NURS 5644 Fall 2018 Advanced Assessment/ Differential Diagnosis Syllabus
NURS 5644 Fall 2018 Advanced Assessment/ Differential Diagnosis Syllabus
NURS 5644 Fall 2018 Advanced Assessment/ Differential Diagnosis Syllabus
Texas Woman’s University College of Nursing
Dallas Campus
Prerequisite Knowledge:
It is expected that the student is knowledgeable of nursing process, nursing diagnoses, problem- oriented documentation, nursing theories, and health promotion, and be able to perform a basic physical examination.NURS 5644 Fall 2018 Advanced Assessment/ Differential Diagnosis Syllabus
Pre-requisite / Co-requisite: BIOL 5333
Course Description:
Students examine the systematic processes involved in performing a holistic health assessment on individuals throughout the life span; Includes knowledge and skills necessary to gather data, interpret findings, make health diagnoses, develop a plan of care, communicate results, and empower clients.
| Faculty | Office | |
| Annie Abraham, DNP, RN, FNP-BC Course Manager | 7125 | [email protected] |
| Susan Chrostowski. DNP, APRN, ANP-C | 7104 | [email protected] |
| Julie Dreadin, DNP, RN, WHNP-BC | 7302 | [email protected] |
| Margaret Ernster, DNP, RN, FNP-C | TBA | [email protected] |
| Kathryn Kremer, MSN, RN, FNP-C | 7215 | [email protected] |
| William Lodrigues, DNP, RN, WHNP-BC | 7302 | [email protected] |
| Office hours by appointment. | ||
| Course Credit: |
4 semester hours. 3 didactic hours and 3 hours of clinical practicum per week.
Course Objectives:
- Demonstrate sound critical thinking and clinical decision-making.
- Develop a comprehensive database, including complete functional assessment, health history, physical examination, and appropriate diagnostic testing.
- Perform a risk assessment of the client including assessment of lifestyle and other risk
- Identify signs and symptoms of common emotional/cognitive health problems and the impact on physical
- Perform basic laboratory tests and interpret other laboratory and diagnostic
- Relate assessment findings to underlying pathology or physiologic
- Establish a differential diagnosis based on assessment
- Develop an effective and appropriate plan of care for the client, which takes into consideration life circumstances and cultural, ethnic, and developmental
- Develop beginning skills at writing accurate
- Recognize the variations in health, including physiologic variations, in a wide range of cultural, racial, ethnic, age, and gender groups that may influence the assessment and plan of care.
NURS 5644 Fall 2018 Advanced Assessment/ Differential Diagnosis Syllabus Course Content:
Emphasis in this advanced course will be to individualize the history and physical exam to the presenting health concerns of the client throughout the lifespan. A review of the systematic process involved in performing a comprehensive history, physical, and psychological health assessment on individuals includes knowledge and skills necessary to gather data, interpret findings, formulate differential diagnosis, and communicate findings/plans.
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Learning Activities:
Activities of the course include: class lecture, independent study of online presentations, laboratory hours, online videos, microscopy lab, and an online simulated patient experience. Please note that the course is partially online and that it is the student’s responsibility to review and print the course materials/documents prior to arriving in class. Materials may be printed in the computer lab on the 6th floor before the day of class or from home.
Evaluation:
The student must achieve a minimum average of 80% (B) for course work AND obtain a satisfactory grade for the clinical lab assignments to pass the course. Assignments include the following: completion of 45 clinical lab hours, comprehensive and focused exam practicum, focused SOAP notes, child development assignment, Microscopy assignment, Shadow Health assignments, quizzes, and 3 proctored exams.
