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Practicum Learning Objectives

 Practicum Learning Objectives

Life is a succession of lessons which must be lived to be understood.

—Ralph Waldo Emerson

The practicum experience provides a significant hands-on opportunity to cultivate your professional growth and development. This course includes a 216-hour practicum as part of the 1,000 clinical hours that are required for the DNP credential.

During your practicum experience for this course, you will cultivate effective interactions to promote the implementation, evaluation, and dissemination of an evidence-based project. In addition, you should pay close attention to the role of leadership in such endeavors and reflect on your own development of leadership competencies, including skillful communication. As you do this, also think about how you may meaningfully contribute to the organization during your remaining time in the setting.

This week you prepare for the practicum experience by developing a plan, including learning objectives and activities. (This is addressed in this week’s Discussion as well).

To prepare:

  • Think      about learning objectives that will guide your practicum hours, as well as      the activities you will undertake to achieve those objectives. Draft three      learning objectives that are related to the AACN Essentials, your practice area specialty competencies,      and the focus of this course (see course outcomes below).
  • Develop      a timeline for your practicum experience.

Complete by Friday May 31, 2019 before 10 pm America/New York time

Write a 2-page paper in APA format with at least 3 scholarly references that includes the level one headers as numbered below: (refer to the DNP Essential IV in the attached file named “AACN 2006 DNP Essential” to write the objectives).

1) Three learning objectives for your practicum hours that are aligned to the AACN Essentials, your specialty area competencies, and the focus of this course (i.e., implementation, evaluation, and dissemination of an evidence-based project).

2) Key leadership and other activities you will undertake to fulfill your identified learning objectives

3) A proposed timeline for accomplishing your practicum hours (please divide 216 hours over a ten weeks period).

Required Readings

The Learning Management Corporation. (n.d.). Developing clear learning outcomes and objectives. Retrieved from

Osters, S., & Tiu, F. S. (n. d.). Writing measurable learning outcomes. Retrieved from

Course Outcomes

By the conclusion of this course, you should be able to:

  • Synthesize      principles of evidence-based practice and appropriate theoretical      frameworks in order to evaluate the interventions utilized to address a      health care problem at the aggregate, systems, or organizational level
  • Evaluate      the planning and implementation of evidence-based interventions used to      address a health care issue
  • Appraise      the evaluation process of implemented evidence-based interventions to      address health care issues at the aggregate, systems, or organizational      level
  • Engage      in the scholarly dissemination of evidence-based practice activities that      promote quality and improved health outcomes
  • Demonstrate      leadership skills during the practicum experience that demonstrate      advanced nursing practice knowledge




DISTINCTION – LEARNING GOALS vs. LEARNING OUTCOMES When developing student learning outcomes, it is important to distinguish between broad course goals – focused on content the instructor intends to communicate – and more specific learning outcomes that focus on what the students will know or be able to do by the end of a learning experience. In trying to answer the question “What do I want my students to be able to do by the end of … (today’s class, this assignment, my course, etc.)?” instructors often use verbs such as those in the left column below, followed by important course content. For example, “I want my students to understand key events in late 20th century European history.” Such a broad goal is a good place to start, and these kinds of goals can be very useful in helping you identify the importance or scope of a topic. However, phrasing your goals in such general terms creates a challenge for determining whether students have achieved them. How do you measure “understanding”, “appreciation”, “knowledge” or “familiarity”? What evidence would demonstrate students’ achievement of these goals? Course goals are:

 broad statements of teaching intention (i.e., they indicate what content you intend to cover in your course);

 focused on long-range intended concept and skills;

 usually written using abstract teams and phrases like appreciate, understand and become familiar with;

 expressed in 3 to 5 statements. I want students to be able to:

GENERAL GOALS As the instructor, how do I know?


Know Analyze Learn …because students can… Solve Understand Compare Appreciate Critique Value Evaluate

(Adapted from Linse, A. (2011), Schreyer Institute for Teaching Excellence at The Pennsylvania State University.

Linse in turn adapted her text from Walvoord, B., (1998), Kaneb Center for Teaching and Learning, University of Notre Dame.)

