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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 multi-disciplinary teams to improve clinical practice in mental health settings 

Beginning

Identifies ethical and legal dilemmas with possible resolutions

Beginning

Demonstrates non-judgmental practice approach and empathy

Mostly confident

Practices within scope of practice

Confident

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

New

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

The greatest strength that I have built over the years is establishing effective communication with my clients. I develop professional and interprofessional communication with patients, families, and co-workers using verbal and nonverbal communication skills. By practicing effective communication in the facility, I have gained rewarding skills like handling my clients with compassion which are fundamental guiding nursing principles leading to quality and safe service delivery. As a result, my open communications have increased over the years, which has opened other avenues like accepting and responding to criticisms constructively and improving my professional communication mistakes. As a healthcare provider, effective communication cannot

be compromised, especially when addressing psychiatric problems, because one needs to be empathetic and possessive to assess psychopathologies’ symptoms and identify appropriate treatment tools (American Academy of Nurse Practitioners [AANP], 2020).

It is the responsibility of an Advanced Practice Registered Nurse (APRN) to assess psychiatric problems with appropriate physical and mental assessment tools to determine the probable diagnosis and therapeutic plan (Price & Reichert, 2017). Another strength I have is

performing a comprehensive and focused physical examination using the skills of self-assessment form by applying essential techniques. As a practicing nurse for many years, I have gained multifaceted skills in various specialties to collect health data for early identification and diagnosis of medical conditions (AANP, 2020).

Opportunities for growth:

It is complicated to run the test for mental diagnosis and behavioral disorders. The PMHNP must be competent to determine the differential diagnosis and rule out the psychopathology diagnosis by using psychosocial assessment, mental status evaluation, diagnostic test, and physical examination (Chambers & Ryder, 2018). However, I need to improve on some areas, like differentiating between pathophysiological and psychopathology variables when attempting to prioritize psychopathological diagnosis. As a registered nurse, I have been caring for patients with behavioral and mental disorders. I have realized that broad knowledge and assessment skills are required to diagnose and manage psychopathological conditions. This is because the diagnosis of and treatment of psychopathological disorders is dependent on the

clinician’s ability and competency of assessment (Price & Reichert, 2017).

I must continuously expand my psychiatric knowledge and assessment skills to improve on the weaknesses mentioned above and apply every gained knowledge during the clinical shifts. Also, interpreting a patient’s mental status reports has proved to be my weakness. However, I need to utilize every opportunity during clinical rotations to improve on this weakness. Furthermore, I will continuously expand my knowledge by enrolling in the facility’s training program, especially in research and clinical sites assessment skills. Overall, I will engage in activities that improve my personal and professional skills to sharpen my PMHNP skills and knowledge to foster evidence-based quality and safe care (Krautter et al., 2017).

Goals and objectives for this practicum experience.

Goal: After completing my practicum project, I need to have developed vast advanced mental status assessment skills.

Objective: Using a mental status exam, you can find out if you have any mental or behavioral issues.

Objective: Observe the patient's mental status during the examination.

Objective: Interpret the results of the mental status assessment

Goal: Develop autonomous skills and knowledge of assessing psychiatric problems towards the end of this project.

Objective: Apply advanced evaluation skills to psychiatric differential diagnosis and prioritization.

Objective: Using the patient's concerns, physical examination, and test results, develop psychiatric

differential diagnoses for patient encounters.

Objective: Demonstrate innovative skills in focused examination to make the appropriate diagnosis

Goal: To have gained sufficient psychiatric screening knowledge and skills, as well as the ability to use instruments, by the completion of the practicum.

Objective: Advanced psychometric screening techniques will be demonstrated.

Objective: Understand various psychiatric screening methods by applying advanced knowledge of practice.

Objective: I interview my patients utilizing excellent communication skills and advanced interviewing strategies to get to know them better.

1.

References

American Academy of Nurse Practitioners. (2020). Standards of practice for nurse practitioners. American Academy of Nurse Practitioners.

Chambers, C., & Ryder, E. (2018). Compassion and caring in nursing. Routledge.

Krautter, M., Diefenbacher, K., Schultz, J. H., Maatouk, I., Herrmann-Werner, A., Koehl-Hackert, N., ... & Nikendei, C. (2017). Physical examination skills training: Faculty staff vs. patient instructor feedback—A controlled trial. PLoS One, 12(7), e0180308.

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.