Clinical Performance Evaluation Tool

Report
Student Evaluation in a
Concept Based Curriculum
Lorraine P. Buchanan, RN, MSN
University of Kansas School of Nursing
Contact Information
Lorraine Buchanan, RN, MSN
Clinical Instructor,
University of Kansas School of Nursing
913-588-3355
[email protected]
1
Objectives
The objectives for this session are:
 Participants will discuss methods of evaluating a
concept in the classroom and the clinical setting.
 Participants will describe converting traditional
classroom and clinical evaluation methods for use
in concept-based courses.
2
Classroom- Nurs 338/Nurs 474
 N338 is a junior level, second semester nursing course in
the KU Undergraduate School of Nursing concept based
curriculum, 3 credit hours.
 N474 is a senior level , first semester nursing course in the
KU Undergraduate School of Nursing concept based
curriculum, 4 credit hours.
 Involves teaching Health and Illness Concepts
(i.e. Family dynamics, Oxygenation I, Perfusion I, Anxiety)
 We do NOT teach to a specialty.
 We are educating a Generalist Nurse.
Concept Based Classroom Curriculum
 As part of the new curriculum, we wanted students involved
in their own learning.
 Key points to remember:




Student discover so they will remember and transfer knowledge.
Faculty facilitate and guide student.
More active learning occurs.
Content saturation is minimized.
4
Team Based Learning
Tell me and I’ll forget,
Show me and I may remember,
Involve me and I’ll understand.
--Chinese Proverb
5
Concepts for Nurs 332 Health and Illness:
Foundations
Biophysical Concepts
Semester I Nurs 332 – 3
credit hours
1. Health Promotion &
Illness Prevention
6. Mobility
7. Comfort
8. Nutrition
9. Tissue Integrity
10. Infection
11. Inflammation
12. Thermoregulation
13. Elimination
15. Sleep
Psychosocial Concepts
Semester I Nurs 332 – 3
credit hours
1. Clinical Reasoning
2. Interpersonal
Relationships
3. Stress & coping
4. Patient Education
14. Self-concept
6
Concepts for Nurs 338 Health and Illness II:
Lifespan
Semester II Nurs 338 –
3 credit hours
3. Fluid Balance
4. Electrolyte Balance
5. Metabolism
6. Oxygenation I
7. Acid-Base Balance
8. Perfusion I
12. Sensory-Perceptual
13. Fatigue
Semester II Nurs 338 –
3 credit hours
1. Human
Development
2. Family Dynamics
9. Anxiety
10. Mood & Affect
11. End of Life
7
Concepts for Nurs 474 Health and Illness III:
Diverse Populations
Semester III Nurs 474 –
4 credit hours
1. Oxygenation II
2. Reproduction
3. Perfusion II
4. Clotting
5. Cognitive
Impairment
9. Immune Response
10. Intracranial
Regulation
11. Cellular Regulation
14. Genetic
Association
15. Sexuality
Semester III Nurs 474 –
4 credit hours
1. Addiction
2. Behavior/Temperam
ent
3. Abuse
12. Altered Thought
Process
13. Spirituality
8
Classroom Concept Delivery
 Team based learning has five major components for
course delivery. They are:





Individual Quiz
Team Quiz
Concept Mini-Lecture
Case Involvement- Concept Activity-Adobe Connect
Group Discussion-Presentations and ”Huddle”
9
Classroom Evaluation
The Concept Based, team based courses have six major
components of course evaluation. They are:
 Individual Quiz score
 Team Quiz score
 Peer Evaluation/Attendance points
 3 or 4 Exam scores
 Critical Thinking (Essay) score
 Standardized Testing score (Practice and Proctored Exam)
10
Adobe Connect
 Used to evaluate student understanding of concept.
 Wanted each team accountable for their entry and
work on case study.
 Needed a method that allowed all 16 teams to enter
data at the same time=immediate insight.
 Wanted a way for faculty to monitor team entry.
