Learning Assurance Report. for the. WellStar Primary Care Nurse Practitioner Program. in the. Wellstar College of Health and Human Services

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1 Learning Assurance Report for the WellStar Primary Care Nurse Practitioner Program in the Wellstar College of Health and Human Services Spring 2004 Prepared by WellStar School of Nursing Curriculum Committee

2 SECTION I - ARTICULATING LEARNING OUTCOME Listing of General and Specific Student Leaning Outcomes for the Program Professional nursing is a dynamic field, ever-expanding and adapting to the evolution of health care. The WellStar School of Nursing offers the Primary Care Nurse Practitioner (PCN) program that builds upon the competencies established during the baccalaureate nursing education. The graduate primary care nurse practitioner program is a professional degree, which prepares experienced registered nurses to sit for certification as a family or adult nurse practitioner. The program builds on the background of professional nurses by preparing them to function as primary care providers in the emerging collaborative world of health care. Upon completion of the PCN Program, graduates sit for Nurse Practitioner Certification Examination. The WellStar School of Nursing maintains core performance standards for admission and progression within the nursing major. These standards proceed to the establishment of outcomes necessary to perform in an independent manner within a practice discipline. Rather than a series of discrete and uncoordinated courses, the PCN Program is a total series of experiences within the specific courses that work together to achieve student learning outcomes. Thus, the program identifies general and course specific student learning outcomes that correlate to the competencies for the graduate professional nursing education. The following grid, PCN Program Outcomes and Corresponding Course Objectives,) presents the general (GLOs) and specific student learning outcomes (SLOs) for the PCN Program. The grid identifies the general SLOs for the program and each nursing course required for the program with the corresponding specific SLOs. An expanded formate follows the grid with the identified general SLOs and the specific SLOs listed within each nursing course that correlates to the general SLO. Please note that the listing of the SLOs in this format is into in numeric order because the number of the specific SLO corresponds to the course objective for that course. This section also presents the identification of the categories of knowledge-oriented, skill-oriented an expanded format follows the grid with the identified categories of knowledgeoriented, skill-oriented and/or attitude-oriented international/intercultural competencies developed by the American Council on Education for each general and specific SLO. In addition, each general and specific SLOs displays a leveling of order thinking, as or an order of increasing complexity as identified from Bloom s Taxonomy which categorizes knowledge (Level 1) and Comprehension (Level 2) Objectives as lower-order, Thinking Skills and Application (Level 3), Analysis (Level 4), Synthesis (Level 5), and Evaluation (Level 6) objectives as higher-order Thinking Skills (Bloom, 1956). 1

3 PCN Program Outcomes and Corresponding Course Objectives PCN REQUIRED COURSES (Specific SLOs*) Program Outcomes Provide culturally competent age specific primary care to diverse clients based on a strong theoretical and research foundation thereby improving health care delivery and client care outcomes 2. Use critical thinking, clinical judgment skills and ethics to make safe independent and interdependent clinical decisions, incorporating principles of health \ promotion, assessment, diagnosis and management of client potential and actual health care problems in variety of settings. 3. Utilize therapeutic and professional communication techniques with clients, colleagues and other health care professionals in order to facilitate client self care, coordinate services, secure consultations and referrals by using technologies when appropriate. 4. Assume the role of the advanced practice nurse by demonstrating accountability for the quality of one s own practice, engaging in professional activities, advocating for change and working effectively in interdisciplinary relationships. 2,3 2,3,5 2 2,3,4,6,7 1,2,3,4,5, 6 None Apply 1,3 1,4,7 1,2,3,6, 7,10 3,5,6,7, 9,10 5,6,7,8 1,2,3,4 1,2,3,4,5 1,2,3,4,5 6,7,8,9, 10,11 3,4,5,6,8 1,2,3,4 1,2,3,4,5 1,2,3,5 1,4,6,8,9 5 1,2,3,4, 2,4 4,6,8 None Apply 1,2,6,8 None Apply None Apply 5,6,10 5. Demonstrate leadership in roles as divergent as clinician, educator, advocate and manager in a variety of areas such as education, practice and community health programs be influencing health care delivery systems as shaped by health care policy and societal norms and expectations. 1,2,3,4,5, 6 6,7,8 5 6,8 None Apply None Apply 9,10 * The numbers listed in the various columns labeled 7710 through 8800 refer to the specific objectives/outcomes for each of he courses that correspond to the general program outcomes (GLOs) a complete listing of these various objective/outcomes follows this document. 2

