Barbara schedules a meeting with a core group of clinic managers. The purpose of the meeting is to review the strategic plan and to gather additional feedback from the managers. Barbara is aware of the importance of diversity within the organization. Diversity and inclusion is particularly important because of the population served by UCCO facilities. However, she realizes during the meeting that there may be some issues with diversity and culture. Furthermore, how diversity and culture impact team performance. Several managers made comments regarding distribution of work and employee perspectives based on stereotypes. She also found out that there are many personality conflicts and issues with subordination. Barbara encountered the conflict and degradation comments, first-hand during the meeting.

Visit the Rasmussen online Library and search for a minimum of 3 articles covering diversity and culture and teamwork.

For this project assignment on UCCO complete a minimum of a 3 page report to address management of change with strategic planning and with the following concepts:

• What is the role of executives in the process of change management and strategic planning? How do issues with diversity and culture relate to change management?
• Why is diversity inclusion important? What are the benefits? Specifically address UCCO purpose for diversity.
• Discuss how working with others can help with respect for diversity and respect for diverse perspectives.
• What are the challenges and benefits of employing a diverse workforce?
• What should Barbara’s plan be for encouraging teamwork among a diverse workforce and ensuring that employees make meaningful and valuable contributions to team projects and tasks. Incorporate Barbara’s personal experience with the team of clinic managers.

Remember to integrate citations accurately and appropriately for all resource types; use attribution (credit) as a method to avoid plagiarism. Use NoodleBib to document your sources and to complete your APA formatted reference page and in-text citations.

Week 8: Reflection Assignment

Submit Assignment

• Due Saturday by 11:59pm
• Points 50
• Submitting a file upload

Purpose 

The purpose of this assignment is to reflect on achievements in this course based on three criterion: Program Outcome, MSN Essential, NONPF Core Competency.  

Activity Learning Outcomes 

Through this assignment, the student will demonstrate the ability to: 

1. Reflect on personal and professional growth toward achieving competence as a family nurse practitioner (CO3). 

Due Date: Assignment must be submitted by Saturday 11:59 p.m. MT of week 8. Nothing can be accepted AFTER the Week 8 deadline when the course closes. 

Total Points Possible:  50 

Requirements: 

1. Choose one (1) MSN Program Outcome, one (1) MSN Essential, and one (1) NONPF Core Competency from the list below: 
   • MSN Program Outcome
     1. Provide high quality, safe, patient-centered care grounded in holistic health principles.
     2. Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice.
   • MSN Essential
     I. Background for Practice from Science and Humanities
     VIII. Clinical Prevention and Population Health for Improving Health
     IX. Master’s Level Nursing Practice

• NONPF Core Competencies
  Scientific Foundation Competencies
  These competencies ensure that nurse practitioners graduate with a comprehensive background in medical sciences. All nurse practitioner students are required to take foundational pathophysiology and pharmacology, but depending on their specialty, they may take additional courses. Psychiatric nurse practitioners often take courses in neuroscience whereas neonatal nurse practitioners take courses in neonatology. Scientific core competencies also include knowledge and understanding of clinical practice guidelines, evidence-based practice, translational research, and treatment of vulnerable and diverse patient populations.
  The scientific foundation core competencies defined by the NONPF include the following:
  1. Thinks critically about data and applies this evidence to improving practice.
  2. Allows knowledge from the humanities and other disciplines to inform one’s work in nursing.
  3. Incorporates research findings to enhance practice methods and patient outcomes.
  4. Creates fresh evidence-based approaches and techniques, paying thought to research findings, core theory, and experience from practice.
  5. Quality Competencies
     Quality care, as defined by the NONPF, refers to the degree to which health services increase the desired health outcomes consistent with professional knowledge and standards. Quality competencies focus on understanding how to access and use information databases and how to critically evaluate research findings.
     The quality core competencies include the following:
  6. Applies the best and most contemporary research findings to clinical practice.
  7. Considers the complex relationships between cost, safety, access, and quality in healthcare delivery.
  8. Assesses the effects of organizational structures, financial management, policy, and other factors on healthcare.
  9. Offers feedback in peer reviews to “promote a culture of excellence.”
  10. Tailors care to each practice situation and uses interventions as necessary.
  11. Practice Inquiry Competencies
      Practice inquiry competencies focus on translational research, i.e., taking academic research and applying it to the clinical setting. These competencies ensure that nurse practitioner students understand how to apply research to improve their patients’ health outcomes.
      The practice inquiry core competencies include the following:
  12. Translates new knowledge into practice through leadership.
  13. Uses clinical experiences to inform practice and improve patient outcomes.
  14. Applies investigative abilities in a clinical setting to improve healthcare.
  15. Facilitates practice inquiry, both individually and in partnerships.
  16. Transmits knowledge from inquiry to others.
  17. Thinks critically about the individual applications of clinical guidelines.

2. Reflect over the past eight weeks and describe how achieving the course outcomes have prepared you to meet 1 program outcome, 1 MSN essential and 1 NONPF competency. 

3. Provide a specific example for each category.

Preparing the paper

• The written portion of this assignment is to be completed in a WORD document (.doc) and submitted to the course.
• Grammar, punctuation, spelling should be observed. In-text citations and reference page should follow APA format.
• Assignments will not be accepted once the course closes in Week 8.

ASSIGNMENT CONTENT

Category

Points

%

Description

Outcome Achievement

40

80%

The student identifies at least one of the listed program outcomes;

AND

Provides at least one specific example of how the program outcome was met;

AND

The student identifies at least one of the listed MSN essentials;

AND

Provides at least one specific example of how the MSN essential was met;

AND

The student identifies at least one of the listed NONPF competencies;

AND

Provides at least one specific example of how the NONPF competency was met.

(6 required elements)

40

80%

Total CONTENT Points= 40 pts

ASSIGNMENT FORMAT

Category

Points

%

Description

Organization, spelling, grammar and APA format

10

20%

Narrative summary is provided with consideration to organization, spelling, grammar and APA format.

10

20%

Total FORMAT Points= 10

ASSIGNMENT TOTAL= 50 points

Rubric

NR565 Reflection Assignment (1)NR565 Reflection Assignment (1)CriteriaRatingsPtsThis criterion is linked to a Learning OutcomeOutcome AchievementThe student identifies at least one of the listed program outcomes;
AND
Provides at least one specific example of how the program outcome was met;
AND
The student identifies at least one of the listed MSN essentials;
AND
Provides at least one specific example of how the MSN essential was met;
AND
The student identifies at least one of the listed NONPF competencies;
AND
Provides at least one specific example of how the NONPF competency was met;
(6 required elements)40.0 ptsExcellentAll 6 required elements are present.36.0 ptsV. Good5 critical elements are present.33.0 ptsSatisfactory4 critical elements are present.20.0 ptsNeeds Improvement1-3 critical elements are present.0.0 ptsUnsatisfactory0 critical elements are present.40.0 pts
This criterion is linked to a Learning OutcomeAssignment FormatNarrative summary is provided with consideration to organization, spelling, grammar and APA format. (2 critical elements required)10.0 ptsExcellentSummary is clear & easy to follow. AND There are two or less errors in spelling, grammar or in-text/reference APA format.9.0 ptsV. GoodSummary is clear to follow AND There are three to four errors in spelling, grammar or in-text/reference APA format.8.0 ptsSatisfactorySummary is clear to follow AND There are five to six errors in spelling, grammar or in-text/reference APA format.5.0 ptsNeeds ImprovementSummary is clear to follow AND There are seven to nine errors in spelling, grammar or in-text reference APA format.0.0 ptsUnsatisfactorySummary is difficult to follow/understand OR There are >10 errors in spelling, grammar or in-text reference APA format.10.0 pts
Total Points: 50.0PreviousNext
 

Required Resources
Read/review the following resources for this activity:

• Link (Word doc): Week 8 CCC Part 8 Template (Use this template to complete the assignment.)
• Minimum of 4 scholarly sources (This can include all course materials and your previous research.)

Introduction: Communication Change Challenge (CCC) Part 8
Part 8 is where you will evaluate the impact of the project as it relates to interpersonal communication and the course objectives (COs). It is important here that you clearly demonstrate your understanding of many of the course concepts through application to your course project.