 Allows faculty to evaluate understanding and
challenge student thinking.
 Needed to be able to print feedback from case so
faculty could use it for a “huddle” or case summary.
Individual Case Studies
Guide for Case Study
Evaluation
Adobe Connect Chat for Multiple
Case Studies
Huddle Worksheets from Chat
 Use chat to make “huddle” summary worksheets.
 Huddle worksheets summarize important points of the
case studies for the concept.
 Students use Huddle worksheets to study for the
exam.
Huddle Worksheet
Multiple Choice Exams
 Each exam covered 3-5 concepts per exam.
 Included general concept questions + exemplar
content questions.
 Questions assessed understanding of concpet via
application and analysis of concept information.
 Developed using NCLEX style questions
17
Exam Review
18
Exam- Multiple Choice QuestionExample
The nurse is planning care for a patient with fatigue
from Infectious Mononucleosis. Based on her
understanding of this concept, which of the following
nursing diagnoses is a priority for this patient?
A. Bowel Incontinence
B. Ineffective Activity Planning
C. Disturbed Body Image
D. Activity Intolerance
19
Exam- Multiple Choice QuestionAnswer
The nurse is planning care for a patient with fatigue
from Infectious Mononucleosis. Based on her
understanding of this concept, which of the following
nursing diagnoses is a priority for this patient?
A. Bowel Incontinence
B. Ineffective Activity Planning
C. Disturbed Body Image
D. Activity Intolerance
20
Exam- Multiple Choice QuestionRationale
Rationale: Fatigue in the patient with Infectious
Mononucleosis is aggravated by exertion, so the
nurse would choose activity intolerance as a priority
nursing diagnosis. The patient with this disease will
likely not experience bowel incontinence or a
disturbed body image. The problem is not that the
client is unable to plan activities, but that the patient
does not tolerate the activity due to the fatigue from
the disease process.
21
Concept Critical Thinking (Essay)
 Used as part of the final exam to evaluate their
comprehensive understanding of the concepts
discussed throughout the semester.
 25 pts of the approx 500 or 600 point course.
 See handout for sample.
22
Critical Thinking (Essay) Example
23
Hands-on Activity
 Pair up with someone.
 Review the 2 Critical Thinking Exams (Essays)
 Select Pediatric or Adult Case Study.
 Try to identify for each question the concept that is
being evaluated.
 Discussion answers as an entire group.
24
Concept List
25
Concepts for Nurs 338 Health and Illness II:
Lifespan
Semester II Nurs 338 –
3 credit hours
3. Fluid Balance
4. Electrolyte Balance
5. Metabolism
6. Oxygenation I
7. Acid-Base Balance
8. Perfusion I
12. Sensory-Perceptual
13. Fatigue
Semester II Nurs 338 –
3 credit hours
1. Human
Development
2. Family Dynamics
9. Anxiety
10. Mood & Affect
11. End of Life
26
Concepts in the Adult Essay
Sara Jones case had these concepts:
 Metabolism
 Anxiety and Mood/Affect
 Clinical Reasoning *
 Nutrition *
 Electrolyte Balance (Calcium)
 Perfusion I
 Comfort *
 Human Development
 Family Dynamics
 *Denotes concepts from Health and Illness: I Foundations
27
Concepts in the Pediatric Essay
Maggie case had these concepts:
 Fluid Balance
 Clinical Reasoning *
 Electrolyte Balance (Potassium)
 Acid- Base Balance
 Oxygenation I
 Family Dynamics
 Human Development
 Patient Education *
 *Denotes concepts from Health and Illness: I Foundations
28
Moving on to Clinical Evaluation
 During a comprehensive curriculum revision, faculty
developed a plan to scaffold core clinical
competencies/concepts through the undergraduate
clinical experiences.
 Eight broad core competencies/ clinical concepts
were developed from the QSEN competencies and
The Essentials of Baccalaureate Education for
Professional Nursing Practice (AACN, 2008.
