Portfolios To Assess Professional Competence And Development Nursing Essay

Portfolios To Assess Professional Competence And Development Nursing Essay Portfolios have been recommended for the assessment of professional development. To stimulate engagement and assess professional development during laboratory training, portfolio assessment was proposed for the final year BMLS and DMLT programmes in Kampala International University. Work Done The students undergoing clinical laboratory training in teaching hospitals, and engaged in routine laboratory services under supervision of qualified Medical Laboratory Scientists, composed a portfolio detailing their daily experiences, work done, and lessons learned. Their supervisors and facilitators provided daily feedback and endorsed their entries. The portfolios were examined at the end of training by faculty staff and external examiner through oral presentation and interviews. Rating rubric considered quality of presentation, portfolio content, demonstration of progressive development, and ability to make professional judgment. Students and assessors acceptance of this instrument was determined with questionnaire. Results 72 % of the students and assessors accepted the method. Many students reported that it improved commitment to training, encouraged reflection, and allowed for frequent feedback. Many believed that it was a rational assessment, but it was time consuming. 88 % of the participants would welcome it as a supplement to the standard tests. Conclusions The portfolio assessment was well accepted, rational, and provided a valid assessment of student engagement and progression during professional training. Take Home Message The inclusion of portfolio assessment in Medical Laboratory Sciences Education provided valid assessment of students engagement in training and professional development over time. Introduction The use of portfolios in health professions education has increased dramatically over the years. The enthusiastic acceptance of this principle is in part born out of the ever growing interest in outcomes based education in all divisions of health science.1 The curricula of most health sciences schools now emphasize authentic experiences, promote self direction and reflection in learning, and outcomes based assessment. Portfolios not only stimulate professional development and reflective learning, they also provide opportunity for self direction, and avenues for feedback from faculty.2, 3 Portfolios have been recommended for the assessment of professional development in medical education,4 and several reports document their successful use in assessment of competence at both undergraduate and postgraduate levels.5,6 To stimulate engagement and to assess professional development during clinical laboratory training, portfolio development and assessment was proposed for the final year Bac helor of Medical Laboratory Sciences and the Diploma in Medical Laboratory Technology students of the Kampala International University, Uganda in 2008. This article reports the experience of the use of portfolios to assess professional development in these programmes. Methods Institutional approval for the study was obtained from the IREC. Eighteen final year students who were undergoing clinical laboratory training in the teaching hospitals at the Kampala International University Teaching Hospital Ishaka and the Mulago Hospital in Kampala and participating in routine daily laboratory work were requested to compose and maintain a portfolio comprising details of their daily experiences, work done and lessons learnt during their training. Their supervisors and programme facilitators provided daily feedback on their work and endorsed all entries. At the end of their clinical laboratory training, the portfolios were examined by the four faculty staff and an external examiner. The students were also required to make a 15 minutes presentation based on the portfolio content, and take interview on lessons learned and overall impact of the training on their development. A rating rubric used for the assessment considered the quality of students presentation, portfo lio content, demonstration of students progressive development over time, and their ability to make professional judgment. Questionnaires were used to determine the students and raters views on the acceptability, convenience, and usefulness of this method of assessment. The data were analyzed quantitatively and qualitatively. Table 1: Rubric for the assessment of the students portfolios Standard met Standard not met 1 Presentation was complete in 15 minutes 2 Quality of presentation 3 Student showed progressive development over time 4 Student reflected on experiences and could make good professional judgment 5 Portfolio content was adequate 6 Overall assessment Pass Fail General comments: Results The result showed that seventy two per cent (72 %) of the students and assessors accepted the method as a valid and effective means of assessing professional competence. Many students (15 of the 18) reported that it improved their commitment to the laboratory training, and encouraged them to reflect on their daily experiences. Both faculty and students reported that it allowed for frequent feedback and more engagement in the programme. Many believed that it was a rational assessment as it captured development over time, but it was time consuming and quite tasking on both students and staff. Eighty eight per cent (88 %) were of the view that it should be a supplement and not a substitute for the standard written and practical tests. Discussion The evolution of portfolio as a tool for the assessment of professional competence and development offers several advantages over the traditional standard tests which to a large extent are reductionist and do not capture progression over time. Application of portfolio assessment in Medical Laboratory Sciences education is not widespread and only few reports are available in literature.7 This study demonstrated that portfolio development and assessment is well accepted by both staff and students in the medical laboratory sciences programme of the Kampala International University. An important aspect of medical education is the matching of assessment methods with learning mode, as assessment drives learning. Portfolio assessment aligns well with competency based education whose tenets include learner centeredness, formative feedback, developmental process, reflection, and multiple types and sources of assessment.3 This study demonstrated this clearly as it promoted student /staff engag ement in the clinical laboratory training programme, students ownership of their training, and reflective learning which are some of the advantages highlighted by similar previous reports of the use of portfolio in other programmes.8, 9 The study also showed that many of the study participants would not welcome this form of assessment as the only mode of student assessment. Rather it would be a valuable addition to the traditional methods of assessment of competence. The limitations of this study include the small sample size used for the study. It is recommended that a larger sample of students be included in a more elaborate study possibly over a longer study period. To ease the burden of assessment, using structured interview to assess the portfolio as recommended by Burch and Seggie 10 could be helpful. Conclusion: The use of portfolios to assess students progress and professional competence in Medical Laboratory Sciences is a welcome proposition. It should be used to supplement the standard written and practical tests. Its advantages include stimulation of student engagement, self direction, reflective learning, and monitoring of progress over time. It is however seen to be time consuming for the students. Its introduction extends the methods of assessment in Medical Laboratory Sciences.

