Assignment 2: Clinical Skills Self-Assessment
Before embarking on any professional or academic activity, it is important to understand the background, knowledge, and experience you bring to it. You might ask yourself, “What do I already know? What do I need to know? And what do I want to know?” This critical self-reflection is especially important for developing clinical skills such as those for advanced practice nursing.
The Psychiatric-Mental Health Nurse Practitioner (PMHNP) Clinical Skills List and Clinical Skills Self-Assessment Form provided in the Learning Resources can be used to celebrate your progress throughout your practicum and identify skills gaps. The list covers all necessary skills you should demonstrate during your practicum experiences.
Just as you did in PRAC 6635, for this Assignment, you assess where you are now in your clinical skill development and make plans for this practicum. Specifically, you will identify strengths and opportunities for improvement regarding the required practicum skills. In this practicum experience, when developing your goals and objectives, be sure to keep assessment and diagnostic reasoning in mind.
Instructions Assignment
1. Use the PMHNP Clinical Skills Self-Assessment Form to complete the following:
· Rate yourself according to your confidence level performing the procedures identified on the Clinical Skills Self-Assessment Form.
· Based on your ratings, summarize your strengths and opportunities for improvement.
· Based on your self-assessment and theory of nursing practice, develop 3–4 measurable goals and objectives for this practicum experience. Include them on the designated area of the form.
· Use at least 3 references.
2. Please review the Self-Assessment for the previous class NRNP – 6635 (See attachment), so you don’t repeat the strengths and opportunities for improvement and the goals
Self-assessment of Clinical Skills
Ariel Cordova Lopez
Walden University
PRAC 6635: Psychopathogy and Diagnostic Reasoning Practicum
Dr. Brandy Benson
March 05, 2022
Introduction
According to the American Association of Nurse Practitioners, NPs are licensed clinicians with a doctorate or master’s education who provide advanced health care to clients in collaboration with other health care professionals. Clinical training is an educational module that provides psychiatric mental health nurse practitioners an opportunity to assess, diagnose, and treat patients with mental and behavioral disorders. Clinical training offers PMHNP with essential skills to undertake their job functions. The clinical assessment form identifies and discusses my strengths and weaknesses concerning clinical skills. During the practicum experience, goals and objectives are necessary to maintain focus throughout the experience (Kleinpell et al., 2018).
| Desired Clinical Skills forStudents to Achieve | Confident (Cancompleteindependently) | Mostlyconfident (Cancomplete withsupervision) | Beginning (Haveperformed withsupervision orneedsupervision tofeel confident) | New (Haveneverperformed ordoes not apply) |
| Comprehensive psychiatric evaluation skills in: | ||||
| Recognizing clinical signs and symptoms of psychiatric illness | Confident | |||
| Differentiating betweenpathophysiological andpsychopathologicalconditions | Mostly confident | |||
| Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies) | Mostly confident | |||
| Performing and interpreting amental status examination | Beginning | |||
| Performing and interpreting apsychosocial assessment andfamily psychiatric history | Mostly confident | |||
| Performing and interpreting afunctional assessment(activities of daily living,occupational, social, leisure,educational). | Mostly confident | |||
| Diagnostic reasoning skill in: | ||||
| Demonstrate knowledge ofpsychopathology of mentalillnesses through discussionfor different age groups andmental illnesses | Beginning | |||
| Developing and prioritizing adifferential diagnoses list | Beginning | |||
| Formulating diagnosesaccording to DSM 5 based onassessment data | Beginning | |||
| Differentiating betweennormal/abnormal age-relatedphysiological andpsychologicalsymptoms/changes | Beginning | |||
| PsychotherapeuticTreatment Planning | ||||
| Provide psychoeducation toindividuals and/or anycaregivers | Beginning | |||
| Promote health and diseaseprevention techniques | Mostly confident | |||
| Self-Assessment skill: | ||||
| Develop SMART goals forpracticum experiences | Mostly confident | |||
| Evaluating outcomes ofpracticum goals and modifyplan as necessary | Mostly confident | |||
| Documenting and reflectingon learning experiences | Mostly confident | |||
| Professional skills: | ||||
| Maintains professionalboundaries and therapeuticrelationship with clients andstaff | Confident | |||
| Collaborate with multidisciplinary teams to improveclinical practice in mental health settings | Confident | |||
| Identifies ethical and legaldilemmas with possibleresolutions | Confident | |||
| Demonstrates nonjudgmental practiceapproach and empathy | Confident | |||
| Practices within scope ofpractice | Confident | |||
| Selecting and implementingappropriate screeninginstrument(s) andinterpreting results: | ||||
| Demonstrates selecting thecorrect screening instrumentappropriate for the clinicalsituation | Beginning | |||
| Implements the screeninginstrument efficiently andeffectively with the clients | Beginning | |||
| Interprets results forscreening instrumentsaccurately | Beginning | |||
| Identifies the need to refer toanother specialty providerwhen applicable | Beginning | |||
| Accurately documentsrecommendations forpsychiatric consultationswhen applicable | Mostly confident |
Summary of strengths
Patient-centered care is my greatest strength during my daily routines with my patients. my patient-centered approach enables me to obtain relevant historical information and perform a complete physical and mental status exam. My culturally competent communication methods make me aware of patients’ empathic interview techniques. Patient-centered care enables a nurse practitioner to treat clients with respect and dignity. Another strength is delivering personalized and supportive care to my clients (Chambers & Ryder 2018). Over the years, I gained experience maintaining a positive attitude while communicating with patients to avoid annoying them. Empathic interview techniques allow me to perform a comprehensive examination of patients to develop an accurate diagnosis of their condition. To maintain these skills, I practice them daily in community health clinics and medical wards. I can describe the variations in the patient presentation according to age and cultural background.