TWU COLLEGE OF NURSING GRADING SCALE:
Students must achieve a minimum of 80% to successfully complete the course. 90 – 100= A
80 – 89= B
70 – 79= C
60 – 69= D
Below 60 = F
NURS 5644 Fall 2018 Advanced Assessment/ Differential Diagnosis Syllabus Overall Course Grade:
| Grading Elements: | Weight % |
| Shadow Health – Health History Assignment | 4% |
| Shadow Health – Focused Exam – cough | 5% |
| Shadow Health – Focused Exam – abdominal pain | 5% |
| Quizzes (3 quizzes @ 2% each) | 6% |
| Exam I | 20% |
| Exam II | 20% |
| Final Exam | 25% |
| Final SOAP note | 15% |
| Comprehensive Physical Examination | Pass/Fail |
| Final Focused Practicum | Pass/Fail |
| Shadow Health System-by-system Assignments Must achieve a minimum DCE score of 80 % | Pass/Fail |
| SOAP 1 and 2 | Pass/Fail |
| Clinical Calendar completion | Pass/Fail |
| Child Development Assignment | Pass/Fail |
| Microscopy Assignment | Pass/Fail |
*For the final grade only, grades will be rounded. For example, 79.5 or greater will round to
- 5 or greater will round to 90. This means that 79.49 and 89.49 will not be rounded.
*Students are expected to review their grades as they are entered. Students will have up to two weeks after a grade is entered to contest a grade; faculty may refuse to allow grades to be contested after the two-week period. Grades may be reviewed by a second faculty, and after review may sometimes result in either increasing or lowering of the grade per faculty judgment.
*Pass/fail assignments are considered integral to the course. If a student fails a written pass/fail assignment they may be given an opportunity to resubmit at discretion of their faculty. There will only be one re-submission allowed, and after that the assignment will be marked as failing and the student will be given a make-up assignment to complete. Student failing more than one Pass/fail assignment for the semester are at jeopardy for failing the course.
NURS 5644 Fall 2018 Advanced Assessment/ Differential Diagnosis Syllabus FINAL ASSESSMENT CHECKOFFS:
- Comprehensive Physical Exam– For this assignment, all students will record themselves doing a complete head-to-toe physical assessment per the requirements on the check-off rubric on Canvas. The lab administrators will post a sign-up sheet for exam recording on the 4th floor after the semester begins. You may only sign up for one slot. Examinations should be recorded in the school lab
The physical should be one continuous exam, without starts and stops. Students may not view notes until the end of the examination time, and are only allowed a total of 2 minutes for note viewing. No other forms of note viewing or answer prompting will be allowed. Students will be expected to follow these rules and if not, it will be considered a breach of academic integrity and will result in automatic class failure.
Students may bring a 16G thumb drive to save their videos and watch for completeness and accuracy. There is no need for students to submit their videos to faculty.
2) Focused Physical Exam Practicum-
- Part 1: History and Physical exam: Students will be paired with another student to do a focused history and physical exam. This will not be their usual lab partner, but someone they have not previously examined. Students will have 30 minutes to collect an appropriate history and do a focused exam. Their partner will be given a sheet with specifics about a common, uncomplicated complaint. He/she will answer the student’s questions with this information. Students will be given a sheet to take notes during the
- Part 2: Final SOAP note: When both of the paired students have completed the history and physical exam each student will have 1 hour and 30 minutes to type the Final SOAP note. Students will complete the SOAP note in Room 6504. This will include a diagnosis with one additional differential and a treatment plan. Students need at least 2 references for this paper. They may use their texts and online references such as Emedicine, Medscape, Epocrates, CDC.gov, or other professional sites. (NO WIKIPEDIA!)
· Final Soap Note Late Penalty:
If the SOAP note is 1-29 minutes late there is a 5-point penalty. If it is 30-60 minutes late there is a 10-point penalty. No notes will be accepted if >60 minutes late (total time >2.5 hours).
Failure of Assessment Checkoffs: Students must pass both checkoffs to pass the course. If students fail either final checkoff they may be asked to return to lab on final exam day to be evaluated by a second faculty in order to pass the class. If a student does not pass at this time then they will automatically fail the class, even if their cumulative grade average is passing.
QUIZZES:
To encourage students to be prepared with class readings and attend class regularly, during some class days students will have a one question pop quiz. The quiz will be based on the assigned readings for the day. There will be 3 of these quizzes given during the semester. Quizzes are 6% of the total course grade. Students will earn one point on the quiz for being present, and one point for a correct answer, with a total of two points possible for each quiz. Students not present for the quiz will not be able to take the quiz. There is no make-up for these quizzes.
