The University of Vermont
College of Nursing and Health Sciences
Department of Nursing
Course Syllabus
Spring 2014
Course: GRNU 343 – Optimizing Health and Management of Common Health Issues
GRNU 344 – Optimizing Health Practicum
Placement: Graduate track course for Primary Care: Adult and Family Nurse
Practitioner
Pre-requisite: GRNU 305, 333
Course Credits: 2 credits class (with one credit for 120 hours practicum)
Faculty:
Mary Val Palumbo DNP, APRN, GNP-BC
mpalumbo@uvm.edu (802) 656-0023
Barb Rouleau MS, APRN, FNP
brouleau@uvm.edu
(802) 363-1706
Robin L Myers DNP, ANP, FNP, CDE
rmyers@chcrr.org
(888) 225-7774
Callan Janowiec MS, FNP
callan.janowiec@gmail.com
802-879-1802
Catalogue Description: Assessment and optimization of health of adolescents and adults.
Diagnostic reasoning and management of common acute health conditions.
Course Description:
This course will focus on the assessment and optimization of the health of adolescents
and adults. National guidelines and standards for health promotion and disease
prevention will be explored. Evidence based guidelines for the assessment and
management of common acute health conditions will be used to illustrate diagnostic
reasoning and critical thinking.
Course Objectives: (GRNU 343)
At completion of this course, the student will be able to:
1. Explain health screening recommendations for adolescents and adults.
2. Identify health risks and health promotion needs of adolescents and adults.
3. Explain client education for health promotion.
4. Describe selected behavior change strategies to enhance the health of adolescents
and adults.
5. Critically analyze assessment data to formulate differential diagnosis for
adolescents and adults.
Course Objectives: (GRNU 344)
At completion of this clinical practicum, the student will be able to:
6. Select appropriate therapeutic interventions and treatments for common acute
health conditions.
7. Prescribe strategies for individuals and families to enhance health promoting
behavior for the prevention of illness and injury, improvement of function and
well-being, and maintenance of health.
8. Perform appropriate components of the history and physical exam for a brief or
complete assessment of common health problems and overall health status.
Course Topics:
 Domains/competencies of nurse practitioner practice
 Health promotion and disease prevention
 National guidelines for primary and secondary health prevention
 Behavior change strategies
 Assessment and management of common acute health conditions
Teaching Strategies:
* We will meet 7 times for lecture, sharing of clinical experiences, and discussion and
debate of health promotion guidelines.
* There will be 7 online classes to participate in.
* You will each have at least one site visit from a faculty member.
* We will utilize standardized patients for 2 sessions, practicing documentation on an
Electronic Medical Record and for evaluation of clinical progression/ meeting of clinical
objectives.
* 120 hours will be spent with a clinical preceptor in a healthcare setting.
Course Policies:
 All course assignments must be completed for a passing grade to be achieved.
 Students are expected to complete course assignments by the due dates identified
in the syllabus. Unless previously approved, course assignments not completed
by the due date will be penalized 2 points per day.
 All students must acquire a minimum of 120 hours of clinical experience during
this course and satisfactorily complete the clinical objectives.


Students who miss a “Standardized Patient (SP)” learning experience will be
expected to attend a “Make-up Session.” This is an additional expense for the
course and each student will be responsible for the increased cost of having the SP
available (maximum cost/students is $40 – actual cost dependent upon number of
students and number of hours SP is needed).
Students must demonstrate competency in the theoretical aspects of the course as
well as in the clinical application of the content through their practicum
experiences to receive a passing grade. Students who do not receive a satisfactory
grade for the practicum experience will receive a grade of "F" for the entire
course. An unsatisfactory grade in a clinical course may be grounds for dismissal.
Grading Policy: (Department of Nursing Graduate Completion Policy (effective
8/30/2013)




