Tag: Clinical-Nursing

Week One Discussion: Biological Basis and Ethical/Legal Considerations of Psychotherapy

Recognizing psychotherapy as the biological treatment alternative to psychopharmacological treatment for mental health disorders has been up for debate for many years historically according to research (Manthey et al, 2021).  Current technological advancements have innovatively integrated Telepsychiatry for online psychotherapy counselling services that have evolved into mental healthcare services ever since the COVID-19 pandemic posing legal and ethical concerns in Telepsychiatry (Pierce et al, 2022).  Although there are a multitude of psychotherapy approaches utilized as an alternative to psychopharmacological treatment to manage psychiatric conditions, it is important to understand as a PMHNP student if there is a biological basis for psychotherapy (Wheeler, 2020). For this discussion, I will consider whether psychotherapy has a biological basis and analyze how legal and ethical considerations vary in individual, family, and group therapy clinical settings.

Biological Basis of Psychotherapy

Conceptually understanding the paradigm of the biological basis of psychotherapy requires identifying the inherent multifactorial changes in the brain’s neurodynamic functioning impact on the psychopathological responses to stressful and traumatic stimuli (Manthey et al, 2021). Characteristically, this concept is controversial thus, it is further explained by the biophysical aspect in the theory and practice of psychotherapy dealing with the element of mind-body as a unified entity notable in the biological cycle of circadian rhythm signalling (somatic) automatic and (biophysical/psychological) nonautomatic control (Manthey et al, 2021). Reiterating the notion of this theory which denotes that the premise of psychotherapy in the essence of the biophysical mind generates biofeedback from inherent and innate neuronal electrical pathway communication systems in response to internal or external antagonistic variants of stress is key (Manthey et al, 2021).

A prime example of this theory is substantiated by heritable genetic changes from traumatizing life encounters such as neglect, and sexual, emotional, and physical abuse experienced during early childhood research has shown that potentiates an epigenetic response inducing psychiatric symptomology and disorders for victims (Wheeler, 2020).  According to compounding evidence from research analysis of psychotherapy states, it is clinically effective as a modifier of the biological psychosomatic maladaptive responses to chronic medical/psychiatric disorders, stress, relapse, and remittent traumatic episodes that induce an altered state of the biochemical messaging network in the brain (Manthey et al, 2021).  Essentially, psychotherapy mediates these neuronal biological reactions in the brain, thus research findings suggest that are most vulnerable to exposure to stressful and traumatizing experiences by structurally deregulating mechanisms of neural inhibition (Manthey et al, 2021). Furthermore, the biological psychodynamics of psychotherapy are scientifically known to deactivate manifestations of neuronal dysfunction by transposing messenger molecules that encompass relevant structures located in the thalamus, hypothalamus, corpus callosum, amygdala, and cerebellum (Manthey et al, 2021).

Particularly, changes in the prefrontal cortex of the brain are vital in disrupting the dopamine modulation of cognitive control hence thereby being influential in impulse inhibition, attention, cognitive reactivity, adaptability, and prospective memory (Manthey et al, 2021). Psychotherapy has been proven to enable extreme psychopathological benefits in the treatment of mental health problems such as generalized anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorders, and major depression (Manthey et al, 2021).  Primarily, psychotherapy can serve the central role in modifying maladaptive behavioral responses through cognitive behavioral therapy (CBT) and (PDT) Psychodynamic Therapy (Wheeler, 2020). Ultimately the biological basis of psychotherapy is deemed instrumental in the biological approach utilized to disinhibit the cognitive distortion of negative thought processes and the innate biological instincts cultivated by incidences of stressful adversities experienced throughout the lifespan (Wheeler, 2020).

 

Cultural, Religious, and Socioeconomic Influence on Psychotherapy Treatments

Psychosocially factors that influence integral decision-making are instinctively sculpted by social and cultural environmental and societal norms (Nichols & Davis, 2020). Primarily, psychosocial interrelationship dynamics of an individual or group’s religious, cultural beliefs, and socioeconomics are predetermining factors that play a key role in being impressionable on their perspectives, value system, misconceptions, and overall lifestyle choices (Shah et al, 2021). Therefore, without any preconceived notion, a PMHNP must be cognoscente of how an individual’s lifestyle choices involve the complexities of social determinants associated with their cultural/religious beliefs, and socioeconomic resources may increase their susceptibility to mental healthcare disparities (Wheeler, 2020).  Culturally, for example, the stigmatization affiliated with mental illness (represents having a curse or hexed in some cultures), homosexuality, HIV/AIDS, and drug addiction have been known as an underlying deterrent of societal norms (Stuart & Ward, 2018).  This may influence the prominence of those who are ostracized avoiding methods of psychotherapeutic treatment to the detriment of their overall emotional, psychosocial, physiological, and psychological well-being (Shah et al, 2021).  Religious influences are significantly important to understanding how individuals’ perception of psychotherapy correlates with their beliefs (Stuart & Ward, 2018).  For instance, those patients whose life may be heavily reliant on the belief in divine/supernatural intervention of worship may not seek psychotherapy but conform to spiritual counsel through church leadership and prayer (Stuart & Ward, 2018).

Muslims and Christians are some typical examples of religious groups who may obey the religious principles of God being the ultimate healer of their indiscretions making psychotherapy an obsolete treatment option (Stuart & Ward, 2018). Furthermore, findings relative to the issues associated with cost-efficient barriers to access psychotherapy-related care are commonly experienced by individuals considered to be in the lower-income bracket versus those who are in a higher socioeconomic class (Shah et al, 2021).  Additionally, studies have shown that the probability of the likelihood of the misconception of psychotherapy being influenced by an individual’s knowledge deficit on treatment efficacy, socioeconomic, religious, and cultural dynamics is high in some communities as unique barriers impeding optimal mental healthcare outcomes (Shah et al, 2021). Theoretically, this is evident in the principle of the nature versus nurture concept that accounts for the innate and inherent biopsychosocial and environmental conditioning that subconsciously permeates all dimensions of our lives that impact pivotal choices to resist or receive psychotherapy (Wheeler, 2020).

