Week 5: Shadow Health Assessment Assignment

Introduction and Pre-brief

Mrs. Esther Park is a 78-year-old woman who comes to the clinic complaining of abdominal pain. She reports that the pain isn’t severe, but that her daughter was concerned and brought her in. It is very important to determine whether or not the situation is an emergency and the underlying cause of Esther’s discomfort. Be sure to inquire about a variety of psychosocial factors related to the GI system, including her diet, toilet habits, immunizations, recent travel, etc. This case study will offer you the opportunity to take a complete surgical, reproductive, and current sexual history. During her physical examination, take particular note as to where Mrs. Park verbalizes pain during palpation so that you may synthesize verbal and non-verbal cues. Be sure to apply the supportive information learned in this week’s concept lab to your critical thinking process in this case study.

Tips and Tricks

Evaluation of the elderly patient with abdominal pain can be difficult, time-consuming, and fraught with potential missteps. Abdominal pain is the most common emergency department complaint and the fourth most common complaint among elderly patients. The physiologic, pharmacologic, and psychosocial aspects of elderly patients make an evaluation of their abdominal pain different than in the general population.

As a clinician, you must develop an index of suspicion which is defined as awareness and concern for potentially serious underlying and unseen injuries or illness. Having a well-developed index of suspicion for abnormality will help to differentiate diagnoses.

To optimize your assessment experience and sharpen your skills, be sure to explore the Abdominal Concept Lab prior to beginning the assignment.

 

Purposes

The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge.  

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

  1. Apply knowledge and understanding of advanced practice physical assessment skills and techniques (CO1)
  2. Perform focused and comprehensive histories and physical assessments for various patient populations (CO4 and CO5)
  3. Adapt skills and techniques to suit the individual needs of the patient (CO4)
  4. Differentiate normal from abnormal physical examination findings (CO2)
  5. Summarize, organize, and document findings using correct professional terminology (CO3)

Due Date

Sunday 11:59 PM MT at the end of each respective week.

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment.

In the event of an emergency that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.

Total Points Possible: 75 Points

Assignment

Step One: Complete the designated Shadow Health (SH) Assignment on the SH platform.

Step Two: Document your findings on the Fillable Soap Note Template or the Printable Soap Note

Step Three:  Upload the Lab Pass and completed SOAP Note as separate documents to the same assignment tab in the gradebook. 

Requirements

NOTE: Before initiating any activity in Shadow Health, complete the required course weekly readings and lessons as well as review the introduction and pre-brief.

  1. Complete the Shadow Health Concept Lab (Weeks 2, 4, and 5) prior to beginning the graded assignment. 
  2. Gather subjective and objective data by completing a focused, detailed health history and physical examination for each physical assessment assignment.
  3. Critically appraise the findings as normal or abnormal.  
  4. Complete the post activity assessment questions for each assignment .
  5. Complete all reflection questions following each physical assessment assignment.
  6. Digital Clinical Experience (DCE) scores do not round up. For example, a DCE score of 92.99 is a 92, not a 93.
  7. You have a maximum of two (2) attempts per Shadow Health assignment to improve your performance. However, you may elect not to repeat any assignment. NOTE: If you repeat an attempt, ONLY the second attempt will be graded, regardless of the DCE score. Please refer to the grading rubric categories for details. 
  8. Download the Lab Pass for the final attempt on the assignment.

On the Canvas Platform:

  1. Summarize, organize, and appropriately document findings using correct professional terminology on the SOAP Note Template.
  2. Identify three (3) differential diagnoses and provide ICD-10 codes and pertinent positive and negative findings for each diagnosis.
  3. Create a comprehensive treatment plan for each assignment. Must address the following components: Diagnostics, Medication, Education, Referral/Consultation, and Follow-up planning. If no interventions for one or more component, document “none at this time” but do not skip over the component.
  4. Provide rationales and citations for diagnoses and interventions.
  5. Include at least one scholarly source to support diagnoses and treatment interventions with rationales and references on the SOAP note. Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are NOT considered to be outside scholarly sources. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These websites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.  For example, the American Heart Association is a .com site with scholarship and quality. Each student is responsible for determining the scholarship and quality of any .com site.  Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.  Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.
  6. Upload the Lab Pass to the appropriate assignment area in Canvas Grades

 

Shadow Health Grading Rubric

Portions of the rubric are designated with a ***. The following explains those portions of the rubric:

Digital Clinical Experience (DCE) Score is automatically translated by Shadow Health based on individual student performance and reflects how student work compares to their peer learners across the country for a particular assignment. The DCE Score is a fair assessment of effort, and therefore is appropriate for use when grading assignments.

**Scholarly Sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are NOT considered to be outside scholarly sources. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These websites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.  For example, the American Heart Association is a .com site with scholarship and quality. Each student is responsible for determining the scholarship and quality of any .com site.  Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.  Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.

***Components of a treatment plan include diagnosticsmedicationeducationconsultation/referral, and follow-up planning

****Insight refers to the capacity to gain an accurate and deep intuitive understanding of a concept or thing. For example, one might demonstrate insight by relating a concept to a personal or meaningful experience.

