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Comprehensive Exam Orientation

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1 Comprehensive Exam Orientation
Fall 2014 Barbara Hollinger, RN, MSN, FNP-BC Mary Lynch, RN, MS, MPH, FAAN, PPCPNP-BC Macera

2 Starting Spring 2015 Comprehensive exam submissions will use the new format. Comprehensive exams submitted prior to Spring 2015 will use old format. Macera

3 Outline of Comp Process
Description of the Comp assignment The Comprehensive Exam Handbook Qualifying for the examination Important dates Technical requirements Resources Comprehensive Exam options Macera

4 Graduate Division Language
“The comprehensive examination should demonstrate the student’s mastery of the major field and ability to think critically.” Macera

5 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 Macera

6 Critical Points Twenty (20) page paper not including title page, references, grid and appendices Four exam options Research Proposal Critical Literature Review Problem-solving White Paper Macera

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

8 How to Qualify 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. Macera

9 The Last Quarter of Course and Clinical Work
Advance to Candidacy the quarter before you plan to submit your comp Your last chance to Advance to Candidacy is the first week of the quarter in which you plan to turn in the comp One incomplete grade on your academic record allowed to Advance to Candidacy Payment of fees required for comp exam number Macera

10 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. Macera

11 Filing Fee Status Talk with your advisor to determine if you are eligible for filing fee You may not take courses of any type or utilize faculty as a resource for writing your paper if you are on Filing Fee status except for resubmission of a failed comp Apply and pay filing fee to OAR Most frequently used for second time comp exam submission Macera

12 Know the Important Dates

13 Formatting Expectations
APA Sixth Edition format Margins 1 inch on all four sides of page Can separate syllables at the end of a line 20 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) Macera

14 What Should be Submitted?
The following items are to be submitted electronically by the student A completed face sheet. One copy of the Comprehensive Examination submitted as a PDF or MS Word document. A Student Contact Page of paper that provides the student’s name, mailing address, home and cellphone numbers, and any other pertinent information that allows the student to be reached during the reading period. A TurnitinTM originality report. An additional copy of the exam should be retained by the student. Macera

15 Securing Your Comp Number
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 Macera

16 NAME The student’s name should not appear on any part of the Comprehensive Examination. The paper is identified only by the assigned ID number, entered on the face sheet and every page of the examination at the top right margin to the left of the page number Macera

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18 Reading & Scoring Student may select up to five preferred readers (not required) Students may elect to exclude one faculty reader if desired 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 Macera

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

21 Plagiarism Defined “to steal or pass off as one’s own (the ideas or words of another); use (a created production) without crediting the source; to commit literary theft; to present as new and original an idea or product derived from an existing source.” Webster’s Third New International Dictionary of the English Language Macera

22 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 five quarters of advance to candidacy Macera

23 Vital Resources Vital resource—Dept. Administrative Assistants
CHS: Judy Alonzo and Sharon Solorio PN: Mary Margaret FHCN: Maggie Pena SBS: Brandee Woleslagle Comprehensive Exam Coordinators CHS: Beth Phoenix and Dana Drew-Nord PN: Roxanne Garbez FHCN: Barbara Hollinger and Mary Lynch SBS: Susan Chapman Macera

24 Additional Resources Advisors- topic and format Specialty faculty
Sample comps on reserve Scientific Writing Program Coordinator Consider other arrangements Typist Paid tutors and editors Peers as editors and proofreaders Create a timeline See sample provided Macera

25 Comprehensive Exam Spring 2015
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 2015 Pick up Comp # from Departments 04/08/2015 Submit Comp to Departments: 4/22/15 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 Macera

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

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

28 Comprehensive Exam Overview

29 Choosing a Theory Applicable to research proposal, critical literature review, and problem solving comp 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 Macera

30 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. Macera

31 Concept or Phenomenon Possible Mechanisms Underlying the Increased Risk of Type 2 Diabetes in People on Atypical Psychotrophic Medications Macera

