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Analytic Rubrics for Evaluation of Psychomotor Skills and PortfolioResearch Paper

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Nursing -- Evaluation Plan With Rubrics

In the current scenario, I am a hospital-based director of staff education working with a new group of graduate nurses. I have chosen the psychomotor skills that I want to assess for these new graduate nurses and have developed an evaluation plan and an analytic rubric specific to those chosen skills. The objectives for this test are to determine development of the psychomotor skills of taking blood pressure. The parameters against which learners will be evaluated are the clinical practice parameters moving from close supervision/imitation to naturalization/mastery of the skill. The weightings that each grading criteria will carry are equal, at two points each. In addition, the chief nursing officer (CNO) of my organization has informed me that for this accreditation cycle, the method for evaluating nursing competency for these new graduates will be portfolios. Consequently, I must develop an analytic rubric for the portfolio.

B. Body

Analytic Rubric for Evaluation of Psychomotor Skill of Taking Blood Pressure

Simply put, psychomotor learning is the development of motor skills and capabilities in the use of technology (Oermann & Gaberson, 2014, p. 20). Here, the rubric is analytical, with distinct, precise performance measures, rating scale, and explanations of the standard performance for each criterion (Shipman, Roa, Hooten, & Wang, 2012, p. 247). Evaluation planning for development of nursing psychomotor skills advances in five levels: Imitation, in which the student observes and imitates the instructor under supervision; manipulation, in which the student follows instructions and practices; precision, in which the student is able to perform independently with few errors; articulation, in which the skills are coordinated and modified; and naturalization, in which the student has mastered the skill, performing it automatically and with a consistently high level of competency (Allnurses.com, Inc., 2009). The five levels were first articulated as early as 1970 but its simplicity and reliability have made it one of the standards for development of psychomotor skills.

For purposes of this paper, the selected psychomotor skill(s) involve taking blood pressure. The psychomotor and accompanying skills assessed are: interviewing the patient regarding medical, psychosocial, substance abuse and other factors possibly affecting blood pressure reading; properly securing the Sphygmomanometer; indexing the Stethoscope; placing the Diaphragm over Brachial Artery; tightening the screw valve and using the inflation bulb to inflate the cuff; slightly loosening the screw valve to slowly allow cuff deflation; noting the pressure at which the systolic pressure (first pulsing sound) is heard; noting the diastolic pressure (at which the sounds disappear); loosening the screw valve to allow complete cuff deflation; completing the entire process in less than 1 minute; and recording blood pressure as systolic over diastolic pressure in fraction-like form (American Heart Association, 2016). Each of these eleven criteria is assigned a 2-point value, for a possible total of 22 points. The rubric for this evaluation is accompanied by a checklist and is located in Appendix A.

2. Part 2: Analytic Rubric for Evaluation of Nursing Portfolio

There are essentially two types of nursing portfolios: a best work portfolio, containing the nurse's best final products that evince the nurse's demonstration of appropriate competencies and achievements in clinical practice; and a growth portfolio, showing the nurse's progress and self-reflection regarding learning outcomes at some key points in time (Oermann & Gaberson, Evaluation and testing in nursing education, 4th edition, 2014, p. 290). Combined, these enable instructors to review progress and give feedback, empower the student to discern and achieve his/her professional goals and provide potential employers with vital information in their hiring decisions.

For evaluation purposes, the analytic rubric should address not only content but also display and critical thinking in its development (Oermann, Developing a professional portfoilio in nursing, 2002). It also typically includes a checklist regarding all three facets: display; contents and critical thinking. Each facet is assigned 5 possible points, with a possibility of 15 total points. While a portfolio may be constructed online this paper addresses a paper portfolio. Guidelines for the preparation of a paper portfolio typically include: using a high quality 3-ring binder with dividers for each section, which might consist of the resume, clinical practice, program outcomes and community activities; a table of contents; plastic sleeves for multiple or unevenly shaped pages; no folded documents; dynamic organization to allow the examiner to discern competencies, goals and progress and to allow ease of amendment/refinement as the portfolio grows; and copies rather than originals (Oermann, Developing a professional portfoilio in nursing, 2002).

