Discussions replies wk 8

1. There are several reasons why teachers select grading policies. Some people may choose a method that corresponds to how they were evaluated when they were students, while others might take their cue from a mentor or more experienced faculty member in their field (Calsamiglia & Loviglio, 2019). A crucial decision is whether to curve or not. Teachers can choose the best grading policies for their courses by having a thorough understanding of the motivations and justifications for varying or not varying grades. For several reasons, I support assigning grades based on a curve.

One of the major reasons why I support curves because they offer a technique to standardize grades. Norm-referenced grading can guarantee that the breakdown of grades remains comparable from year to year if an institution distributes faculty responsibilities to instructor a course. A norm referencing method may also be used in a course with numerous graders, including a laboratory where a group of graduate learners grade the assignments (Molenaar, Horvers & Baker, 2021). In this situation, teaching the graders should be the first step in standardizing among many graders. In order for learners to understand what their educator expects for an A, B, C, evaluations revolve around on explicitly defined objectives for learning and grading rubrics.

Curving can be utilized as a method to correct scores on a test that was badly constructed, but it shouldn’t be consistently utilized as a replacement for creating tests that effectively measure what the educator wants learners to understand by the conclusion of the course. Along with establishing grade uniformity, norm-referenced grading enables professors to create more difficult tasks that distinguish top achievers who perform well above the mean (Calsamiglia & Loviglio, 2019). Higher-stakes tests may distort the distribution of grades; norm-referenced marking can then lessen the effect on a greater number of learners, so their scores will probably be lower. Because of these factors, I favor giving grades that rely on a curve.

2. There are certainly advantages and disadvantages to grading on a curve or a relative scale. Grading on a curve means that grades are affected by the students’ scores, where the instructor can find the mean of the scores and grade accordingly (Billings & Halstead, 2016). This means if most of the students scored low, the curve could move towards the left. This means the one who scored the highest (even if their score was 80) would be given an A for that assignment/quiz. Those who scored in the mean would be given a C. This ranks student performance relative to each other. Some say that this encourages healthy competition among students. Some argue that this method of grading takes into the account the level of difficulty of the assignment and that their collective level of understanding also moves the curve.

Opponents of the curve method say that their grades should be independent of other students. The grade should match their effort and their achievement, not relative to others’. This may create a stressful and competitive environment that may not be beneficial in their learning.

I think as an instructor, I prefer assigning grades based on a curve if the assignment or test shows that many students failed to understand or grasp the concept that is being taught. For example, if large sum of students failed the test or the assignment, this may be a sign of poor teaching or poor understanding from the students. I would be willing to curve the grades then, and ensure I find an opportunity to reteach the concept that they have failed to understand. If the spread of the grades is pretty average, I think I prefer to grade them according to their independent effort then.

3. Clinical Evaluation Strategies

Clinical evaluations enable educators to know whether students in clinical environments grasp the lessons. The evaluations’ subjective nature allows professionals to choose effective methods. Observation is among the strategies that I prefer to use in evaluating learners. The strategy involves observing students during their activities (Thampy et al., 2022). The method may help determine people’s performance of psychomotor, cognitive learning, and other aspects by looking at them while performing roles. For instance, observing a student in a simulation situation may help determine their performance. The method is very common because it enables professionals to determine where students require help and where they are excellent at. For instance, I may focus on technique or preparation to determine how one score in the various areas to help them improve.

Another strategy is note-taking. Taking notes works well with observation. I understand that I may not remember everything I see. Hence, I need to have a reminder. Notes help improve accuracy and track performance over time (Sáiz-Manzanares et al., 2020). For instance, one may use notes to determine how the students have performed over time. The method effectively evaluates the various skills that learners have to practice and determines how they progress in their placement. Ensuring that educators can refer to what they saw after some time ensures that the evaluations are as accurate as possible.

Checklists are also important. Checklists include the list of skills and functions that students need to grasp. For instance, in psychomotor skills, there are various skills that one may want to evaluate. They may want to determine their performance of IV insertions, their preparation, hygiene, and other issues. A checklist ensures they cover everything they need (Thampy et al., 2022). I use the strategy to ensure that I remember all areas that students must grasp and use it. When a student passes an aspect on the list, I mark it to show that they have passed. Checklists may work well with observation.

4. Clinical evaluations are given as a chance to express your thoughts on how much an evaluator gained from their experience. Three clinical evaluation strategies that I believe are fair and accurate to measure students learning and competency/safety in a clinical setting are:

Self-evaluations: the reason I chose this strategy is because it allows for both the student and instructor a chance to see where improvement can be made. It aligns with my personal philosophy because if I were an instructor, I would want to see how my students felt from their experience. It’s nice to see students get to see their own growth as well.. This can be done through a quick questionnaire based on their self-evaluation and it could help me see how I can do better for the next course I teach as well. 

Observation: the reason I chose this strategy is because it would allow me to evaluate students psychomotor skills. It will also help students practice the skills needed to use in real-life scenarios. It aligns with my personal philosophy because it creates an added teaching/learning method to the environment. Creating an environment that suits those students who learn best by doing things hands on, can help students get that experience while allowing me to see what I can do better.

Oral-communication: this strategy allows room for respect, honesty and trust. Making sure students feel comfortable enough to tell you where they are failing and what I could do to help them is part of my personal philosophy. When I was in nursing school, I use to love being able to sit down with my professors during their office hours to see how I could improve. They would then work with me on key pointers. In addition, it gives room for the instructor to focus on that students needs as they advance in the course. 

