Summary NR 630 LEARNING AGREEMENT WEEK 1, 4 AND 7

EXECUTIVE PRACTICUM Learning Agreement NR 630 LEARNING AGREEMENT WEEK 1, 4 AND 7 Student Name: Raul Guardiola Student D#: Student email, phone: Mentor Name and Credentials: Mentor Contact Information: Louise V. Hernandez, MSN, BSN, RN, NE-BC 7207 Holder Forest Ct / Directions: For Week 1, fill out the learning agreement with self-identified goals to meet course outcomes and initial plans to meet those self-identified goals; review the goals and plans with mentor. In Week 4 the goals, plan to meet the goals and actual goal attained is to be identified and submitted. At Week 7 of the practicum experience, evaluate success with your mentor and obtain the mentor’s signature at the bottom of agreement. Save this form as a Word document and enter required information directly onto it. See Learning Agreement Grading Rubric for grading details The learning agreement is to be submitted Weeks 1, 4, and 7. Learning agreement consists of three sections: I. Student Learning Outcomes Table II. Signatures approving plan (Week 1) III. Signatures at mid-point (Week 4) IV. Signatures and mentor verification (Week 7) Note: Each section in table and signatures must be completed prior to submission for faculty approval. Due Dates: 1. InitialLearning Agreement is submitted by 11:59 pm MT Sunday of Week 1. 2. Mid-point evaluation and revision is submitted by 11:59 pm MT Sunday of Week 4. 3. Completed Learning Agreement is submitted by 11:59 pm MT Sunday of Week 7. Minimum of 100 hours practicum experience required. I. Student Learning Outcomes