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Discussion: Nursing Research Phase 5 Paper ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Nursing Research Phase 5 Paper Please create an abstract for phase 5 of the nursing research project (phase 5 is a combination of 1-4). Discussion: Nursing Research Phase 5 Paper I already combined the papers together (phase 1-4) please review the paper and make sure is all in past tense (I already reviewed most of the paper It should be a minor fix) I also had some points deducted for tittle and subtitles not being in proper APA format Can you please make sure The paper has the corrects APA format Disregard Masters Essentials after the references phase_5.docx Patients 65 Years And Older Living In Miami Florida Struggling To Transition From Hospital To Home Or Long Term Care Setting Nayvi Brennan Florida National University Professor: Jorge Hirigoyen 11/16/2019 Introduction The paper explores the continuity of care provided to older Hispanic adults 65 to 80 years old with a chronic condition who faces other risks factors such as social barriers, difficulties in managing their healthcare needs, as well as challenges in carrying out daily activities, especially during acute illness. The need to recognize and determine the efficient strategies to improve continuity of care provided to older adults and the outcomes to the health and care for older adults is critical and essential. Discussion: Nursing Research Phase 5 Paper Clinical research was conducted with the ultimate aim of improving treatment options for patients, develop alternative options, and reduce hospital readmissions. The objective of this nursing research was to find out why older Hispanic adults are struggling to transition from hospital to home or other health care settings. The article provides a detailed analysis of the problem and continuity of care. The results of the study will also help the different stakeholders and policymakers on the best approaches to adopt in a bid to improve the welfare of the patients. Treatment options or plans must be subjected to questioning to make sure that they are acceptable within the set standards (Colorafi & Evans, 2016). Further, it is key to ensure that all results from clinical and nursing researches are validated. It will, therefore, be vital to ensure that the findings in this study reduce instances of duplication or replication of research efforts, while at the same time, uphold the transparency of the study (Tappen, 2016). These will, therefore, ensure that no single decision is made without enough reasoning and conclusion. Discussion: Nursing Research Phase 5 Paper Identifying the Problem Among over 20 million Medicare beneficial, more than 40% have a chronic condition (Verhaegh, et al., 2014). Older adults who suffer from a chronic condition, other risks such as social barriers or functioning deficits add to the difficulty in providing their health care needs. Besides of the frequent episodes of the illness, the older adults compared to other chronic condition patients, these patients experience a higher rate of healthcare services such as emergency department visits, hospitalizations, and physicians which adds to their health care costs. Research from various studies has proven that poor healthcare provided to older adults often results in too devastating economic and human problems. Such problem associated with the poorly managed health care provided among the older adults including; inadequate communication, poor continuity of care, poor patients’ engagement, poor follow up, inadequate collaboration among patients and the health care providers, and gaps that exist as patients move between hospitalizations as well as care settings (Verhaegh, et al., 2014). Limited hospitalization and poor follows up are among the most troublesome consequences. Though some re-hospitalizations are necessary and cannot be avoided, 20% of those faced by older patients are estimated to be preventable if well care and managed (Hirshman, Toles, Huang & Naylor, 2019). Moreover, to the human burden, the societal costs related to older adults’ health care services are significant. Studies indicate that health care services provided for medical beneficiaries with five or more chronic conditions make up of about 74% of the total health care cost spent. The majority of these costs are as a result of high rates of avoidable hospitalizations (Allen, Hutchinson, Brown, & Livingston, 2017). Healthcare providers, who focus on continuity of care such as transitional nursing aims at enhancing patient’s experience, reduce health care cost, increase population health. Particularly, transitional nursing which is set of limited services that are provided during an acute illness episode across healthcare settings has been recognized as an efficient approach to improve and manage health care services provided to older adults. Evidence-based show that the transitional care model has consistently proven to be efficient in enhancing economic and health outcomes for older patients. (Verhaegh, et al., 2014) Significance of the Problem In recent years there have been increased issues of poor health care provided to older adults with chronic illness. Due to this, there have been