Transcript Comprehensive Exam Orientation
Comprehensive Exam Orientation
Department of Physiological Nursing UCSF School of Nursing Fall 2012 Theresa Koetters, RN, MS, CNS Roxanne Garbez, RN, PhD, ACNP
Outline of Comp Process
Description of the project The Comprehensive Exam Handbook Qualifying for the examination Important dates Technical requirements Resources
The Assignment
The purpose of this paper is to evaluate your ability to:
– Critique research as it applies to your area of specialization.
– Apply advanced knowledge to clinical practice.
– Apply writing skills to the dissemination of nursing information; scholarly paper – Consumer of research
Critical Points
Thirty (30) page paper (maximum) Three exam options – Critical Literature Review (CLR) – Problem-solving (PS) – Research proposal
The Handbook
You can download a copy of the Comprehensive Examination Handbook from the UCSF School of Nursing website http://nursing.ucsf.edu/student-resources
How to Qualify for the Examination
You are eligible in the last quarter you are enrolled in course and clinical work.
If you have completed ALL course work with the exception of the comp exam you may submit the exam while on filing fee status for a reduced fee.
Filing Fee Status
Talk with your advisor.
You qualify if you have completed ALL course and clinical work. You may not take courses of any type if you are on Filing Fee status. Apply and pay filing fee to OAR Can be used for second attempt Filing fee status can be used only once. If you pay filing fee then do not submit your comp you must pay full tuition for a subsequent quarter.
Advance to Candidacy
Before you can be issued your individualized Comp Number, YOU MUST ADVANCE TO CANDIDACY.
Advance to Candidacy forms are available from the Office of Admissions and Registrar. Forms can also be downloaded online.
After you submit your form Graduate Division notifies Office of Student Affairs. OSA will then generate your Comp Number.
The Last Quarter of Course and Clinical Work
Advance to Candidacy any time before the first week of the quarter in which you plan to turn in the comp.
No incompletes on record.
Current in payment of fees.
Know the Important Dates- Spring 2013
Number pick up date: – Between April 9 and April 22 Submit comp by Noon – April 23 Notification of results – May 23
Technical and Procedural Points
Format Submission Scoring
Formatting Expectations
APA 6th Edition format Margins 1 inch on all 4 sides of page Can separate syllables at the end of a line 30 pages of text, not counting title page, reference list and appendices Title should reflect content No abstract Double-spaced, 12 point uncompressed font (Acceptable font examples: Times New Roman, Arial)
Submission Requirements
One single-sided original of the comprehensive examination Three double sided copies Completed face sheet attached to each copy of the exam Separate paper with student’s name, address, home and work number, and other pertinent information that facilitates the student being contacted if necessary It is the student’s responsibility to ensure that the comprehensive exam is submitted by 12 noon on the due date
Face Sheet
In order to pick up your number you must complete the face sheet and return it – List your specialty – Topic – Suggested readers ID number is given to you to be placed on your comp 14
Reading and Scoring
Student may select up to five preferred readers (not required) Student is not guaranteed a preferred reader Readers use a standard scoring system Student will be given the faculty comment sheets at the end but not the scoring sheets
Plagiarism
Evidence of plagiarism results in a failure of the comprehensive exam.
Plagiarism can become grounds for dismissal from the School of Nursing.
In Case of Failure
Pass/fail discrepancy goes to a third reader.
Exam fails if two readers fail it.
May retake exam only once.
Must submit second exam within 5 quarters.
Vital Resources
Vital resource—Department Administrative Assistants – CHS Kathryn Young – PN James Negri – FHCN Maria-Elena Sotelo – SBS Brandee Woleslagle Comprehensive Exam Coordinators – CHS Beth Phoenix & Dana Drew-Nord – PN Theresa Koetters & Roxanne Garbez – FHCN Karen Duderstadt & Barbara Hollinger – SBS Susan Chapman
Additional Resources
Advisors- topic and format Specialty faculty Sample comps on reserve Office of Student Affairs for tutors and editors, contact Judy Martin-Holland Consider other arrangements – Typist – Paid tutors and editors – Peers as editors and proofreaders Create a timeline – See sample provided
Comprehensive Exam 2012-2013 SEP OCT NOV Identifying the phenomenon of interest Topic generation DEC Faculty input re: topic Literature review JAN FEB MAR APR MAY JUN JUL AUG
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Advance to Candidacy: Before end of Winter Quarter
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Pick up Comp # from Departments: From 4/09/13 to 4/22/13
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Submit Comp to Departments: 4/23/13 Refine topic outline Faculty input re: topic outline Draft #1 Advance to Candidacy Pick up Comp # Colleagues read paper for clarity and organization Draft #2 Submit Comp Edit
WORK HARD, DO WELL!
