1.3140: Use effective situational communication for the purpose of conducting a holistic health assessment.

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1 11/12 SMART Report BSN Nursing (Prelicensure) Student Learning Outcomes : Use effective situational communication for the purpose of conducting a holistic health assessment. 1. Student s self-rating of course outcome. 2. Weekly Lab participation and documentation of findings. 3. Therapeutic Communications portion of the Health Assessment NCLEX simulated exam % of students will rate themselves as satisfactorily meeting the course outcome % of students will demonstrate satisfactory participation in weekly lab activities and will demonstrate satisfactory documentation of findings. 3. Students will average 900 or higher on the Therapeutic Communication portion of the Health Assessment NCLEX simulated exam % of students rated themselves as satisfactorily meeting the course outcome % of students demonstrated satisfactory participation in weekly lab activities and will demonstrate satisfactory documentation of findings. 3. Students averaged 936 on the Therapeutic Communication portion of the Health Assessment NCLEX simulated exam. Do these results indicate that this outcome was?: Yes 1. Students exceeded the desired standard of achievement

2 (96% vs. 90% in rating themselves as satisfactorily meeting the course outcome. 2. Students exceeded the desired standard of achievement (100% vs. 90%) in demonstrating satisfactory participation in weekly lab activities and demonstrating satisfactory documentation of findings. 3. Students exceeded the desired standard of achievement (936 vs. 900) on the Therapeutic Communication portion of the Health Assessment NCLEX simulated exam. No changes needed since all goals were. The outcome will continue to be monitored : Use appropriate medical terminology, English language, and technology to communicate in the healthcare environment. 1. Criterion referenced clinical evaluation communication criteria 2. Concept paper grading by rubric 3. Student course evaluation survey 1. 98% of student will achieve satisfactory evaluation of communication criteria in clinical evaluation % of students will achieve grade >80% on concept paper. 3. Mean student self-rating will be > 3.5 course survey for this learning outcome.

3 % of student achieved satisfactory clinical evaluation. 1 student failure due to attendance issues, not therapeutic communication deficits % of students received grade > 80% based on grading rubric. 3. Mean student self-rating % of students rated either "great" or "good" gains in achievement of the outcome. Do these results indicate that this outcome was?: Yes Results indicate goal was by majority of students on all measures. Faculty team has identified a need to update the clinical evaluation tool to be more appropriate to the course, rather than a generic form. Proposed changes will be brought to the Nursing Faculty organization for Fall There is a need to conduct inter-relater reliability for the paper grading rubric. This will be conducted over the next academic year. Although students rate great or good gains in communication, course survey comments indicate they do not feel they are sufficiently exposed to documentation in the medical record. Will develop plan with clinical faculty to address this in Fall : Apply effective communication in client teaching. 1a. Students self-rating of course objectives 1b.Student self evaluation through reflective journal on Effective Communication Lesson. Reflection Rubric 1c. Lecture & discussion with group work assignment.

4 1d. Module Quiz 1e. Teaching Presentation 1a. 95% of class will rate themselves as satisfactorily meeting course objective (Apply effective communication in client teaching). 1b. 90% of students reflective journals on Effective client teaching: will be scored good or above. 1c. 90% of students group work will score good performance or higher in assignment on use of professional communication techniques in teaching and learning. 1d. Students will score 90% on questions regarding effective client communication. 1e. 90% of students will score good performance or higher in Teaching Learning Presentation. 1a. 94% of the class reported meeting the objective "Apply effective communication in client teaching." satisfactorily or beyond expectations. Falling slightly below the desired standard of > 95%. 1b. 96% of the students students reflective journals on Effective Client Teaching" was scored good or above. Exceeding the desired standard of >90%. 1c. 100% of students group work assignment on "Use of Professional Communication Techniques in Teaching and Learning" scored good performance or higher. Exceeding the standard of >95% 1d. 100% of students correctly answered questions regarding effective client communication on quizzes. Exceeding the desired standard of >90% 1e. 100% of students scored >90% on the Teaching/Learning

5 Presentation. Exceeding the desired standard of >90% Do these results indicate that this outcome was?: Yes 49 of the 53 students enrolled in the class completed the course evaluation. There were 5 measures for this standard. All of the standards of measure were meet or exceeded with the exception of student self assessment which was only slightly below the standard (94% when standard was 95%). With only one of the measures falling slightly below and others exceeding the standards, I am feel the desired outcome was accomplished. However, revisions to the "Teaching and Learning" experience will be implemented in the next offering of this class in an effort to further improve students outcomes. The data collected will be used to enhance the "Teaching and Learning" experience for the students. Students in the Fall '12 courses will work in groups to develop and present their projects on a topic they know well. This will allow time for an additional class where student groups develop a healthcare teaching and learning lesson plan. Increasing the rigor of this class has been discussed in numerous meetings. The intensity of the other courses taught in the 1st semster must be carefully considered before increased rigor is implemented. There is discussion regarding the possibility of moving this course outside the nursing program and merging it with Sophomore Seminar. Increasing the rigor in this new environment maybe a more feasible option : Use effective situational communication when providing care for adult clients and families.

