Competency Appraisal

General Course Objective:

At the end of the course, the student will be able to demonstrate the transition to a higher-level thinking process that is necessary to perform competently in the role of a professional nurse.

SPECIFIC COURSE OBJECTIVES:

At the end of the course, the student will be able to:

1. place data in logical order to sequence events.

2. demonstrate deliberate strategies that reflect a transfer of theory knowledge to the practice setting.

3. analyze situations for similarities with previous experiences.

4. identify cause-and-effect relationship.5. adapt knowledge and skill gained in

previous situations to present the problem.

6. demonstrate the ability to apply sound reasoning to nursing practice.

7. exhibit adequate knowledge in basic nursing concepts covered in NCM 100-103.

8. explain basic nursing concepts covered in NCM 100-103.

9. demonstrate critical thinking skills in solving basic nursing problems.

10. exhibit adequate skills in carrying out the nursing process.

SPECIFIC COURSE OBJECTIVES:

DEFINITION OF TERMS:

Appraisal – a review or survey of performance, normally for the purpose of career and/or educational development.

Collaborative problem – physiological complication that the nurse monitors to detect the onset of changes in client status but for which the nurse cannot independently initiate the definitive treatment

Competency – the degree of accomplishment that meets a satisfactory standard of performance.

Critical Thinking – process of purposeful, self-regulatory judgment; in nursing, it is discipline-specific reflective reasoning that guides the process of deciding what to do or believe in unique situations

Experiential learning – an approach to education and training based on providing students with structured activities and the opportunity to reflect on them so they can learn by doing.

Inference – the nurse’s judgment or interpretation of cues, such as judging a blood pressure to be lower than normal

Learning opportunities – a wide range of knowledge, skills and attitudes that a student may be exposed to during clinical/ practice placement.

Nursing Diagnosis – nurse’s ethical judgment about the client’s responses to actual or potential health problems or state of wellness.

Objective data – includes measurable and observable data that can be detected by someone other than the client

Performance indicator – a pointer that draws attention to whether or not students are competent at carrying out tasks.

Subjective data – data that originates form the client

WHAT ARE THE CHARACTERISTICS OF A COMPETENT NURSE?

He/ She understands reason for task: and is able to perform task

independently. but needs supervision. and is able to perform with assistance.

WHAT ARE THE CHARACTERISTICS OF A NON-COMPETENT NURSE?

He/ She: understands reason for task but

performs task at provisional level. is unable to state reason for task and

performs task at a dependent level.

Why do we need to assess?

To ascertain: The level of theoretical knowledge The level of practical clinical skills Insight into the level of

professional attitudes

ACTIVITY 1:

I should have never qualified – my skills & attitude are inadequate

I am ashamed that I have reached this far but still my skills and knowledge are inadequate for my level

Reflect on the feelings evoked by the statements above. Suggest reasons/ factors that you assessed that lead to these statements.

How could you, as a Level 4 student nurse, address this situation?

 

CULTIVATING CRITICAL THINKING 

INTELLECTUAL STANDARDS IN THINKING:

essential to increasing the quality of thinking. How should we ask then, to cultivate critical

thinking?1. Clarity Could you elaborate further? Could you give me an example? Could you illustrate what you mean?2. Accuracy (In the interpretation of data) How could we check on that? How could we find out if that is true? How could we verify or test that?

3. Precision Could you be more specific? Could you give me more details? Could you be more exact?4. Relevance (Pertinent data) How does that relate to the problem? How does that bear on the question? How does that help us with the issue?

5. Depth (Analyzing deeper into the problem to check the root cause)

What factors make this a difficult question? What are some of the complexities of this

question? What are some of the difficulties we need to

deal with?6. Breadth (thinking about a situation from

different points of view) Do we need to look at this from another

perspective? Do we need to consider another point of view?

7. Logic (Nursing procedures done in logical manner)

Does all this make sense together? Does your first paragraph fit in with your last? Does what you say follow from the evidence?8. Significance (Identifying critical information

from trivial in a given situation) Is this the most important problem to consider? Is this the central idea to focus on? Which of these facts are most important?9. Fairness (Being open to new ideas) Am I sympathetically entering the view points

of others? Am I putting views I oppose in their strongest

form?

Activity 2Scenario Assessment & Interpretation

During the assessment, Mr. Yoso relates a history of sudden onset of chest pain rated at 10 on a 1 to 10 scale, unrelieved by rest, which started while he was mowing the lawn. He describes the pain as “crushing, like a truck ran over my chest.” His blood pressure is 200/110 mmHg, temperature is 36.7C; pulse is 106 beats/min; and respirations are 24 breaths/min. The pulse is irregular and thread, and the respirations are slightly dyspneic. The cardiac monitor reveals atrial fibrillation. During the assessment, his wife confides to the nurse that Mr. Yoso was treated 3 years ago for alcohol dependence. Currently he is complaining of nausea and indigestion. His skin is pale and diaphoretic. He is restless and anxious. His wife is sitting at the bedside very tearful and emotional.

List where you might find pertinent data Identify what the nurse can do to collect

significant data in an organized manner Where would the nurse seek information

to identify missing data? What other points of view should the

novice nurse seek in order to verify conclusions?

How can the nurse evaluate the opinions of others fairly?

Recognize assumptions Possible pharmacologic or surgical

treatments are anticipated

SAMPLE IN MAKING INFERENCE:

SITUATION INFERENCEASSUMPTIONS

that led to the inference

The physician informed the patient that the lab data results are positive for cancer and that the disease has spread t the liver. The patient is very upset

The diagnosis of cancer caused the patient to feel sad.

All patients who learn they have a life-threatening disease are sad.

The physician told the patient that his WBC was abnormal and that it indicated an infection

A variation in the WBC indicates an infection

All patients with a variation in the WBC have an infection

The patient rang the call light for pain medication. The nurse had gone to lunch, and a delay resulted in the patient experiencing extreme pain for an extended time.

The patient was in pain because the nurse attended to her own needs instead of the patient’s need

All nurses cause patients to experience pain while attending to their own needs

ACTIVITY 3 Scenario Assessment & Interpretation Frank Furter, a 72 year old patient admitted

for acute confusion presented in the ER with a history of hypertension, DM type 1, and arthritis. He lives in a single-family home with his wife. The patient is slightly confused and has an unsteady gait. He frequently forgets to use his walker and fails to call for assistance from the nursing staff when ambulating to the bathroom. Based on this scenario, discuss your interpretation, analysis, evaluation, inference, and explanation and how you would use these to resolve a situation related to the patient’s safety?

 

Clarify that the behavior means During assessment, what questions should

the nurse ask to determine the best plan of care?

What outcomes do you expect to achieve with your patient today?

What conclusion could the nurse make, based on the analysis?

During implementation, how can the nurse justify the actions being initiated?

What should the nurse reexamine to correct or improve the nursing care?