NURS 8520: Syllabus 1 ST. CATHERINE UNIVERSITY DEPARTMENT OF NURSING DOCTOR OF NURSING PRACTICE PROGRAM NURS 8520: ADVANCED EVIDENCE-BASED PRACTICE Winter 2012 I. COURSE NUMBER NURS 8520 II. COURSE TITLE Advanced Evidence-Based Practice III. COURSE CREDITS 5 credits (Classroom: 4, Practicum: 1) IV. PLACEMENT IN CURRICULUM Level II Winter 2012 V. CLASS TIME Feb 3, March 2, April 13, May 4, 2012 5:00 - 9:00 pm Feb 4, March 3, April 14, May 5, 2012 9:00 am - 4:00 pm Weekly Online Discussions VI. PLACE Whitby Hall (Fridays-120B; Saturdays-10; Except 2/4) VII. COURSE FACULTY Rozina Bhimani, PhD, DNP, RN, CNP Office Phone: 651-690-8817 Office: G9C, Whitby Hall E-mail: rhbhimani@stkate.edu VIII. COURSE DESCRIPTION This course explores the nature of evidence as it relates to the discipline of nursing. Emphasizing critical appraisal of nursing research and research from other scientific disciplines as evidence, knowledge development activities address translation of research in practice, the evaluation of practice, and activities aimed at improving the reliability of healthcare practice and outcomes for individuals and populations. The integration of knowledge and evidence from diverse sources and across disciplines is used to evaluate practice patterns against national benchmarks to determine variances in outcomes and explore alternative solutions surrounding clinical problems to improve healthcare outcomes. Prerequisites: NURS 8500, 8510 or instructor permission. IX. COURSE OBJECTIVES (with related Department of Nursing curricular threads, “Liberal Arts Goals,” and DNP Essentials [please see Appendix A]) Upon completion of this course, you will: 1. Use evidence as it relates to advanced nursing practice and the elimination of disparities. (Phenomena of Nursing; “Discipline based Competence,” Essential I) DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 2 2. Use analytical methods to critically appraise existing research, practice guidelines, and other evidence to determine and implement the best practice. (Critical thinking; “Critical and Creative Inquiry,” Essential I) 3. Function as a practice specialist in leading the evaluation of evidence to determine and implement the best practice. (Role, “Ethics and Social Justice” Essentials I, II, III, IV, V, VI, VII, VIII) 4. Evaluate practice patterns to determine variances in outcomes. (Systems, “Leadership and Collaboration, Diversity and Global Perspectives” Essentials III, V, VII) 5. Apply relevant findings/evidence from research to develop practice guidelines and improve practice and practice environments. (Therapeutic Interventions, “Effective Communication in a Variety of Modes,” Essential III) 6. Disseminate findings from evidence-based practice to improve outcomes. (Communications, “Ethics and Social Justice,” Essentials III, VI, VII) X. TEACHING-LEARNING ACTIVITIES/ENVIRONMENT Teaching-learning activities in NURS 8520 include (a) discussion-based lectures (b) project groups to evaluate and apply readings, (c) individual and/or group presentations, (d) testing, (e) written assignments, (f) online activities and (g) other collaborative learning activities. The andragogical, feminist, and critical transformative philosophies underlying the learning activities in this doctoral-level course include: Collaborative learning: Learning is mutual and nonhierarchical among students and faculty. Community of learners: Learning is accomplished with a cooperative spirit among students and faculty. Collegial learning: Learning is respectful and noncompetitive within the community of learners. Colearning: Learning extends outside the community of learners in the course to peers in the clinical and academic settings. Liberatory learning: Learning opens up new avenues for leadership to address inequalities and create a more just world. In this course, like all DNP courses, the primary difference between faculty and students is the faculty’s responsibility for developing the course description, objectives, topical outline, and readings. This responsibility stems from the faculty’s accountability for assuring that students in the DNP Program achieve the DNP competencies required at the completion of the program. FACULTY EXPECTATIONS As faculty members, our responsibility is to ensure that you receive the best possible education and learning experiences. Therefore to offer you the best educational experiences, students can expect from faculty members that we… Appreciate the diversity of our campus and respect the rights of each member. Show human concern for each of those with whom we work and study while presenting a positive attitude and professional demeanor. Be on time for class and return from scheduled breaks. Respond to e-mail messages and voice mail messages within 24-48 hours, except on weekends and holidays. Treat the students with courtesy. Refrain from any behaviors that may distract others. Minimize distraction and interruptions. This includes limiting private conversations, and keeping phones and pagers in a vibrate mode. DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 3 Understand that this class is a dynamic one, where disagreements may occur. Respect diverse opinions and listen politely when others are speaking. Give everyone a chance to contribute and value hearing all voices. Come prepared for the class and having thought about how the day's teaching-learning will unfold. STUDENT EXPECTATIONS To create an optimal respectful learning environment for everyone, your faculty members expect you to… Appreciate the diversity of our campus and respect the rights of each member. Show human concern for each of those with whom you work and study while presenting a positive attitude and professional demeanor. Be on time for class and return from scheduled breaks. Treat the faculty members and fellow students with courtesy. Refrain from any behaviors that may distract others. Minimize distraction and interruptions. This includes limiting private conversations, and keeping phones and pagers in a vibrate mode. Understand that this class is a dynamic one, where disagreements may occur. Respect diverse opinions and listen politely when others are speaking. Give everyone a chance to contribute and value hearing all voices. Accept the challenge of doctorate level studying, thinking, and learning. Anticipate that the level and quantity of work in this course may exceed your prior experiences. Come to class prepared, having read the assignment beforehand and having thought about how you can participate in that day's discussion. XI. COURSE/TOPICAL OUTLINE Please note. Our course outline may be revised to address particular areas of interest related to this course. Potential revisions will be discussed in class prior to making any changes. Class content may also be modified during class sessions based upon learning needs and interests of course participants. The topical outline for this course will address the following content areas: Session Topic Readings & Assignments*1 1 Understanding Research as Evidence as it Readings: Melnyk (2004): Chapters 5, 6, 10 relates to Advance Practice (Friday and 11 5 p.m-9 p.m.) Students/Faculty Introductions; Syllabus/Course Overview Melnyk (2010): Chapters 5, 6, 17, Assignments Review (5-6:30 pm) and 18 Zaccagnini: Chapters 3 Break (6:30 pm-7:15 pm) (recommended) Pavlish: Chapter 1 and 2 Online Assignments (7:15-7:45 pm) Assignments: Please complete the assigned readings prior to the IRB Overview (7:45-8:45 pm) class. 