6 This is a new outcome; it will be assessed during the 2013 fiscal year. Do these results indicate that this outcome was?: : Demonstrate effective communication when providing care for the childbearing family This outcome was not assessed this cycle. It is a newly approved outcome that will be assessed during the 2013 cycle. Do these results indicate that this outcome was?: : Apply therapeutic communication in psychiatric care. 1. Student self-assessment of achievement of course outcome. 2. Therapeutic communication pre-class quiz and/or in class activity.

7 3. Basic therapeutic communication questions on Test #1 NRSG Care maps in Acute Care Rotations 5. Therapeutic Communication Section of NLCEX Psychiatric Simulation Exam (final) 1. 90% of the class will rate themselves 3 or above on achievement of the course outcomes (3 satisfactory/4 point scale) 2. 80% of the class will score 80% or higher on therapeutic communication pre-class quiz and/or in class activity 3. 80% of the class will respond correctly to the basic therapeutic communication questions on Test #1 NRSG % of randomly selected final care maps will correctly identify therapeutic techniques. (20% of class should be selected) 5. The class average on the Therapeutic Communications section (NLNAC categories) of NLCEX Psychiatric Simulation Exam (final) will be 850 or greater (25 items) % of the students that responded rated themselves 3 or higher (4-Meet objective to a degree beyond my expectationsfeel very comfortable with this concept-3 Meet objective satisfactorily-feel fairly comfortable with this objective (53 of 53 students responded) % of the 53 students scored 80% or above on the prequiz. 3. Average of 80.5 % of the class responded correctly to the 9 items on basic therapeutic communication questions on Test #1 NRSG % of randomly selected final care plans/maps (9 out 11) correctly identified therapeutic techniques (20% of class, 11 out of 53, was randomly selected). 5. The class average on the NLNAC Therapeutic Communications

8 section (NLNAC categories) was 943. Do these results indicate that this outcome was?: Yes The results indicate the outcome was because all the benchmarks were achieved at the minimal or above level. The means of assessing this outcomes will stay the same. Faculty believe the results are logical. Scores on therapeutic communication are well above the benchmark at the beginning of the semester on the pre class quiz (unmonitored 10 point quiz) and a little above the benchmark on the unit one monitored exam The scores on the NCLEX simulation are well above the 850 benchmark and this measure is at the end of the semester. Clinical work (care maps) are at various points during the semester based on the student's rotation schedule. Students have mastered the concept by the end of the semester and their self-evaluation indicates they believe they have achieved this outcome at the satisfactory level. The only change that will be made at this point in time is the size of the random sample. In discussion with some of the math faculty on the University Assessment Team it was decided that 30% would be a more appropriate random sample based on the usual class sizes in nursing. There is a good mix of indirect and direct measures that represent classroom and clinical learning : Use effective situational communication in population focused community settings This outcome was not assessed this cycle. It is a newly approved outcome that will be assessed during the 2013 cycle.

9 Do these results indicate that this outcome was?: : Collaborate with the pediatric client, their families/designee, and the healthcare team to provide compassionate and coordinated care to maximize health potential. This outcome was not assessed this cycle. It is a newly approved outcome that will be assessed during the 2013 cycle. Do these results indicate that this outcome was?: : Utilize scholarly writing in professional communication. This outcome was not assessed this cycle. It is a newly approved outcome that will be assessed during the 2013 cycle. Do these results indicate that this outcome was?:

10 1.4580: Use effective situational communication when providing complex care for multiple adult clients and families. This outcome was not assessed this cycle. It is a newly approved outcome that will be assessed during the 2013 cycle. Do these results indicate that this outcome was?: : Use effective situational communication in leadership roles This outcome was not assessed this cycle. It is a newly approved outcome that will be assessed during the 2013 cycle. Do these results indicate that this outcome was?:

11 1.4980: Use effective situational communication. This outcome was not assessed this cycle. It is a newly approved outcome that will be assessed during the 2013 cycle. Do these results indicate that this outcome was?: : Construct an individualized, evidenced based nursing plan of care to support physiologic and psychosocial integrity. 1a.Criterion referenced clinical evaluation 1b. Care plan grading rubric 1c.Exams 2,3 and 4 content regarding promotion of physiologic integrity. 1.d Course evaluation survey

12 1a.98 % of students will achieve satisfactory evaluation. 1b.100% of students will achieve satisfactory (> 75%) on 2 care plans within 3 attempts. 1c.98% of students will achieve exam average sufficient for progression within the nursing program (> 75%). 1d. 80% of students or better will score themselves as having achieved this outcome at the satisfactory or above satisfactory level. a % of students achieved satisfactory clinical evaluation. 1 student failure due to attendance issues, not care plan deficits. b % of students achieved this goal. The student who failed the clinical portion of the course was not required to complete a second care plan. c % of course progressed. Course failure due to clinical attendance issues, not exam content. Do these results indicate that this outcome was?: Yes Students learning outcomes. Many new exam items were used as a result of curriculum changes, and some were not effective. Informal student feedback indicates students do not always see the value in these assignments. Revision of clinical evaluation tool to be conducted academic year Creation of smaller lab assignments prior to care plan will enable increased student feedback and attempt to show students relationship between thinking like a nurse and the assignments. Exam item development and testing will continue. Will consider using portion of HESI standardized exam as an objective measure in future.

