Spring 2021

NURS 6210-001 Advanced Health Assessment and Clinical Reasoning

All students are responsible for checking their UTHSCSA Livemail account regularly (i.e., daily or several times every week) to obtain Official University Communication regarding their courses, program and student status.

COVID-19
Students are expected to follow all policies related to COVID-19 found on the university webpage: https://wp.uthscsa.edu/coronavirus/.

NOTE: Our campus has enabled the CANVAS MOBILE LEARN application. CANVAS tools such as discussions, quizzes or videos May or May NOT function on all mobile devices. This is because mobile devices are available with rapidly changing and different configurations. Hence, students must not depend on only a mobile device to access course materials. Students must have access to a laptop or desktop device to access course materials and complete assignments.

This course is Web Enhanced with 
Please be sure to check the Current Computer Requirements

Welcome to Advanced Health Assessment!

First Day of Class LOCATION---Virtual Synchronous Class on Canvas Microsoft Teams

Welcome to NURS 6210 Advanced Health Assessment! We look forward to working with you over the course of the semester as you improve and refine your health assessment skills.

Our first class session will be on January 12th, Tuesday, at 8 am.  We will have a synchronous class on MS Teams through Canvas.  This course is taken in conjunction with NURS 6110 clinical course.  Therefore, we will have the didactic portion of the courses delivered virtually.  The laboratory time will be on campus, but physical distancing and safety precautions implemented related to the pandemic.

Please review the Canvas course modules and calendar for the specific location of class each week.  Each week will be different, but we will expect your availability and attendance for all sessions, which will take place every Tuesday from 8 am until 12:50 pm.

This is a busy semester with lectures, labs, and sim center activities. This course explores the foundational health history and physical examination skills needed by all advanced practice nurses. This course requires many hours of time and effort but is very rewarding.  

FACULTY CONTACT INFORMATION

Heidi Worabo, DNP, APRN, FNP-BC, FAANP

Associate Professor / Clinical

Email: worabo@uthscsa.edu 

Office Phone:  210-567-5867

Office Room:  2.380

Office Hours:  Tuesdays 3-4 pm and by appointment

COURSE DESCRIPTION

This course will build upon health assessment skills developed in the professional nurse's basic educational program. The theoretical and clinical basis for health assessment by the advanced clinician will be developed. The process whereby the advanced clinician utilizes comprehensive hisotry, physical, psychosocial, and cultural assessment across the lifespan to gather specific data relevant to common health problems is demonstrated. Students will develop clinical reasoning skills to begin to formulate differential diagnoses.

CREDIT AND TIME ALLOCATION

Credit Hour Allocations: 2 semester credit hours
Clock Hour Allocation: 2 clock hours class (30 hours class)

PREREQUISITES

Prerequisite
NURS 6338 Advanced Pathophysiology

Corequisite
NURS 6110 Advanced Health Assessment and Clinical Reasoning: Clinical Application

PROGRAM OUTCOMES

Upon completion of the Master of Science in Nursing Program (MSN) students will:

1. Integrate scientific findings from nursing and related sciences, including genetics and genomics, into the delivery of advanced nursing care to populations in diverse settings.
2. Demonstrate organizational and systems leadership to assure ethical and critical decision-making at all systems’ levels for quality and patient safety.
3. Incorporate performance improvement strategies for quality, safety, and patient-centered care delivery.
4. Use improvement science to achieve optimal patient care and care environment outcomes.
5. Integrate meaningful and usable information systems and healthcare technologies to support safe, quality patient care and healthcare systems effectiveness.
6. Advocate for policy changes that influence healthcare at appropriate levels.
7. Lead interprofessional teams using collaborative strategies to effect quality patient care and population health outcomes.
8. Analyze and incorporate broad ecological and social health determinants to design and deliver evidence-based clinical prevention and population healthcare and services to individuals, families, and aggregates/identified populations.
9. Integrate the advanced competencies expected of a master’s prepared nurse to design, deliver, and evaluate outcomes of systems of care for individuals, families, and diverse populations.