Instructions
Remember that your patterns for communicating interpersonally have been developed over many years. Therefore, you should be neither surprised nor discouraged to find that changing your interpersonal communication behavior takes time. In order for you to take this project to its fullest potential, you may need to continue to modify, implement, and reinforce these new behaviors for far longer than the duration of the project. It is possible, however, to modify the way you communicate, and because the payoff is improvement to our communication and relationship outcomes, changing interpersonal communication is worth the effort. You have now implemented your target behaviors for about two weeks, write a final evaluation addressing the following:

8A. Topic Selection Reflection
What was the course material that suggests that this particular communication behavior was an appropriate target for change?

8B. Implementation Analysis: Satisfaction
Consider the implementation of your new behaviors in Part 7, and address the following:

• Which of your behaviors particularly please you?
• What was the course material that suggests that this new communication behavior is a positive change?

8C. Implementation Analysis: Dissatisfaction
Consider the implementation of your new behaviors in Part 7, and address the following:

• Were there any situations in which you were dissatisfied with your approach to improving your interpersonal communication?
• What was the course material that suggests that this particular communication behavior continues to be less than ideal?
• If you were not dissatisfied with your approach, why do you think this happened?

8D. Implementation Analysis: Additional Changes
Consider the implementation of your new behaviors in Part 7, and address the following:

• What changes would you still like to make?
• What was the course material that suggests that this modification would complement or enhance your communication outcomes?

8E. Project Reflection
Consider the entire course project, and address the following:

• How have your interpersonal relationships changed as a result of this project?
• What is the course material that suggests that these particular relationship changes are positive or negative?

Note: For each question, be detailed and specific. You need to use several course materials from different chapters, course outcomes, videos, assessments, articles, etc.

Your course project evaluation will be graded for comprehensive content, analysis evaluation, application of the course material, organization, and so forth. Please consider its weight when you place value on its importance to your final course grade.

Writing Requirements (APA format)

• Length: 2-3 pages (not including title page or references page)
• 1-inch margins
• Double spaced
• 12-point Times New Roman font
• Title page
• References page (minimum of 4 scholarly sources)

Grading
This activity will be graded based on the W8 CCC Grading Rubric.

Course Outcomes (CO): 1, 2, 4, 5, 7

Due Date: By 11:59 p.m. MT on Saturday

The Case of Will Smithers: To Exhume or not Exhume, that is the Question

A surprising amount of information can be gleaned about an individual just from one’s tissues. In this case, you have been assigned to shadow histopathologist Dr. Jonas Riehm as he attempts to identify the cause of death of 42-year-old Will Smithers. Mr. Smithers’s body was discovered sitting in his car near an alley several miles from his home. There was no obvious cause of death, necessitating an autopsy to determine if the death was from natural causes or foul play. However, due to a clerical error, the decedent’s body was released and interred before a proper autopsy could be performed, and an official cause of death was not established.

Fortunately, several tissue samples were taken before the interment and remain available for examination. Mr. Smithers’s family does not wish to have his body exhumed, so local law enforcement professionals have asked Dr. Riehm to examine the tissue samples in the hopes of determining his cause of death and whether or not an exhumation is needed. The following sections have been taken from the official report that Dr. Riehm sent to the local coroner’s office. You are to report to Dr. Riehm’s office with your anatomy and physiology textbook. He expects students to answer questions related to the work that he does in his histopathology laboratory.

Dr. Riehm enjoys teaching, and has a collection of microscope slides that he uses to introduce students to the fascinating universe of histology. He starts with the following definition: histology is the study of the normal structure of tissues. Although Dr. Riehm is an expert in the study of the diseases and abnormalities of tissues, histopathology, he is a firm believer that you must be able to recognize normal tissue before you can understand diseased tissue. He has set up four microscope stations for students to get familiar with how the microscopes function and to view slides of normal tissues.

1. Each station has a microscope with a slide of one of the four primary tissue types. (a) Define tissue and organ, and then describe how each fits into the levels of body organization. (b) Describe what you would expect to observe on the epithelial tissue slide. What are the general functions of this tissue? (c) Describe what you would expect to see on the connective tissue slide. What are the general functions of this tissue? (d) Describe what you would expect to see on the muscle tissue slide. What are the general functions of this tissue? (e) Describe what you would expect to observe on the nervous tissue slide. What are the general functions of this tissue?

