Comprehensive Assessment Plan: Quality and Safety Education for Nurses

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23.11.2022
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The curriculum areas chosen for the current assignment include nursing ethics (theory part) and vital signs monitoring (clinical part). The paper presents a comprehensive assessment plan including the description of the curriculum content areas, learning objectives in the context of the Quality and Safety Education for Nurses (QSEN) objectives, and the assessment plan (assignment description, scoring rubrics, and a test blueprint). The intended audience for the assessment plan targets includes nursing students approaching the end of the courses “Nursing Ethics in Clinical Practice” and “Vital Signs Monitoring” who would like to better understand the assessment criteria used to evaluate their performance.

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Part 1: Theory

The current part of the assessment plan includes the assessment of student’s knowledge of the theoretical course “Nursing Ethics in Clinical Practice.”

Curriculum Focus Area

The assessed curriculum area is nursing ethics. The course content encompasses such areas as working knowledge of the American Nurses Association (ANA) Code of Ethics for Nurses, ethical decision-making in nursing, professional moral values and ethical standards, moral theories, and ethics in interdisciplinary collaboration and clinical research (Butts & Rich, 2015). The curriculum focuses on helping students to build a solid theoretical foundation and develop skills that nurses need to apply nursing ethical norms to mortally challenging clinical situations and find solutions to address multiple moral issues that arise in nursing practice.

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Learning Objectives

After completing the course, the student can

Objective #1: Recall all of the provisions of the ANA Ethics Code and give examples of practical application of the provisions to a clinical situation.

Objective #2: Give examples of referring to the provisions of the ANA Code of Ethics in resolving ethical dilemmas in nurse-nurse, nurse-patient, and nurse-physician relations.

Objective #3: Give examples of applying ethical theories to find solutions to clinical problems.

Objective #4: Locate and research relevant literature to determine an appropriate ethical course of actions and recommend ethical solutions in challenging situations.

Objective #5: Evaluate nursing values and decisions through the prism of the ANA Ethics Code and demonstrate awareness of how personal values affect professional behaviors (Butts & Rich, 2015).

Matching the Learning Objectives and the QSEN Competencies

Learning Objectives QSEN Competencies
Objective #1: Recall provisions of the ANA Ethics Code and give examples of their practical application Patient-centered care: Exploring ethical and legal implications of nursing care (QSEN, 2018)
Objective #2: Give examples of referring to the ANA Ethics Code in resolving ethical dilemmas in nurse-nurse, nurse-patient, and nurse-physician relations Teamwork and collaboration: Functioning effectively within teams and fostering shared decision-making, mutual respect, and open communication to achieve quality patient care (QSEN, 2018)
Objective #3: Give examples of applying ethical theories to find solutions to problems Patient-centered care: Describing basic principles of solving conflicts and building consensus (QSEN, 2018)
Objective #4: Locate relevant literature to determine an appropriate ethical course of actions in ethically challenging situations Evidence-based practice (EBP): Relying on evidence to determine best clinical practice and describing reliable sources for locating evidence and clinical practice (QSEN, 2018)
Objective #5: Evaluate nursing attitudes, actions, values, and decisions through the prism of the ANA Ethics Code and demonstrate awareness of how personal values affect professional behaviors Quality improvementGiving examples of the tension between system functioning and professional autonomy (QSEN, 2018)

Formative and Summative Assessment Plan

The assessment plan includes both formative and summative assessment. The formative assessment plan includes asking students to (a) write three reflection journals describing their views on the choice of optimal ethical theories to guide clinical practice, (b) provide verbal feedback about applying ANA Ethics Code to patient care scenarios, (c) complete test quizzes, (d) explain verbally how they understand Ethics Code provisions, and (e) draw concept maps demonstrating how the application of different ethical theories leads to different decisions and outcomes (Butts & Rich, 2015; Billings & Halstead, 2015; Oermann & Gaberson, 2016). The summative assessment plan includes completing a power point presentation, take-home exam, and mid-term and final written assignments where the students explore the practical application of ethical theories and provisions of the ANA Ethics Code to clinical situations.

There are several reasons why the assessment is constructed in the described way. First, the combination of formative and summative evaluations allows evaluating student learning more objectively, determining students’ learning needs, and providing timely feedback. Second, using different assessment strategies allows considering the needs of students with different preferred learning styles and taking into account individual learning differences (Billings & Halstead, 2015). Finally, combining formative and summative evaluating strategies makes assessment more comprehensive and objective, stimulates learning and greater student engagement and promotes greater student accountability.

Test Blueprint

Content area/ Topic Level of Cognitive Skill
Remembering Understanding Applying Analyzing Total number of questions (20)
1. ANA Ethics Code  Remembering provisions of the ANA Code of Ethics  Analyzing the meaning of the provisions of the ANA Code of Ethics  5
2. Ethical theories Remembering main ethical theories  Understanding conceptual differences between main ethical theories  Analyzing differences between the (a) premises of the main ethical theories and (b) implications of applying different theories  5
3. Solving ethical dilemmas  Understanding how to apply Ethics Code and ethical theories to find solutions to ethical dilemmas  Applying Ethics Code and ethical theories to solve ethical dilemmas  Analyzing consequences of different approaches to solving ethical dilemmas  5
4. Using research and literature to manage ethically challenging situations  Understanding what credible and reliable sources are and how research and academic literature are used to empower nurses to manage ethically challenging situations  Understanding how research and academic literature are used to empower nurses to manage ethically challenging situations  Analyzing and comparing/ contrasting literature-based recommendation and approaches to managing ethically challenging situations  5

Written Assignment: Description and a Scoring Rubric

Directions for the final written assignment (assignment criteria):

1. Compose 8-10 page research paper on the topic of ethical dilemmas associated with the provision of end-of-life care.

2. Chose an ethical dilemma and propose a literature-based solution. Elaborate on how and why you arrived at your solution. Discuss the advantages and disadvantages of alternative solutions.

