Course Number

& Title

Course Credit Hours

NUPR 539: Nurse Practitioner Practicum I: Management of Health and Illness in Adults 5 Semester Hours (225 clinical clock hours)

Semester Length

The clinical semester for this course will run from January 11 until April 29, 2016. Failure to complete the total number of required clinical hours within that time will result in a failing clinical grade.

Course Faculty

Chicago Acute Care Rockford Melissa Carlucci, MS, APN, ACNP-BC Rich McLaughlin, MS, APN, ACNP-BC mcarlu2@uic.edu Rhamcmc@uic.edu 312-413-0054 815-395-5624 Amy Morgan, MS, APN, ACNP-BC amorga7@uic.edu Sarah Fitz, MSN, APN, ACNP-BC safitz@uic.edu Chicago Primary Care Quad Cities Dr. Lauren Vacek DNP, APN, FNP -BC Alyssa Wislander, MS, APN, ACNP-BC, Ljvacek@uic.edu CPNP-BC 312-413-5749 309-757-9467 ext. 26 awisla2@uic.edu Leah Burt, MS, APN, ANP-BC lcalli2@uic.edu Peoria Dr. Susan Copp, Ed.D, MS, APN scopp2@uic.edu Sue Wilson, MS APN, ANP-BC 309-671-3411 Sbwilson@uic.edu Urbana Rowena Abasolo, MS, APN, ANP-BC Erica Halcomb, MS, APN rmaria1@uic.edu ehalcom2@uic.edu

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Item Adult-Gerontology Primary Care and Adult-Gerontology Acute Care Practicum

Welcome to NUPR 539! This 5 credit semester-hour practicum will be your introduction to evidence-based clinical practice. Practicum Description Each practicum in the AGPCNP and AGACNP program curriculum is a 5 Semester Credit Hour/225 clock hour clinical course designed to provide opportunities for you to develop your clinical skills and integrate them with the theoretical and scientific underpinnings for effective primary care or acute care practice. The practicum emphasizes evidence-based clinical practice in the management of common and complex health problems. Students will utilize concepts acquired in prior core courses to conduct comprehensive and episodic history and physical exams, and use the data gathered to form a differential diagnosis and management plan. It also encompasses the realms of health promotion, anticipatory guidance, disease prevention, and management of acute and chronic disease across the adult lifespan. Overall Practicum Objectives The focus of the AGPCNP student and the AGACNP student is to provide patient-centered quality care to the adult and older adult populations. The student applies evidence in practice designed to improve quality of care and health outcomes under the guided supervision of faculty and clinical preceptors.

1. Accurately assess the health status of patients with common health problems. 2. Develop a diagnosis of patient health status. 3. Develop a plan of care. 4. Evaluate responses to treatment and modify treatment plans. 5. Demonstrate a personal, collegial, and collaborative approach to patient care. 6. Implement a teaching/coaching component to patient care. 7. Demonstrate professionalism in an advanced practice role. 8. Monitor the quality of health care practice. 9. Provide culturally competent care. 10. Utilize evidenced-based approaches to improve outcomes.

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PRIMARY CARE Track: Course Evaluation Criteria

Evaluation

Graded by

Percent of Grade

Clinical Evaluation Tool (mid-point & final @ each site) Clinical Preceptor 50% Student Clinical Case Presentation Clinical Instructor 10% Shadow Health Case Study Clinical Instructor 10% Standardized Patient SOAP Note Clinical Instructor 10% Simulation Lab Case Clinical Instructor 10% Faculty Communication Clinical Instructor 10% Standardized Patient Encounter Clinical Instructor P/F Self Reflection Assignment Clinical Instructor P/F Typhon Practice Profile Clinical Instructor P/F Typhon Data Checklist Clinical Instructor P/F ACUTE CARE Track: Course Evaluation Criteria

Evaluation

Graded by

Percent of Grade

Clinical Evaluation Tool (mid-point & final @ each site) Clinical Preceptor 50% Student Clinical Case Presentation Clinical Instructor 10% Simulation Lab Case Clinical Instructor 10% Standardized Patient SOAP Note Clinical Instructor 10% Faculty Communication Clinical Instructor 10% Completed DRT Exam Clinical Instructor 10% Standardized Patient Encounter Clinical Instructor P/F Self Reflection Assignment Clinical Instructor P/F Typhon Practice Profile Clinical Instructor P/F Typhon Data Checklist Clinical Instructor P/F

P/F = Pass/Fail Grading ScaleCumulative Percentage Practicum Grade 90-100% A 80-89% B 70-79% C 60-69% D <60% F Students must earn a minimum grade of “B” to pass the practicum courses. Failure to do so will require you to retake the course. All assignment and final course scores are calculated to the number 2 places to the right of the decimal point (for example, 85.25%). For further information please see the information on practicum policies in the UIC CON student handbook.

