1rate Yourselfaccording Toyour Confidence Levelperforming The Skil ✓ Solved

1. Rate yourself according to your confidence level performing the skills identified in the Clinical Skills Self-Assessment Form.  2. Based on your ratings, summarize your strengths and opportunities for improvement.   3. Based on your self-assessment and theory of nursing practice, develop four (4) measurable goals and objectives for a practicum experience.  4. Include them on the designated area of the form.

Self-Assessment Form Desired Clinical Skills for Students to Achieve Confident (Can complete independently) Mostly confident (Can complete with supervision) Beginning (Have performed with supervision or needs supervision to feel confident) New (Have never performed or does not apply) Comprehensive psychiatric evaluation skills in: Recognizing clinical signs and symptoms of psychiatric illness across the lifespan X Differentiating between pathophysiological and psychopathological conditions X Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies) X Performing and interpreting a mental status examination X Performing and interpreting a psychosocial assessment and family psychiatric history X Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).

X Diagnostic reasoning skill in: Developing and prioritizing a differential diagnoses list X Formulating diagnoses according to DSM 5 based on assessment data X Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes X Pharmacotherapeutic skills in: Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management) X Evaluating patient response and modify plan as necessary X Documenting (e.g., adverse reaction, the patient response, changes to the plan of care) X Psychotherapeutic Treatment Planning: Recognizes concepts of therapeutic modalities across the lifespan X Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation) X Applies age appropriate psychotherapeutic counseling techniques with individuals and/or any caregivers X Develop an age appropriate individualized plan of care X Provide psychoeducation to individuals and/or any caregivers X Promote health and disease prevention techniques X Self-assessment skill: Develop SMART goals for practicum experiences X Evaluating outcomes of practicum goals and modify plan as necessary X Documenting and reflecting on learning experiences X Professional skills: Maintains professional boundaries and therapeutic relationship with clients and staff X Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings X Identifies ethical and legal dilemmas with possible resolutions X Demonstrates non-judgmental practice approach and empathy X Practices within scope of practice Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals: Demonstrates selecting the correct screening instrument appropriate for the clinical situation X Implements the screening instrument efficiently and effectively with the clients X Interprets results for screening instruments accurately Develops an appropriate plan of care based upon screening instruments response X Identifies the need to refer to another specialty provider when applicable X Accurately documents recommendations for psychiatric consultations when applicable X Summary of strengths: Opportunities for growth: write four (4) possible goals and objectives for this practicum experience.

Ensure that they follow the SMART Strategy, as described SMART STRATEGY: Goals • Is it specific? • Is it measurable? • Is it achievable? • Is it relevant? • Is it timely? 1. Goal: a. Objective: b. Objective: c.

Objective: 2. Goal: a. Objective: b. Objective: c. Objective: 3.

Goal: a. Objective: b. Objective: c. Objective: 4. Goal: a.

Objective: b. Objective: c. Objective: Chapter 5 Evidence-Based Practice Definitions #1 Variety of definitions, interpretations Definition according to David Sackett Definition by Sigma Theta Tau International Use of the term best practice by industries Association with “benchmarking†Now, one of the less scientific forms of evidence used Definitions #2 Goal: provide optimal patient care Enhancement of nursing practice Improvement of patient or system outcomes Use of Evidence-Based Practice #1 Why? Control of health care costs: early stimulus Provision of highest quality patient care: selection of optimal interventions for patients Patient satisfaction Use of Evidence-Based Practice #2 When and Where?

Priority across nursing specialties (see Table 5.1) Valued across nursing roles and responsibilities Preparation of nurse leaders and administrators Refinement of nursing curricula Expectation of staff nurses to participate in or lead initiatives Use of Evidence-Based Practice #3 Around the World Worldwide commitment Australia (the Joanna Briggs Institute) Canada (Registered Nurses’ Association of Ontario) United Kingdom Nursing Knowledge International (NKI): international clearinghouse, facilitator Question #1 Is the following statement true or false? The term evidence-based practice was first defined during the time of Florence Nightingale. Answer to Question #1 False Evidence-based practice emerged as a term in response to the ongoing expansion and demanding changes in health care.

