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THE OHIO STATE UNIVERSITY
COLLEGE OF NURSING GRADUATE PROGRAM
Nursing 7268.02: Advanced Practice Family Nurse Practitioner Clinical Practicum II
Autumn 2016
11 credits (5 didactic, 6 clinical)
Course Faculty *(Office hours by appointment)
Course Head
Joyce Karl, DNP, APRN, ANP-BC, COHN-S* Oralea Pittman, DNP, APRN, FNP-BC, FAANP*
361 Newton Hall 359 Newton Hall
Cell: 614-530-8973 Office: 614-292-4742
Cell: 937-844-3155 (for urgent matters)
Lindi McGaughy, MS, APRN, FNP-BC*
361 Newton Hall Heidi Bobek, DNP, APRN, FNP-BC
Cell: 740-398-1198 (best) Cell: 614-226-3824
Office: 614-247-7129
Course Description
Advanced Practice Nursing applied to Family as population focus. Emphasis on reproductive families and health promotion strategies; differential diagnosis, reflective practice and evidence based strategies. Prerequisites: Admission to the Family Nurse Practitioner program, 7260 (721), 7400, 7410 (705), 7440 (601), 7450 (704), 7470 (706), 7480, 7490 (713), 7500 (603), 7780 (702). Note: 7410 must be completed immediately prior to beginning the 7268 series; not open to students with credit for 859.
Course Objectives
Upon completion of the course, the student will be able to:
1. Incorporate appropriate concepts, models and theories from nursing, behavioral, biological and medical science into practice (Essential I)
2. Use research in practice (Essential IV)
3. Collaborate with health care professionals and community agencies to provide accessible, high quality care (Essential VII).
4. Provide health promotion and risk reduction interventions to clients (Essential VIII).
5. Diagnose actual or potential health problems (Essential IX).
6. Manage acute and chronic health problems with pharmacological and non-pharmacological interventions (Essential IX).
7. Provide culturally competent health care (Essential VIII).
8. Analyze economic, ethical, legal, political and professional issues related to practice (Essentials II and VI).
9. Evaluate outcomes of practice (Essentials III, V, VII).
The ACCN Essentials of Master’s Education (2011) and ACCN Essentials for Advanced Nursing Practice (1996) were used to guide course development.
CARMEN Online Technical Information
Web-based components of this course will use The Ohio State University’s course management system, the updated version of CARMEN. Access to this course will require a username and password. Access 7268.02 at: https://carmen.osu.edu (the same password used to enroll for classes at the Registrar’s website). CARMEN requires the use of your UNIVERSITY login and password. Information concerning your University email and login account can be found at https://acctmgt.service.ohio-state.edu/. As part of CARMEN, your homepage after you log in will reflect all courses that you are taking across the University. Twenty-four hour technical support can be reached at: 614-688-4357 (688-HELP) or through the CARMEN Help Web page at: https://resourcecenter.odee.osu.edu/canvas. Answers to frequently asked questions (FAQ) about online courses in the College of Nursing are at http://u.osu.edu/cononlinecoursefaq/. Course content will be available via CARMEN. Grades will be posted via CARMEN.
Course Specifics
Class will meet from 9a-3p on Tuesday, August 23-December 13, 2016. Students should register for 11 credits for this course. All students must register for the didactic portion (5 credits) or the course concurrent with or preceding registration for clinical credit (6 credits). 225 clinical hours are required Autumn semester.
Conduct of the Course
This course will be taught in Autumn semester for a total of 12 weeks. The course will meet weekly and will be in seminar format using the Problem Based Learning (PBL) format. PBL is an approach to teaching and learning where students actively learn from solving real world problems in their discipline. For further information on PBL see the essay posted on CARMEN under Content, Orientation. Classes will be attended by students, faculty, and occasional guest speakers. Content will also be presented online and students are responsible for any content posted on CARMEN.