Legal and Ethical Considerations for Group and Family Therapy that Differs from Individual Therapy

Considerations for the legal and ethical standards of psychiatric care among groups, families, and individuals differ characteristically in the realm of evidence-based psychotherapy practices (Nichols & Davis, 2020). Each of these classifications of therapy settings illustrates methods of treatment designated to facilitate informed consent and confidentiality agreements that a provider and participants are legally and ethically bound to abide by (Kivlighan et al, 2020).  Unlike group and family therapy involves where consumers have intrapersonal and interpersonal issues discussed in settings amongst multiple individuals that elicit a sense of community, thus it differs from individual therapy which focuses only involves one individual and the provider (Kivlighan et al, 2020). A provider must ensure that group, family, and individual treatment goals are met individually and collectively, which may pose challenges when multiple members are involved (Nichols & Davis, 2020). This can become a complicated process more so in family and group therapy than individual therapy. For instance, when the group/family therapy focus is diverted to the sole interest of an individual client and not moderated properly by the provider treatment is counterproductive (Kivlighan et al, 2020).

Data from a meta-analysis research study uncovered findings that empirically indicate mutual behavioral influences are more prominent among group and family membership settings than in individual therapy relative to the nature of participation and attendance patterns (Kivlighan et al, 2020). The element of mutual influence of family and group membership is obliviously irrelevant in individual therapy (Kivlighan et al, 2020).  Educating members on the risks and benefits of group, family, and individual therapy is the sole responsibility of the clinician to establish a therapeutic milieu that reinforces standards of care which include nonmaleficence (no harm), confidentiality, and trust (Nichols & Davis, 2020). Ethically, confidentiality concerns present differently in group/family therapy settings versus individual therapy. Primarily, these concerns revolve around the aspect of a provider’s inability to guarantee the nondisclosure of shared information being maintained by a family or group member in group and family therapy sessions or a stranger if Telepsychiatry is used (Nichols & Davis, 2020).

Therefore, further obligating the clinician to ensure that terms, conditions, and confidentiality agreements with online and in-person consultations are adhered to and not breached to protect the best interest of the group and/or individual (Nichol & Davis, 2020). Breached treatment agreements from group membership dynamics can, directly and indirectly, impact levels of treatment outcomes, such as frequent absenteeism, subtle or overt deliberate acts of antagonizing, disrespectfulness, and dismissive behaviors according to research (Kivlighan et al, 2020).   Intentionally being proactive in ensuring nonmaleficence (not harm) by prioritizing what is in the best interest of the consumer the provider must conduct individual consultations to provide an overview/reinforcement of the terms and conditions of the group, family, and individual psychotherapy (Kivlighan et al, 2020).

 

Legal and Ethical Considerations Impact on Therapeutic Approaches

Fundamentally, as a PMHNP adhering to the code of ethics is an integral component of facilitating clinical approaches to a group, family, and individual psychotherapy (Wheeler, 2020). Substantiating treatment modalities proven by evidence-based practice to enhance the efficacy of psychiatric treatment increases the probability of sustaining a therapeutic milieu (Manthey et al, 2021). Particularly, as a provider being committed to not being complicit in restricting patients’ rights to refuse psychiatric care if they are deemed legally responsible to do so in non-emergent and emergent circumstances is paramount (Nichols & Davis, 2020). Leading by example in avoiding any promotion of conflicts of interests is an ethical and legal obligation of a mental healthcare provider to not violate patients’ rights and be subjected to revocation of professional licensure as a PMHNP (Wheeler, 2020). Therefore, acquiring and adhering to the institutional psychotherapy policies and guidelines as a PMHNP is imperative to conduct high-quality clinical practice efforts in mental healthcare that are also legally and ethically abiding according to governing State regulations (Nichols & Davis, 2020).

Prioritizing, all standards of care that illustrate the mindfulness of the risk factors associated with social determinants of care involving a person’s religious, cultural, socioeconomic background, and knowledge base will foster moral grounding of how this may influence their perspectives, biases on psychotherapy treatment (Wheeler, 2020).  It is vital to make sure patients understand that informed consent is a legally binding contract that holds them accountable for acknowledging the terms and conditions of their psychiatric treatment that also have consequences for nonadherence to those terms (Wheeler, 2020). Moreover, it is vital that as an aspiring PMHNP student I advocate, educate, and mitigate social determinants of barriers to access equitable mental healthcare for patients across the lifespan that will optimize high-quality patient outcomes (Wheeler, 2020).

 

Conclusion

Overall, being cognoscente of how the biological framework of psychotherapy impacts inherent and innate maladaptive responsiveness to adverse life experiences is crucial to facilitating group, family, and individualized psychiatric therapy services (Wheeler, 2020). This will all enable the PMHNP to address the perspectives and religious, cultural, and socioeconomic influences that impact a group, family, or individual’s options for psychotherapy to effectively mitigate their barriers to psychiatric care (Wheeler, 2020). Therefore, it is equally imperative for a PMHNP to establish and sustain a therapeutic milieu while considering the legal and ethical concerns associated with group/family therapy versus individual therapy dynamics (Nichols & Davis, 2020).

References

Kivlighan, D. M., Aloe, A. M., Adams, M. C., Garrison, Y. L., Obrecht, A., Ho, Y. C. S., Kim, J. Y. C., Hooley, I.W., Chan, L., & Deng, K. (2020). Does the group in group psychotherapy matter? A meta-analysis of the intraclass correlation coefficient in group treatment research. 
Journal of Consulting and Clinical Psychology
, 
88
(4), 322–337. https://doi.org/10.1037/ccp0000474

Manthey, A., Sierk, A., Brakemeier, E.-L., Walter, H., & Daniels, J. K. (2021). Does trauma-focused psychotherapy change the brain? A systematic review of neural correlates of therapeutic gains in PTSD. 
European Journal of Psychotraumatology
, 
12
(1), 1929025. https://doi.org/10.1080/2008198.2021.1929025

Nichols, M., & Davis, S. D. (2020). 
The essentials of family therapy
 (7th ed.). Pearson.

Pierce, B. S., Perrin, P. B., & McDonald, S. D. (2022). Pre-COVID-19 deterrents to practicing with videoconferencing telepsychology among psychologists who didn’t. 
Psychological Services
, 
19
(1), 157–166. 
https://doi.org/10.1037/ser0000435
Links to an external site.

Shah, N., Walker, I. F., Naik, Y., Rajan, S., O’Hagan, K., Black, M., Cartwright, C., Tillmann, T., Pearce Smith, N., & Stansfield, J. (2021). National or population-level interventions addressing the social determinants of mental health – an umbrella review. 
BMC Public Health
, 
21
(1), 2118. 
https://doi.org/10.1186/s12889-021-12145-1
Links to an external site.

Stuart, J., & Ward, C. (2018). The relationships between religiosity, stress, and mental health for Muslim immigrant youth. 
Mental Health, Religion & Culture
, 
21
(3), 246–261. https://doi.org/10.1080/13674676.2018.1462781

Wheeler, K. (Ed.). (2020). 
Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
 (3rd ed.). Springer Publishing.

Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan

Treatment Plan: 38 of 40 (95.0%)

Problem Selection

6 out of 6

Diagnosis

Learner Selection

Model Documentation

 Diagnosis: 
Herpes Zoster

Evidences:

 
Burning pain at rash location

 
Clustered rash with vesicular lesions

 
History of chickenpox infection

 
Recent period of severe mental stress

 
Rash placement along the dermatome on one side of the body

Learner Rationale:

Above symptoms are consistent with Herpes Zoster

Score: 
6 
out of
 6

 Diagnosis: 
Herpes Zoster

Evidences:

Burning pain at rash location

Clustered rash with vesicular lesions

History of chickenpox infection

Recent period of severe mental stress

Rash placement along the dermatome on one side of the body

Model Rationale:

Herpes zoster is the most likely diagnosis for Mr. Barbosa given his signs and symptoms. The clustered rash of vesicular lesions, causing burning pain and occurring along the dermatome on one side of the body, is consistent with herpes zoster. Mr. Barbosa has previous history of a chickenpox infection, which is required in order for herpes zoster to be triggered. Additionally, the patient’s recent stress after losing his loved one provides a potential antecedent to the onset of the zoster outbreak Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan.

Plan of Care

7 out of 7

PLACE YOUR ORDER HERE

Review your answers for the Plan of Care activity. You must select “Yes” or “No” for each of the seven care actions. You will receive one point for determining the correct answer for each care action.

Learner Selection

Model Documentation Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan

Pharmacological Intervention

Selected:
xx

Learner Rationale:

xx

Score: 
1 
out of
 1

Recommended:
xx

You will want to prescribe medication for the patient. You will conduct a medication selection in the next activity.

Non-Pharmacological Intervention

Selected:
xx

Learner Rationale:

xx

Score: 
1 
out of
 1

Recommended:
xx

xx.

Educate Patient

Selected:
xx

Learner Rationale:

xx

Score: 
1 
out of
 1

Recommended:
xx

You should xx; until this has happened, the patient should avoid sharing towels, clothing, and bedding, as such items can pass the virus to others who come in contact with them. The patient needs to return for an urgent follow-up if symptoms worsen, which include: exacerbated pain, fever, the appearance or spread of lesions near the eyes, inside the mouth, or on the genitals.

Preventive Screening and Intervention

Selected:
xx

Learner Rationale:

 

Score: 
1 
out of
 1

Recommended:
xx

At this time,xxx. Recommending preventative screens and interventions at this time are xx. Preventative screenings and interventions can be recommended during an xx

Diagnostic Testing: Labs and Imaging

Selected:
xx

Learner Rationale:

 

Score: 
1 
out of
 1

Recommended:
xx

As the patient’s diagnosis is evident, further diagnostic testing is needed.

Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan

Referral of Care

Selected:
 

Learner Rationale:

 

Score: 
1 
out of
 1

Recommended:
 

There’s evidence that the patient requires any referral to another healthcare provider at this time.

Continued Care and Follow-up

Selected:
 

Learner Rationale:

x

Score: 
1 
out of
 1

Recommended:
 

You want to instruct the patient to follow up as needed for this condition and address any ongoing issues that arise with regards to pain management and medication changes. Additionally, it is good practice to remind patients to follow-up for their annual physicals and wellness checks.

Medication Selection

xx

This activity represents your ability to synthesize subjective data, objective data, guidelines, drug interactions, and contraindications to select the most effective medications(s) for the patient’s problems. Your points are based on the selection of correct medication(s) for the patient’s indication(s), with some points being removed based on the number of attempted tries.

Learner Selection

Model Documentation

Target:

Herpes Zoster Treatment

Selected Medication:

 
acyclovir (800 mg 5x/day for 7 days)

Score: 
9 
out of
 9

Acyclovir, famciclovir, and valacyclovir are all appropriate choices for the treatment of Mr. Barbosa’s herpes zoster when prescribed with the correct dosing instructions. Antibiotics are an inappropriate selection because herpes zoster is a viral infection, which antibiotics cannot treat. The antivirals oseltamivir and remdesivir have not been proven effective in the treatment of herpes zoster Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan.

Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

Transcript

Started:
Feb 16, 2023 | 
Total Time:
102 min

All Lines (82)
Interview Questions (59)
Statements (9)
Exam Actions (14)

Hello. I am xxx, I will interview and examine you.

Greet

02/19/23 5:47 PM EST

Hi.

What is your name?

Question

02/19/23 5:47 PM EST

Felipe Barbosa

Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

What brings you here today?

Question

02/19/23 5:48 PM EST

I’m here for this pain and rash on my back.

I am sorry about that

Empathize

02/19/23 5:49 PM EST

Thank you.

How long have you had the pain and rash?

Question

02/19/23 5:51 PM EST

The pain and rash has been going on for two days, though I had some tingling in the area four days ago . . . [AUDIO COMING SOON]

Can you describe the rash?

Question

02/19/23 5:51 PM EST

Yeah, the rash is red, has small blisters, and I feel a burning pain.

How long does the pain last?

Question

02/19/23 5:52 PM EST

The pain has been constant.

How severe is your pain?

Question

02/19/23 5:53 PM EST

Pain — 7 out of 10.

PLACE YOUR ORDER HERE

Where is the rash located?

Question

02/19/23 5:53 PM EST

The rash is on my right lower back. I have pain there too, but it’s not radiating.

What relieves your symptoms?

Question

02/19/23 5:53 PM EST

I took some ibuprofen for the pain — that helped a little. I tried an ice pack, but that did nothing. I didn’t try any ointments or anything for the rash.

I’m glad that ibupfrofen helped a little

Empathize

02/19/23 5:55 PM EST

I appreciate that.

What makes your symptoms worse

Question

02/19/23 5:56 PM EST

Sweat and being hot make the pain feel worse. The pain is constant and in the area of the rash.

What is your medical history?

Question

02/19/23 5:57 PM EST

Aside from the rash and the pain, no other health issues.

Any allergies?

Question

02/19/23 5:57 PM EST

Nope, I don’t have allergies.

Have you had a rash in the past?

Question

02/19/23 5:58 PM EST

Yeah I have a rash and pain in my back.

Are your immunizations up to date?

Question

02/19/23 5:58 PM EST

Yup, I have all my shots.

Any past history of skin conditions?

Question

02/19/23 5:59 PM EST

I don’t have any skin conditions or other medical conditions. Just this rash. [AUDIO COMING SOON]

Any history of chronic disease?

Question

02/19/23 6:02 PM EST

Yeah, my family has some health issues — Dad has high cholesterol and hypertension. Mom has diabetes. They’re both living.