Another essential skill that is quite beneficial to me is recognizing and making recommendations on the possible use of psychotropic drugs. I usually embrace a warm demeanor during my interactions with my patients, which is essential in obtaining historical data from multiple sources. I have a complete understanding of each component of the mental status exam which enables me to describe common abnormalities and their causes. The principle of communication has allowed me to conduct myself professionally and be more empathetic to accept criticism and learn from my mistakes. Documentation is another notable strength that I utilize to note down clinical findings, diagnoses, and clinical reasoning. At times, laboratory findings may be unavailable; hence, I use my communication skills to obtain information with the patient and other professionals. My multifaceted skill sets have been an immense help, especially in the early identification of psychopathology symptoms.
Opportunities for growth
I need to develop more interview techniques for challenging situations, such as dealing with hostile, potentially assaultive, and cognitively impaired patients. There are many complications when it comes to diagnosing mental and behavioral disorders. Most psychological and pathophysiological disorders are challenging to diagnose because they require extensive knowledge; hence I need to gain a more comprehensive understanding and better my assessment skills. I need to focus on psychopathological differential diagnosis in that it becomes my priority. Another area of improvement is distinguishing between psychopathology and pathophysiology since they are two broad fields that require more profound understanding. The mental diagnosis process is lengthy in that it begins with the conduction of a physical examination of the patient (Phillips, 2020).
A mental status examination is then done, followed by a psychological assessment to do away with differential diagnosis to arrive at an accurate psychosocial diagnosis. Over the years that I have been caring for patients with behavioral disorders, it goes unnoticed that psychopathological diagnosis and treatment require in-depth knowledge and assessment skills. As a result, most diagnostic tests are unreliable during diagnosing psychopathological diseases. I need to widen my knowledge of psychopathological conditions to improve these weaknesses. I have to take advantage of every opportunity during the clinical rotations to apply the acquired knowledge. I also have a liability in the performance and interpretation of mental status examinations. I have to embark on vigorous clinical practice sessions to boost my experience in the interpretation of mental status examinations. Another way to improve my knowledge at the clinical sites is by continuous practice and personal and professional development. The newly acquired skills will encourage the provision of evidence-based and patient-based care as PMHNP (Price & Reichert, 2017).
Possible Goals and objectives
1. Goal: Incorporate knowledge on clinical reasoning and differential diagnosis
a) Objective: Identify signs and symptoms predisposing to any psychopathological disorder
b) Objective: understand basic test outcomes and other professional reports
c) Objective: Develop differential diagnosis of some clients with psychiatric disorders.
2. Goal: Independently develop psychiatric diagnosis at the end of the practicum
a) Objective: demonstrate the practical application of advanced techniques in the assessment process
b) Objective: Identify differential psychiatric diagnosis by utilizing patient’s concerns and physical assessment
c) Objective: Apply laboratory and other medical tests to evaluate clients
3. Goal: Expand mental status examination skills by the end of the period
a) Objective: monitor patients and perform cognitive assessments
b) Objective: recognize and differentiate clinical features to make accurate recommendations
c) Objective: perform mental status exams and interpret its results accurately
References
Chambers, C., & Ryder, E. (2018). Compassion and caring in nursing. Routledge.
Kleinpell, R., Cook, M. L., & Padden, D. L. (2018). American Association of Nurse Practitioners National Nurse Practitioner sample survey: Update on acute care nurse practitioner practice. Journal of the American Association of Nurse Practitioners, 30(3), 140-149.
Phillips, K. (2020). Mental illness is not anyone’s fault: a review of NAMI, the National Alliance on Mental Illness. Journal of Consumer Health on the Internet, 24(1), 75-81.
Price, S., & Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: meeting the needs of novice to mid-to late-career nurses throughout their career span. Administrative Sciences, 7(2), 17.
PMHNP PRAC 6645 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 across the lifespan | ||||
| 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: | ||||
| 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 | ||||
| Pharmacotherapeutic skills in: | ||||
| Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management) | ||||
| Evaluating patient response and modify plan as necessary | ||||
| Documenting (e.g., adverse reaction, the patient response, changes to the plan of care) | ||||
| Psychotherapeutic Treatment Planning: | ||||
| Recognizes concepts of therapeutic modalities across the lifespan | ||||
| Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation) | ||||
| Applies age appropriate psychotherapeutic counseling techniques with individuals, families, and/or groups | ||||
| Develop an age appropriate individualized plan of care | ||||
| Provide psychoeducation to individuals, family, and/or groups | ||||
| Promote health and disease prevention techniques | ||||
| Self-Assessment skills: | ||||
| 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), interpreting results, and making recommendations and referrals: | ||||
| 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 | ||||
| Develops an appropriate plan of care based upon screening instruments response | ||||
| Identifies the need to refer to another specialty provider when applicable | ||||
| Accurately documents recommendations for psychiatric consultations when applicable |
Summary of strengths:
Opportunities for growth:
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.
| 1. Goal:a. Objective:b. Objective:c. Objective:2. Goal:a. Objective:b. Objective:c. Objective:3. Goal:a. Objective:b. Objective:c. Objective:4. Goal:a. Objective:b. Objective:c. Objective: |
Signature:
Date:
Course/Section:
