Running head: CLINICAL GOALS
Clinical Goals
Author's Name
Institutional Affiliation
CLINICAL GOALS
Submit at least three written clinical goals that you and your preceptor defined for your clinical
faculty to review and provide you feedback.
Objective one–Related to Adaptation, Nursing Theory and Practice,
and Planning Therapeutic Nursing Interventions
Facilitates collection of the client data base through use of appropriate
interviewing skills
Utilizes nursing and related theories in developing a plan of care
Collects a complete subjective data base for both acute and chronic health
problems
Demonstrates technically proficient physical assessment skills
Appropriately focuses the physical exam based on the health history
Objective two–Related to Clinical Management, Decision Making and
Practice
Identifies likely differentials for client’s presentation based on the logical
integration of the history and physical exam
Provides scientific rationales for the consideration of differentials
Accurately assesses the current status of the client with attention to functional
status, developmental milestones, psychosocial well being, health promotion
and prevention
Provides rationales for interventions and plans of care
CLINICAL GOALS
Manages client in collaboration with other professional members of the team,
consults appropriately
Utilizes interventions that flow logically from assessment of the client’s status
Evaluates patient outcomes to define appropriate interventions
Considers indications, side effects, potential drug-drug interactions in ordering
medications
Objective three–Related to Documentation and Therapeutic
Communication
Uses verbal presentations that are concise, accurate and pertinent to the
patient’s presenting problems
Writes clinical notes that are concise, complete and accurate
Develops problem lists that are comprehensive and reflect a holistic approach to
patient health problems
In the professional role the student communicates with all others including, but
not limited to, clients, colleagues, faculty, preceptors and office staff, in a clear,
respectful, civil and informative manner
Objective four–Related to Clinical Research and Teaching
Utilizes current literature in designing and evaluating plans of care
Plans care including appropriate diagnostic, therapeutic, and educational
interventions
CLINICAL GOALS
Integrates current research on pharmacotherapeutics while designing the
therapeutic plans of care for individuals
Communicates current research findings to faculty and peers during clinical
seminar
Objective five–Related to Ethical, Legal and Professional Standards of
Practice
Integrates ethical, legal and professional standards of practice in all interactions
with clients and colleagues
Objective six–Related to Self-Directed Learning, Professional
Development, and Role of Advanced Practice
Accepts feedback from faculty and community preceptors and incorporates
suggestions for improvement into practice
Develops clinical goals and objectives and assumes responsibility for identifying
and meeting these objectives
Fulfilled the required clinical hours in the area of specialty
CLINICAL GOALS
CLINICAL GOALS
Introduction
Goal setting is a very vital ingredient for any successful career not only in healthcare but also in
any other field. Clinical competence is not achieved overnight but rather a gradual process that
required a clear vision, commitment, and hard work. My preceptor has been very instrumental in
guiding, advising, and inspiring my clinical learning experience and has significantly facilitated
clinical competence and autonomy. As part of the process, we have collaboratively developed
five fundamental clinical goals that would guide my professional development and career path.
These include:
CLINICAL GOAL ONE: To enhances therapeutic interviewing skills and data collection
skills and focused history and physical assessment.
In the words of Michael (2008), successful healthcare professionals must possess the
"foundational strategies, skills, and tools of therapeutic interviewing along with an understanding
of the formats and settings in which they will be working.' As a competent healthcare
professional, I must possess the requisite therapeutic interviewing skills such as questioning,
empathy, reflection, restatement, self-disclosure, cognitive reframing, among others. I aspire to
become an affective therapist who can effectively use interviewing as well as counseling
techniques to understand clients' problems and offer appropriate professional help.
Data collection, history, and physical assessment are the other vital skills that I aspire to develop.
It is important to note that proper data collection is critical in creating holistic views of patients
and their health problems, offer tailored treatment and improve treatment methods. As a
competent healthcare provider, I will seek to develop the necessary data collection techniques.