Documenting and tracking student learning is easier if you specify what you would like students to do with the course content. In the right column above are examples of verbs that involve specific actions, observable behaviours, measurable achievements and/or student products. Once you have a list of 3-5 goals, you can translate them into effective learning outcomes which you can use to guide your decisions about course content, teaching methods and assessment. DRAFTING LEARNING OUTCOME STATEMENTS When crafting student learning outcomes, it can be useful to consult a learning taxonomy to identify the kinds of learning you would like to foster in your course. Bloom’s Taxonomy—developed by educational theorist Benjamin Bloom in the 1950s and revised by Krathwohl et al. in 2001—identifies three domains of learning: cognitive (knowledge), affective (attitudes), and psychomotor (skills). The cognitive domain highlights intellectual outcomes and is further divided into six specific categories or levels:




Evidence shows that students retain more information in a course setting when they discuss, practice by doing, or teach others (Marzano, R. J. and Kendall, J.S., (2008), Designing & Assessing Educational Objectives: Applying the New Taxonomy, Thousand Oaks: Corwin Press; Maki, P.L., (2010), Assessing for Learning: Building a Sustainable Commitment Access the Institution, 2nd ed., Sterling: Stylus Publishing, 2010). To truly tap into higher-order learning and thinking, students should analyze, evaluate and create. A well-developed course should aim to cycle through these various levels of cognitive development, culminating in the upper levels, and the course learning outcomes should correspond to appropriate levels of learning. Our goal is for students to do more than remember—they should also be able to apply what they have learned in other contexts beyond the course itself. To sum up, there are some key differences between course goals and course learning outcomes. Student learning outcomes:

 are student-centred;

 speak directly to students;

 align content, activities, and assessment;

 tell students the purpose of the learning;

 articulate to students how they are expected to apply their newly-acquired knowledge, skills and attitudes;

 are narrow and specific;

 are observable and measurable to verify that learning has been accomplished;

 are typically expressed in 5 to 10 statements.

An effective course will move students through the various levels of cognitive development. As students are introduced to course concepts and then given opportunities to practice applying them in increasingly complex ways, course learning outcomes should ideally reflect and speak to the different levels of learning in a course. The chart below provides definitions and attributes for each of the six levels of Bloom’s Revised Taxonomy, along with action verbs that can be used when developing learning outcomes. Also included are examples of learning outcomes from across different disciplines. Chart adapted from: Anderson, L.W., Krathwohl, D.R. (2001). A taxonomy of learning, teaching, and assessing. Boston: Allyn and Bacon. Also from the Center

for University Teaching, Learning, and Assessment, University of West Florida and the Center for Teaching and Learning, University of Texas.

Level Level Definition & Attributes Action Verbs Example of Learning Outcomes

Level 1: Remember

Students exhibit memory of previously learned materials by recalling facts, terms, basic concepts, and simple answers.

choose, define, find, how, label, list, match, name, omit, recall, relate, select, show, spell, tell, identify, describe, copy, locate, recognize, memorize, quote, reproduce, tabulate, discover, duplicate, listen, enumerate

Physics: By the end of this course, students will be able to recite Newton’s three laws of motion.

Bloom’s Revised Taxonomy


(Adapted from National Training Laboratories Institute, Bethel, Maine.)


The Learning Pyramid




Level Level Definition & Attributes Action Verbs Example of Learning Outcomes

Level 2: Understand

Students demonstrate understanding of facts and ideas by interpreting, exemplifying, classifying, summarizing, inferring, comparing and explaining main ideas.

classify, compare, contrast, extend, demonstrate, explain, illustrate, infer, interpret, outline, relate, rephrase, show, summarize, select, translate, describe, paraphrase, ask, differentiate, discuss, express, distinguish, restate, group

History: By the end of this course, students will be able to explain the causes of the French Revolution.

Level 3: Apply

Students solve problems in new situations by applying acquired knowledge, facts, techniques and rules in a different way.

calculate, predict, apply, solve, illustrate, use, demonstrate, determine, model, build, construct, develop, experiment with, identify, make use of, organize, plan, select

Engineering: By the end of this course, students will be able to calculate the kinetic energy of a projectile.