COURSE OUTCOMES

1. Apply advanced knowledge of the problem-solving approach to the collection, synthesis, and communication of data gathered, both oral and written. (DNP Essential VIII; NONPF Competencies: Practice Inquiry 1,2; Ethics 2,3; Independent Practice 1, 2, 4)
2. Compile a comprehensive database, including age-appropriate history, physical examination, laboratory and diagnostic studies. (DNP Essential VIII; NONPF Competencies: Practice Inquiry 1,2; Ethics 2, 3; Independent Practice 1, 2, 3)
3. Adapt history and physical examination data, and screening according to age, developmental status, culture, language, and patient needs, preferences, and values.(DNP Essential VIII; NONPF Competencies: Practice Inquiry 3; Ethics 2, 3; Independent Practice 1, 2, 4, 8)
4. Compare critical reasoning approaches that guide patient-centered care. (DNP Essential VIII; NONPF Competency: Independent Practice 1, 2, 3, 8)
5. Present an organized and complete oral and written summary of the database and problem list. (DNP Essential VIII; NONPF Competency: Independent Practice 1, 2, 3, 8)
6. Select advanced assessment techniques specific to the various systems presented in this course. (DNP Essential VIII; NONPF Competencies: Practice Inquiry 1, 2; Ethics 2, 3; Independent Practice 1, 2, 4)
7. Formulate prioritized differential diagnoses and problem lists. (DNP Essential VIII; NONPF Competency: Independent Practice 1, 2, 3, 5, 8)
8. Develop motivational interviewing skills. (DNP Essential VIII; NONPF Competencies: Ethics 1, 2, 3; Independent Practice 1, 2, 4, 5)

CLINICAL OUTCOMES

N/A

GRADING SCALE FOR GRADUATE COURSES

A = 4 points (90-100)
B = 3 points (80-89)
C = 2 points (75-79)
D = 1 point (66-74)
F = 0 points (65 or below)

CRITERIA FOR EVALUATION / GRADES

Grade Percentages

30% Midterm

30% Final Exam

10% Special Population Presentations

30% Quizzes (4 quizzes)

 

100% – TOTAL

 

CLASSROOM ATTENDANCE

Attendance in class is an expectation of each student.

WRITTEN ASSIGNMENTS

1. If written assignments are made in a course they are required.
2. Students are expected to submit written work on the scheduled date and time.
3. The student must notify the course coordinator prior to the scheduled due date and time if they are unable to submit the written work as scheduled. Failure to make this notification in advance will result in a "zero" for that written work.
4. If the excuse is accepted as reasonable and necessary, arrangements will be made for an alternative due date and time.
5. Each student is responsible for making sure that he or she has completed the written work prior to submission.
6. Late work will be accepted with consequences as outlined per course syllabi.

APA GUIDELINES

The APA Publication Manual 7th edition is required for use in all nursing school programs. 

SCHOLASTIC DISHONESTY

Students are expected to be above reproach in all scholastic activities. Students who engage in scholastic dishonesty are subject to disciplinary penalties, including the possibility of failure in the course and dismissal from the university. "Scholastic dishonesty includes but is not limited to cheating, plagiarism, collusion, and submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, any act designed to give unfair advantage to a student or the attempt to commit such acts." Regents Rules and Regulations, Part One, Chapter VI, Section 3, Subsection 3.2, Subdivision 3.22.

PROFESSIONAL CODE OF CONDUCT

Students who are nurses or are preparing to enter the profession of nursing are expected to treat others with respect and compassion. “The principle of respect for persons extends to all individuals with whom the nurse interacts. The nurse maintains compassionate and caring relationships with colleagues and others with a commitment to the fair treatment of individuals, to integrity-preserving compromise and to resolving conflict. This standard of conduct precludes any and all prejudicial actions, any form of harassment or threatening behavior, or disregard for the effects of one’s actions on others” (American Nurses Association Code for Nurses, Interpretive Statement 1.5).

The students, faculty, Department Chairs, Associate Deans, and the Dean of the School of Nursing of the University Texas Health Science Center San Antonio subscribe to the highest standards of conduct. Our aim is professional behavior beyond reproach. Failure to abide by the signed code of professional conduct may lead to suspension and/or permanent dismissal from the UTHSCSA SON. In particular, we subscribe to the provisions of the Code of Ethics for Nurses (http://bit.ly/1mtD5p2) and the following points of conduct.

http://catalog.uthscsa.edu/schoolofnursing/policiesandprocedures/

School of Nursing Netiquette Guidelines for Online Interaction

Netiquette guidelines provide information for behaving properly online, when using email, tweets or texts so that you may successfully communicate your thoughts in a manner that is respectful and avoids misunderstandings with others.