The FNP portion of the course will be presented using the Principles of Narrative Pedagogy. Important elements of the Narrative Centered Curriculum are reading, writing, critical thinking and dialogue. This approach is different from the traditional lecture format. Clinical stories and other experiences form the best framework for students to reconstruct, interpret and learn from the experience. The FNP philosophy: The family is the identified unit of care, not just the context for the care provided to various individuals.
Educational strategies employed in the 7268 series include using cases to provide practice diagnostic reasoning, experiences in information finding and synthesis, written case study analysis, simulations, examinations, and frequent reflection and self-evaluation of individual progress toward individual goals. Detailed strategies will be found below.
*BEFORE YOU READ ANY FURTHER: NOW is the time to consider whether you might need to strengthen your writing skills. Please make good use of the writing resources at the University.
Teaching and Learning Strategies and Assignments
The faculty believes that the Principles of Adult Learning are essential for advanced professional education and has thoughtfully developed the following learning opportunities:
· Assigned Readings: There will be weekly assigned readings from the required textbooks, PEAC modules, as well as other resources available through Prior Health Sciences Library and online. These readings will be posted at least one week in advance under the topic(s) for the week. The expectation for graduate students is that they are reading about 100 pages per credit hour per week. For this course, that should mean you are reading about 500 pages per week. This may include but is not limited to reading the discussion board, reading you do to prepare your posts and responses, and reading you do to prepare the other assignments in this course. A schedule of the topics for the semester can be found with the syllabus on CARMEN.
· Weekly Prescription Writing/Medication Management Practice: Advanced Practice Nurses fought long and hard for the privilege of writing prescriptions and it is essential that all of us are excellent at it as we take on this responsibility. The faculty will present you with a medication and patient weight and you will write the prescription in class and turn it in. Feedback will be provided.
· Student Led Oral Case Studies: Each week four students will present a 6 minute oral case from their clinical experience. It will be to everyone’s advantage to choose a case that was exceptional, out of the ordinary, unusual, unexpected, etc…to present. You will turn in to the CARMEN Assignment a one-page written comprehensive documentation of the case the night before your presentation (CC, HOPI, Medications, Allergies, PMH, PFH, PSH, ROS, PE including vitals, Plan, Pt. education, Follow-up if needed).
· Objective Structured Clinical Exam (OSCE): Each student will participate in a video standardized patient encounter on Aug. 30. A H&P, Differential Diagnosis, and Management plan will be completed and a SOAP/Progress note submitted. More details will be presented on the CARMEN site and discussed in class.
· Simulation: Each student will participate in a simulation exercise experience. Each student will be scheduled to participate in one simulation experience to be held after class, into the evening, on either Sept. 20 or Sept 27. In order to prepare for the simulation, students need to complete the IHIS training modules (Fundamentals and Ambulatory). Before the simulation students will find and learn how to use a template for an Asthma Action Plan and be prepared to use and individualize it for a specific patient scenario. Also prepare an asthma infographic or patient education handout on a specific asthma-related self-care topic. Remember that Microsoft Publisher can help you with infographic/patient education handout. The grade will be based on the Action Plan, infographic/ patient education handout simulation preparation, and participation. More details will be presented on the CARMEN site and discussed in class.
· Content Delivery: From time to time, guests will be invited to lecture, provide a Panopto, or lead discussions on a particular topic. Some of this information may be accessed from CARMEN and you will be responsible for the content. Fast cases will be presented throughout the semester with a focus on lab ordering and interpretation, imaging, and medication dosing (bring your reference material to class). Other lectures or activities will be designed to deliver the content in the most productive way possible.
· Certification Review: We will begin to focus on certification-type questions in a brief review most weeks using the Top Hat program on your mobile device, tablet or laptop. More information will be provided in class. There are several good certification review books. Start exploring, looking for one that most meets your personal learning needs. We will bring examples to class for you to look at.
· Case Studies: There will be 2 case studies this semester, one adult and one pediatric, with a focus on acute and/or chronic primary care. Case study due dates will be found on the class schedule. Case study details and grading rubrics will be found on the CARMEN class site. These case studies are comprehensive, and designed to be a large part of your grade for the course. If students attend the Statewide OAAPN Conference October 20-22, 2016 and submit CE certificate verification of attendance or complete their verified volunteer commitment by the due date; they will receive full credit in lieu of completing the adult case study.
