Professional Practice Program Mental Health

SWSLHD Mental Health Services

Transition to Professional Practice Program Mental Health


Interim Performance Review

(For Placements One and Two)


This document must be completed at the end of each clinical placement. The Registered Nurse will complete the ‘Employee’ rating and comments section for each Performance Indicator. Each rating must be accompanied by a couple of examples providing evidence of how the rating is justified (bullet points are fine).

The Preceptor or Manager then initials the ‘Preceptor or Manager’ section to confirm the rating. If the Preceptor does not agree with the RNs self-rating they must right their rating in the ‘Preceptor or Managers’ section and initial to indicate that the amended rating has been discussed with the RN.

At the completion of the document the RN then arranges time with the NUM or Team Leader to go through the form and summarise their progress. At this time the NUM or Team Leader would then complete the checklist at the bottom of the last page. Finally the document must be scanned and an email a copy of the document to the Nurse Manager – Workforce / Delegate for filing.


The purpose of the Interim Performance Assessment is to ascertain whether or not the Employee is on track to meet the relevant performance indicator by the end of their transition year, as will be evidenced by a full Registered Nurse Performance Management Review at the end of the third placement. The Registered nurse is required to rate themselves against each performance indicator and provide an example. The manager will also need to rate the Registered Nurse against the performance indicators and provide feedback.

Rating Scale

1 – Considerable improvement required

2 – Some improvement required

3 – On track to achieve by completion of TPMHN year

4 – Outstanding progress

Rating ‘3 or 4’

No further action is required. Complete the document, sign it and forward a scanned copy to the Nurse Manager, Workforce.

Rating ‘1 or 2’

The Participant’s Learning Development Plan must be updated to evidence that the Employee has a SMART Goal to improve the rating in the next placement.

The Process


Manager reviews Participant

Workbook and the HETI
Completion Report.
PerformanceManager reviews the Summary of
AssessmentClinical Skills Assessment
completed at
the end of the
placementCEWD advice non-attendance
LDP for any IndicatorsLearning
scored 1 or 2.Development
Plan Reviewed
Feedback provided
by NUM/ManagerProgress


Online                  Summary

of Clinical






SWSLHD Mental Health Services

TPPP MH Interim Performance Review – Mar 2017

SWSLHD Mental Health Services

Transition to Professional Practice Program-Mental Health (TPPPMH) Interim Performance Review

Name of Participant:
Employee Number:
Name of Manager:
Date of Assessment:
Location of Placement:
Rotation Number:1 or 2 (please circle)
Performance IndicatorEmployee Rating and CommentsPreceptor
1 – Considerable Improvement Required/Managers
2 – Some Improvement Required
3 – On track to achieve by end of the year
4 – Outstanding Progress
1. Work ConductSelf-ExamplesManager/Please initial
The Nurse advocates the values of the organisationRatingPreceptor
through ethical behaviour, professionalism and cultural
sensitivities. They Display a positive attitude, are
genuinely interested, curious and authentic in their
conduct and model reliability and accountability.
2. Teamwork/Collaboration
The Nurse demonstrates an understanding of how
collaboration has an impact on the safe and effective
provision of comprehensive care. They support the
integrity of team practice by collaborating in decision
making, following team processes and sharing team
responsibilities. They contribute discipline specific skills
to multidisciplinary team practice.
3. Decision-making and safe practice
The Nurse is able to analyse problems and use critical
thinking to solve problems within own scope of practice.
They Integrate organisational policies and guidelines with
professional standards and this is demonstrated by safe
working practices. They intervene, act and report where
4. Work Practice
The Nurse demonstrates a thorough knowledge and
understanding of the clinical and Technical /skills aspects
within their practice. The Nurse displays a sound
judgement in the Practical application of these principles
in daily work practices.
5. Problem-Solving
The Nurse identifies problems/issues, consults and
implements creative, innovative and Workable solutions.
Identifies relevant priorities and meets deadlines.
Assesses effectiveness of interventions and acts
accordingly. Applies information appropriately and
effectively to achieve desired outcomes
6. Communication-Verbal
The Nurse expresses their position clearly, in a concise
and confident manner. They interact respectfully and
professionally with colleagues, consumers and carers.
They communicate with relevant health care
professionals and service providers to facilitate continuity
of care, and deliver accurate and relevant information
e.g. clinical handovers, health care team reviews.
SWSLHD Mental Health Services
TPPP MH Interim Performance Review – Mar 2017
Page 2 of 4


Performance IndicatorEmployee Rating and CommentsPreceptor
1 – Considerable Improvement Required/Managers
2 – Some Improvement Required
3 – On track to achieve by end of the year
4 – Outstanding Progress
7. Communication-WrittenRatingExamplesPlease
The Nurse presents facts clearly, concisely and logically ininitial
documentation and reports. Incidents are accurately
documented in a timely fashion in accordance with the
minimum standard for documentation.
8. Adaptability
The Nurse demonstrates ability to support change and
apply knowledge/skill to accommodate service needs at
the organisation level.
9. Personal and Professional Development
The Nurse actively seeks opportunities for learning and
self-improvement; requests feedback and welcomes
advice when offered. Supports personal and professional
development for self and others.
10. Continuous Improvement
The Nurse seeks to improve their own practice and
actively contributes to the improvement of services and
efficiencies on the ward through ongoing reflective
practice, attendance and input at staff and clinical
meetings and involvement in project work.
11. Complies and Contributes to Infection
Control and WH&S; Commitment to
EEO/Anti discrimination
The Nurse complies with Infection Control, WH&S and
EEO/Anti discrimination legislation and policies.
12. Customer Service
The Nurse is professional and respectful attitude toward
clients and carers while providing care and service
delivery. Interactions are courteous and foster a
partnership with consumers and carers.


Items for Addition to Learning Development Plan (if applicable)

SWSLHD Mental Health Services

TPPP MH Interim Performance Review – Mar 2017

Participant General Comments

Preceptor Comments

Manager Comments

Office Use Only
Yes/No/N/APrevious Learning Development Plan goals met (Check previous Performance Review
Yes/No/N/ALearning Development Plan amended to include any new goals (if applicable).
Yes/NoMHPOD up-to-date (As per report)
Yes/NoClinical Skills Assessments up-to-date (should be two per placement)
Yes/NoAttendance at Block Training during placement (CEWD report non attendance)

SWSLHD Mental Health Services

TPPP MH Interim Performance Review – Mar 2017

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