In order to obtain the best possible portfolio, in addition to the basic documents included with a job application, the preparer should include documents and aspects based on asking himself/herself: what he/she wants the portfolio to demonstrate about himself/herself; his/her characteristics as a nurse; what has been learned and how it can be conveyed in the portfolio; how the portfolio projects future growth and development; his/her goals, the timelines and preparations needed to achieve those goals, and how those could be conveyed in the portfolio; and any comments/documents have been prepared by instructors, supervisors and peers could be included (Oermann, Developing a professional portfoilio in nursing, 2002). The analytic rubric for evaluating a nursing portfolio is in Appendix B.

C. Conclusion

I am a hospital-based director of staff education working with a new group of graduate nurses. In that capacity, I have developed an analytic rubric for evaluating the psychomotor skills (and related skills) involved in taking blood pressure. In addition, I have developed an analytic rubric for evaluation of nursing portfolios. Evaluation planning for development of nursing psychomotor skills progresses from a "beginning" level to the level of mastery in five levels: imitation; manipulation; precision; articulation and naturalization. In order to evaluate psychomotor skills, we assess 11 criteria, each of which is given a 2-point value, for a possible total of 22 points. Those 11 criteria are: interviewing the patient; properly securing the Sphygmomanometer; indexing the Stethoscope; placing the Diaphragm over Brachial Artery; tightening the screw valve and using the inflation bulb to inflate the cuff; slightly loosening the screw valve to slowly allow cuff deflation; noting the pressure at which the systolic pressure (first pulsing sound) is heard; noting the diastolic pressure (at which the sounds disappear); loosening the screw valve to allow complete cuff deflation; completing the entire process in less than 1 minute; and recording blood pressure as systolic over diastolic pressure in fraction-like form. The analytic rubric for the psychomotor skills of taking blood pressure is in Appendix A.

The nursing portfolio ideally enables instructors to review progress and give feedback, empowers the student to discern and achieve his/her professional goals and provides potential employers with vital information in their hiring decisions. Evaluation of the portfolio focuses on display, content and critical thinking in the portfolio's development. Assigning 5 possible points to each of these criteria, with a possible total of 15 points, the analytic rubric is accompanied by a checklist of desired content. The analytic rubrics for evaluating nursing portfolios, along with the companion contents checklist, are in Appendix B.

APPENDIX A

Part 1: Analytic Rubric for Taking Blood Pressure (22 possible points)

Patient Interview about medical, psychosocial, drug abuse and other factors possibly affecting blood pressure:

Correctly secure Sphygmomanometer.

around upper arm, snugly with arrow aligned with brachial artery

Indexing Stethoscope by turning chest piece to amplify sound in diaphragm, checked by inserting ear tips into ears and gently tapping diaphragm.

Placing diaphragm over brachial artery, medial to biceps tendon.

Tightening screw valve and using inflation bulb to inflate cuff to approximately 200 mmHg pressure

Slightly loosening screw valve to allow slow cuff deflation.

Noting systolic pressure (at which the first pulsing sound is heard).

Noting diastolic pressure (at which the sounds disappear).

Loosening screw valve to allow complete cuff deflation.

Completed in less than 1 minute

Record Blood Pressure, with systolic over diastolic pressure (in "fraction-like" form)

APPENDIX B

Part 2a: Analytic Rubric for Evaluating Nursing Portfolio

Criteria

Portfolio Display

Portfolio Contents

Critical Thinking in Portfolio Development

Nice-looking and well-systematized, in a 3-ring binder with a table of contents, numbered pages and structured in logical sections. Items show consistently strong focus, and correct grammar, spelling and vocabulary.

Holds all required content based on the checklist below, all arranged neatly and creatively. Every program outcome is headed by a current narrative reflection.

Contents show the nurse's methodical progress toward each outcome/goal.

Evinces clear, logical, analytical thinking, with well-developed thoughts. Shows vibrant evidence of individual insights into personal and professional development.

Scores

Part 2b: Checklist of Portfolio Contents:

( ) Clearly organized sections

( ) Title page: (name, credentials, address, phone number(s) and e-mail address(s)

( ) Table of contents

( ) Nursing Philosophy Statement

( ) Resume

( ) Professional goals

( ) Program Outcomes: Each outcome separated by sub-divider and including:

- supporting exhibits

- individual insights into personal and professional development toward goals of:

• Patient-centered care

• Professionalism

• Leadership

• Systems-Based Practice

• Informatics & Technology

• Communication

• Teamwork & Collaboration

• Safety

• Quality Improvement… [END OF PREVIEW]

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