Assignment: Journal Entry

Assignment: Journal Entry

Critical reflection on your growth and development during your practicum experience in a clinical setting helps you identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes. 

Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum.

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.

In 450–500 words, address the following:

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 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?  

Communicating and Feedback 

·         Reflect on how you might improve your skills and knowledge and how to 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. 

 

I was precepting in a drug /substance abuse clinic this semester,,

These was my evaluation from my preceptor.

Response scale: 4 = Exceeds expectations 3 = Meets expectations 2 = Needs improvement 1 = Unsatisfactory N/A = No opportunity to assess

Below 3 needs improvement and is unsatisfactory. Please add comments if score is below a 3. Other comments welcome.

Criteria

Midterm Score

 

Communication

Uses effective communication and interpersonal skills when meeting with patients, office staff, preceptor and other health care professionals.

4

 

Professionalism

Interacts in a collegial and professional manner.

4

Accepts constructive feedback and seeks to integrate it into clinical performance.

4

Is punctual and appropriately dressed.

4

Assumes responsibility for evaluating own progress and is able to define the areas that need improvement.

4

 

Subjective Data

Obtains an accurate, comprehensive diagnostic assessment from the client appropriate to the presenting issue and the level of the student.

4

Establishes a therapeutic alliance with an individual, family or group that is developmentally appropriate.

4

 

Objective Data

Performs a thorough review of systems, physical assessment (when indicated), developmental assessment, family assessment, past psychiatric history, and mental status exam appropriate to the client’s presenting issue.

4

 

Assessment

Uses information from the interview, history, clinical record review and observation of client to create a concise problem list.

4

Recognizes and prioritizes the issues in the problem list that need attention and generate differentials.

4

Determines and uses appropriate assessment tools for the clients’ presenting problem and understands the results.

4

 

Plan

Collaborates with client to develop a treatment plan, taking into consideration patient’s factors and cultural background.

4

Uses the literature to formulate evidence-based practice, interventions and treatment plans.

4

Considers issues of client safety to include risk to self and others.

4

Considers legal and ethical issues.

4

 

Presentation and Documentation

Oral presentation includes succinct summary of pertinent findings, diagnosis, differentials, and treatment plan, taking into consideration patient factors and cultural background.

4

Clear, logical and organized written documentation of patient encounters.

4

Average Score

4

 

Rubric Detail

 

Select Grid View or List View to change the rubric’s layout.

Name: PRAC_6645_Week11_Assignment_Rubric

 

·         Grid View

·         List View

 

Excellent

Good

Fair

Poor

Assimilation and Synthesis: Content Reflection

45 (45%) – 50 (50%)

Reflection demonstrates a high level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Insightful and relevant connections are made through contextual explanations and examples.

40 (40%) – 44 (44%)

Reflection demonstrates moderate level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Connections are made through explanations and/or examples.

35 (35%) – 39 (39%)

Reflection demonstrates minimal critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or experiences. Minimal connections made through explanations and/or examples.

0 (0%) – 34 (34%)

Reflection lacks critical thinking. Superficial connections are made with key course concepts and resources, and/or assignments.

Assimilation and Synthesis: Personal Growth

27 (27%) – 30 (30%)

Expresses solid evidence of reflection on own work. Demonstrates substantial personal growth and awareness of deeper meaning through inferences, well developed insights, and significant depth in awareness and challenges. Synthesizes current experience into future implications.

24 (24%) – 26 (26%)

Expresses moderate evidence of reflection on own work. Demonstrates satisfactory personal growth and awareness through some inferences, insights, and challenges. There is mention of the future implications of student’s current experience.

21 (21%) – 23 (23%)

Expresses minimal evidence of reflection on own work. Demonstrates less than adequate personal growth and awareness through limited or simplistic inferences made, insights, and/or challenges that are not well developed. Minimal thought of future implications of student’s current experience.

0 (0%) – 20 (20%)

Expresses inadequate evidence of reflection on own work. Personal growth and awareness are not evident and/or demonstrate an impersonal experience. Lacks personal insights, challenges, inferences, and/or future implications are overlooked.

Written Expression and Formatting

14 (14%) – 15 (15%)

Well written and clearly organized using standard English, characterized by elements of a strong writing style and basically free from grammar, punctuation, usage, and spelling errors.

12 (12%) – 13 (13%)

Above average writing style and logically organized using standard English with minor errors in grammar, punctuation, usage, and spelling.

11 (11%) – 11 (11%)

Average writing style that is sometimes unclear and/or with some errors in grammar, punctuation, usage, and spelling.

0 (0%) – 10 (10%)

Poor writing style lacking in standard English, clarity, language used, and/or frequent errors in grammar, punctuation, usage, and spelling. Needs work.

APA

5 (5%) – 5 (5%)

Contains no APA errors.

4 (4%) – 4 (4%)

Contains one to two (1–2) APA errors.

