COURSE OUTLINE ACADEMIC YEAR 2013/2014

Transcription

1 1 Faculty Faculty Availability Program Coordinator As above By Appointment please Mary Elliott, RN, BScN, MEd COURSE OUTLINE ACADEMIC YEAR 2013/2014 Course Title: CLINICAL PRACTICUM: ACUTE HEALTH CHALLENGES Course Code NRS.323 (NURS 3073) Schedule Type Code CLN Credit Value: 5 Class Hours: 14 hrs x 12 weeks clinical Assigned Preparation: Prerequisite for Clinical Practice 14 hours x 1 week Program: University of New Brunswick (UNB) - Pre-Requisite(s) Co-Requisite (s): NRS.322 Humber Institute of Technology & Advanced Learning Collaborative Bachelor of Nursing Year 1 & 2 courses Pre-requisite for: Year 4 Courses Restrictions: Open only to UNB-Humber Bachelor of Nursing Students Program Outcomes emphasized in this course: See Appendix A for BN Program Abilities Level Outcomes Year 1: Year 2: Year 3: X Year 4: 1 Knowledge & its Application 2 Communication 3 Critical Thinking / Skills Analysis 4 Professional Identity 5 Social Justice / Effective Citizenship x 1.1 x 2.1 x 3.1 x x 1.2 x x 4.2 x x x x 2.4 x x 2.5 x 4.5 x x 4.7 Approved By: Dean/Associate Dean: Signature Dr. Lenore Duquette, RN, BSCN, MEd, EdD Associate Dean Nursing Date: November 22, 2013

2 2 Course Description / Course Rationale Complements and supplements NRS.322, Co-requisite: NRS.322 Purpose: To practice safe, comprehensive care in collaboration with children or adults in acute care environments under direct clinical supervision. Learning Outcomes Upon successful completion of this course, students will be able to: 1. Knowledge and its Application 1.1 Draws from multiple forms and sources of knowledge when providing nursing care with clients and families experiencing acute health challenges. 1.2 Uses a holistic approach that considers knowledge from nursing and the social sciences when planning and implementing nursing care with clients experiencing acute health challenges. 2. Communication 2.1 Reports and documents information effectively in a concise and defendable manner according to policies of the practice setting. 2.2 Provides appropriate teaching to clients and families in the acute care setting. 2.3 Begins to incorporate developmentally appropriate communication techniques within a counseling framework to facilitate therapeutic and caring relationships in anticipated acute health care situations. 2.5 Uses appropriate technology to retrieve, manage and interpret relevant information related to client care. 3. Critical Thinking/Skills of Analysis 3.1 With direction, analyzes data and considers perspectives and ways of knowing to make connections, formulate clinical decisions and plans for care. 3.4 Reflects on previous experiences determining the meaning and relevance to current nursing care. 4. Professional Identity 4.1 Integrates applicable legal, ethical and professional standards when providing nursing care with clients and families in complex situations. 4.2 Reflects on knowledge of nursing theories to deepen one s philosophy of nursing care and guide practice. 4.3 Begins to develop leadership skills to advocate for clients and families with other health professionals. 4.5 Identifies learning needs and formulates a plan to develop professional competence. 4.7 Considers personal wellness in individual health practices. 5. Social Justice/Effective Citizenship 5.2 Applies the principles of primary health care and recognizes the impact of the determinants of health on the hospitalization of patients and families and engages in culturally safe nursing practice. 5.5 Critically examines personal bias, scientific evidence and cultural knowledge in decision making.

3 3 Essential Employability Skills (See Appendix B for definitions of essential employability skills) Essential Employability Skills are transferable skills that provide the foundation for a student s academic, vocational, and personal success. x Communication x Critical Thinking & Problem Solving x Interpersonal x Numeracy x Information Management x Personal Learning Resources American Psychological Association. (2009). Publication manual of the american psychological Association. (6 th ed.). Washington, D.C.: Author Anderson, K., Anderson, L. & Glanze, W. (2002). Dictionary.Toronto: Mosby. Mosby s medical, nursing and allied Bucholz, S. & Henke, G. (2009). Henke s med-math: dosage calculation preparation & administration (6 th ed.). Philadelphia, Pennsylvania: Wolters Kluswer. Deglin, J.H. & Vallerand, A.H. (2009), Davis drug guide for nurses (11 th ed.). Philadelphia, Pennsylvania: F.A. Davis Company. Jarvis, C. (2008). Physical examination and health assessment (1 st Canadian ed.). Toronto: Saunders. Karch, A.M. (2011) Focus on nursing pharmacology (5 th ed.). Philadelphia: Wolters Kluser Lippincott Williams and Wilkens Lehne, R. (2009). Pharmacology for nursing care (7 th ed.). Philadelphia, Pennsylvania: Saunders Elsvier. Lewis, S., Heitkemper, M. & Dirksen, S. (2010). Medical-surgical nursing in Canada Toronto: Mosby. (2 nd ed.). Perry, S., Hockenberry, M., Lowdermilk, D. & Wilson, D., (2010). Maternal child nursing care (4 th ed.). St. Louis: Mosby Potter, P. & Perry, A. (2010). Canadian fundamentals of nursing (Revised 4 th ed.). Toronto: Mosby *Scholarly literature as assigned by the clinical instructor Supplemental Resources See blackboard site and other resources as directed by Clinical Teacher.