Are you using any other medications? (Clarified to What other medications are you taking?.)

Question

02/19/23 6:03 PM EST

I don’t have any prescriptions. I just take ibuprofen. (Clarified to what other medications I am taking.)

Have you been sexually active

Question

02/19/23 6:03 PM EST

Not totally sure how that relates, but yes . . . I’m sexually active with my husband. Not since I got this rash, though. [AUDIO COMING SOON]

Some skin conditions are spread through contact

Educate

02/19/23 6:05 PM EST

I’ll make a note of that.

Any fever?

Question

02/19/23 6:05 PM EST

No, I haven’t had a fever.

Any history of eczema? (Clarified to Do you have a history of psychiatric illness?.)

Question

02/19/23 6:06 PM EST

I don’t have any clinical mental health issues, but I’m grappling with a traumatic incident — my best friend died recently. (Clarified to if I have a history of psychiatric illness.)

Am sorry about that

Empathize

02/19/23 6:07 PM EST

Thanks.

Are you using any supplements? (Clarified to Do you take vitamins or supplements?.)

Question

02/19/23 6:08 PM EST

No, I don’t take vitamins or supplements. (Clarified to if I take vitamins or supplements.)

Any recent travel?

Question

02/19/23 6:09 PM EST

We haven’t traveled recently. Not since our honeymoon a few years ago. [AUDIO COMING SOON]

Any history of surgeries?

Question

02/19/23 6:09 PM EST

Nope, I’ve never had surgery before.

Any history of hospitalizations?

Question

02/19/23 6:10 PM EST

Nope, no hospitalizations.

Any recent exposure to chemicals? (Clarified to Have you had any recent exposure to plants?.)

Question

02/19/23 6:13 PM EST

No, I haven’t touched any strange plants or anything. [AUDIO COMING SOON] (Clarified to if I have had recent exposure to plants.)

What is your diet like?

Question

02/19/23 6:13 PM EST

I usually do a protein shake for breakfast and load it up with lots of stuff — I use some super greens powder, or fresh greens if I have them on hand, some fruit, oatmeal, yogurt . . . they keep me pretty full in the morning before my workouts. Lunch is usually something quick like a salad and pizza, or grain bowl. Dinner I’ll have some steak or fish with pasta and roasted vegetables. I snack too . . . nuts, chips and guacamole, a good cheese plate, an occasional doughnut Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript.

Healthy diet is good for your skin

Educate

02/19/23 6:15 PM EST

Ah, alright, thanks.

Any family history of skin conditions?

Question

02/19/23 6:16 PM EST

I don’t think any skin diseases run in my family. [AUDIO COMING SOON]

Any joint pain?

Question

02/19/23 6:18 PM EST

I don’t have any joint issues.

Any night sweats? Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

Question

02/19/23 6:18 PM EST

I don’t get night sweats.

Any vision problems?

Question

02/19/23 6:20 PM EST

My eyes and vision are good. [AUDIO COMING SOON]

Any numbness or tingling?

Question

02/19/23 6:21 PM EST

I have some tingling sensations in the rash area. The tingling has been going on for about four days. The rash only showed up two days ago.

Am sorry about that

Empathize

02/19/23 6:22 PM EST

That’s nice of you.

Any nausea?

Question

02/19/23 6:22 PM EST

I haven’t been nauseated.

Auscultated breath sounds: Breath sounds present in all areas with no adventitious sounds

Exam Action

02/19/23 7:09 PM EST

 Auscultated heart sounds: S1 and S2 audible with no extra heart sounds

Exam Action

02/19/23 7:10 PM EST

 Assessed location of rash.

Exam Action

02/19/23 7:12 PM EST

 Assessed character of rash.

Exam Action

02/19/23 7:13 PM EST

 Palpated abdomen light

Exam Action

02/19/23 7:13 PM EST

 Palpated spine: Spine and accessory muscles were nontender to palpation.

Exam Action

02/19/23 7:14 PM EST

 Palpated rash: Patient verbalized pain by saying “Ouch” upon palpation Felipe Barbosa Sick Visit: Integumentary
ShadowHealth
Transcript

Exam Action

02/19/23 7:14 PM EST

 Tested sensation in left and right legs: Expected sensation in left and right legs

Exam Action

02/19/23 7:15 PM EST

 Tested sensation of left and right feet: Tested sensation in feet. Expected sensation in left and right feet

Exam Action

02/19/23 7:15 PM EST

 Tested spine range of motion: Full range of motion performed without discomfort

Exam Action

02/19/23 7:15 PM EST

Are you able to work?

Question

02/19/23 7:22 PM EST

Well I’m a firefighter and I’ve been on my off schedule. I guess I’ll find out tomorrow when I’m back on shift if the pain is going to get in the way . . . I’ll grit through the pain.

Can you stand? (No matching questions found.)

Question

02/19/23 7:25 PM EST

Have the symptoms affected your sleep?

Question

02/19/23 7:25 PM EST

Aside from the pain, I have a rash and I’ve been feeling a little tired.

Any fatigue?

Question

02/19/23 7:26 PM EST

Yeah, I’ve been tired lately.

How many hours do you sleep per day?

Question

02/19/23 7:26 PM EST

Usually 8 hours a night. [AUDIO COMING SOON]

Any sore throat?

Question

02/19/23 7:27 PM EST

My throat feels fine. [AUDIO COMING SOON]

Any history of infection? (Clarified to Have you ever been diagnosed with an STD?.)

Question

02/19/23 7:28 PM EST

Um . . . that’s sort of out of nowhere, but no, I don’t have an STD. [AUDIO COMING SOON] (Clarified to if I have been diagnosed with an STD.) Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

Any stress? (Clarified to Have you been stressed recently?.)

Question

02/19/23 7:29 PM EST

I recently lost my best friend . . . he died in the line of duty, he was a firefighter too. It’s been hard. (Clarified to if I have been stressed out lately.)

Am sorry about that

Empathize

02/19/23 7:30 PM EST

I appreciate it. Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

Any history of back pain?

Question

02/19/23 7:34 PM EST

Before the current pain in my right lower back, I haven’t had major back pain. [AUDIO COMING SOON]

Are you depressed?

Question

02/19/23 7:34 PM EST

I don’t have clinical depression or anything, but . . . I lost my best friend recently, and I’ve been in mourning. [AUDIO COMING SOON]

Any history of HIV? (Clarified to Do you have a history of anxiety?.)