• Be courteous about what you say to or about others in any electronic format. In electronic communication the golden rule is "Remember the Human." Remember there is a real person with real feelings on the receiving end of your email or post.
• Be respectful and open to opinions and ideas that differ from yours. The exchange of diverse thoughts, ideas and opinions are an important part of the scholarly environment. Keep in mind that the people in your classes may come from different backgrounds and have views that may vary significantly from your own.
• Flaming (defined as posting of messages that are deliberately hostile and insulting in an online social context) is never appropriate. While everyone (learners and instructors alike) is encouraged to share ideas and opinions openly, you should never use insults or resort to name-calling even if you disagree strongly with what someone else has written.
• When responding to messages or posts made by others, address the ideas, not the person.
• It’s often best to avoid using sarcasm and humor online. Without social cues, such as facial expressions and body language, a remark meant as humorous could come across hurtful or offensive. Keep in mind that ‘emoticons’ (such as J) may not convey your tone or intent.
• Capitalizing whole words is generally seen as SHOUTING and is difficult for most people to read. Use all capital letters sparingly, such as to highlight an important word or point.
• Think and reread what you’ve written before you post! Make sure that what you’ve written makes sense (is clear and to the point).
• Remember you are responsible for the content you communicate on CANVAS. What you write represents you, so use appropriate language. Remember that all writing should be professional, consisting of complete sentences, and free of grammatical and spelling errors.
• Be aware that distributing copyrighted materials, such as articles and images, is illegal. Most of the materials on the Internet are copyrighted. The only time it’s ok to distribute materials from the Internet is when you are sure those materials are "fair use." To be safe, if you want to share materials with classmates and/or your instructor, share the web link or URL only.
• To avoid plagiarism, make sure you properly cite all source materials. All materials should be cited unless you are the author of the content.
• Protect your privileges in online communication (avoid posting spam or emailing chain letters).

ADA ACCOMMODATIONS

Any student seeking reasonable accommodations through the Americans with Disabilities Act (ADA) should contact either the Associate Dean for Admissions and Student Services within the first week of the semester or schedule a meeting with the UTHSCSA ADA Compliance Office so that appropriate accommodations may be arranged. A request for accommodations (Form ADA-100: http://uthscsa.edu/eeo/form100-Faculty-student-resident.pdf) must be completed and submitted to the Executive Director of the ADA Compliance Office before accommodations can be provided. Additional information can be provided in the Student Success Center, Room 1.118 or through the ADA Compliance Office website: http://uthscsa.edu/eeo/request.asp.

REQUIRED TEXT / REFERENCE

Laptop for in class quizzes with ExamSoft and Examplifyloaded

 

Bickley, L. (2020). Bates' Guide toPhysical Examination and History Taking. 13^th Edition. Philadelphia,PA: Wolters Kluwer. ISBN-13: 9781496398178

 

Gawande, A. (2014). BeingMortal. New York: Metropolitan Books. ISBN: 978-0-8050-9515-9

 

Seller, R.H. & Symons, A.B. (2018). Differential diagnosis of common complaints (7thed.). St. Louis, MO: Elsevier.  ISBN: 9780323512329

RECOMMENDED (OPTIONAL) TEXT / REFERENCE

Hagan, J.H., Shaw, J.S., & Duncan, P.M. (Eds.). Bright Futures: Guideline Pocket Guide.4th ed. American Academy of Pediatrics. ISBN-13:  978-1610020824. Can also be viewed as an E-book.

 

CONTENT OUTLINE

CONTENT OUTLINE

1. Foundations of Clinical Proficiency, Clinical Reasoning and Recording Findings
2. Evaluating Clinical Evidence and Differential Diagnoses
3. Health History and Motivational Interviewing
4. General Survey
5. HEENT
6. Dermatology and Lymphatics
7. Abdominal and Renal
8. Cardiovascular
9. Pulmonary
10. Musculoskeletal
11. Neurology and Mental Health
12. Male and Female Genitourinary, Breasts, Rectal
13. Special Populations: Pregnancy, Newborn, Pediatrics, Geriatrics

CALENDAR - 1st Day Only

Please check the schedule for recent updates on Class Dates & Room.

Topics we will cover on January 12^th from 8 am until 12:50 pm:

*Clinical Proficiency, Clinical Reasoning, Documenting, Differential Diagnoses

*Health history, Motivational Interviewing

*The General Survey, Vitals, Pain

*Virtual Orientation to the Center for Simulation & Innovation (CSI) and HEB Clinical Skills Lab and course schedule and policies.

*Orientation to DxR Clinician

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