13 2.3340: Identify components of evidenced based practice. 1. Students self-assessment of achieving course outcome. 2. Bib card assisgnment 3. Geriatric assignment 4. Quiz questions 1. 95% of class will rate themselves as satisfactorily meeting course outcome % of the class will achieve a satisfactory grade on the bib card assignment. 3. > 95% of the class will score 90% or above on the presentation 4. 90% of class will answer the evidence based practice questions correctly % of the students rated themselves as satisfactorily meeting this course outcome. Exceeding the desired standard of 95% % of the students achieved a satisfactory grade on the bib card assignment. Exceeding the desired standard 90% % of the students scored of the students scored 90 or above on the presentation. Exceeding the desired standard of > 95% % of students answered the evidence based practice questions correctly. Exceeding the desired standard of 90%.

14 Do these results indicate that this outcome was?: Yes All standards were or exceeded for this outcome. I am satisfied that it measures the outcome appropriately by utilizing diverse assignments with different measures that are presented throughout the semester. The content supporting this outcome will be continued in the upcoming semester. Increasing the rigor of this class has been discussed in numerous meetings. The intensity of the other courses taught in the 1st semester must be carefully considered before increased rigor is implemented. There is discussion regarding the possibility of moving this course outside the nursing program and merging it with Sophomore Seminar. Increasing the rigor in this new environment maybe a more feasible option : Identify current scientific evidence relevant to providing psychiatric nursing care. 1. Student self assessment of achievement of course outcome. 2. Service-learning project evaluation - self-rating of outcome on evidence-based psychiatric planning 3. Research and EBP QSEN sub score of the NLCEX Psychiatric Simulation Exam (final) 1. 90% of the class will rate themselves 3 or above on achievement of the course outcome (3 satisfactory/4 point scale) 2. Based on the service-learning project evaluations, 90% of the

15 class will rate themselves 3 or above on achievement of the outcome on evidence-based psychiatric planning (3 satisfactory/4 point scale). 3. The class average on the Research and EBP QSEN sub score of the NLCEX Psychiatric Simulation Exam (final) will be 850 or greater % of the class rated themselves 3 or above on achievement of the course outcome (3 satisfactory/4 point scale) 2. Based on the service-learning project evaluations, 88.4% of the class rated themselves 3 or above on achievement of the outcome on evidence-based psychiatric planning (3 satisfactory/4 point scale). 3. The class average on the Research and EBP QSEN sub score of the NLCEX Psychiatric Simulation Exam (final) was 885 Do these results indicate that this outcome was?: No Only 2 of the 3 benchmark measures were achieved. Each semester there are a variety of new service learning projects. Possibly, the benchmark of 90% is too high. Faculty will examine the benchmark as well as examine other possible learning activities that may contribute to student success in understanding the use of evidence-based practice to plan care : Modify the immediate client care environment to promote safety and infection control. 1a.Exam 1-4 content

16 1b.Successful completion of competency based learning modules. 1c.Criterion referenced clinical evaluation 1.d Course evaluation survey 1a.98% of students will achieve exam average sufficient for progression within the nursing program (> 75%). 1b. 80% of students will achieve grade > 80%. 1.c 98 % of students will achieve satisfactory evaluation. 1d. 80% of students will report good or great gains in achievement of this learning outcome on course evaluation survey. a % of students progressed in course based on exam grade average > 75%. Single course failure not due to exam grades. b. Modules were not developed due to faculty reassignment to take an additional 6 credit hour clinical group. c % of students progressed in course based on exam grade average > 75%. Single course failure not due to unsafe clinicl practice. d. Mean student self-rating Do these results indicate that this outcome was?: Yes Standards a, c, and d were or exceeded. Standard b was not. Continue to review, revise and refine new course materials in view of new curriculum. Will evaluate use of learning modules commercially available from ATI in place of the DVD student currently use as preparation for clinical skills. Work with team to

17 revise clinical evaluation tool. Compile qualitative data regarding students' perception of simulation experience, "Little Room of Errors" as a tool for learning about unsafe environments : Discuss roles of the professional nurse. 3a. Student Course evaluation of objective. 3b. Class discussion 3c. Care Planning 3d. Quiz Questions 3a. >95% students will satisfactory meet objective. 3b. Engaged class discussions on Philosophy of Nursing, Professionalism, -S/U 3c. >95% will score 90 or above on Care Plan assignment. 3d. >90% quiz questions regarding collaboration of care will be answered correctly. 3a. 100% of students reported meeting this objective satisfactorily or beyond expected. Exceeding the standard of > 95%. 3b. Class discussion on Philosophy of Nursing, Professionalism was evaluated as satisfactory. 3c. 100% of students scored 90 or above on the Care Plan assignment. Exceeding the standard of > 95%. 3d. 98% of quiz questions regarding collaboration of care were answered correctly. Exceeding the >90% standard. Do these results indicate that this outcome was?: Yes Standards were or exceeded.

