Week 11

1. Please review the complete instructions and the rubric details
2. APA 7
3. At least 3 references
Journal
ATTACHED FILE(S)
Assignment 11: 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 your “Clinical Skills Self-Assessment Form” you submitted in Week 1, (see attached document) 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.
INSTRUCTIONS
1. In 450–500 words, address the following:
· 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?
2. 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.
10
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 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

Confident

Differentiating between
pathophysiological and
psychopathological
conditions

Mostly confident

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

Mostly confident

Performing and interpreting a
mental status examination

Beginning

Performing and interpreting a
psychosocial assessment and
family psychiatric history

Mostly confident

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

Mostly confident

Diagnostic reasoning skill in:

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

Beginning

Developing and prioritizing a
differential diagnoses list

Beginning

Formulating diagnoses
according to DSM 5 based on
assessment data

Beginning

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

Beginning

Psychotherapeutic
Treatment Planning

Provide psychoeducation to
individuals and/or any
caregivers

Beginning

Promote health and disease
prevention techniques

Mostly confident

Self-Assessment skill:

Develop SMART goals for
practicum experiences

Mostly confident

Evaluating outcomes of
practicum goals and modify
plan as necessary

Mostly confident

Documenting and reflecting
on learning experiences

Mostly confident

Professional skills:

Maintains professional
boundaries and therapeutic
relationship with clients and
staff

Confident

Collaborate with multidisciplinary teams to improve
clinical practice in mental health settings

Confident

Identifies ethical and legal
dilemmas with possible
resolutions

Confident

Demonstrates nonjudgmental practice
approach and empathy

Confident

Practices within scope of
practice

Confident

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

Demonstrates selecting the
correct screening instrument
appropriate for the clinical
situation

Beginning

Implements the screening
instrument efficiently and
effectively with the clients

Beginning

Interprets results for
screening instruments
accurately

Beginning

Identifies the need to refer to
another specialty provider
when applicable

Beginning

Accurately documents
recommendations for
psychiatric consultations
when 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.

5/13/22, 2:15 AM Rubric Detail – Blackboard Learn
https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16940198_1&rubric_id=_2965172_1 1/3
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Excellent Good Fair Poor
Assimilation
and
Synthesis:
Content
Re�ection
50 (50%) – 50
(50%)
Re�ection
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.
40 (40%) – 49
(49%)
Re�ection
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.
31 (31%) – 39
(39%)
Re�ection
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.
0 (0%) – 30
(30%)
Re�ection
lacks critical
thinking.
Super�cial
connections
are made with
key course
concepts and
resources,
and/or
assignments
Name:PRAC_6635_Week11_Assignment_Rubric EXIT
Grid View List View
5/13/22, 2:15 AM Rubric Detail – Blackboard Learn
https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16940198_1&rubric_id=_2965172_1 2/3
Excellent Good Fair Poor
Assimilation
and
Synthesis:
Personal
Growth
30 (30%) – 30
(30%)
Expresses
solid evidence
of re�ection
on own work.
Demonstrates
substantial
personal
growth and
awareness of
deeper
meaning
through
inferences,
well
developed
insights, and
signi�cant
depth in
awareness
and
challenges.
Synthesizes
current
experience
into future
implications.
20 (20%) – 29
(29%)
Expresses
moderate
evidence of
re�ection 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.
10 (10%) – 19
(19%)
Expresses
minimal
evidence of
re�ection 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%) – 9 (9%)
Expresses
inadequate
evidence of
re�ection 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.
5/13/22, 2:15 AM Rubric Detail – Blackboard Learn
https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16940198_1&rubric_id=_2965172_1 3/3
Excellent Good Fair Poor
Written
Expression
and
Formatting
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.
11 (11%) – 14
(14%)
Above
average
writing style
and logically
organized
using
standard
English with
minor errors
in grammar,
punctuation,
usage, and
spelling.
6 (6%) – 10
(10%)
Average
writing style
that is
sometimes
unclear
and/or with
some errors
in grammar,
punctuation,
usage, and
spelling.
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 5 (5%) – 5 (5%)
No APA errors
4 (4%) – 4 (4%)
Contains one
to two (1–2)
APA errors
2 (2%) – 3 (3%)
Contains
three to �ve
(3–5) APA
errors
0 (0%) – 1 (1%)
Contains
more than
�ve (> 5) APA
errors
Total Points: 100
Name:PRAC_6635_Week11_Assignment_Rubric
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