIC NURSING
FORMAT FOR CLINICAL EVALUATION

Name of College:

Name of the student: _

 Year: _
Area of clinical experience:
Duration of posting in weeks:
Name of the supervisor: _
Total marks: 100 marks

4 = Very good, 3 = Good, 2 = Satisfactory / fair, 1 = Poor

Sr. No Evaluation Criteria Grades

4 3 2 1
I Personal & Professional behavior
f. Wears clean & neat uniform and well groomed.
g. Arrives and leaves punctually
h. Demonstrates understanding of the need for quietness in
speech & manner & protects the patient from undue
notice.
i. Is notably poised and effective even in situations of
stress
j. Influential & displaced persuasive assertive
k. leadership behaviour

II Attitude to Co-workers and patients

e. Works well with member of nursing team
f. Gives assistance to others in clinical situations
g. Understands the child as an individual
h. Shows skills in gaining the confidence & co- operation of
child and relatives, tactful and considerate.

III Application of knowledge

f. Possess sound knowledge of pediatric conditions.
g. Has sound knowledge of scientific principles
h. Has knowledge of normal growth and development of
children
i. Has knowledge of current treatment modalities inclusive
medicine, surgery, pharmacology and dietetics.
j. Takes interest in new learning from current
literature & seeks help from resourceful people

IV Quality of clinical skill

l. Able to elicit health history of child and family
accurately.
m. Skillful in carrying out physical examination,
developmental screening and detecting
deviations from normal
n. Identifies problem& sets priorities and grasps
essentials while performing duties
o. Able to plan and implement care both
preoperatively and post operatively.
p. Applies principles in carrying out procedures & carries
out duties promptly.
q. Has technical competence in performing nursing
procedures.
 r. Able to calculate and administer medicines
accurately
s. Resourceful and practices economy of time material
and energy.
t. Recognizes the role of play in children and
facilitates play therapy in hospitalized children
Observes carefully, reports & records signs &
symptoms & other relevant information
u. Uses opportunities to give health education to
patients & relatives

Total

Grade

Very good = 70 % and above

Good = 60 – 69 %

Satisfactory =50- 59 %

Poor = Below 50

Remarks for improvement:

Student’s Remark:

SIGNATURE OF THE STUDENT SIGNATURE OF THE TEACHER

M.Sc NURSING II YEAR

PEDIATRIC NURSING
FORMAT FOR PROCEDURE EVALUATION

Name of College:
Name of the student: Year:
 Procedure: Date:

Sr. Marks
Particular Marks
No obtained
A Planning and organization 10
Theoretical knowledge and content 05
Preparation of patient and unit 03
Safety measures of the patient 02
B Tray Setup 10
Play articles or chocolates 02
Collection of articles 03
Arrangement of articles 02
Use of available resources 03
C Skill and technique 20
Specific principles 04
Steps of procedures 06
Handling the child 02
Handling of instruments 02
Confidence 02
Time management 02
Communication skill 02
D After care 10
After care of child 04
After care of the articles 03
Recording and reporting 03
TOTAL 50

Name Of Evaluator : Total Marks :

Signature : Comments :
Student Signature :

M.Sc NURSING II YEAR

PEDIATRIC NURSING
EVALUATION FORMAT FOR HEALTH EDUCATION
Name of College:

Name of the student: Year :

Topic: Date :
Ward Place :

Sr. Marks
Particulars Marks
No Obtained
9 Preparation of Health talk 02
10 Selection and arrangement of group 03
11 Content
-Adequacy 03
-Relevancy 02
-Organization 02
12 Presentation --
Appearance and confidence 02
Adequate explanation 02
Voice 01
13 AV aids
Adequacy 02
Relevance 01
Appropriateness 01
14 Discussion and Questioning 02
15 Response of group 01
16 Summery and Conclusion 01
TOTAL 25

Signature of evaluator: Signature of student:

Comments:

M.Sc NURSING II YEAR

PEDIATRIC NURSING
FORMAT FOR INSERVICE EDUCATION
Name of College:
Name of the student: Year :
Topic: Date :
 Group: Place :

S.No Criteria Total Marks Marks Remark

Obtained
1 Assessment and planning
a. Identified the need for 3
the group
b. Priority of need 3
c. Formulation for objectives 3
d. Development of evaluation 3
criteria
e. Obtained formal permission 3