Question

02/19/23 7:35 PM EST

I don’t have an anxiety disorder . . . but . . . and I don’t know if “anxiety” is the right word . . . I lost my best friend recently, and I’ve definitely been on edge. [AUDIO COMING SOON] (Clarified to if I have a history of anxiety.)

Any history of childhood illnesses?

Question

02/19/23 7:36 PM EST

Um, I had chickenpox as a kid.

Does the pain radiate?

Question

02/19/23 7:42 PM EST

The pain in the rash area is really only on my right lower back. It doesn’t go anywhere else.

Do you work?

Question

02/19/23 7:43 PM EST

Yeah, I’m firefighter.

Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

Advancements in Nursing Informatics

Nursing informatics is not a new concept. Review the following timeline to understand the advancements in nursing informatics since the 1950s.

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1950s – Harriet Werley, the first designated nurse researcher at the Walter Reed Army Research Institute, was asked by IBM to consult on the use of computers in health care.

1960s – Critical care technology emerged in the form of mechanical ventilators and cardiac monitors.

1970s – Computer-based information systems (CIS) were implemented in hospitals.

1980s – The American Nurses Association (ANA) and the National League for Nursing established a council and forum on Computer Applications in Nursing.

1990s – The ANA published the first versions of the Scope of Nursing Informatics Practice and the Standards of Nursing Informatics Practice.

2006 – The
HIMSS TIGER
initiative began, focused on increasing the use of technology and informatics in practice, research, and education to improve patient care.

2008 – The ANA released a revised scope and standards for practice in nursing informatics.

2009 – The Health Information Technology for Economic and Clinical Health
(HITECH) Act
passed to provide the Department of Health and Human Services (HHS) the “authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT, including electronic health records and private and secure electronic health information exchange.”

2010 – The Institute of Medicines’
Future of Nursing
report is released listing “effective workforce planning and policy making require better data collection and information infrastructure” as one of its four key messages – having a direct impact on the field of informatics.

 

Source

Ozbolt, J. & Saba, V. (2008). A brief history of nursing informatics in the United States of America. Nursing Outlook, 56, 199-205.e2. doi: http://dx.doi.org/10.1016/j.outlook.2008.06.008 Advancements in Nursing Informatics

HSN/376: Health Information Technology for Nursing

Course Information

Description

This course examines electronic modalities that assist in patient-centered health care management. Topics include informatics, automation of data management, and evaluation of information systems. A key focus is the relationship between technology in health care delivery and patient safety.

Credits

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Learning Outcomes

In this course you will learn to:

Where you will demonstrate your learning:

Explain the role of information and data management in improving patient care.

Wk 1
– Summative Assessment: Information Technology, Safety, and Patient Outcomes

Describe how clinical decision support systems are used to improve patient safety and care.

Wk 3  – Summative Assessment: Solution Proposal: General Solution

Analyze how consumer health information and informatics changes can redefine health advice and care.

Wk 5  – Summative Assessment: Informatics Solution Proposal: Specific Solution Presentation HSN/376: Health Information Technology For Nursing

 

Materials

Textbook

Hebda, T., Hunter, K., & Czar, P. (2019).
Handbook of informatics for nurses and healthcare professionals
(6th ed.). Prentice-Hall/Pearson.

 

 

 

Schedule Overview

Note: Assignments are due Monday unless indicated otherwise. Initial discussion posts are due Thursday and the 2 required responses are due Monday.

Wk and Topic

Activities

Assignments and Points

Wk 1 – Role of Technology and Informatics in Nursing

Handbook of Informatics for Nurses and Healthcare Professionals
, Ch. 1 and 7

Advancements in Nursing Informatics

P.A.T.C.H. Test (Pretest for Attitudes Toward Computers in Healthcare)

Nursing Informatics: Beyond the Electronic Health Record

HSN/376: Health Information Technology For Nursing

University Library Resources

Discussion – 40 points

Summative Assessment: Information Technology, Safety, and Patient Outcomes
– 150 points

Wk 2 – Health Information System Overview

Handbook of Informatics for Nurses and Healthcare Professionals
, Ch. 3, 4, and 8

Health Information System Components

What is a Health Information System (HIS)?

University Library Resources

Discussion
– 40 points

Informatics Solution Proposal: Issue Identification – 150 points

Wk 3 – Clinical Decision Support Systems

Handbook of Informatics for Nurses and Healthcare Professionals
, Ch. 10

Clinical Decision Support

University Library Resources

Discussion – 40 points

Summative Assessment: Informatics Solution Proposal: General Solution – 150 points

Wk 4 – Consumer Education and Informatics

Handbook of Informatics for Nurses and Healthcare Professionals
, Ch. 18

Consumer Health Informatics (CHI)

Self-Paced Patient Education

Consumer Health

University Library Resources

Discussion – 40 points

Informatics Solution Proposal: Areas of Evaluation – 150 points

Wk 5 – Future Trends in Health Care Technology

Handbook of Informatics for Nurses and Healthcare Professionals
, Ch. 19

AI Technology in Healthcare

The Future of Healthcare

The Future of Nursing Technology

Nursing Informatics: A Day in the Life

University Library Resources

Discussion – 40 points

Summative Assessment: Informatics Solution Proposal: Specific Solution Presentation – 200 points

HSN/376: Health Information Technology For Nursing

Wk 2 Discussion – Health Care Information Systems [due Thurs]

Discussion Topic

Post a total of 3 substantive responses over 2 separate days for full participation. This includes your initial post and 2 replies to other students.

Due Thursday

As outlined in the case study at the end of Ch. 8 in the
 Handbook of Informatics for Nurses & Healthcare Professionals
, take an inventory of the information systems in your organization or at an organization in which you were previously employed.

 

Use your own observations and conversations with staff and leaders.

 

Compare your list with the systems described in Ch. 8.

 

Answer the following questions in a minimum of 175 words:

How would you rate the information technology status of your organization?

How would you improve your information systems?

 

Due Monday  

Post 2 replies to classmates or your faculty member. Be constructive and professional.

b

Summative Assessment: Information Technology, Safety, and Patient Outcomes

Course Content

Rubric Details

Safe patient care

25% of total grade

Accomplished

Fully explained why information and technology skills are essential for safe patient care.

90 – 100%

Emerging

Partially explained why information and technology skills are essential for safe patient care.

70 – 89%

Beginning

Inadequately explained why information and technology skills are essential for safe patient care.

50 – 69%

Not Evident

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Did not explainwhy information and technology skills are essential for safe patient care Summative Assessment: Information Technology, Safety, and Patient Outcomes.

0 – 0%

Baccalaureate nurse’s role

20% of total grade

Accomplished

Fully identified the baccalaureate nurse’s role in championing the use of information and technology to improve safety and patient outcomes.