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Late Assignments All late assignments that are a percentage of the course grade will be penalized with a 5% deduction from the assignment grade for each day that it is late. For pass/fail asssignments, 5% will be deducted from the final course grade for any assignment that is submitted late. Standards of Practice The professional competencies used as resources for course content include the Advanced Practice Nursing Core Curriculum of The Essentials of Master’s Education for Advanced Practice Nursing (AACN, 1996), the Criteria for Evaluation of Nurse Practitioner Programs (NTF, 2012), the National Organization of Nurse Practitioner Faculties (NONPF) Nurse Practitioner Core Competencies (2011; amended 2012), and the National Organization of Nurse Practitioner Faculties (NONPF) Population-Focused Nurse Practitioner Competencies (2010, 2012). Practicum Policies Please see the College of Nursing Student Handbook at http://www.nursing.uic.edu/sites/default/files/2015-16_UIC_CON_Student_Handbook.pdf Academic Dishonesty Please see the UIC graduate student handbook for specific policies related to academic dishonesty. In brief, the following (although not a complete list) constitutes academic dishonesty: giving or receiving any information regarding standardized patient or simulation cases (including via social media and other forms of electronic communication) and plagiarism in any form, including power point slides for the student case presentation. If plagiarism is suspected, the assignment will receive a grade of “0” and there will not be an opportunity to resubmit the assignment. Attendance Policies

Attendance at ALL scheduled clinical days is expected. If you must be absent, notify your preceptor and clinical instructor immediately and arrange to make up the time.

Attendance at ALL scheduled student workshops and on-campus activities is mandatory. Failure to attend a required on-campus day, including but not limited to simulation, standardized patient encounter, case presentation, and all student workshops, will result in a 5% deduction from the final course grade.

Incomplete Grades A practicum grade of incomplete will be given only in extreme circumstances. All assignments, including those given a pass/fail grade, must be completed for the student to be given a passing grade for this course. If a student recieves an “Incomplete” grade in a practicum course, they will not be permitted to progress to the next practicum course in the program until the “Incomplete” grade is converted to a final course grade of A or B.

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Practicum Performance Any student who demonstrates unsafe or ineffective advanced nursing practice may be dismissed from the practicum at any time. Unsafe or ineffective practice is any behavior determined by faculty or preceptor to be acutally or potentially detrimental to the patient or health care agency. Additionally, students may be removed from the practicum for any unprofessional behavior, lack of preparation for clinical, deficits in problem-solving skills, or if it is determined that they are not meeting the required NONPF competancies. See the UIC College of Nursing Student Handbook for further information. Disabilities The Office of Disability Services works to ensure the accessibility of UIC programs, classes, and services to students with documented disabilities, including vision or hearing impairments and emotional or physical disabilities. Students with disability/access needs or questions may contact the Office of Disability Services at (312) 413-2183 (voice) or (312) 957-4822 (TTY only) or visit: http://www.uic.edu/depts/oaa/disability_resources/index.html . HIPAA Requirements The federal government's Privacy Rule became effective April 14, 2003. The Privacy Rule provides the first comprehensive federal protection for the privacy of health information. The College initiated the following course requirements to ensure privacy compliance for all CON students: 1. You will be required to sign a confidentiality statement before you access any patient information (paper, electronic and oral), and your instructor will keep copies on file. 2. You will be required to keep all patient information confidential. 3. Patient information is reviewed only in private areas (i.e., not in elevator or cafeteria). 4. You will not be allowed to take any patient information that is identifiable from the hospital/clinic. 5. You are not to access a patient chart or information outside of your clinical rotation area, e.g. from your home computer. 6. You will be required to follow all hospital/clinic policies and procedures for patient privacy at your site of clinical placement.

Failure to protect patient health information is considered a federal offense, and failure to comply with this College requirement may result in failure of the practicum course and possible disciplinary action including dismissal from the University.

