Transcultural Assessment

Transcultural Assessment and Course Project Reflections Template

Use this template to record your information for this assignment. Do not modify the template. Do not rely only on this template to determine everything you must include! Please review Milestone 3: Transcultural Assessment and Course Project Reflections guidelines, grading criteria, and grading rubric on the assignment page in order to learn details of what to include on this template. 

Once you have completed this template, click Save as and save the file with Assignment name and your last name e.g., NR394_Milestone3_Smith). Submit to assignment page by 11:59 p.m. MT at the end of Week 6 by 11:59 p.m. MT.

Note: This template is expandable to accommodate your typing.

Title: Milestone 3   (Fill in all the blanks in this section)

Your Name: __________________________Individual’s Initials______________

Date & Time of Interview ________________Place of Interview_____________________

Working phone number or Email of Individual Assessed _________________________

Individual’s Culture of Origin_________________Age_____________Career/Profession_________________

Assignment Criteria Type statements into the boxes below. Use direct quotes or paraphrasing. NOTE: See Milestone 3 Grading Rubric for details required in each area.
 
Introduction of Student, Individual being Assessed and Purpose of Assessment    
Individual Gives Permission for Assessment; States Understanding of Ability to Refuse Answers and Stop Assessment            
Questions and Answers:     In the left column name the category based on those selected in Milestone 2. Your instructor needs to know to which category your questions and the answers pertain.  
Primary Question #1: Fill in Category________________ Student’s Question Individual’s Answer
Follow-up a. Student’s Question Individual’s Answer
Follow-up b. Student’s Question Individual’s Answer
Primary Question #2: Fill in Category________________ Student’s Question Individual’s Answer
Follow-up a. Student’s Question Individual’s Answer
Follow-up b. Student’s Question Individual’s Answer
Primary Question #3: Fill in Category_______________ Student’s Question Individual’s Answer
Follow-up a. Student’s Question Individual’s Answer
Follow-up b. Student’s Question Individual’s Answer
Primary Question #4: Fill in Category_______________ Student’s Question Individual’s Answer
Follow-up a. Student’s Question Individual’s Answer
Follow-up b. Student’s Question Individual’s Answer
Primary Question #5: Fill in Category_______________ Student’s Question Individual’s Answer
Follow-up a. Student’s Question Individual’s Answer
Follow-up b. Student’s Question Individual’s Answer  
Course Project Reflections See grading rubric for evaluation criteria.                        
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