Comprehensive Exam
Orientation
Fall 2014
Barbara Hollinger, RN, MSN, FNP-BC
Mary Lynch, RN, MS, MPH, FAAN, PPCPNP-BC
Starting Spring 2015
Comprehensive exam
submissions will use the
new format.
Comprehensive exams
submitted prior to Spring
2015 will use old format.
Outline of Comp Process
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Description of the Comp assignment
The Comprehensive Exam Handbook
Qualifying for the examination
Important dates
Technical requirements
Resources
Comprehensive Exam options
Graduate Division
Language
comprehensive
examination should
demonstrate the student’s
mastery of the major field and
ability to think critically.”
 “The
The Assignment

The purpose of this paper is to
evaluate your ability to:
– Critique research as it applies to your
area of specialization
– Apply advanced clinical and theoretical
knowledge to practice
– Utilize writing skills to disseminate
nursing information using a
scholarly paper
– Demonstrate you can be a
consumer of research
Critical Points
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Twenty (20) page paper
not including title page,
references, grid and
appendices
Four exam options
– Research Proposal
– Critical Literature Review
– Problem-solving
– White Paper
The Handbook

You can download a
copy of the
Comprehensive
Examination
Handbook
from the UCSF
School of Nursing
website
http://nursing.ucsf.edu/comp-exams
How to Qualify
Advance to Candidacy
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Before you can be issued your individualized
Comp Number, YOU MUST ADVANCE TO
CANDIDACY.
Advance to Candidacy forms are available
from the Office of Admissions and Registrar.
Forms can also be downloaded online.
After you submit your form Graduate
Division notifies Office of Student Affairs.
OSA will then generate your Comp Number.
The Last Quarter of
Course and Clinical Work
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Advance to Candidacy the quarter
before you plan to submit your
comp
Your last chance to Advance to
Candidacy is the first week of the
quarter in which you plan to turn
in the comp
One incomplete grade on your
academic record allowed to
Advance to Candidacy
Payment of fees required for comp
exam number
How to Qualify for the
Examination
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You are eligible in the last quarter you
are enrolled in course and clinical
work.
If you have completed ALL course
work with the exception of the comp
exam you may submit the exam while
on filing fee status for a reduced fee.
Filing Fee Status
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Talk with your advisor to determine if you
are eligible for filing fee
You may not take courses of any type or
utilize faculty as a resource for writing your
paper if you are on Filing Fee status except
for resubmission of a failed comp
Apply and pay filing fee to OAR
Most frequently used for second time comp
exam submission
Know the Important Dates
Formatting Expectations
APA Sixth Edition format
Margins 1 inch on all four sides of page
Can separate syllables at the end of a line
20 pages of text, not counting title page,
reference list and appendices
Title should reflect content
No abstract
Double-spaced, 12 point uncompressed font
(Acceptable font examples: Times New
Roman, Arial)
What Should be
Submitted?

The following items are to be submitted
electronically by the student
– A completed face sheet.
– One copy of the Comprehensive Examination submitted
as a PDF or MS Word document.
– A Student Contact Page of paper that provides the
student’s name, mailing address, home and cellphone
numbers, and any other pertinent information that allows
the student to be reached during the reading period.
– A TurnitinTM originality report.
– An additional copy of the exam should be retained by
the student.
Securing Your Comp Number

In order to pick up your number you
must complete the face sheet and
return it
– List your specialty
– Topic
– Suggested readers

ID number is given to you to be
placed on your comp
15
NAME
The student’s name should not appear
on any part of the Comprehensive
Examination. The paper is identified
only by the assigned ID number,
entered on the face sheet and every
page of the examination at the top
right margin to the left of the page
number
Reading &
Scoring
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Student may select up to five preferred
readers (not required)
Students may elect to exclude one faculty
reader if desired
Student is not guaranteed a preferred reader
Readers use a standard scoring system
Student will be given the faculty comment
sheets at the end but not the scoring sheets
Plagiarism
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Evidence of
plagiarism results in
a failure of the
comprehensive
exam.
Plagiarism can
become grounds for
dismissal from the
School of Nursing.
Plagiarism Defined