90 – 100%

Emerging

Partially identified the baccalaureate nurse’s role in championing the use of information and technology to improve safety and patient outcomes.

70 – 89%

Beginning

Inadequately identified the baccalaureate nurse’s role in championing the use of information and technology to improve safety and patient outcomes.

50 – 69%

Not Evident

Did not identify the baccalaureate nurse’s role in championing the use of information and technology to improve safety and patient outcomes.

0 – 0%

Technology and healthcare-related decision-making

25% of total grade

Accomplished

Provided comprehensive examples of how nurses use technology to make healthcare-related decisions.

90 – 100%

Emerging

Provided partial examples of how nurses use technology to make healthcare-related decisions.

70 – 89%

Beginning

Provided inadequate examples of how nurses use technology to make healthcare-related decisions.

50 – 69%

Not Evident

Did not provide any examples of how nurses use technology to make healthcare-related decisions.

0 – 0%

Data quality and integrity

25% of total grade

Accomplished

Fully analyzed the relationship between the quality and integrity of data entered into a database and the effect on the quality of patient care. Summative Assessment: Information Technology, Safety, and Patient Outcomes

90 – 100%

Emerging

Partially analyzed the relationship between the quality and integrity of data entered into a database and the effect on the quality of patient care.

70 – 89%

Beginning

Inadequately analyzed the relationship between the quality and integrity of data entered into a database and the effect on the quality of patient care.

50 – 69%

Not Evident

Did not analyze the relationship between the quality and integrity of data entered into a database and the effect on the quality of patient care.

0 – 0%

Written Communication

3% of total grade

Accomplished

The completed assignment was concise, with exceptional attention to detail, and was free of errors.

90 – 100%

Emerging

The completed assignment showed attention to detail through careful editing and quality writing; minimal writing convention errors (i.e., spelling, punctuation, usage, and sentence formation) were present.

70 – 89%

Beginning

The completed assignment lacked detail and careful editing; numerous writing convention errors (i.e., spelling, punctuation, usage, and sentence formation) were present, but errors did not detract from the readability of the content.

50 – 69%

Not Evident

The completed assignment was difficult to read and understand because of the number and degree of writing convention errors.

0 – 0%

APA guidelines

2% of total grade

Accomplished

The assignment was properly formatted according to APA guidelines, and it included correct APA citation of sources.

90 – 100%

Emerging

The assignment was partially formatted according to APA guidelines, and it included mostly correct APA citation of sources.

70 – 89%

Beginning

The assignment was minimally formatted according to APA guidelines, and it included incorrect APA citation of sources.

50 – 69%

Not Evident

The assignment did not incorporate APA guidelines in its formatting nor in citing sources.

0

Course Questions for Glenda or your peers

Have a question about this course? Ask here! I will monitor this area. If you know the answer, feel free to help your peers by posting a reply. If you have a question that only applies to you and your work, please use a private message Summative Assessment: Information Technology, Safety, and Patient Outcomes

Have a question about this course? Ask here! I will monitor this area. If you know the answer, feel free to help your peers by posting a reply. If you have a question that only applies to you and your work, please use a private message

Show more

Wk 1 – Role of Technology and Informatics in Nursing

Meet Your Faculty and Peers!

I am so excited to get to know you all. Please watch my welcome video then reply with the following information: What kind of nursing you are currently doing. Summative Assessment: Information Technology, Safety, and Patient Outcomes Where you’re from About your family (kids, pets) Your favorite movie or song Your favorite food or restaurant One interesting fact about you Transcript Note : Posts in this discussion area do not count for participation; however, this is a great way to get to know each other.

Show less

Wk 1 Overview

Wk 1 Discussion –
Role of Informatics in Patient Care Outcomes
[due Thurs]

Due date: 2/21/23, 9:59 AM

Post a total of 3 substantive responses over 2 separate days for full participation. This includes your initial post and 2 replies to other students. Due Thursday Review Informatics Strategies & Tools to Link Nursing Care with Patient Outcomes in …

Show less

Wk 1 – Summative Assessment: Information Technology, Safety, and Patient Outcomes [due Mon]

Due date: 2/21/23, 9:59 AM

Wk 1 Learning Activities

Handbook of Informatics for Nurses and Healthcare Professionals, Ch. 1

Read Ch. 1, “An Overview of Informatics in Healthcare.”

Read Ch. 1, “An Overview of Informatics in Healthcare.”

Handbook of Informatics for Nurses and Healthcare Professionals, Ch. 7

Read Ch. 7, “Electronic Health Record Systems.”

Read Ch. 7, “Electronic Health Record Systems.”

Advancements in Nursing Informatics Summative Assessment: Information Technology, Safety, and Patient Outcomes

P.A.T.C.H. Test (Pretest for Attitudes Toward Computers in Healthcare)

Complete the P.A.T.C.H. test from Nursing Informatics Learning Center. This exercise will help you explore your feelings toward computers.

Complete the P.A.T.C.H. test from Nursing Informatics Learning Center. This exercise will help you explore your feelings toward computers.

Nursing Informatics: Beyond the Electronic Health Record

Watch “Nursing Informatics: Beyond the Electronic Health Record.” A transcript is available on YouTube.

Watch “Nursing Informatics: Beyond the Electronic Health Record.” A transcript is available on YouTube.

Wk 1 University Library Resources

Review the selected resources from the University Library.

Review the selected resources from the University Library.

HSN/376: Health Information Technology For Nursing – Role of Informatics in Patient Care Outcomes HSN 376 Wk 1 Discussion

Wk 1 Discussion – Role of Informatics in Patient Care Outcomes [due Thurs]

Discussion Topic

Post a total of 3 substantive responses over 2 separate days for full participation. This includes your initial post and 2 replies to other students.

 

Due Thursday 

Review
Informatics Strategies & Tools to Link Nursing Care with Patient Outcomes in the Learning Health Care System
from the American Medical Informatics Association (AMIA) about linking informatics strategies to patient outcomes.

 

Respond to the following in a minimum of 175 words:

How does standardized data entry relate to improving patient safety and improved care outcomes?

Provide examples from your own clinical practice.

 

Due Monday 

Post 2 replies to classmates or your faculty member. Be constructive and professional.