Practicum Overview This course has a competency-based clinical curriculum designed to assist you to develop and apply the knowledge, skills, and attitudes you will need to successfully transition into the nurse practitioner role. Approximately 2-3 days per week will be needed to fulfill the 225 practice hours required for the practicum. For the spring 2016 semester, clinical hours must be completed between January 11 and April 29, 2016. The required credentials for each

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clinical will vary by clinical site and need to be completed prior to beginning the practicum. Information regarding requirements for you to fulfill is available on Blackboard, with additional information available from your clinical instructor. So as to NOT be delayed in your practicum site, you must promptly adhere to satisfying its requirements. You cannot begin your practicum rotation until you have met all credentialing requirements for the assigned site. Additionally, Certified Profile must be kept current, and any past due requirements will result in removal from the clinical until all requirements are met. While in clinical, you will be seeing approximately 4-6 patients in a clinical day, depending on the site and acuity of the patients (ie...AGACNP students in ICU rotations may only see 1-2 patients per day). Each patient assessment must be presented for your preceptor’s review and critique, and then final assessments and all clinical decisions are to be made under the guided supervision of your preceptor. Each patient encounter along with the time spent at the clinical site must be logged in the NPST system (see below). All students are required to have the UpToDate app (downloaded through the library website) on their mobile device as a resource for clinical. NPST time and case logs; student schedule The Typhon Nurse Practitioner Student Tracking System (NPST) is used to log data from all patient encounters and document clinical hours during the practicum courses. Each clinical day or at the end of the day, you are expected to enter encounter data directly online via the Typhon/NPST site. NPST technical support includes online tutorials and student FAQs that are available on the NPST website. Refer to these first if questions arise about how to enter and upload your encounter data. NOTE: You will have a maximum of 2 weeks in which you are able to enter your case log and time log records. If hours are not documented within that time period, you may lose credit for those hours and will need to repeat them in order to complete the required clinical hours. Please note: Any falsification of a case log record or clinical hours is considered to be a violation of academic integrity and disciplinary action will be taken. As a student in this course, you are expected to keep your schedule current and accurate in the NPST student scheduling system so that your clinical instructor can plan site visits and track your clinical hours. Selected procedures and skills for primary care practice are listed in Appendix A and for acute care practice are listed in Appendix B. As you perform these procedures during clinical rotations, document the date in the NPST system using the appropriate CPT code (or in the clinical notes section if there is no procedure code). Share your log information with your clinical preceptor so they can assist with planning your clinical rotation experiences. Entering of Clinical Site Schedule Your clinical site schedule must be entered a minimum of four weeks ahead into the NPST/Typhon database. Students are expected to communicate with their assigned faculty member immediately via email if there is any reason that you will not be at a site as scheduled and the reason. It is your responsibility to keep your database updated and communicate with your faculty instructor immediately if you are experiencing any issues with your clinical site assignment or preceptor. Clinical groups All students are assigned to a campus-specific clinical group. Each group will be assigned a clinical instructor, who will act as your faculty supervisor and main contact person for the

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clinical and all other required course assignments. Clinical Instructor Site Visit During the semester your clinical instructor will arrange a visit to your practicum site to meet with your preceptor. Your clinical instructor may also observe one or more clinical encounters. The purpose of this ungraded evaluation is to assess your clinical progress, provide feedback, and confirm that you are meeting expectations for safe practice and developing the AGPCNP or AGACNP competencies. For the vast majority of our students, the clinical instructor site visit is an opportunity for mentoring and to build collaborations with you and your preceptor. However, a remediation plan will be developed in consultation with you and your preceptor and further site visits scheduled if it is determined that expectations are not being met. You must demonstrate that you are meeting these expectations in order to pass the practicum. Your clinical instructor will also maintain regular contact with your clinical preceptors throughout the semester to discuss any clinical practicum issues at their discretion and/or by request. Following this site visit, your clinical instructor will discuss your clinical progress with you. Acute Care Students Only The following are additional requirements for AGACNP students:

1. All AGACNP students are required to maintain a current ACLS certification throughout the practicum courses. A copy of your ACLS card must be submitted to your clinical instructor prior to starting clinical.

2. All AGACNP students are required to attend the Fundamentals of Critical Care Support course offered by the Society of Critical Care Medicine at one time point during the clinical courses. This course is offered twice per year in Chicago; however, you may also choose to attend at an alternate location (see the Society of Critical Care Medicine website for more details). The hours from this course will be applied to one of your clinical courses, as determined by the program director. A copy of the certificate from the course must be submitted to your clinical instructor to verify your attendance.

3. All AGACNP students are required to complete a diagnostic readiness test in preparation for the board certification exam.