4 Copyright Copyright is the exclusive legal right given to a creator to reproduce, publish, sell or distribute his/her work. All members of the Humber community are required to comply with Canadian copyright law which governs the reproduction, use and distribution of copyrighted materials. This means that the copying, use and distribution of copyright- protected materials, regardless of format, is subject to certain limits and restrictions. For example, photocopying or scanning an entire textbook is not allowed, nor is distributing a scanned book. See the Humber Libraries website for additional information regarding copyright and for details on allowable limits. 4 Learning Delivery Format There will be a variety of formats: independent study, discussion, group work, on-line resources and collaboration with community agencies. Course Content WK WEEK OF ACTIVITY 1 January 6 Assigned Preparation: Pre-requisite for Clinical Practice 2 January 13 Clinical Placement 14 hours per week Orientation to Course and Facility/ Clinical practice day Clinical Simulation two (2) hours every other week Dosage Calculation Proficiency Test 3 January 20 Clinical Lab two 7 hour) labs 14 hours per week Nursing Skills Lab and Practice (see Blackboard site for schedule) 4 January 27 Clinical Placement 14 hours per week Clinical Simulation two (2) hours every other week 5 February 3 Clinical Placement 14 hours per week Clinical Simulation two (2) hours every other week 6 February 10 Clinical Placement 14 hours per week Clinical Simulation two (2) hours per week February READING WEEK- 7 February 24 Clinical Placement 14 hours per week Clinical Simulation two (2) hours every other week 8 March 03 Clinical Placement 14 hours per week Clinical Simulation two (2) hours every other week 9 March 10 Clinical Placement 14 hours per week Clinical Simulation two (2) hours every other week 10 March 17 Clinical Placement 14 hours per week Clinical Simulation two (2) hours every other week 11 March 24 Clinical Placement 14 hours per week Clinical Simulation two (2) hours every other week 12 March 31 Clinical Placement 14 hours per week Clinical Simulation two (2) hours every other week 13 April 07 Clinical Placement 14 hours per week Clinical Simulation two (2) hours every other week

5 5 **Please note: The clinical synthesis (post conference) is part of the 14 hours per week of clinical practice day** * Please refer to the NRS.323 Blackboard site for all clinical forms, documents and independent study requirements * Additional CASA supplemental documentation may be required. Student Evaluations N ASSIGNMENT O. 1 Assigned Preparation: Prerequisite for Clinical Practice WEEK DUE Week 2 2 Clinical Synthesis (Post Conference) Led by Clinical teacher weekly 3 Simulation Lab (See Blackboard for schedule) Every other week beginning in Week 2 or Week 3 4 Reflection(s) Weeks 5 & 10 * additional Reflections as assigned by Clinical Teachers 5 Clinical Assessment Student Abilities (CASA) - Midterm - Final *Must be submitted electronically to Clinical Teacher week after Week 12 Supplemental Documentation as necessary Week 7 Week 13 6 Mini Nursing Care Plan (NCP) Weeks Dosage Calculation Proficiency Test Week 2 and as required (see Blackboard site for information) 8 Comprehensive Nursing Care Plan (NCP) Week 9 9. E-Portfolio Week Clinical Learning Summary Week 13

6 6 School Specific Field 1. Assigned Preparation: Prerequisite for Clinical Practice Complete all required pre-requisite material for assigned lab day including previewing multi- media products (on-line). Refer to information posted on Blackboard. It is expected that Students will come fully prepared to the lab and able to participate. Due: Week 2 2. Clinical Synthesis (Post Conference) Clinical synthesis will be conducted by the clinical instructor and will include opportunities for discussion experiences. Clinical experience on the unit, best practice guidelines and research will inform and support the discussion. Clinical synthesis will provide an opportunity to review clinical learning in a group approach. Due: Led by clinical teachers weekly 3. Simulation Lab (every other week) Students are expected to attend a two-hour simulation experience every other week beginning either Week 2 or Week 3. The experience is an opportunity to consolidate learning in a simulated environment with simulated clients and case studies. Attendance at these simulation experiences is mandatory and is counted as clinical hours. To receive a credit grade for this course, students must attend and participate in all simulation experiences. Clinical simulation is timetabled outside of your clinical days as part of your regularly scheduled class timetable. 4. Collaborative Assessment of Student Abilities (CASA) The Collaborative Assessment of Student Abilities (CASA) is a process of assessing student learning and performance in light of the clinical practicum s ability outcomes. Collaborative Assessment of Student Abilities (CASA) - Reflection(s) Students will be required to reflect on their clinical experiences daily in the assigned setting. They will complete two reflections on their clinical practice experience using the Reflective Tool posted on the Blackboard site. Students will utilize the CNO Compendium of Standards, the CNA Code of Ethics for Registered Nurses and two scholarly nursing articles to further guide their nursing practice and self-reflection. Students will receive feedback from their Clinical Teacher/ Professor based on the self-reflection. The Reference List must be APA format. Each reflection will address at least one of the learning outcomes within one of the five abilities outlined in the course outline (please note that one reflection will need to address two abilities with two learning outcomes to ensure that all five abilities are discussed throughout the term). All of the five abilities must be addressed throughout the semester. The Personal Ethics Statement must be included. Due: Self Reflection is to be completed at Weeks 5 & 10 and as assigned by clinical teacher and submitted electronically to the Clinical Teacher.