Satisfied that you are properly introduced to the concepts of normal tissue, Dr. Riehm begins to fill you in on the details of Mr. Smithers’s case, whose tissue samples have coincidentally arrived just in time for your shadowing visit. The first set of slides included an epithelium sample taken from Mr. Smithers’s forehead. The slide was taken from some oddly colored patches of skin that revealed some abnormal cells, specifically, squamous cell carcinoma. These cancerous cells were in the early stages of the disease and had not spread, or metastasized, to cause disease in other tissues. Dr. Riehm documented that while there was pathology noted in the epithelial slides provided, the squamous cell carcinoma, this was not the cause of Mr. Smithers’s death. Dr. Riehm continued to ask questions about epithelial tissues.

1. Dr. Riehm has asked you to look at the epithelial tissue slide from the skin of Mr. Smithers’s forehead, and describe how the normal epithelium appeared. (a) Describe the difference between simple and stratified epithelium. Which type would you expect to see in Mr. Smithers’s tissue slide? (b) What are the different shapes that epithelial cells can assume in different epithelial tissues? Which cell shape would you expect to see in Mr. Smithers’s tissue slide; what type of specific epithelium is found in the skin? How would you describe the other two cell shapes? (c) Define what the basement membrane is and discuss the functions of its two components. (d)Which cellular junctions would you expect to find holding these cells to one another? (e) Describe where the apical, basal, and lateral surfaces of an epithelial cell are located.

Dr. Riehm began to review the next set of tissue samples, which included slides prepared from liver tissue and blood smears. He began with the slides taken from the liver and documented the following: the microscopic evaluation of the liver tissue is abnormal. Large deposits of adipose tissue can be seen interspersed throughout the normal structure of the liver tissue that is suggestive of hepatic lipidosis, or fatty liver. The most likely cause of hepatic lipidosis is excessive alcohol consumption, but this would need to be corroborated by further investigation outside the scope of this inquiry. For the record, he documented his findings of hepatic lipidosis. He then explained to you that these findings only indicate that the patient had tissue evidence of an unhealthy behavior, likely alcoholism, which could be a contributing factor in his cause of death but unlikely the cause itself. His family and friends would need to fill in the details about Mr. Smithers’s personal life. This wasn’t enough individually to warrant an exhumation of the body, nor was it enough to establish the cause of death as liver failure. He explained that this is a common histological finding in several long-standing illnesses, but in particular hepatitis, obstructive jaundice, and acute and chronic alcoholism with liver disease. This was still not enough to establish a cause of death but it was more information that would support an exhumation order by the state authorities. A review of Mr. Smithers’s medical history or a report from his personal physician would be helpful in determining the relevance of this finding.

Dr. Riehm moved on to Mr. Smithers’s peripheral blood smear slides. The erythrocytes appeared abnormally large, which provided more evidence that Mr. Smithers had done some significant damage to his body and tissues with alcohol consumption. Dr. Riehm documented his findings from the blood smear as abnormal, having found these large round erythrocytes called macrocytes. This condition called megaloblastic anemia leads to fewer normal cells, which limits the amount of oxygen and metabolic waste products that can be transported. This is a common finding in the peripheral blood smears of alcoholic patients with anemia. Many people suffering from alcohol dependence also have nutritional deficiencies, including poor intake of vitamin B12 and folate, both of which are critical for the normal development of erythrocytes in the bone marrow.

Dr. Riehm asked you to quickly finish your work on the connective tissue slides and take a look at the new set of cardiac muscle samples. Has he finally found something that could have caused Mr. Smithers’s death?

Dr. Riehm has been keeping you busy cataloging the slides that he has finished with while he prepares to review the slides of Mr. Smithers’s cardiac muscle tissue. Dr. Riehm described regions of necrosis, or dead tissue, as he explains, where cardiac muscle cells have died after being separated from the blood supply. This finding indicated that Mr. Smithers had a myocardial infarction or heart attack. Before you are able to even speculate “Was this the cause of Mr. Smithers’s death,” Dr. Riehm poses this question—are heart attacks always fatal, or in other words, can we determine from this slide that this event preceded and therefore caused Mr. Smithers’s death? People survive heart attacks, don’t they? Dr. Riehm would need to look at the slides more closely later in the day before he completed this portion of his report. He was not ready to sign off on myocardial infarction as the cause of death just yet.

