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You have been asked by an applicant to the Johns Hopkins School of Nursing’s Supporting Professional Advancement in Nursing (SPAN) Program to provide a recommendation evaluating their clinical performance. The SPAN program is a competitive opportunity available exclusively to talented pre-licensure JHSON nursing students who intend to pursue advanced graduate studies in nursing in the near future. The program begins with the final Synthesis practicum experience and continues for 3 years. If selected, program participants will complete their Integrated Clinical Management: Synthesis Practicum course at one of four partner sites. Upon successful completion of their pre-licensure degree and passing the NCLEX exam they will be hired by their Synthesis practicum site and begin full-time work as a staff nurse in the nursing service area in which they completed their practicum.

Applicants must meet all hiring criteria established by the employer and must commit to working for at least 1 year full-time on their unit, followed by two years of employment either part-time, or with the option of continuing to work working full time on the unit. During their first year of employment the applicant will apply to a graduate specialty degree nursing program and will be expected to attend graduate school full or part-time while working during years 2 and 3 of the program. Upon completion of the program, participants will have obtained an advanced specialty graduate degree in nursing. 

This form should be completed by a clinical preceptor who has observed the applicant in a clinical setting for at least one entire shift.  In this case, a clinical preceptor is defined as a registered nurse with whom the applicant shadowed and/or assisted during a clinical rotation on a unit where s/he works as an RN or clinical instructor. This person may be a JHSON clinical course coordinator, JHSON clinical instructor or may be a nurse employed at any hospital where the applicant has completed clinical hours since beginning nursing school.

Please take a moment to assign numerical ratings to the qualities and skills listed below providing an honest assessment of the applicant’s abilities as you have observed. The deadline to submit a SPAN Program Preceptor Form is midnight, October 17, 2019. If you have any questions about the SPAN Program or this form please do not hesitate to contact me. Thank you for your time.

Sarah S. Firestone, MSW
SPAN Program Manager

Please complete this form before hitting submit. If you have any questions, contact Sarah Firestone (
Have you Worked in Direct Supervision of this Applicant?
Please provide a numerical rating based on the applicant's academic performance and clinical nursing skills.
(Poor/ 1------2------3-----4-----5 \Excellent), n/a = Did not observe/Cannot assess

1. Critical Thinking*
2. Clinical Performance*
3. Academic Performance*
4. Academic Aptitude*
5. Ability to interact with peers*
6. Ability to interact with patients/families*
7. Accountability*
8. Professionalism (attendance, punctuality)*

Please note: 1) rating forms may be shared with students , and 2) you will receive a confirmation email from Sarah Firestone within one business day of submitting this preceptor rating form. If you do not receive a confirmation email from Sarah, your form was not received. Please contact Sarah if this is the case. Thank you.