1 All readings are available online. Use the library’s Journals A-Z to locate the journal and article. DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus Session 1 (Saturday 9am-4 pm) 4 Topic Wrap-up (8:45-9:00 pm) Understanding Research as Evidence as it relates to Advance Practice Readings & Assignments*1 Assignments: Please complete thee assigned readings prior to the class. Check-in, Questions, Discussion (9-9:30 am) Readings: Review of Research Concepts I (9:30-10:30 am) Break: (10:30-10:50 am) Review of Research Concepts II (10:50 12:00 pm) Lunch: (12-12:45 pm) Review of Statistics Concepts in ResearchDr. Bhimani (12:45-2:00 pm) Break (2:00-2:20 pm) Review of Research Critique: Systematic Reviews and Meta-Analysis- Dr. Bhimani (2:20-2:45 pm) Williamson, G. R (2003). Misrepresenting random sampling? A systematic review of research papers. Journal of Advanced Nursing, 44 (3), 278-288. (In-class activity article): Tanabe, P., Ferket, K., Thomas, R., Paice, J., & Marcantonio, R. (2002). The effect of standard care, ibuprofen, and distraction on pain relief and patient satisfaction in children with musculoskeletal trauma. Journal of Emergency Nursing, 28 (2), 118-125. Critique of an article: Small Group Discussions (2:45-3:15 pm) Back to Large Group-Presentation from small groups, 10 minutes each (3:15-3:45 pm) 2 (Friday 5-9 pm) Wrap-up, next class expectations (3:45-4:00 pm) Introduction to Evidence-Based Practice (EBP) Faculty-Topic Introduction (5-5:15 pm) Introduction to Community Based Collaborative Action Research (Dr. Margaret Pharris-(5:15-6:30 pm) Break: (6:30 pm-7:15 pm) Introduction to EBP- Dr. Bhimani What is EBP, Myths, Ethical Considerations, Barriers to EBP, Determination of EBP (Ways of knowing)-(7:15-8:45 pm) DNP Program St. Catherine University: Department of Nursing Readings: DiCenso: Chapters 1, and 2. Melnyk (2004): Chapters 1, 2, 3. Melnyk (2010): Chapters 1, 2, 3. Pavlish: Chapter 3, 4, and 5. Sackett, D.L., Rosenberg, W.M., Gray. J.A., Haynes, R.B., & Richardson, W.S. (1996). What evidence-based medicine is and isn’t. British Medical Journal, 312, 71-72 Girard, NJ. (2008). Practice-based Evidence. AORN, 87 (1), 15-16. NURS 8520: Syllabus 5 Session Topic Wrap-up: (8:45-9:00pm) Readings & Assignments*1 Lavin, M.A., Meyer, G., Krieger, M., McNary, P., Carlson, J., Perry, A., James, D, & Civitan, T. (2002). Essential differences between evidence-based nursing and evidence-based medicine. International Journal of Nursing Terminologies and Classifications, 13(3), 101-106. Zander, PE. (2007). Ways of knowing in nursing: The historical evolution of a concept. The Journal of Theory Construction & Testing, 11 (1), 7-11. Westfall, JM, Mold, J, & Fagen, L. (2007). Practice-based research: Blue Highways on the NIH Roadmap. JAMA, 297, 403-406. 2 (Saturday 9-4 pm) Introduction to Evidence-Based Practice (EBP) Check-in, Questions, Discussion (9-9:30 am) Readings: Melnyk (2004): Chapter 6 Melnyk (2010): Chapter 6 DiCenso: Chapters 8, 9 Pavlish: Chapter 6 Asking the Clinical Question: How to generate PICO question (9:30-10:00 am) Think-Pair-Share: Student Activity (10:0010:30 am) Break: (10:30-10:50 am) Finding the Evidence- Dr. Bhimani (Review of Matrix Method, Use of Agree Instrument) (10:50-12:00 pm) Assignments: Student Presentations-Total time 30 minutes (Content Presentation 15-20 minutes, Q&A 10 minutes) (In-class activity articles): Group 1- (Dr. Edinger, Janice, Kristin, Sue Irle) Lunch: (12:00 pm-12:45pm) Large Group-(1:30-2:15pm) Deborah Al-Shaer, D., Pamela D. Hill, P. D., & Anderson, M. A. (2011). Nurses’ Knowledge and Attitudes Regarding Pain Assessment and Intervention. MEDSURG Nursing, 20 (1), 7-11. Break (2:15-2:35 pm) Group 2- (Natalie, Kathleen V, Jane): Appraising Qualitative Research (Melnyk Matthews, E., & Malcolm, C. Use of Matrix-Small Group Activity (12:451:30 pm) DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus Session 6 Topic Chapter 6, DiCenso Chapter 8)- Kristin Schams -(2:40-3:10pm) Appraising Systematic Reviews (DiCenso, Chapter 9)-Meghann Pierce -(3:15-3:45pm) Wrap-up, next class expectations (3:45-4:00 pm) Readings & Assignments*1 (2007). Nurses' knowledge and attitudes in pain management practice. British Journal of Nursing, 16 (3), 174-179. Group 3- (Darcy, Kathleen T, Maureen): McMillan, S. C., Tittle, M., Susan J. Hagan, S. J., & Small, B. J. (2005). Training Pain Resource Nurses: Changes in Their Knowledge and Attitudes. Oncology Nursing Forum, 32 (4), 835-842. Group 4- (Renee, Ann, Meghan): Naser, E., Sinwan, S., & B. (2005). Nurses’ Knowledge on Pain Mangement. Singapore Nursing Journal, 32 (2), 29-36. Group 5- (Susan, Donna, Laurel): Wilson, B., & McSherry, W. (2005). A study of nurses’ inferences of patients’ physical pain. Journal of Clinical Nursing, 15, 459-468. 3 (Friday 5-9 pm) Critically Appraising the Evidence Faculty-Topic Introduction (5-5:15 pm) Health Care Interventions (DiCenso-Chapter 4)-Maureen Quick (5:15-5:45 pm) Harm (Dicenso-Chapter 5)-Ann Sullivan (5:45-6:15 pm) Dinner Dialogue with Student Panel about EBP and Practice Patterns- Integrating the evidence, evaluate practice change (Break6:20-7:40 pm) Diagnosis (DiCenso, Chapter 6)- Janice James -(7:45- 8:15 pm) Prognosis (DiCenso, Chapter 7)- Laurel Chelstrom -(8:15-8:45) Wrap-up: (8:45-9:00pm) DNP Program St. Catherine University: Department of Nursing Readings: DiCenso: Chapters 4, 5, 6, 7 Melnyk (2004): Chapter 9, 11 Melnyk (2010): Chapter 9, 18 Pavlish: 7, 8, and 9 Assignments: Student Presentations-Total time 30 minutes (Content Presentation 15-20 minutes, Q&A 10 minutes) Rycroft-Malone, J., Seers, K., Titchen, A., Harvey, G., Kitson, A., & McCormack, B. (2003). What counts as evidence in evidence-based practice? Journal of Advanced Nursing, 47 (1), 81–90. NURS 8520: Syllabus Session 3 (Saturday 9-4 pm) 7 Topic Critically Appraising the Evidence Check-in, Questions, Discussion (9-9:30 am) Readings & Assignments*1 Readings: DiCenso: Chapters 9, 10, and 11 Melnyk(2004): Chapter 7, 9, 15 Melnyk(2010): Chapter 7, 8, 13 Introduction to National Guidelines, Expert Opinions- Dr. Bhimani (9:30-10:15 am) Patient Choices in EBP (Melnyk, Chapter 7)Kathleen Valusek - (10:15-10:45 pm) Break: (10:45-11:05 am) Assignments: Student Presentations-Total time 30 minutes (Content Presentation 15-20 minutes, Q&A 10 minutes) Using Models and Strategies for EBP (Melnyk, (In-class activity articles): Chapter 9/Melnyk, Chapter 8)-Ranking the Evidence-Qualitative/Quantitative- Dr. Bhimani Group 1- (Dr. Edinger, Janice, Kristin, Sue Irle) (11:10-12:20 pm). Lunch: 12:20 -1 pm CBCAR- (Pavlish-Chapter 