18 The content supporting this outcome will be continued in the upcoming semester. This class has an essential amount of core knowledge needed to build a strong basis for the nursing program. However consideration of revising the quizzes to encompass more applied question will be considered. Increasing the rigor of this class has been discussed in numerous meetings. The intensity of the other courses taught in the 1st semester must be carefully considered before increased rigor is implemented. There is discussion on moving this course outside the nursing program and merging it with Sophomore Seminar. Increasing the rigor in this new environment maybe a more feasible option : Demonstrate strategies to manage a safe environment for the psychiatric client. 1. Student self-assessment of achievement of course outcome. 2. Suicide content test Suicide Case studies. 4. Culture of Safety & Safety Monitoring QSEN Section of NLCEX Psychiatric Simulation Exam (final) 5. Assessment of psychiatric clients in clinical settings % of the class will rate themselves 3 or above on achievement of the course outcomes (3 satisfactory/4 point scale) 2. 80% of the students will answer the suicide questions correctly on test % of randomly selected case studies will show satisfactory identification of suicide assessment and interventions (20% of class should be selected). 4. The class average on the Culture of Safety & Safety

19 Monitoring QSEN Section of NLCEX Psychiatric Simulation Exam (final) will be 850 or greater % of randomly selected assessments will show satisfactory identification of potential for violence (including suicide and homicide) % of the class will rate themselves 3 or above on achievement of the course outcomes (3 satisfactory/4 point scale) 2. An average of 59.9% of the students answered the 4 suicide questions correctly on test Class activity returned to students prior to recording information. 4. The class average on the Culture of Safety & Safety Monitoring QSEN Section of NLCEX Psychiatric Simulation Exam (final) was (Class activity not completed) Do these results indicate that this outcome was?: Yes Two of the benchmarks were. The strongest measure used at the end of the semester (nationally normed test and QSEN sub scale) indicated an understanding of safety. It is apparent that more work needs to be done prior to test two on this important outcome as the measure associated with suicide on test two was not achieved. However, the selfassessment by students at the end of the semester clearly indicated how satisfied they are in meeting this objective. Faculty will examine the questions for clarity and its difficulty level appropriate for first semester students. Faculty will also be more cognizant of recording assessment data prior to distributing papers back (these are not used for a grade). Faculty will also augment the clinical assignment to more accurately measure the student's ability to identify suicidal and homicidal intent.

20 In discussion with some of the math faculty on the University Assessment Team it was decided that 30% would be a more appropriate random sample based on the usual class sizes in nursing. Therefore this will be changed for : Demonstrate professional nursing values of altruism, autonomy, human dignity and integrity when conducting a health assessment. 1. Student's self-rating of course objective. 2. Weekly lab participation and documentation of findings. 3. Physical exam check-off. 4. Completion of Health History % of students will rate themselves as satisfactorily meeting the course objective % of students will demonstrate satisfactory participation in weekly lab activities and will demonstrate satisfactory documentation of findings % of students will demonstrate satisfactory mastery of performing a physical assessment with a passing grade of 85 or better % of students will satisfactorily complete a health history of a client with a different cultural background. 1. Did not measure % of students demonstrated satisfactory participation in weekly lab activities and demonstrated satisfactory documentation of findings % of students demonstrated satisfactory mastery of

21 performing a physical assessment with a passing grade of 85 or better % of students satisfactorily completed a health history of a client with a different cultural background. Do these results indicate that this outcome was?: Yes 1. Unknown, did not measure. 2. Students exceeded the desired standard of achievement (100% vs. 90%) in demonstrating satisfactory participation in weekly lab activities and demonstrating satisfactory documentation of findings. 3. Students exceeded the desired standard of achievement (100% vs. 90%) in demonstrating satisfactory mastery of performing a physical assessment with a passing grade of 85 or better. 4. Students the desired standard of achievement (100%) in demonstrating satisfactory completion of a health history on a client with a different cultural background. No changes needed since all goals were. The outcome will continue to be monitored : Demonstrate conduct compatible with the ANA's Code of Ethics for Nurses. 1. Student self-evaluation 2. HESI sub-specialty category Legal/Ethical

22 1. 98% of students will rate themselves satisfactory for this learning outcome. 2. Establish baseline for HESI exam score data (no standard previously used) % of students achieved satisfactory clinical evaluation including criteria regarding legal and ethical issues. I student failed clinical portion of course due to attendance issues, and not a violation of professional ethics. 2. HESI exam sub-specialty mean score for the group was 694 in the category of legal and ethical. National mean for this sub-specialty was 809. Do these results indicate that this outcome was?: Yes 1. Student clinical evaluation outcome was. 2. Baseline was established for the HESI exam sub-specialty, with low mean scores. Since this is a custom exam, the comparison to national mean is not an equal comparison. 1. Work with team to consolidate clinical evaluation documentation in manner acceptable for both APR and NFO requirements. Determine ways to work with new Student Conduct committee. 2. Work with faculty team to review/revise curriculum to incorporate this topic into course in more detail. Recommend to NFO to convert HESI examination to the standardized exam, rather than the custom, to enable better comparison to the national sample : Discuss the ANA Code of Ethics for Nurses and