numerous models that target to resolve the issues such as the transitional care model which is a nurse based model that targets to provide efficient health care service to older adults with chronic illness. The issues are significant to nursing as it threatens the ability of healthcare nurses to meet the ethical requirement and role for providing basic health care (Verhaegh, et al., 2014). The increased number of older patients with chronic illness who are at a high risk of facing other risks factors pose a significant threat to health care services systems. Managing healthcare service provided to older adults, improves health outcomes, patients’ experiences and enhances better use of the available resources. Health care service provided to older adults includes a range of services aimed to ensure the continuity of care for older adults across multiple healthcare teams and healthcare settings like homes to hospitals. Nursing as a professional should present policy, practice, and research that can address the issues. (Allen, Hutchinson, Brown, & Livingston, 2017) Most older adults with a chronic condition who require to transit from one health care setting to another normally experiences risks of poor outcomes as they move between various settings to health care providers. In the recent years, there have been increased cases of older adults too with a chronic condition to transit to various settings because of other risks such as a frequent episode of acute illness, for nursing, rehabilitative and medical before they transit again to home (Hirshman, Toles, Huang & Naylor, 2019). Properly and efficient health care during the older adults transition from one health care settings to another to enhances their health outcomes. Purpose The purpose of the study was to identify the reason for poor health care outcomes: studies indicate that most older adults who move between health care settings for medical and other health care services experience poor health outcomes during their transit. Dependence on others, low socioeconomic status, and advances ages play a significant role in the vulnerability for the poor outcomes. Patient and their caregivers often have a burden to self- manage health tasks, such as taking the correct medications, monitoring changes, medical treatments and managing follows ups. Besides, the paper aims to identify ways in which poor health care outcomes can be enhanced and improved to ensure that older adults receive better health care outcomes. Properly and efficient health care during the older adults transition from one health care settings to another to enhances their health outcomes. Research Questions What are the main factors affecting transition from hospital to home or other health care setting of older Hispanic adults living in Miami, Fl? Are health care providers prepared and ready to provide sufficient service to the older adult with a chronic condition? Within the selected population, which patients have the highest readmission rate? What are the major factors that lead to poor health care outcomes? What are the best ways in which health care providers can deal with poor outcomes? How could the transitional nursing be allied with transitional care model to ensure enhanced health outcome? How can we help this population transition without difficulty and reduce readmission rate. Literature Review Now days older adults are facing many challenges in healthcare. Literature review was conducted in order to identify why this is happening. In a study conducted by Dyrsad, Laugaland & Storm in 2015, it points out that older patient have minimal participation in the hospital from the admission up to the time they are discharged. In improving the quality of healthcare provided in hospitals, there is certain information that needs to be available to the healthcare providers. This is based on the fact the level of participation for different groups during admission up to discharge in the hospitals vary. The article focuses on the level of participation for older people in the hospital (Dyrstad, Laugaland & Storm, 2015). As indicated by Dyrstad, Laugaland and Storm, among the facts that limit the participation of the older people in the hospital are the time constraints for the healthcare professionals and the high number of patients. It is noted that improving the involvement of the patients is one of the ways of improving the quality of health care (Dyrstad, Laugaland & Storm, 2015). Therefore, there is the need to create awareness among the healthcare professionals on the factors that affect the participation of older patients in health care. This is based on the fact that improving the patient of the older patients in the hospital is critical to improving the quality of patient care. A study published by the Journal of Clinical Nursing was able to identify that patients with low socioeconomic have poor results during a post-hospital transition. This article explores the problems which this group of patients encounters during the period. The report focuses on the experience of these patients during hospitalization period, alignment of the team care goals, health behaviors, socioeconomic constraints, and self-efficacy (Kangovi et al…, 2014). According to the article, patients