4 PCN Program Outcome and Corresponding Course Objectives PCN REQUIRED COURSES cont. (Specific SLOs) Program Outcomes Provide culturally competent age specific primary care to diverse clients based on a strong theoretical and research foundation thereby improving health care delivery and client care outcomes. 2. Use critical thinking, clinical judgment skills and ethics to make safe independent and interdependent clinical decisions, incorporating principles of health promotion, assessment, diagnosis and management of client potential and actual health care problems in variety of settings. 3. Utilize therapeutic and professional communication techniques with clients, colleagues and other health care professionals in order to facilitate client self care, coordinate services, secure consultations and referrals by using technologies when appropriate. 4. Assume the role of the advanced practice nurse by demonstrating accountability for the quality of one s own practice, engaging in professional activities, advocating for change and working effectively in interdisciplinary relationships. 5. Demonstrate leadership in roles as divergent as clinician, educator, advocate and manager in a variety of areas such as education, practice and community health programs b influencing health care delivery systems as shaped by health care policy and societal norms and expectations. 1,2,3,4, 5,6,7,8, 9,10 1,2,3,4, 5,6,7,8, 9,10 2,9 7,10 2,3,4,5, 7,8,9, 10 1,3,4,6 1 1,2,3 1,6 2,5,7 3 1,2,3 None Apply None Apply 7 1 1,2,3,4, 5,6 1,2,3,4, 5,6 1,2,3,5 1,2,7 8,9,10 2 1,2 1,2,5 4,8,9,10 None Apply None Apply 2,3 2,3 2 2,3 1,2,3,4, 5,6 1,2,3,4, 5,6 1,2,3,5, 7,8,9, 11,13 3,4,7,14,15 4,6,10, 11,12 1,2,3,5 7,8,10 6,10 12 * The numbers listed in the various columns labeled 7710 through 8800 refer to the specific objectives/outcomes for each of he courses that correspond to the general program outcomes (GLOs) a complete listing of these various objective/outcomes follows this document. 3

5 I. General Student Learning Outcomes Provide culturally competent age specific primary care to diverse clients based on a strong theoretical and research foundation thereby improving health care delivery and client care outcome. Knowledge and Skill, Level 3 Specific Learning Outcomes A. N Investigate and analyze legal, socioeconomic and political issues that impact contemporary nurse practitioner practice. Knowledge and Attitude, Level 2 3. Explore ethical and cultural issues that serve to sharpen nurse practitioner practice in a completed and diverse society. Knowledge and Attitude, Level 2 B. N Engage in multiple ways of knowing and become open to new ideas and new ways of seeing and being in nursing. Skill and Attitude, Level 5 3. Explore the effects of a changing philosophy of science on nursing theory and advanced nursing practice. Skill and Attitude, Level 4 5. Embrace diversity in initializing multiple theoretical perspectives toward enhancing understanding of nursing phenomena. Attitude, Level 5 C. N Obtain complete and episodic health histories utilizing age appropriated interviewing skills. Attitude, Level 3 2. Perform complete exams utilizing techniques of inspection, percussion, palpation and auscultation, identifying normal versus abnormal findings based on age groups. 3. Utilize subjective and objective data in developing a problem diagnosis list. Knowledge and 6. Provide health promotion and disease prevention teaching and services cognizant of age, development, risk, geographic location and culture. Skill and Attitude, Level 5 4

6 7. Select, perform and interpret common screening and diagnostic laboratory tests and tools. Skill, Level 3, 4 & Demonstrates knowledge and incorporates theories of learning, human behavior, change theory, stress and coping, cognitive and learning theories into practices. Knowledge and Attitude, Levels, 5 D. N Critique public research studies for scientific merit and contribution to the knowledge base of nursing/discipline. 6. Examine the utilization of nursing research findings in clinical practice focusing on the nurse practitioner role. Knowledge, Level 2 7. Evaluate computerized analysis techniques on selected data sets and interpret the results obtained from these analyses. 8. Develop a research proposal appropriate to the nurse practitioners role such as an investigation of clinical phenomena, delivery systems, or cost effectiveness in primary health care. E. N Demonstrate knowledge of pharmacokinetics principles in choosing drug therapies, selecting administration route and prescribing dosing schedules. Knowledge, Level 3 2. Demonstrate knowledge of available drug therapies in recommending appropriate pharmacologic interventions and in evaluating therapeutic outcome. Knowledge, Level 3 3. Demonstrate the ability to identify adverse drug reaction such as side effects and drug-to-drug interactions. Skill, Level 3 4. Demonstrate a working knowledge of the following for drugs that are extensively utilized in primary care settings: a. pharmacokinetics properties and mechanism of action b. indications and contraindications for use c. dosage regimen and administration d. adverse side effects Knowledge, Level 3 5

7 F. N Apply advanced knowledge of alterations in body function that occur with specific pathological conditions across the life span. Skill, Level 3 2. Demonstrate evidence of thought processes indicating understanding of selected disease states. Skill, Level 3 3. Synthesize and apply current research-based knowledge concerning the pathological changes in selected disease states. 4. Demonstrate the ability to systematically develop an appropriate, differential diagnosis. Skill, Level 3 5. Analyze physiologic response to selected disease states and treatment modalities. G. N Develop knowledge of the definitions and etiologies of common health problems encountered in the primary care of children. Knowledge, Level 4 2. Use history taking and physical assessment skills to evaluated signs and symptoms of common health problems encountered in children. 3. Decide on the appropriate laboratory studies necessary to aid in diagnosing common health problems in children. 4. Be able to discuss the differential diagnoses associated with common health problems in children. Skill, Level 2 5. Be able to decide on the appropriated pharmacological and nonpharmacological treatments of common health problems found in children in a primary care setting. 6. Have an understanding of the appropriated education, anticipatory guidance, prevention, referral and follow-up needed for common health problems. 7. Develop and understanding of cultural diversities and ethical considerations in the care of children. Attitude, Level 5 8. Recognize the importance of a caring and supportive climate that empowers parents as caregivers. Attitude, Level 1 6

