Nursing at Michigan Performance Evaluations

For Framework/RSAM Nurses Fillable PDF Forms

Performance Evaluation Steps:

RN receives email notice from unit AA (month prior
to seniority month), then completes 3 steps:


Obtain peer feedback from at least
3 peers covering all domains


Complete self-evaluation
within 3 weeks


Meet with clinical nursing
director/supervisor Date set by unit

Important! Read below before proceeding.  Click arrows to open...

Performance Evaluation Process Overview - for RNs

The process of annual evaluation is a professional and contractual obligation. All parties are accountable for following this process and ensuring timely review. The evaluation process is supportive of professional growth and development in order to ensure quality patient care and optimal outcomes.

Upon receiving notification of the annual evaluation email from the unit AA, the employee has three weeks to complete the performance evaluation process (including peer feedback and self-evaluation). Nurses should be sure to select the appropriate role/level and follow the instructions that are included within the performance evaluation forms.

Review the following before you begin:

1. Peer Feedback - obtain feedback from at least 3 peers covering all domains within 7 days

  • The nurse obtains peer feedback from a minimum of 3 peers.
  • At least one peer must be an RN who has completed peer feedback/review education.
  • Each peer will be asked to evaluate the nurse on selected domains, so that all Framework or RSAM domains are reviewed.
  • The Framework Clinical Skills and Knowledge or RSAM Clinical Thinking and Judgment domain must be completed by an RN.
  • Completed peer feedback forms should be forwarded via email by the peer to both:
    • the RN who is being evaluated
    • the clinical nursing director/supervisor

2. Self Evaluation - complete form and email to leadership within 3 weeks

  • Using links below, the nurse will complete the fillable PDF self-evaluation form for their Framework/RSAM role. Within the form the nurse will be prompted to select their level within Framework (A, C, D, E or F) or RSAM (Role Entry/Competent, Expert, Mastery, or Mastery+).
  • The nurse will consider the input provided by the peer evaluation(s) when completing their self-evaluation and will summarize the peer feedback within the self-evaluation form in the Required Feedback Section.
  • Supportive responses for behaviors will be included in the summary section(s).
  • The nurse should forward their completed self-evaluation form via email to the clinical nursing director/supervisor who will then complete the leadership portion of the form.

3. Meet with clinical nursing director/supervisor - date set by unit

  • Above items must be completed prior to the 1:1 meeting.
Peer Feedback Process Overview - for Peers

Peers will complete the Peer Feedback fillable PDF form for the RN requesting their feedback.

  • Peers will indicate the level/behaviors that best describe the nurse for whom they are providing feedback.
  • Peer reviewers are encouraged to provide examples as prompted within the form.
  • Peers should complete the form within 7 days
  • Completed peer feedback forms should be forwarded via email by the peer to both:
    • the RN who is being evaluated
    • the clinical nursing director/supervisor
Tip Sheets, Video Clips and Helpful Resources

Video Clips

Working with Fillable PDF Forms

Working with Fillable
PDF Forms

Digitally Signing Peer Feedback Forms

Digitally Signing Peer
Feedback Forms

What is my H Drive?

What is my H Drive? 1:31

More Helpful Resources

H Drive

Nurses and Peers: Your H drive
is a convenient place to store self-
evaluations and peer feedback forms

Every non-temporary, Michigan Medicine employee receives access to personal file space at orientation. This space is referred to as the Home Directory or *H:* drive. The H drive is intended for work-related files that are personal in nature (i.e., these files will be deleted when a user leaves UMHS).
~ Excerpt from Michigan Medicine H Drive Wiki

Michigan Medicine Knowledgebase:


CNDs/Supervisors: Use of a Dropbox account, shared with unit leadership, is recommended for file storage of nurse evaluations and peer feedback

Dropbox at U-M is a cloud file storage
option that provides automatic back-up
and is readily accessible from any device.

Per Diem/Temp Nurses



ALERT: DO NOT attempt to fill forms in the website. Download (save) fillable PDF forms to your computer, flash drive or H drive first. Close the website. Fill saved form only using Adobe Acrobat - do not use other PDF software.

  • Include RN name and year in new file name.
  • Close the website view of the form (Chrome, Edge, etc.) after downloading.
  • Go to your File Explorer from your computer's Start menu to open and complete the form - this opens the form in Adobe Acrobat.
  • Your responses may not save if you attempt to complete the form in your web browser.

For RNs Due for Evaluation:

For Peers Providing Feedback:


For Clinical Nursing Directors and Supervisors

Within the anniversary month of the nurse, the clinical nursing director/supervisor should:

  1. Receive completed Peer Feedback forms - The clinical nursing director/supervisor should save and print all peer feedback forms received for employee's blue folder and the evaluation meeting.
  2. Complete the clinical nursing director/supervisor portion of the evaluation form - When the nurse provides the completed self-evaluation form, the clinical nursing director/supervisor should view the nurse's responses and enter clinical nursing director/supervisor responses/ratings within each section as prompted, and prepare any additional supporting materials (please use Template). Clinical nursing director/supervisor should utilize peer and self-evaluations as well as own knowledge of employee performance, include supporting comments for behaviors in the summary section(s), and include rationale for ratings other than “meets expectations”.
  3. Arrange an appointment to meet with the nurse. The clinical nursing director/supervisor may send the completed evaluation form via email for review prior to the meeting to allow conversation to be focused on goals.
  4. Meet with the nurse and finalize the performance evaluation process. The clinical nursing director/supervisor should print the completed annual evaluation form and any additional supporting information for review/signature. Printed peer feedback forms should be attached to the printed evaluation for the RN's blue folder and HR. All items should be sent to HR for placement in RN's blue folder. The clinical nursing director/supervisor should provide the RN with a copy of all performance evaluation materials.

Leadership-initiated Evaluations (for use ONLY when RN does not provide self data)

Leadership should use above forms as needed for leadership-initiated evaluations.

Performance Evaluation Tracking

Tracking Log Template (Excel) - for unit tracking of performance evaluation process documents/steps

Per Diem/Temp Nurses





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Target Audience: UMHS Nursing | Contact: Kathy Dunnuck | Last updated: 10/20/21