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NURS 5102/6102/7102 Syllabus

Course Syllabus

NURS 5102/6102/7102 - Advanced Health Assessment - Clinical

1 Credit Hours

Course Information

Course Description:

This clinical lab course emphasizes the application of advanced assessment techniques to perform focused and comprehensive health assessments of clients across the lifespan. Clinical analysis and synthesis of physical assessment data and diagnostic reasoning skills are developed.

Course Outcomes:

Upon successful completion of this course, students will:

  • obtain a pertinent, relevant, and problem-specific health history utilizing interviewing skills that are appropriate to the developmental, educational, and cultural characteristics of the client.
  • conduct a focused and comprehensive physical examination for the purpose of health promotion, physical diagnosis, and treatment utilizing advanced health assessment techniques.
  • analyze the findings from the health history, physical examination, and diagnostic procedures to differentiate normal from abnormal findings.
  • synthesize the findings from the health history, physical examination, diagnostic procedures, and differential diagnoses to formulate a problem list.
  • present the findings of the history and physical examination in a clear, concise, and organized manner using the problem oriented (SOAP) recording method.
Prerequisites & Co-requisites:

 Admission to the TN eCampus MSN program.  Corequisite:  NURS 5102

Course Topics:
  • Interviewing and the Health History: Developmental and Cultural Considerations
  • Recording Problem-Focused Assessments
  • Conducting Advanced Assessments of Children and Adults with Problems Related to the:
  • Skin, Hair, and Nails
  • Head, Eyes, Ears, Nose, Mouth and Neck
  • Thorax and Lungs
  • Cardiovascular System
  • Abdomen
  • Musculoskeletal System
  • Neurological System
  • Male Genitalia
  • Female Genitalia
Specific Course Requirements:

None.

Textbooks, Supplementary Materials, Hardware and Software Requirements

Required Textbooks:

Please visit the Virtual Bookstore to obtain textbook information for this course. Move your cursor over the "Books" link in the navigation bar and select "Textbooks & Course Materials." Select your Program, Term, Department, and Course; then select "Submit."

Supplementary Materials:

American Nurses Association. (2015).  Essentials of nursing practice package . Atlanta, GA: Author. PUB# FNDN2015. This package contains the three documents listed below at a discounted rate. 

American Nurses Association (2015). Guide to Nursing’s social policy statement: Understanding the profession from social contract to social covenant .Silver Springs, MD: Author. ISBN 9781558102705

American Nurses Association (2015). Code of ethics for nurses with interpretative statements. Silver Springs, MD: Author. ISBN 978-1-55810-599-7

American Nurses Association (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Springs, MD: Author. ISBN 978-1-55810-619-2

 

It is strongly recommended that nurse practitioner students purchase or secure a high quality stethoscope with a diaphragm and bell (adult and pediatric), ophthalmoscope, and otoscope.

Hardware and Software Requirements:

Minimum hardware requirements can be found here.

Minimum software requirements can be found here.

Common applications you might need:

Web Resources:

Purdue OWL Online Writing Lab (for APA, MLA, or Chicago style)

The Writing Center Online Writer's Handbook

Student Resources:
  • Technical support information can be found on the TN eCampus Help Desk page.
  • Smarthinking virtual tutoring is available FREE of charge. to access Smarthinking, visit the course homepage and select Smarthinking under Course Resources. You also view sample sessions to see what Smarthinking offers and how it works.
  • Information on other student issues or concerns can be located on the TN eCampus Student Resources page.

Instructor Information

Please see "Instructor Information" in the Getting Started Module for instructor contact information, virtual office hours, and other communication information. You can expect to receive a response from the instructor within 24-48 hours unless notified of extenuating circumstances.

Participation, Assessments, & Grading

Testing Procedures:

All course requirements are submitted online.

Grading Procedures:

If a D or F is made in EITHER NURS 5101 or NURS 5102, both courses must be retaken together and passed to progress in the program. 

6 Focused problem SOAP notes (equally weighted)

40%

1 Focused video (#1) physical examinations 

20%

1 Final comprehensive video (#2) physical examination 

25%

3 Quizzes (equally weighted)

15%

Please note that the focused videotaped physical examinations are not connected to the 6 focused problem write ups.

If a D or F is made in EITHER NURS 5101 or NURS 5102, both courses must be retaken together and passed to progress in the program. 

If barriers or challenges to progress in this course are encountered, the student must discuss those issues with the course faculty prior to the achievement of a final grade in this course.

The TNeCampus MSN Curriculum Committee strongly recommends, and the Executive Committee has approved, that the course faculty assign a grade of ‘F’ for the course when a student submits another person’s work as their own, or re-submits their own work from a previous course.