feel powerless when they are hospitalized; hence, they are not able to participate from hospitalization to discharge. There is also a lack of alignment of the patients and health professional goals. This result in scenarios where health care professionals suggested what patients cannot afford after hospitalization. Further, Kangovi and his colleagues in the article argue that there is a lack of saliency behaviors because instead of focusing on the discharge instructions after hospitalization, patients concentrate on the pressing socio-economic challenges (Kangovi et al…, 2014). The financial difficulties cause the patients not to follow discharge instructions. Therefore, the authors propose for the designing of policies to improve the post host outcomes with a particular focus for the collaboration of the hospitals and other social support groups. A study conducted by Allen, Hutchinson, Brown & Livingston, (2018), other major challenges are identified. There is a significant need for nurses and health care providers to focus on continuing to provide quality care to older Hispanic adults with chronic conditions, even getting discharged. According to Allen, Hutchinson, Brown & Livingston (2018), the patients also face other risk factors like challenges in managing their health needs, carrying out basic daily activities, and social barriers, among others. The realization on these challenges is an indication that with coordinated and dedicated care provision, nurses and healthcare providers can be able to continue offering quality care to patients, as observed by Allen et al., (2018). The study conducted by Allen, Hutchinson, Brown & Livingston, (2017), has insisted on the need of quality care by arguing that transition for health care services from the hospital to home should include effective communication between the practitioners involved, a framework for assessment, preparation, and planning. The understanding in this context is that medication reconciliation supported by follow?up care and self?management education will help older Hispanic patients avoid readmission or help them in the recovery process (Allen et al., 2017). Further, Allen et al. (2017), through their study, have also revealed that it is important to consider four thematic areas in the provision of care. These areas include; who will be the caretaker, what standards must we adhere to, what involves a proper discharge, and finally, how to adjust to provide quality care, since these are key to the quality transition. Brown (2018), in Transitions of care; In Chronic Illness Care , also notes that the world’s population is aging, but despite this happening, advanced medical procedures and medical science has made it increasingly possible for people with advanced diseases to stay longer. Brown (2018) has also observed chronic care has dominated the American healthcare system over the last ten years, and therefore there is the need to onboard and practice the effective management of treatment options for Hispanic adults aged 65 and above and with chronic diseases. Finally, the study by Brown (2018), also found out that the process of discharging patients and taking them to home care is seen as a social process as it involves aspects of negotiation and navigation of dependence and independence between the health care providers and the recipients of care. Hirschman, Shaid, McCauley, Pauly, and Naylor, (2015), have in their studies on continuity of care noted that the transitional care model is all about providing intervention to older adults who have high risks of deprived healthcare. The argument put forward in their study is on ensuring that there need to recognize, develop, and determine the effective and efficient strategies that can be used to improve the continuity of care without interruptions. Bookey?Bassett, Markle?Reid, Mckey & Akhtar?Danesh, (2017) have also revealed that transitional care should be able to facilitate the safe and timely transfer of patients across the two settings without compromising quality care. This would, in a significant way to reduce the cases of hospital readmissions and also strengthen community health programs related to the management of chronic diseases among the older Hispanic population. Bookey?Bassett et al., (2017), have also revealed that there is also the challenge that arises as a result of a limited understanding of how to actively and successfully involve care providers and care recipients in transitional care. This has made provision of care for an older Hispanic population a challenge. My study will focus on Hispanic patients 65 year old and older in Miami, FL struggling to transition from hospital to home or long term care setting as a target population. The purpose will be to identify specific issues affecting the transition. Studies mentioned above focus on other populations and issues affecting healthcare. The purpose of this study is to help facilitate transition from hospital to home or long term care setting. Methodology and Design of the Study This research aimed to find out a concept or rather approaches that can be used to promote a positive, successful, and working inter-professional relationship and collaboration for health care providers, health facilities, and