7 7 5. CASA Midterm and Final Evaluation Student learning and performance in relation to the clinical practicum s ability outcomes will be assessed using the Collaborative Assessment of Student Abilities (CASA) process. Students will engage in self-assessment of progress in meeting course learning outcomes at midterm and end of term using the Midterm and Final CASA respectively. Clinical Teachers/ Professors will also assess learning and ability in meeting course learning outcomes at Midterm and Final using the Midterm and Final CASA respectively. These forms will be posted on Blackboard The Midterm and Final CASA forms must be completed by the student and sent electronically to the Clinical Instructor one week before the evaluation is scheduled. See the Blackboard site for required forms and instructions. The Personal Ethics Statement must be included. Due: Week 7 and Week 13 CASA Supplemental Documentation When there is concern about student progress toward meeting one or more course outcomes prior to the midway or final summative assessment in the course the Clinical Teacher/Professor will meet with the student and document concerns on the CASA Supplemental Documentation Form. This record will provide data for inclusion in the Midway and Final Assessment of Student Learning. Students will have access to read and sign the information included in the record. The CASA Supplemental Documentation Record will become a part of the student file. The form should be reserved for concerns about student progress that have not responded to face to face discussion about the learning challenge /incident. This documentation would occur in consultation with the year program coordinator and would refer to previous verbal communication the student and Clinical Teachers / Professors had around progress with this learning outcome. Depending upon the student s particular weekly clinical assignment, the student will have gained experience in many, but not all, abilities according to S (satisfactory), N D (needs development), and U (unsatisfactory). By the end of the term it is expected the student will have addressed each of the abilities outlined in the guide. 6. Mini Nursing Care Plan (NCP) Students will develop a Nursing Care Plan for at least one assigned client on a weekly basis. The Mini Nursing Care Plan will include; assessment data collected, identified nursing problems and problem statement, goals for the plan of care, target dates, nursing interventions and an evaluation of the nursing interventions carried out. To ensure that student s work does not breach copyright law, the group must review the guide for copyright for Students. This is located under Quick Guides at The Personal Ethics Agreement must be included. Due: Weeks: 4-13

8 8 7. Accuracy in Dosage Calculations Math Proficiency is essential for safe nursing practice. Because math for medications is so important, medication calculation questions may appear on any or all nursing core course exams, even if the subject of math was not directly taught in the course. Policy: The pass mark for Dosage Calculation Testing is 90%. Three attempts to achieve accuracy are permitted in all clinical practicum courses where the student is expected to administer medications or monitor the effects of medications. This includes NRS.115, NRS.221, NRS.218, NRS.215, NRS.206, NRS.323, NRS.413. Students will not be permitted to administer medications in the clinical setting until 90% has been achieved on the dosage calculation quiz. Please note that students in the following courses: NRS.323 and NRS.413 will also have Intravenous Infusion Rate Calculations included in the testing. Failure to achieve 90% will prevent students from demonstrating competency in the area of medication administration and intravenous management and prevent the student from successfully achieving this learning outcome. This will result in a NON-CREDIT grade for the course. If 90% has not been achieved students will be directed to develop a learning plan to address this area needing improvement. Students must seek remedial assistance from a variety of resources which may include but are not limited to their Clinical Teacher \ Professor, Math Centre in the Guelph Humber Building, on-line learning options as well as their Dosage Calculation textbook. Those Students who were not successful will be retested. Students who are not successful in the third attempt will receive an unsatisfactory grade. These students must meet with their respective Program Coordinator to review and discuss strategies for success. Students will have maximum of three attempts to be successful. Calculators are permitted. Adapted from University of New Brunswick, Saint John, Department of Nursing & Health Sciences Nursing Student Handbook. 7. Comprehensive Nursing Care Plan (NCP) Utilizing the Nursing Process Students, Students will develop a written plan of care for one of their assigned clients in the clinical setting. The plan of care will include the following; assessment data collected, identification of nursing problems and a problem statement, goals for the plan of care, target dates, nursing interventions including the rationale for each intervention and an evaluation of the nursing intervention(s) carried out. Goals and actions must reflect evidence-based practice. Sources need to be cited as per APA format. The Personal Ethics Agreement must be included. Due: Week 9

9 9 9. E-Portfolio A mark of professional practice is the collection of materials to indicate your growth in the area. According to Herteis & Simmons (2010) a learning portfolio is A collection of self-selected evidence of students academic learning and personal growth, enriched by an analytical narrative that explains and contextualizes the relevance of each piece of evidence. Portfolios are a method of collecting your information to demonstrate development throughout the program. Students can take this portfolio when they graduate. Students developed their own personal e-portfolio in Year 1, and will update this e-portfolio to reflect their activities through this term. It will consist of two (2) parts - a repository and a reflective piece. Information regarding the E-Portfolio will be posted on Blackboard. Due: Week Clinical Learning Summary (CLS) Throughout the nursing program, students are expected to continuously build upon knowledge, skills and attitudes from previous clinical courses. This attainment of ability or growth is demonstrated through meeting the program outcomes in clinical practice and through application of knowledge, skills and attitudes from previous and concurrent courses. Clinical teachers / faculty are expected to promote student achievement of the course outcomes and to professionally support continuous student learning both within and between courses. This CLS is a document that: is collaboratively developed by the student and current clinical teacher / faculty at the end of each clinical rotation outlines student strengths and areas requiring further growth in subsequent clinical courses will be submitted, by the student, to the clinical teacher / faculty in the subsequent clinical course will be reviewed at the beginning of the subsequent clinical course by the student and clinical teacher / faculty with the goal of supporting student learning and growth. More information regarding the CLS will be posted on Blackboard Due: Week 13 Process of Evaluation Signing the Midterm and Final evaluations will indicate that both the student and the instructor have read, discussed, and had an opportunity to respond to the feedback. To receive credit for NRS.313, students will be required to achieve an overall satisfactory level of competence in clinical practice in each of the five abilities. Failure to meet the course abilities will result in a NON-CREDIT grade for the course. A NON-CREDIT grade means that the students will not be able to proceed in the program until a CREDIT is achieved in the course. Satisfactory Needs Development (ND) Unsatisfactory (U) (S) The student consistently performs at the expected level. (e.g. uses theoretical foundations to address health needs; facilitates therapeutic relationships; provides organized, safe, ethical care, demonstrates responsibility for own learning) The student performs below the expected level.(e.g. needs change/improvement in behaviour to meet the expected level; requires frequent assistance; at times is unprepared for clinical practice) The student does not meet the expected level. (e.g. needs extensive change/improvement in behaviour to meet the expected required level; requires extensive, consistent assistance; is unprepared for clinical practice)