3. Discuss how nurses can apply the ANA Ethics Code and ethical theories to find solutions to the presented ethically challenging situation (Butts & Rich, 2015).

4. Conduct a mini-literature review to explore how the discussed ethically challenging situation is addressed in nursing practice.

5. The paper needs to use five or more peer-reviewed sources published within the last seven years and be formatted in accordance with the APA academic writing style (Oermann & Gaberson, 2016).

The holistic scoring rubric provided below will be used to determine whether the

completed assignment meets all the expectations. It was developed on the basis of ideas and suggestions for developing scoring rubrics offered by Oermann and Gaberson (2016).

Score Criteria
Excellent (89-100) Completed paper shows a complete understanding of the topic. All parts of the assignment are included. Relevant ANA Ethics Code provisions and moral theories are discussed and analyzed clearly and adequately. Writing reflects through research and current evidence. Assertions and conclusions are supported with references. Diverse viewpoints are presented and discussed adequately. Errors in writing, mechanics, and sentence structure are very minor and few. APA format is used throughout the paper correctly and consistently. The number of pages and references correspond with assignment instructions.
Good

(75-88)

Completed paper shows considerable understanding of the topic. The writing shows accuracy, coherence, clarity, and balance in developing assignment parts. Nevertheless, there are occasional minor weaknesses, inaccuracies, or ambiguities in the discussion of relevant concepts and theories. Content reflects adequate research and evidence. Most of the arguments and conclusions are supported. Diverse perspectives are discussed to a different extent. APA format is used mostly correctly. The number of pages and references mostly correspond with assignment instructions.
Adequate

(60-74)

Completed paper shows adequate understanding of the assignment topic. Some body parts are not fully developed. Writing has some lapses in correctness, ambiguities, and unclear statements/ sentences. Some errors in mechanics, grammar, and sentence structure make some sentences incoherent. Although content demonstrates some research and evidence, some assertions and conclusions are insufficiently supported or unsupported. The discussion of different perspectives is limited. There are some errors and inconsistencies in APA format, assignment length, and sources used.
Below expectations (0-59) Completed paper shows the student has limited understanding of the topic. The writing is vague, weak, incomplete, and imbalanced (in terms of developing body parts of appropriate length). The paper has numerous errors and ambiguities making it difficult to read. Evidence and research are poorly used to support claims; conclusions are poor or absent. No diverse perspectives are discussed. There are major errors in APA format. Paper length and most of the sources used are inadequate.

Part #2: Clinical

The second part presents the assessment pertinent to the clinical course “Vital Signs Monitoring.”

Curriculum Content Area

The target curriculum content area is vital signs monitoring including practical and theoretical domains. In the context of the given assignment, the focus is on the practical clinical skills nurses must possess to be able to take vital signs. While the nursing student demonstrates in practice how he/she takes vital signs, an instructor can use a clinical observation and evaluation rubric to assess whether and how well the student mastered the clinical psychomotor skills necessary to take vital signs such as pulse/heart rate, blood pressure, body temperature, and breathing or respiratory rate.

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Learning Objectives

After completing the course, the student can

Objective #1: Demonstrate how to take blood pressure.

Objective #2: Demonstrate how to take breathing/ respiratory rate.

Objective #3: Demonstrate how to take pulse-heart rate.

Objective #4: Demonstrate at least three ways how to take the temperature.

Objective #5: Demonstrate where the ventral aspect of the wrist on the side of the thumb is located and where and how the nurse needs to press when taking a patient’s pulse.

Mapping the Learning Objectives to the QSEN Competencies

Learning Objectives QSEN Competencies
Objective #1: Demonstrate how to take blood pressure Quality improvement: Monitoring the outcomes of care processes and participating in the analysis of the root causes of illnesses (QSEN, 2018)
Objective #2: Demonstrate how to take breathing/ respiratory rate Quality improvement: Valuing measurement and its role in effective patient care (QSEN, 2018)
Objective #3: Demonstrate how to take pulse -heart rate Quality improvement: Using measures to evaluate the effects of care (QSEN, 2018)
Objective #4: Demonstrate at least three ways how to take temperature Quality improvement: Demonstrating the importance of measurement and valuation in assessing the quality of care (QSEN, 2018)
Objective #5: Demonstrate where the ventral aspect of the wrist on the side of the thumb is located and where and how the nurse need to press when taking a patient’s pulse Quality improvement: Seeking information about outcomes of care (QSEN, 2018)

Conclusion and Summary

This course became a valuable learning experience in several ways. For example, some of my major takeaways about assessment and evaluation in nursing education (in terms of practical skills) include learning to design and select appropriate assessment strategies and tools and developing skills in formulating relevant and meaningful learning objectives, and matching evaluation methods to learning objectives. Other important takeaways (in terms of practical skills) include learning to develop different types of test items and holistic and analytical scoring rubrics, learning about different types of formative and summative assessment, and learning to develop coherent evaluation strategies that take into account learning objectives, students’ learning needs, and different levels of cognitive skills to be assessed. Importantly, I learned how to interpret assessment results and develop test items for evaluating lower- and higher-level cognitive skills. Therefore, I believe that this course will surely inform my teaching practice since it equipped me with critical expertise, skills, and competencies I will need and use as a nurse educator to assess students’ knowledge and skills professionally and objectively.

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