2 Implementation of programme
a. Selection of content 5
b. Depth of content 3
c. Organization of content 3
d. Presentation of content 5
e. Group participation 4
3 Feasibility and practicability
a. Interesting to learn 2
b. Economic in term of 2
cost, effort & time
c. Up to the level of learner 2

4 A V Aids
a. Appropriate selection 3
b. Effectively used 2
5 Effectiveness of the programme 4

TOTAL 50

Name Of Evaluator : Total Marks :

Signature : Comments :

Student Signature :

M.Sc NURSING II YEAR

PEDIATRIC NURSING
EVALUATION FORMAT FOR FIELD VISIT REPORT
 Name Of College : Place of Visit:
Year :
Date &Time :

SR.NO CRITERIA MARKS

1 Introduction 2

2 Objectives Of Visit 5

3 Selection Of visit Area 4

4 Organization Structure 5

5 Physical Facility 10

6 Functions 8

7 Staffing 7

8 Learning Objective Met 5

9 Summary & Conclusion 4

10 Total 50

Name Of Evaluator : Total Marks :

Signature : Comments :

Student Signature

M.Sc NURSING II YEAR

PEDIATRIC NURSING
EVALUATIONFORMAT FOR DAILY DIARY

Name of College……………………………
 Name of the student ……………………….
Topic ……………………… Ward………………..
Name of evaluator …………...…………. Date & time ………………….

S.no Evaluative aspects Points Points Remarks

allotted obtained
1. Patient Profile 2
2. History collection (Immunization) 3
3. Physical examination 4
4. Growth & Development (Milestones & theories) 3
5. Investigation and Medication 3
6. Diet Plan 3
6. Theory application:
u. List out theories appropriate to condition 2
v. Selection of theory apply to the condition 2
w. Explain the concepts of the theory 5
x. Plan the care of patients with theory 4
y. Prepare modified conceptual frame work 4
5. Nursing care plan 5

6 Submission on time 3
7. Neatness 2
8. Revision of Plan as per Patient Need 3
9. Completeness 2
Total 50

Signature of evaluator: Signature of student:

Comments:

VEER NARMAD SOUTH GUJARAT UNIVERSITY, SURAT

EVALUATION CRITERIA FOR THE UNIVERSITY PRACTICAL & VIVA EXAMINATION
CHILD HEALTH NURSING
2ND YEAR M.SC NURSING
Sr.No Criteria Max. Marks
1
 Assessment ( 20)
History 3
+

Physical examination 4

Growth and development 7

Immunization 3

Nutritional status 3

2 Care plan, priority & theory based. ( 20 )

Assessment 4

Nursing diagnoses 4
Objectives 4

Plan of care 8

3 Implementation ( 35 )
Skill in care 10

Application of scientific principles 8

Meeting Play needs 4

Health education 5

Establishing IPR 3

Recording and reporting 5

4 Evaluation ( 5 ) 5
5 Viva ( 20 ) 20
TOTAL 100
COMMUNITY
HEALTH
NURSING –II
 INTERNAL ASSESSMENT CRITERIA FOR

COMMUNITY HEALTH NURSING-II (Theory)

II YEAR M.Sc. Nursing

Sr. no Criteria No Total Marks

1 Assignment 2 2x50=100

2 Unit test 4 4x25=100

3 Seminar 1 4x100=400

4 Mid – term exam 1 75

5 Pre- university exam 1 75

Total 750
 SECOND YEAR M. Sc. NURSING
EVALUATION FORMAT FOR WRITTEN ASSIGNMENTS
COMMUNITY HEALTH NURSING-II
Name of the college:
Name/ Seat Number of the student:
Topic: Date/ Time:

SR. CRITERIA TOTAL MARKS MARKS

NO. OBTAINED
1 Relevancy of content: 10
 Clarity (3)
 Concise (3)
 Simplicity of language(4)

2 Depth of content: 20
 Simple to complex(3)
 Key points emphasized(7)
 Description of important
points with
illustration(10)
3 Organization of content 10
 Sequential (5)
 Grammar , punctuation(2)
 Clean, neat , tidy(3)
4 A.V. Aids/Diagram/Tables 05

5 Bibliography /references 03

6 Submission on time 02

Total 50

Comment of Evaluator:-

Signature of student: Signature of Evaluator:

 SECOND YEAR M. Sc. NURSING
COMMUNITY HEALTH NURSING-II
EVALUATION CRITERIA FOR
SEMINAR
Name of student Date:
Subject College:
Topic Maximum Marks: 100
Sr. No Basic of evaluation 5 4 3 2 1 Remarks
1 Content
a) Introduction
b) Relevancy content
c) Adequacy of content
d) Organization of the topic
e) Submission in time
2 Organization and management of class
f) Arrangement of class
i) Budgeting of time
j) Group participation
k) Control of Group
3 AV aids
l) Appropriate to subject
m) Selection and adequacy
n) Following Principles
4 Presentation
o) Mastery over content
p) Overall presentation & explanation
5 Personal appearance
q) Neatness and professional appearance
r) Degree of self confidence
s) Voice and clarity
t) Mannerism
6 Summery &Conclusion
7 Bibliography
Total marks out of 100

Signature of Student Name & Signature of Supervisor

 PRACTICAL ASSESSMENT
CRITERIA M.SC. NURSING SECOND
YEAR
( COMMUNITY HEALTH NURSING – II )

SR.NO PRACTICAL ASSIGNMENT NUMBERS MARKS

(EACH)

1 Family Care Study (Urban ,Rural) 4 4x50=200

2 Health education can be divided as 10 10x50=500

4. Individual-4
5. Family -4
6. community-2 (urban,rural)

3 Procedure evaluation (Urban ,Rural) 4 4x50=200

4 Clinical evaluation 2 50x2=100

5 Observational Visit 3 3x50=150

6 Nutritional assessment 1 25

7 Mid Term Practical 1 100

8 PreUniversity Exam 1 100

TOTAL 1375

Remaining requirement as per the INC syllabus & log book

 2nd YEAR M.Sc. NURSING
COMMUNITY HEALTH NURSING-II
EVALUATION CRITERIA FOR FAMILY CARE STUDY
Name of the student: Year
Field placement: Period
S .no Criteria Marks Marks Remark
allotted obtained
1 Personal and professional Grooming 02
2 Initial data : 05
Subjective data and objective data
4 Family health (Assessment of Family 05
members physical mental & social)
Health of each member
Gynac & Obstetric
health Nutritional data
Rest & sleep
Use of health
resources Family
planning status
Health practices of each member
Family life style
5 Identification of vulnerable groups and 03
high risk individual
6 Health needs / problems identified 03
7 Planning for family health nursing care 06
(including short term & long term
plan)
8 Implementation of home nursing 06
care plan with scientific rationale
9 Health education planning & 05
implementation
10 Planning for diet 03
11 Evaluation : 03
Outcome of family health care
12 Evaluation : Self learning as a Nurse 04
13 Future plan 02
14 Conclusion & suggestion 03
Total 50

Signature of student Signature of supervisor

 SECOND YEAR M. Sc NURSING
COMMUNITY HEALTH NURSING-II
EVALUATION CRITERIA FOR HEALTH TEACHING

Name of the Institution:

Name of the student:
Language:
Topic:
Audience:
Ward / Field:
Name of the Supervisor / teacher: Date
S. No Criteria Marks Allotted Marks obtained
Content
1 Lesson planning 05
2. Appropriateness, relevancy 08
& adequacy of content
3 Organization 04
4 Up to date and evidence based 03
Presentation
1. Physical arrangement 03
2 Communication skill 05
3. Confidence 03
4 Group involvement 03
A.V. Aids
1 Selection & Preparation 04
2 Effective use of A. V. Aids 03
Other
1 Time Management 03
2 Acceptance of guidance 03
3 Reference 03
Total 50

Signature of Student Signature of Supervisor

 SECOND YEAR M. Sc NURSING
COMMUNITY HEALTH NURSING-II
EVALUATION CRITERIA FOR PROCEDURE EVALUATION USING BAG
TECHNIQUE
Name of the student:
Field placement:
Period: Year:

S. No Content Maximum Marks Obtained Marks

1 Approach to the family 02

2 Selection of procedures based 05
on family needs
3 Preparation of the bag for the 05
procedure
4 Hand washing 05
5 Caring out all the steps of 10
procedure correctly
6 Scientific principles followed while 05
doing procedure
7 Involvement of family while doing 03
procedure
8 Health education during the 05
procedure
9 Termination of procedure ( 05
after care of bag and equipment
&
disposal of waste)
10 Recording and reporting 05
Total 50
Remarks