8 9. Identify sources of current research and health related information to incorporate into client care management modalities. Knowledge, Level Utilize current research to develop interventions that facilitate positive care management outcomes. 11. Describe the usefulness of family theory in the assessment of health. Attitude, Level 3 H. N Explain the definitions and etiologies of selected chronic health problems encountered in primary care in the middle-aged and older adult. Skill, Level 2 2. Identify the history taking and physical assessment skills used in the evaluation of chronic health problems encountered in primary care in middle-aged and older adults. Skill, Level 1 3 Describe the diagnostic studies necessary to correctly identify chronic health problems encountered in primary care in middle-age and older adults. 4. Determine and discuss differential diagnoses associated with chronic health problems encountered in primary care in middle-aged and older adults. 5. Select the appropriated pharmacological and non-pharmacological treatment modalities for the management of chronic health problems encountered in primary care in the middle-aged and older adult. 6. Demonstrate an awareness of cultural diversities and ethical considerations in and incorporate this knowledge into primary care of middle-aged and older adults with chronic health problems. Attitude, Level 6 7. Facilitate a climate that applies the principle of support and self-efficacy to practice. Skill, Level 3 8. Attend to patient s concerns in the creation of management plans. Skill and Attitude, Level 2 9. Develop strategies to evaluate the effectiveness of patient teaching and counseling. 10. Utilize current research to develop interventions that facilitate positive outcomes in the primary care of middle-aged and older adults with chronic health problems. 7

9 I. N Do complete health histories with physical examinations and focused, episodic visits on men and women of all ages across the lifespan. Knowledge and Skill, Levels 3 3. Assess and screen for health problems of the reproduction system and provide information, treatments, health promotion strategies, and referrals as necessary. Knowledge and Skill, Levels 6 4. Be able to discuss and assist clients in choosing the family planning methods of their choice. Knowledge and Attitude, Level 5 5. Identify the common sexually transmitted diseases and provide appropriate treatments and prevention strategies. Knowledge and 7. Be able to identify the common complaints of women during the prenatal and postpartum periods of pregnancy and plan the appropriate treatment and education. Knowledge and Skill, Levels, 5 8. Be able to identify complications during the prenatal and postpartum periods of pregnancy and make the appropriated referrals. Knowledge and Skill, Levels 5 9. Identify the common complaints and health problems of menopausal women and provide appropriate treatment and health education. Knowledge and 10. Do health assessments of men in regard to reproductive health concerns. Knowledge and Skill, Levels, 3 J. N Perform complete health histories and physical examinations on ageappropriate clients. 3. Generate appropriated problem list from health histories and physical findings. 4. Complete focused, episodic visits on clients with common acute illnesses and stable chronic diseases. 6. Develop an appropriate treatment plan that takes into account the client s ethnic and cultural beliefs. 8

10 K. N8851 L. N Provide primary care to clients appropriate-age with common health problem: a. Obtain a complete health history and perform an appropriate physical examination Skill, Level 3 b. Assess risk factor as evidenced by health history and physical examination findings c. Generate appropriate problem lists based on health history and physical examination d. Integrated findings from the health history and physical examination to identify common health plans and follow-up plans e. Develop an appropriated treatment plan that takes into account the client s ethnicity and cultural beliefs Skill and Attitude, Level 5 f. Accurately document all findings and interventions 1. Provide primary reproductive health care to clients (both male and female). a. Obtain a complete health history and perform an appropriated physical examination Skill, Level 3 b. Assess risk factors for reproductive health problems as evidenced by health history and physical examination findings c. Generate appropriate problem lists based on health history and examination findings. d. Integrate findings from the health history and physical examination to identify reproductive health problem and develop appropriate diagnostic, therapeutic, educational plans and followup plans e. In consultation with clients, develop an appropriate treatment plan that takes into account the client s ethnicity and cultural beliefs. Attitude and f. Accurately document all findings and interventions. 9

11 2. Collaborated with other health care providers/agencies within the health care system: a. Confer with other health care providers (preceptor/colleagues) as needed providing succinct case presentations concerning assessment, treatment and follow-up b. Serve as a consultant when appropriate Skill and Attitude, Level 6 3. Evaluate one s own practice with regard to accountability to self, clients and colleagues: Skill and Attitude, Level 6 a. Note strengths/weakness and identify learning needs Skill and Attitude, Level 1 b. Recognize the boundaries of advanced nursing practice as delineated by the profession, one s own competency Skill, Level 1 c. Utilize current research to guide diagnostic testing and treatment decision-making M. N Perform complete health histories and physical examination on age appropriate clients. Skill, Level 3 2. Teach health promotion and disease prevention for clients of age appropriate groups. 3. Perform focused, episodic sick visits on clients of age-appropriate groups. Skill, Level 3 4. Identify and treat common, complex and reproductive health problems found in age appropriate groups taking into consideration the clients ethnic and/or cultural diversity. Skill and Attitude, Level 1 5. Identify potential complication of health problems with appropriate follow-up and referrals. Skill, Level 1 6. Integrate all previously learned theoretical knowledge and clinical skills into advanced nursing practice. 10