29
KU Clinical Concept Model
Quality
Improvement
Patient
Centered
Care
Evidence
Based
Practice
Safety
Competent
as a Novice
Generalist
Nurse
Systems
Based
Practice
Informatics
&
Technology
Teamwork &
Collaboration
Professional
-ism
Clinical Evaluation
 How do we evaluate the student in clinical?
 What is an FLA and DPC?
 Review evaluation tools.
 How are the Health and Illness and Professional
nursing concepts included and evaluated in clinical?
31
What is a DPC and FLA?
 DPC= Direct Patient Care
 FLA= Focused Learning Activity
 Let’s take a look at some evaluation tools and a few
examples of what we use to evaluate the students.
32
Clinical Performance Evaluation
Tool
PURPOSE:
The clinical performance evaluation tool is used to measure the
student’s clinical performance as described by the course
objectives in the clinical practicum.
INSTRUCTIONS:
The evaluation tool is used in an ongoing manner as
eachstudent progresses through the course.
33
Clinical Performance Evaluation ToolStudent Instructions
Student performance is to be monitored by both student and instructor, and
behavior documented with supporting comments. The student is
responsible for supplying sufficient data for evaluation. The student
should seek assistance, guidance and/or consultation of his/her instructor
as necessary to evaluate or improve student performance.
Students must obtain a satisfactory grade in the DPC and all FLAs to pass
the clinical course. The student can only fail an FLA one time and repeat
it once otherwise they receive an unsatisfactory in clinical. The student
will then have to repeat the clinical practicum next time it is offered.
Student and faculty will also complete a mid-term and final evaluation.
Conferences will be held at these times to discuss clinical progress and
final grade. It is the student's responsibility to attend the mid-term and
final evaluation conference prepared to discuss their progress toward
meeting the objectives of this course. The student is to initial and date
evaluation tool each time he/she reviews the faculty's evaluation
34
Clinical Performance Evaluation ToolRating Key
S
U
NP
Satisfactory
Student able to meet the
criterion
Unsatisfactory Student fails to meet the
criterion
Not Practiced Student has not had the
opportunity yet to complete
this assignment
35
Clinical Evaluation Tool Sample
36
37
38
39
Clinical Paperwork for DPC
40
DPC Student Guidelines from Playbook
41
Junior Level, 2nd Semester- Lifespan Clinical
DPCStudent Instructions
• Go to the unit, find your assignment posted and review the EHR of your
patient(s) to become prepared for clinical practicum.
• Utilize Preclinical Conference patient workup, Laboratory/Diagnostic
Tests, Medication Information sheets to guide this preparation.
• Bring completed preparation forms to pre-conference on the clinical day.
This will guide you in your presentation to faculty. The faculty may ask to
review them.
• At end of each clinical day of DPC, complete reflection in the on-line
Reflective Practice Journal (ANGEL Nurs 339 Health and Illness: Nursing
Across the Lifespan Practicum). There are different reflection questions
for the first part of clinical (prior to spring break) and the last part of clinical
(after spring break).
42
Clinical Grade Profile ToolInstructions
Grade Determination for Clinical Performance
Students must complete all assignments with either “proficient”,
”satisfactory” or a grade of 80% to pass this clinical course satisfactorily.
The student may repeat an assignment only once to achieve the
satisfactory standard. Inability to complete any assignment satisfactorily
in two tries indicates failure of the course.
If a student demonstrates unprofessional behavior or delivers unsafe patient
care, the NURS 333 clinical faculty will discuss the student’s situation with
the Clinical Coordinator and make a decision regarding the student’s
status in the clinical course and grade.
43
Clinical Grade Profile Tool Sample
A grade of 80% must be obtained on this component of the Clinical Grade Profile to pass this course
satisfactorily.
*FLA: Focused Patient Assessment & Care Plan
__________
A grade of “Proficient” or “Satisfactory” must be obtained on these components of the Clinical Grade Profile to
pass this course satisfactorily.