“to steal or pass off as one’s own (the
ideas or words of another); use (a
created production) without crediting
the source; to commit literary theft; to
present as new and original an idea or
product derived from an existing
source.”
Webster’s Third New International Dictionary of the English Language
A Comp Does Not Pass
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One pass and one
fail from two readers
goes to a third
reader for decision
Exam fails if two
readers fail it
May re-submit exam
once within five
quarters of advance
to candidacy
Vital Resources

Vital resource—Dept. Administrative Assistants
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CHS: Judy Alonzo and Sharon Solorio
PN: Mary Margaret
FHCN: Maggie Pena
SBS: Brandee Woleslagle
Comprehensive Exam Coordinators
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CHS: Beth Phoenix and Dana Drew-Nord
PN: Roxanne Garbez
FHCN: Barbara Hollinger and Mary Lynch
SBS: Susan Chapman
Additional Resources
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Advisors- topic and
format
Specialty faculty
Sample comps on
reserve
Scientific Writing
Program Coordinator
Susana.Leong@ucsf.edu
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Consider other
arrangements
– Typist
– Paid tutors and
editors
– Peers as editors and
proofreaders
Create a timeline
– See sample provided
Comprehensive Exam
Spring 2015
SEP
OCT
NOV
DEC
JAN
Identifying the
phenomenon of interest
FEB
MAR
APR
MAY
JUN
JUL
AUG
• Advance to Candidacy: Before end of Winter
Quarter 2015
Topic generation
• Pick up Comp # from Departments 04/08/2015
Faculty input re: topic
• Submit Comp to Departments: 4/22/15
Literature review
Refine topic outline
Faculty input re:
topic outline
Advance to
Candidacy
Pick up
Comp #
Draft #1
Colleagues read paper
for clarity and organization
Draft #2
Edit
Submit
Comp
WORK HARD, DO WELL!
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Extensions, summer
comps, oral exam are
available only by
special arrangement.
Read the
corresponding
section of the comp
handbook.
Sample Examinations
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On reserve in each of the departments
Ask your advisor and/or your
department's comprehensive
examination coordinator
27
Comprehensive Exam
Overview
Choosing a Theory
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Applicable to research proposal, critical
literature review, and problem
solving comp
A theory should further clarify,
support, and explain your topic
Nursing theory not required
Explain your theory in the text—don’t
depend on diagrams in the appendix
29
Theory or Conceptual
Framework
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Theory is the format that enables you
to explain a phenomenon. There is no
right or wrong theory—it is all in how
you want to frame the argument you
want to make.
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Concept or Phenomenon
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Possible Mechanisms Underlying the
Increased Risk of Type 2 Diabetes in
People on Atypical Psychotrophic
Medications
Potential Theoretical Frameworks
Physiological
HPA axis and sympathetic nervous system hyperactivity
resulting in overproduction of cortisol.
Genetics
Diabetes only occurs in those with a genetic
predisposition.
Co-morbidity
The diabetes is really due to alcoholism or binge eating.
Socio-cultural Due to socioeconomic, disability, marital status, access to
health care
Health care
Providers fail to adequately monitor overall health.
Behavioral
Inactivity, diet, smoking due to the psychiatric illness
Medication
Side effects, appetite stimulation and subsequent weight
gain
32
Research Literature
Summary Critique Table
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Organize your literature into a table to
compare and contrast different components
of the critique
Briefly describe each study in the paper
Should be 1 page/article
Detailed information in table should not be
repeated in body of Comprehensive Exam
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Appendix I: Quantitative Research Literature Review Table
Citation
Conceptual
Frame work
/Theory
Aims
Design &
Methodology
Sample &
Setting
Variables
Measuremen
t & Analysis
Findings
Author/s
name, title
of article
Year of
publication,
journal
The
theoretical
basis of the
study
What was
purpose of
the
study?
What were
the
hypotheses/
null
hypotheses
or
states
research
Indicate the
design and
briefly
describe the
procedures
used to
collect data.
n=?
Sample
demographi
cs
Recruitment
procedures?
Inclusion/Ex
clusions
criteria
Setting
selection?
What were
variables &
definitions?
Give
function of
variables
What scales
used to
measure
variables
What
statistical
tests were
used to
answer the
research
Question?
Key findings
from result
table c sig
values
34
Appendix II: Qualitative Research Literature Review Table
Citation
Theoretical
Framework
Design &
Methodology
Aims
Sample & Sampling
Analysis
Findings
Author/s
name, title
of article
Year of
publication,
journal
The
theoretical
basis of the
study
Study
design.
Data
sources
and datacollection
strategies
What was
purpose of
the
study?
How many participants
were there?
What were the
sample demographics
What was the sampling
approach?
Inclusion/Exclusions
criteria
How was the setting
selection?
How were
data
analyzed?
What
software
was
Used
(if any)
What were
the major
themes and
findings?
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Recommended Number of Articles
for Each Comprehensive Exam
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Research Proposal
4–
Critical Literature Review
5–
Problem-Solving Proposal
4–
White Paper
4–
5 articles
7 articles
5 articles
5 articles
36
The Comprehensive Exam
is Pass/Fail
 Total
points available – 330
 Points
needed to pass - 231
37
Quality of Writing
Area I applies to All Comps
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Content & Focus
Logic & Flow
Structure & organization
Sentence structure
APA format
Correct grammar, punctuation, word
usage, and spelling
Each category 5 points = 30 points
Score of 15 points or less is a technical fail
38
Research Proposal
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To evaluate a student’s ability to
identify a significant research question
relevant to nursing practice, and to
design a methodology for addressing
the question.
Study does not have to be
implemented
Must have access to UCSF faculty with
research experience to mentor you
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Research Proposal
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Good choice if you plan to build on
this topic for future research or
doctoral work
Could be taken back to your workplace
for implementation if approval given
by institution
40
Scoring Areas II - IV
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II: Study & its Context -70 points
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III: Conceptual Framework &
Literature Review -125 points
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IV: Methodology -105 points
41
Critical Literature Review
Choosing a Topic
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Pose a question
Do initial searching
There is enough research, but no clear
synthesis of findings or clear direction
You want to argue a point that has
some evidence, but is not established
practice
42
Critical Literature Review
Topic or Issue
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Clarity of topic or purpose
– State in 1 sentence!
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The purpose of this paper is to