12 N. N Identify an area of concern in primary health care that is in need of further investigation in order to increase knowledge and skills in nurse practitioners in providing health care to clients. Knowledge, Level 1 2. Confer with faculty concern in the significance, scope and feasibility of the proposal. Skill, Level 2 3. Submit a research proposal and an IRB application regarding your chosen area of concern. (Students may use their proposal for NURS 7740). 5. Using a theoretical model as framework, design a research project that will increase knowledge and understanding of this area of concern. O. N Develop knowledge of the definitions and etiologies of common health problems encountered in the primary care of adults. 2. Use history taking and physical assessment skills to evaluate signs and symptoms of common health problems encountered in adults. 3. Decide on the appropriate laboratory studies necessary to aid in diagnosing common health problems in adults 5. Be able to decide on the appropriate pharmacological and nonpharmacological treatments of common health problems found in the primary care setting. 7. To develop an understanding of cultural diversities and ethical considerations in the care of adults. Attitude and 8. To recognize the importance of a caring and supportive climate which protects client confidentiality. Skill and Attitude, Level 4 9. To attend possible client s concerns in the creation of management plans. Skill and Attitude, Level To utilize current research to develop interventions which facilitate positive care management outcomes. 11

13 II. General Student Learning Outcome Use critical thinking, clinical judgment skills and ethics to make safe independent and interdependent clinical decisions, incorporating principles of health promotion, assessment, diagnosis and management of client potential and actual health care problems in a variety of settings. Knowledge and Skill, Level 3 Specific Learning Outcomes A. N 7710 B. N Investigates and analyze legal, socioeconomic, and political issues that impact contemporary nurse practitioner practice. Knowledge and Attitude, Level 2 2. Engage in multiple ways of knowing and become open to new ideas and new way of seeing and being in nursing. Skill and Attitude, Level 5 3. Explore the effects of a changing philosophy of science on nursing theory and advanced nursing practice. 4. Understanding the nature of praxis in nursing. 6. Describe, analyze and critique selected nursing theories and paradigms that influence advanced practice nursing. Knowledge and 7. Formulate a philosophical position on the nature of advanced practice nursing. D. N Utilize subjective and objective data in developing a problem list/diagnosis list. Knowledge and 5. Apply principles of epidemiology and demography in planning anticipatory guidance and counseling regarding wellness, lifestyle, disease risks and potential changes in health status. Knowledge and Skill, Levels 5 6. Provide health promotion and disease prevention teaching and services cognizant of age, development, risk, geographic location and culture. Skill and Attitude, Level 5 & 6 7. Select, perform and interpret common screening and diagnostic laboratory tests and tools. 12

14 D. N7740 E. N Assess the patient s readiness to learn and evaluate the effectiveness of health promotional activities as appropriate upon follow-up visits. Knowledge and Attitude, Levels, Demonstrates knowledge and incorporates theories of learning, human behavior, change theory, stress and coping theory, cognitive and learning theories into practice. Knowledge and Attitude, Level 5 5. Compare and contrast quantitative and qualitative research approaches. 4. Conduct the four steps of the critique process (comprehension, comparison, analysis and evaluation). 5. Critique published research studies for scientific merit and contribution to the knowledge base of nursing/discipline. 6. Examine the utilization of nursing research findings in clinical practice focusing on the nurse practitioner role. Knowledge, Level 2 8. Develop a research proposal appropriate to the nurse practitioners role such as an investigation of clinical phenomena, delivery systems, or cost effectiveness in primary health care. 4. Demonstrate knowledge of pharmacokinetics principles in choosing drug therapies, selecting administration route and prescribing dosing schedules. Knowledge, Level 3 5. Demonstrate knowledge of available drug therapies in recommending appropriate pharmacologic interventions and in evaluating therapeutic outcomes. Knowledge, Level 3 6. Demonstrate the ability to identify adverse drug reactions such as side effects and drug-to-drug interactions. Skill, Level 3 4. Demonstrate a working knowledge of the following for drugs that are extensively utilized in primary care settings: (a) pharmacokinetics properties and mechanism of action (b) indications and contraindications for use (c) dosage regimen and administration (d) adverse side effects Knowledge, Level 3 13

15 G. N7760 G. N 8805 H. N Apply advanced knowledge of alterations in body function that occur with specific pathological conditions across the life span. Skill, Level 3 2. Demonstrate evidence of thought processes indicating understanding of selected disease states. Skill, Level 3 3. Synthesize and apply current research-based knowledge concerning the pathological changes in selected disease states. 4. Demonstrate the ability to systematically develop an appropriate, differential diagnosis. Skill, Level 3 5. Analyze physiologic response to selected disease states and treatment modalities. 1. Develop knowledge of the definitions and etiologies of common health problems encountered in the primary care of children. Knowledge, Level 4 2. Use history taking and physical assessment skills to evaluate signs and symptoms of common health problem encountered in children. 3. Decide on the appropriate laboratory studies necessary to aid in diagnosing common health problem in children. 5. Be able to decide on the appropriate pharmacological and nonpharmacological treatment of common health problems found in children in primary care setting. Skill Level 6 1. Explain the definitions and etiologies of selected chronic health problems encountered in primary care in the middle-aged and older adults. Skill, Level 2 2. Identify the history taking and physical assessment skills used in the evaluation of chronic health problems encountered in primary care in middle-aged and older adults. Skill, Level 1 3. Describe the diagnostic studies necessary to correctly identify chronic health problems encountered in primary care in middle-aged and older adults. 14