7)-Helen Jane Peterson- (1:00-1:30 pm) Teaching EBP in Academic Settings (Melnyk Chapter 13/ Melnyk Chapter 15)-Kathleen Tilton- (1:30-2:00 pm) Break-(2:00-2:20 pm) Critique of Reviews-Group Activity-(2:202:50 pm) Moving from Action to Practice (DiCenso, Chapter 10)- Donna Lupien (2:50-3:20 pm) Changing Nursing Practice in an Organization (DiCenso, Chapter 11)-Sue Irle (3:20-3:50 pm) Wrap-up, next class expectations -(3:504:00pm) Morgan, B., D., & White, D., M. (2009). Managing Pain in Patients with Co-Occurring Addictive Disorders. Journal of Addictions Nursing, 20, 41–48. Group 2- (Natalie, Kathleen V, Jane) Zhou, H., Roberts, P., & Horgan, L. (2008). Association between selfreport pain ratings of child and parent, child and nurse and parent and nurse dyads: metaanalysis. Journal of Advanced Nursing, 63 (4): 334-42. Group 3- (Darcy, Kathleen T, Maureen) Sim, J., & Madden, S. (2008). Illness experience in fibromyalgia syndrome: A metasynthesis of qualitative studies. Social Science & Medicine 67, 57–67. Group 4- (Renee, Ann, Meghan) Walker, B. F., French, S. D., William Grant, W., & Green, S. (2011). A Cochrane Review of Combined Chiropractic Interventions for Low-Back Pain. Spine, 36 (3), 230–242. Group 5- (Susan, Donna, Laurel) Courtenay, M., & Carey, N. (2008). DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 8 Session Topic Readings & Assignments*1 The impact and effectiveness of nurse-led care in the management of acute and chronic pain: a review of the literature. Journal of Clinical Nursing 17, 2001–2013. 4 (Friday 5-9 pm) Integrating All Evidence to Make Practice Change Decisions Faculty-Topic Introduction (5-5:15 pm) Readings: Melnyk (2004): Chapter 13, 14 Melnyk (2010): Chapter 16, 19 Pavlish: Chapter 10 Grant Writing-Guest Speaker (5:15-6:30 pm) Break-(6:30-7:15 pm) Basics of Focus Group: Case Study-Small Group (7:15-8:15 pm). Case Study-Large Group (8:15-8:45 pm). 4 (Saturday 9-4 pm) Wrap-up: (8:45-9:00 pm) Disseminate findings from evidence-based practice to improve outcomes Final Student Presentations Check-in, Questions, Discussion (9-9:20 am) 1. Meghann (9:20-9:40 am) 2. Jane (9:40-10:00 am) 3. Sue Irle (10:00-10:20 am) 4. Laurel C (10:20-10:40 am) Break: 10:40-11:00 am 5. Kristin (11:00-11:20 am) 6. Kathy Valusek (11:20-11:40 am) 7. Kathleen Tilton (11:40-12:00 pm) 8. Jan (12:00-12:20 pm) Lunch: 12:20-1:00 pm 9. Donna (1:00-1:20 pm) 10. Ann (1:20-1:40 pm) 11. Maureen (1:40-2:00 pm) 12. Group 1 Susan (2:00-2:20 pm) Break: 2:20-2:40 pm 13. 14. 15. 16. Group 2 Natalie (2:40-3:00 pm) Group 3 Renee (3:00-3:20 pm) Group 4 Darcy (3:20-3:40 pm) Group 5 Dr. Edinger (3:40-4:00 pm) DNP Program St. Catherine University: Department of Nursing Assignments: Student Presentations-Total time 30 minutes (Content Presentation 15-20 minutes, Q&A 10 minutes) Student Presentations-Total time 20 minutes (Content Presentation 10 minutes, Q&A 10 minutes) NURS 8520: Syllabus 9 Session Readings & Assignments*1 Topic Wrap-up and final comments Please note. The topical outline may be revised to address emergent issues and/or particular areas of interest related to the underpinnings of the discipline of nursing. Potential revisions will be posted on the D2L course site. Class content may also be modified during class sessions based upon learning needs of course participants and considerations related to course objectives. Practicum requirements: Please maintain a log of your non-class practicum hour requirements. Specifically for this class, record time includes but is not limited to collecting, reviewing and analyzing literature for your project; discussions regarding the literature with classmates and other professionals; and writing for the project. XII. COURSE ASSIGNMENTS AND GRADING Assignments, assigned points, and due dates will be reviewed, revised, and/or developed by students and faculty during our first class session (please see Appendix D for Assignment Outlines). Name of Assignment Points Seminar facilitation/participation 10 points (objectives 1-3) Weekly four Online 20 points (5 Discussions(objective 2) points each) CITI-Human Subject Training S/U Certificate (objective 2) Written Assignment-Review of the 20 points Literature(objectives 1-2) Written Assignment-Integrating Multiple 20 points Sources of Evidence(objectives 3-4) Seminar presentation-Practice 30 points Change Decision (objectives 5-6) Practicum Assignments Systems Change Project Practicum (1-6) 100 points % 10 % Due Date As Assigned 20% S/U Ongoing-End of Semester 2/13/12 20% 3/11/12 20% 5/4/12 30 % 5/5/12 S/U 100% S/U Assignments: Students are responsible for completing all course assignments and learning activities. Course assignments are due at the beginning of class (5 PM) on the scheduled due date. Please submit written assignments by using the Drop Box in our D2L course site. Assignments and papers will be returned via the Drop Box in our D2L course site. Late assignments will not be accepted unless you notify Dr. Bhimani by e-mail (rhbhimani@stkate.edu) or voice mail (651.690.8817) prior to when the assignment is due. Thank you! Grading Policy: NURS 8520 must be taken for a grade and must be satisfactorily completed with a minimum grade of B (87% of the total possible points). A minimum grade of C- (75% of total possible points) must also be achieved for each course assignment. Assignments may be resubmitted once DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 10 if not completed satisfactorily the first time. Resubmitted assignments receive a maximum of 75% of total possible points for that assignment. If you have questions about how to complete a particular assignment, please contact Dr. Bhimani. Grading Scale: The grading scale for NURS 8520 is as follows: A 96 and over B 87-89 C 78-80 A- 93-95 B- 84-86 C- 75-77 B+ 90-92 C+ 81-83 D+ 72-74 XIII. D 69-71 D- 65-68 F 64 or below COURSE POLICIES Please note. Additional policies related to this course are located in the student policies for the Doctor of Nursing Practice Program, located in the online Nursing Student Handbook. Academic Integrity: Please refer to the “Academic Integrity Policy” in the Graduate Academic Catalog. Accommodations: If you have a documented disability and believe you would benefit from accommodations, please contact the Disabilities Coordinator in the O’Neill Center for Academic Development (651.690.6563) to ensure that appropriate accommodations are implemented in a timely manner. Please refer to the student policy in LeGuide: “Services for Students with Disabilities.” Attendance: The most significant learning activity is attendance and active participation in all class sessions. Taking initiative in learning is a hallmark of advanced nursing practice. This requires preparation for all class sessions, the belief that you have a unique and valuable perspective to offer to class discussions, and the willingness to enter into to our class discussions. Therefore, attendance and active participation and engagement in class discussions and learning activities will be noted. Please e-mail or