Practicum Evaluation Methods 1. Faculty Communication It is an expectation that you check in with your clinical instructor via email at least weekly to update them on your clinical activities and address any questions or conconcers. Effective and professional communication includes responding to email from any faculty member within 1 business day and notifying your assigned clinical instructor if you will miss a scheduled clinical day. Communication grades will be assigned as follows:

Weekly faculty communication = 75 points (5 points x 15 weeks; does not include the week of spring break) Responding to all communication from faculty within 1 business day = 15 points Professionalism in all communication with faculty and others = 10 points

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The following information must be included in your weekly check-in emails:

1) How many patients did you see and what was your role in the assessment and management of these patients? Did you present these patients and to whom?

2) How many notes did you write and what type (ie…H&P, progress note, clinic note)?

3) How did you prepare for clinical that week? What did you learn in clinical that week?

4) How do you feel you are doing in clinical and what feedback has your preceptor given? 5) What are your goals for next week? How many hours have you completed thus far?

2. Clinical Preceptor Evaluations Each of your preceptors will complete the "UIC Student Competency Clinical Evaluation Form" at the midpoint and end of each clinical rotation to evaluate your progress (Appendix F). It is your responsibility to provide your preceptors with the evaluation form and to ensure that the completed evaluation is returned to your clinical instructor by the dates specified on the course calendar. Failure to submit evaluations may result in a grade of “0” for the evaluation and/or an “incomplete” for the course. Evaluations must be submitted in either a pdf or Word format. Jpeg files will not be accepted. Scoring for this evaluation is explained with the Evaluation Form. The scoring is weighted so that a straight 2.0 average equals 85%. On any single item, a “1” indicates that performance is below basic expectations for a student at this level, and is thus an area for you to focus on for improvement. A “3” indicates an area where performance is above basic expectations for a student at this level, and thus is an area where you have been doing exceptionally well. Our expectation is that most students will average at least “2” or above on their clinical preceptor evaluations. Please note: final clinical evaluation grades are assigned by faculty with preceptor input. It is the responsibility of the student to ensure that midpoint and final clinical evaluations are submitted by the due date on the course calendar. Late evaluation forms will be penalized with a 5% deduction from the evaluation grade for every business day that the form is submitted after the due date. 3. Standardized Patient Encounter An on-campus observed clinical encounter using a standardized patient will be used as a clinical performance evaluation. All standardized patient encounters will take place at your regional campus. The evaluation will be conducted using a trained patient and will be observed and graded by your clinical instructor. This is an opportunity for you to demonstrate interview and physical exam skills and clinical decision-making in a controlled environment. More information about the standardized patient encounter will be made available prior to the encounter date. A SOAP note from the encounter will be submitted via SafeAssign and graded according to the rubric in Appendix E.

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4. Lab Simulation An on-campus observed clinical encounter using a high fidelity simulator or standardized patient will be used as a clinical performance evaluation. All simulation experiences will take place at your regional campus. The simulation lab is a learning environment that allows you to practice your clinical assessment and decision-making skills. A debriefing session will be held following the simulation to review the case, discuss appropriate management, and receive feedback from faculty. More information about the simulation experience will be made available prior to the scheduled date. 5. Student Clinical Case Presentation Clinical case presentations will be held according to the course schedule during the semester. This will be done in small groups and feature a 20 minute case presentation from each student that is based on a patient from their current practicum site. The presentation of clinical topics is designed to foster development of scholarly presentation skills centered on a clinical topic of importance. Students should choose a patient/problem they have encountered in the clinical setting and focus on one exceptional disease state that offers a unique learning opportunity. A list of references used to prepare the presentation should also be included. See Appendix C for the clinical case presentation grading rubric. Your assigned clinical instructor will evaluate your presentation and provide feedback. 6. NPST Data Quality Checklist; Practice Profile These logs form the basis for your developing practice profile and will be a key part of your professional portfolio. The NPST system must be accurately completed and 225 total hours logged for completion of this practicum. NPST data quality is determined by a number of factors, including the following:

Completeness of patient case logs Completeness of student time logs Completeness of student clinical schedule Timeliness of data entry 100% accuracy in reflecting all clinical time and activities

6a. NPST Data Quality Checklist NPST data quality will be evaluated by faculty at the end of each semester; however, it is your responsibility to monitor your data quality regularly. Important: Be sure to enter your data in timely fashion, as it is set for access to a maximum of two weeks post your clinical day. Any further delay and you risk losing your ability to post your past clinical hours and cases. Students will complete the NPST/Typhon Data Quality Checklist (Appendix D) and submit via SafeAssign by April 29, 2016. 6b. Practice Profile The practice profile is the “Case Log Totals (Graphical)” report from your NPST data and provides a visual representation of your clinical experiences for the current semester. Filter the report so that it represents the cases solely for the current semester. Students will submit their practice profile via SafeAssign by April 29, 2016.