16 4. Determine and discuss differential diagnoses associated with chronic health problems encountered in primary care in middle-aged and older adults. 5. Select the appropriate pharmacological and non-pharmacological treatment modalities for the management of chronic health problems encountered in primary care in the middle-aged and older adults. 6. Demonstrate an awareness of cultural diversities and ethical considerations in and incorporate this knowledge into primary care of middle-aged and older adults with chronic health problems. Attitude, Level 6 7. Facilitate a climate that applies the principles of support and self-efficacy to practice. Skill, Level 3 8. Attend to patient s concerns in the creation of a management plan. Skill and Attitude, Level 2 9. Develop strategies to evaluate the effectiveness of patient teaching and counseling. 10. Utilize current research to develop interventions that facilitate positive outcomes in the primary care of middle-aged and older adults with chronic health problems. I. N Identify the health care issues and concerns of reproductive health. Knowledge, Level 1 6. Plan health promotion and management strategies for the women with a normal pregnancy. Knowledge and Skill, Levels 3 J. N Assess risk factors obtained from client s health history and physical findings. 5. Identify common health problems encountered in primary care and develop appropriated diagnostic, therapeutic and educational plans. 7. Choose appropriate medications in the treatment of common health problems. 15

17 K. N8851 L. N Evaluate one s own practice with regard to accountability to self, client and colleagues: Skill and Attitude, Level 6 a. Note strengths/weaknesses and identify learning needs. Skill and Attitude, Level 1 b. Recognize the boundaries of advanced nursing practice as delineated by the profession and one s own competency. Skill, Level 1 c. Utilize current research to guide diagnostic testing and treatment decision-making. 1. Provide primary reproductive health care to clients (both male and female). a. Obtain a complete health history and perform an appropriate physical examination. Skill, Level 3 b. Assess risk factors for reproductive health problems as evidenced by health history and physical examination findings. c. Generate appropriate problem lists based on health history and physical examination findings. d. Integrate findings from the health history and physical examination to identify reproductive health problems and develop appropriate diagnostic, therapeutic, educational and follow-up plans. e. In consultation with client, develop an appropriate treatment plan that takes into account the client s ethnicity and cultural beliefs. Skill and Attitude, Level 5 f. Accurately document all findings and interventions. 2. Collaborate with other health care providers/agencies within the health care system: a. Confer with other health care providers (preceptor/colleagues) as needed providing succinct case presentations concerning assessment, treatment and follow-up. b. Serve as a consultant when appropriate. Skill and Attitude, Level 6 16

18 3. Evaluate one s own practice with regard to accountability to self, clients and colleagues: a. Note strengths/weakness and identify learning needs. Skill and Attitude, Level 1 b. Recognize the boundaries of advanced nursing practice as delineated by the profession, one s own competency. Skill, Level 1 c. Utilize current research to guide diagnostic testing and treatment decision-making. M. N Perform complete health histories and physical examinations on age appropriate clients. Skill, Level 3 2. Teach health promotion and disease prevention for clients of age appropriate groups. 3. Perform focused, episodic sick visits on clients of age-appropriate groups. Skill, Level 3 4. Identify and treat common, complex and reproductive health problems found in age appropriated groups taking into consideration the client s ethnic and/or cultural diversity. Skill and Attitude, Level 1 5. Identify potential complication of health problems with appropriate follow-up and referrals. Skill, Level 1 6. Integrate all previously theoretical knowledge and clinical skills into advanced nursing practice. N. N Identify an area of concern in primary health care that is in need of further investigation in order to increased knowledge ands kills of nurse practitioners in providing health care to clients. Knowledge, Level 1 2. Confer with faculty concerning the significance, scope and feasibility of the proposal. Skill, Level 2 7. Adhere to the professional (ANA Code of Ethics), ethical and legal standards in conducting the project. (Refer to the KSU IRB Assurance of Compliance and the IRB Approval Request form). Attitude, Level 3 17

19 O. N Decide on the appropriated laboratory studies necessary to aid in diagnosing common health problems in adults. 4. Be able to discuss the differential diagnoses associated with common health problems. 7. To develop an understanding of cultural diversities and ethical considerations in the care of adults. Skill and Attitude, Level To apply selected family theories to holistic primary health care. 15. To describe models of family theory and their relationships to role expectations. 18

20 III. General Student Learning Outcome Utilize therapeutic and professional communication techniques with clients, colleagues and other health care professionals in order to facilitate client self care, coordinate services, secure consultations and referrals by using advanced information and communication technologies when appropriate. Knowledge and Skill, Level 3 Specific Learning Outcomes A. N Analyze and articulate the role of the nurse practitioner in the context of an ever changing health care delivery system. Knowledge and Skill, Level 2 2. Investigates and analyzes legal, socioeconomic, and political issues that impact contemporary nurse practitioner practice. Knowledge and Attitude, Level 2 3. Explore ethical and cultural issues that serve to sharpen nurse practitioner practice in the complete and diverse society. Knowledge and Attitude, Level 2 4. Explore and analyze the impact of health care policy on client care and nurse practitioner practice. Knowledge and Attitude, Level 2 5. Analyze the impact of health care policy on client care and nurse practitioner practice. Knowledge and Attitude, 2 6. Demonstrate knowledge of classic/current literature related to development and implementation of the role of the nurse practitioner. Knowledge and Skill, Levels 2 B. N 7720 No objectives apply to this outcome E. N Obtain complete and episodic health histories utilizing age appropriate interviewing skills. Attitude, Level 3 4. Document health history, physical exam, plan of care and health promotion/disease prevention measures utilizing SOAP format. Knowledge, Levels, 5 6. Provide health promotion and disease prevention teaching and services cognizant of age, development, risk, geographic location and culture. Skill and Attitude, Level 6 8. Communicate the patient s health status and health risk verbally and in writing, using appropriate upon follow-up visits. Knowledge, Levels 5 19