10 10 The Clinical Excellence Committee (CEC) is comprised of the Program Coordinators from the Nursing programs at Humber College who are experts in scholarly teaching and learning. The committee meets weekly as required when students are experiencing difficulty achieving clinical course outcomes. The purpose of the CEC meeting is to review the data on student performance presented by the clinical teacher/professor and provide recommendations and remediation strategies to support student success CASA Supplemental Documentation Clinical Teachers\Professors will record consultation with students regarding performance and assessment of learning throughout the semester in relation to course abilities using the CASA Supplemental Documentation form. This record will provide data for inclusion in the Midway and Final Assessment of Student Learning. Students will have access to read and sign the information included in the record. The CASA Supplemental Documentation Record will become a part of the student file. Depending upon the student s particular weekly clinical assignment, the student will have gained experience in many, but not all, abilities according to S (satisfactory), N D (needs development), and U (unsatisfactory). By the end of the term it is expected the student will have addressed each of the abilities outlined in the guide. Clinical Practice Attendance Policy To successfully complete the UNB - Humber Bachelor of Nursing Program students must acquire, maintain, and continuously enhance nursing competence. Educational experiences which occur in a variety of practice contexts are designed to advance nursing competence in an integrated and deliberate manner. The acquisition of nursing competence is progressively structured in an incremental manner on a daily, weekly, and monthly basis. Failure to achieve competence in some learning activities can negatively impact success in other placement areas. Attaining competence in professional practice requires that nursing students actively engage in all planned clinical experiences throughout the program. Guidelines for Implementing the Clinical Practice Attendance Policy 1. Clinical practice refers to all laboratory, institution and community practice experiences. 2. In accordance with the General Course Regulations, Class Attendance in the University of New Brunswick Undergraduate Calendar, students are expected to attend all classes, laboratories, tutorials, or other class meetings officially designated for a particular course. An instructor may assign a final grade of F in the course to a student who fails to maintain the stipulated attendance policy. In addition, the Nurse s Association of New Brunswick, the regulatory body that approves the program, requires a minimum number of hours of clinical practice for graduation from the program.

11 11 3. Missed clinical time will be tracked for each student within each term and annually. Students who miss clinical time due to illness or personal crisis are required to submit documentation to support their absence (health care provider note) and must notify the clinical instructor and Coordinator in advance of the missed clinical time. 4. Students in the generic four-year program who miss more than 10% of the required hours for the clinical practicum course, but have successfully met the course outcomes will receive an incomplete (INC) grade until they have completed the required 18 hours of clinical simulation learning (CSL). Failure to complete the simulated learning experience will result in a non-credit grade. Due to the accelerated and condensed nature of the program of study for the Second Entry/RPN to BN student in the collaborative degree the clinical practice attendance policy is different than those in the generic program. Second entry/rpn to BN students who miss more than 4% of the required hours for the NRS.323 clinical practicum course and have met the learning outcomes will be expected to complete 18 hours of clinical simulation learning (CSL). The grade for the course will be incomplete until the CSL is completed successfully. Failure to complete the simulated learning experience will result in a non-credit grade. There will be a fee charged for this make-up course and the student will be referred to Registrar s office by the coordinator to enroll. 5. The CSL is not a repeat of the clinical course. Students who have received a non-credit grade for the course are not eligible to participate in CSL and must repeat the entire course. School Specific Academic Regulations It is the student s responsibility to be aware of the UNB Academic Regulations Nursing Program Test and Exam Protocol Policy, and the UNB-Humber Student Handbook. Reference should be made to the Humber website at as the source for the academic regulations. Turnitin, an electronic plagiarism detection service, will be used for the submission of papers. Details of how to submit your paper will be provided in Week 1. Students who do not want their work submitted to this service must, by the end of the second Week of class, consult with the instructor to make alternate arrangements. When an instructor has reason to suspect that an individual piece of work has been plagiarized, the instructor shall be permitted to submit that work to any plagiarism detection service. Use of Turnitin is intended to support the student s learning by offering an opportunity for students to review their assignments for appropriate citation of sources prior to submitting the assignment. Students should be aware that their assignments are added to the Turnitin software pool of documents.