Leadership and Management in Nursing Essay

Nursing is a very demanding and dedicated profession and the current shortage is a serious problem at all levels of nursing and is the dearth of leaders among nurses. Leadership and management are essential skills for all qualified healthcare professionals and have a pivotal role in ensuring a delivery of high standards of care. Developing future nurse leaders is one of the greatest challenges faced by the nursing profession, (Mahoney, 2001). The author is currently working as a midwife in one of the big hospitals in Riyadh, Saudi Arabia. The average deliveries per month are 500-600. There are 22 midwives in this unit and there are eight vacant posts for midwives . Due to the shortage of midwives, these professional staffs are subjected to personal and work related stress. Preston et, al. (1981) defined stress as an adaptive response, mediated by individual characteristics or psychological processes. The negative effects of stress could be evident in staff absenteeism, hostility, and aggression. This will impair the provision of quality care and the effective functioning of the organization. (Healy & McKay, 1999). The adverse effect of workload and stress in the author’s placement has lead to an alarming high staff turnover. Apparently, the increased workload has affected the staff performances and the quality of nursing care. When the staff feel that they are not cared for, then they find it difficult to care for patients ( Atwater & Bass 1994, Lancaster 1999). In this assignment, the author will explore the various leadership styles and their theories and also distinguish the functions between leadership and management. The author will also critically explore the manager’s leadership practice in labor and delivery suite, thus creating a culture of reducing stress. The link of leadership style from the aspect of work, environment, communication, empowerment, delegation, implications, conclusion and recommendations will be discussed further. Leaders are not someone who holds top position but also able to give assistance to others, (Mahoney, 2001). Whereas in my placement, the head nurse, who is the leader, never gives a helping hand during the deliveries. She anticipates the midwives to conduct and manage the deliveries, even though there’s shortage of staff. The nurse manager has to prepare the correct number of staff on each shift with the credentials to do the job and must be aware of the policies regarding overtime, floating from one unit to another. She must form a competent team and manage them to carry out the plan for reaching the goal of excellent patient care. Effective leaders are not merely someone who is skillful but they must acquire good attitudes, (Cook, 2001). The nurse manager must understand the factors surrounding the current situation in the unit and have the knowledge of various approaches to leadership that will help to understand and determine the best leadership approach to create a positive work environment to reduce stress. Leadership is defined as the ability to influence, inspire and motivate a group of people towards the achievement of its goal, (Yuki, 2002). Management is a process of getting things done effectively through planning and organization of services which is one of the basic function of management whereas the leader is an intermediary between work group and the top management, (Marquis and Huston, 2006). The manager uses a formal and rational method whilst the leader uses passions and stirs emotions. Without enabling and empowering nursing leadership, efforts to improve the quality and safety of healthcare will be limited and short-lived, as said by Kelly (2008). For a leader to achieve the goal, she must have the three essential things which are power, authority and influence to act in a way that will stimulate a positive respond from the staff (Tomey, 2009). Leaders will emerge when nurses feel valued and inspired to strive for excellence. They aim to improve patient care via a cohesive work force by focusing on interpersonal relationships between leaders and subordinates, (Malby 1997). A nursing leader should have a distinctive set of personal qualities, integrity, courage, initiative, ability to handle stress, think critically, able to resolve problems without conflicts, skillful communication and must be empathetic. They are not those who control others but they act as visionaries who help staff to plan, lead, control and organize their activities, (Jooste,2004). There are many types of leadership. Autocratic type of leaders are those who make all decisions and expect others to follow without questioning and never seek advice from others, (Sullivan & Decker 2005). This situation had made some of the midwives to leave for greener pastures. The current health system has advanced in technology and improved in care giving services (Cook, 2001). The author feels that this leadership style is no longer tenable and fits into the contemporary nursing practice and a consumer responsive culture. Democratic leaders encourage the participant of staff and use a consensus for decision making, (Sullivan & Decker 2005) whereas bureaucratic leadership occurs when a leader rigidly adheres to rules, regulations and policies of the organization, (Jenkins and Henderson, 1984). Instead of providing sufficient support and consideration, my nurse manager demonstrates these leadership qualities because she uses rules and policies thus expecting strict compliance from the midwives. . By following the organizational hierarchy’s influence, she puts herself in a high position but never use her power constructively (Masquis & Huston, 2006). Due to top management instructions, she adheres to the current