· Practice Based Learning: At most class meetings a “patient” will be interviewed as if they had presented in the primary care office. The patient may be an adult or a child. The patient’s history will be obtained. Physical exam findings and lab results will be requested by the students, and a list of differential diagnoses and learning issues will be generated. The following week, the differential diagnosis chart and the management plan will be discussed based on what the group has learned through learning issues. The management plan may then be refined through group in-put. Students have the opportunity to sign up to be the “patient” for one of 11 weeks. They will be given the primary diagnosis the week before in order to prepare. The students who serve as patients will have the opportunity to forego their posting on the Discussion Board for the topic that week.
· Discussion Board: Each week, students will be assigned one or more of the learning issues from the practice-based learning experience to investigate and repost on for their classmates on the discussion board. Topics may be shared, but posts MAY NOT BE SHARED. Reports should be posted directly on the board, and not attached to postings as separate documents. This makes the flow of reading the board easier. Learning issue posts should include a reference list which can serve as a resource list for further reading. Please do not post a link to an article without summarizing that article in your post.
o Discussion Board schedule:
§ Posts (Learning Issues, Complementary Therapies, Labs and Imaging): Thursday by 9pm
§ Graded Responses: Saturday by noon
§ Additional Discussion Comments: Until Monday morning at 8am
§ Planners: Monday by 8pm
§ Although the discussion boards will remain open for your review and study, postings made after 8pm Monday will not be graded.
On the discussion board you need to title your posting according to your topic, your group, and your role on the discussion board for the week. For example, if you were assigned the topic Asthma and were a poster in Group A, your title would read: Asthma, Group A, Poster. If you are in the Complementary Therapy Group, your title would read: Asthma Treatment, Group B, CT. If you are in the Labs and Imaging Group, your title would read: Chest X-ray, Group C, LI. If you are a responder for the week, your title would be: Response, Group D, Graded. There may be multiple responses to the topics during the week. Please use the label “GRADED” to point out to faculty which of your responses you want graded. There is no limit to the number of differential diagnoses or learning issues, however, be thinking critically about what the most pertinent would be. Please consider that the goal of the Complementary Therapies post is to try to determine which therapies might be most common in your patient population so that the class can become familiar with those therapies. Please do not spend your time on obscure alternative treatments.
The planning group will present the differential chart briefly and then present the final diagnosis with rationale for their choice and how other differentials were ruled out. The planners will share which diagnostic tests were chosen with rationale and expected interpretation, prescriptions and treatments with rationale, patient education, and follow-up, along with a nursing theoretical framework.
Discussion Board Participation: Students are expected to participate as scheduled, with completed assignments posted on time. The Discussion Board serves as a forum for you and your colleagues to collaborate on the development of a plan and gain insight on the learning issues. During the 7268 series you will be spending a great deal of time on the discussion board sharing information and insights. Be prepared to review the discussion board regularly during the week. Placing your assigned post on the board is only PART of your discussion board assignment. The faculty will be reading the board throughout the week. Sometimes we will comment on the responses or ask some probing questions to help you develop your critical thinking skills. If the conversation seems to be tangential the faculty will intervene. A lack of comments or questions does not mean the faculty is not reading the discussion board. Remember that this is a critical thinking exercise, so just copying and pasting a chart/article/portion of a textbook or something you found online does not constitute a legitimate post. You may post the evidence, but then it is your responsibility to analyze the quality of the evidence and synthesize it into a reasonable plan, taking the individual patient needs into consideration. All postings must be referenced according to APA format.
Although Up-to-Date and other .com sources can be helpful for background information, postings with Up-to- Date as the only reference will receive a 0 for that posting. Also, when looking at online sources, make sure you have found the section of the site addressed to health professionals, which usually provide more complex and nuanced information appropriate for diagnostic reasoning compared to pages geared to patients. Patient education/information sites should only be used as references when scripting information for patients.