Reflection writing


Assignment: Journal Entry

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Critical reflection on your growth and development during your practicum experience in a clinical setting helps you identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes. 

Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum.

To Prepare

· Refer to the “Population-Focused Nurse Practitioner Competencies” found in the Week 1 Learning Resources and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.

· Refer to your “Clinical Skills Self-Assessment Form” you submitted in Week 1 and consider your strengths and opportunities for improvement.

· Refer to your Patient Log in Meditrek and consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.

In 450–500 words, address the following:

Learning From Experiences 

· Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.

· Reflect on the three most challenging patients you encountered during the practicum experience. What was most challenging about each?  

· What did you learn from this experience?  

· What resources were available? 

· What evidence-based practice did you use for the patients? 

· What would you do differently?  

· How are you managing patient flow and volume?  

Communicating and Feedback 

· Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor. 

· Answer the questions: How am I doing? What is missing?  

· Reflect on the formal and informal feedback you received from your Preceptor. 

By Day 7

Submit your Journal.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

· Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.

· Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.

· Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.

· Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.

· If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

· Click on the Submit button to complete your submission.

Grading Criteria

Referred to previous self-evaluation checklist and use different grammatical expression in each skills level

PMHNP PRAC 6645 Clinical Skills 

Self-Assessment Form

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 across the lifespan


Differentiating between pathophysiological and psychopathological conditions 


Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies) 


Performing and interpreting a mental status examination 


Performing and interpreting a psychosocial assessment and family psychiatric history 


Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).


Diagnostic reasoning skill in:

Developing and prioritizing a differential diagnoses list


Formulating diagnoses according to DSM 5 based on assessment data 


Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes


Pharmacotherapeutic skills in:

Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management) 


Evaluating patient response and modify plan as necessary 


Documenting (e.g., adverse reaction, the patient response, changes to the plan of care)


Psychotherapeutic Treatment Planning:

Recognizes concepts of therapeutic modalities across the lifespan


Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation) 


Applies age appropriate psychotherapeutic counseling techniques with individuals, families, and/or groups


Develop an age appropriate individualized plan of care


Provide psychoeducation to individuals, family, and/or groups


Promote health and disease prevention techniques


Self-Assessment skills:

Develop SMART goals for practicum experiences 


Evaluating outcomes of practicum goals and modify plan as necessary 


Documenting and reflecting on learning experiences


Professional skills:

Maintains professional boundaries and therapeutic relationship with clients and staff


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


Identifies ethical and legal dilemmas with possible resolutions


Demonstrates non-judgmental practice approach and empathy


Practices within scope of practice


Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals:

Demonstrates selecting the correct screening instrument appropriate for the clinical situation 


Implements the screening instrument efficiently and effectively with the clients


Interprets results for screening instruments accurately


Develops an appropriate plan of care based upon screening instruments response


Identifies the need to refer to another specialty provider when applicable


Accurately documents recommendations for psychiatric consultations when applicable


Summary of strengths:

Capacity to commendably converse both unwritten and written with the patients, family members and colleagues. I am a resilient listener, culturally thoughtful and able to stipulate patient psychoeducation.

Opportunities for growth:

The practicum experience will give me a chance to apply the knowledge learned beforehand and presently in the PMHNP program into my clinical and future practice.

Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.

1. Goal: At the end of this practicum experience, I would have mastered the role of PMHNP across lifespan.

a. Objective: I will learn designated course information; put together all assignment in a timely manner.

b. Objective: I will follow and take part in care of patients receiving cares for psychiatric and substance abuse across lifespan.

c. Objective: Ask preceptor and clinical instructor informative questions.

2. Goal: Be able to conduct a psychiatric evaluation independently by week 5 of practicum experience.

a. Objective: I will shadow the preceptor.

b. Objective: I will partake in the admission of new and old patients. Also, I will follow-up, diagnosis and explain treatment plan to the patients.

c. Objective: I will practice and conduct self-reliant or collaboration psychiatric evaluation on patients with psychiatric disorders.

3. Goal: Develop trust with patients by maintaining legal and ethical standards of care.

a. Objective: I will promote a friendly communication channels with patients, family members and colleagues.

b. Objective: Validate lawful and ethical code of conduct in treating patient with varying characteristics.

c. Objective: Use advanced nursing skills to gain an understanding of cultural diversity and cultural trends.