NUR-665E Nursing Education Practicum Documentation. (NEPD) Form: Competency 6
Directions: Complete the documentation form. Type in your response in the unshaded box below each question.
The form will expand for as long as you type. The purpose of this
assignment is to document meeting the competency and to promote deep reflection on your practicum activities.
Consider reviewing course textbooks: Certified Nurse Educator Review
Book: The Official NLN Guide to the CNE Exam and NLN Core Competencies for Nurse
Educators: A Decade of Influence for suggested practicum activities
Weeks
11 and 12 Nurse Educator Competency 6: Function as a Change Agent and Leader.
Learner Name: Date(s):
Complete this
section before
you begin the
weeks’ clinical.
Learning Goals: What do you want to accomplish for Competency 6:
Function as a Change Agent and Leader?
Be sure your goals are specific, measurable, achievable, relevant, and time
bound (S.M.A.R.T. goals).
Some goals should reflect higher cognitive learning levels in Bloom’s
taxonomy.
My goal/s for this competency is/are to:
Resources and Strategies: What type of resources or strategies will you utilize
to accomplish your learning goals? Include both human and material resources.
The resources (human and material) and strategies I need to meet my weekly
goal are:
Measurement: How will you know that you have accomplished your learning
goal(s)? What criteria will you use to measure this?
The criteria I will use to measure my goals are:
Complete this Evaluation: Did you meet your goal? What did you accomplish that you can
2
section after
you complete
the weeks’
clinical.
use as evidence that you met your learning goals?
Did you meet your goal? Why or why not?
Reflect on Competency 6, analyzing your practicum experiences: Be sure to
connect your experiences directly to the competency.
Reflection:
Clinical hours completed this topic:
Total clinical hours completed to date:
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