call Dr. Bhimani prior to class if you will be absent (rhbhimani@stkate.edu or 651.690.8817). Failure to attend class sessions results in implementation of the Performance Issue Algorithm/Guided Improvement Plan described in the Name of Program Student Policies: Doctor of Nursing Practice Student Polices 2012. Since St. Catherine University is committed to the healthy well-being of our community, we support The Centers for Disease Control and Prevention’s recommendations related to communicable diseases that could be transferred during class activities. In the event that students are unable to attend classes due to self-isolation recommendations, they should notify their professors of their absence and arrange alternative activities. Course Communication: Please check your St. Kate’s e-mail for messages and updates related to the course frequently (at least every 2-3 days). Faculty will respond to e-mail messages and voice mail messages within 24-48 hours, except on weekends and holidays. You are encouraged to discuss optimal means of communication with course faculty. Grades will be posted in the online grade book on the D2L site. Evaluation: Evaluation is an essential component of this course. Informal and formal evaluations will be conducted during the course and evaluative data will be used by faculty to improve the course and ensure that learning is being facilitated through teaching-learning activities and course DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 11 assignments. Online course and faculty evaluations are completed at the end of this course. Information about how to complete these online evaluations will be sent by the Department of Nursing staff, usually during the final week of the term or before the final class session. Please note. Final course evaluations are confidential, only the Department of Nursing staff have access to individual responses; only aggregated data are reported to faculty. Inclusivity:2 Nurses are called to promote human dignity. In order to be aware of the ever changing environment in nursing and health care, an open dialogue must be able to occur in a nonthreatening environment in which students and faculty can engage in discussions that are taking place, challenge comments that are made, and evaluate aspects of the structural environment that support injustice. Bringing attention to expressions of cultural bias is a way to model against stereotyping. At any time, a moment of consideration can be called. This can and should be called by anyone, student or faculty, in order to facilitate needed conversation around sensitive issues. These moments are times for all of us to learn how to become more sensitive in our language and actions. Such dialogues may pertain to stereotypes related to “race,” sex, religion, gender identity, sexual preference, weight, economic status, and anything that can impact the dignity of persons, including equitable treatment of patients and students. These moments of consideration should be freely addressed in the classroom and are an essential aspect of learning in this course. XIV. PROFESSIONAL STANDARDS, WRITING AND TECHNOLOGY REQUIREMENTS Professional Standards: Faculty in the Department of Nursing use professional nursing standards in the development, implementation, and evaluation of curricula. Professional standards are also used by nursing faculty to promote and evaluate student learning. In the Doctor of Nursing Practice Program, professional standards include: Code of Ethics for Nurses with Interpretive Statements (ANA, 2001) Core Competencies of Nurse Educators (NLN, 2005) The Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006) International Council of Nurses Code of Ethics for Nurses (ICN, 2006 [All]) NLNAC Accreditation Standards and Criteria: Clinical Doctorate (NLNAC, 2008) NONPF Practice Doctorate Nurse Practitioner Entry-Level Competencies (NONPF, 2006) Nursing: Scope and Standards of Practice (ANA, 2010) Nursing’s Social Policy Statement: The Essence of the Profession, 2nd Edition (ANA, 2010) Writing and Technology Requirements: Access to broadband internet is required for this course. The ability to write, use technology, and communicate effectively is essential in advanced nursing roles. Professional nursing standards and competencies for advanced nursing practice specifically address these skills. Courses in the Doctor of Nursing Practice Program in Nursing are designed to provide opportunities for you to learn and develop writing abilities and skills in using technology. In NURS 8520, written assignments will be evaluated by faculty for (a) the logical flow of ideas and organization of content; (b) spelling, grammar, and punctuation; and (c) the use of American Psychological Association style (APA, 2010). If specific concerns are identified, you will be encouraged to seek assistance with your professional writing skills, including the use of APA style. 2 This statement is based on a statement written by NURS 6790 student, Maria Kludt (Spring 2009). DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 12 Congruence with University Mission: NURS 8520 advances the “Goals of a Liberal Arts Education” at St. Catherine University by challenging you to develop evidence based practice skills and function as a practice specialist in leading the evaluation of evidence to determine and implement the best practice using a social justice framework to your systems change project. Each of the “Goals of a Liberal Arts Education” is related to one or more of the course objectives and consistent with the teaching and learning activities used in this course. XV. TEXTBOOKS AND COURSE MATERIALS Required Textbooks: American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author. DiCenso, A., Guyatt, G., & Ciliska, D. (2005). Evidenced-based practice. St. Louis, MO: Elsevier Mosby. Melnyk, B., & Fineout-Overholt, E. (2004). Evidence-based practice in nursing and health care: A guide to best practice. Philadelphia: Lippincott Williams & Williams. OR Melnyk, B., & Fineout-Overholt, E. (2010). Evidence-based practice in nursing and health care: A guide to best practice. Philadelphia: Lippincott Williams & Williams. Pavlish, C., & Pharris, M. (2011). Community-Based Collaborative Action Research: A Nursing Approach. Jones & Bartlett Learning Required Articles: As assigned in the weekly assignments. Recommended Texts and Articles: American Nurses Association. (2010). Code of ethics for nurses with interpretive statements. Washington, DC: Author. American Nurses Association. (2010). Nursing’s social policy statement: The essence of the profession. Washington, DC: Author. American Nurses Association. (2010). Nursing: Scope and standards of practice, 2nd edition. Washington, DC: Author. Conn, Y., Isaramalai, S., Rath, S., Jantarakupt, P., Wadhawan, R., & Dash, Y. (2003). Beyond MEDLINE for literature searches. Journal of Nursing Scholarship, 35(2), 177-182. Malloch, K., & Porter-O’Grady, T. (2006). Introduction to evidence-based practice in nursing and health care. Boston: Jones & Bartlett Publishers. DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 13 Whittenmore, R. (2005). Analysis of integration in nursing science and practice. Journal of Nursing Scholarship, 37(3). 