other professionals in the provision of care. The research focused on the older Hispanic adults, an aspect that will make it different from the rest and dependable in providing important data sets and patterns about challenges they face while transitioning from hospital care to home care. Specifically, Hispanic adults aged 65 years and older living in Miami, Florida were targeted. Finding data on the nature of chronic diseases, their prognosis, and other factors will involve collaborating with agencies like the Center for Diseases Control, among others. The study involved patients’ assessments and interviews as well as the use of secondary data that relates to the management of chronic diseases for older adults. The study mainly depended on qualitative research designs and methodologies since they are highly preferred in the fields of nursing and other associated fields. The research designs and methodologies involved phenomenology, narrative inquiry, grounded theory, and ethnography (Tappen, 2016). The purpose of phenomenology in this study was help the researchers in finding and describing the areas of interest which individuals live in and interact with. Phenomenological studies are important in helping capture the experience of individuals about a subject of study. Using phenomenology ensured that the study is developed only through reliable and information that can be validated. Inclusion and exclusion criteria was used ensure that only those who have had an experience with a chronic disease will be interviewed. Discussion: Nursing Research Phase 5 Paper In a bid to understand what social or family-related traits or factors have on chronic disease, the study used ethnography. Ethnography aims to seek a deeper understanding of the community, group, or even a specific family. The final methodology used narrative inquiry, especially from the patient, family members, or caregivers. The narrative inquiry helped in capturing the experiences of individuals and probably find a connection between their narratives and chronic diseases (Wang & Geale, 2015). Sampling Methodology The sampling method is simply a way to select the members of a population who are qualified for this study. The Study was conducted with the support of two local hospitals, West Gables Hospital and Hialeah Hospital using random sampling. The study aimed to achieve results and data that can be used in decision and policy-making and towards making permanent interventions on how to assist caregiver’s transition caregiving from a hospital setting to a home setting without compromising the quality of care given (Tappen, 2016). In achieving this; simple random sampling was used since it will help in selecting a fairly representative. The study avoided using convenience sampling and voluntary response sampling as they might give biased results, which could, in turn, affect the outcomes. In essence, sampling methodology was used because it provided a fair and unbiased representation, which guaranteed that all population groups are represented. Necessary Tools The study was highly organized, rigorous, and comprehensive to ensure that the results obtained can be used in the decision and planning processes of the management and treatment of chronic diseases among older adults. Several organizational and project management tools were used especially in carrying out the interviews, collecting data, recording data, and finally, to ease the access of the obtained data sets and results. The tools included; event calendars, screening and enrollment logs, data summary sheets, instrument scoring tables, and protocol & eligibility checklists. These tools created efficiency, promote a professional outlook and a positive image, provide a sense of control during the study, maintain the integrity of the collected data and minimize errors (Tappen, 2016). Algorithms and Flow Maps Based on the design and an analysis of the entire research study process, flow maps and data table were used in order to present the collected data. Algorithms and flow maps are usually preferred in instances where the flow or process is uniform and not random. The methodologies and designs used in the research study are popular and widely used in nursing and healthcare, making it easy for researchers to implement without the flow maps (Tappen, 2016). The objectives, goals, and constraints of the research study are also well laid down, thus removing any aspect of ambiguity that might confuse the researchers. Finally, the scope of the study is narrow and does not involve aspects like medical test selection, therapy & prognosis, and diagnosis. The study was implemented in stages to ensure that we fully onboard our partners and sponsors. We are going to involve Agency for Healthcare Research and Quality, Health Resources and Services Administration, Centre for Diseases Control and Prevention, the Centers for Medicare and Medicaid Services (CMS), and other agencies as the study might require. Our study adheres to Good Clinical Practice guidelines (GCPs) as set out by the Federal Government and other regulators. Implementation Phase The project focused on finding concepts and approaches that will be used to promote a positive and successful working relationship for