CLINICAL CALENDAR:
Students are required to create an account on Clinical Calendar (CC). CC will be used by students to document clinical lab time in N5644 as well as clinical hours and patient encounters during the remainder of their course of study. Clinical Calendar is not part of the Canvas or Pioneer Portal
systems. If you need support in getting the calendar to work, do not email or call TWU’s IT department. Instead, use the following email: [email protected]
All clinical calendar entries are expected to be completed within 2 weeks of the given activity (lab, video, etc.). All entries must be entered by the last class day before final exams in order to be counted for the semester and the Clinical Hours Inventory form must be submitted to drop box. The total hours
for the semester should equal 45 hours. Failure to complete 45 hours by the end of the semester will result in course failure.
At the end of each semester, students should print the report of total hours completed and keep this documentation for their personal records. An orientation to Clinical Calendar will be given the first day of class.
SHADOW HEALTH ASSIGNMENTS
Shadow Health provides a clinical simulation designed to improve your assessment skills in a safe learning environment. You will examine digital patients throughout the course that are accessible online 24/7. There is a certain learning curve involved with the technical components of SH, such as learning the ‘vocabulary’ required for “Tina” to understand your questions, so be patient and persistent, allowing adequate time to become familiar with this virtual learning resource. Reading all the instructions offered in the online modules before you begin will be particularly helpful. The DCE score will be the grade that is recorded for completed modules. This score normalizes student results based on national averages and a normal grade distribution. You can view this grade within each of the modules in the Shadow Health platform. The due dates for your assignments are listed in your course calendar. Do not go by the due dates in Shadow Health. Most of the Shadow Health assignments will be pass/fail, but in order to receive lab credit and a “pass/complete” for the assignment, you will need to score a minimum of 80% on the System-by-System Assessment assignments. These system assignments will remain open until the Final exam to allow you the opportunity to retake them until you obtain a successful score. It is highly recommended you do the assignments that correlate with the exam content to help you prepare throughout the semester. There will be other Shadow Health assignments that are part of the weighted course grade, and additional information will be provided in the module instructions.NURS 5644 Fall 2018 Advanced Assessment/ Differential Diagnosis Syllabus
Assignment options:
Flexible Turn In
Students have the ability to choose which of their attempts to ‘Turn In’ or flag for submission. Here is a link explaining how students can turn in an attempt of their choice: https://support.shadowhealth.com/hc/en-us/articles/360004578773-Turn-In-attempt
Allow Reopening
Students are able to manually reopen their attempts after submission prior to the assignment due date. Here is a link explaining how students can reopen an attempt: https://support.shadowhealth.com/hc/en-us/articles/360004546134-Reopen-attempt
Registration and purchase must be completed prior to the first class. Students are to create their accounts by visiting http://app.shadowhealth.com/ and enroll with this course-specific PIN:
Fall2018-2679-7692-1587-0781
Students will be required to complete Shadow Health assignments throughout the semester. Students will also enter lab time for some of these simulations on clinical calendar.
Shadow Health Support:
- Contact Shadow Health with technical issues regarding Shadow Health before contacting your
- Support is available at http://support.shadowhealth.com.
- You may email the Learner Support team directly at mailto:[email protected] at any time or by calling 860.3241.
NURS 5644 Fall 2018 Advanced Assessment/ Differential Diagnosis Syllabus CLINICAL LAB REQUIREMENTS:
Pass / Fail: To successfully complete the course, 45 lab hours must be successfully completed and documented on Clinical Calendar. Students must pass lab activity and assignment requirements in order to meet requirements for the course.
Students in this course do not need to find preceptors and clinical sites because all lab hours will be attained on campus or via simulation activities.
Lab activities will be conducted in the assessment labs on campus on the 4th floor. Check course schedule for your room assignment. Students will use the same assessment lab each week.