261-267. Whittenmore, R. (2005). Combining evidence in nursing research. Nursing Research, 54(1), 5662. Whittenmore, R., & Knafl, K. (2005). The integrative review: Update methodology. Journal of Advanced Nursing, 52(5), 546-553. Zaccagnini, M., & White, K. (2010). The doctor of nursing practice essentials. Boston,MA: Jones and Bartlett. XVI. LEARNING RESOURCES Agency for Health Care Research and Quality http://www.ahcpr.gov/ The Center for Chronic Disease Outcomes Research http://www.hsrd.minneapolis.med.va.gov/ CINAHL http://web.ebscohost.com/ehost/search?hid=119&sid=efa4fb41-9797-450a-9deb83040aa28fd4%40sessionmgr102 Cochrane Library http://www.mrw.interscience.wiley.com/cochrane/cochrane_search_fs.html Geriatric Research Education and Clinical Centers (GRECCs) http://www1.va.gov/grecc/ Health Services Research & Development Service http://www.hsrd.research.va.gov/ MNCAT Twin Cities http://saturn.oit.umn.edu/F/?func=file&file_name=find-b&local_base=tcmncat Minnesota Department of Health http://www.health.state.mn.us/ National Center for Health Statistics http://www.cdc.gov/nchs/ PubMed http://www.ncbi.nlm.nih.gov/entrez/query.fcgi References: American Association of Colleges of Nursing. (2010). Doctor of Nursing Practice. Retrieved from http://www.aacn.nche.edu/DNP/index.htm The Purdue online Writing Lab: APA Formatting and Style Guide (2012). Retrieved from http://owl.english.purdue.edu/owl/resource/560/01/ DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 14 SYLLABUS APPENDIX A UNIVERSITY LIBERAL ARTS GOALS AND DNP ESSENTIALS St. Catherine University Liberal Arts Goals: Leadership and Collaboration: The ability to lead and influence for ethical and responsible action and for systemic change; the ability to work well with others, especially in joint intellectual effort. Ethics and Social Justice: The ability to apply ethical standards to judge individual and collective actions; the development of attitudes and behaviors that reflect integrity, honesty, compassion, and justice in one’s personal and professional life. Diversity and Global Perspectives: The ability to understand and analyze the impact of diversity and systems of power and privilege on the individual and society; the ability to decipher and honor multiple and global perspectives in creating mutual understanding; the ability to imagine and take action towards justice. Critical and Creative Inquiry: The ability to gather, analyze and critically evaluate information to develop reasonable arguments, sound judgments, and effective solutions. This ability is founded on a broad knowledge of the achievements of human creativity and of the variety of disciplinary approaches for exploring truths. Discipline-Based Competence: The ability to demonstrate in-depth knowledge, values and skills in at least one major field of study and to relate disciplinary approaches to those of other fields. Effective Communication in a Variety of Modes: The ability to read, write, speak and listen effectively; the ability to present information in a clear and engaging manner. Purposeful Life-long Learning: The ability to continue personal and professional development based on ongoing self-assessment, feedback from others, and new learning. The Essentials of Doctoral Education for Advanced Nursing Practice (DNP Essentials): Essential I. Scientific Underpinnings for Practice Essential II. Organizational and Systems Leadership for Quality Improvement and Systems Thinking Essential III. Clinical Scholarship and Analytical Methods for Evidence-Based Practice Essential IV. Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care Essential V. Health Care Policy for Advocacy in Health Care Essential VI. Interprofessional Collaboration for Improving Patient and Population Health Outcomes Essential VII. Clinical Prevention and Population Health for Improving the Nation’s Health Essential VIII. Advanced Nursing Practice DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 15 APPENDIX B NURS 8520: Advanced Evidence-Based Practice Practicum Component (1 credit) This assignment is for the practicum component of this course, NURS 8520, and relates to the development of the systems change project. This component is 1 practicum credit (60 practicum hours) and is evaluated by the faculty project advisor as “Satisfactory” or “Unsatisfactory.” This practicum component must be successfully completed to fulfill course requirements and pass this course. Purpose The purpose of the practicum component in NURS 8520 is to continue work on the systems change project, with an emphasis on accessing and analyzing the evidence available on the topic and synthesizing this evidence in the literature review. Student Responsibilities Student responsibilities for the practicum component in NURS 8520 include the following: 1. Conduct a systematic review of the evidence regarding the topic of the systems change project. 2. Synthesize knowledge gained in NURS 8520 to access and analyze the evidence related to the topic of the systems change project, synthesizing this evidence in the literature review. 3. Prepare and present the preliminary project presentation, integrating feedback from this presentation into the systems change project. For accreditation purposes, the student is required to spend a minimum of 60 total hours on the systems change project which comprises the NURS 8520 clinical practicum component. For accountability purposes, each student will document these practicum hours using the Clinical Practicum Documentation Form (please see form in project handbook). Faculty Advisor Responsibilities Faculty responsibilities for the practicum component in NURS 8520 include the following: 1. Submit a “Satisfactory” or “Unsatisfactory” grade for the practicum component based on the student’s completion of the “Student Responsibilities” identified for the practicum. DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 16 APPENDIX C ST. CATHERINE UNIVERSITY DEPARTMENT OF NURSING CLINICAL/PRACTICUM DOCUMENTATION FORM Please use this form to document your clinical and/or practicum experiences included in your graduate coursework. Clinical is defined by the Department of Nursing as: Faculty and/or preceptor-directed learning experiences in clinical and/or community agencies and settings. Practicum is defined as application of classroom learning in student practice setting with no direct (onsite) faculty or preceptor supervision. If you have questions about how to complete this form, please contact your course faculty/faculty project advisor. Thank you! Date Term/Year Course Number and Title Practice Site Preceptor/ Mentora Faculty Evaluator Description of Clinical/Practicum Experienceb C P Total Hours Please note. aPlease include credentials of preceptor/mentor. bPlease to indicate if experience is clinical (C) or practicum (P). Provide