23 nursing standards of care and practice. 1. Students self-assessment of achieving course outcome. 2. Case Study exercises 3. Quiz questions 1. 95% of class will rate themselves as satisfactorily meeting course outcome % of the class will achieve a satisfactory grade on the case study assignment % of class will answer the ANA Code of Ethics and standard of care/practice questions correctly % of the students rated themselves as satisfactorily or beyond expectation meeting this course objective. This is slightly below the 95% standard % of the students achieved a satisfactory grade on the case study assignment. Exceeding the 90% standard % of the students answered the ANA Code of Ethics and standard of care/practice questions correctly. Exceeding the 90% standard. Do these results indicate that this outcome was?: Yes I am satisfied with the results though attentive to the fact that the self-evaluation of meeting this objective was 1% lower than the standard. Discuss on the topics are held in class and group and the students are given two changes to complete the questions on these topics. I feel comfortable that the outcome of discussion is measured but the extent of the understanding of these topics may not be reflected in these measures.

24 Consider revising the outcome to include "understanding" and assess in a different format. Increasing the rigor of this class has been discussed in numerous meetings. The intensity of the other courses taught in the 1st semester must be carefully considered before increased rigor is implemented. There is discussion on moving this course outside the nursing program and merging it with Sophomore Seminar. Increasing the rigor in this new environment maybe a more feasible option : Demonstrate professional nursing values in the care of psychiatric clients. 1. Student self assessment of achievement of course outcome. 2. Service-learning project evaluation - self-rating of outcome on professional values 3. Professional Issues HESI Specialty area of NLCEX Psychiatric Simulation Exam (final) 1. 90% of the class will rate themselves 3 or above on achievement of the course outcome (3 satisfactory/4 point scale) 2. Based on the service-learning project evaluations, 90% of the class will rate themselves 3 or above on achievement of the outcome on professional values (3 satisfactory/4 point scale). 3. The class average on the Professional Issues sub score of the NLCEX Psychiatric Simulation Exam (final) will be % of the class rated themselves 3 or above on achievement of the course outcome (3 satisfactory/4 point scale)

25 2. Based on the service-learning project evaluations, 98.1% of the class rated themselves 3 or above on achievement of the outcome on professional values (3 satisfactory/4 point scale). 3. The class average on the professional issues sub score (HESI sub score) of the NLCEX Psychiatric Simulation Exam (final) was 882 Do these results indicate that this outcome was?: Yes All of the benchmarks were achieved. There were no critical clinical incidents associated with values/ethics during the semester. Faculty are fairly satisfied with the results. There are two indirect and one direct measure. The course is during the first semester of the nursing program so understanding all the professional issues and Code of Ethics for Nurses is new to the students. Faculty will look for a values clarification instrument or a self assessment instrument and consider a pre/post test measure on values associated with caring for psychiatric clients : Employ a systematic process to conduct a health assessment that is culturally and spiritually sensitive. 1. Student s self-rating of course outcome. 2. Weekly Lab participation and documentation of findings % of students will rate themselves as satisfactorily meeting the course outcome % of students will demonstrate satisfactory participation in

26 weekly lab activities and will demonstrate satisfactory documentation of findings % of students rated themselves as satisfactorily meeting the course outcome % of students demonstrated satisfactory participation in weekly lab activities and demonstrated satisfactory documentation of findings. Do these results indicate that this outcome was?: No 1. Students did not meet the desired standard of achievement (88% vs. 90%) in rating themselves as satisfactorily meeting the course outcome. 2. Students exceeded the desired standard of achievement (100% vs. 90%) in demonstrating satisfactory participation in weekly lab activities and demonstrating satisfactory documentation of findings. More emphasis should be placed on class activities that emphasize performing a culturally and spiritually sensitive physical assessment : Construct an individualized, evidenced based

27 nursing plan of care to support physiologic and psychosocial integrity. 1. Criterion referenced clinical evaluation. 2. Care plan grading rubric. 3. Exams 1, 2, 3 and 4 content regarding promotion of psychosocial and physiologic integrity % of students will have documentation of satisfactory clinical performance % of students will achieve satisfactory (> 75%) on 2 care plans within 3 attempts % of students will achieve exam average (> 75%) sufficient for progression within the nursing program % of students achieved satisfactory clinical evaluation. 1 student failure due to attendance issues, not care plan deficits % of students achieved satisfactory care plans. Student who failed the clinical portion of the course did not submit a second care plan % of students progressed to the second semester courses. The single failure was due to clinical attendance and not exam grade failure. Do these results indicate that this outcome was?: No 1. Goal for successful documentation of clinical performance was not. There is room for improvement of the tool and faculty understanding of the clinical evaluation process. 2. Care plan goal not due to student with clinical failure grade.

