Clinical Skills Self-Assessment
Providing mental health services requires psychiatric-mental health nurse practitioners (PMHNP) to possess advanced skills in diagnosing and managing psychiatric disorders. The development of these skills requires proper training and experience. Continuous skill development also ensures PMHNP students are capable of performing their responsibilities. Clinical practicum is an avenue for PMHNP to gain experience, knowledge, and skills crucial for professional practice. However, to maximize the benefits of a practicum experience, PMHNP students must identify the strengths and gaps in their abilities. The skills self-assessment allows the identification of growth opportunities. The purpose of this paper is to pinpoint my strengths and skill gaps concerning the required practicum skills.
PRAC 6635 Clinical Skills Self-Assessment Form
Desired Clinical Skills for Students to Achieve
Confident (Can complete independently)
Mostly confident (Can complete with supervision)
Beginning (Have performed with supervision or need supervision to feel confident)
New (Have never performed or does not apply)
Comprehensive psychiatric evaluation skills in:
Recognizing clinical signs and symptoms of psychiatric illness
Confident
Differentiating between pathophysiological and psychopathological conditions
Beginning
Performing and interpreting a comprehensive and interval history and physical examination (including laboratory and diagnostic studies)
Mostly confident
Performing and interpreting a mental status examination
Beginning
Performing and interpreting a psychosocial assessment and family psychiatric history
Mostly confident
I perform and interpret a functional assessment (activities of daily living, occupational, social, leisure, educational).
Mostly confident
Diagnostic reasoning skill in:
Demonstrate knowledge of psychopathology of mental illnesses through discussion for different age groups and mental illnesses
Beginning
Developing and prioritizing a differential diagnoses list
Mostly confident
Formulating diagnoses according to DSM 5 based on assessment data
Mostly confident
Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes
Beginning
Psychotherapeutic Treatment Planning:
Provide psychoeducation to individuals and any caregivers
Mostly confident
Promote health and disease prevention techniques
Confident
Self Assessment skill:
Develop SMART goals for practicum experiences
Confident
Evaluating outcomes of practicum goals and modifying plan as necessary
Mostly confident
Documenting and reflecting on learning experiences
Mostly confident
Professional skills:
Maintains professional boundaries and therapeutic relationship with clients and staff
Confident
Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings
Confident
Identifies ethical and legal dilemmas with possible resolutions
Beginning
Demonstrates non-judgmental practice approach and empathy
Mostly confident
Practices within the scope of practice
Confident
Selecting and implementing appropriate screening instrument(s) and interpreting results:
Demonstrates selecting the correct screening instrument appropriate for the clinical situation
Beginning
Implements the screening instrument efficiently and effectively with the clients
Beginning
Interprets results for screening instruments accurately
Identifies the need to refer to another specialty provider when applicable
Beginning
Accurately documents recommendations for psychiatric consultations when applicable
Beginning
Summary of Strengths
The most notable strength regarding the required clinical skills recognizes clinical signs and symptoms of psychiatric disorders. Psychiatric patients have different symptoms depending on their mental conditions and psychosocial situations (Wainberg et al., 2017). Recognizing the symptoms and sights assist psychiatric-mental health nurse practitioners (PMHNP) in diagnosing disorders and selecting effective treatment options. There are no absolute medical tests for diagnosing mental illnesses, unlike physical diseases. The practicum affords a critical opportunity to demonstrate this strength when assessing patients. I will exploit this opportunity to enhance this skill as I interact with multiple patients.
Another key strength is my ability to promote health and recommend disease prevention practices. Mental health is an essential component of individuals and populations. Prevention and management of psychiatric disorders are necessary (Wainberg et al., 2017). Multiple disease prevention interventions should be considered by PMHNPs, including lifestyle modification, stress management, and positive psychotherapy (Wainberg et al., 2017). Disease prevention may be promoted through individual- and community-based interventions. While psychiatric nurses are not prepared to promote disease prevention, it is significant for PMHNP to become accustomed to different interventions for mental disease prevention and health promotion. For effective mental health promotion, PHMNP needs to adopt an integrative approach to the assessment and treatment of psychiatric disorders. This model involves the consideration of mental illness as a product of multiple factors, including genetics, behavioral, emotions, culture, and cultural issues (Jones et al., 2016). By applying these techniques, I can promote mental health.
My skills in establishing a therapeutic relationship and professional boundaries are also notable strengths that I would apply during my practicum. Professional boundaries present the mechanisms for healthy and productive relations between practitioners and patients (Smith, 2020). They are emotional and physical restrictions that safeguard the client’s vulnerability. One approach to maintaining professional boundaries is to apply effective communication techniques constantly. This includes actively listening to patients and other healthcare providers. As a practitioner, it is crucial to have effective interpersonal relationships with other workers to establish a collaborative environment (Smith, 2020). I have grown this skill over the years as I work in different settings and accept constructive feedback whenever I make mistakes. Empathy when interacting with others is an essential requirement for effective therapeutic interactions (Smith, 2020). Communication skills are vital for me since many aspects of psychiatric nursing are about communicating with patients and other clinicians.