Students are required to earn a final grade of B or better in the course. If a student
earns two grades of B- or any grade below B- is grounds for dismissal.
Students are required to earn a satisfactory grade in clinical. An unsatisfactory
grade in a clinical course is grounds for dismissal.
In order to graduate, all program requirements must be met within one academic
semester of completion of final practicum.
Refer to the Department of Nursing Graduate Handbook and The University of
Vermont Graduate Catalogue for additional information regarding grading.
Course Assignments/Evaluation Methods:
Attainment of course objectives will be evaluated on:
Assignment
% of
Grade
Office note from standardized patient visit (submitted on the
5%
PRISM EMR)
Due Date
2/17/14
Cancer Screening: Oral Debate
10%
2/27/14
Or
3/20/14
Risk Appraisal: young, middle-aged,(5%) and older
adult (5%)
10%
3/20/14
And 4/3/14
Health promotion activities and reflective blog
35%
By 4/30/14
Midterm
10%
2/24 and
2/25
Class and online participation
5%
ongoing
Office note from standardized patient visit (submitted on the
5%
PRISM EMR)
5/09/14
Final Exam
20%
4/24/14
Clinical Log
S/U
5/10/14
Student self evaluation of clinical proficiency
S/U
5/11/14
Student evaluations of preceptor/clinical site
S/U
5/11/14
Faculty evaluation (site visit or standardized patient) of
student clinical proficiency
S/U
5/11/13
Preceptor evaluation of student clinical proficiency
S/U
5/11/13
Test out with standardized patient
S/U
5/11/13
Required Texts:
The Guide to Clinical Preventive Services 2012 128 pp. PDF or Pocket-sized guide is
a compilation of abridged USPSTF recommendations released from 2002 to March 2010
that can be used as an evidence-based tool at the point of patient care. (AHRQ 10-05145;
single copy costs is $5).Go to http://www.ahrq.gov/clinic/pocketgd.htm and order this as
soon as possible.
Miller, WR and Rollnick, S, (2012) Motivational Interviewing Helping People
Change. New York, NY: Guilford Press.
Bickley, Lynn. (2007). Bates' Guide to Physical Examination and History Taking, (9th
Edition). Lippincott ISBN: 0781767180
Henderson, MC, Tierney, LM, and Smetana, GW. The Patient History An EvidencedBased Approach to Differential Diagnosis. (2012) McGraw Hill Medical
Subscription to a “point of care” clinician’s network is required and should be
downloaded onto a handheld devise. Here are three options:
UpToDate - http://www.uptodate.com/home/clinicians/index.html - UpToDate, which is
available through the Web and Mobile Devices, combines the best evidence with the
experience of expert physicians around the world. Whenever you have a clinical question,
you can tap into the collective wisdom and experience of our faculty of over 4,400 leading
clinicians.
Recommended Books: (You may use any other book as your preferred “go to”
reference for diet, physical exercise, and cancer information. Choose a book that
you plan to read in its entirety and use for clinical teaching). Here are my choices:
Ades, Philip and Editors of Eating Well, (2008) Eating Well for a Healthy Heart
Cookbook: a cardiologist’s guide to adding years to your life. New York, N.Y.:
Countryman Press. (It’s available at the FAHC gift shop in the ACC)
Marcus, B. H. & Forsyth, L. H. (2008). Motivating people to be physically active.
Champaign, IL: Human Kinetics.
Recommended Websites:
National Cancer Institute. Cancer screening overview (PDQ) Retrieved from
http://www.cancer.gov/cancertopics/pdq/screening/overview/HealthProfessional.
USDA, My Plate for Professionals. Retreived from
http://www.choosemyplate.gov/information-healthcare-professionals.html
Explanation of course assignments

Office notes - The focus of your assessment should be the primary diagnosis (as
appropriate) and health risk appraisal with the focus of your intervention on
addressing the identified needs of health care maintenance, risk appraisal,
asymptomatic screening, health promotion, and disease prevention.
 Cancer Screening: Oral Debate – Succinctly written synopsis for posting online.
We will have a debate about the recommendations to screen for skin, colon,
breast, lung, prostate, and cervical cancer. Prepare to defend your position –
explain the evidence or lack of evidence, explain the benefit or the downside,
explain how you will present this to your patients….the goal is to recognize the
“problems” with screening yet the “benefits” of screening, to understand the
statistics of cancer, to recognize the limitations of published research, and to
develop a strategy/approach to recommendations for cancer screening that you
may adopt in your practice. Dr, Welch’s book Should I Be Tested for Cancer? or
Over-diagnosed: Making People Sick in the Pursuit of Health H. Gilbert Welch
Lisa Schwartz , Steve Woloshin will be very helpful for this assignment. Grading
based upon the use of evidence to defend your position, clear articulation of the
reasons for your position, and a succinct description of how you will present this
view to patients using clear communication.
 Risk Appraisal: young, middle-aged, and older adult – You will be given a
brief description of a patient. For each patient, post a written response to the
following questions. This will be a succinctly written “group” synopsis for
posting online. Include the references you used to support your recommendations.
1. What are the leading causes of death for this age group?
2. What risk appraisal and what screening (questions, diagnostic tests) are a high
priority for this patient?
3. What specific health promoting behaviors are important for this patient?
4. Are there any immunizations you would recommend for this patient?
5. Is there any chemoprophylaxis you would recommend for this patient?
 Service Learning – Employer health promotion activities and reflective blog This activity will provide each graduate student with and opportunity to practice
“brief” health promotion encounters at a worksite. This time spent explaining a
healthy behavior may be comparable to health promotion opportunities in a busy
primary care setting. The student will develop skills and tools for use in clinical
practice as a nurse practitioner. See posted instructions.
Other information:
Student Learning Accommodations: In keeping with University policy, any student
with a documented disability interested in utilizing accommodations should contact
ACCESS, the office of Disability Services on campus. ACCESS works with students to
create reasonable and appropriate accommodations via an accommodation letter to their
professors as early as possible each semester. Contact ACCESS: A170 Living/Learning
Center; 802-656-7753; access@uvm.edu; www.uvm.edu/access UVM’s policy on
disability certification and student support:
www.uvm.edu/~uvmppg/ppg/student/disability.pdf
Religious Holidays: Students have the right to practice the religion of their choice. If you
need to miss class to observe a religious holiday, please submit the dates of your absence
to me in writing by the end of the second full week of classes. You will be permitted to
make up work within a mutually agreed-upon time.
Academic Integrity: The policy addresses plagiarism, fabrication, collusion, and
cheating. www.uvm.edu/~uvmppg/ppg/student/acadintegrity.pdf
Grade Appeals: If you would like to contest a grade, please follow the procedures
outlined in this policy: www.uvm.edu/~uvmppg/ppg/student/gradeappeals.pdf
Grading: For information on grading and GPA calculation, go to
www.uvm.edu/academics/catalogue and click on Policies for an A-Z listing.
Code of Student Rights and Responsibilities:
www.uvm.edu/~uvmppg/ppg/student/studentcode.pdf
FERPA Rights Disclosure: The purpose of this policy is to communicate the rights of
students regarding access to, and privacy of their student educational records as provided
for in the Family Educational Rights and Privacy Act (FERPA) of 1974.
http://www.uvm.edu/~uvmppg/ppg/student/ferpa.pdf