Please review the attached instructions. Use the Practicum Experience Plan (attached word document – Practicum_Experience_Plan

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Self-assessment of Clinical Skills

Ariel Cordova Lopez

Walden University

PRAC 6635: Psychopathogy and Diagnostic Reasoning Practicum

Dr. Brandy Benson

March 05, 2022

Introduction

According to the American Association of Nurse Practitioners, NPs are licensed clinicians with a doctorate or master's education who provide advanced health care to clients in collaboration with other health care professionals. Clinical training is an educational module that provides psychiatric mental health nurse practitioners an opportunity to assess, diagnose, and treat patients with mental and behavioral disorders. Clinical training offers PMHNP with essential skills to undertake their job functions. The clinical assessment form identifies and discusses my strengths and weaknesses concerning clinical skills. During the practicum experience, goals and objectives are necessary to maintain focus throughout the experience (Kleinpell et al., 2018).

Desired Clinical Skills for Students to Achieve	Confident (Can complete independently)	Mostly confident (Can complete with supervision)	Beginning (Have performed with supervision or need supervision to feel confident)	New (Have never performed or does not apply)
Comprehensive psychiatric evaluation skills in:
Recognizing clinical signs and symptoms of psychiatric illness	Confident
Differentiating between pathophysiological and psychopathological conditions		Mostly confident
Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)		Mostly confident
Performing and interpreting a mental status examination			Beginning
Performing and interpreting a psychosocial assessment and family psychiatric history		Mostly confident
Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).		Mostly confident
Diagnostic reasoning skill in:
Demonstrate knowledge of psychopathology of mental illnesses through discussion for different age groups and mental illnesses			Beginning
Developing and prioritizing a differential diagnoses list			Beginning
Formulating diagnoses according to DSM 5 based on assessment data			Beginning
Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes			Beginning
Psychotherapeutic Treatment Planning
Provide psychoeducation to individuals and/or any caregivers			Beginning
Promote health and disease prevention techniques		Mostly confident
Self-Assessment skill:
Develop SMART goals for practicum experiences		Mostly confident
Evaluating outcomes of practicum goals and modify plan as necessary		Mostly confident
Documenting and reflecting on learning experiences		Mostly confident
Professional skills:
Maintains professional boundaries and therapeutic relationship with clients and staff	Confident
Collaborate with multidisciplinary teams to improve clinical practice in mental health settings	Confident
Identifies ethical and legal dilemmas with possible resolutions	Confident
Demonstrates nonjudgmental practice approach and empathy	Confident
Practices within scope of practice	Confident
Selecting and implementing appropriate screening instrument(s) and interpreting results:
Demonstrates selecting the correct screening instrument appropriate for the clinical situation			Beginning
Implements the screening instrument efficiently and effectively with the clients			Beginning
Interprets results for screening instruments accurately			Beginning
Identifies the need to refer to another specialty provider when applicable			Beginning
Accurately documents recommendations for psychiatric consultations when applicable		Mostly confident

Summary of strengths

Patient-centered care is my greatest strength during my daily routines with my patients. my patient-centered approach enables me to obtain relevant historical information and perform a complete physical and mental status exam. My culturally competent communication methods make me aware of patients' empathic interview techniques. Patient-centered care enables a nurse practitioner to treat clients with respect and dignity. Another strength is delivering personalized and supportive care to my clients (Chambers & Ryder 2018). Over the years, I gained experience maintaining a positive attitude while communicating with patients to avoid annoying them. Empathic interview techniques allow me to perform a comprehensive examination of patients to develop an accurate diagnosis of their condition. To maintain these skills, I practice them daily in community health clinics and medical wards. I can describe the variations in the patient presentation according to age and cultural background.

Another essential skill that is quite beneficial to me is recognizing and making recommendations on the possible use of psychotropic drugs. I usually embrace a warm demeanor during my interactions with my patients, which is essential in obtaining historical data from multiple sources. I have a complete understanding of each component of the mental status exam which enables me to describe common abnormalities and their causes. The principle of communication has allowed me to conduct myself professionally and be more empathetic to accept criticism and learn from my mistakes. Documentation is another notable strength that I utilize to note down clinical findings, diagnoses, and clinical reasoning. At times, laboratory findings may be unavailable; hence, I use my communication skills to obtain information with the patient and other professionals. My multifaceted skill sets have been an immense help, especially in the early identification of psychopathology symptoms.