Extensions, examination by mail, summer comps, oral exam are available only by special arrangement. Read the corresponding section of the comp handbook.
Part 2
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Sample Examinations
On reserve in each of the departments Ask your advisor and/or your department's comprehensive examination coordinator 23
Other Resources
UCSF SON website 24
Choosing a Theory
A theory should further clarify or explain your topic Nursing theory not required Explain your theory in the text—don’t depend on diagrams in the appendix 25
Theory or Conceptual Framework
A theory is a structure that enables you to explain a phenomenon. There is no right or wrong theory--it is all in how you want the argument you want to make. 26
Possible Mechanisms Underlying the Increased Risk of Type 2 Diabetes in People on Atypical Psychotrophics
Physiological HPA axis and sympathetic nervous system hyperactivity resulting in overproduction of cortisol.
Genetics Co-moridity Socio cultural Diabetes only occurs in those with a genetic predisposition.
The diabetes is really due to alcoholism or binge eating.
Due to socioeconomic, disability, marital status, access to health care Health care Behavioral Medication Providers fail to adequately monitor overall health.
Inactivity, diet, smoking due to the psychiatric illness side effects, appetite stimulation and subsequent weight gain 27
Possible Titles
The Relationship Between Atypical Psychotropic Use and Diabetes Mellitus: The role of Genetics Sociocultural Factors in the Development of Diabetes Mellitus in Patients with Severe Mental Illness 28
Types of Examinations
Research Proposal (check with your advisor as early as possible) Problem-solving Critical Literature Review 29
Research Proposal
To evaluate a student’s ability to identify a significant research question relevant to nursing practice, and to design a methodology for addressing the question.
Study does not have to be carried out Must have access to UCSF faculty with research experience to mentor you 30
Research Proposal
Good choice if you plan to build on this topic for future research or doctoral work Could be taken back to your workplace for implementation if approval given by institution
Research Proposal Scoring
Total Points – 330 – Area 1 – Study and Context – 63 – Conceptual Framework and Literature Review 126 – Methodology – 126 – Technical (grammar, organization, use of APA format) – 15
The Comprehensive Exam is Pass/Fail
Points needed to pass 231
Problem-solving Examination
Purpose: To evaluate the student’s ability to effectively communicate the resolution of a problem in an area of specialization.
Describes an identified need stemming from a discrepancy between what is or what could/should be.
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Choosing a Problem-solving Topic
Can be a problem on an individual or a systems level.
Must be appropriate to the clinical situation – Think of a situation that is challenging to you Must be feasible!
Must be measurable!
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Examples of Problem-Solving Topics
Initiating an Oral Care Program in a Nursing Home Post-Partum Depression: Transition to Motherhood ICU Nurses’ Knowledge Deficit Regarding Hemodynamic Monitoring Loss of Venous Access and Dialysis Delay in End Stage Renal Disease Patients 36
Problem-solving Cautions
Instituting a delirium treatment program in acute care setting – Is delirium identified? Multiple etiologies…what will the intervention be? How will you measure this?
Improving parenting skills by identifying temperament in toddlers in preschools – What is meant by “parenting skills?” How will you get access to preschools? Is there literature that indicates that identifying temperament will change parenting behavior?
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The Problem and its Environmental Context
Clarity of the Problem Significance of the Problem Clarity of Setting Clarity of Roles and inter-relationships 38
The Problem and its Environmental Context
Clarity of the Problem –
Who
is solving the problem – – – APN
Where
the problem occurs ICU
What
is to be accomplished Improve Nurses’ Knowledge
Target
population ICU Nurses 39
The Problem and its Environmental Context
Significance of the Problem – Importance of the problem to patients or profession – Accurate Hemodynamic Monitoring is essential for ICU patients 40
The Problem and its Environmental Context
Clarity of the Setting – Home, hospital, nursing home – Intensive Care Unit 41
The Problem and its Environmental Context
Clarity of Roles & Inter-relationships – Describes functions of individuals sig to problem, their roles and influence on the setting – ICU nurses, Clinical Nurse Specialist, Head Nurse 42
Literature Review
Quality of references Addresses elements of critique Quality of critique and interpretation Quality of theoretical discussion
Intervention, Implementation & Evaluation
Expected Outcomes Defensibility Realism Clarity & Appropriateness of Intervention Implementation Clarity & Appropriateness of Evaluation Procedure 44
Intervention, Implementation & Evaluation
Clarity of Expected Outcomes – Improvement of Nurses Knowledge evidenced by improvement on post-test scores 45
Intervention, Implementation & Evaluation
Clarity & Appropriateness of Implementation – Outline procedures for implementing the intervention and ensuring they are appropriate – Educational intervention was three-fold Self-study, then 4 hour mandatory class, bedside guides developed 46
Intervention, Implementation & Evaluation
Clarity & Appropriateness of Evaluation Procedure Delineates specific measurable and appropriate evaluation criteria – Pretest and post-test measure of ICU nurses’ knowledge is measured – Number of incident reports are analyzed regarding monitoring 47
Intervention, Implementation & Evaluation
Defensibility – Demonstrates intervention has potential for substantial improvement in the problem Realism – Feasibility of intervention – Will an educational intervention be possible?