examine the literature related to the
efficacy of using BNP to diagnose
patients with heart failure
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Literature Review
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Theoretical Discussion
Must address the foundation of your
question or problem
– Example: Sepsis and Early Goal Directed
Therapy (EGDT)
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Use Physiologic theory to explain why EGDT is
appropriate for septic patients
Use Change Theory if you want to implement EGDT in
a new setting that manages septic patients
44
Critical Literature Review
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Quality of References
– References significant to the problem
area – classic & current while noting gaps
in research literature if any
– Avoid multiple articles from the same
overall study (different purposes but
same sample, methodology,
statistics, etc.)
45
Critical Literature Review
– Meta-analyses and literature
review articles are discussed as
appropriate for background and
significance purposes.
– Articles critiqued in the Literature
Review section should be primary
sources.
46
Critical Literature Review
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Organization of review
Rationale for selected articles, describe how you
organized your paper
– The journal articles were chosen because they
include…….and the oldest is reviewed first….
5 – 7 articles recommended should be critiqued
Use well written AND perhaps not so well written
research articles – the heart of the critique process
is identifying why they may have similar study
questions and yet end up with different results
47
Literature Review Critique
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Synthesis and interpretation
– YOUR ASSESSMENT OF THE STUDIES
– Too small of a sample size to have power
to find a difference between those with
and without HF
– Authors were biased b/c they knew the
BNP level and may have changed
treatment
– Only generalizable to men
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Critical Literature Review
Identifies gaps in literature,
implications for practice,
need for further research
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STICK your neck out there! Make
your opinion known, however you
must base it on the critique of the
literature you presented rather
than your opinion.
49
Lit Review Scoring Areas
II - IV
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II: Topic or Issue – 50 points
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III: Literature Review - 150 points
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IV: Discussion & Application –
100 points
50
Problem-Solving Comp
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Purpose: To evaluate the student’s
ability to effectively communicate the
resolution of a problem in an area of
specialization.
Describes an identified need stemming
from a discrepancy between what is or
what could/should be.
51
Choosing a
Problem-Solving Topic
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Can be a problem on
an individual or a
systems level.
Must be appropriate
to the clinical
situation
– Think of a situation
that is challenging
to you
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Must be feasible!
Must be measurable!
52
Problem-Solving Cautions
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Instituting a delirium treatment
program in acute care setting
– Is delirium identified? Multiple etiologies . . .
what will the intervention be? How will you
measure this?
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Improving
parenting skills by identifying
temperament in toddlers in preschools
– What is meant by “parenting skills?” How will
you get access to preschools? Is there literature
that indicates that identifying temperament will
change parenting behavior?
53
The Problem and its
Environmental Context
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Clarity of the Problem
– Who is solving the problem
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APN
– Where the problem occurs
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ICU or community clinic
– What is to be accomplished
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Improve Nurses’ Knowledge
– Target population
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ICU Nurses or all PCPs at “X” clinic
54
The Problem and its
Environmental Context
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Significance of the Problem
– Importance of the problem to patients
or profession
Accurate Hemodynamic Monitoring is
essential for ICU patients
 Increase in Type II DM in obese children
must be addressed
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55
The Problem and its
Environmental Context
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Clarity of the Setting
– Home, hospital,
nursing home
– Community Health Clinic
– School Based Health Center
– Intensive Care Unit
56
The Problem and its
Environmental Context
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Clarity of Roles & Inter-relationships
– Describes functions of individuals sig to
problem, their roles and influence on the
setting
– ICU nurses, Clinical Nurse Specialist,
Head Nurse, APN,
Community Outreach
Workers
57
The Problem-Solving
Proposal Lit Review
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Quality of theoretical discussion
Quality of references
Addresses elements of critique
Quality of critique and interpretation
58
The Problem-Solving
Proposal Lit Review
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Quality of References:
– Reviews literature significant to the area,
including classic and current works, and
identifies gaps in the literature. Metaanalyses and literature review articles are
discussed as appropriate for background
and significance purposes.
Articles critiqued in the Literature Review
section should be primary sources.
59
The Problem-Solving Proposal
Intervention, Implementation,
and Evaluation
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Expected Outcomes
Clarity and Appropriateness of
Intervention Implementation
Clarity and Appropriateness of
Evaluation Procedure
Defensibility
Realism
60
The Problem-Solving Proposal
Intervention, Implementation,
and Evaluation
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Clarity of Expected Outcomes
– Improvement of Nurses Knowledge
evidenced by improvement on
post-test scores
61
The Problem-Solving Proposal
Intervention, Implementation,
and Evaluation
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Clarity and Appropriateness of
Implementation
– Outline procedures for implementing
the intervention and ensuring they
are appropriate
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Educational intervention was three-fold
– Self-study, then 4 hour mandatory class,
bedside guides developed
62
The Problem-Solving Proposal
Intervention, Implementation,
and Evaluation
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Clarity and Appropriateness of
Evaluation
– Delineates specific measurable and
appropriate evaluation criteria
Pretest and post-test measure of ICU nurses’
knowledge is measured
 Number of incident reports are analyzed
regarding monitoring
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63
The Problem-Solving Proposal
Intervention, Implementation,
and Evaluation
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Defensibility
– Demonstrates intervention has potential
for substantial improvement in the
problem