12 12 While every effort is made by the Professor to cover all material listed in the outline, the order, content, and/or evaluation may change in the event of special circumstances (e.g. time constraints due to inclement weather, sickness, College closure, technology/equipment problems or changes, etc.) In any such case, students, will be given appropriate notification in writing, with approval from the Dean (or designate) of the School. It is the responsibility of each student to be knowledgeable of the University of New Brunswick/ Humber General Academic Regulations, the Nursing Program Academic Regulations and the Charter of Student Responsibilities and Rights. Academic Integrity Academic integrity is essentially honesty in all academic endeavors. Academic integrity requires that students avoid all forms of academic misconduct or dishonesty, including plagiarism, cheating on tests or exams or any misrepresentation of academic accomplishment. The University of New Brunswick places a high value on academic integrity and has a policy on plagiarism, cheating and other academic offences. Plagiarism includes: 1. Quoting verbatim or almost verbatim from any source, including all electronic sources, without acknowledgement. 2. Adopting someone else s line of thought, argument, arrangement, or supporting evidence without acknowledgement. 3. Submitting someone else s work, in whatever form without acknowledgement. 4. Knowingly representing as one s own work any idea of another. Examples of other academic offences include: cheating on exams, tests, assignments or reports; impersonating somebody at a test or exam; obtaining an exam, test or other course materials through theft, collusion, purchase or other improper manner, submitting course work that is identical or substantially similar to work that has been submitted from another course; and more as set out in the academic regulations found in the Undergraduate Calendar. Penalties for plagiarism and other academic offences range from a minimum of F (zero) in the assignment, exam or test to a maximum of suspension or expulsion from the University, plus a notation of the academic offence on the student s transcript. For more information, please see the Undergraduate Calendar, Section B, Regulation VII.A or visit; It is the student s responsibility to know the regulations.

13 13 Personal Ethics Agreement In accordance with the UNB Academic Regulations Nursing Program Test and Exam Protocol Policy and the UNB-Humber Student Handbook students are expected to demonstrate academic integrity. All individual and group assignments submitted will now include a statement written or typed by the student(s) attesting to the authenticity of the work. Students will be expected to write this statement on the title page or covering page of all work they submit including exams and the last page of their Collaborative Assessment of Student Abilities (CASA) documents. If the assignment is submitted electronically the Personal Ethics Agreement statement should be typed on the assignment in the same manner as is expected for those assignments submitted in hard copy. Electronic submission of material containing the Personal Ethics Agreement implies signing the pledge. Students are expected to declare the following statement on all individual and group assignments submitted: I declare that this is my original work and the sources used are acknowledged. Student Name: (please print) Student Signature: Date: Please refer to Personal Ethics agreement that is required for all assignments (located on Blackboard site.) Policies and Procedures It is the student s responsibility to be aware of the College Academic Regulations which can be found on the following website: - follow link for Admission Requirements & University Regulations for the Bachelor of Nursing Degree Program. In addition, the School of Health Sciences have a link to outlines specific program-based policies and procedures. These policies can be found on the following websites: and school site at Research Principles 1. At Humber, no research activities involving human subjects, beyond the scope of professional practice, happen without an REB designation. 2. No research activities involving animals are permitted at Humber.

14 14 Research Activity This course has received approval from the Humber Research Ethics Board (REB) in accordance with criteria established by the Tri-Council. This designation permits minimal and no risk projects involving human participants to be approved by the course Professor. The Professor has completed ethics training and is well qualified to oversee these research projects. Any projects undertaken that are of greater than minimal risk, including those conducted with vulnerable populations, must be individually approved by the Humber REB. Academic Concern/Appeals If a student has questions or concerns regarding a grade on an assignment or test, the student should discuss the matter with the faculty member. The Program Co-ordinator and/or the Associate Dean may be asked to assist if the faculty member and student are unable to resolve issues. For additional information please refer to Section 13 of College s Academic Complaint and Appeal Policy at the web site identified above. Disability Services Humber seeks to create a welcoming environment where equity, diversity and safety of all groups are fundamental. Humber is dedicated to providing equal access to students with disabilities. The Disability Services staff are available by appointment to assess specific needs, provide referrals and arrange appropriate accommodations. If you require academic accommodations, contact: Disability Services: North Campus: (416) X 5180 Lakeshore Campus: (416) X 3265 Disclaimer While every effort is made by the Professor/faculty to cover all material listed in the outline, the order, content, and/or evaluation may change in the event of special circumstances (e.g. time constraints due to inclement weather, sickness, college closure, technology/equipment problems or changes, etc.). In any such case, students will be given appropriate notification in writing, with approval from the Dean (or designate) of the School.