health care transition for older Hispanics with chronic diseases. We implemented this project in phases to ensure continuity and completion of each phase and stage. According to Kadu & Stolee (2015), transitioning care is a systematic approach that is used to study, identify challenges facing patients who transition from hospital care to home-based care, and at the same time, prevent hospital readmissions from occurring. The implementation involved assessment, diagnosis, planning, and evaluation. The implementation of the study was also included the study design, identification of the site, development, monitoring of sites, and their management. In a bid to ensure that implementation was not affected by issues to do with data, the project focused on data management, quality, and integrity (Kadu & Stolee, 2015). Furthermore, the study team was also focus on biostatistics and statistical analysis while at the same time, protocol development was used while working with our partners and stakeholders. The communities were involved in the studies, and therefore, it was important to assess their preparedness. Research operations and logistical support also played a key role in strengthening the study. The implementation skills needed from nurses and caretakers are cognitive, interpersonal, and technical skills. Cognitive skills will be vital in problem-solving, critical thinking, and creativity. Interpersonal skills focused on helping to address issues to do with communication (Kadu & Stolee, 2015). Technical skills were required in the implementation process. According to Friesen?Storms et al,. (2015) ; Leff, Soones & DeCherrie, (2016), the process of implementing nursing projects involves reassessing the client, determining the nurses’ needs for assistance, implementing nursing interventions, supervising delegated care, and documentation. Discussion: Nursing Research Phase 5 Paper Project management tools were used to ensure that it is consistent in implementation, coordination, and deliverables. We monitored the project and make adjustments based on the milestones and goals set. The nursing team also recorded any variances that might be experienced during the implementation process. The project reviewed weekly to ensure that any challenges and discrepancies from the main goals are noted and corrected. We updated sponsors and other critical stakeholders on the status of our clinical study and adopt recommendations. Status reports generated during the implementation phase showed the anticipated endpoint, cost of study, the schedule, as well as the quality of deliverables. West Gables and Hialeah Hospital worked with the team to ensure that the project goes full scale. Before the implementation, there was a need to ensure that the central clinical site monitoring is done. The monitoring was important in ensuring compliance with the set standards and protocols, follow the Good Clinical Practices, the Federal government regulations, as well as other institutions concerned with the subject of study (Smith & Johnson, 2019). The implementation fallowed the clearly set guidelines as it relates to clinical research studies. The implementation plan was bolstered by a Clinical Monitoring Plan that has set guidelines on issues of complexity of the study, human subject risk, and nature of the study. The project management team understanded that the implementation of the project depended on the quality of communication with the involved stakeholders. According to Kadu & Stolee (2015), communication involved debriefing, follow-ups, visit reports, and Action Item Tracking. In finality, the preparation for the implementation of the study also focused on on-site assessment review, protocol compliance, the integrity of data and samples, human subjects protection, staff training, protocol compliance, and laboratory SOPs and compliance. Time Frame of the Project The success of the study was purely be driven by the use of quality approaches towards the project. The study involved many activities ranging from assessment to evaluation. Additionally, since the project involved different stakeholders, there was the need to onboard them for ease of implementation of the project. The communities to be involved was trained on the importance of this study. These steps further made the project a reality. The entire project was achieved in milestones, thereby narrowing the chances of failure. Working in different phases also reduce the pressure on available resources committed in the study. Activity Duration Cost Assessment 2 months $8,000 Data Collection 3 months $14,010 Data Organization and Analysis 1 month $3,200 Nursing Diagnosis 3.5 months $36,175 Planning 6 months $84,014 Implementation 9 months $112,068 Evaluation 3 months $8,953 The entire project from the assessment phase to the evaluation phase required 27.5 months and a financial commitment of $266,420. The budget was broken down into units that were seen the different stakeholders investing to make the study a reality. Resources and Statistical Tools Patient assessment after transitioning from hospital to home-based care and clinical data collection required a dedicated approach (Leff, Soones & DeCherrie, 2016). Our study was implemented in a way that enhances data