Dr. Riehm reviewed the remaining slides in the set. He selected a blood vessel slide and discovered hypertrophy, or an enlargement of the smooth muscle, and damage to the endothelium lining the vessel walls. Both were signs of vascular disease, as was the finding of atherosclerosis, or plaque, which had probably clogged Mr. Smithers’s arteries and veins. All of these were pathological findings that supported a diagnosis of vascular disease. Vascular disease increases the likelihood of myocardial infarction. Mix the cardiovascular findings with fatty liver disease, anemia, and enough alcohol, and that could explain this man’s death. But it would still be speculation. All of these certainly could lead to a myocardial infarction, no doubt. There was evidence that a cardiac event had happened at some point in Mr. Smithers’s life. Like his fatty liver, these findings indicated that Mr. Smithers was unhealthy.

A review of Mr. Smithers’s medical history or a report from his personal physician would be helpful in determining the relevance of these finding. A pathologist would probably need to see the actual heart itself to make a cause of death by myocardial infarction determination. Dr. Riehm reminded you to get those slides filed away so we could move on to the last set of samples from Mr. Smithers’s brain tissue.

1. Dr. Riehm suggested that you make flashcards of the following information: (a) briefly describe the structural characteristics and functions of skeletal muscle; (b) briefly describe the structural characteristics and functions of cardiac muscle; (c) briefly describe the structural characteristics and functions of smooth muscle; and (d) discuss the similarities and differences between the three different muscle tissue types.

Finally, being thorough, Dr. Riehm wanted to review his assessment of the cardiac tissue slides. Finding evidence of fibrous tissue interspersed among cardiac muscle cells indicated that the heart had tried to heal itself. Mr. Smithers would have had to have been alive long enough for scar tissue to form in his heart. The evidence from the cardiac tissue was consistent with an old myocardial infarction that Mr. Smithers survived. There was no evidence in the tissue samples to suggest that he had had an acute myocardial infarction. Dr. Riehm could only document what he observed in a small amount of cardiac tissue. Mr. Smithers could have had an acute and fatal myocardial infarction in a region of the heart from which no tissue samples were collected. For what he observed from the available tissue slide, however, a cardiac event as the cause of his death was unlikely. His report would undoubtedly leave more unanswered questions about the cause of Mr. Smithers’s death. A full gross examination of Mr. Smithers’s heart would be needed, which would obviously require that his body be exhumed.

1. Dr. Riehm has found evidence of fibrosis in the cardiac muscle tissue slides, scattered throughout the dead cardiac muscle cells. This suggested that Mr. Smithers had survived that particular cardiac event. Which of the following statements is true with regard to how cardiac muscle tissue is repaired?
   1. Cardiac muscle cells are only capable of regeneration if the degree of damage is minimal. Extensive damage results in healing by fibrosis.
   2. Cardiac muscle cells are incapable of tissue regeneration because they are no longer capable of dividing by mitosis. Damaged cardiac tissue is replaced with scar tissue.
   3. Cardiac muscle cells differentiate into fibroblasts and regenerate functional cardiac tissue through the process of fibrosis.
   4. Fibroblasts secrete cardiac tissue ECM and once surrounded differentiate into mature cardiac muscle cells. This leads to regeneration of fully functional cardiac tissue.

WRAPPING UP THE CASE

Based on his findings, Dr. Riehm is fairly confident that the cause of Mr. Smithers’s death could not be determined based on an examination of tissue slides alone. Given the liver and vascular disease, he certainly wasn’t healthy, and a heart attack is a common outcome associated with both conditions. However, one question remains unanswered: the damage to the brain. This could have been the result of an accident or deliberate blunt force trauma. Mr. Smithers’s body would need a full autopsy to answer these questions. Tissue slides could provide details not seen with the naked eye but a close look at the body is required—this could be a criminal case. Mr. Smithers’s remains would need to help answer these questions. Due to the unknown cause of head trauma, Dr. Riehm recommends that Mr. Smithers’s body be exhumed so that it can be examined more closely. The details of the pathology will be available in the continuation of Mr. Smithers’s case (see Chapter 12).

Assignment Expectations

Length: 750 – 1250 words

Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment. Be sure to include an introduction and conclusion paragraph for the assignment.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.