 

Electronic Health Record Systems (EHRS) help store and retrieve data, making the work environment an organized system. But that is not the most important benefit; patient safety and patient-quality care delivery are the leading causes of why this technology is being implemented. Patient care can be delivered more safely now and that is because all proper clinicians have access to the same data as you. One newly implemented technology I observed at work was that the pharmacy my facility is contracted with now has access to all medication orders imputed in the patient’s record Role of Informatics in Patient Care Outcomes HSN 376 Wk 1 Discussion. So, for example, if a new medication imputed has an interaction or risk for an allergic reaction it automatically alerts the person imputing the order. The pharmacy will withhold the medication until given an okay by the nurse to release it. This is after the nurse has clarified the order with the doctor. Traditional paper health records used in the past did not give you this benefit and many times these mistakes were not caught on time and resulted in patient harm.

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The EHRS is now being implemented in most facilities, and you see less use of traditional paper health records. Another benefit as stated in the Handbook of Informatics, “The SEHR enables a clinician at the point of care to access a patient’s records without the delays of submitting requests and waiting for transmissions” (Hebda et al., 2019, p.113). Role of Informatics in Patient Care Outcomes HSN 376 Wk 1 Discussion At work, when doctors give us narcotic prescription orders over the telephone, a doctor must sign the order for the pharmacy to dispense the medication to the facility. This is another example of how EHRS has improved communication and made patient care delivery fast and efficient by having doctors easily access and sign these prescriptions.

 

Reference:

Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses & healthcare professionals (6th ed). Prentice-Hall/Pearson Role of Informatics in Patient Care Outcomes HSN 376 Wk 1 Discussion

Altered Physiology

Question 1

The patient presented with symptoms consistent with acute kidney rejection, a severe complication of kidney transplantation. Renal transplant recipients are at risk of developing acute kidney rejection because they have immunosuppression, which is why they need to take anti-rejection drugs after their transplant (Lai et al., 2021). The patient’s nephrologist should have closely monitored him for the first few months after transplantation and adjusted his medication accordingly if necessary.

The patient also experienced an increase in weight, which is common in patients who experience rejection. If a patient has gained too much weight, he will be unable to tolerate the anti-rejection drug Cyclosporine (Neoral), which can cause toxicity and lead to death if left untreated (Lai et al., 2021). The patient had decreased urine output and increasing temperatures, both signs indicating inflammation within the body. Inflammation can become severe enough that it leads to organ damage if not treated appropriately.

The patient also presented with symptoms of acute kidney rejection because he had a cadaver donor for his kidney transplant. Although it is normal for the body to reject a new organ, this can be treated with cyclosporine and tacrolimus (Justiz Vaillant et al., 2022). However, the patient’s body could not handle the combination of these medications, and he developed rejection symptoms.

Question 2

The most likely genes to be associated with the development of acute kidney transplant rejection are the HLA genes and the B7-H1 gene. HLA genes are found on chromosome 6, called HLA-A, -B, -C, -DRB1, -DQB1, -DQA1, -DPB1, and -DQA2 (Brehm et al., 2019). They are responsible for determining what cells can be used in a transplant.

HLA-DRB1*15:01 is a significant risk factor for developing acute kidney transplant rejection in people who have received an allogeneic transplant from an HLA-DRB1*15:01 donor with graft-versus-host disease (GVHD) (Brehm et al., 2019). It has been shown that this gene is responsible for up to 10%-45% of cases of acute kidney transplant rejection after receiving an allogeneic donor. HLA-DQA1*02:01 is another risk factor for developing acute kidney transplant rejection after receiving an allogeneic donor who has had GVHD and received a graft from someone with the identical HLA-DQA1*02:01 genetic makeup (Loupy & Lefaucheur, 2018). This gene increases the likelihood of developing a graft.

The patient’s genetic makeup is most likely to be associated with the development of acute kidney transplant rejection (Lai et al., 2021). The presence of HLA-DR2 in his kidney would make him more likely to experience a stronger immune response to the transplant, which may lead to inflammation and an increase in the expression of genes that cause inflammation.

Question 3

Immunosuppression is a process by which the immune system is weakened. This can significantly affect body systems and make it more likely for an individual to get sick (McCance & Huether, 2019). The immune system is made up of white blood cells responsible for protecting the body from bacteria and viruses. These cells produce antibodies that bind to foreign invaders, such as bacteria or viruses.

Many things, including medications, infections, and cancer therapies, can cause immunosuppression. The most common causes of immunosuppression are cancer therapies (chemotherapy) and organ transplantation (McCance & Huether, 2019). Immunosuppression can also occur in people with HIV/AIDS who take antiretroviral therapy (ART), suppressing their immune system so they cannot fight off infections.

Cancer therapies and organ transplantation weaken the immune system by destroying some components or suppressing others so it can no longer fight off infections or fend off tumors (McCance & Huether, 2019). Immunosuppressive drugs are used to prevent rejection of transplanted organs and tissues after cancer surgery or after bone marrow transplants

In the case study, the patient’s immunosuppression was initially done with Tacrolimus (Prograf), Cyclosporine (Neoral), and Imuran (Azathioprine). These drugs are known as TAC-susceptible triazines (TACS). TAC-susceptible triazines work by inhibiting a type of cell that is part of the immune system called T-cells (McCance & Huether, 2019). This prevents them from responding to transplanted organs or tissues.

Immunosuppression has several effects on the body:

It decreases inflammation, which can help prevent organ damage or loss.

It reduces the activity of white blood cells, which helps prevent infection and promotes healing.

It decreases the production of substances that cause pain and fever, which helps treat pain and illness related to rejection or inflammation.

 

References

Brehm, M. A., Kenney, L. L., Wiles, M. V., Low, B. E., Tisch, R. M., Burzenski, L., Mueller, C., Greiner, D. L., & Shultz, L. D. (2019). Lack of acute xenogeneic graft- versus-host disease, but retention of T-cell function following engraftment of human peripheral blood mononuclear cells in NSG mice deficient in MHC class I and II expression. 
FASEB journal : official publication of the Federation of American Societies for Experimental Biology
, 
33
(3), 3137–3151.
https://doi.org/10.1096/fj.201800636R

Justiz Vaillant, A. A., Vashisht, R., & Zito, P. M. (2022). Immediate Hypersensitivity Reactions. In 
StatPearls
. StatPearls Publishing.

Lai, X., Zheng, X., Mathew, J. M., Gallon, L., Leventhal, J. R., & Zhang, Z. J. (2021). Tackling Chronic Kidney Transplant Rejection: Challenges and Promises. 
Frontiers in immunology
, 
12
, 661643.
https://doi.org/10.3389/fimmu.2021.661643

Loupy, A., & Lefaucheur, C. (2018). Antibody-Mediated Rejection of Solid-Organ Allografts. 
The New England journal of medicine
, 
379
(12), 1150–1160.
https://doi.org/10.1056/NEJMra1802677

McCance, K. L. & Huether, S. E. (2019). 
Pathophysiology: The biologic basis for disease in adults and children 
(8th ed.). St. Louis, MO: Mosby/Elsevier.