Effective clinical management also requires an accurate assessment of current situations of
CLINICAL GOALS
patients with attention to functional status, individual psychological status, developmental
milestones, and health promotion (Melnyk et al. 2016). One of the effective strategies to achieve
this particular goal is a constant improvement of my therapeutic decision making. For example, I
must clearly understand risks, benefits as well as compliance issues when choosing treatment.
Moreover, professional clinical management and practice require proper collaboration with all
other professional colleagues and teams. As a young practitioner, I must learn to consult
appropriately to gain much-needed experience and confidence. Effective communication is
indispensable in the process of developing relationships and collaboration with other
professional members and, more importantly, with patients. Care providers must be able to
identify hidden agendas by actively engaging and listening to patients. Also, they must recognize
hidden psychological issues that have potential impacts on the treatment process.
CLINICAL GOAL TWO: to demonstrate and maintain an effective and efficient patient care
delivery system, clinical decision making support systems, and refine all applicable clinical
practice skills to provide effective, reliable, and efficient care.
To achieve this, I must be able to identify all relevant differentials for each client's presentation
based on the logical integration of history as well as physical exams. It is essential for care
providers to obtain patient history and other exams in a logical, well-organized, and thorough
manner. They also need to adapt to the urgency of each medical situation as well as the time
available. Of course, physicians should also provide rationales for each intervention or plan of
care made. I must perfect my diagnosis decision making by formulating differential diagnoses
based on the key findings obtained from patient history and physical examination. Additionally,
my clinical management competence should entail the use of various programs that apply
science, technology and incentives to improve medical practice. These programs also assist
CLINICAL GOALS
consumers and other support systems in becoming more engaged in a collaborative process for
efficient and effective medical service delivery. The primary purpose of this particular goal is to
achieve optimal levels of wellness while also improving care coordination.
Moreover, I must refine all applicable clinical practice skills and work hand-in-hand with other
professional members in the organization to provide cost-effective, reliable, and non-duplicative
scare services. The healthcare industry has undergone rapid changes in the last couple of
decades. In the words of Felton &Royal (2014), the healthcare industry has seen "growing
challenge to prepare newly qualified nurses who are clinically competent and confident to meet
the demands of contemporary healthcare." To overcome this challenge, I must focus on
enhancing my practice skills in order to not only improve the quality of care but also increases
my chances of promotion. The increased competition in the healthcare industry requires care
providers to be equipped with the necessary clinical management skills and competencies.
CLINICAL GOAL THREE: To develop necessary patient-centered clinical communication
skills and clinical documentation competencies provide effective, reliable, and satisfactory
care.
As mentioned earlier, communication is an essential element of successful healthcare service
delivery. Developing quality communication skills is vital to creating positive client/patient
experience hence the need to commit myself to develop essential communication skills. As the
healthcare market continues to shift from the seller's market to the consumer's demand has made
patient satisfaction an integral part of healthcare practice in many medical facilities. Research
has established that good communication skills are an essential factor in nurturing patient
satisfaction. As an ambitious healthcare professional who aspires to venture into higher
positions of healthcare management, I must develop the necessary communication skills. These
CLINICAL GOALS
include skills such as active listening, compassion, empathy, trust, cultural awareness, emotional
intelligence, as well as non-verbal communication.
On the other hand, clinical documentation is equally important in healthcare service delivery.
Essentially, documentation seeks to inform and support care providers by supplying relevant
information highlighting the trends, offering insights into disease processes while also uniting
healthcare professionals through a good flow of data. There are several strategies through which
healthcare professionals can improve clinical documentation. These include a clear definition of
professional standards, expansion of education through structured training, creation of peer-to-
peer support systems, review of information, and allowing patients greater access to electronic
health records (EHR) (Melnyk et al. 2016). Clinical documentation is an essential tool for
effective clinical communication since it ensures accurate reflection of provider's assessments
and also supports multidisciplinary teams in delivering high-quality care.
CLINICAL GOAL FOUR: To develop and demonstrate the ability to apply clinical research
to conduct ongoing education.