My understanding of PMHNP’s scope of practice regulations is another strength that would be significant for the practicum. As a PMHNP student, I have made significant efforts in learning about the rules that define responsibilities and authority. The laws are established to protect patients and safeguard the integrity of the nursing profession (Jones et al., 2016). Despite the restrictive nature of these regulations, I always commit practice within the established boundaries to avoid possible licensure cancellation.
Opportunities for Growth
Several skills gaps were identified from the self-assessment. The holes present ideal opportunities for professional development. These gaps will essentially guide my practicum experience as I seek to prepare myself for professional practice.
A key opportunity for growth is the skill of differentiating between pathophysiological and psychopathology disorders. Patients who seek psychiatric evaluation services may present with pathophysiological conditions (Jones et al., 2016). For instance, a patient may have brain tumors that may occur together with psychiatric symptoms. Thus, distinguishing between these disorders allows PMHNPs to determine the exact diagnosis and apply appropriate treatment interventions. Psychopathological diseases are not tested or diagnosis using the usual medical diagnostic procedures. Instead, diagnosis of mental illness largely relies on the assessment done by practitioners (Jones et al., 2016). Understanding the psychopathological conditions would allow me to quickly diagnose mental illnesses and demonstrate this knowledge to patients during the assessment.
The second skill development opportunity is the performance and interpretation of mental status examination (MSE). The MSE is a helpful diagnostic tool as it helps clinicians to differentiate between thought disorders, cognitive impairments, and mood disorders (Zdanys, 2021). However, applying this tool may be challenging for new nurses because they are not well accustomed to the various components of MSE. Additionally, I need to group my skills in distinguishing between age-related psychological and physiological changes. Age is among pertinent that influence the development of the psychiatric disorder. The specific psychiatric disorder occurs in older adults (Zdanys, 2021). Distinguishing between psychological alterations associated with normal and abnormal ages would facilitate the accurate diagnosis of psychological problems.
The third opportunity for learning is appropriately selecting and utilizing mental health screening tools. PMHNPs have access to multiple devices for screening possible psychiatric disorders. However, the usefulness of these tools relies on the practitioners’ capacity to apply them effectively (Zdanys, 2021). Without appropriate knowledge of these tools, practitioners can find disorders very complicated. The ability of the screening tests will come along with an understanding of how to interpret the results (Jones et al., 2016). I believe the practicums allow me to grow my knowledge that will facilitate my capacity to diagnose problems and deliver appropriate therapeutic services. The effectiveness of psychiatric care depends on the practitioners’ ability to assess and identify psychiatric problems (Jones et al., 2016). Continued exposure to patients with mental illness is an effective opportunity to enhance skills while contributing to the patients’ wellness.
Possible Goals and Objectives for the Practicum Experience
Goal: Perform mental status assessment in collaboration with the preceptor by the end of the fifth week.
Objective: Identify the different components of the mental status examination
Objective: Learn how to interpret the findings from the mental status examination.
Objective: Apply the mental status examination findings in developing an appropriate treatment plan.
Goal: Conduct detailed psychiatric evaluations of patients across the lifespan by the end of the sixth week.
Objective: Identify the clinical presentations of various psychiatric disorders.
Objective: Identify any abnormal and normal age-related psychological changes.
Objective: Exhibit an understanding of the pathology of psychiatric disorders occurring across the lifespan.
Goal: Provide psychoeducation to clients with psychiatric using appropriate motivational and teaching principles.
Objective: Enhance personal knowledge of psychoeducation principles.
Objective: Apply different techniques to promote health and prevent diseases.
Objective: Choose appropriate psychoeducation techniques based on the patient’s needs.
Conclusion
The practicums offer excellent opportunities for the personal growth of skills that facilitate professional practice as a PMHNP. From the self-assessment, I have identified skill gaps that translate to opportunities for skill development. I will exploit this experience to utilize my strengths and address my weaknesses in the mental status examination, selection of mental illness screening tools, and the ability to differentiate between psychological diseases. The skill development will enhance my ability to deliver psychiatric patients’ best services.
References
Jones, J. S., Fitzpatrick, J. J., & Rogers, V. L. (Eds.). (2016). Psychiatric-mental health nursing: An interpersonal approach. Springer Publishing Company.
Smith, K. (2020). Talking therapy: Knowledge and power in American psychiatric nursing. Rutgers University Press.
Wainberg, M. L., Scorza, P., Shultz, J. M., Helpman, L., Mootz, J. J., Johnson, K. A., … & Arbuckle, M. R. (2017). Challenges and opportunities in global mental health: a research-to-practice perspective. Current psychiatry reports, 19(5), 28. https://doi.org/10.1007/s11920-017-0780-z
Zdanys, K. (2021). Mental Status Examination. In Absolute Geriatric Psychiatry Review (pp. 151-154). Springer, Cham.
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