 

CASE STUDY ANALYSIS

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

RESOURCES

 

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Announcements” section of the classroom for your assignment from your Instructor.

The Assignment

Develop a 1- to 2-page case study analysis in which you:

Explain why you think the patient presented the symptoms described.

Identify the genes that may be associated with the development of the disease.

Explain the process of immunosuppression and the effect it has on body systems.

BY DAY 7 OF WEEK 2

Submit
 your Case Study Analysis Assignment by Day 7 of Week 2.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at 
https://academicguides.waldenu.edu/writingcenter/templates
Links to an external site.
). All papers submitted must use this formatting.

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the 
Turnitin Drafts
 from the 
Start Here
 area.

To submit your completed assignment, save your Assignment as 
MD1Assgn_LastName_Firstinitial

Then, click on 
Start Assignment
 near the top of the page.

Next, click on 
Upload File
 and select 
Submit Assignment
 for review.

 

Rubric

NURS_6501_Module1_Case Study_Assignment_Rubric

NURS_6501_Module1_Case Study_Assignment_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning Outcome
Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:Explain why you think the patient presented the symptoms described.

30
 
to >
27.0
 pts

Excellent

The response accurately and thoroughly describes the patient symptoms. … The response includes accurate, clear, and detailed reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

27
 
to >
24.0
 pts

Good

The response describes the patient symptoms. … The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

24
 
to >
22.0
 pts

Fair

The response describes the patient symptoms in a manner that is vague or inaccurate. … The response includes reasons for the symptoms, with explanations that are vague or based on inappropriate evidence/research.

22
 
to >
0
 pts

Poor

The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. … The response does not include reasons for the symptoms, or the explanations are vague or based on inappropriate or no evidence/research.

30
 pts

This criterion is linked to a Learning Outcome
Identify the genes that may be associated with the development of the disease.

25
 
to >
22.0
 pts

Excellent

The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease.

22
 
to >
19.0
 pts

Good

The response includes an accurate analysis of the genes that may be associated with the development of the disease.

19
 
to >
17.0
 pts

Fair

The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease.

17
 
to >
0
 pts

Poor

The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing.

25
 pts

This criterion is linked to a Learning Outcome
Explain the process of immunosuppression and the effect it has on body systems.

30
 
to >
27.0
 pts

Excellent

The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems.

27
 
to >
24.0
 pts

Good

The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems.

24
 
to >
17.0
 pts

Fair

The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

17
 
to >
0
 pts

Poor

The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

30
 pts

This criterion is linked to a Learning Outcome
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5
 
to >
4.0
 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. … A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4
 
to >
3.0
 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. … Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3
 
to >
2.0
 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. … Purpose, introduction, and conclusion of the assignment are vague or off topic.

2
 
to >
0
 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. … No purpose statement, introduction, or conclusion were provided. 5  pts This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation 5   to >
4.0
 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4
 
to >
3.0
 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3
 
to >
2.0
 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

2
 
to >
0
 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5
 pts

This criterion is linked to a Learning Outcome
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.

5
 
to >
4.0
 pts

Excellent

Uses correct APA format with no errors.

4
 
to >
3.0
 pts

Good

Contains a few (1 or 2) APA format errors.

3
 
to >
2.0
 pts

Fair

Contains several (3 or 4) APA format errors.

2
 
to >
0
 pts

Poor

Contains many (≥ 5) APA format errors.

5
 pts

Total Points: 
100

Personal Philosophy of Teaching, Revised (Part II)

As discussed earlier in this course, your personal teaching philosophy is a work in progress. During week 8, you will revisit and revise your teaching philosophy that you submitted during week 1. As part of this assignment, you should evaluate your original philosophy and include a one-page discussion of how your thoughts and ideas about teaching have changed and developed during this course. Guidelines for revising your teaching philosophy and the one-page discussion are below Personal Philosophy of Teaching, Revised (Part II).

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Assignment Guidelines

Revised Personal Teaching Philosophy (3–5 pages)

Reflect on the teaching principles and practices discussed during the course.

What did you learn about teaching that you did not know prior to this course?

What stood out as important to you over the past 8 weeks?

Consider how you might expand, adapt, or change your original philosophy to your current perspective on teaching (or you may feel compelled to take it in a completely new direction).

Your revised teaching philosophy should:

Have a clear focus or theme.

Be authentic and personal.

Relay who you are (or aspire to be) as a teacher.

Exhibit genuine enthusiasm for teaching.

Personal Philosophy of Teaching, Revised (Part II)

Clearly express your current teaching values and beliefs, and discuss why you hold those values and beliefs (whether or not they have changed).

Describe your current teaching goals (whether or not they have changed).

Explain the teaching methods or strategies that you believe are best (whether or not they are different from your original philosophy).
Note
: make sure the teaching methods you find best are consistent with your goals.

Incorporate any new ideas and/or practices that encourage a rich teaching and learning experience.

Be 3–5 pages, including the evaluation discussion but excluding title and reference pages; length should suit the context. It should be typed in Times New Roman using 12-point font and double-spaced with 1″ margins.

Be well written, using a first person narrative and present tense.

Follow APA style.

Have no any grammatical, typographical, or spelling errors.

Personal Philosophy of Teaching, Revised (Part II)
 

 

Evaluation Discussion of Teaching Philosophy (1 page)

As part of this revised teaching philosophy assignment, you should include a discussion evaluating how your personal thoughts and ideas about teaching have changed during this course.

After you have revised your personal teaching philosophy, carefully review your original teaching philosophy that you submitted during week 1 of this course.

Compare your original philosophy to your revised teaching philosophy and evaluate the following in a one-page written discussion:

Have your teaching goals, methods, or strategies changed, and if so, how and why? Have your teaching priorities and/or perspectives changed or shifted, and if so, how and why?

Do you value different learning experiences, and if so, what are they and why?

Include any additional information that may highlight how your thoughts and ideas have changed or developed during this course.

Include references that you found helpful, insightful, or meaningful in the development of your philosophy of teaching
Personal Philosophy of Teaching, Revised (Part II)
.

In addition to the course texts, include at least two outside sources from peer-reviewed journals to support your ideas.

Your evaluation discussion should:

Be one page excluding title and reference pages, typed in Times New Roman using 12-point font, and double-spaced with 1″ margins.

Be well written, using a first person narrative and present tense.

Follow APA style.