Signature of Students Signature of Supervisor

 SECOND YEAR M. Sc NURSING, COMMUNITY HEALTH NURSING-II
CLINICAL EVALUATION PROFORMA
Name: Year:Areas of community health nursing
Period under Evaluation From to Max. Marks: 100
S. Areas Rating Scale*
No 1 2 3 4 5
I Knowledge and understanding about family
Assesses family health in detail and collects relevant and significant
1 data of each individual in the family
2 Interprets significant findings appropriately
II Home visit
3 Planning and organization of home visits based on the health
needs of the family and identified goals
4 Establishes rapport with the family and is able to
communicate effectively and tactfully with different
individual / group
III Health assessment and observation
5 Does physical health assessment of family members
6 Identifies deviation from normal and set priorities in home
care activities
7 Plans home care based on identified health needs and health
problems
8 Implements simple home nursi
ng procedure based on plans
IV Nursing activities carried out
9 Application of scientific principles
10 Technical skills with necessary modification and
completeness of the procedure
11 Involvement and participating of the family members
12 Interpretation, reporting, recording of results
13 Takes corrective action , follow standing orders and selects
appropriate referral agencies
14 Evaluates outcome of family health care rendered
V Health education
15 Uses every opportunities for incidental / planned health
teaching for individual and group
16 Uses appropriate teaching learning principles
VI Post visit
17 Reports significant information
18 Completes record, promptly, precisely, accurately
VII Professional qualities
19 Professional in dealing with family
20 Is resourceful and has leadership qualities

Total
Signature of student Signature of Superviso
 EVALUATION FORMAT OBSERVATIONAL VISIT REPORT

2ND YEAR M.SC NURSING

COMMUNITY HEALTH NURSING - II

COLLEGE NAME:

STUDENT NAME: ROLL NO:

TOPIC: DATE & TIME:

SR.NO CRITERIA MARKS MARKS

OBTAINED
1 Introduction 2

2 Objectives Of Visit 2

3 Selection Of visit Area 2

4 Organization Structure 2

5 Physical Facility 5

6 Functions 5

7 Staffing 3

8 Learning Objective Met 2

9 Summary & Conclusion 2

10 Total 25

REMARK

STUDENT’S SIGNATURE EVALUATOR’S SIGNATURE

 EVALUATION FORM FOR NUTRITIONAL ASSESSMENT
M.SC. NURSING SECOND YEAR
COMMUNITY HEALTH NURSING-II

Name of College :
Name/ Seat No of Student :
Date &Time :
Address
SR.NO CRITERIA MARKS MARKS
OBTAINED
1 FamilyInformation and Detail (24 recall) 7

2 Diet Pattern / History of family 2

3 Calorie Calculation as Per family members Need 5

4 Diet Education 4

6 100 Gm Value of Food Stuff (Required For Menu ) 2

7 Menu Planning ( 24 Hours ) 5

8 Total 25

Name Of Evaluator : Total Marks :

Signature : Comments :

Student Signature :
 PRACTICAL EXAMINATION SCHEME OF EVALUATION
SECOND YEAR MSC NURSING
SUBJECT: COMMUNITY HEALTH NURSING-II

S.N CRITERIA MAX

O THEORY/NURSING PROCESS MARKS(100)
1 Approaches to the family 6
 Professional appearance 2
 Concern to family members 2
 Interviewing technique 2
II Family health assessment 20
 Health history of all members 7
 Physical asessment 5
 Nutritional Assessment 4
 Socioeconomic assessment 2
 Environmental assessment 2
III Nursing Diagnosis 10
 Individual 7
 family 3
IV Family care plan 15
 Comprehensive plan 8
 Priority 2
 Theory application 5
V Implementation 30
 Procedure based on scientific 10
principle
 Effective use of community bag 4
 Making use of family resources 3
 Need based health education 8
 Appropriate use of AV aids 5
VI Evaluation 4
 Recording and Reporting

VII Viva 15
Total 100
EXTERNAL EXAMINER INTERNAL EXAMINER
M.Sc. NURSING
EVALUATION
FORMATS OF
PAEDIATRIC
NURSING
(CLINICAL
SPECIALTY-I)