additional comments about clinical/practicum experience on back of form. DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 17 APPENDIX D ASSIGNMENT OUTLINES Student Facilitation/Participation Expectations Purpose: The purpose of the student presentation/discussion is for you to maximize your leadership skills in helping to foster dialogue with your peers contributing to collaborative learning. Due Date: As Assigned Directions: Information must be presented concisely, highlighting key areas. Presentations should show depth of thought weaving-in elements from your reading, other literature, and your project experiences. Guiding classroom dialogue should facilitate provocative questions and discussion contributing/responding to the thoughts of your peers. Activity must be completed in total of 30 minutes, with approximately 15-20 minutes spent on content and 10-15 minutes on Q&A and wrap-up. Grading Criteria Dimension Points Description of the content 3 Connections to Clinical Question Dialogue and facilitation 3 Timeliness 1 TOTAL 10 DNP Program St. Catherine University: Department of Nursing 3 Criteria A complete, succinct, objective, and accurate description of the issue is presented Logical connection to personal Clinical Question is outlined clearly Dialogue is interactive and facilitates discussion with peers Activity completed in a timely manner without feeling of haste/rush. NURS 8520: Syllabus 18 Online Discussions Purpose: The purpose of the online discussions is to apply evidence based concepts to maximize your learning and to foster dialogue with your peers contributing to collaborative exchange of ideas. Due Date: Participation Requirements and Timeline- See D2L course site. Directions: Students will be assigned to different groups. Weekly questions will be posted by the instructors. Each student will be graded on these weekly questions, (four questions randomly, 5 points/question each; total 20 points). Students are required to initially post their response and respond to at least one other peer’s comments in their assigned group in a timely manner as applicable. Grading Criteria: Online Discussion Forum Participation 100% 75% 50% 0% Posted initial comments to the D2L site on the due date/time (by discussion topic initial comment due date). Posted initial comments within 48 hours (2 days) of the discussion topic initial comment due date. Posted initial comments within 49-96 hours (2-4 days) of the discussion topic initial comment due date. No initial comment posting within 96 hours (4 days) of the discussion topic initial comment due date. Posted responses to the D2L site on the due date/time. Posted responses to others within 49-96 hours (2-4 days) of the discussion topic initial response due date. Posted responses to others within 97-144 hours (4-6 days) of the discussion topic initial response due date. No responses posted within 144 hours (6 days) of the discussion topic initial response due date. Character/ Quality-2pts Character of postings demonstrates synthesis, analysis, and integration of ideas from readings and other students’ discussion postings as related to the discussion topic. Interaction builds on ideas of other members and/or points out strengths, weaknesses of arguments. Character of postings indicated understand of readings, but does not demonstrate adequate synthesis analysis or integration of ideas. Character of postings is limited, does not demonstrate integration of course materials and/or contributes minimally to the discussion. No postings within the discussion period. Quantity-1pt Met minimum number of responses per forum directions. (e.g., one initial comment and ONE quality responses to other students’ postings). Less than minimum number of responses per forum directions. (e.g., one initial comment and ONE LATE quality responses to other students’ postings). Posted initial comment but no quality responses to other students’ postings. No postings within the discussion period. Timeliness Part 1-1 pt. (Initial Comments) Timeliness Part 2-1pt (Response to Others) DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 19 NIH-Human Subject Training Certificate Assignment Purpose: This assignment focuses on understanding ethical behaviors when engaging in basic and applied research with human subject. Due Date: 2/13/12-5 pm Directions: 1. The url that links you to the human subjects training program that we recommend to students: http://phrp.nihtraining.com/users/login.php 2. Create your account, indication organization affiliation with College/University. 3. Complete Basic Research training modules. 4. Once completed, take a test as indicated. 5. Once you pass the training, you will be given your scores and training certificate, please save it for your record and provide a copy to the faculty via assignment drop box. DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 20 Written Assignment-Literature Review Purpose: This assignment provide students with an opportunity to write an evidence-based scholarly paper that addresses a clinical practical problem aimed at improving the reliability of healthcare practice and outcomes for individuals and populations. The scholarly paper should be approximately 8-10 pages in length with APA format (excluding title page, abstract and reference pages). Due Date(s): 3/11/12-5pm Directions: Title Page: Per APA Format Abstract - The abstract is a short (150 word) summary of the scholarly paper. It should include: title of the paper, statement of the research question, identification of the research literature search parameters, brief statement of the answer to the question based on the analysis and synthesis of the literature and implications for clinical practice. The abstract should be typed on a separate page. Provide exact word count at bottom of abstract page. Significance of the Problem/Topic Identify the clinical topic and provide background about the importance and scope of the problem. For clinical problems: Explain why this topic is relevant to patients/families/communities and to nursing profession. Perhaps controversy exists regarding the use of an intervention and this has been reported widely in the media creating uncertainty among health care consumers. Does the problem have practically important consequences? Statement of the Clinical/PICO Question Identify a focused question that is derived from clinical practice or from a nursing perspective. Appropriate clinical questions are formulated in terms PICO format. Database Search/Articles selected Describe the search strategies, search parameters (e.g., literature search limited to the last five years and English language journals only), and the sources used to collect the evidence to answer the question. Indicate publication types used to constrain the search (e.g., clinical trials, cohort studies, meta-analyses) and identify keywords used for searching. It is expected that students will use computerized data bases and will conduct a literature search within nursing and related fields. The bulk of the evidence