It evolved when discussions of evidence-based medicine were expanded to include an interdisciplinary audience. David Sackett, one of the leaders of the movement, defined evidence-based medicine. Sigma Theta Tau expanded the definition to address nursing. Determination of Evidence-Based Practice Questions arising in practice settings Nurses empowered to ask critical questions (see Box 5.1) Questions leading to decision making to affect outcomes Best answers, decisions from informed, evidence-based analysis of each situation Sources of Evidence #1 Tradition based Consultation with more experienced, educated, higher-authority-level nurse Institutional standards, procedure manuals Coworkers, other health care providers Sources of Evidence #2 Evidence based Research Randomized controlled trial (RCT): considered the gold standard of clinical evidence Integrative review Meta-analysis Additional Sources of Evidence Benchmarking data Clinical expertise Cost-effectiveness analyses Infection control data Medical record review data National standards of care Pathophysiologic data Quality improvement data Patient and family preferences Question #2 Is the following statement true or false?

Institutional standards are considered evidence based. Answer to Question #2 False Institutional standards and procedure manuals are typically considered sources for tradition-based evidence rather than evidence-based information. Support Mechanisms for Best Evidence Garner administrative support Collaborate with research mentor (see Box 5.3) Seek assistance from professional librarians Search already reviewed or summarized research (journals, Cochrane Collaboration, AHRQ) Access resources from professional organizations (AACN, AWHONN, AORN, ONS) Benchmark with high-performing teams, units, institutions Mechanisms for Incorporation Into Practice Development, refinement of research-based policies, procedures Protocols, algorithms, decision trees, standards of care, critical pathways, care maps, institutional clinical practice guidelines Consensus of interdisciplinary team Patient, family support Challenges to Implementation #1 Accessibility of research findings Anticipated outcomes of using research Support from others Lack of organizational support (Funk et al., 1991) Spiva and colleagues (2017) used this instrument in the implementation of a mentoring program to promote evidence-based practice Challenges to Implementation #2 Practicing nurses often feel overwhelmed by the volume of research on their topics of interest Practicing nurses often lack the time and experience to be able to efficiently read and synthesize the literature Practicing nurses struggle with the political challenges of attempting to change long-standing policies and procedures in their clinical settings See Box 5.4 Question #3 Which of the following would a nurse most likely need to address as the greatest obstacle when planning to implement evidence-based practice?

A. Accessibility of research findings B. Support from others C. Setting D. Organizational support Answer to Question #3 D On the basis of research about barriers to implementing evidence-based practice, lack of organizational support was perceived to be the most significant limitation. End of Presentation

Paper for above instructions

Self-Assessment Overview

Engaging in a self-assessment provides a valuable opportunity for reflection on one's clinical skill set. After evaluating my confidence levels in performing various skills outlined in the Clinical Skills Self-Assessment Form, I have identified a range of strengths as well as areas where I can improve. The purpose of this assignment is to synthesize my self-assessment results, highlight my strengths and weaknesses, and set SMART goals for my upcoming practicum experience.

Confidence Level Ratings

1. Comprehensive Psychiatric Evaluation Skills
- Recognizing clinical signs and symptoms of psychiatric illness across the lifespan: Confident
- Differentiating between pathophysiological and psychopathological conditions: Mostly confident
- Performing and interpreting a comprehensive and/or interval history and physical examination: Beginning
- Performing and interpreting a mental status examination: Mostly confident
- Performing and interpreting a psychosocial assessment and family psychiatric history: Beginning
- Performing and interpreting a functional assessment: Beginning
2. Diagnostic Reasoning Skills
- Developing and prioritizing a differential diagnoses list: Beginning
- Formulating diagnoses according to DSM-5: Mostly confident
- Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes: Beginning
3. Pharmacotherapeutic Skills
- Selecting appropriate evidence-based clinical practice guidelines for medication plan: Mostly confident
- Evaluating patient response and modifying plans as necessary: Beginning
- Documenting patient response, adverse reactions, changes to the plan of care: Beginning
4. Psychotherapeutic Treatment Planning
- Recognizes concepts of therapeutic modalities across the lifespan: Beginning
- Selecting appropriate evidence-based clinical practice guidelines for psychotherapeutic plan: Beginning
- Applies age-appropriate psychotherapeutic counseling techniques: Beginning
- Develop an individualized plan of care: Beginning
- Provide psychoeducation and promote health: Beginning

Summary of Strengths

From the self-assessment, my strengths lie predominantly in recognizing clinical signs and differentiating existing psychopathological conditions. I feel confident in formulating psychiatric diagnoses and can effectively utilize some pharmacotherapeutic guidelines. Additionally, my understanding of mental health across the lifespan enables me to approach patients with compassion and precision.

Opportunities for Growth

There remain several opportunities for improvement, particularly in comprehensive psychiatric evaluations, diagnostic reasoning, and psychotherapeutic treatment planning. More specifically, I need to enhance my skills in interpreting assessments, refining differential diagnoses, modifying medication plans, and developing individualized care plans.