Grading Scale:

%  Range

Assigned Grade

93 - 100

A

85 - 92

B

77 - 84

C

70 - 76

D

under 70

F

Assignments and Projects:

1. Focused Problem Write-Ups (8)

Six SOAP notes of focused physical examinations related to selected problems of the systems covered in class will follow the problem oriented (SOAP) format. The following lab modules require a SOAP write-up: 

  1. Interview and the Health History 
  2. Neuro and HEENT Systems
  3. Musculoskeletal System
  4. Abdomen and Female Genitalia Systems
  5. Male Genitalia
  6. Lungs and Cardiovascular Systems

The grading criteria below will be applied to each focused SOAP write-up. Criteria used for evaluation will be accuracy, organization, logical flow, appropriate use of abbreviations, succinctness, and inclusion of appropriate advanced assessment tests and procedures. Refer to the text,  for format guidelines and a sample SOAP write-up.

If a failing grade (< 70) is made on the initial SOAP write-up, one re-write will be allowed and graded. The re-write must be submitted within a week of notice of the failing grade in order to be regraded by your instructor. The final grade for the assignment will be based on an average of the two grades. Each write-up is to be submitted to the assignment drop box in Desire2Learn (D2L) by the due date noted on the course calendar. Late assignments will receive a 10 point reduction for every day or portion of a day that the assignment is late.

Grading Rubric For Write-Ups (SOAP notes) 

Note: When the faculty member grades the SOAP note, the highlighted number in each cell is the grade for that section of the rubric.

 

Subjective (50 points) 

Data not present 

5=

Unacceptable 

7= Poor 

8= Acceptable 

9= Very Good 

10= Exceptional

CC and HPI are targeted toward the reason for presentation without the inclusion of extraneous information

 

0

 

5

 

7

 

8

 

9

 

10

HPI is fully developed and includes location, duration, timing, character, severity provocative/palliative factors, pertinent positives and pertinent negatives

 

0

 

5

 

7

 

8

 

9

 

10

Elements of the PMH that expand on the CC and HPI are included, yet irrelevant information is excluded

 

0

 

5

 

7

 

8

 

9

 

10

Elements of the FH and SH that expand on the CC and HPI are included, yet irrelevant information is excluded

 

0

 

5

 

7

 

8

 

9

 

10

Elements of the ROS that expand on the CC and HPI are included, yet irrelevant information is excluded

 

0

 

5

 

7

 

8

 

9

 

10

Objective (40 points) 

 

 

 

 

 

 

General survey includes vital signs, height and weight, BMI, and other relevant data related to CC.

 

0

 

5

 

7

 

8

 

9

 

10

All systems assessed focus on the CC

 

0

 

5

 

7

 

8

 

9

 

10

Appropriate descriptors are used to articulate the physical findings

 

0

 

5

 

7

 

8

 

9

 

10

Pertinent lab and diagnostic findings are included

 

0

 

5

 

7

 

8

 

9

 

10

Organization and Grammar (10 points)

 

 

 

 

 

 

 

Documentation is clear and well organized without spelling errors. Correct medical terminology is used. Redundant words, phrases, and other distracting information are omitted. Record has a logical flow.

 

0

 

5

 

7

 

8

 

9

 

10

Total Score     _________/100

Comments:

2. Focused Physical Examinations (Video Recording) (2)

Two focused physical exams will be conducted throughout the semester, each one being focused on one or two health problems, symptoms, or complaints provided in a content module. Another student in the course, partner, or friend will be selected to be interviewed and examined. Each examination will be recorded (audio and video) and should not exceed 20 minutes. If possible, a client with the actual symptom should be selected. If this is not possible, the student must develop a script with responses related to the symptom for the client to use during the staged examination. The student may choose one problem for the comprehensive recording. The video recording must be downloaded to a DVD or USB Flash Drive, mailed to your faculty, and postmarked by 12 midnight of the day that the assignment is due.  To ensure academic integrity, the USB drives will not be returned to the student during the semester or up to one year after the last grades earned in the MSN program have been recorded. At the end of one year, if the student wishes to have the USB drive returned, a self-addressed, stamped envelope must be included with the request. The video recording must NOT be uploaded to an internet site. Late assignments will receive a 10 point reduction for every day or portion of a day that the assignment is late.

The following examinations must be demonstrated and video recorded:

  1. The first video should include the critical elements in the client’s health history, client’s general appearance, eyes, ears, nose, mouth, pharynx systems.
  2. The comprehensive video should include the critical elements in the client’s health history, client’s general appearance, eyes, ears, nose, mouth, pharynx, thorax and lungs, cardiovascular, abdomen, musculoskeletal, and neurological systems. 