21 9. Assess the patient s readiness to learn and evaluate the effectiveness of health promotional activities as appropriate upon follow-up visits Attitude and Skill, Levels 6 D. N Critique public research studies for scientific merit and contribution to the knowledge base of nursing/discipline. E. N7750 H. N7760 G. N Demonstrate knowledge of pharmacokinetics principles in choosing drug therapies, selecting administration route and prescribing dosing schedules. Knowledge, Level 3 2. Demonstrate knowledge of available drug therapies in recommending appropriate pharmacologic interventions and in evaluating therapeutic outcomes. Knowledge, Level 3 3. Demonstrate the ability to identify adverse drug reactions such as side effects and drug-to-drug interactions. Skill, Level 3 6. Demonstrate a working knowledge of the following for drugs that are extensively utilized in primary care settings: a. pharmacokinetics properties and mechanism of action b. indications and contraindications for use c. dosage regimen and administration d. adverse side effects Knowledge, Level 3 2. Demonstrate evidence of thought processes indicating understanding of selected disease states. Skill, Level 3 4. Demonstrate the ability to systematically develop an appropriated differential diagnoses. Skill, Level 3 4. Be able to discuss the differential diagnosis associated with common health problems in children. Skill, Level 2 6. Have an understanding of the appropriate education, anticipatory guidance, prevention, referral and follow-up needed for common health problems. 20

22 8. Recognize the importance of a caring and supportive climate that empowers parents as caregivers. Attitude, Level 1 H. N 8815 I. N 8830 J. N Identify the history taking and physical assessment skills used in the evaluation of chronic health problems encountered in primary care in middle-aged and older adults. Skill, Level 1 9. Develop strategies to evaluate the effectiveness of patient teaching and counseling. No objectives apply to this outcome 8. Discuss with clients their diagnoses, medications, treatments, expected outcomes and appropriate follow-up. 9. Document all management interventions appropriately. Skill, Level Make a succinct case presentation concerning assessment, treatment and appropriate follow-up to preceptor and colleagues. K. N Collaborate with the other health care providers/agencies within the health care system: a. Confer with other care providers (preceptor/colleagues) as needed providing succinct case presentations concerning assessment, treatment and follow-up. Skill and Attitude, Level 1 b. Serve as a consultant when appropriate. Skill and Attitude, Level 6 c. Utilize current research to guide diagnostic testing and treatment decision-making. 21

23 L. N Provide primary reproductive health care to clients (both male and female). a. Obtain a complete health history and perform an appropriate physical examination. Skill, Level 3 b. Assess risk factors for reproductive health problems as evidenced by health history and physical examination findings. c. Generate appropriate problem lists based on health history and physical examination findings. d. Integrate findings from the health history and physical examination to identify reproductive health problems and develop appropriate diagnostic, therapeutic, educational plans and follow-up plans. e. In consultation with client, develop an appropriate treatment plan that takes into account the client s ethnicity and cultural beliefs. Skill and Attitude, Level 5 f. Accurately document all findings and interventions. 2. Collaborate with other health care providers/agencies within the health care system: Skill, 5 a. Confer with other health care providers (preceptor/colleagues) as needed providing succinct case presentations concerning assessment, treatment and follow-up. b. Serve as a consultant when appropriate. Skill and Attitude, Level 6 M. N Perform complete health histories and physical examinations on age appropriate clients. Skill, Level 3 2. Teach health promotion and disease prevention for clients of age appropriate groups. 5. Identify potential complication of health problems with appropriate follow-up and referrals. Skill, Level 1 22

24 N. N Review the literature on the identified area of concern. Knowledge, Level 2 8. Present the research project in class to peers and faculty. 9. Report the research project (in the form of a journal article) to faculty. 10. Submit the article to a relevant professional journal for publication. O. N Be able to discuss the differential diagnoses associated with common health problems. 6. To have an understanding of the appropriate education, prevention, referral and follow-up needed for common health problems found in adults. Skill and Attitude, Level To identify sources of current research and health related information to incorporate into client care management modalities. Skill, Level To utilize current research to develop interventions which facilitate positive care management outcomes. 12. To utilize group process and peer review in developing practice guidelines which are aimed at creating cost-effective, quality care. 23