To gain an edge in the increasingly competitive industry, I must be able to utilize current
literature to design and evaluate plans of care. For instance, I must demonstrate proficiency in
developing plans of care, such as appropriate diagnostic, therapeutic, psychiatric, or education
intervention. Additionally, being a competent healthcare professional, I must be proficient in
integrating current research on pharmacotherapeutics and therapeutic design plans of care for
each individual patient. Noteworthy, this is one competence that will potentially set me apart
from peers hence the need to commit myself in achieving. The other ley advantage of clinical
research competence is the ability to communicate research findings to faculty as well as peers in
different settings.
CLINICAL GOALS
References
Felton, A., & Royal, J. (2015). Skills for nursing practice: Development of clinical skills in pre-
registration nurse education. Nurse education in practice, 15(1), 38-43.
Michael, D. (2008). Therapeutic Interviewing: Essential skills and contexts of counseling.
Kennedy, M. B. A., Denise, M., Fasolino, M. D., John, P., Gullen, M. D., & David, J. (2014).
Improving the patient experience through provider communication skills building. Patient
Experience Journal, 1(1), 56-60.
Melnyk, B. M., Gallagher-Ford, L., & Fineout-Overholt, E. (2016). Implementing the evidence-
based practice (EBP) competencies in healthcare: a practical guide for improving quality, safety,
and outcomes. Sigma Theta Tau.
CLINICAL GOALS
Motivational Interviewing
++https://www.youtube.com/watch?embed=no&v=XsmY1VVxUIE
https://www.youtube.com/watch?embed=no&v=67I6g1I7Zao
Overview
After you complete the readings and watch the videos for this week, select one of the videos
and write an analysis which addresses the following:
A. Introduction: Overview of Motivational Interviewing:
Begin your paper by providing an overview of Motivational Interviewing (MI). Ensure
you include one article and summarize the main components of MI and populations
that are appropriate to use the MI principles.
B. Assessment of Videos:
Using the key components of MI, assess the role play videos in your chosen video for
appropriate integration.
C. Discriminatory Analysis Section:
What would you do differently or similarly in the video you chose to analyze? Provide
rationales that are specific utilizing sources for substance and depth.
D. Plan and Summary:
Integrate evidence-based information using one to two scholarly articles in your plan
and summary of the scenario you watched (opioid or alcohol). How does the concept
of coping play out in the scenario you watched? Integrate coping psychotherapeutic
CLINICAL GOALS
skills, as well as teaching and education, into your plan and summary.
Paper Requirements
Your paper should be three to four pages in length, excluding a required cover sheet and
references page that includes one to two textbooks and two to three scholarly articles (that were
published no longer than three years ago). Use APA formatting for all components of your
paper.
CLINICAL GOALS
Introduction
Simply put, motivational interviewing (MI) is a psychotherapeutic technique that seeks to
resolve people's ambivalent feelings as well as insecurities and to find the internal motivation
needed for them to change their behavior. MI was developed by William R. Miller and Stephen
Rollnick about thirty years ago. It blends both patient-centered strategies as well as coaching
strategies and the understanding of what triggers human behavior change. This guide clinician-
patient interaction. MI is founded on four fundamental values: accepting the client, compassion,
collaboration, and curiosity (Frost et al. 2018). It is important to note that MI primarily seeks to
move the individual away from their state of uncertainty towards finding the motivation to make
more positive decisions and accomplish their established goals.
According to Interviewing (2013), MI is built on five foundational principles:
i. Expressing empathy towards clients.
ii. Developing and supporting discrepancy
iii. Avoiding argument and confrontation/deal with resistance.
iv. Supporting self-efficacy and optimism.
v. Developing autonomy.
Over the years, MI has been applied in a wide array of conditions such as substance abuse
rehabilitation, obesity treatment, and management, enhancement of direct as well as
exercise/fitness behavior, among others. Equally important, MI has gained increased application
CLINICAL GOALS
in the management of chronic diseases. For all these populations, MI seeks to enhance the
individuals' capacity to change.