collection through clinical observations, specimen collection, clinical measurements, data and information documentation, and in some instances, the manipulation of the collected outcomes. Interventions and study procedures for older Hispanics with chronic illnesses involved the administration of investigational drugs, other treatment options, and detailed evaluation to reveal the implications of the treatment options on the health of the patients. The resources used in the clinical study were also used in phenotyping to find out the natural history of chronic illnesses. According to Friesen?Storms et al,. (2015), the study team should also focus on training caregivers and caretakers on the best way to physiologically monitor patients and help them in the recovery process. The study carried out with the input of the partner hospital and other agencies in Florida and from the Federal government and, therefore, required comprehensive tools and resources. There was a team of dedicated health practitioners and professionals whose expertise were required in guiding the clinical nursing officers from carrying out the study successfully. The study was engaging, rigorous, and comprehensive to ensure that it makes important inferences that are supported by facts and can be used in minimizing cases of readmission into hospitals after they are discharged. Discussion: Nursing Research Phase 5 Paper Significant activities in the study involved interviews, data collection, data recording, and storage of the data for use in the future. Tools that were used in this case included data sheets and screening tools (Ali & Bhaskar, 2016). The team consisted of Registered Nurses who trained and educated patients during the period of the study. This will be instrumental in reducing cases of hospital readmissions. Clinical Nurse Specialists, Nursing Educators, and Public Health Nurses also required to strengthen the human resources team and further to guide the team on the ground. All these efforts invested in helping generate consistent and valuable data that can be used in decision making. Data collected in the study was manipulated by the use of the Bradford Hill criteria, while the Statistical Package for the Social Sciences (SPSS). The project team also made use of Microsoft Excel and the Statistical Analysis Software (SAS) (Ali & Bhaskar, 2016; Chen, Carlin, & Hobbs, 2018). Instant Data Entry Application (IDEA) was used in capturing data during the period of the project. This application reduced instances of losing data and at the same time, help to develop a relationship of data sets. Google Forms and Zoho Survey tools were used in administering surveys to the different target populations (Chen, Carlin, & Hobbs, 2018). OpenRefine was also important in linking data sets. Airtable, a cloud-based database, was used in the study because it has capabilities for capturing data and displaying information. Data integration was done by using the Talendi tool (Ali & Bhaskar, 2016). According to Smith & Johnson, (2019), such projects involved a lot of activities, especially in assessment, planning, and implementation. Creating quality results was instrumental in the study because the data collected and the results will be shared with our partners and other stakeholders like the Centre for Diseases Control, and other agencies working to improve public health (Kadu & Stolee, 2015). Scoro was the best software to use in project management since combines all aspects of project management and made it easy to improve the project as needed. Since the study involved finding ways by which nurses can continue offering quality care to older Hispanic adults with chronic conditions, it was important to consider comparing data with other countries. Discussion: Nursing Research Phase 5 Paper Baseline Data The baseline data was collected before the research study started. These data include demographics, the characteristics of the patients, and other characteristics that are key in the assessment of patients with chronic illnesses. All participants selected were Hispanic male or females living in the Miami, Florida area with admission diagnosis of exacerbation of current chronic illness. Chronic illnesses included Congestive Heart Failure, Chronic Pulmonary Obstructive diseases and Diabetes. The age rage of the participants was taken to be between 65 to 80 years old. The average weight of the participants was at a mean age of 81.5 kilograms, while the Body Mass Index (kg/m2) was at 31.8. These data sets were important in setting the basis for the research study. Participants Age Range 65-70 years old 134 patients 71-75 years old 131 patients 76-80 years old 85 patients Average age 72.3 years old Total participants 350 patients Chronic Illness exacerbation as admitting diagnosis COPD Exacerbation 94 patients CHF Exacerbation 122 patients Complications related to poor management of diabetes 134 patients Total participants 350 patients Gaussian Distribution The research study can be termed as a biological study because, on the one hand, it was about chronic illnesses, aging, and the recovery process of patients while, on the other hand, it was trying to find ways of reducing readmissions in the hospital. These aspects make most