Collaborative Design and Use of an Agency Feedback Form for Student Clinical Practicum Experience in Community/Public Health Nursing


Janet Resop Reilly, DNP, A.P.R.N-B.C., University of Wisconsin, Green Bay, Professional Program in Nursing, 2420 Nicolet Drive, Rose Hall-325L, Green Bay, WI 54311. E-mail:


ABSTRACT Evaluation of students in community and public health (C/PH) nursing clinical practica is a challenge, especially when preceptors are expected to evaluate students from different academic nursing programs. The need for a standardized student evaluation tool was identified during federally funded collaborative meetings held between C/PH academic and practice partners in Northeastern Wisconsin. This article focuses on the development and appraisal of the standardized Agency Feedback Form (AFF) for Student Practicum Experience in Community/Public Health Nursing, which was designed to meet the identified need. Four baccalaureate nursing programs implemented the AFF for 3 purposes: (1) to provide a consistent and easy evaluation form for preceptors to complete; (2) to communicate useful information about students' individual professional behaviors observed during practicum; and (3) to increase students' and preceptors' understanding of the population-based nursing interventions, using the Public Health Intervention Wheel. Future uses and implications of the AFF are also discussed.