policies, making no changes in them but gives verbal instruction and changing policies to her likes and dislikes. This swifts away trust and open communications between the manager and the midwives. Due to unvented stress and high expectations from the nurse manager, the midwives burnout level have been exacerbated . Burnout is a syndrome of emotional exhaustion, depersonalization and lack of personal accomplishment, as said by Maslach &Jackson (1981). Reports have proved that in this kind of environment, patient’s safety is at risk (Institute of Medicine, 2004). Participative leadership allows staff to participate in decision making and actively seek out the participation of those involved. This type of leadership allows staff to feel more committed to the goals they were involved (Faugier & Woolnough, 2002). The author feels that the head nurse should have these qualities so that the unit will run smoothly, and the staff will be appreciated and acknowledged so that good nursing care can be rendered. Transformational leadership is especially well suited for today’s fast changing healthcare environment where adaptation is extremely important (Welford,2002). It starts with the development of a vision that will excite and convert potential followers, (Outhwaite, 2003). To achieve organizational success, this style advocates for strong leadership qualities and these leaders use motivation in their approach than use rewards and punishment as said by Kouzes & Posner (2002). In the author’s point of view, this leadership is proposed as empowering leadership style which well suits in my unit and to be recognized by the nurse manager. According to Bowles & Bowels (2002), transformational leaders create a leadership culture for all team members nurturing empowerment, increase their autonomy and open communication for inclusive decision making. The nurse manager takes responsibilities for discussing care related matters with the midwives which makes them to be motivated and work more effectively to contribute to the development and provision of the unit, (Murphy. 2005). The ability of the leader to articulate a shared vision is an important aspect of transformational leadership (Faugier & Woolnough, 2002). Another leadership style is transactional leadership which focuses on providing day to day care between leaders and their employee. It aims to maintain equilibrium and harmony by using incentives to enhance staff loyalty and performance (Bass and Riggio, 2006). Laissez faire leadership is another style that leaves the staff alone to work with no directions or facilitations and is a highly risky form of leadership, (Sullivan & Decker 2005). Since the author’s placement is labor and delivery, it’s not advisable to have this kind of leader in this unit as it will increase the mortality rate. The high level of burnout and increased workload due to shortage of midwives and less rest days has resulted them to leave. This disequilibrium may trigger the risk of physical and mental health of these midwives. The manager has depleted the nurses basic psychological needs which are rest and sleep and at the same time reducing their self- esteem, as said in Maslow’s theory of human motivation. The leader should explore barriers and identify conflicts when they arise and collaborate with the team and be able to understand the employee’s perspective (Outhwaite,2003). A more effective form of leadership maybe situational leadership where the leader switches the style depending upon the situation at hand and upon the competence of the staff, (Faugier & Woolnough, 2002). The nurse manager must be good clinician and have judgment skills to handle any problem that cannot be handled by the staff. By doing so, the staff will listen to her as she guides them. Communication also plays a vital role as this can prevent conflict and smoothes the progress of team building in the unit Calpin-Davies, (2000). A good communicator gives the staff detailed instructions to perform tasks that are necessary to reach the goal. The nurse manager uses a communication book to provide important information to all the staff in the unit, as supported by Sullivan & Decker (2005). By reading and acknowledging with a signature, she assures the message has been reached effectively. As a leader, the nurse manager has to be a good listener. It provides the opportunity to receive valuable feedback that is used to avert some problems and resolve others and also giving greater understanding of the issues being discussed. When there are incidences in the unit, the nurse manager gives a listening ear to the staff and tries to solve the problems. She puts aside preconceived ideas or prejudices when listening to staff. Being a leader, the nurse manager delegates some of the tasks to the staff to focus on more complex aspects of running the unit. She delegates the right task to the right person, for example sending and collecting of narcotics by the midwife as these drugs used are cautioned in Saudi Arabia. A good leader fosters a congenial work environment by coaching, praising and training the staff to perform an excellent job and also by conducting continuous nursing education. Supervision goes in the observation of staff and to evaluate in the yearly performance appraisal. The author would recommend that the nurse manager in this unit has to change her leadership style to She should resources for proper quality care Conclusion Today, healthcare environment requires leaders to be skillful and knowledgeable and have strong inspirational leadership qualities across the health care organization. In this millennium, nursing must make a dedicated effort to nurture its young nurses to grow into effective and motivating leaders.