3.5 (3.5%) – 3.5 (3.5%)

Contains three to five (3–5) APA errors.

0 (0%) – 2 (2%)

Contains more than five (>5) APA errors.

Total Points: 100

 

Name: PRAC_6645_Week11_Assignment_Rubric

 

Assignment: Journal Entry

 

 

Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes. 

 

Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum

​To Prepare

• Refer to the “Advanced Nursing Practice Competencies and Guidelines” 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. Reflect on your observations and experiences.

In 450–500 words, address the following:

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 did you have available?
• What evidence-based practice did you use for the patients?
• What new skills are you learning?
• What would you do differently?
• How are you managing patient flow and volume? 

Communicating and Feedback

• Reflect on how you might improve your skills and knowledge and how to 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. 

 

​Rubric Detail

Select Grid View or List View to change the rubric’s layout.

​Content

​Name: PRAC_6635_Week11_Assignment_Rubric

• Grid View
• List View

 

Excellent

Good

Fair

Poor

Assimilation and Synthesis: Content Reflection

Points Range: 50 (50%) – 50 (50%)

Reflection demonstrates a high level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or Discussions. Insightful and relevant connections are made through contextual explanations and examples.

Points Range: 40 (40%) – 49 (49%)

Reflection demonstrates moderate level of critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or Discussions. Connections are made through explanations and/or examples.

Points Range: 31 (31%) – 39 (39%)

Reflection demonstrates minimal critical thinking in applying and integrating key course concepts and theories from readings, lectures, and/or Discussions. Minimal connections made through explanations and/or examples.

Points Range: 0 (0%) – 30 (30%)

Reflection lacks critical thinking. Superficial connections are made with key course concepts and resources, and/or assignments

Assimilation and Synthesis: Personal Growth

Points Range: 30 (30%) – 30 (30%)

Expresses solid evidence of reflection on own work. Demonstrates substantial personal growth and awareness of deeper meaning through inferences, well developed insights, and significant depth in awareness and challenges. Synthesizes current experience into future implications.

Points Range: 20 (20%) – 29 (29%)

Expresses moderate evidence of reflection on own work. Demonstrates satisfactory personal growth and awareness through some inferences, insights, and challenges. There is mention of the future implications of student’s current experience.

Points Range: 10 (10%) – 19 (19%)

Expresses minimal evidence of reflection on own work. Demonstrates less than adequate personal growth and awareness through limited or simplistic inferences made, insights, and/or challenges that are not well developed. Minimal thought of future implications of student’s current experience.

Points Range: 0 (0%) – 9 (9%)

Expresses inadequate evidence of reflection on own work. Personal growth and awareness are not evident and/or demonstrate an impersonal experience. Lacks personal insights, challenges, inferences, and/or future implications are overlooked.

Written Expression and Formatting

Points Range: 15 (15%) – 15 (15%)

Well written and clearly organized using standard English, characterized by elements of a strong writing style and basically free from grammar, punctuation, usage, and spelling errors.

Points Range: 11 (11%) – 14 (14%)

Above average writing style and logically organized using standard English with minor errors in grammar, punctuation, usage, and spelling.

Points Range: 6 (6%) – 10 (10%)

Average writing style that is sometimes unclear and/or with some errors in grammar, punctuation, usage, and spelling.

Points Range: 0 (0%) – 5 (5%)

Poor writing style lacking in standard English, clarity, language used, and/or frequent errors in grammar, punctuation, usage, and spelling. Needs work.

APA

Points Range: 5 (5%) – 5 (5%)

No APA errors

Points Range: 4 (4%) – 4 (4%)

Contains one to two (1–2) APA errors

Points Range: 2 (2%) – 3 (3%)

Contains three to five (3–5) APA errors

Points Range: 0 (0%) – 1 (1%)

Contains more than five (> 5) APA errors

 

Total Points: 100

​Name: PRAC_6635_Week11_Assignment_Rubric

 

This is the self assessment form submitted I submitted in Week 1 PRAC 6635 Clinical Skills Self-Assessment Form

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 

 

 

 

Differentiating between pathophysiological and psychopathological conditions 

 

 

 

Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies) 

 

 

 

Performing and interpreting a mental status examination 

 

 

 

Performing and interpreting a psychosocial assessment and family psychiatric history 

 

 

 

Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).