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Technical Criteria
Grammar and spelling Organization of paper APA format 49
Caveats
Must have a feasible, effective and defensible evaluation method Do not wait until the end to decide on method of evaluation When writing, do not always start with the beginning of the paper and progress to the end or your evaluation will suffer.
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Problem-solving Scoring
Total Points Evaluation 330 – Area 1 – The Problem – Area 2 – Literature Review – Area 3 – Intervention, Implementation,
105
– Area 4 – Technical (grammar, organization, APA) 15
105 105
EACH SECTION IS EQUALLY WEIGHTED SO PLAN FOR 10 PAGES PER SECTION!
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Critical Literature Review Choosing a Topic
Pose a question Do initial searching There is enough research, but no synthesis of findings or clear direction You want to argue a point that has some evidence, but is not established practice 52
Critical Literature Review Topic or Issue
Clarity of topic or purpose State in 1 sentence!
The purpose of this paper is to examine the literature related to the diagnosis of BNP in heart failure 53
Topic or Issue
Significance of topic 4.8 million in US have HF, 50% are rehospitalized in 6 mos., there is no lab test for diagnosing HF, BNP might provide better method for evaluation of SOB than symptoms 54
Literature Review – Examples
Evaluating cognitive function after stroke Family presence during resuscitation HRT in perimenopausal women BNP levels in the diagnosis of heart failure Evaluation of depression in adolescence 55
Some evidence exists, but practice is not well delineated
Should diabetics use ACE inhibitors to prevent renal impairment ?
This is well-established by scientific study and standard of practice in most settings. Is it safe to give people with stage 4 kidney disease ACE inhibitors to prevent progression?
Practitioners have been hesitant to give people with stage 4 CKD ACE inhibitors for fear of increasing creatinine or potassium to dangerous levels.
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Literature Review
Quality of References Elements of Critique Quality of Critique Theoretical Discussion 57
Literature Review
Quality of References – References significant to the problem area – classic & current while noting gaps in research literature if any 58
Literature Review
Organization of review Rationale for selected articles, describe how organized How many articles should you critique?
These journal articles were chosen because they include…….and the oldest is reviewed first….
Quality of references – key classic and current literature 59
Literature Review
Elements & Quality of Critique – Articulate Main Points – Sample – Design – Procedure – Measures – Results – Conclusions 60
Literature Review
Theoretical Discussion Must address the foundation of your question or problem – Example: Sepsis and EGDT Use Physiologic theory to explain why EGDT is appropriate for septic patients Use Change Theory if you want to implement EGDT in a new setting that manages septic patients 61
Literature Review Critique
Quality of Theoretical discussion Theoretical approach to the topic 62
Literature Review Critique
Addresses elements of critique – Sample – Design – Procedure – Measures – Results – Conclusions 63
Literature Review Critique
Quality of critique and interpretation YOUR ASSESSMENT OF THE STUDIES Too small of a sample size to give power to find a difference between those with and without HF, authors were biased b/c they knew the BNP level and may have changed treatment, only generalizable to men… 64
Make a Table!
Organize your literature into a table to compare and contrast Describe each study 65
Literature Review Discussion and Application
Critical and original analysis Integration and synthesis of research articles Implications for practice Future research 66
Discussion and Application – Where students get stuck!
Critical and original analysis Final summary of the literature 67
Identifies gaps in literature, implications for practice, need for further research
STICK your neck out there! Make your opinion known, however you must base it on the critique of the literature you presented rather than your opinion.
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Literature Review Scoring
Total Points - 330 – Area 1 – Topic or Issue -
70
– Area 2 – Literature Review -
165
– Area 3 – Discussion & Application – Area 4 – Technical (grammar, organization, APA) 15
80
LITERATURE REVIEW 50% OF THE PAPER 69
Most common reasons why comps fail
Started too late to put in necessary time and effort Did not meet with advisor to make sure you are on track Did not follow the advice of your advisor Primary editor was someone whose english composition skills were not adequate to give you appropriate feedback on your writing
I PASSED!
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