ASSIGNMENT CONTENT

Category

Points

%

Description

Health History Communication, Education, Empathy, and Summary

(DCE Scoreor transcript)

 

15

20%

The Digital Clinical Experience (DCE)Score is automatically translates by Shadow Health based on individual student performance and reflects how student work with data collection, health history communication, education, empathy, and summarization compares to peer learners across the country for a particular assignment. The DCE Score is a fair assessment of effort, and therefore is appropriate for use when grading assignments.Occasionally, performance transcripts may be reviewed for secondary support.

Assessment, Documentation, Treatment Plan, and Scholarly Sources

35

47%

This category is evaluated on the quality of student’s ability to: Identify pertinent normal and abnormal findings for the assignment, utilize professional terminology, provide comprehensive and detailed subjective and objective findings, identify differential diagnoses, and create a comprehensive treatment plan. Includeat least one appropriate EBP scholarly sourceand use the SOAP Note format template to document all findings. 

 

Self-Reflection

15

20%

Self-reflection posts must demonstrate the student’s own perspective. The quality of this criterion is based upon responding to all the reflection questions; providing responses that are substantive (add importance, meaningfulness, and relevance to the post); demonstrate analysis of own performance; and demonstrate insight. Insight refers to the capacity to gain an accurate and deep intuitive understanding of a concept or thing. For example, one might demonstrate insight by relating a concept to a personal or meaningful experience.Reflection post responses should vary from SH assignment to assignment.

 

 

65

87%

Total CONTENT Points= 65

ASSIGNMENT FORMAT

Category

Points

%

Description

Grammar, Spelling, Syntax, Mechanics and APA Format

10

13%

Reflection post has minimal grammar, spelling, syntax, punctuation and APA* errors. Direct quotes (if used) is limited to 1 short statement** which adds substantively to the post.

* APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.

**Direct quote should not to exceed 15 words & must add substantively to the assignment

 

10

100%

Total FORMAT Points= 10

 

 

 

ASSIGNMENT TOTAL=75 points

Rubric

NR509 Weeks 2-6 Shadow Health Assignment_Sept19 (4)

NR509 Weeks 2-6 Shadow Health Assignment_Sept19 (4)

CriteriaRatingsPts

This criterion is linked to a Learning OutcomeAssignment Content Possible Points = 65 Points

Criterion 1Health History Communication, Education, Empathy, and Summary(DCE Score or Transcript)

15.0 pts

Excellent

DCE Score > 93

14.0 pts

V. Good

DCE Score 86-92

12.0 pts

Satisfactory

DCE Score 80-85

8.0 pts

Needs Improvement

DCE Score < 79

0.0 pts

Unsatisfactory

No Assignment

15.0 pts

This criterion is linked to a Learning OutcomeCriterion 2 Assessment, Documentation, Treatment Plan, and Scholarly Sources

Must demonstrate the following elements:Identified all pertinent normal and abnormal findings;Used professional terminology;Subjective and objective documentation was detailed and comprehensive;Used the SOAP Note Format template for documentation;Identified three (3) differential diagnoses with ICD-10 codes and pertinent positive/negative findings;Addressed each of the following on the treatment plan: Diagnostics, Medication, Education, Referral/Consultation, and Follow-up Planning;Interventions are detailed and appropriate for the focused assignment;Provided at least one appropriate EBP scholar source(8 Required Elements)

35.0 pts

Excellent

Demonstrated all elements for this Criterion

32.0 pts

V. Good

Missing 1 element for this Criterion

29.0 pts

Satisfactory

Missing 2 or 3 elements for this Criterion

18.0 pts

Needs Improvement

Missing 4 or 5 elements on for this Criterion

0.0 pts

Unsatisfactory

Missing 6 or more elements for the criterion Or No Assignment

35.0 pts

This criterion is linked to a Learning OutcomeCriterion 3 Self-Reflection

Must demonstrate the following elements:Written from the student’s own perspective;Responded to all the reflection questions;Responses were each substantive (added importance, meaningfulness, and relevance to the post);Offer self-analysis of performance and insight;Reflection post responses should vary from SH assignment to assignment.(5 Required Elements)

15.0 pts

Excellent

Demonstrated all elements for this Criterion

14.0 pts

V. Good

Missing 1 element for this Criterion

12.0 pts

Satisfactory

Missing 2 elements for this Criterion

8.0 pts

Needs Improvement

Missing 3 elements for this Criterion

0.0 pts

Unsatisfactory

Missing 4 or more elements for the criterion Or No Assignment

15.0 pts

This criterion is linked to a Learning OutcomeAssignment Format Possible Points = 10 Points

Format Criterion 1Grammar, Spelling, Syntax, Mechanics and APA Format

10.0 pts

Excellent

0-1 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format

9.0 pts

V. Good

2-3 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format

8.0 pts

Satisfactory

4-5 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format

5.0 pts

Needs Improvement

6-7 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format

0.0 pts

Unsatisfactory

8 or more errors in grammar, syntax, spelling, punctuation, mechanics, or APA format Or No assignment

10.0 pts

This criterion is linked to a Learning OutcomeLate Penalty Deductions

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.

0.0 pts

Minus Points

0.0 pts

Minus Points

0.0 pts

Total Points: 75.0

 

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