28 3. Goal for exam grade average was. 1. Revise clinical evaluation process in manner acceptable to both APR and NFO requirements. 2. Continue the care plan assignment. Create smaller lab assignments prior to the first care plan to better assist students in developiing skills for completion. 3. Continue to revise and refine new course materials and exams items based on changes in curriculum and exam analysis : Describe nursing strategies that promote delivery of culturally competent care. 5a. Student Self Evaluation 5b. Cultural Assignment 5c. Quiz 5a. >95% students will satisfactory meet objective. 5b. >95% will score satisfactory on cultural competency exercise. 5c. >90% quiz questions regarding cultural competency will be answered correctly. 5a. 94% of the students reported satisfactory or beyond expectation in meeting this objective. Slightly lower than >95% standard 5b. 100% of students score satisfactory on cultural competency

29 exercise. Exceeding the >95% standard. 5c. 100% quiz questions regarding cultural competency were answered correctly. Do these results indicate that this outcome was?: No I am not satisfied with the results as I question the measures were valid means of students' ability to "Describe nursing strategies that promote delivery of culturally competent care". With the increasing diversity in the population of the US and the emerging need for globalization in nursing practice, I feel the this course should provide a stronger knowledge-base for culturally competency. The Fall 12 semester 3340 course will include enhanced student exercises on cultural competency with a focus on student engagement and reflection. Increasing the rigor of this class has been discussed in numerous meetings. The intensity of the other courses taught in the 1st semster must be carefully considered before increased rigor is implemented. There is discussion on moving this course outside the nursing program and merging it with Sophomore Seminar. Increasing the rigor in this new environment maybe a more feasible option. However consideration of revising the quizzes to encompass more applied question will be considered : Provide cultural and spiritual care that meets the needs of psychiatric clients. 1. Student self assessment of achievement of course outcome.

30 2. Service-learning project evaluation - self-rating of outcome on providing culturally and spiritually sensitive care. 3. Dimensions of patients care QSEN sub score of the NLCEX Psychiatric Simulation Exam (final) 1. 90% of the class will rate themselves 3 or above on achievement of the course outcome (3 satisfactory/4 point scale) 2. Based on the service-learning project evaluations, 90% of the class will rate themselves 3 or above on achievement of the outcome on providing culturally and spiritually sensitive care (3 satisfactory/4 point scale). 3. The class average on the Dimensions of patient care QSEN sub score of the NLCEX Psychiatric Simulation Exam (final) will be 850 or greater % of the class rated themselves 3 or above on achievement of the course outcome (3 satisfactory/4 point scale) 2. Based on the service-learning project evaluations, 73.1% of the class rated themselves 3 or above on achievement of the outcome on providing culturally and spiritually sensitive care (3 satisfactory/4 point scale). 3. The class average on the Dimensions of patient care QSEN sub score of the NLCEX Psychiatric Simulation Exam (final) was 885 Do these results indicate that this outcome was?: Yes Two of the three benchmarks were achieved. The direct measure was one of the benchmarks achieved.

31 By the end of the semesters, students felt comfortable with this outcomes as indicated on indirect measure #1. In relation to indirect measure #2, some students reported that their service project did not lend itself to providing cultural/spiritual care and the faculty agree with that assessment. This may explain the low number. Students results on the QSEN sub scale indicated a satisfactory level of understanding in providing cultural and spiritual care : Analyze assessment data to form appropriate nursing diagnoses for individual clients. 1. Student's self-rating of course outcome. 2. Weekly lab participation and documentation of findings. 3. Physical exam check-off. 4. Unit exams % of students will rate themselves as satisfactorily meeting the course outcome % of students will demonstrate satisfactory participation in weekly lab activities and will demonstrate satisfactory documentation of findings % of students will demonstrate satisfactory mastery of performing a physical assessment with a passing grade of 85 or better % of students will respond correctly to the nursing diagnosis questions on unit exams in NRSG % of students rated themselves as satisfactorily meeting the course outcome.

32 2. 100% of students demonstrated satisfactory participation in weekly lab activities and demonstrated satisfactory documentation of findings % of students demonstrated satisfactory mastery of performing a physical assessment with a passing grade of 85 or better % of students responded correctly to the nursing diagnosis questions on unit exams in NRSG Do these results indicate that this outcome was?: Yes 1. Students exceeded the desired standard of achievement (96% vs. 90%) in rating themselves as satisfactorily meeting the course outcome. 2. Students exceeded the desired standard of achievement (100% vs. 90%) in demonstrating satisfactory participation in weekly lab activities and demonstrating satisfactory documentation of findings. 3. Students exceeded the desired standard of achievement (100% vs. 90%) in demonstrating satisfactory mastery of performing a physical assessment with a passing grade of 85 or better. 4. Students exceeded the desired standard of achievement (75% vs. 70%) in responding correctly to the nursing diagnosis questions on unit exams in NRSG No changes needed since all goals were. The outcome will continue to be monitored : Perform basic nursing interventions according to professional nursing standards.

