Comprehensive Exam Orientation

Comprehensive Exam Orientation Spring 2013 Roxanne Garbez, RN, PhD, ACNP-BC, CNS

Outline of Comp Process • Description of the project • The Comprehensive Exam Handbook • Qualifying for the examination • Important dates • Technical requirements • Resources

The Assignment • The purpose of this paper is to evaluate your ability to: • Critique research as it applies to your area of specialization • Apply advanced clinical and theoretical knowledge to practice • Utilize writing skills to disseminate nursing information using a scholarly paper • Demonstrate you can be a consumer of research

Critical Points • Thirty (30) page paper (maximum) • Three exam options • Research Proposal • Critical Literature Review • Problem-solving

The Handbook • You can download a copy of the Comprehensive Examination Handbook from the UCSF School of Nursing website

How to Qualify for the Examination • You are eligible in the last quarter you are enrolled in course and clinical work. • If you have completed ALL course work with the exception of the comp exam you may submit the exam while on filing fee status for a reduced fee.

Filing Fee Status • Talk with your advisor • You may not take courses of any type if you are on Filing Fee status • Apply and pay filing fee to OAR • Most frequently used for second time comp exam submission • Filing fee status can be used only once. If you pay filing fee then do not submit your comp you must pay full tuition for the subsequent quarter you submit your comp

Advance to Candidacy • Before you can be issued your individualized Comp Number, YOU MUST ADVANCE TO CANDIDACY. • Advance to Candidacy forms are available from the Office of Admissions and Registrar. Forms can also be downloaded online. • After you submit your form Graduate Division notifies Office of Student Affairs. OSA will then generate your Comp Number.

The Last Quarter of Course and Clinical Work • Advance to Candidacy any time before the first week of the quarter in which you plan to turn in the comp • One incomplete on record allowed • Payment of fees required for number

Know the Important Dates- Spring 2013 • Number pick up date: • Between April 9 and April 22 • Submit comp by Noon • April 23 • Notification of results • May 23

Technical and Procedural Points • Format • Submission • Scoring

Formatting Expectations APA 6th Edition format Margins 1 inch on all 4 sides of page Can separate syllables at the end of a line 30 pages of text, not counting title page, reference list and appendices Title should reflect content No abstract Double-spaced, 12 point uncompressed font (Acceptable font examples: Times New Roman, Arial)

Submission Requirements • One single-sided original of the comprehensive examination plus three double sided copies • Next fall submission likely PDF, no hard copies • Completed face sheet • Separate paper with student’s name, address, home and work number, and other pertinent information that facilitates the student being contacted if necessary • It is the student’s responsibility to ensure that the comprehensive exam is submitted by 12 noon on the due date

Face Sheet In order to pick up your number you must complete the face sheet and return it List your specialty Topic Suggested readers ID number is given to you to be placed on your comp

Reading and Scoring • Student may select up to five preferred readers (not required) • Student is not guaranteed a preferred reader • Readers use a standard scoring system • Student will be given the faculty comment sheets at the end but not the scoring sheets

Plagiarism • Evidence of plagiarism results in a failure of the comprehensive exam. • Plagiarism can become grounds for dismissal from the School of Nursing.

A Comp Does Not Pass • One pass and one fail from two readers goes to a third reader for decision • Exam fails if two readers fail it • May re-submit exam once within 5 quarters of first submission

Vital Resources • Vital resource—Department Administrative Assistants • CHS Kathryn Young • PN James Negri • FHCN Kathryn Keihl • SBS BrandeeWoleslagle • Comprehensive Exam Coordinators • CHS Beth Phoenix & Dana Drew-Nord • PN Roxanne Garbez • FHCN Karen Duderstadt & Barbara Hollinger • SBS Susan Chapman

Advisors- topic and format Specialty faculty Sample comps on reserve Office of Student Affairs for tutors and editors, contact Judy Martin-Holland Consider other arrangements Typist Paid tutors and editors Peers as editors and proofreaders Create a timeline See sample provided Additional Resources

Comprehensive Exam2012-2013 SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG Identifying the phenomenon of interest • Advance to Candidacy: Before end of Winter Quarter • Pick up Comp # from Departments: From 4/09/13 to 4/22/13 • Submit Comp to Departments: 4/23/13 Topic generation Faculty input re: topic Literature review Refine topic outline Faculty input re: topic outline Advance to Candidacy Draft #1 Pick up Comp # Colleagues read paper for clarity and organization Draft #2 Submit Comp Edit

WORK HARD, DO WELL! • Extensions, examination by mail, summer comps, oral exam are available only by special arrangement. Read the corresponding section of the comp handbook.

Sample Examinations • On reserve in each of the departments • Ask your advisor and/or your department's comprehensive examination coordinator

Other Resources • UCSF SON website

Choosing a Theory • A theory should further clarify, support and explain your topic • Nursing theory not required • Explain your theory in the text—don’t depend on diagrams in the appendix

Theory or Conceptual Framework • Theory is the format that enables you to explain a phenomenon. There is no right or wrong theory--it is all in how you want to frame the argument you want to make.