should be original research studies from professional refereed journals. At least 7-10 studies should be reviewed and analyzed. Critical Analysis of the Evidence Related to the Clinical Question The central portion of the paper will be a critical analysis of the evidence concerning the clinical question. Listed below are some factors to consider in analyzing the evidence. (This is not an exhaustive list.) Inclusion of tables using matrix method comparing the various factors across studies is a requirement of this section. Purpose of the studies: What are the study purposes? Are the purposes consistent with the clinical question? DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 21 Research Design: A clear pattern of findings established through a series of well-designed studies will be more persuasive than findings from a single poorly controlled study. In this section, the research designs used should be identified and their strengths and weaknesses should be evaluated. In general, large clinical trials, double-blind studies, and well-controlled experimental studies provide stronger evidence than studies that involve small samples and quasiexperimental designs or correlational designs. Sampling: What populations have been studied? How well do these match the population in which the student is interested? What sampling method was used? What are the sample characteristics (e.g., gender, age, ethnicity, and other pertinent variables)? How large was the sample? Was the sample size justified through the use of power analysis? Did investigators adequately address reasons for attrition of subjects? Human Subjects Issues: How did investigators protect their human subject? E.g., was the study's methodology approved by an IRB? How was informed consent obtained? Were there any unresolved issues related to selection/assignment of subjects and/or interventions used? Extraneous variables: Did the study control for confounding/extraneous variables? What were they? Were there extraneous variables that were not adequately controlled? For questions concerning interventions: What was the intervention offered? Were there variations in the exact nature of the intervention, the intensity (e.g. number and length of group sessions), "dosage", etc. What type of intervention (if any) did the control group subjects receive? What outcome measure have researchers used: E.g., how have they measured effectiveness? How are the outcomes measured? Do researchers use the same types of outcome measures or are they quite different? (If there are major differences in outcome measures it can be difficult to compare study outcomes). What was the length of follow-up of the outcome measurement across the studies? Are there any adverse effects of the intervention or diagnostic procedure? Are the likely benefits worth the potential harm and cost? Study variables: What are the variables of interest and how did the researchers measure them? If researchers used questionnaires or other tools, are they comparable across studies? Have the researchers used established measures with acceptable reliability and validity or did they create their own data collection instruments? Statistical Analysis: What kinds of statistical analyses were used and were they appropriate? Were the statistical analyses comparable across studies? E.g., did t t-tests, etc.)? Study Findings: What were the study findings? Did the authors find statistically significant results? In the table(s), report the statistics used and the p-values. Is there a clear pattern of findings in regard to the evidence? The Synthesis "Answer" to the Clinical Question Formulate an answer to the clinical question. What does the evidence suggest? In the case of intervention questions, is there clear evidence that the intervention is effective (or the diagnostic procedure useful) with the population in which the student is interested? DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 22 Grading Criteria Dimension Abstract Points 2 Significance of the Clinical Problem 3 PICO 2 Database Searches 2 Analysis of the literature 5 Synthesis of the evidence based on the literature review 5 Organization, Style, Spelling, Grammar 1 Total 20 DNP Program St. Catherine University: Department of Nursing Criteria Summary is succinct with 150 word limit, which captures the essence of the entire paper. Clearly explains the topic and background of the clinical project issue. Justifies the rationale/need for the critical literature review as it relates to evidence based practice change project. Clear statement of the clinical problem in PICO format is provided Succinct and brief explanation of the literature databases searched. (Years covered; type of initial databases searched and why; description of key search term selection). Narrative description of the data abstraction process used and the description of characteristics of literature included/excluded and rationale for such inclusion/exclusion. Incorporates non-research sources as appropriate to provide definitions of important topic, historical/theoretical perspectives on the topic, or additional background information. Uses 7-10 original research articles to analyze evidence from the literature as it relates to the clinical practice problem. Critically reviews and analyzes the research literature. Synthesizes and summarizes current state of knowledge on the topic. Identifies flaws, gaps, and/or inconsistencies revealed by the critical analysis of the literature. Describes how the findings from critical analysis would be incorporated into the student’s clinical change project. The paper is logical, complete, well synthesized, and grammatically correct. Page limit is observed. There are no spelling errors. Correct APA format is utilized. NURS 8520: Syllabus 23 Written Assignment: Integrating Multiple Sources of Evidence Purpose: Doctoral students are expected to complete a rigorous project change based on the multiple sources of evidence for the DNP program. Students work on this project truly began with the first didactic courses. The final project will ultimately be a synthesis of knowledge gained and scholarly work completed in all DNP courses with a focus toward improvement of a clinical practice problem. The assignment integrates all types of evidence and purposefully dovetails all components into a comprehensive document. Syntheses of the evidence from diverse sources are used to evaluate practice patterns against national benchmarks to determine variances in outcomes and explore alternative solutions surrounding clinical problems to improve healthcare outcomes. The scholarly paper should be approximately 18-20 pages in length with APA format (excluding title page, abstract and reference pages). Due Date(s): 5/4/12-5pm Directions: Title Page: Per APA Format Abstract The abstract is a short (150 word) summary of the scholarly paper. The abstract should be typed on a separate page. Provide exact word count at bottom of abstract page. Background and Significance of the Clinical Practice Problem Provide