Realism
– Feasibility of intervention
– Will an educational intervention be
possible?
64
The Problem-Solving Proposal
Caveats
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Do not wait until the end to decide on
method of evaluation
When writing, do not always start with
the beginning of the paper and
progress to the end or your evaluation
will suffer.
65
The Problem-Solving Proposal
Scoring Areas II - IV
 II: Problem and Environmental
Context – 75 points
 III: Literature Review: Research,
Narrative, & Theory – 100 points
 IV: Intervention, Implementation,
and Evaluation – 125 points
66
White Paper
67
White Paper
Area
Content Criteria
I: Quality of Writing
Content & focus, logic & flow, structure &
organization, sentence structure, APA,
grammar
II: Introduction &
Background
Clarity of policy issue, significance of
issue/policy, importance to health
care/nursing, quality of evidence
III: Literature Review, Quality of theoretical discussion,. Quality of
Theoretical Framework, references, addresses elements of critique,
Summary of Research
quality of critique & interpretation
IV: Policy Solutions &
Recommendations
Implementation of solutions, feasibility &
cost analysis, evaluation framework,
summary & conclusion
Possible Score
(330)
30
*must score minimum
15
80
115
105
68
Most common reasons
why comps fail
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Started too late to put in necessary time
and effort
Did not meet with your advisor to obtain
feedback and make sure you are on track
Did not follow the advice of your advisor
Changed your comp topic at the last minute
Primary editor was someone whose English
composition skills were not adequate to give
you appropriate feedback on your writing
69
I PASSED!
70