25 IV. General Student Learning Outcome Assume the role of the advanced practice nurse by demonstrating accountability for the quality of one s own practice, engaging in professional activities, advocating for change and working effectively in interdisciplinary relationships. Specific Learning Outcomes A. N Analyze and articulate the role of the nurse practitioner in the context of an ever changing health care delivery system. Knowledge and Attitude, Levels 5 3. Explore ethical and cultural issues that serve to sharpen the nurse practitioner practice in the complete and diverse society. Knowledge and Attitude, Level 5 B. N 7720 C. N 7730 D. N7740 E. N Appreciate the philosophical and historical perspectives of theory development in nursing. 4. Understand the nature of praxis in nursing. 7. Formulate a philosophical position on the nature of advanced practice nursing. No objectives apply to this outcome 1. Discuss the framework that links nursing research to the clinical practice of nursing. Knowledge, Level 2 2. Examine the steps of the research process (comprehension, comparison, analysis and evaluation). Skill, Level 2 6. Examine the utilization of nursing research findings in clinical practice focusing on the nurse practitioner role. Knowledge, Level 2 8. Develop a research proposal appropriate to the nurse practitioner role such as an investigation of clinical phenomena, delivery systems, or cost effectiveness in primary health care. No objectives apply to this outcome 24

26 F. N7760 No objectives apply this to outcome G. N Be able to decide on the appropriate education, anticipatory guidance, prevention, referral and follow-up needed for common health problems. 6. Have an understanding of the appropriate education, anticipatory guidance, prevention, referral and follow-up needed for common health problems. 10. Utilize current research to develop interventions that facilitate positive care management outcomes. H. N Facilitate a climate that applies the principle of support and self-efficacy to practice. Skill, Level Utilize current research to develop interventions that facilitate positive outcomes in the primary care of middle age and older adults with chronic health problems. I. N 8830 No objectives apply to this outcome J. N8850 No objectives apply to this outcome K. N Collaborate with other health cared providers/agencies within the health care system: a. Confers with other health care providers (preceptor/colleagues) as needed providing succinct case presentations concerning assessment, treatment and follow-up. b. Serve as a consultant when appropriate. Skill and Attitude, Level 6 25

27 3. Evaluate one s own practice with regard to accountability to self, client and colleagues: Skill and Attitude, Level 6 d. Note strengths/weaknesses and identify learning needs. Skill and Attitude, Level 1 e. Recognize the boundaries of advanced nursing practice as delineated by the profession, and one s own competency. Skill, Level 1 f. Utilize current research to guide diagnostic testing and treatment decision-making. L. N Collaborate with other health care providers/agencies within the health care system: Skill, 5 a. Confer with other health care providers (preceptor/colleagues) as needed providing succinct case presentations concerning assessment, treatment and follow-up. b. Serve as a consultant when appropriate. Skill and Attitude, Level 6 3. Evaluate one s own practice with regard to accountability to self, clients and colleagues: Skill and Attitude, Level 6 g. Note strengths/weakness and identify learning needs Skill and Attitude, Level 1 h. Recognize the boundaries of advanced nursing practice as delineated by the profession and one s own competency Skill, Level 1 i. Utilize current research to guide diagnostic testing and treatment decision-making M. N Perform complete health histories and physical examinations on age appropriate clients. Skill, Level 3 2. Teach health promotion and disease prevention for clients of age appropriate groups. 3. Perform focused, episodic sick visits on clients of age-appropriate groups. Skill, 3 26

28 4. Identify and treat common, complex and reproductive health problems found in age appropriate groups taking into consideration the clients ethnic and/or cultural diversity. Skill and Attitude, Level 1 5. Identify potential complication of health problems with appropriate follow-up and referrals. Skill, Level 1 6. Integrate all previously learned theoretical knowledge and clinical skills into advanced nursing practice. N. N Identify an area of concern in primary health care that is in need of further investigation in order to increase knowledge and skills in nurse practitioners in providing health care to clients. Knowledge, Level 1 2. Confer with faculty concerning the significance, scope and feasibility of the proposal. Skill, Level 2 3. Submit a research proposal and an IRB application regarding chosen area of concern. (Students may use their proposal for NURS 7740) 5. Using a theoretical model as framework, design a research project that will increase knowledge and understanding of this area of concern. O. N To develop an understanding of cultural diversities and ethical considerations in the care of adults. Skill and Attitude, Level 5 8. To recognize the importance of a caring and supportive climate which protects client confidentiality. Skill and Attitude, Level To identify sources of current research and health related information to incorporate into client care management modalities. Skill, Level 1 27

29 V. General Student Learning Outcomes Demonstrate leadership in roles as divergent as clinician, educator, advocate and manager in a variety of areas such as education, practice and community health programs by influencing health care delivery systems as shaped by health care policy and societal norms and expectations. Knowledge and Skill, Level 3 Specific Learning Outcomes A. N Analyze and articulate the role of the nurse practitioner in the context of an ever changing health care delivery system. Knowledge and Attitude, 5 2. Investigate and analyze legal, socioeconomic and political issues that impact contemporary nurse practitioner practice. 3. Explore ethical and cultural issues that serve to sharpen the nurse practitioner practice in the complete and diverse society. 4. Explore and analyze historical events that have influenced the view of the nurse practitioner role. Knowledge, Level 3 5. Analyze the impact of health care policy on client care and nurse practitioner practice. Knowledge and 6. Demonstrate knowledge of classic/current literature relating to the development and implementation of the role of the nurse practitioner. Knowledge and Skill, Levels 5 B. N Describe, analyze and critique selected nursing theories and paradigms that influence advanced practice nursing 7. Formulate a philosophical position on the nature of advanced practice nursing. 8. Demonstrate an appreciation for the relationship between nursing theory and advanced nursing practice. Skill and Attitude, Level 5 C. N Apply principles of epidemiology and demography in planning anticipatory guidance and counseling regarding wellness, lifestyle, disease risks and potential changes in health status. Knowledge and Skill, Levels, 5 28