Typical onsite lab activities will include:
- Interactive case studies led by the instructor
- Instructor demonstration of focused physical exam based on the weekly system/s
- Student pair up with a peer and practice physical examination of the weekly system/s (instructors will monitor student performance)
Students will also obtain lab hours by watching the physical exam videos on Canvas, completing the Shadow Health assignments, participating in the pelvic exam skills lab, performing the child development assessment, and performing their final checkoffs.
NOTE: N5644 Advanced Assessment/Differential Diagnosis will utilize Canvas on-line activities (lectures, forms, announcements, and exams) extensively throughout the course. Students are expected to access Canvas and check their emails frequently (at least once a day during the semester).
Required Materials:
Bickley, L. S. (2017). Bates’ Guide to Physical Examination and History Taking (12th ed.) Philadelphia: Lippincott. (ISBN: 9781469893419)
Bickley, L. S. (2017). Bates’ Pocket Guide to Physical Examination and History Taking (8th ed.) Philadelphia: Lippincott. (ISBN: 9781496338488)
Goolsby M.J. & Grubbs, L. (2015). Advanced Assessment: Interpreting Findings and Formulating Differential Diagnoses (3rd ed.) Philadelphia: F.A. Davis (ISBN-978-0-8036-4363-5).
Shadow Health. (2017). Digital Clinical Experience (Version 5.0) [Software]. (ISBN: 978-0-9897888-0-9) Available from http://www.shadowhealth.com
Recommended Materials:
Prabhu, F.R. & Bickley, L.S. (2007). Case Studies to Accompany Bates’ Guide to Physical Examination and History Taking (9th ed.) Philadelphia: Lippincott. (ISBN: 078179221-5)
Additional Requirements:
Current, unencumbered Texas RN License
Attestation of current Basic Life Support (CPR & AED) for health care providers
One year of clinical experience
Immunizations as required by the College of Nursing
It is the student’s responsibility to provide the TWU Student Health Center with documentation of all required immunizations. The fax number at Student Health Services is 940-898-3849 and phone number is 888-898-8825. A demographic cover sheet is required the first time that a student submits information to the Immunization Verification Program. The demographic page for each healthcare program can be found on the forms page (http://www.twu.edu/student–health- services/forms.asp). Please make sure that the demographic page is signed at the bottom prior to faxing. After Denton has received your immunization records, you can obtain a copy by going to Portal/My Info/Immunization Information. Students must keep immunizations and TB testing current. Students may also submit immunizations through the online system through the Office of Student Health at Log into http://patient-twu.medicatconnect.com/. Use Portal ID and password to access this. To View current immunizations and or print IMZ Portal Go to immunization, click “View History”, and then “Print”. For questions on using the online immunization system please email [email protected] or call 940-898-3826.
There is no need to come to campus to turn in your RN or CPR information. You can fax or email you CPR and RN information to Ms. June Roberts at [email protected] or fax to 214-689-6539 and mark “ATTN: June”.
N5644 is a clinical course. Students will not be able to participate in any clinical experience after the first day of class if immunization requirements are not satisfied.
Drug and Criminal Background Screening
TWU requires students to submit to drug and a criminal background screening. Please review the College of Nursing policy: https://twu.edu/media/documents/nursing/Student-Drug-Testing- Procedures-agh-09-July-2017.pdf
Students are to review & sign the College of Nursing policy posted under the Compliance Items assignment – follow the instructions within the assignment posted on Canvas.
Criminal background screening must be completed by the company designated by the College of Nursing. This is an online process which should be completed before the first-class day. Link for this semester is: https://gp1.acciodata.com/cgi- bin/pub/unsolicited_portal?guid=H8oh3BlFwx07acIdJfMnt7t8yVaQMVSl
Proof that the student requested criminal background screening must be submitted prior to the start of N5644 Advanced Assessment. Once completed, print off the confirmation form and bring to first day of class. The form should be given to the student’s course faculty.
Drug screening will be performed on campus on a designated Monday class day. See class schedule for this date. Students will go to the website www.surscan.com and select the Red Login/Registration Button at the top right of the page.