Level 4: Analyze

Students are able to examine and break information into parts by identifying motives, causes and relationships. They can make inferences and find evidence to support generalization.

classify, outline, break down, categorize, analyze, diagram, illustrate, assume, compare, conclusion, contrast, discover, dissect, distinguish, divide, examine, function, inference, inspect, list, motive, relationships, simplify, survey, take part in, test for

English: By the end of this course, students will be able to determine key elements of William Shakespeare’s political perspective.

Level 5: Evaluate

Students are able to present and defend opinions by making judgments about information, validity of ideas, or quality of work based on a set of criteria. They can justify a decision or course of action.

design, formulate, build, invent, create, compose, generate, derive, modify, develop, agree, appraise, assess, award, choose, compare, conclude, criteria, criticize, decide, deduct, defend, determine, disprove, estimate, evaluate, explain, influence, judge, interpret, justify, mark, measure, perceive, prioritize, rate, recommend, rule on, select, support, value

Economics: By the end of the course, students will be able to apply discrete and continuous probability distributions using industry standard statistical software, in order to evaluate the probability of real world events.

Level 6: Create

Students are able to compile, generate or view information, ideas or products together in a different way by combining elements in a new pattern or by proposing alternative solutions.

adapt, build, change, choose, combine, compile, compose, construct, create, delete, design, develop, discuss, elaborate, estimate, formulate, happen, imagine, improve, invent, make up, maximize, modify, originate, plan, predict, propose, solve, suppose, test, hypothesize, substitute, compile, develop, rearrange, anticipate, assemble, collaborate, collect, devise, imagine, intervene

Chemistry: By the end of this course, students will be able to design and execute synthetic and analytical experimental procedures found in the scientific literature in physical and inorganic chemistry.

Once you are able to clearly determine what students will be doing to practice and demonstrate their newly acquired knowledge and skills at each level of learning, you can develop effective learning outcomes that can help both you and your students track your students’ progress through the course. Remember that outcomes should not simply refer to course content. In other words, they must be observable, measurable and expressed to show what learners will do and what they will achieve. Flowing from your general course goals and student learning outcomes, all components of your teaching—teaching strategies and methods, assessment and feedback—can then be closely aligned to create a coherent course structure that will help students achieve significant learning.




The Essentials of Doctoral Education for Advanced Nursing Practice

October 2006


Page Introduction

Background 3 Comparison Between Research-Focused and Practice-Focused

Doctoral Education 3 AACN Task Force on the Practice Doctorate in Nursing 4 Context of Graduate Education in Nursing 5 Relationships of Master’s, Practice Doctorate, and Research Doctorate Programs 6

DNP Graduates and Academic Roles 7 The Essentials of Doctoral Education for Advanced Nursing Practice 8 I. Scientific Underpinnings for Practice 8 II. Organizational and Systems Leadership for Quality Improvement and Systems Thinking 9 III. Clinical Scholarship and Analytical Methods for Evidence-Based Practice 11 IV. Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care 12 V. Health Care Policy for Advocacy in Health Care 13 VI. Interprofessional Collaboration for Improving Patient and Population Health Outcomes 14 VII. Clinical Prevention and Population Health for Improving the Nation’s Health 15 VIII. Advanced Nursing Practice 16 Incorporation of Specialty-Focused Competencies into DNP Curricula 17 Advanced Practice Nursing Focus 17 Aggregate/Systems/Organizational Focus 18


One Dupont Circle NW, Suite 530 · Washington, DC 20036 · 202-463-6930 tel · 202-785-8320 fax ·


Curricular Elements and Structure 18 Program Length 18 Practice Experiences in the Curriculum 19 Final DNP Project 19 DNP Programs in the Academic Environment: Indicators of Quality in Doctor of Nursing Practice Programs 20 Faculty Characteristics 20 The Faculty and Practice 20 Practice Resources and Clinical Environment Resources 21 Academic Infrastructure 21 Appendix A Advanced Health/Physical Assessment 23 Advanced Physiology and Pathophysiology 23 Advanced Pharmacology 24 Appendix B DNP Essentials Task Force 25 References 27