 

 

 

Diagnostic reasoning skill in: 

 

 

 

 

Demonstrate knowledge of psychopathology of mental illnesses through discussion for different age groups and mental illnesses

 

 

 

Developing and prioritizing a differential diagnoses list

 

 

 

Formulating diagnoses according to DSM 5 based on assessment data 

 

 

 

Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes

 

 

 

Psychotherapeutic Treatment Planning: 

 

 

 

Provide psychoeducation to individuals and/or any caregivers

 

 

 

Promote health and disease prevention techniques

 

 

 

Self Assessment skill: 

 

 

 

Develop SMART goals for practicum experiences 

 

 

 

Evaluating outcomes of practicum goals and modify plan as necessary 

 

 

 

Documenting and reflecting on learning experiences

 

 

 

Professional skills: 

 

 

 

 

Maintains professional boundaries and therapeutic relationship with clients and staff

 

 

 

Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings

 

 

 

Identifies ethical and legal dilemmas with possible resolutions

 

 

 

Demonstrates non-judgmental practice approach and empathy

 

 

 

Practices within scope of practice

 

 

 

Selecting and implementing appropriate screening instrument(s) and interpreting results:

 

 

 

Demonstrates selecting the correct screening instrument appropriate for the clinical situation 

 

 

 

Implements the screening instrument efficiently and effectively with the clients

 

 

 

Interprets results for screening instruments accurately

 

 

 

Identifies the need to refer to another specialty provider when applicable

 

 

 

Accurately documents recommendations for psychiatric consultations when applicable

 

 

 

 

Summary of strengths:

My strength includes creating a good rapport with the patient which is needed for patient to build trust and open up during interview. I make a great team member which is needed to coordinate with the other multidisciplinary health care-team. I Approach all patients with a listening ear and a non-judgmental practice approach which makes patients comfortable to talk with me despite their religion, gender, ethnicity or condition. I attend my patient with empathy and out of these I win favor very quickly from the patient. 

 

 

 

Opportunities for growth:

I need growth in: 

• Differentiating between pathophysiological conditions and Psychopathological conditions. 
• Recognizing clinical signs and symptoms of psychiatric illness 
• Performing and interpreting a mental status exam.
• Performing and interpreting a comprehensive and /or interval history and physical examination(including laboratory and diagnostic studies)

 

I will work with my preceptor to improve these skills by writing down a plan which will be my goal for this clinical preceptor period. After writing this plan, I will follow it through by working closely with my preceptor and asking questions in areas where I need clarification. These will help me in improving these identified need for growth. By the end of this preceptor period the identified need for growth will have have moved from “Beginning to mostly confident”.

 

 

 

Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources. 

 

THESE IS AN EXAMPLE FROM A FRIEND

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Journal Entry

kiikkkkk

PMHNP, Walden University

PRAC 6635: Psychopathology and Diagnostic Reasoning Practicum

Dr. kkkkkkkkkkkk

02/06/2021

 

 

 

 

 

Part One

Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.

1. I have learned a lot about diagnostic testing. I feel I have a “working knowledge” of what requires monitoring with pharmacological treatments. I feel much more confident in this skill. I have not mastered this skill but I feel more confident I will learn more as I progress.
2. My preceptor took time to explain the concept of differentiating pathophysiological and psychopathological in detail. I feel very confident that I have reached this goal and will be able to apply this knowledge in practice. 
3. I have had much opportunity to develop psychodynamic treatment plans throughout this practicum. I have become very skillful and feel I reached my goal. 
4. I have used several different screening and diagnostic tools during this practicum. My preceptor and the didactic part of the practicum gave me ample opportunity to learn more about the tools. I have successfully implemented this skill and reached my goal. 

Part Two

Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?

Patient One- JS was difficult because she did not see anything wrong with her lifestyle. She is a recovering alcoholic who believes drinking a little is ok. She is also an opioid addict who believes using cannabis helps her to manage opioid misuse. She demanded medication that would make her “feel” something. 

Patient Two- JR was challenging because he was so jaded regarding psychotherapy and sharing his feelings. He has a lot of physical issues that he focuses on. He is schizophrenic and paranoid toward new providers.

Patient Three- AJ was very challenging because she needed so much more than I could provide. She requires much support almost on a daily basis. She has much potential to improve her quality of life and she deserves a therapist who can dedicate more time to her.

Part Three

1. What did you learn from this experience? I learned I have much to learn. I also learned how important it is to understand different treatment modalities in order to offer the patient individualized treatment.
2. What resources did you have available? I had many resources including two psychiatrists, a psychiatric PA, and an LCSW. I also had two other students with whom I could discuss topics with and learn from.
3. What evidence-based practice did you use for the patients? CBT and DBT
4. What new skills are you learning? I am learning diagnostic skills, communication skills, and business skills.
5. What would you do differently? I would start building professional relationships with the patients sooner.
6. How are you managing patient flow and volume? Planning for the day and number of patients before starting in the morning.

Communicating and Feedback

I can improve my skills and knowledge by researching evidence-based material and asking questions. I communicate my skills and knowledge by sharing evidence-based articles and completed assignments with my preceptor. The feedback from my preceptor was good information weather it was from doing well or missing the mark. I received useful information in feedback. 

How am I doing? I am feeling much more confident and much less nervous about my chosen career path.

What is missing? I have a lot of missing pieces that will come together as I progress in my academic efforts. I feel like I have experienced a good start with the completion of my first practicum