Possible Mechanisms Underlying the Increased Risk of Type 2 Diabetes in People on Atypical Psychotrophics

Possible Titles • The Relationship Between Atypical Psychotropic Use and Diabetes Mellitus: The role of Genetics • Sociocultural Factors in the Development of Diabetes Mellitus in Patients with Severe Mental Illness

Types of Examinations • Research Proposal (check with your advisor as early as possible) • Critical Literature Review • Problem-solving

Research Proposal • To evaluate a student’s ability to identify a significant research question relevant to nursing practice, and to design a methodology for addressing the question. • Study does not have to be implemented • Must have access to UCSF faculty with research experience to mentor you

Research Proposal • Good choice if you plan to build on this topic for future research or doctoral work • Could be taken back to your workplace for implementation if approval given by institution

Research Proposal Scoring • Total Points – 330 • Area 1 – Study and Context – 63 • Conceptual Framework and Literature Review - 126 • Methodology – 126 • Technical (grammar, organization, use of APA format) – 15

The Comprehensive Exam is Pass/Fail • Points needed to pass - 231

Critical Literature ReviewChoosing a Topic • Pose a question • Do initial searching • There is enough research, but no clear synthesis of findings or clear direction • You want to argue a point that has some evidence, but is not established practice

Critical Literature ReviewTopic or Issue Clarity of topic or purpose State in 1 sentence! The purpose of this paper is to examine the literature related to the efficacy of using BNP to diagnose patients with heart failure

Topic or Issue Significance of topic 4.8 million in US have HF, 50% are rehospitalized in 6 mos., there is no lab test for diagnosing HF, BNP might provide better method for effective evaluation of SOB than symptoms

Should diabetics use ACE inhibitors to prevent renal impairment ? This is well-established by scientific study and standard of practice in most settings. Is it safe to give people with stage 4 kidney disease ACE inhibitors to prevent progression? Practitioners have been hesitant to give people with stage 4 CKD ACE inhibitors for fear of increasing creatinine or potassium to dangerous levels. Some evidence exists, but practice is not well delineated

Literature Review Theoretical Discussion Quality of References Elements of Critique Quality of Critique

Literature Review Theoretical Discussion Must address the foundation of your question or problem Example: Sepsis and EGDT Use Physiologic theory to explain why EGDT is appropriate for septic patients Use Change Theory if you want to implement EGDT in a new setting that manages septic patients

Literature Review Quality of References References significant to the problem area – classic & current while noting gaps in research literature if any Avoid multiple articles from the same overall study (different purposes but same sample, methodology, statistics, etc.)

Literature Review Organization of review Rationale for selected articles, describe how you organized your paper The journal articles were chosen because they include…….and the oldest is reviewed first…. How many articles should you critique? Use well written AND perhaps not so well written research articles – the heart of the critique process is identifying why they may have similar study questions and yet end up with different results

Literature Review Elements & Quality of Critique – Articulate Main Points Sample Design Procedure Measures Results Conclusions

Literature ReviewDiscussion and Application Critical and original analysis Integration and synthesis of research articles Implications for practice Future research

Literature Review Critique Synthesis and interpretation YOUR ASSESSMENT OF THE STUDIES Too small of a sample size to have power to find a difference between those with and without HF Authors were biased b/c they knew the BNP level and may have changed treatment Only generalizable to men

Make a Table! Organize your literature into a table to compare and contrast Describe each study

Identifies gaps in literature, implications for practice, need for further research • STICK your neck out there! Make your opinion known, however you must base it on the critique of the literature you presented rather than your opinion.

Technical Criteria Grammar and spelling Organization of paper APA format

Literature Review Scoring Total Points - 330 Area 1 – Topic or Issue - 70 Area 2 – Literature Review - 165 Area 3 – Discussion & Application - 80 Area 4 – Technical (grammar, organization, APA) 15 LITERATURE REVIEW IS 50% OF THE PAPER

Problem-solving Comp • Purpose: To evaluate the student’s ability to effectively communicate the resolution of a problem in an area of specialization. • Describes an identified need stemming from a discrepancy between what is or what could/should be.

Choosing a Problem-solving Topic • Can be a problem on an individual or a systems level. • Must be appropriate to the clinical situation • Think of a situation that is challenging to you • Must be feasible! • Must be measurable!

Examples of Problem-Solving Topics • Initiating an Oral Care Program in a Nursing Home • Post-Partum Depression: Transition to Motherhood • ICU Nurses’ Knowledge Deficit Regarding Hemodynamic Monitoring • Loss of Venous Access and Dialysis Delay in End Stage Renal Disease Patients

Comprehensive Exam Orientation