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7. Self-reflection Toward the end of each semester, students complete a self-reflection assignment for the purpose of validating progress. The goal for this activity is to engage you in considering how your clinical abilities and professional growth are changing. You will submit this assignment via SafeAssign by April 15, 2016.

The self-reflection documents your developing competencies as an AGPCNP or AGACNP in relation to the NONPF professional standards for nurse practitioner practice.

AGPCNP competencies are available at http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/adult-geropccomps2010.pdf

AGACNP competencies are available at http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/adult-geroaccompsfinal2012.pdf

This is a written assignment divided into 2 parts. (1) Use your current practice profile (from the NPST system; See above) to write a narrative about your practice so far. Discuss how you have progressed throughout the practicum, what goals you have achieved and/or are still working toward, and your overall thoughts about the clinical. (2) Choose 2 of the NONPF competencies (see above) and describe either (a) how you have met them or (b) how you plan to work toward meeting them in the future. Provide specific examples from your clinical rotation as support.

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Appendix A: Selected Procedures and Skills for Primary Care

As you perform these procedures during clinical rotations, document the date in the NPST system using the appropriate CPT code (or in the clinical notes section if there is no procedure code). Share your log information with your clinical preceptor so your preceptor can assist with planning your clinical rotation experiences.

Laboratory Procedures

Miscellaneous

Procedures

Pregnancy test Woods light

PPD placement/interpretation Visual acuity

Rapid strep screening/culture Fluorescein staining

Urinalysis dipstick/interpretation Electrocardiogram (12 lead)

Pap smear techniques Peak flow evaluation tests

Microscopy: KOH/wet mount) Spirometry

GC/Chlamydia cultures (M/F) Wound Care

Herpes/viral culture

Shave biopsy

Hematocrit (finger stick)

Blood glucose monitoring device Selected radiographic test interpretation:

-Chest x-ray -Skeletal x-rays -Abdominal series -Other (indicate)

Common wound cultures

KOH prep of skin lesions

Therapeutic Interventions

Eye irrigation

Cerumen removal

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Appendix B: Selected Procedures and Skills for Acute Care

Below is a list of common activities, assessments, skills and procedures performed by Adult-Gerontology Acute Care Nurse Practitioners. You should be seeking out opportunities to participate in these activities during your clinical rotations. Share this list with your preceptors so they can assist with planning your clinical experiences. As you perform these activities during clinical, document the date in the Typhon Nurse Practitioner Student Tracking System. If applicable, document the appropriate CPT code. Daily Activities/Assessments General Skills/Consults

Note Writing & Documentation

Perform Comprehensive History & Physical Exam (inpatient & clinic)

History and Physical Exam

Perform Focused History & Physical Exam (inpatient & clinic)

Daily Progress Note - SOAP Note

Perform a Consult Consult Note

Call a Consult Discharge Instructions/Summary

Participate in Rounds Clinic Note

Present Assigned Patients (during rounds, to preceptor, MD, etc.)

Procedure Note

Focused Assessments (i.e., heart and lungs sounds, neurological exam, GI exam)

Document assessment and diagnostic criteria that supports working and differential diagnoses in the plan of care

Management/Plan of Care Medication Management

Formulate working and differential diagnoses/prioritize diagnoses

Perform thorough medication history

Develop plan of care/revise plan of care based on new and ongoing data

Select new medications based on diagnoses, guidelines and patient history

Select, interpret and supervise diagnostic tests, procedures and plan of care that contribute to working and differential diagnoses

Use electronic device/program to look up drugs, dosing, drug interactions, side effects, special considerations

Follow up with consulting service recommendations

Consider organ (kidney, liver) function when selecting/dosing medications

Collaborate with interdisciplinary team, patient and family members

Perform teaching for new medications

Perform discharge teaching Laboratory monitoring for drugs

Arrange follow up appointments Antibiotic management/guidelines

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Skills Common Laboratory Tests to Interpret