Robert Frost - WWI Poet - Free Essay Example

Sample details Pages: 2 Words: 680 Downloads: 10 Date added: 2019/10/30 Category People Essay Level High school Tags: Robert Frost Essay Did you like this example? During the time of World War I, Robert Frost composed his poetry to contrast themes that dealt with issues, and he also used his poems to portray difficulties that inspire living things to achieve their wants. In the poems, Mending Wall and The Cow in Apple Time, Robert Frost reveals the deeper meaning of a wall and a fence as an extended metaphor in order to convey that a barrier serves as a motivation for individuals or animals to accomplish their purpose. The poem, Mending Wall, illustrates how a wall is dividing the speaker and his neighbor, yet they still work together to repair the wall to remain their relationship. The phrase, And spills the upper boulders in the sun; and makes gaps even two can pass abreast (lines 3-4), demonstrates that it is not right for people to be separated and the gaps indicate them to pass through easily. The literal meaning of this phrase is that it is natural for people to remain connected and be able to communicate with each other. The metaphoric meaning is that gaps make change, yet keep connections alive. The line, Good Fences make Good Neighbors (line 45), indicates that both neighbors respect each others property and are willing to work with one another to guarantee that the wall maintains complete. The literal meaning of this line expresses that they will remain good neighbors as long as the fence remains. Metaphorically, it describes their respect for each others property. The phrase, And set the wall between us once again, we keep the wall between us as we go (lines 14-15), demonstrates that this is an ongoing issue between the two, however they appear to overcome it by repairing the wall annually. The literal meaning of the phrase is that this is not something new to them and that it should keep them separated but united as well. The metaphoric meaning is that the neighbors dont let anything come in between them, and repair what is broken. Fewer walls between people will create better relationships. Don’t waste time! Our writers will create an original "Robert Frost WWI Poet" essay for you Create order The poem, The Cow in Apple Time, is about a cow who jumps over a wall to get apples, upon eating the apple she is impressed with the taste of cider but shortly faces the consequences of illness and is unable to produce milk due to the excessive intake. The lines, She leaves them bitten when she has to fly, she bellows on a knoll against the sky (lines 9-10), demonstrate that as she bites more of the apples she starts to feel sick. The literal meaning is that the apple or fruit have negative consequences. The metaphorical meaning is that too much of something is not good and change can sometimes be harmful. The lines, Her face is flecked with pomace and she drools, a cider syrup, having tastes fruit (lines 4-5), indicates that after tasting the fruit, the cow is admired by the fruit and eats more than what she can handle. The literal meaning of these lines is to show her inspiration of the taste of fruit. The metaphorical meaning is for her to understand that an excessive amount of so mething is not good and there was a reason why the wall barrier was put before her. The lines, To make no more of a wall than an open gate, and think no more of wall-builders than fools (lines 2-3), demonstrate how the cow did not think about the purpose for the divider or the outcomes of going through the gate, she followed her craving to taste the juice. The literal meaning is there is a wall and barrier for a reason. However, humans or animals dont realize to think beyond those walls. The metaphorical meaning is to think before act. Thinking before acting will overall lead to accomplishments apart from opposing, which then leads to the downfall of morality. These both poems highlight how walls between people symbolizes separating yet uniting and how the more good things one gets may lead to disappointment. Make sure choices are well made in order to sustain a healthy relationship.

Death Is The Middle Child Of Parents Edward And Emily...

Emily Dickinson was born on December 10, 1830 in Amherst, Massachusetts. She was the middle child of parents Edward and Emily Norcross Dickinson. Young Emily Dickinson’s early childhood consisted of attending school, reading books, taking part in church activities, and learning to sing and play the piano. Her formal schooling was phenomenal for girls in the early 19th century, though not unusual for girls in Amherst. After spending some time in Amherst district school, she attended Amherst Academy for about 7 years before entering Mount Holyoke Female Seminary (now Mount Holyoke College) in 1847. Dickinson’s early years were not without distress. Deaths of friends and relatives, including her young cousin Sophia Holland, prompted questions about death and immortality. Death happens to be a recurring theme in Dickinson’s poetry. Although this is the case, no two poems have exactly the same understanding of death, however. Death is sometimes frightening, lenient an d gentle, or simply inevitable. The intent of this paper is to analyze the persistent theme of death in Dickinson’s poetry and how it is portrayed in some of her most well-known pieces. These select few poems will include â€Å"I like a look of Agony†, â€Å"I heard a Fly buzz—when I died† and â€Å"Because I could not stop for Death.† As Dickinson got older, her personal life went through a tremendous change. She came into her own as an artist during a short but intense period that scholars estimate ranged from 1858-1865. These