Opportunities for growth

I need to develop more interview techniques for challenging situations, such as dealing with hostile, potentially assaultive, and cognitively impaired patients. There are many complications when it comes to diagnosing mental and behavioral disorders. Most psychological and pathophysiological disorders are challenging to diagnose because they require extensive knowledge; hence I need to gain a more comprehensive understanding and better my assessment skills. I need to focus on psychopathological differential diagnosis in that it becomes my priority. Another area of improvement is distinguishing between psychopathology and pathophysiology since they are two broad fields that require more profound understanding. The mental diagnosis process is lengthy in that it begins with the conduction of a physical examination of the patient (Phillips, 2020).

A mental status examination is then done, followed by a psychological assessment to do away with differential diagnosis to arrive at an accurate psychosocial diagnosis. Over the years that I have been caring for patients with behavioral disorders, it goes unnoticed that psychopathological diagnosis and treatment require in-depth knowledge and assessment skills. As a result, most diagnostic tests are unreliable during diagnosing psychopathological diseases. I need to widen my knowledge of psychopathological conditions to improve these weaknesses. I have to take advantage of every opportunity during the clinical rotations to apply the acquired knowledge. I also have a liability in the performance and interpretation of mental status examinations. I have to embark on vigorous clinical practice sessions to boost my experience in the interpretation of mental status examinations. Another way to improve my knowledge at the clinical sites is by continuous practice and personal and professional development. The newly acquired skills will encourage the provision of evidence-based and patient-based care as PMHNP (Price & Reichert, 2017).

Possible Goals and objectives

1. Goal: Incorporate knowledge on clinical reasoning and differential diagnosis

a) Objective: Identify signs and symptoms predisposing to any psychopathological disorder

b) Objective: understand basic test outcomes and other professional reports

c) Objective: Develop differential diagnosis of some clients with psychiatric disorders.

2. Goal: Independently develop psychiatric diagnosis at the end of the practicum

a) Objective: demonstrate the practical application of advanced techniques in the assessment process

b) Objective: Identify differential psychiatric diagnosis by utilizing patient's concerns and physical assessment

c) Objective: Apply laboratory and other medical tests to evaluate clients

3. Goal: Expand mental status examination skills by the end of the period

a) Objective: monitor patients and perform cognitive assessments

b) Objective: recognize and differentiate clinical features to make accurate recommendations

c) Objective: perform mental status exams and interpret its results accurately

References

Chambers, C., & Ryder, E. (2018). Compassion and caring in nursing. Routledge.

Kleinpell, R., Cook, M. L., & Padden, D. L. (2018). American Association of Nurse Practitioners National Nurse Practitioner sample survey: Update on acute care nurse practitioner practice. Journal of the American Association of Nurse Practitioners, 30(3), 140-149.

Phillips, K. (2020). Mental illness is not anyone's fault: a review of NAMI, the National Alliance on Mental Illness. Journal of Consumer Health on the Internet, 24(1), 75-81.

Price, S., & Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: meeting the needs of novice to mid-to late-career nurses throughout their career span. Administrative Sciences, 7(2), 17.

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Assignment 2: Practicum Experience Plan (PEP)

As you establish your goals and objectives for this course, you are committing to an organized plan that will frame your practicum experience in a clinical setting, including planned activities, assessment, and achievement of defined outcomes. In particular, they must address the categories of clinical reasoning, quality in your clinical specialty, and interpersonal collaborative practice. 

For this Assignment, you will consider the areas you aim to focus on to gain practical experience as an advanced practice nurse. Then, you will develop a Practicum Experience Plan (PEP) containing the objectives you will fulfill in order to achieve your aims. In this practicum experience, when developing your goals and objectives, be sure to keep psychiatric assessment and diagnostic reasoning in mind. 

To Prepare

· Review your Clinical Skills Self-Assessment Form you submitted last week (See attached document) and think about areas for which you would like to gain application-level experience and/or continued growth as an advanced practice nurse. How can your experiences in the Practicum help you achieve these aims? 

