1. Comprehensive Exam Orientation
Fall 2014
Barbara Hollinger, RN, MSN, FNP-BC
Mary Lynch, RN, MS, MPH, FAAN, PPCPNP-BC
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2. Starting Spring 2015 Comprehensive exam submissions will use the new format. Comprehensive exams submitted prior to Spring 2015 will use old format.
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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
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4. Graduate Division Language
“The comprehensive examination should demonstrate the student’s mastery of the major field and ability to think critically.”
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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
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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
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7. The Handbook
You can download a copy of the Comprehensive Examination Handbook from the UCSF School of Nursing website
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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.
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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
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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.
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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
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12. Know the Important Dates
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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)
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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.
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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
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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
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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
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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.
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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
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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
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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
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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
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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
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26. WORK HARD, DO WELL!
Extensions, summer comps, oral exam are available only by special arrangement.
Read the corresponding section of the comp handbook.
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27. Sample Examinations On reserve in each of the departments
Ask your advisor and/or your department's comprehensive examination coordinator
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28. Comprehensive Exam Overview
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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
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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.
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31. Concept or Phenomenon
Possible Mechanisms Underlying the Increased Risk of Type 2 Diabetes in People on Atypical Psychotrophic Medications
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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
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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
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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
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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
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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
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37. The Comprehensive Exam is Pass/Fail
Total points available – 330
Points needed to pass - 231 37
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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
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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
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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
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41. Scoring Areas II - IV II: Study & its Context -70 points
III: Conceptual Framework & Literature Review -125 points
IV: Methodology -105 points 41
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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
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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
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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
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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.)
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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.
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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
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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
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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.
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50. Lit Review Scoring Areas II - IV
II: Topic or Issue – 50 points
III: Literature Review points
IV: Discussion & Application –
100 points
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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.
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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!
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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?
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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
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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
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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
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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
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58. The Problem-Solving Proposal Lit Review
Quality of theoretical discussion
Quality of references
Addresses elements of critique
Quality of critique and interpretation
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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.
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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
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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
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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
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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
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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?
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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.
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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
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67. White Paper
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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
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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
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70. I PASSED!
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