15 Appendix A: BN PROGRAM ABILITIES - LEVELED OUTCOMES 1. Knowledge and its Application Nursing Students integrate and apply knowledge, from nursing and an array of disciplines in the arts and sciences to provide comprehensive nursing care in times of health and illness. Program Outcomes Year One Year Two Year Three Year Four 1.1. Seeks, utilizes, and develops knowledge to support and enhance competence in professional nursing practice Intentionally applies understanding of the psycho-social, historical, spiritual and cultural dimensions of health and illness when working with diverse individuals, families, communities, and populations Appraises, provides and modifies nursing actions by synthesizing knowledge from nursing, the arts, and sciences integrating these with appropriate professional guidelines for best nursing practices Practices according to the standards, scope of practice and code of ethics of the provincial regulatory body, consistent with other national practice guidelines, in accord with provincial and federal legislation and in the context of primary health care. 1.1 With direction, accesses and uses knowledge from the humanities, social sciences, sciences and nursing to inform a beginning and holistic understanding of health and illness in diverse contexts and across the lifespan. 1.2 Recognizes multiple dimensions of health and illness, (biological, psycho-social, historical, spiritual, and cultural), appreciating their interrelated influences and their relevance to nursing practice. 1.3 Utilizes knowledge from nursing and the social sciences to create caring relationships in promoting health and understanding illness Identifies political, social, economic, cultural and environmental contexts that influence professional practice, disease prevention, health promotion, protection, and health maintenance. 1.1 With greater self-direction, examines and incorporates knowledge, principles, and information from nursing and other disciplines/professions, integrating these to assess, plan and provide beginning levels of nursing care with individuals and families Seeks, integrates, and utilizes knowledge of determinates of health, along with other holistic conceptual frameworks of health and illness, incorporating these in planning and implementing nursing interventions with diverse individuals and families Applies knowledge from the sciences, liberal arts, and nursing incorporating a philosophy of caring to develop beginning levels of best nursing practice Recognizes own developing nursing role (professional responsibilities) as well as those of the different interdisciplinary healthcare team members within the context of primary health care. 1 Seeks, critically examines, and utilizes evidence-based knowledge, informed by multiple theoretical frameworks, integrating these to provide nursing care with clients, families, and communities facing more complex acute or population based health challenges Critically examines social, cultural, spiritual and historical changes in definitions of health and illness, transferring this knowledge in culturally relevant practices that promote health or provide nursing care during illness with clients, families, communities and populations Begins to integrate the determinants of health, evidence-based knowledge, research findings, and practice standards, theoretical and philosophical frameworks to appraise nursing therapeutics and to determine best nursing practice in the context of primary health care. _ 1.4. Integrates understanding of the Canadian health care system and the provincial professional regulating body into nursing practice environments Critically examines and integrates evidence-based knowledge from credible sources in nursing and other disciplines, basing practice decisions on this holistic, integrative process, and using this knowledge to provide competent nursing care with individuals, families, and populations experiencing complex health challenges. 1.2.Integrates contextually relevant dimensions of health and illness when providing nursing care in practice situations that are complex and unfamiliar. _ 1.3 Contextualizes nursing practice, by considering multiple sources of guidance for best practice, appraising and modifying professional actions to provide, safe, competent and effective nursing care in complex and unfamiliar environments. _ 1.4. Practices collaboratively and more autonomously, based on knowledge of the standards, regulations, competencies, and objectives of the provincial professional regulating body and in the context of primary health care.

16 2. Communication APPENDIX A -CONTINUED Nursing students communicate orally and in writing using structured coherent arguments to convey accurate and reliable information to diverse audiences in practice. Nursing students engage in authentic purposeful and collaborative communication using the concepts and techniques of the discipline. Program Outcomes Year One Year Two Year Three Year Four 2.1 Composes articulate, concise, credible, and defensible text consistent with the topic and appropriately leveled for the audience. 2.2 Connects with audience to convey ideas and information using effective verbal skills, non-verbal behaviours, and visual aids appropriate to the setting and intended purpose. 2.3 Uses therapeutic communication approaches to establish and maintain caring relationships with clients from a variety of cultures and diverse settings. 2.4 Engages in professional interactions with colleagues, administrators, and stakeholders, to address challenges and build partnerships in inter/intradisclipinary practice. 2.5 Uses available technologies to support communication in professional and therapeutic contexts. 2.1 Writes with beginning awareness of the elements of good writing, accurately portraying ideas consistent with the topic. 2.2 Speaks with beginning awareness of the elements of oral communication to convey ideas in predictable environments. 2.3 Recognizes the dimensions of the therapeutic relationship and with guidance uses purposeful communication techniques to promote the health of clients. 2.4 Recognizes the dimensions of professional relationships and begins to engage with peers, groups, and other members of the health team with awareness for differing perspectives, cultures, and ideas. 2.5 Beginning to use relevant information technologies to support communication. 2.1 Uses the elements of good writing to accurately and concisely communicate credible information in a variety of forms. 2.2 Uses elements of effective oral communication appropriately incorporating visual aids to enhance presentations. 2.3 Uses purposeful communication techniques that establish therapeutic and caring relationships to promote the health of clients and families. 2.4 Intentionally engages in professional relationships with colleagues and contributes the nursing perspective within the interdisciplinary health care team. 2.5 Beginning to use available technologies to support professional and therapeutic communication. 2.1 Adapts writing to effectively convey reliable information to a variety of audiences. 2.2 Engages audience using elements of effective oral communication incorporating presentation techniques appropriate to the setting and intended purpose. 2.3 Incorporates communication techniques within a counseling framework to facilitate therapeutic and caring relationships in changing health care situations. 2.4 Begins to develop partnerships with stakeholders and members of the health care team to support interdisciplinary practice that promotes the health of clients, communities, and populations. 2.5 Selects appropriate technology for use in a variety of settings with diverse audiences Composes articulate, concise, credible, and defensible text consistent with the topic and appropriately leveled for the audience. 2.2 Communicates complex ideas in engaging and appropriate ways to diverse audiences 2.3 Uses effective communication techniques and counseling frameworks independently to facilitate and maintain therapeutic and caring relationships in complex and unfamiliar situations. 2.4 Engages in professional interactions that address challenges with colleagues, administrators, and stakeholders, considering cultural and differing perspectives, and building relationships that enhance health and wellness. 2.5 Adapts to available technologies using them appropriately to support communication in professional and therapeutic contexts.