33 1. Student self-evaluation 2. Clinical skills checklist 1. 80% of students will report good or great gains in achievement of this learning outcome on course evaluation survey % of students rated as clinically satisfactory will have documentation of successful demonstration of the following skills: Hand hygiene Vital signs Medication administration Complete bed bath Indwelling catheter insertion Application and removal of PPE for isolation Capillary blood glucose measurement 1. Only 79.6% rated themselves as having great or good gains for this outcome. Mean rating was No data collected on this new measure. Current clinical evaluation system does not enable collection of this data. Do these results indicate that this outcome was?: No 1. Outcome was substantially below the goal. 2. No data regarding skills documentation. 1. Faculty team to consider why students rate themselves lower, yet attain passing clinical grades. 2. Need for a major revision of the clinical evaluation system to enable capture of skills competencies apropriate to the course

34 level : Discuss principles of health promotion, disease, and injury prevention. 1. Students self-assessment of achieving course outcome. 2. Geriatric presentation 3. Quiz questions 1. 95% of class will rate themselves as satisfactorily meeting course outcome % of the class will achieve a satisfactory grade on the geriatric assignment % of class will answer the wellness/illness quiz items correctly % of the students rated themselves as satisfactorily or beyond expectation meeting this outcome. Exceeding 95% standard % of the students achieved a satisfactory grade on the geriatric assignment. Exceeding the 90% standard % of the students answered the wellness/illness quiz items correctly. Exceeding the 90% standard. Do these results indicate that this outcome was?: Yes All standards were exceeded.

35 The geriatric projects have provided a positive avenue for active learning on varied geriatric topics and will be continued. Enhancing these projects to include a service learning component is warranted. The intensity of the other courses taught in the 1st semester must be carefully considered before implement a time intense service learning component. There is discussion on moving this course outside the nursing program and merging it with Sophomore Seminar. Adding the service learning component in this new environment maybe a more feasible option : Use principles of health promotion and illness prevention in designing psychiatric nursing care. 1. Student self assessment of achievement of course otucomes 2. Teaching plans from the Community Mental Health rotation 3. Unit Exams 4. Clinical Prevention and Population Health AACN section sub score of the NLCEX Psychiatric Simulation Exam (final) 5. The Psychiatric Mental Health Specialty NLCEX Psychiatric Simulation Exam (final) % of the class will rate themselves 3 or above on achievement of the course outcomes (3 satisfactory/4 point scale) 2. 80% of randomly selected teaching plans from the CMH rotation will show satisfactory identification of health promotion and disease prevention concepts. (20% of class should be selected). 3. The class average on each exam will be 80 or greater. 4. The class average on the Clinical Prevention and Population Health AACN Section of NLCEX Psychiatric Simulation Exam (final) will be 850 or greater. 5. The class average on the Psychiatric Mental Health Specialty NLCEX Psychiatric Simulation Exam (final) will be 850 or greater.

36 % of the class rated themselves 3 or above on achievement of the course outcomes (3 satisfactory/4 point scale) 2. (teaching plans were returned to students after grading and were not kept for further evaluation) 3. The class average on three unit exams was The class average on the Clinical Prevention and Population Health AACN Section of NLCEX Psychiatric Simulation Exam (final) was The class average on the Psychiatric Mental Health Specialty NLCEX Psychiatric Simulation Exam (final) was 885. Do these results indicate that this outcome was?: Yes Four of the five measures the benchmark. Faculty did not record assessment data on the fifth measure. This outcomes has a good mix of clinical and classroom assessment (although the clinical data was not recorded this term). Because all students passed clinical, we know their teaching plans the stander rubric for satisfactory completion. Faculty will be more cognizant of recording data on teaching plans. In discussion with some of the math faculty on the University Assessment Team it was decided that 30% would be a more appropriate random sample based on the usual class sizes in nursing. Therefore this will be changed for : Adhere to regulations and accreditation standards. 1a.Exams 1 content regarding HIPAA privacy laws, safety, and patient identification. 1b. Course evaluation survey

37 1c. Criterion referenced clinical evaluation 1a. 98% of students will correctly answer comprehension level items regarding HIPAA, safe patient handling, and patient identification. 1b. 80% of students will report good or great gains in achievement of this learning outcome on course evaluation survey. 1c. 98 % of students will achieve satisfactory evaluation. a. Exam mapping did not include specific exam items regarding these topics. No results available. b. Mean student self-rating 4.09 on 5 point scale. 83% rates "great" or "good" gains in achieving course outcome. c % of students achieved satisfactory clinical evalution. Student failure due to attendance issues and not failure to adhere to standards. Do these results indicate that this outcome was?: No Consider use of ATI skills module on HIPAA as a piece of evidence. Consider how to better incorporate OSHA safe patient handling curriculum. Provide better exam mapping to these concepts. Set the standard of achievement higher for the student self-assessment. Work with team to revise clinical assessment tool : Discuss roles of the professional nurse. 7a. Student Course evaluation of objective.