biological variables to cluster around a central value. This, too, can be explained by the statistical tools used in interpreting the data sets. The variables, despite this clustering, have symmetrically positive and negative attributes (Leung, 2015; Polit, 2017). The research study indicated that out of the 500 participants, only a mere half were focusing on improving their wellbeing by being at home. The rest were not aware as to whether taking treatment at home would be of any help in their recovery process. These behaviors are attributed to normal or Gaussian distribution. Adverse Events Experienced by the Study Participants The research study was not without several adverse events, as some aspects did not work as planned. There were several unanticipated adverse events, especially when participants cited as the new setting as to ha

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Assistance with Marketing Assignment ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assistance with Marketing Assignment I’m trying to learn for my Health & Medical class and I’m stuck. Can you help? Assistance with Marketing Assignment Please assist with two page writing assignment. Please see attached word document with instructions database_marketing__houston_methodist.docx chapter_10_organization_growth.docx swot_analysis___houston_methodist.docx houston_methodist.docx Database Marketing This week you will obtain information on database marketing to support the Marketing Mix section of your Final Project. As discussed in Chapter 10 of the course text, database marketing centers on gathering customer-based information such as gender, age, occupation, and lifestyles. As an example, to better understand the wants and needs of patients and their families, the Happy Valley marketing director monitors activities on the long-term care center’s web page. Data is collected regarding specific links viewed such as activities, skilled care services offered, and physical therapy. If a certain link is viewed more than other links, this could indicate to the marketing director that potential patients and their family members prefer specific amenities or services. Those amenities or services would then be marketed as a priority for the organization. Considering the marketing plan for your chosen healthcare organization, construct a three- to four-page paper in which you: Assistance with Marketing Assignment Describe your understanding of database marketing and how it could potentially be applied to your marketing plan for the Final Project. Discuss the benefits and drawbacks of using database marketing. State the ethical, legal, and HIPAA issues that need to be considered. Articulate reasons why you would implement or exclude the use of database marketing in your marketing plan for the Final Project. The paper Must be two double-spaced pages in length (not including the title page and references page) and formatted according to APA style as outlined in the Ashford Writing Center(Links to an external site.)Links to an external site. . Must include a separate title page with the following: Title of paper Student’s name Course name and number Instructor’s name Date submitted Must use at least three scholarly sources in addition to the course text. Must document all sources in APA style as outlined in the Ashford Writing Center. Must include a separate references page that is formatted according to APA style as outlined in the Ashford Writing Center. 10.1 Organizational Growth Most organizations have growth as a basic goal. Growth means an increase in revenue and a greater impact on the communities served.Growth also creates opportunities for staff to advance and take on new responsibilities. While many activities can help an HCO grow, the mostimportant is the development of an effective marketing plan to provide a consistent platform for the organization’s visibility and to brand theHCO as an attractive option for medical services. The development of an effective marketing plan was stressed in Chapter 8 as a basicmarketing need for an HCO: that is, to inform new and existing customers of the organization’s services and to persuade them to continueusing or to try using these services. Product/Service Life Cycles Like people, products and services have a life cycle. The term product life cycle refers to the stages that a product or service goes throughfrom the time it is introduced until it is taken off the market or “dies.” The stages of the product life cycle, illustrated in Figure 10.1, usuallyinclude the following descriptions: Introduction—The stage of researching, developing, and launching the product or service. Growth—The stage when revenues are increasing at a fast rate. Maturity—The stage when revenues peak, and the rate of growth slows down. Decline—The final stage of the life cycle, when revenues start to decline. Assistance with Marketing Assignment For example, a pharmaceutical manufacturer introduces a new cholesterol drug, and it is promoted by sales reps and possibly promoteddirectly to consumers during the product’s introduction stage. As more and more physicians prescribe the drug, sales grow at a fast pace, andthe drug enters the growth stage. As time passes, sales begin to slow as the drug reaches