NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation

Faculty will lead virtual debriefing sessions during Weeks 1-6. The date, time, and duration of the weekly debriefing session will be posted by the course faculty. Students must register to attend the debriefing session.

During the debriefing process, students reflect upon their simulation experience and revisit their assessments, interventions, observations, and patient responses. Faculty coach students to review patient data and reflect upon the interventions performed in response to the clinical situation presented during the simulation experience. This process facilitates students to analyze their own thought processes and supports transference of knowledge gained from simulation experiences to actual clinical practice. NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation.

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The goals of each debriefing session are to:

Answer questions
Address perspectives, perceptions, and concerns
Emphasize and reinforce learning objectives and clinical outcomes
Create linkages to the “real world”
Assess and validate what was learned

Each student is expected to contribute to the debriefing session by: NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation

Reflecting on personal strengths, limitations, beliefs, prejudices, or values
Identify improvement goals and strategies
Discuss the simulation experience and provide comments and suggestions to student peers
Transfer knowledge from the simulation experience to actual clinical practice

Please refer to the Debriefing Session Guidelines and Grading Rubric located in the Course Resource section.

NR 509 Week 1 Assignment Alternate Writing Assignment

NOTE: You will complete this alternate writing assignment ONLY if you had not participated or do not plan to participate in a debriefing session for the given week.

As a family nurse practitioner, you must possess excellent physical assessment skills. This alternate writing assignment mirrors the discussion content of the debriefing session and will allow the student to expand their knowledge of physical health assessment principles specific to the advanced practice role. NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation.

The purposes of this assignment are to: (a) identify and articulate advanced assessment health history and physical examination techniques which are relevant to a focused body system (CO 1), (b) differentiate normal and abnormal findings with regard to a disease or condition that impacts the body system (CO 2), and (c) adapt advanced assessment skills if necessary to suit the needs of specific patient populations (CO 4).

Please refer to the Alternate Writing Assignment Guidelines and Grading Rubric located in the Course Resource section.

NR 509 Week 1: Shadow Health: Digital Clinical Experience (DCE) Orientation

NR 509 Week 1: Shadow Health: Conversation Concept Lab

These activities and exercises will introduce the student to the functions of open and closed questions in effective communication during a patient interview. NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation.

Pre-brief

Obtaining an accurate history is the critical first step in determining the etiology of a patient’s problem. A large percentage of the time, you will actually be able to make a diagnosis based on the history alone. The value of the history, of course, will depend on your ability to elicit relevant information. NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation Your sense of what constitutes important data will grow exponentially as you practice your interviewing skills and through increased exposure to patients and illness. However, you are already in possession of the tools that will enable you to obtain a good history. Specifically, you must listen and ask appropriate questions to define the nature of a particular problem. In fact, seasoned clinicians occasionally lose sight of this important point, placing more reliance on the use of diagnostic testing rather than taking the time to listen to their patients. Interviewing patients is an art and should remain an essential skill for successful practice. NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation.

In this activity, you will interview Tina Jones to collect data to assess Ms. Jones’ condition. You will also have the opportunity to educate and empathize with Tina to engage in effective therapeutic communication; create a problem list using evidence from the data you collected; prioritize the identified problems to differentiate immediate from non-immediate care; plan how to best address the most important concern with further assessment, interventions, and patient education; and compare your documentation to model documentation.

Ms. Jones is a pleasant, 28-year-old obese African American single woman who presents to establish care and with a recent right foot injury. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Her speech is clear and coherent and she maintains eye contact throughout the interview.

Reason for visit: Patient presents for an initial primary care visit today complaining of a right foot wound. NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation.

Rubric

Shadow Health Physical Assessment Rubric

Criteria

Ratings

Pts

Subjective Data, Organization, Communication, and Summary (DCE Score or transcript). NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation.

25.0 pts

Above Average- DCE Score greater than or equal to 93; Comprehensive introduction with expectations of exam verbalized; questions worded in a non-judgmental way; professional language exercised; questions well-organized; appropriate closing with summary of findings verbalized to patient. NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation

21.0 pts

Average- DCE Score greater than or equal to 86-92; Adequate introduction; some questions worded in a non-judgmental way; professional language mostly exercised; questions generally organized; somewhat complete closing.

10.0 pts

Below Average- DCE Score greater than or equal to 80-85; Incomplete introduction; many questions worded in a judgmental way; some professional language exercised; questions somewhat organized; incomplete closing.

0.0 pts

Unsatisfactory- DCE Score less than or equal to 79; Introduction missing; questions worded in a judgmental way; little professional language; questions unorganized; closing missing.

25.0 pts

Objective Data, Physical Examination, Interpretation of Findings, Assessment, and Documentation

20.0 pts

Above Average- Physical assessment documentation includes all relevant body systems; all pertinent normal and abnormal findings identified; documentation reflects professional language; treatment plan includes each of the following components: diagnostics, medication, education, consultation/referral, and follow-up planning.

16.0 pts

Average- Physical assessment documentation lacks sufficient details pertaining to one or two relevant body systems; or identifies ≥ 50% of the pertinent normal and abnormal findings; or documentation lacks professional language; or treatment plan lacks one or two components (diagnostics, medication, education, consultation/referral, or follow-up planning).

8.0 pts

Below Average- Physical assessment documentation lacks sufficient details pertaining to three or more relevant body systems; or identifies < 49% of the pertinent normal and abnormal findings; or documentation includes unprofessional language; or treatment plan lacks three or more components (diagnostics, medication, education, consultation/referral, or follow-up planning).

0.0 pts

Unsatisfactory- No physical assessment documentation or no treatment plan.

20.0 pts

Self-Reflection

5.0 pts

Above Average- Responds to three of the three reflection post questions; and provides analysis of performance; and reflection posts written using professional language; and reflection posts demonstrate insight.

3.0 pts

Average- Responds to two of the three reflection post questions; or provides limited self-analysis of performance; or reflection posts are somewhat unclear related to the assignment and the student’s experience; or reflection posts lack insight.

2.0 pts

Below Average- Responds to one of the three reflection post questions; or does not provide self-analysis of performance; or reflections are not related to the assignment and the student’s experience; or does not provide insight. NR 509: Shadow Health: Digital Clinical Experience (DCE) Orientation

0.0 pts

Unsatisfactory- No reflection posts for the assignment.

5.0 pts

Total Points: 50.0