38 7b. Class discussion 7c. Care Planning 7d. Quiz Questions 7a. >95% students will satisfactory meet objective. 7b. Engaged class discussions on Philosophy of Nursing, Professionalism, -S/U 7c. >95% will score 90 or above on Care Plan assignment. 7d. >90% quiz questions regarding collaboration of care will be answered correctly. 7a. 100% of students reported meeting this objective satisfactorily or beyond expected. Exceeding the standard of > 95%. 7b. Class discussion on Philosophy of Nursing, Professionalism was evaluated as satisfactory. 7c. 100% of students scored 90 or above on the Care Plan assignment. Exceeding the standard of > 95%. 7d. 98% of quiz questions regarding collaboration of care were answered correctly. Exceeding the >90% standard. Do these results indicate that this outcome was?: Yes The standards were exceeded. The content supporting this outcome will be continued in the upcoming semester. This class has an essential amount of core knowledge needed to build a strong basis for the nursing program. However consideration of revising the quizzes to encompass more applied question will be considered. Increasing the rigor of this class has been discussed in numerous meetings. The intensity of the other courses taught in the 1st semster must be carefully considered before increased

39 rigor is implemented. There is discussion on moving this course outside the nursing program and merging it with Sophomore Seminar. Increasing the rigor in this new environment maybe a more feasible option : Discuss the need for advocacy in regulatory, legislative, and public policy in relation to changes that influence mental health care system. 1. Student self assessment of achievement of course outcomes. 2. Randomly selected reflection journals 3. Legal, regulatory and public policy questions on test # Service-learning project evaluation - self-rating of outcome on the need for advocacy in psychiatric care. 5. Healthcare policy AACN sub score of the NLCEX Psychiatric Simulation Exam (final) % of the class will rate themselves 3 or above on achievement of the course outcomes (3 satisfactory/4 point scale) % of randomly selected journals in the Child and adolescent, alcohol and drug and geriatric rotations will correctly discuss regulatory, legislative and public policy issues that influence mental health care % of the class will correctly answer the legal, regulatory and public policy questions on test # Based on the service-learning project evaluations, 90% of the class will rate themselves 3 or above on achievement of the outcome on discussing the need for advocacy in psychiatric care (3 satisfactory/4 point scale). 5. The class average on Healthcare Policy AACN sub score of the NLCEX Psychiatric Simulation Exam (final) will be 850 or greater

40 % of the class rated themselves 3 or above on achievement of the course outcomes (3 satisfactory/4 point scale). 2. (reflection papers were returned to students after grading and were not kept for further evaluation) 3. An average of 84.9% of the class responded correctly to the 3 items on legal and ethical issues on Test #1. (no items specific to policy and advocacy were included on test 1) 4. Based on the service-learning project evaluations, 75% of the class rated themselves 3 or above on achievement of the outcome on discussing the need for advocacy in psychiatric care (3 satisfactory/4 point scale). 5. The class average on Healthcare Policy AACN sub score of the NLCEX Psychiatric Simulation Exam (final) was Do these results indicate that this outcome was?: Yes While only two of the 5 measures the benchmark, the faculty believe this outcome was achieved because these were the two direct measures. Students, however, feel more unsure of themselves in this area. There are limited healthcare policy issues on the AACN category of the NCLEX Simulation Exam. There are none on unit one. Possibly, since this is a first semester course, faculty need to reexamine this outcome as it includes so many areas. Journals also were returned without recorded evidence. Faculty will be more cognizant of recording the data before returning journals. The service learning projects will also need to be reevaluated in

41 relation to this outcome. All of the projects may not lend themselves to the outcome which could be reflected in the student's response : Differentiate roles of other healthcare disciplines in the provision of care. 1. Student self-evaluation 2. Teacher-made exam items 1. 80% of students will report good or great gains in achievement of this learning outcome on course evaluation survey 2. 80% of students will correctly answer exam items related to interdisciplinary roles 1. Only 64.8% rated themselves as having great or good gains for this outcome. Mean rating was exam items included in 3 different exams were linked to this course outcome. Item topic % Correct Interdisciplinary wound care Nutrition consult Medical specialists Respiratory Therapist Team roles Do these results indicate that this outcome was?: No

42 1. Student self-rating considerably lower than desired level of achievement. 2. Some, but not all, exam items the standard. 1. Initiate weekly student self-rating of progress toward course outcomes with specific examples in online journal 2. Develop mechanism for better tracking link between specific exam items and course outcomes. Current system with exam blueprints in Word and item analysis in the course learning system does not currently facilitate retrieval and analysis : Discuss roles of the professional nurse. 8a. Student Course evaluation of objective. 8b. Class discussion 8c. Care Planning 8d. Quiz Questions 8a. 100% of students reported meeting this objective satisfactorily or beyond expected. Exceeding the standard of > 95%. 8b. Class discussion on Philosophy of Nursing, Professionalism was evaluated as satisfactory. 8c. 100% of students scored 90 or above on the Care Plan assignment. Exceeding the standard of > 95%. 8d. 98% of quiz questions regarding collaboration of care were answered correctly. Exceeding the >90% standard.

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