17 3. Critical Thinking/Skills of Analysis APPENDIX A-CONTINUED Nursing students engage in critical, reflective, and holistic analysis to evaluate the strength of a wide spectrum of evidence to formulate decisions. Program Outcomes Year One Year Two Year Three Year Four 3.1. Uses multiple ways of knowing to ensure the provision of evidence-informed nursing practice Utilizes a holistic approach guiding nursing practice through analysis of data from multiple sources. 3.3 Develops well reasoned arguments to formulate and defend sound, innovative and creative decisions. 3.4 Engages in reflective activities to enhance insight, intuition and ability to think beyond the obvious. 3.1 Comprehends the relationships between nursing knowledge and ways of knowing from the humanities, social sciences and sciences. 3.2 Completes holistic nursing assessments by collecting and considering data from the clients physical, psychosocial, cultural, and spiritual domains. 3.3 Scrutinizes evidence and identifies fallacies in reasoning to determine relevant and accurate information that informs personal decision making. 3.4 Reflects on personal knowledge, experience, and world view, acknowledging the presence of intuition and subjective ways of knowing. 3.1 Begins to develop clinical judgment by gathering relevant knowledge from multiple sources, questioning its use and with some direction applying it to formulate a plan of care. 3.2 Critically and reflectively uses more than one framework to organize and systematically summarize information as guides for nursing practice. 3.3 Formulates arguments and decisions about nursing care based on cause and effect analysis of information and evidence. 3.4 Recognizes limits to personal knowledge; examines assumptions and sources of uncertainty and discerns how these influence one s interpretation and assessment. 3.1 With some direction critically integrates varying perspectives and ways of knowing to formulate or challenge clinical decisions and plans for care. 3.2 With some direction critically and reflectively integrates multiple sources and frameworks to plan and implement care when working with clients, families, communities and populations. 3.3 Uses inductive, deductive, and other forms of reasoning to evaluate evidence, make connections between what is and what could be and propose sound and innovative interventions. 3.4 Critically reflects on and evaluates previous nursing situations, intentionally and carefully, transferring theoretical and experiential knowledge to the care of clients with similar diagnoses Implements nursing actions after engaging in a process of holistic inquiry and critical reflection. 3.2 Critically synthesizes intuitive and analytical processes to formulate nursing decisions that guide care. 3.3 Presents well reasoned arguments to and with peers to propose and defend sound, creative, and innovative changes. 3.4 Critically examines and uses previous learning experiences, intentionally and carefully transferring theoretical and experiential knowledge to augment nursing care in contexts that are complex and/or unfamiliar.

18 4 Professional Identity/Ethics APPENDIX A- CONTINUED Nursing students develop a dynamic and evolving professional identity and capability, incorporating personal and professional attributes and skills for practice in complex and unpredictable contexts Program Outcomes Year One Year Two Year Three Year Four 4.1 Integrates personal values with professional frameworks to ensure practice in accordance with legal, professional standards, and Code of Ethics. 4.2 Uses self-reflection to intentionally assess, critique, and modify nursing practice to ensure the ongoing delivery of comprehensive nursing care. _ 4.3 Demonstrates leadership when working in professional relationships with others. 4.4 Provides culturally competent nursing care honoring diversity among individuals, families, communities and populations. _ 4.5 Develops effective learning strategies for maintaining ongoing professional competence. 4.6 Demonstrates conduct and comportment/behavior consistent with a professional identity. 4.7 Recognizes the importance of maintaining wellness in one s own life. 4.1 With direction and within the context of nursing, health and wellness, recognizes, internalizes and uses basic concepts related to legal issues, professional standards and code of ethics to inform nursing care. 4.2 Recognizes and articulates personal values and beliefs and through selfreflection considers how these influence professional identity. 4.3 Recognizes diverse definitions and attributes of leadership when considering personal leadership style. 4.4 Articulates personal beliefs about culture and other forms of diversity and recognizes their potential influence on nursing care. 4.5 Recognizes one s personal learning preference in comparison to different learning styles and assumes personal responsibility for learning. 4.6 Recognizes socially constructed definitions of nursing comportment and how these influence one s own professional identity and conduct. 4.7 Recognizes the relationship between personal health practices and wellness in one s own life. 4.1 With direction, and within the context of working with clients experiencing health challenges and life transitions, considers and uses multiple concepts related to legal issues, professional standards and code of ethics to provide nursing care. 4.2 Analyzes personal and societal beliefs, values, and prejudices, to determine one s own philosophy of nursing practice. 4.3 Uses knowledge of leadership theory and understanding of context to enhance relationship with members of the health care team. 4.4 Recognizes cultural and other forms of diversity and with direction, acquires knowledge to inform culturally sensitive care. _ 4.5 Recognizes gaps in one s knowledge of nursing and related fields, and with guidance, develops and uses strategies to address learning needs. 4.6 Critically assesses and uses nursing discourse (code of ethics, Faculty policies, nursing theory) to define and develop professional identity and conduct. 4.7 Identifies individual health practices to maintain balance and wellness in one s life. 4.1 With some direction, and within the contexts of working with communities and clients with complex health challenges, integrates multiple concepts to discern applicable legal and professional standards when providing nursing care in ethically complex situations. _ 4.2 Uses critical self reflection and knowledge of nursing theories to deepen one's philosophy of nursing care and to guide practice. 4.3 Develops a personal leadership style and considers that of others, to work effectively with clients, members of the health care and inter-sectoral teams. 4.4 Is inclusive when working with those from diverse cultures and groups to determine requirements of culturally competent care 4.5 Identifies gaps in knowledge and incorporates new knowledge and strategies to provide effective nursing care in complex situations. 4.6 Recognizes and considers the influence of context, consistently discerning and demonstrating professional conduct when faced with complex situations. 4.7 Recognizes personal wellness through individual health practices Independently integrates multiple concepts, as well as legal, ethical and professional standards to provide optimal nursing care in complex and unfamiliar situations. 4.2 Use critical self reflection to assess and modify nursing practice to ensure the ongoing delivery of comprehensive nursing care. 4.3 Adapts and uses personal leadership style in complex and unfamiliar settings to work effectively with clients, members of the health care and inter-sectoral teams. 4.4 Adapts knowledge, beliefs and values to determine and provide culturally competent nursing care. 4.5 Anticipates one s own learning needs in the context of current professional trends, and develops new learning strategies to ensure the provision of quality nursing care. 4.6 Demonstrates professional conduct in ambiguous and unfamiliar situations. 4.7 Recognizes the capacity to balance personal wellness and professional commitment.

