To Prepare
Refer to the “Population-Focused Nurse Practitioner Competencies” found in the Week 1 Learning Resources, and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
Refer to your Clinical Skills Self-Assessment Form you submitted in Week 1, and consider your strengths and opportunities for improvement.
Refer to your Patient Log in Meditrek, and consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.
Journal Entry (450–500 words)
Learning From Experiences
Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?
What did you learn from this experience?
What resources were available?
What evidence-based practice did you use for the patients?
What would you do differently?
How are you managing patient flow and volume?
How can you apply your growing skillset to be a social change agent within your community?
Communicating and Feedback
Reflect on how you might improve your skills and knowledge, and communicate those efforts to your Preceptor.
Answer the questions: How am I doing? What is missing?
Reflect on the formal and informal feedback you received from your Preceptor
PRAC 6665/6675 Clinical Skills
Self-Assessment Form
| Desired Clinical Skills | Confident | Mostly confident | Beginning | New |
| Comprehensive psychiatric evaluation skills in: | ||||
| Recognizing clinical signs and symptoms of psychiatric illness across the lifespan | Mostly confit | |||
| Differentiating between pathophysiological and psychopathological conditions | Mostly confident | |||
| Performing and interpreting a comprehensive and/or interval history and physical examination | Mostly confident | |||
| Performing and interpreting a mental status examination | Beginning | |||
| Performing and interpreting a psychosocial assessment and family psychiatric history | Beginning | |||
| Performing and interpreting a functional assessment | Mostly confident | |||
| Diagnostic reasoning skill in: | ||||
| Developing and prioritizing a differential diagnoses list | Mostly confident | |||
| Formulating diagnoses according to DSM 5 based on assessment data | Beginning | |||
| Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes | Mostly confident | |||
| Pharmacotherapeutic skills in: | ||||
| Selecting appropriate | ||||
| evidence based clinical practice guidelines for medication plan | Beginning | |||
| Evaluating patient response and modify plan as necessary | Mostly confident | |||
| Documenting | Mostly confident | |||
| Psychotherapeutic Treatment Planning: | ||||
| Recognizes concepts of therapeutic modalities across the lifespan | Beginning | |||
| Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan | Beginning | |||
| Applies age appropriate psychotherapeutic counseling techniques with individuals and/or | Mostly confident | |||
| any caregivers | ||||
| Develop an age appropriate individualized plan of care | Mostly confident | |||
| Provide psychoeducation to individuals and/or any caregivers | Mostly confident | |||
| Promote health and disease prevention techniques | Mostly confident | |||
| Self-assessment skill: | ||||
| Develop SMART goals for practicum experiences | Mostly confiden | |||
| Evaluating outcomes of practicum goals and modify plan as necessary | Mostly confiden | |||
| Documenting and reflecting on learning experiences | Mostly confident | |||
| Professional skills: | ||||
| Maintains professional boundaries and therapeutic relationship with clients and staff | Confident | |||
| Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings | Confident | |||
| Identifies ethical and legal dilemmas with possible resolutions | Confident | |||
| Demonstrates non-judgmental practice approach and empathy | Confident | |||
| Practices within scope of practice |
Mostly confident
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| Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals: | ||||
| Demonstrates selecting the correct screening instrument appropriate for the clinical situation |
Mostly confident
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| Implements the screening instrument efficiently and effectively with the clients |
Mostly confident
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| Interprets results for screening instruments accurately | Beginning | |||
| Develops an appropriate plan of care based upon screening instruments response |
Mostly confident
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| Identifies the need to refer to another specialty provider when applicable | New | |||
| Accurately documents recommendations for psychiatric consultations when applicable | Confident | |||
Summary of strengths:
| Personal strength and opportunities for improvement
Based on personal experience based on the practicum task, some various personal strengths and areas require further improvement. The personal strength is related to professional skills whereby the aspects of the ethical and the legal challenges with potential solutions have been improved and maintained. Under this skill, the importance of collaborative work has been supported and appreciated (Wood et al., 2019). The collaboration with the multidisciplinary team has been supported to ensure that there is a team within the clinical setting. The practice based on the scope of practice has been the guider throughout the practice. |
| The successful treatment process relies on effective assessment and proper diagnosis. The task has been achieved effectively through the involvement of the comprehensive psychiatric assessment skills in the areas that require acknowledgment of the clinical signs and symptoms of the psychiatric diseases across the lifespan, the performance of the interpretation and mental health examination, and the interpretation of the functional assessment based on the activities of the daily living, leisure, occupation, and the social. The successful treatment throughout the practicum was made successful through involving the diagnostic reasoning skill (Poghosyan & Bernhardt, 2018). In this case, the development, and the prioritization of the potential disease through differential diagnosis have been relied on to assist in differentiating other diseases. The proper diagnosis has been made using the DSM-5 guidelines. |
Opportunities for growth:
| Throughout the practicum experience, some available opportunities can make the performance of the clinical tasks a successful one. One of the areas of the opportunities is pharmacotherapeutic skills. These skills allow involvement in research work to help in the development and selection of suitable evidence-based clinical practice guidelines for the treatment plan. It gives an opportunity in planning for the follow-up of the clients to find out the needed changes and the tolerance level of the patients based on the medication prescribed. The skills of the psychotherapeutic treatment given an opportunity of involving other healthcare providers such as counselors in the caring process (Poghosyan & Bernhardt, 2018). It guides on the promotion of patient-centeredness whereby there is the development of the age-appropriate individualized plan of healthcare, promoting disease and health prevention, and psychoeducation. |
| The measurable goals and objectives for the practicum experience based on the self-assessment and theory of nursing practice Goal: At the end of my practicum, I need to gain the confidence required for the use of the research throughout the interaction with patients and offer up to date information during service delivery Objective: Identify Evidence-based practice (EBP) to provide health care. Objective: To raise awareness, understanding, and attitude toward EBP. Objective: To investigate information sources based on critically assessed and scientifically validated data. Goal: At the end of my practicum, I should develop an advancement in medical knowledge about the disease processes, their treatments, and diagnoses, among others. |
| Objective: Make and prioritize differential diagnoses using advanced assessment skills.
Objective: Using the patient’s concerns, physical examination, and test results, develop differential diagnoses for patient encounters. Objective: Demonstrate improved ways of doing focused examination to make the appropriate diagnosis Goal: By the end of my practicum, I should have mastered a wide range of advanced mental status assessment skills. Objective: Using a mental status test to spot potential mental and behavioral issues. Objective: Conduct a mental status assessment on every patient Objective: Interpret the findings of the mental status exam |