Direct Patient Care (DPC)
__________
FLA: Pump Lab
__________
FLA: Interdisciplinary I-SBARR Lab
__________
FLA: Safety Simulation-Sam Jayhawk & James Robinson
__________
*FLA: Change Intervention
__________
*FLA: Focused Assessment
__________
*FLA: Medication Administration Observation
__________
*FLA: Intraprofessional Team Member Interview
*FLA: Evidence-based Practice
__________
__________
__________
*FLA: Therapeutic Communication-Process Recording
*Print and bring all of these FLAs to each clinical experience because the clinical environment is dynamic and
you need to be prepared to do other learning activities besides the one assigned that day.
44
Senior Clinical Evaluation Tool Sample
45
46
47
Senior Level- 2nd semester- Diverse ClinicalFLAInterdisciplinary Team Conferences/Rounds
48
Senior Clinical Evaluation Tool
49
Senior Level – 2nd semester- Diverse
Clinical- FLAInterdisciplinary Team Conferences/Rounds- Grading Rubric
Competency
Attends team rounds
during time in clinical
practicum.
Identifies all team
members participating
in team rounds
Identifies team
members who
evaluate patient
outcomes but could
not attend team
rounds
Identifies nurse’s
contribution to the
team
Assumes nurse’s role
in team meeting at
least twice during
rotation
Satisfactory
Attends 80% of team
rounds.
Unsatisfactory
Attends 50% or less team
rounds.
Accurately identifies most
team members and requires
no prompting.
Identifies many other team
members who could
contribute to the evaluation
of patient outcomes and
requires no prompting.
Unable to identify most team
members; or requires
significant prompting.
Identifies a few team members
who could contribute to the
evaluation of patient outcomes
or needs significant prompting.
Discusses nurse’s role in
team rounds with no
prompting.
Assumes nurse’s role in
team rounds at least twice
during rotation and requires
no prompting.
Unable to identify nurse’s role
in team rounds or requires
significant prompting.
Unable to assume nurse’s role
in team rounds without
significant prompting.
50
Student Reflection Questions
Who led the team conference?
Identify any differences in how individual team members talked
to the team leader (authority gradient)?
What outcomes were being monitored?
What would you change about your performance during the
team conference/rounds in preparation for the next time you
participate?
51
Course-Senior Level- 2nd semesterPopulations-Based Clinical- FLA
Physical/Social Determinants of Health for a PopulationGrading Rubric
Behavior
Satisfactory
Unsatisfactory
Collects comprehensive data when
assessing a target population and
includes windshield survey and key
informant interviews.
Identify key environmental/social health
issues of assigned population
Completed windshield survey form with
accurate comprehensive data of target
population. Lists the key informants to the
interview
Identified 3 key environmental or social
health problems from the
environmental/social assessment or
windshield survey assignment.
Adequately described resources and
strengths of assigned population to address
identified environmental health needs.
Windshield survey does not accurate reflect
population data or is incomplete. Key
informants were not utilized in data
collection.
Identified environmental health problems
that did not relate well to assigned
population.
Described two community strategies to
address identified environmental/social
health issue.
Does not thoroughly describe strategies to
address identified environmental/social
health issue.
Determines resources and strengths
within assigned population to address
identified environmental/social health
issues
Recommends two strategies to address
the identified health issue
52
Did not adequately describe resources
and/or strengths of assigned population to
address environmental health issues.
Course-Senior Level- 2nd semesterPopulations-Based Clinical- FLARecommendations for Clinical Instructor:
 This will be assigned during the first rotation.
 The faculty will assign students to care for patients on DPC days. These
are the patients that the student will watch or participate in team rounds
with.
 Inform the nurse assigned to the patient that the student is expected to
attend team rounds.
 Schedule the last two DPC days for the student to participate in the team
rounds. Student may participate more than the last two days.Attend the
rounds or obtain nurse’s feedback about the student’s performance in
team rounds.
53
Questions?

similar documents