32 Potential Theoretical Frameworks
Physiological HPA axis and sympathetic nervous system hyperactivity resulting in overproduction of cortisol. Genetics Diabetes only occurs in those with a genetic predisposition. Co-morbidity The diabetes is really due to alcoholism or binge eating. Socio-cultural Due to socioeconomic, disability, marital status, access to health care Health care Providers fail to adequately monitor overall health. Behavioral Inactivity, diet, smoking due to the psychiatric illness Medication Side effects, appetite stimulation and subsequent weight gain Macera

33 Research Literature Summary Critique Table
Organize your literature into a table to compare and contrast different components of the critique Briefly describe each study in the paper Should be 1 page/article Detailed information in table should not be repeated in body of Comprehensive Exam Macera

34 Appendix I: Quantitative Research Literature Review Table
Citation Conceptual Frame work /Theory Aims Design & Methodology Sample & Setting Variables Measurement & Analysis Findings Author/s name, title of article Year of publication, journal The theoretical basis of the study What was purpose of the study? What were the hypotheses/null hypotheses or states research Indicate the design and briefly describe the procedures used to collect data. n = ? Sample demographics Recruitment procedures? Inclusion/Exclusions criteria Setting selection? What were variables & definitions? Give function of variables What scales used to measure variables What statistical tests were used to answer the research Question? Key findings from result table c sig values 34 Macera

35 Appendix II: Qualitative Research Literature Review Table
Citation Theoretical Framework Design & Methodology Aims Sample & Sampling Analysis Findings Author/s name, title of article Year of publication, journal The theoretical basis of the study Study design. Data sources and data- collection strategies What was purpose of the study? How many participants were there? What were the sample demographics What was the sampling approach? Inclusion/Exclusions criteria How was the setting selection? How were data analyzed? What software was Used (if any) What were the major themes and findings? 35 Macera

36 Recommended Number of Articles for Each Comprehensive Exam
Research Proposal 4 – 5 articles Critical Literature Review – 7 articles Problem-Solving Proposal 4 – 5 articles White Paper 4 – 5 articles 36 Macera

37 The Comprehensive Exam is Pass/Fail
Total points available – 330 Points needed to pass - 231 37 Macera

38 Quality of Writing Area I applies to All Comps
Content & Focus Logic & Flow Structure & organization Sentence structure APA format Correct grammar, punctuation, word usage, and spelling Each category 5 points = 30 points Score of 15 points or less is a technical fail 38 Macera

39 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 Macera

40 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 40 Macera

41 Scoring Areas II - IV II: Study & its Context -70 points
III: Conceptual Framework & Literature Review -125 points IV: Methodology -105 points 41 Macera

42 Critical Literature Review Choosing 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 Macera

43 Critical Literature Review Topic 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 Macera

44 Literature Review Theoretical Discussion
Must address the foundation of your question or problem Example: Sepsis and Early Goal Directed Therapy (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 Macera

45 Critical 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.) Macera

46 Critical Literature Review
Meta-analyses and literature review articles are discussed as appropriate for background and significance purposes. Articles critiqued in the Literature Review section should be primary sources. Macera

47 Critical 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…. 5 – 7 articles recommended should be critiqued 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 Macera

48 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 Macera

49 Critical Literature Review
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. Macera

50 Lit Review Scoring Areas II - IV
II: Topic or Issue – 50 points III: Literature Review points IV: Discussion & Application – 100 points Macera

51 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. Macera

52 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! Macera

53 Problem-Solving Cautions
Instituting a delirium treatment program in acute care setting Is delirium identified? Multiple etiologies . . .  what will the intervention be? How will you measure this? Improving parenting skills by identifying temperament in toddlers in preschools What is meant by “parenting skills?” How will you get access to preschools? Is there literature that indicates that identifying temperament will change parenting behavior? Macera

54 The Problem and its Environmental Context
Clarity of the Problem Who is solving the problem APN Where the problem occurs ICU or community clinic What is to be accomplished Improve Nurses’ Knowledge Target population ICU Nurses or all PCPs at “X” clinic Macera