- Students will create an account using the Account Code: TWUDALLAS
- After that; students will be sent an email confirmation and temporary password
- Students then login to pay for their test. (The website will walk them through the process)
Background check and drug screening are conducted once while you are a graduate student at TWU, provided a student remains enrolled in consecutive semesters throughout your program of study. The school reserves the right to require additional drug screening if warranted.
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NURS 5644 Fall 2018 Advanced Assessment/ Differential Diagnosis Syllabus Course Policies:
Attendance Policy:
The University expects students to attend all classes, seminars, laboratories, clinicals, and examinations regularly and punctually. Please see the university absence policy under the TWU Student Handbook.
Quizzes/Exams Absence Policy:
- The purpose of quizzes and exams in the course is to verify student learning, ensure retention of foundational knowledge to be used in clinical practice, and to prepare students for national board
- Students should plan to arrive on campus on exam days allowing enough time to safely account for traffic, weather, etc. It is advised to arrive at least 45 minutes before the test, just to allow for unexpected traffic or mechanical
- There are no makeup exams or quizzes. If a student is late to a quiz or exam, extra time will not be allotted to the
- When a student is absent from an announced examination (if any), the following procedure shall be followed:
- The student will contact the faculty/course manager prior to the starting time of the examination via telephone and email. The student will leave his/her name, telephone number, and reason for absence. At the discretion of the instructor, a return call to the student may be
- All valid excuses must fall under guidelines created by the University policy as stated in the Student Handbook. The only excused absences are documented student illness, serious illness or death in the student’s immediate family, official school activity, state-recognized religious holiday or other verified absences deemed
appropriate by the instructor. If you miss an examination due to illness you must have a note signed by your healthcare provider.
- Upon returning to the University, the student shall present the appropriate faculty member with sufficient verbal or written documentation of the circumstances regarding the nature of the absence. Telephone contact as described in paragraph one
(1) is required regardless of circumstances.
- The student shall be prepared to take the examination the first day upon return to the
- Failure to follow this procedure will result in the student forfeiting the grade on the examination.
- Retaking of exams is not allowed. No
- Examinations may only be rescheduled for a university approved absence (see student handbook). Any excused missed examinations will be rescheduled and will not be the same exam that your classmates
.
Missed lab policy:
Students are required to complete all assigned on-campus labs throughout the semester. Faculty may allow only one weekly lab to be completed at a different lab time if the student cannot attend their regular lab time. This must be approved and scheduled through the student’s faculty. Any student missing more than the one allowed lab time without a university approved excuse (death/major illness in family or student accident/illness) will result in failure of the course for the semester.
Excessive absences, even if documented, may result in disciplinary action and possible failure of the course. An incomplete may be granted if the student has a passing grade, but only if the instructor deems it is feasible for the student to complete the remaining assignments after the semester
Noise Policy:
In order to avoid disruption in the classroom and lab, all electronic communication devices will be turned off or silenced before entering the classroom or labs. Refrain from loud or disruptive conversation or other noisy behavior.
Academic Integrity:
Students enrolled in this course must follow the ethical guidelines listed in the Student Handbook. Specifically, students must NOT falsify documents (clinical encounters), falsify clinical hours, plagiarize, cheat, or engage in dishonesty in any form. As Registered Nurses, students must also comply with the Rules and Regulations of the Texas State Board of Nurse Examiners.
Honesty in completing assignments is essential to the mission of the university and to the development of the personal integrity of the student. Cheating, plagiarism, or other kinds of academic dishonesty will not be tolerated and will result in appropriate sanctions that may include failing an assignment, failing the course, being suspended or expelled. Suspected cases in this course may be reported to Student Life. The specific disciplinary process for academic dishonesty is found in the TWU Student Handbook. Tools to help you avoid plagiarism are available through the TWU Libraries at http://libguides.twu.edu/tutorials.
Students with Disabilities:
If you anticipate the need for reasonable accommodations to meet the requirements of this course, you must register with the office of Disability Support Services (CFO 106, 940-898-
3835, ([email protected] ) in order to obtain the required official notification of your accommodation needs. More information is available at https://twu.edu/disability-services/. Please plan to meet with your instructor by appointment or during office ho
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