 

· Your practicum learning objectives that you want to achieve during your Practicum experience must be: 

· Specific  

· Measurable  

· Attainable  

· Results-focused  

· Time-bound 

· Reflective of the higher-order domains of Bloom’s taxonomy (i.e., application level and above)  

Note: Please make sure your objectives are outlined in your Practicum Experience Plan (PEP).  (Attached document)

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Master of Science in Nursing  

Practicum Experience Plan

Overview:

Your Practicum experience includes working in a clinical setting that will help you gain the knowledge and skills needed as an advanced practice nurse. In your practicum experience, you will develop a practicum plan that sets forth objectives to frame and guide your practicum experience.

As part of your Practicum Experience Plan, you will not only plan for your learning in your practicum experience but also work through various patient visits with focused notes as well as one (1) journal entry.

Complete each section below.

Part 1: Quarter/Term/Year and Contact Information

Section A

Quarter/Term/Year:

Student Contact Information

Name:

Street Address:

City, State, Zip:

Home Phone:

Work Phone:

Cell Phone:

Fax:

E-mail:

Preceptor Contact Information

Name:

Organization:

Street Address:

City, State, Zip:

Work Phone:

Cell Phone:

Fax:

Professional/Work E-mail:

Part 2: Individualized Practicum Learning Objectives

Refer to the instructions in Week 2 to create individualized practicum learning objectives that meet the requirements for this course. These objectives should be aligned specifically to your Practicum experience. Your objectives should address your self-assessment of the skills found in the “PMHNP Clinical Skills Self-Assessment Form” you completed in Week 1.

As you develop your individualized practicum learning objective, be sure to write them using the SMART format. Use the resources found in Week 2 to guide your development. Once you review your resources, continue and complete the following. Note: Please make sure each of your objectives are connected to your self-assessment. Also, consider that you will need to demonstrate how you are advancing your knowledge in the clinical specialty.

** YOU MUST HAVE 3 NEW OBJECTIVES EACH QUARTER. You may include previous practicum objectives; however, you still must have 3 new objectives for your current course.

Objective 1: <write your objective here> ( Note : this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment: (Note: Verification will be documented in Meditrek)

PRAC Course Outcome(s) Addressed:

· (for example) Develop professional plans in advanced nursing practice for the practicum experience

· (for example) Assess advanced practice nursing skills for strengths and opportunities 

Objective 2: <write your objective here> ( Note : this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment: (Note: Verification will be documented in Meditrek)

PRAC Course Outcome(s) Addressed:

·

Objective 3: <write your objective here> ( Note : this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment: (Note: Verification will be documented in Meditrek)

PRAC Course Outcome(s) Addressed:

·

Part 3: Projected Timeline/Schedule

Estimate how many hours you expect to work on your Practicum each week. *Note: All of your hours and activities must be supervised by your Preceptor and completed onsite. Your Preceptor will approve all hours, but your activities will be approved by both your Preceptor and Instructor. Any changes to this plan must be approved.

This timeline is intended as a planning tool; your actual schedule may differ from the projections you are making now.

I intend to complete the 144 or 160 Practicum hours (as applicable) according to the following timeline/schedule. I also understand that I must see at least 80 patients during my practicum experience. I understand that I may not complete my practicum hours sooner than 8 weeks. I understand I may not be in the practicum setting longer than 8 hours per day unless pre-approved by my faculty.

	Number of Clinical Hours Projected for Week (hours you are in Practicum Setting at your Field Site)	Number of Weekly Hours for Professional Development (these are not practicum hour)	Number of Weekly Hours for Practicum Coursework (these are not practicum hours)
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Week 7
Week 8
Week 9
Week 10
Week 11
Total Hours (must meet the following requirements)	144 or 160 Hours

Part 4 – Signatures

Student Signature (electronic): Date:

Practicum Faculty Signature (electronic)**: Date:

** Faculty signature signifies approval of Practicum Experience Plan (PEP)

Submit your Practicum Experience Plan on or before Day 7 of Week 2 for faculty review and approval.

Once approved, you will receive a copy of the PEP for your records. You must share an approved copy with your Preceptor. The Preceptor is not required to sign this form.

© 2020 Walden University 3

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