ECG Interpretation CBC with differential

Chest X-Ray Interpretation Chemistry Panel

Abdominal X-Ray Interpretation Liver Function Tests

CT Interpretation (head, chest, abdomen)

Urinalysis

ABG Analysis Amylase/Lipase

Spirometry Interpretation Troponin, CPK, BNP, Cholesterol Panel

Hemodynamic Monitoring (ICU) Thyroid Panel

Ventilator Management (ICU) ESR, Lactate

Non-Invasive Ventilation (CPAP/BiPAP)

Glucose, A1C

Calculations (ie: Cr Clearance, Anion Gap, FENa, corrected Ca, risk scores)

Microbiology - blood culture, fungal culture, urine culture, respiratory viral panel

Procedures (if you get the opportunity to watch, assist or perform)

Arterial Blood Gas Endotracheal Intubation

Central Venous Line Insertion and Removal

Suturing

Chest Tube Insertion/Removal Abscess I&D

Arterial Line Insertion/Removal Defibrillation/Cardioversion

Thoracentesis Wound Debridement

Paracentesis Local Anesthesia Application

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Appendix C: Clinical Conference Case Presentation Rubric

Student Name __________________________________________________________ Date________________________________

Criteria Points Possible

Points Earned

Presentation of the History and Physical Exam 1. CC, HPI 6. Physical exam by system 2. PMH, PSH 3. Allergies, Medications 4. Family History, Social History 5. ROS

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List of Early Differential Diagnosis Based on H&P 1. Must include 5 diagnoses

5

Presentation of Diagnostic Testing and Findings 1. Appropriate laboratory studies with interpretation 2. Appropriate imaging studies with interpretation (include images)

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Differential Diagnosis 1. List of revised differential diagnoses – Must include 3 diagnoses 2. Discussion of how each diagnosis in the revised list was ruled in or ruled out 3. Final diagnosis with supporting evidence

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Presentation of the Management Plan 1. Must be evidence-based approach 2. Recent research studies and clinical practice guidelines must be included as supporting evidence

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EBP Discussion 1. Choose one current research article (within 5 years; United States studies only) that supports your management plan. Describe the study and summarize the findings, strengths, and weaknesses. Discuss the implications for practice. 2. Ask 2 critical thinking questions to engage the group and lead a discussion.

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Brief overview of your clinical rotation and the role of your preceptor 5

Utilize PowerPoint to Enhance Learning 1. Slides are easy to read and support the main points of the talk 2. Uses slides as cues – does not read from them

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Overall Presentation Style 1. Speaks clearly and at an understandable pace 2. Dresses appropriately and portrays confidence 3. Observes 20 minute time limit

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Instructor Signature ________________________________________________ Total score: __________ / 100

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Appendix D: NPST/Typhon Data Quality Checklist Directions: Review your NPST/Typhon entries and check off the elements that are current (or not)

and correct items that are incorrect or incomplete. After all columns are checked ‘yes’ submit your checklist via SafeAssign.

It is highly recommended that you enter your data daily and check the quality of your data and

scheduler weekly. After each clinical day you are expected to log encounter data directly into the Typhon/NPST site online. NOTE: You will have a maximum of 2 weeks following your clinical encounter to enter data for your case log and time log records. Any further delay and you risk losing your ability to post your past clinical hours.

Elements of Data Entry Present? Yes No

Patient care hours and shift time: [Location: My Time Logs]

Shift time is accurate and complete

Columns are entered correctly for each clinical day: [Location: My Time Logs]

Patient Time (from case logs)

Other columns (simulation, workshops, standardized patient, conferences) recorded as appropriate

Demographics and visit characteristics, social problems, coding:

Review of case log totals should reveal complete demographics and visit characteristics with identified social problems

CPT and ICD­9 codes are accurate and complete

[Location: Case Log Totals (Graphical); Daily/Weekly Case List (Spreadsheet)]

Scheduler calendar: [Location: My Schedule]

Scheduler accurately reflects all scheduled clinical days

225 Clinical hours per semester: [Location: Clinical Hours Achieved by Course]

Clinical hours reflect progressive accumulation to reach 225 hours by the end of the practicum course

NUPR 541 ONLY: Total clinical hours for all 3 practica = 675 clock hours

Comments: Student Signature and date: _____________________________________ (written or electronic)

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Appendix E: Standardized Patient Encounter Note Grading Rubric

Student: _________________________________ Date: ____________________________________

Scoring Criteria: 0 = Omitted or done incorrectly; 1 = Item partially completed; 2 = Item completed appropriately Item Criteria Documented

Chief Complaint 1. The response is recorded in quotation marks using the patient’s own words and is no

more than one sentence.