55 The Problem and its Environmental Context
Significance of the Problem Importance of the problem to patients or profession Accurate Hemodynamic Monitoring is essential for ICU patients Increase in Type II DM in obese children must be addressed Macera

56 The Problem and its Environmental Context
Clarity of the Setting Home, hospital, nursing home Community Health Clinic School Based Health Center Intensive Care Unit Macera

57 The Problem and its Environmental Context
Clarity of Roles & Inter-relationships Describes functions of individuals sig to problem, their roles and influence on the setting ICU nurses, Clinical Nurse Specialist, Head Nurse, APN, Community Outreach Workers Macera

58 The Problem-Solving Proposal Lit Review
Quality of theoretical discussion Quality of references Addresses elements of critique Quality of critique and interpretation Macera

59 The Problem-Solving Proposal Lit Review
Quality of References: Reviews literature significant to the area, including classic and current works, and identifies gaps in the literature. Meta-analyses and literature review articles are discussed as appropriate for background and significance purposes. Articles critiqued in the Literature Review section should be primary sources. Macera

60 Clarity and Appropriateness of Intervention Implementation
The Problem-Solving Proposal Intervention, Implementation, and Evaluation Expected Outcomes Clarity and Appropriateness of Intervention Implementation Clarity and Appropriateness of Evaluation Procedure Defensibility Realism Macera

61 Clarity of Expected Outcomes
The Problem-Solving Proposal Intervention, Implementation, and Evaluation Clarity of Expected Outcomes Improvement of Nurses Knowledge evidenced by improvement on post-test scores Macera

62 Clarity and Appropriateness of Implementation
The Problem-Solving Proposal Intervention, Implementation, and Evaluation Clarity and Appropriateness of Implementation Outline procedures for implementing the intervention and ensuring they are appropriate Educational intervention was three-fold Self-study, then 4 hour mandatory class, bedside guides developed Macera

63 Clarity and Appropriateness of Evaluation
The Problem-Solving Proposal Intervention, Implementation, and Evaluation Clarity and Appropriateness of Evaluation Delineates specific measurable and appropriate evaluation criteria Pretest and post-test measure of ICU nurses’ knowledge is measured Number of incident reports are analyzed regarding monitoring Macera

64 Defensibility Realism
The Problem-Solving Proposal Intervention, Implementation, and Evaluation Defensibility Demonstrates intervention has potential for substantial improvement in the problem Realism Feasibility of intervention Will an educational intervention be possible? Macera

65 The Problem-Solving Proposal Caveats
Do not wait until the end to decide on method of evaluation When writing, do not always start with the beginning of the paper and progress to the end or your evaluation will suffer. Macera

66 The Problem-Solving Proposal Scoring Areas II - IV
II: Problem and Environmental Context – 75 points III: Literature Review: Research, Narrative, & Theory – 100 points IV: Intervention, Implementation, and Evaluation – 125 points Macera

67 White Paper Macera

68 White Paper Area Content Criteria Possible Score (330)
I: Quality of Writing Content & focus, logic & flow, structure & organization, sentence structure, APA, grammar 30 *must score minimum 15 II: Introduction & Background Clarity of policy issue, significance of issue/policy, importance to health care/nursing, quality of evidence 80 III: Literature Review, Theoretical Framework, Summary of Research Quality of theoretical discussion,. Quality of references, addresses elements of critique, quality of critique & interpretation 115 IV: Policy Solutions & Recommendations Implementation of solutions, feasibility & cost analysis, evaluation framework, summary & conclusion 105 Macera

69 Most common reasons why comps fail
Started too late to put in necessary time and effort Did not meet with your advisor to obtain feedback and make sure you are on track Did not follow the advice of your advisor Changed your comp topic at the last minute Primary editor was someone whose English composition skills were not adequate to give you appropriate feedback on your writing Macera

70 I PASSED! Macera

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