Video Recording Grading Guidelines and Rubric  

The video demonstration will be reviewed and critiqued by the clinical lab instructor using the grading criteria listed below. If a failing grade (< 70) is made on the initial video, one re-do will be allowed and graded. The video re-do must be submitted within a week of notice of the failing grade in order to be regraded by your instructor. The final grade for the assignment will be based on an average of the two grades.

Students may not use notes or the criteria sheet while performing and videotaping either the focused or comprehensive examination assignments. If notes are evident, the student will receive a 0 on the assignment. Partners or clients are not permitted to assist or cue the student examiner. If this occurs, the student will receive a 0 on the video assignment.

Criteria used for evaluation will be accuracy, organization, logical flow, appropriate use of descriptors, succinctness, and performance of appropriate advanced assessment techniques and procedures.

Note: When the faculty member grade the video, the highlighted number in each cell is the grade for that section of the rubric.

Presentation/Communication (40 points)

 

5 =  Unacceptable

 

7 =   Poor 

 

8 =  Acceptable

 

9 =  Very good

 

10 =  Exceptional

 

Introduces himself/herself and elicits pertinent information in the focused interview (focused CC, HPI, PMH, FH, SH, ROS) Conducts self professionally.

 

5

 

7

 

8

 

9

 

10

Appropriate descriptors are verbalized to describe physical findings throughout the exam.

 

5

 

7

 

8

 

9

 

10

Verbally identifies and points out correct landmarks throughout the exam.

 

5

 

7

 

8

 

9

 

10

Verbalizes pertinent negative and positive findings throughout the exam. Findings are summarized at the end of the exam.

 

5

 

7

 

8

 

9

 

10

Organization and Inclusion of Critical Elements (50 points)

 

 

 

 

 

 

All examination equipment is utilized appropriately during the exam.

 

5

 

7

 

8

 

9

 

10

Assessment is organized and follows a logical sequence. 

 

5

 

7

 

8

 

9

 

10

Correct technique is demonstrated while performing procedures.

 

5

 

7

 

8

 

9

 

10

Exam includes all critical elements.

 

10

 

14

 

16

 

18

 

20

Technical (10 points)

 

 

 

 

  

Camera is focused on patient. Patient, student and exam equipment are in plain view without obstruction.  Sound is clear and volume is appropriate.

 

5

 

7

 

8

 

9

 

10

  Total Score     __________/100  

3.  Quizzes (3)

Three quizzes related to selected practices covered in class will be given to assess the knowledge of the skill or procedure presented in each module. The following practices will have quizzes:

  1. Suturing
  2. Radiology
  3. Microscopy

4. Comprehensive Physical Examination (Video Recording)

One comprehensive head-to-toe assessment (inclusive of all systems except the breast and the genitourinary system) applying basic and advanced assessment techniques will be performed on an adult client or adolescent over the age of 13 years old. If an adolescent is assessed, the permission from the parent must be obtained and submitted to your faculty prior to the exam. 

The demonstration must not exceed 30 continuous minutes. All critical elements must be audible and visible on the video. The student may not refer to notes during the examination. The examination must take place in an appropriate setting and the examiner must be in professional dress. The video recording must be downloaded to a DVD or USB Flash Drive, mailed to your faculty, and postmarked by 12 midnight of the day that the assignment is due. To ensure academic integrity, the USB drives will not be returned to the student during the semester or up to one year after the last grades earned in the MSN program have been recorded. At the end of one year, if the student wishes to have the USB drive returned, a self-addressed, stamped envelope must be included with the request.T The video recording must NOT be uploaded to an internet site. Late assignments will receive a 10 point reduction for every day or portion of a day that the assignment is late. 

The video demonstration will be reviewed and critiqued by the clinical lab instructor using the grading criteria for video recordings. No redo will be allowed on the final comprehensive examination video. Criteria used for evaluation will be accuracy, organization, logical flow, appropriate use of descriptors, succinctness, and performance of appropriate advanced assessment techniques and procedures. The final grade for the comprehensive examination is the average of the grades made on the write-up and the video demonstration.

Video Recording Guidelines

Students are required to supply all video recording equipment. Digitalized videos or DVDs are preferred for clarity. DVDs or USB Flash Drives will be returned to the student upon the request of the student only. 

  • A video talent release form must be signed by the client and student each time an examination is video recorded. A signed release form (located in course content section) should be turned in with each assignment. If the student fails to turn in a release form with the video, the faculty will not grade the assignment until the release form is submitted. The assignment will be considered late, and penalties for late assignments will be assigned.
  • When video recording, the camera must be focused on the examiner, patient, and the area being assessed. The faculty grading the assignment will need to verify technique, and if the video camera is too far away from the area being examined, the technique can not be verified and the student will have to repeat the videotape.
  • Any identifiers related to the client being examined must be removed prior to videotaping.
  • Time limits for each assignment will be strictly enforced. The student will not edit the video prior to submitting it to the faculty.
  • Search Answers/Ask a Question (requires login) 
  • Observe course nettiquette at all times
Class Participation:
Late Policy:

Students are expected to:

  • Check the course calendar for the due dates of assignments.
  • Check the course home page frequently for announcements.