19 19 5 Social Justice/Effective Citizenship APPENDIX A- CONTINUED Nursing students become responsible global citizens, by engaging the principles of Primary Health Care and the ethics of caring and social justice in diverse contexts Program Outcomes Year One Year Two Year Three Year Four 5.1 Recognizes the limits and bias of knowledge and uses this recognition to collaboratively propose and engage in alternative approaches to nursing practice Utilizes culturally relevant concepts and frameworks of social justice, Primary Health Care, and caring to engage in collaborative practice. 5.3 Considers local, national, and global perspectives of social justice to arrive at informed decisions for nursing practice. 5.4 Critically examines the effects of membership in a privileged group, as well as power dynamics of oppression and domination, and explores root causes of disparities and considers possible approaches to addressing them. 5.5 Engages in activities that consciously develop self as a respectful, responsible and committed citizen, who promotes social justice, in professional, local, national, and global communities. 5.1 Compares and contrasts historical views and cultural paradigms of justice (distributive, restorative, social), considering how these change historically and how they influence personal conceptions of justice Recognizes the central attributes of Primary Health Care, social justice and caring and their relationship to culturally competent and safe nursing practice. 5.3 Recognizes the influences of social, political and economic structures on the organization of health care. 5.4 Reflectively explores Trans -national literature, scholarship on the ethics of social justice, professional identity, social privilege, and effective citizenship, recognizing contradictions that may exist in one s own values and beliefs, and communicates effectively with self and with others about the effects of these contradictions. 5.5 Develops a narrative imagination through the exploration of diverse literature, art, film, social scientific, scientific and applied experiences, which contribute to an enhanced appreciation of the complexity of the natural and cultural world, across time and across diverse social, political and economic contexts. 5.1 Critically reflects on one s own social and cultural conceptions of social justice and caring, and with facilitation, uses new understandings of these to reach decisions about competent and safe nursing practice with individuals/groups 5.2 Compares and contrasts different discourses of ethics based on the language of Primary Health Care, social justice and caring, and with facilitation, uses these to reach culturally sensitive and competent nursing decisions when working with individuals and families in diverse contexts. 5.3 Compares and contrasts differences in health outcomes and health delivery based on an understanding of the determinants of health and various political-economic and national/ international contexts. 5.4 Engages effectively in collaborative efforts and communication with others to develop shared understandings of power dynamics and imbalances to learn about best practices or alternative approaches that address structural causes of disparities. 5.5 Uses basic understanding of culture, society and history to engage with clients and consider different approaches to nursing care that are culturally sensitive. 5.1 Critically examines research approaches, scientific evidence and culturally accurate knowledge, and with facilitation, uses these to collaborate with others, and to reach informed decisions about nursing interventions in diverse contexts. 5.2 With facilitation, uses frameworks of social justice to identify contradictions in health outcomes and to engage in culturally safe nursing practice that addresses disparities in health outcomes. 5.3 Recognizes and incorporates international, trans-national or cross cultural approaches to social justice exploring their application to current practice. 5.4 With some facilitation in experiential and service learning, integrates new knowledge to develop practices and relationships that engage and challenge the dynamics of colonialization, oppression or domination. 5.5 With some direction, collaborates with others, reviewing existing research and knowledge to critically appraise and select effective approaches to care that are culturally competent and safe. 5.1 Integrates culturally relevant frameworks of Primary Health Care while collaborating effectively with others, to identify contradictions in health outcomes, to propose and engage in alternative approaches to nursing practice. 5.2 Collaborates with others in unfamiliar contexts, considering perspectives of social justice, to provide culturally competent and safe nursing practice in the context of Primary Health care. 5.3 Collaborates with others in determining how new approaches to the delivery of care may improve Primary Health care and address disparities in health outcomes. 5.4 Collaborates and communicates effectively with others in unfamiliar contexts to form interprofessional, intraprofessional and interdisciplinary relationships based in social justice and egalitarian relationships of power. 5.5 Engages with others, in unfamiliar contexts, to develop approaches to health care that are culturally competent and safe supporting self-determination and de-colonialization.