a brief overview of the problem and provide rationale for this problem as significant and a priority topic in nursing PICO Statement and Purpose Statement for Scholarship Change Project State your clinical practice question (PICO). Clinical question should have a logical flow from introduction. Try to limit the purpose to a few sentences. Synthesis/Evidence from the Review of the Literature Provide narrative synthesis from previous paper on the state of the art information/evidence available from the literature (from previous assignment). National Practice Guideline Review Description of process for national/institutional guidelines review for content that is appropriate to the problem. Types of Guideline Review Databases searched (National Guideline Clearinghouse, Cochrane Collaboration, Others) High Level narrative description of AGREE results (No more than 1 paragraph). Narrative description of the overall findings and refer to the appropriate table in the appendix as applicable. Systematic Reviews Description of existing systematic reviews. Critique at least one systematic review related to your clinical practice problem. Follow up on seminal evidence. Ranking and Type/Level of Evidence Narrative description of Ranking of Type/Level of Evidence as well as summary of findings. This section should analyze/integrate the guidelines DNP Program St. Catherine University: Department of Nursing NURS 8520: Syllabus 24 and literature to determine the comprehensive strength of what is known about the clinical problem. You should use established evidence rankings according to pre-established categories. Use of table is recommended. Integrative Review Provide overall narrative through synthesis of literature including current/seminal/landmark literature, national guidelines, and systematic reviews. Support all of the above with tables and appendices as needed. Summary of Recommendations Summarize recommendations for protocol, guideline, policy, procedure recommendation, nursing interventions/activities, clinical care recommendations and/or or another type of synthesis product based. Include clear, brief, statement of the recommendations Evidence in support of the recommendations Organize the recommendations with supporting evidence. Review the general state of the literature, what your determinations were (for change to guideline/practice), and how your project will be addressing priority clinical practice problem. Grading Criteria Dimensions Introduction Abstract PICO Review of the Literature Points 1 S/U 1 2 National Guideline Review 3 Systematic Reviews 3 Ranking and Type/Level of Evidence 3 Integrative Review 3 DNP Program St. Catherine University: Department of Nursing Criteria Clearly explains the topic and background of the clinical project issue. Justifies the rationale/need for the critical literature review as it relates to evidence based practice change project. Provides overall understanding of the paper succinctly. Word limit of 150 is observed. Clear statement of the clinical problem in PICO format Narrative overview of literature database search and description of key search term selection with inclusion/exclusion criteria is provided. Clear and concise narrative synthesis from previous paper on the state of the art information/evidence available from the literature review (from previous assignment). Relevant description of process for national/institutional guidelines review for content that is appropriate to the problem is included. If no national guidelines exist, regional and local guideline(s) are included. Description of existing systematic reviews. Provide critique of at least one systematic review related to the clinical practice problem that is available. Include narrative description of AGREE tool results. Narrative description of Ranking of Type/Level of Evidence as well as summary of findings is well articulated. Both level and strength of the evidence is used to analyze/integrate the guidelines and literature to determine the comprehensive picture what is known about the clinical problem is provided. Evidence from appropriate multiple sources is identified. NURS 8520: Syllabus Dimensions 25 Points Recommendation Summary 3 Organization, Style, Spelling, Grammar 1 Total 20 DNP Program St. Catherine University: Department of Nursing Criteria Gaps in the clinical knowledge related to the clinical problem is identified and linked to support the clinical change project/PICO. Include clear, brief, statement of the recommendations based on the multiple source of evidence is integrated and used in support of the recommendations. Organize the recommendations with supporting evidence. The paper is logical, complete, well synthesized, and grammatically correct. Page limit is observed. There are no spelling errors. Correct APA format is utilized. NURS 8520: Syllabus 26 Seminar Presentation Purpose: The purpose of this activity is to articulate your DNP project from evidence based perspective. Topic of the seminar will be based on your DNP project with input from evidence from multiple sources including national/regional/local benchmarks, social justice and ethical considerations. Due Date: 5/5/12-As assigned Directions: 1. Each student will have responsibility for facilitating/leading one 20 minutes (10-15 minutes on content, 5 minutes on Q&A) power point presentation. Please maintain appropriate time frame, you will NOT be given more than 20 minutes to present and respond to class mates’ questions/feedback. 2. Create a PowerPoint using at most 8 slides (excluding title and references). 3. This presentation is the culmination of the evidence based practice perspective learned in this semester and as applied to your project. 4. As the leader, you will be presenting your DNP project from EBP perspective to the group and articulating your clinical change project design. Be sure to include following component: 1. Introduction, 2. Identification of the Problem or Issue, 3. Review and Synthesis of the Literature, 4. Multiple Sources of evidence 5. Stakeholders/Patients/Organization Context and Resources 6. Ethical issues and Social Justice Issues inherent in the change project. 7. Proposed Solution based on the Evidence 8. Summary Recommendation and Evaluation Method. Grading Criteria Dimension Points Power Point Presentation 5 Critical Thinking 5 Scholarliness 5 EBP 5 Social Justice and Ethical Considerations 5 Discussion/Facilitation TOTAL 5 30 DNP Program St. Catherine University: Department of Nursing Criteria PowerPoint was professional, addressed topic areas, and was delivered in allotted timeframe Presentation reflected critical thinking and had logical connections to the DNP Project. Presentation demonstrated scholarliness as evident in the synthesis of the ideas and based on evidence. Concepts pertinent to multiple sources of evidence are clearly identified using the DNP project. Clear arguments are made for proposed change using social justice, cultural sensitivity and ethical issues perspectives. Student facilitated the discussion well.