Background Doctoral programs in nursing fall into two principal types: research-focused and practice- focused. Most research-focused programs grant the Doctor of Philosophy degree (PhD), while a small percentage offers the Doctor of Nursing Science degree (DNS, DSN, or DNSc). Designed to prepare nurse scientists and scholars, these programs focus heavily on scientific content and research methodology; and all require an original research project and the completion and defense of a dissertation or linked research papers. Practice-focused doctoral programs are designed to prepare experts in specialized advanced nursing practice. They focus heavily on practice that is innovative and evidence-based, reflecting the application of credible research findings. The two types of doctoral programs differ in their goals and the competencies of their graduates. They represent complementary, alternative approaches to the highest level of educational preparation in nursing. The concept of a practice doctorate in nursing is not new. However, this course of study has evolved considerably over the 20 years since the first practice-focused nursing doctorate, the Doctor of Nursing (ND), was initiated as an entry-level degree. Because research- and practice-focused programs are distinctly different, the current position of the American Association of Colleges of Nursing (AACN, 2004) [detailed in the Position Statement on the Practice Doctorate in Nursing] is that: “The two types of doctorates, research-focused and practice-focused, may coexist within the same education unit” and that the practice-focused degree should be the Doctor of Nursing Practice (DNP). Recognizing the need for consistency in the degrees required for advanced nursing practice, all existing ND programs have transitioned to the DNP. Comparison Between Research-Focused and Practice-Focused Doctoral Education Research- and practice-focused doctoral programs in nursing share rigorous and demanding expectations: a scholarly approach to the discipline, and a commitment to the advancement of the profession. Both are terminal degrees in the discipline, one in practice and one in research. However, there are distinct differences between the two degree programs. For example, practice-focused programs understandably place greater emphasis on practice, and less emphasis on theory, meta-theory, research methodology, and statistics than is apparent in research-focused programs. Whereas all research- focused programs require an extensive research study that is reported in a dissertation or through the development of linked research papers, practice-focused doctoral programs generally include integrative practice experiences and an intense practice immersion experience. Rather than a knowledge-generating research effort, the student in a practice- focused program generally carries out a practice application-oriented “final DNP project,” which is an integral part of the integrative practice experience.


AACN Task Force on the Practice Doctorate in Nursing The AACN Task Force to Revise Quality Indicators for Doctoral Education found that the Indicators of Quality in Research-Focused Doctoral Programs in Nursing are applicable to doctoral programs leading to a PhD or a DNS degree (AACN, 2001b, p. 1). Therefore, practice-focused doctoral programs will need to be examined separately from research-focused programs. This finding coupled with the growing interest in practice doctorates prompted the establishment of the AACN Task Force on the Practice Doctorate in Nursing in 2002. This task force was convened to examine trends in practice-focused doctoral education and make recommendations about the need for and nature of such programs in nursing. Task force members included representatives from universities that already offered or were planning to offer the practice doctorate, from universities that offered only the research doctorate in nursing, from a specialty professional organization, and from nursing service administration. The task force was charged to describe patterns in existing practice-focused doctoral programs; clarify the purpose of the practice doctorate, particularly as differentiated from the research doctorate; identify preferred goals, titles, and tracks; and identify and make recommendations about key issues. Over a two-year period, this task force adopted an inclusive approach that included: 1) securing information from multiple sources about existing programs, trends and potential benefits of a practice doctorate; 2) providing multiple opportunities for open discussion of related issues at AACN and other professional meetings; and 3) subjecting draft recommendations to discussion and input from multiple stakeholder groups. The final position statement was approved by the AACN Board of Directors in March 2004 and subsequently adopted by the membership. The 2004 DNP position statement calls for a transformational change in the education required for professional nurses who will practice at the most advanced level of nursing. The recommendation that nurses practicing at the highest level should receive doctoral level preparation emerged from multiple factors including the expansion of scientific knowledge required for safe nursing practice and growing concerns regarding the quality of patient care delivery and outcomes. Practice demands associated with an increasingly complex health care system created a mandate for reassessing the education for clinical practice for all health professionals, including nurses. A significant component of the work by the task force that developed the 2004 position statement was the development of a definition that described the scope of advanced nursing practice. Advanced nursing practice is broadly defined by AACN (2004) as:

any form of nursing intervention that influences health care outcomes for individuals or populations, including the direct care of individual patients, management of care for individuals and populations, administration of nursing and health care organizations, and the development and implementation of health policy. (p. 2)