30 D. N Examine the utilization of nursing research findings in clinical practice focusing on the nurse practitioner role. Skill, Level 2 8. Develop a research proposal appropriate to the nurse practitioner role such as an investigation of clinical phenomena, delivery systems, or cost effectiveness in primary health care. E. N7750 No objectives apply to this outcome F. N7760 G. N 8805 H. N 8815 No objectives apply to this outcome 11. Identify sources of current research and health related information to incorporate into client care management modalities. Knowledge, Level Utilize current research to develop interventions that facilitate positive care management outcomes. 7. Facilitate a climate that applies the principle of support and self-efficacy to practice. Skill, Level 3 I. N Identify the health care issues and concerns of reproductive health. Knowledge, Level 1 J. N8850 No objectives apply to this outcome 29

31 K. N Collaborate with other health care providers/agencies within the health care system: a. Confer with other health care providers/agencies (providers/colleagues) as needed providing succinct case presentations concerning assessment, treatment and follow-up. Skill, Level 5 b. Serve as a consultant when appropriate. Attitude and L. N8852 M. N Collaborate with other health care providers/agencies within the health care system: a. Confer with other health care providers (preceptor/colleagues) as needed providing succinct case presentations concerning assessment, treatment and follow-up. b. Serve as a consultant when appropriate. Skill and Attitude, Level 6 3. Evaluate one s own practice with regard to accountability to self, clients and colleagues: Skill and Attitude, Level 6 a. Note strengths/weakness and identify learning needs Skill and Attitude, Level 1 b. Recognize the boundaries of advanced nursing practice as delineated by the profession, and one s own competency Skill, Level 1 c. Utilize current research to guide diagnostic testing and treatment decision-making 1. Perform complete health histories and physical examinations on age appropriate clients. Skill, Level 3 2. Teach health promotion and disease prevention for clients of age appropriate groups. 3. Perform focused, episodic sick visits on clients of age-appropriate groups. Skill, Level 3 4. Identify and treat common, complex and reproductive health problems found in age appropriate groups taking into consideration the client s ethnic and/or cultural diversity. Skill and Attitude, Level 1 30

32 N. N Identify potential complication of health problems with appropriate follow-up and referrals. Skill, Level 1 6. Integrate all previously learned theoretical knowledge and clinical skills into advanced nursing practice. 6 Conduct the research project within the specified time frame. 10. Submit the article to a relevant professional journal for publication. O. N Use group process and peer review in developing practice guidelines which are aimed at creating cost-effective, quality care. 31

33 SECTION I ARTICULATING STUDETN LEARNING OUTCOMES The Self-Evaluation of Indicators IA. Knowledge/Skill/Attitude Balance and Student Centered Rating and Response: Exemplary The general student learning outcomes, GLOs, reflect knowledge, skill, and attitudinal student learning outcomes as identified in the international/intercultural competencies developed by the American Council on Education. Nursing is a practice discipline and therefore incorporates knowledge, skill, and attitude into every GLO and SLO in the program. There is a priority, however, given to each of the outcomes. This process continues in the SLOs with some outcomes identified as only one of the competencies or a combination of the competencies. The identification of the competencies given to both the GLOs and SLOs represent the prioritization of these competences as they relate to the overall curriculum for the PCN program. For example, the GLO #3 (utilize therapeutic and professional communication techniques with clients, colleagues, and other health care professionals in order to facilitate client self care, coordinate services, secure consultations and referrals by using advanced information and communication technologies when appropriate.) has a priority of a Knowledge and Skill objective. A course SLO that correlates to this program outcome is in NUR 7710, SLO #1 (analyze and articulate the role of the nurse practitioner in the context of an ever-changing health care delivery system.). This specific course SLO is a knowledge and skill SLO indicating the integration of two categories. Another example of a course objective from NURS 7760, SLO #2 (demonstrate evidence of thought processes indicating understanding of selected disease states.), is a knowledge SLO. Whereas, in NURS 8815, the specific course objective SLO #2 (identify the history taking and physical assessment skills utilized in the evaluation of chronic health problems encountered in primary care in middle-aged and older adults.), is a knowledge and skill SLO. All GLOs and SLOs are student centered; they begin with action verbs such as synthesize, demonstrate, and apply which focus on student achievement of knowledge, skills, and/or attitudes rather than what the program or courses provide. The three examples of SLOs stated in the earlier part of IA provide examples of the student centered focus. A complete overview of the grid and expanded format in the first section of this report further documents this overall assessment rating. IB. SLO Differentiation Rating and Response: Exemplary The specific student learning outcomes are focused, use action verbs, and are measurable. Referring to the grids, specific SLOs are differentiated from the GLOs. Many of the specific learning outcomes restate the general SLOs in terms of specifics to that course s content. In addition, there are more detailed SLOs differentiated from the GLOs. For example, in the GLO #1 (provide culturally competent age specific primary care to diverse clients based on a strong theoretical and research foundation thereby improving health care delivery and client care outcome) expresses a broader outcome for 32

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