Course Ground Rules

The following two statements (1., 2.) were derived from the TBR System-wide Student Rules document, released January 2012:

RULES OF THE TENNESSEE BOARD OF REGENTS STATE UNIVERSITY AND COMMUNITY COLLEGE SYSTEM OF TENNESSEE SYSTEMWIDE STUDENT RULES CHAPTER 0240-02-03 STUDENT CONDUCT AND DISCIPLINARY SANCTIONS

Read the document in its entirety here.

1. Standards of Conduct:

  • Students are required to adhere to the same professional, legal and ethical standards of conduct online as on campus. In addition, students should conform to generally accepted standards of "netiquette" while sending e-mail, posting comments to the discussion board, and while participating in other means of communicating online. Specifically, students should refrain from inappropriate and/or offensive language, comments and actions.

2. Review the TN eCampus Academic Integrity/Academic Honesty Policy:

  • In their academic activities, students are expected to maintain high standards of honesty and integrity. Academic dishonesty is prohibited.

Such conduct includes, but is not limited to:

  • an attempt by one or more students to use unauthorized information in the taking of an exam
  • to submit as one's own work, themes, reports, drawings, laboratory notes, computer programs, or other products prepared by another person,
  • or to knowingly assist another student in obtaining or using unauthorized materials.

Plagiarism, cheating, and other forms of academic dishonesty are prohibited.

Students guilty of academic misconduct, either directly or indirectly through participation or assistance, are subject to disciplinary action through the regular procedures of the student’s home institution.  Refer to the student handbook provided by your home institution to review the student conduct policy.

In addition to other possible disciplinary sanctions that may be imposed, the instructor has the authority to assign an "F" or zero for an activity or to assign an "F" for the course.

Other Course Rules:

Students are expected to:

  • Participate in all aspects of the course
  • Communicate with other students
  • Learn how to navigate in Brightspace
  • Keep abreast of course announcements
  • Use the assigned course management (Brightspace) email address rather than a personal email address
  • Address technical problems immediately:
  • Observe course netiquette at all times.

Guidelines for Communications

Email:

  • Always include a subject line.
  • Remember without facial expressions some comments may be taken the wrong way. Be careful in wording your emails. Use of emoticons might be helpful in some cases.
  • Use standard fonts.
  • Do not send large attachments without permission.
  • Special formatting such as centering, audio messages, tables, html, etc. should be avoided unless necessary to complete an assignment or other communication.
  • Respect the privacy of other class members

Discussions:

  • Review the discussion threads thoroughly before entering the discussion. Be a lurker then a discussant.
  • Try to maintain threads by using the "Reply" button rather starting a new topic.
  • Do not make insulting or inflammatory statements to other members of the discussion group. Be respectful of other’s ideas.
  • Be patient and read the comments of other group members thoroughly before entering your remarks.
  • Be cooperative with group leaders in completing assigned tasks.
  • Be positive and constructive in group discussions.
  • Respond in a thoughtful and timely manner.

Library

The Tennessee Virtual Library is available to all students enrolled in TN eCampus programs and courses. Links to library materials (such as electronic journals, databases, interlibrary loans, digital reserves, dictionaries, encyclopedias, maps, and librarian support) and Internet resources needed by learners to complete online assignments and as background reading will be included within the course modules. To access the Virtual Library, go to the course homepage and select the Virtual Library link under Course Resources.

Students with Disabilities

Qualified students with disabilities will be provided reasonable and necessary academic accommodations if determined eligible by the appropriate disability services staff at their home institution. Prior to granting disability accommodations in this course, the instructor must receive written verification of a student's eligibility for specific accommodations from the disability services staff at the home institution. It is the student's responsibility to initiate contact with their home institution's disability services staff and to follow the established procedures for having the accommodation notice sent to the instructor.

Syllabus Changes

The instructor reserves the right to make changes as necessary to this syllabus. If changes are necessitated during the term of the course, the instructor will immediately notify students of such changes both by individual email communication and posting both notification and nature of change(s) on the course bulletin board.

Disclaimer

The information contained in this syllabus is for general information purposes only. While we endeavor to keep this information up-to-date and accurate, there may be some discrepancies between this syllabus and the one found in your online course. The syllabus of record is the one found in your online course. Please make sure you read the syllabus in your course at the beginning of the semester. Questions regarding course content should be directed to your instructor.


Last Revised on May 14, 2018