SMART Goals for Practicum Experience

Setting SMART goals—specifically Measurable, Achievable, Relevant, and Timely—will guide my learning and development during the practicum. Below are four measurable goals and specific objectives for each.

Goal 1: Enhance Assessment Skills

- Objective 1: By the end of the first month of the practicum, I will perform at least three comprehensive psychiatric evaluations independently, demonstrating improved confidence in recognizing signs and symptoms of psychiatric disorders.
- Objective 2: I will seek feedback from clinical supervisors on my evaluation techniques, aiming for an improvement in feedback score from a baseline of "Beginning" to "Mostly Confident" by the end of six weeks.
- Objective 3: I will complete additional readings and practice mental status examinations, aiming to demonstrate understanding by achieving a score of at least 80% on a related evaluation quiz by the end of the practicum.

Goal 2: Improve Diagnostic Reasoning

- Objective 1: I plan to develop and prioritize differential diagnosis lists for at least five distinct patient cases in my practicum, aiming for a minimum of 75% accuracy as evaluated by my mentors.
- Objective 2: I will participate in four case discussions with colleagues to engage in collaborative reasoning and the application of DSM-5 criteria, aiming to synthesize learned material effectively by presenting a case analysis to peers at the practicum's end.
- Objective 3: I will track my progress in differentiating normal and abnormal age-related symptoms, completing a reflective journal weekly to document insights and receive feedback from my supervisor.

Goal 3: Master Pharmacotherapeutic Planning

- Objective 1: I will select appropriate medication plans for three patients during my practicum, correlating them with evidence-based guidelines, and document my rationales, aiming for supervisor review and approval on 100% of cases.
- Objective 2: I will monitor and document medication responses for all patients assigned to me within one week of initiation, ensuring timely adaptations if adverse reactions occur.
- Objective 3: I will participate in a workshop on pharmacotherapy that occurs during the practicum period, ensuring that I can apply evidence-based guidelines to my professional practice effectively.

Goal 4: Strengthen Psychotherapeutic Skills

- Objective 1: I will construct and implement at least two age-appropriate individualized care plans for patients, with 100% feedback from clinical supervisors, aiming for complete satisfaction in meeting patient needs.
- Objective 2: I will provide psychoeducation to at least two caregivers during my practicum, measuring effectiveness through pre-and post-education questionnaires to evaluate gains in caregiver knowledge.
- Objective 3: I will seek out one-on-one mentoring from my supervisor around psychotherapeutic modalities to understand better and apply treatment techniques, aiming for at least 60 minutes of direct supervisor contact weekly.

Conclusion

My self-assessment has highlighted both my strengths and areas needing enhancement in my clinical skills as I move into my practicum experience. By formulating specific, measurable, achievable, relevant, and timely goals, I intend to guide my learning and development effectively. Continuous evaluation and reflection will be integral to my success in achieving these goals and improving my capabilities as a future nursing professional.

References

1. Sackett, D. L., Rosenberg, W. M., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence-based medicine: What it is and what it isn't. BMJ, 312(7023), 71-72.
2. Sigma Theta Tau International. (2008). Evidence-based practice: A toolkit for the nursing profession. Sigma Theta Tau International.
3. Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. Wolters Kluwer Health.
4. Funk, S. G., Champagne, M. T., Tornquist, E. M., & Wiese, R. A. (1991). BARRIERS: The barriers to research utilization scale. Applied Nursing Research, 4(1), 40-46.
5. Spiva, L., Ralston, S., & Daniel, L. (2017). Evidence-based practice implementation: A mentoring program. Journal of Nursing Administration, 47(2), 53-59.
6. Rycroft-Malone, J., & Bucknall, T. (2010). Models and frameworks for implementing evidence-based practice: Linking evidence to action. Wiley-Blackwell.
7. Bowers, A. A., & Allen, K. J. (2020). Barriers to the implementation of evidence-based practice: A systematic review. Nursing Research and Practice, 2020.
8. Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-Based Practice: Step by Step: Implementing an Evidence-Based Practice Change. American Nurse Today.
9. Peters, M. D. J., Godfrey, C. M., Khalil, H., McInerney, P., Marnie, C., & Parker, D. (2015). Guidance for conducting systematic scoping reviews. International Journal of Evidence-Based Healthcare, 13(3), 141-146.
10. Gradinger, F., et al. (2014). The impact of educational interventions on the achievement of evidence-based practice—A systematic review. Implementation Science, 9(1), 17.