5. In nursing, moral distress occurs when the ethically proper action differs from the activity that was morally meant to be done (Morley et. Al, 2019). This happens when a policy or procedure stops a nurse from doing what he or she believes is the correct thing to do, causing moral distress or a dilemma.

Every day, nurses face unethical situations that can cause them to experience moral distress. I cannot remember how many times manager have asked me to call the doctor to expedite discharge order for patients that were not ready for safe discharge because they need the beds or because the patient’s insurance was not one of the top lines. These situations always have given me a sense of anguish, powerlessness, and breach of integrity.

In 2004, the AACN developed an action plan known as The Four As to Rise Above Moral Distress; the Four “A”s are useful for recognizing and analyzing moral distress. It includes ASK, ACT, AFFIRM, and ASSESS (Butts & Rich, 2016). The nurse can ask appropriate questions about the circumstances to make sure moral distress does not exist. The nurse can affirm the moral discomfort and promise to care for oneself. The nurse should assess the sources of moral distress influences and act to develop and implement methods to maintain integrity and authenticity (Butts & Rich, 2016). When applying the Four A questions, the nurse should reflect on the issues related to patient’s safety. Therefore, organizations must create a safe environment in which inquiries can be questioned, recognizing thoughts and concerns.

6. As mentioned in Butts & Rich (2016), nurses experience moral distress when they are expected to act against what they believe is right to comply with organizational demands. Inadequate staffing is a significant cause of moral distress as the nurse is limited in her ability to provide quality care. Inadequate staffing leads to time constraints, which increase the risk of errors, delayed treatment, patient neglect, and nurse burnout. In applying the AACN The Four A’s to Rise Above Moral Distress, the nurse asks herself:

Ask: What emotions am I experiencing? Would I have taken a different action if there weren’t any work constraints? If so, would that action yield the same emotions I am currently experiencing? Are colleagues sharing the same distress? These types of questions will help identify if moral distress is present (Delgado, 2021).  

Affirm: Once the presence of moral distress is established and the nurse’s distress is self-validated, steps will be taken to address the root cause of the moral distress and improve well-being (Butts & Rich, 2016).

Assess: The nurse identifies the source of moral distress, such as inadequate staffing, organizational constraints, and lack of administrative support (Delgado, 2021).

Act: The nurse can suggest strategies that can help eliminate moral distress. Some strategies to implement are the participation of nurses in staffing decisions, management evaluation of workloads, delegation and teamwork, and balance of patient load based on acuity (Delgado, 2021).

7. According to our textbook, social media sets up the potential for unethical and illegal behaviors in nurses and nursing students (Butts & Rich, 2016, p.107). Social media can violate ethical nursing practices by causing professional boundaries to blur. Anything posted on social media can be misconstrued or misinterpreted by someone reading the comment or viewing the post. Therefore, nurses and nursing students risk violating nonmaleficence in social media exchanges through perceived or actual harm to recipients (Butts & Rich, 2016, p. 107). The positive side of social media use is the ability to network and share knowledge. Social media allows nurses and other health care professionals “opportunities for rapid knowledge exchange” and to build professional relationships (Butts & Rich, 2016, p. 107). There are several pieces of published literature with the purpose to guide nurses in the ethical use of social media, including the National Council of State Boards of Nursing’s A Nurse’s Guide to the Use of Social Media (Butts & Rich, 2016, p. 107).

8. The use of social media has greatly increased over the last couple of years in the nursing profession and health care field. Social Media has beneficial factors that contribute to the growth of the health care industry such as providing easy accessibility for the public to access medical information. Health care professionals can also connect with their patient’s more easily and be more consistent with the followup care. Another benefit is the amount of information being published regarding the new advances in medicine and current research findings. These findings also provide the public with more treatment options and alternatives than before. Social media has been used by the  health care professionals to communicate with people with similar interests and provide insights related to the topic. 

Despite these benefits, social media also possess a great threat by increased risks of compromising confidential patient data or information. It can violate nursing practices by invasion of patient privacy. Due to this, workplaces have now strictly enforced guidelines to be followed  to prevent patient privacy invasion by limiting the type of posts nurses can post on social media and also limiting the social media access at workplace. Patients are increasing worried about the nurses posting about their medical issues online thus preventing the patients from forming the proper nurse-patient relationship (NCSBN, 2018). As a nurse you are entrusted to protect the patient information and only share it with people who are currently involved in patient care along with the consent from the patient. 

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Discussions replies wk 8

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appropriate level of care and further treatment. In these situations, I have felt a sense of moral distress because I knew that discharging the patient prematurely would not be in their best interest and could potentially harm them. However, I also understood that there were pressures to free up beds and manage the hospital’s resources efficiently.

In order to address moral distress in nursing, it is important for healthcare organizations to establish clear ethical guidelines and provide ongoing education and support for nurses. This can help nurses navigate challenging situations and make decisions that align with their moral values while also considering the broader context and patient needs.

Open communication and a supportive work environment are crucial in mitigating moral distress. Nurses should feel comfortable expressing their concerns and seeking guidance from colleagues, managers, and ethics committees. Organizational policies should encourage ethical decision-making and provide mechanisms for reporting and addressing moral distress.

Furthermore, ethical reflection and debriefing sessions can be helpful in processing moral distress and building resilience. These sessions provide a space for nurses to discuss challenging cases and share their experiences. They also allow for collective learning and the identification of strategies to address similar situations in the future.

Ultimately, addressing moral distress requires a collaborative effort from healthcare organizations, educators, and healthcare professionals. By promoting ethical awareness, providing support systems, and fostering a culture of open communication, we can help nurses navigate moral dilemmas and promote ethical nursing practice.

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