2 1 0

History of Present Illness 2. Sentence summarizing patient’s age, gender, ethnic background, and usual state of

health

2 1 0

The chronological story of the patient's illness reported in terms of a thorough analysis of the patient's symptoms (including documentation of "pertinent negatives"):

3. Onset 2 1 0 N/A

4. Location 2 1 0 N/A

5. Duration 2 1 0 N/A

6. Characteristics 2 1 0 N/A

7. Aggravating factors 2 1 0 N/A

8. Relieving factors 2 1 0 N/A

9. Temporal factors 2 1 0 N/A

10. Severity 2 1 0 N/A

11. Patient’s perception of signs/symptoms (to what extent these have disrupted daily life and/or concerns regarding their possible implication) Other History

2 1 0

12. Past medical history

13. Past surgical history 14. Allergies

2 1 0 2 1 0 2 1 0

15. Medications 2 1 0

16. Family history 17. Social history

2 1 0 2 1 0

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18. Pertinent review of systems

2 1 0

Physical Exam

19. Documented vital signs, including pain evaluation 2 1 0

20. Documented a statement of general well being

2 1 0

21. Documented pertinent positive physical exam findings 2 1 0

22. Documented pertinent negative physical exam findings 2 1 0

23. Avoided selecting too many PE components 2 1 0

24. Avoided selecting too few PE components 2 1 0

25. Documented in office point­of­care testing if completed 2 1 0 N/A

Assessment 26. Sentence summarizing patient’s age, gender, pertinent past medical history, and chief

complaint 28. Documented 3 differential diagnoses, all of which were pertinent to the history &

physical exam. The #1 differential is the working diagnosis.

2 1 0 2 1 0

Plan 29. Developed a plan for the patient based on the problem(s) identified in the working diagnosis 30. Avoided selecting too many or too few lab or diagnostic studies 31. Provided rationale for all diagnostic testing 32. Provided patient education as appropriate 33. Documented a plan for follow­up Professional Criteria 34. Accurate, precise terminology used

2 1 0 2 1 0 2 1 0 2 1 0 2 1 0 2 1 0

35. SOAP format used correctly 2 1 0

36. Information well organized by topic and concise 2 1 0

COMMENTS: Grading: Total possible points__________ Total points achieved__________ Percent achieved___________

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Appendix F: Competency-Based Clinical Evaluation Form

This competency-based clinical evaluation form is designed to track your development as a nurse practitioner student throughout the program. Arrange a time to review the evaluation with your preceptor and together make a learning plan to address any particular competencies to work on in the future. In this way you can make the most of your clinical hours. A hard copy of the evaluation form must be submitted to your clinical instructor. Alternately, evaluations may be submitted via or fax or email to your clinical instructor. Two evaluations are required for each clinical placement: a mid-point evaluation and final clinical evaluation from each practicum site. Both are used to calculate the final course grade. The evaluation uses a 0-1-2 scale. A straight “2” indicates you are meeting all the basic expectations for a student at this level and equates to a score of 85%. An item scored as “1” is an area to improve, and a “3” indicates an area in which you are doing exceptionally well. How your evaluation will be scored

a) Points for items 1-14 are summed, divided by the number of items scored, and multiplied by 0.6 for the mean score for Management of Patient Health/Illness. This domain is weighted somewhat more than the other domains to reflect its importance.

b) Points for items 15-27 are summed, divided by the number of items scored, and multiplied by 0.4 for the mean score for all other domains.

c) The mean scores for Management of Patient Health/Illness and all other domains are summed and the sum averaged with any other midterm or final scores for the Evaluation Score. The Assigned Percent Score for midterm or final evaluation is then determined according to the following scale:

Evaluation Score Assigned Percent Score

1.00 – 1.09 65%

1.10 – 1.19 68%

1.20 – 1.36 72%

1.37 – 1.59 75%

1.60 – 1.76 78%

1.77 – 1.99 82%

2.00 – 2.16 85%

2.17 – 2.34 88%

2.35 – 2.49 92%

2.50 – 2.66 95%

2.67 – 2.84 98%

2.85 – 3.00 100%

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UIC CON NP STUDENT COMPETENCY CLINICAL EVALUATION FORM

Student: _____________________________________________________ Date: ______________________________________ Preceptor: ___________________________________________________ Site: _______________________________________ Please circle evaluation cycle: Hours Student Completed Thus Far: _______________ Mid-term Final This form is used by the clinical preceptor for feedback to the student and UIC faculty at midterm and the end of each practicum. Please fill it out considering the level of the student using the following key: 1 = below expectations for this level of student 2 = meets the basic expectations for this level of student3 = exceeds expectations for this level of student NA/NO = not applicable/not observed