Assessment of Videos
"Motivational Interviewing Role Play" Mitchell Kinzer is the video chosen for assessment and
analysis. From the very initial reception and interaction with the patient, it is clear the physician
has mastered the fundamental principles of MI. She is able to express empathy towards the
patient for his unfortunate condition effectively. "Empathic motivational interviewing
establishes a safe and open environment that is conducive to examining issues and eliciting
personal reasons and methods for change. A fundamental component of motivational
interviewing is understanding each client's unique perspective, feelings, and values" (Center for
Substance Abuse Treatment, 2009). The physician in this particular case achieves this through
reflective listening, avoidance of direct confrontation, and adopting a respectful communication
and acceptance of the patient's feelings.
Additionally, the physician demonstrates an exceptional ability to adjust to the patient's
resistance rather than opposing it directly. She achieves this by asking open-ended questions
about the patient's desired outcomes for his visit. While the patient admits being a marijuana
user, the physician completely avoids placing any label on him. Arguments with clients can
often degenerate into a power struggle between the two and hence eroding the motivation for
beneficial change. More importantly, the physician gives the patient the much-needed autonomy
by placing all the power on him. This is a very critical component of MI, which requires care
providers to show respect for the client's autonomy-responsibility and ability to make decisions.
CLINICAL GOALS
Moreover, the doctor shows a genuine concern for the patient and encourages positive behavioral
change necessary to get him back to his desired condition and lifestyle. To show her genuine
interest to collaborate and help alleviate his problem, the doctor engages the patient in deciding
the necessary interventions. In order to build a stronger therapeutic relationship, the doctor
undertakes to create a "buy-in" from the patient by educating on the available options for pain
management.
Discriminatory Analysis Section
As mentioned earlier, the care provider in this particular case demonstrates mastery of MI, as
shown in this interaction with the patient. Showing empathy and genuine concern (empathy) for
the patient is one of the vital aspects that I can borrow from this particular doctor. According to
Good Therapy (2018), "the therapist must not only understand what a person says in a therapy
session but also understand what the person is not saying and communicate this understanding."
To enhance the effectiveness of MI, I would employ more affirmations in order to increase his
confidence in his ability to change. The other vital strategy is decisional balancing. Essentially,
decisional balancing helps the patient to understand that he or she gets some benefits from his
risky behavior. For instance, I will offer my professional advice to him on not only the benefits
of quitting marijuana but also the potential costs if he decides to change behavior. It is important
to note that providing new relevant information empowers the patient to make more informed
decisions regarding risky behaviors (Frost et al. 2018). However, the new information/advice
must be presented in a neutral, sensitive, and nonjudgmental manner.
Plan and Summary
CLINICAL GOALS
The concept of coping play is very relevant to this case. Essentially, play can be an effective
strategy for the patient to manage pain and improve the quality of his life. To achieve this, the
patient should make visualization exercises part of his play coping strategy. One of the key
benefits of this play coping strategy is that it enables the patient to take more responsibility for
certain behaviors and to develop better creative problem-solving skills. The other strategy that
could help the patient is building stronger social and family relationships. The care provider also
has the responsibility to teach and coach the patient in other coping strategies to help manage and
overcome his problem.
CLINICAL GOALS
References
Center for Substance Abuse Treatment. (2009). Enhancing motivation for change in substance
abuse treatment.
Frost, H., Campbell, P., Maxwell, M., O'Carroll, R. E., Dombrowski, S. U., Williams, B. &
Pollock, A. (2018). Effectiveness of Motivational Interviewing on adult behavior change
in health and social care settings: A systematic review of reviews. PloS one, 13(10),
e0204890.
Good Therapy, (2018). Empathy. Retrieved from
https://www.goodtherapy.org/blog/psychpedia/empathy
Kinzer, M. (2016). Motivational Interviewing Role Play. Retrieved from
https://www.youtube.com/watch?embed=no&v=XsmY1VVxUIE