Furthermore, the DNP position statement (AACN, 2004, p. 4) identifies the benefits of practice focused doctoral programs as:

• development of needed advanced competencies for increasingly complex practice, faculty, and leadership roles;

• enhanced knowledge to improve nursing practice and patient outcomes; • enhanced leadership skills to strengthen practice and health care delivery; • better match of program requirements and credits and time with the credential

earned; • provision of an advanced educational credential for those who require advanced

practice knowledge but do not need or want a strong research focus (e.g., practice faculty);

• enhanced ability to attract individuals to nursing from non-nursing backgrounds; and

• increased supply of faculty for practice instruction.

As a result of the membership vote to adopt the recommendation that the nursing profession establish the DNP as its highest practice degree, the AACN Board of Directors, in January 2005, created the Task Force on the Essentials of Nursing Education for the Doctorate of Nursing Practice and charged this task force with development of the curricular expectations that will guide and shape DNP education. The DNP Essentials Task Force is comprised of individuals representing multiple constituencies in advanced nursing practice (see Appendix B). The task force conducted regional hearings from September 2005 to January 2006 to provide opportunities for feedback from a diverse group of stakeholders. These hearings were designed using an iterative process to develop this document. In total, 620 participants representing 231 educational institutions and a wide variety of professional organizations participated in the regional meetings. Additionally, a national stakeholders’ conference was held in October 2005 in which 65 leaders from 45 professional organizations participated. Context of Graduate Education in Nursing Graduate education in nursing occurs within the context of societal demands and needs as well as the interprofessional work environment. The Institute of Medicine (IOM, 2003) and the National Research Council of the National Academies (2005, p. 74) have called for nursing education that prepares individuals for practice with interdisciplinary, information systems, quality improvement, and patient safety expertise. In hallmark reports, the IOM (1999, 2001, 2003) has focused attention on the state of health care delivery, patient safety issues, health professions education, and leadership for nursing practice. These reports highlight the human errors and financial burden caused by fragmentation and system failures in health care. In addition, the IOM calls for dramatic restructuring of all health professionals’ education. Among the recommendations resulting from these reports are that health care organizations and


groups promote health care that is safe, effective, client-centered, timely, efficient, and equitable; that health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement, and informatics; and, that the best prepared senior level nurses should be in key leadership positions and participating in executive decisions. Since AACN published The Essentials of Master’s Education for Advanced Practice Nursing in 1996 and the first set of indicators for quality doctoral nursing education in 1986, several trends in health professional education and health care delivery have emerged. Over the past two decades, graduate programs in nursing have expanded from 220 institutions offering 39 doctoral programs and 180 master’s programs in 1986 to 518 institutions offering 101 doctoral programs and 417 master’s programs in 2006. Increasing numbers of these programs offer preparation for certification in advanced practice specialty roles such as nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists. Specialization is also a trend in other health professional education. During this same time period, the explosion in information, technology, and new scientific evidence to guide practice has extended the length of educational programs in nursing and the other health professions. In response to these trends, several other health professions such as pharmacy, physical therapy, occupational therapy, and audiology have moved to the professional or practice doctorate for entry into these respective professions. Further, support for doctoral education for nursing practice was found in a review of current master’s level nursing programs (AACN, 2004, p. 4). This review indicated that many programs already have expanded significantly in response to the above concerns, creating curricula that exceed the usual credit load and duration for a typical master’s degree. The expansion of credit requirements in these programs beyond the norm for a master’s degree raises additional concerns that professional nurse graduates are not receiving the appropriate degree for a very complex and demanding academic experience. Many of these programs, in reality, require a program of study closer to the curricular expectations for other professional doctoral programs rather than for master’s level study. Relationships of Master’s, Practice Doctorate, and Research Doctorate Programs The master’s degree (MSN) historically has been the degree for specialized advanced nursing practice. With development of DNP programs, this new degree will become the preferred preparation for specialty nursing practice. As educational institutions transition from the master’s to DNP degree for advanced practice specialty preparation, a variety of program articulations and pathways are planned. One constant is true for all of these models. The DNP is a graduate degree and is built upon the generalist foundation acquired through a baccalaureate or advanced generalist master’s in nursing. The Essentials of Baccalaureate Education (AACN, 1998) summarizes the core knowledge and competencies of the baccalaureate prepared nurse. Building on this foundation, the DNP core competencies establish a base for advanced nursing practice in an area of specialization. Ultimately, the terminal degree options in nursing will fall into two


