29 Mar Journal to reflect on your clinical strengths and opportunities for improvement
JOURNAL ENTRY
Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes.
Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum.
TO PREPARE
Refer to the “Advanced Nursing Practice Competencies and Guidelines” found in the Week 1 Learning Resources, and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
Refer to your “Clinical Skills Self-Assessment Form” you submitted in Week 1, and consider your strengths and opportunities for improvement.
Refer to your Patient Log in Meditrek, and consider the patient activities you have experienced in your practicum experience. Reflect on your observations and experiences.
In 450–500 words, address the following:
Learning From Experiences
Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?
What did you learn from this experience?
What resources did you have available?
What evidence-based practice did you use for the patients?
What new skills are you learning?
What would you do differently?
How are you managing patient flow and volume?
Communicating and Feedback
Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
Answer the questions: How am I doing? What is missing?
Reflect on the formal and informal feedback you received from your Preceptor.
Below is my practicum experience plan. Also Clinical self assessment form attached.
Practicum Experience Plan
Part 1: Quarter/Term/Year and Contact Information
Section A
Quarter/Term/Year:
Student Contact Information
Name:
Street Address:
City, State, Zip:
Home Phone:
Work Phone:
Cell Phone:
Fax:
E-mail:
Preceptor Contact Information
Name: Chuks Nwaulu
Organization: Changing Lives Adults and Youths Services
Street Address: 901 Woodyard Rd, Ste 109
City, State, Zip: Clinton, MD 20735
Work Phone: 240-244-2924
Cell Phone: 240-244-2924
Fax:
Professional/Work E-mail: medical@clayshc.com
Part 2: Individualized Practicum Learning Objectives
Objective 1: By the end of week 10 of this practicum quarter, I will possess the capability to conduct a comprehensive assessment and evaluation, hence enabling me to formulate an accurate diagnosis pertaining to various mental health issues.
Planned Activities: To conduct interviews, do assessments, and make evaluations on at least 80 patients across the life span in this practicum session, in order to improve on my knowledge and skill as a potential PMHNP
Mode of Assessment: Direct patient care, and Telehealth with guidance of my preceptor
PRAC Course Outcome(s) Addressed:
• To determine the mental state of a patient based on the results of the assessment and evaluation performed.
• Assess the need for, and gain, advanced nursing practice knowledge and expertise in the field of mental health care.
Objective 2: Using the DSM-5 criteria, I will be able to generate a comprehensive list of differential diagnoses and rank them accordingly by week 10 of this practicum quarter utilizing the information from the psychiatric interview.
Planned Activities: I plan to do this by using the DSM-5, my knowledge of pathophysiology, and other factors that contribute to mental illness.
Mode of Assessment: Direct patient care, and Telehealth with guidance of my preceptor
PRAC Course Outcome(s) Addressed:
• Develop differential diagnoses for patients across the life span dealing with different types of mental health disease.
• Distinguish between pathophysiological and psychopathological disorders, and gain a comprehensive understanding of the DSM-5 criteria pertaining to psychiatric diagnoses and differential diagnoses.
Objective 3: By the end of week 10, I will efficiently assess how well a patient is responding to treatment provided, then utilize that data to adjust treatment if needed, and educate patients and their families.
Planned Activities: I will do ongoing assessment on patients receiving care to learn about their perspectives on their care, and establish an appropriate care plan based on how best to help them.
Mode of Assessment: Direct patient care, and Telehealth with guidance of my preceptor
PRAC Course Outcome(s) Addressed:
• Provide patients with information regarding psychopharmacology and psychotherapy treatment plan, as well as providing them with mental health resources
• Improve patient care by creating actionable plans of care, and making adjustments to treatment plans for patients as needed.
Part 3: Projected Timeline/Schedule
I intend to complete the 160 Practicum hours (as applicable) according to the following timeline/schedule. I also understand that I must see at least 80 patients during my practicum experience. I understand that I may not complete my practicum hours sooner than 8 weeks. I understand I may not be in the practicum setting longer than 8 hours per day unless pre-approved by my faculty.
Number of Clinical Hours Projected for Week (hours you are in Practicum Setting at your Field Site) Number of Weekly Hours for Professional Development (these are not practicum hour) Number of Weekly Hours for Practicum Coursework (these are not practicum hours)
Week 1 16 4 10
Week 2 16 4 10
Week 3 16 4 10
Week 4 16 4 10
Week 5 16 4 10
Week 6 16 4 10
Week 7 16 4 10
Week 8 16 4 10
Week 9 16 4 10
Week 10 16 4 10
Week 11 0 4 10
Total Hours (must meet the following requirements) 160 Hours 44 hours 110 hours
International Council of Nurses. (2020). Guidelines on advanced practice nursing 2020Links to an external site.. Author. https://www.icn.ch/system/files/documents/2020-04/ICN_APN%20Report_EN_WEB.pdf
Student evaluation by preceptor:
The preceptor/faculty evaluates the student’s clinical performances at midquarter (Week 4-6) and final (Week 9-11).
A failure of the student to meet an objective requires a verbal and written Performance Improvement Plan completed by the supervising faculty.
Response scale:
4 = Exceeds expectations
3 = Meets expectations
2 = Needs improvement
1 = Unsatisfactory
N/A = No opportunity to assess
Below 3 needs improvement and is unsatisfactory. Please add comments if score is below a 3. Other comments welcome.
Criteria Midterm
Score Final
Score
Communication
Uses effective communication and interpersonal skills when meeting with patients, office staff, preceptor and other health care professionals. 4 4
Professionalism
Interacts in a collegial and professional manner. 4 4
Accepts constructive feedback and seeks to integrate it into clinical performance. 4 4
Is punctual and appropriately dressed. 4 4
Assumes responsibility for evaluating own progress and is able to define the areas that need improvement. 4 4
Subjective Data
Obtains an accurate, comprehensive diagnostic assessment from the client appropriate to the presenting issue and the level of the student. 4 4
Establishes a therapeutic alliance with an individual, family or group that is developmentally appropriate. 4 4
Objective Data
Performs a thorough review of systems, physical assessment (when indicated), developmental assessment, family assessment, past psychiatric history, and mental status exam appropriate to the client’s presenting issue. 3 4
Assessment
Uses information from the interview, history, clinical record review and observation of client to create a concise problem list. 4 4
Recognizes and prioritizes the issues in the problem list that need attention and generate differentials. 4 4
Determines and uses appropriate assessment tools for the clients’ presenting problem and understands the results. 4 4
Plan
Collaborates with client to develop a treatment plan, taking into consideration patient’s factors and cultural background. 4 4
Uses the literature to formulate evidence-based practice, interventions and treatment plans. 3 3
Considers issues of client safety to include risk to self and others. 4 4
Considers legal and ethical issues. 4 4
Presentation and Documentation
Oral presentation includes succinct summary of pertinent findings, diagnosis, differentials, and treatment plan, taking into consideration patient factors and cultural background. 4 3
Clear, logical and organized written documentation of patient encounters. 4 4
Average Score 3.88 3.88
Comments from midterm:
Major strengths of student:
She is willing to learn and pays attention to details.
Major area(s) needing improvement:
To work on diagnosis.
Major strengths of student:
Student is dedicated and will make a good Psych Provider. Pays attention to details.
Major area(s) needing improvement:
n/a
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