Criteria for Evaluation 1 2 3 NA/NO

Management of Patient Health/Illness Status

1.Obtains a comprehensive and/or problem focused health history

1 2 3 NA/NO

2. Performs a comprehensive and/or problem focused physical exam

1 2 3 NA/NO

3. Documents accurately a relevant health history and physical exam

1 2 3 NA/NO

4. Differentiates normal, variations of normal and abnormal findings

1 2 3 NA/NO

5. Synthesizes data from a variety of sources to make clinical decisions regarding appropriate management, consultation or referral

1 2 3 NA/NO

6. Prioritizes health problems including the need for emergent care

1 2 3 NA/NO

7. Provides anticipatory guidance and counseling for patients and families

1 2 3 NA/NO

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8. Employs appropriate diagnostic, procedural and other interventions with attention to safety, cost, risk and benefit

1 2 3 NA/NO

9. Analyzes and interprets the history, physical findings, and diagnostic information to develop appropriate differential diagnoses

1 2 3 NA/NO

10. Prescribes appropriate pharmacologic and non-pharmacologic treatment modalities based on relevant individual client characteristics

1 2 3 NA/NO

11. Evaluates interventions and revises plan accordingly 1 2 3 NA/NO

12. Uses evidence-based references effectively and efficiently in the clinical setting

1 2 3 NA/NO

13. Presents patients to preceptor in thorough, concise, and organized manner

1 2 3 NA/NO

14. Completes patient encounter in a timely manner 1 2 3 NA/NO

Nurse Practitioner-Patient Relationship

15. Demonstrates effective communication and therapeutic relationships with individuals, families, and caregivers

1 2 3 NA/NO

16. Demonstrates cultural awareness and sensitivity 1 2 3 NA/NO

17. Collects, maintains and documents health care information in a confidential and private manner following current rules and regulations

1 2 3 NA/NO

Teaching-Coaching Function

18. Collaborates with the individual, family, and caregivers in the development of appropriate interventions

1 2 3 NA/NO

19. Adapts teaching-learning approaches based on the physiological and physiological changes, age, developmental stage, readiness to learn, health literacy and the resources

1 2 3 NA/NO

Professional Role

20. Maintains professional standards: dress, timeliness, language

1 2 3 NA/NO

21. Collaborates and consults with the preceptor and with other health care providers to optimize care and outcomes for the adult-gerontology population

1 2 3 NA/NO

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22. Applies current, relevant evidence into planning patient care 1 2 3 NA/NO

23. Demonstrates interest and takes initiative in learning 1 2 3 NA/NO

Managing and Negotiating Health Care Delivery Systems

24. Considers cost, safety, effectiveness and alternatives when making health care decisions

1 2 3 NA/NO

25. Applies knowledge of regulatory processes and principles of payer systems when planning care

1 2 3 NA/NO

Monitoring and Ensuring the Quality of Health Care Practice

26. Uses technology and quality improvement methods to enhance safety and monitor health outcomes

1 2 3 NA/NO

Cultural and Spiritual Competence

27. Shows respect and incorporates individual, cultural, ethnic and spiritual needs of the patient and their families into the plan of care

1 2 3 NA/NO

Strengths: Areas needing improvement: Additional comments: Student Signature: ___________________________________________________ Date: ___________________ *Preceptor signature: _______________________________________________ Date: ____________________ *Preceptors are requested to send a completed evaluation to the student’s clinical faculty contact as below via email (scanned) or fax (see next page, please):

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Chicago: Adult-Gero Acute Care Melissa Carlucci: mcarlu2@uic.edu Fax: 312-996-4979

Adult-Gero Primary Care Dr. Lauren Vacek: ljvacek@uic.edu Fax: 312-996-4979

Rockford: Rich McLaughlin rhamcmc@uic.edu Fax: 815-395-5816

Urbana: Erica Halcomb ehalcom2@uic.edu Fax: (217)-244-0430

Quad Cities: Alyssa Wislander awisla2@uic.edu Fax: (309)-757-9473

Peoria: Sue Copp scopp2@uic.edu Fax (309) 671-8436

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