primary education pathways: professional entry degree (baccalaureate or master’s) to DNP degree or professional entry degree (baccalaureate or master’s) to PhD degree. As in other disciplines with practice doctorates, some individuals may choose to combine a DNP with a PhD. Regardless of the entry point, DNP curricula are designed so that all students attain DNP end-of-program competencies. Because different entry points exist, the curricula must be individualized for candidates based on their prior education and experience. For example, early in the transition period, many students entering DNP programs will have a master’s degree that has been built on AACN’s Master’s Essentials. Graduates of such programs would already have attained many of the competencies defined in the DNP Essentials. Therefore, their program will be designed to provide those DNP competencies not previously attained. If a candidate is entering the program with a non- nursing baccalaureate degree, his/her program of study likely will be longer than a candidate entering the program with a baccalaureate or master’s in nursing. While specialty advanced nursing education will be provided at the doctoral level in DNP programs, new options for advanced generalist master’s education are being developed. DNP Graduates and Academic Roles Nursing as a practice profession requires both practice experts and nurse scientists to expand the scientific basis for patient care. Doctoral education in nursing is designed to prepare nurses for the highest level of leadership in practice and scientific inquiry. The DNP is a degree designed specifically to prepare individuals for specialized nursing practice, and The Essentials of Doctoral Education for Advanced Nursing Practice articulates the competencies for all nurses practicing at this level. In some instances, individuals who acquire the DNP will seek to fill roles as educators and will use their considerable practice expertise to educate the next generation of nurses. As in other disciplines (e.g., engineering, business, law), the major focus of the educational program must be on the area of practice specialization within the discipline, not the process of teaching. However, individuals who desire a role as an educator, whether that role is operationalized in a practice environment or the academy, should have additional preparation in the science of pedagogy to augment their ability to transmit the science of the profession they practice and teach. This additional preparation may occur in formal course work during the DNP program. Some teaching strategies and learning principles will be incorporated into the DNP curriculum as it relates to patient education. However, the basic DNP curriculum does not prepare the graduate for a faculty teaching role any more than the PhD curriculum does. Graduates of either program planning a faculty career will need preparation in teaching methodologies, curriculum design and development, and program evaluation. This preparation is in addition to that required for their area of specialized nursing practice or research in the case of the PhD graduate.


The Essentials of Doctoral Education for Advanced Nursing Practice

The following DNP Essentials outline the curricular elements and competencies that must be present in programs conferring the Doctor of Nursing Practice degree. The DNP is a degree title, like the PhD or MSN, and does not designate in what specialty a graduate is prepared. DNP graduates will be prepared for a variety of nursing practice roles. The DNP Essentials delineated here address the foundational competencies that are core to all advanced nursing practice roles. However, the depth and focus of the core competencies will vary based on the particular role for which the student is preparing. For example, students preparing for organizational leadership or administrative roles will have increased depth in organizational and systems’ leadership; those preparing for policy roles will have increased depth in health care policy; and those preparing for APN roles (nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives) will have more specialized content in an area of advanced practice nursing. Additionally, it is important to understand that the delineation of these competencies should not be interpreted to mean that a separate course for each of the DNP Essentials should be offered. Curricula will differ in emphases based on the particular specialties for which students are being prepared. The DNP curriculum is conceptualized as having two components:

1. DNP Essentials 1 through 8 are the foundational outcome competencies deemed essential for all graduates of a DNP program regardless of specialty or functional focus.

2. Specialty competencies/content prepare the DNP graduate for those practice and

didactic learning experiences for a particular specialty. Competencies, content, and practica experiences needed for specific roles in specialty areas are delineated by national specialty nursing organizations.

The DNP Essentials document outlines and defines the eight foundational Essentials and provides some intro

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