the maturity stage. Then, newer drugs areintroduced, and sales of the older drug start to decline. In an attempt to maintain sales of the older product, the manufacturer may decide tosell the older product as an OTC drug, but at a much lower price than when it was a prescription drug. Of course, not all products reach the final stage and may instead continue to stay at the maturity stage for a long period of time. Regardless,attracting and keeping new customers is critical because of the nature of how products evolve from their conception to extinction. When therevenues produced by the product or service begin to decline, so do profits. To boost or maintain revenues requires keeping existingcustomers, but also attracting new ones. Figure 10.1: Product/service life cycle Some products stay in the maturity phase for a long time. Other products movequickly through the cycle. Source: Adapted from Product Life Cycle Stages at http://productlifecyclestages.com/ Individual Adoption Stages A critical element in attracting new customers is to understand the stages that individual consumers move through when adopting a newproduct as it moves through the product life cycle. These stages, shown in Table 10.1, are referred to as the individual adoption stages . Ofcourse, promotional messages must be aligned with these stages to carry the consumer through them. In the introductory stage, promotionalmessages must inform potential customers of the offering. In the growth stage, promotional messages must encourage potential customers touse that specific offering, or product, rather than competing products. At the maturity stage of the product, customers are reminded of theproduct to build repeat usage and referrals. Thus, messages stressing the firm’s competitive advantage must be developed to answerconsumers’ questions at a given stage in the individual adoption process and to reflect the nature of the product at a given time during its lifecycle. Table 10.1: Individual adoption stages and information needs Stage in Individual Adoption Process Questions Consumers Want Answered 1. Awareness: Consumer first learns of the product,service, or organization. Who are you? What are you all about? What do you do? 2. Interest: Consumer is stimulated to get moreinformation about the product or service. Why would anyone use your services? What benefits would they get? 3. Evaluation: Consumer considers whether to trythe product or service. Assistance with Marketing Assignment Why should I buy your organization’sservices? 4. Trial: Consumer tries the product or service. Will it really deliver those claimed benefits? Can I risk trying the service? 5. Adoption: Consumer decides to use the product orservice, becoming “your” customer or patient. Did I make the right decision? 6. Repeat: Consumer may reevaluate his or herdecision to continue using the product or service. Should I continue to use the same serviceprovider or are there better alternatives? Consumers will be at various stages in their individual adoption process of a product and will have varying levels of knowledge andexperience. Therefore, a variety of promotional messages, conveying different types of information about the product, service, ororganization, is usually necessary to communicate effectively to them. While most consumers are concerned about the benefits received froma product, some are interested in the detailed information that produces those benefits. Such detailed information should be available toconsumers who request it. Information from the marketing plan’s consumer analysis is vital in making communications decisions on promotional message content. Theneeds and motives of consumers become the center of such content decisions. If time and money permit, promotional messages should betested before use, and measures indicative of consumer responses to those promotional messages should be evaluated in the decision-makingprocess to finalize the message content. 10.2 Attracting New Customers New customers, or patients, can be attracted to an HCO in several different ways, some at a relatively low cost. One source has identified fourlow-cost approaches (Guerrero, 2013), which follow: Create an online presence with a website because people search for information, and sometimes ratings, online. Use social media to create a profile of your business and to get feedback. Using social media increases visibility and presence, and showspotential patients you are up-to-date. Increase community involvement, which is an age-old technique, but it works. Clubs, churches, speaking engagements, and so forth allincrease name recognition and awareness. Make it easy for patients to contact you. This can be done by creating a link on your website for customer contact or by using text,tweets, and email. Some hospitals have started using animated videos to attract new patients. These videos can be linked from your website, or emails can besent to provide links to videos on YouTube. This allows potential and existing patients to view the videos at their leisure and provides aninteresting interface, which can serve to present useful information (PRWeb, 2012). Another approach for increasing patients/revenues is to offer additional services. Dr. Clint Long of Long Eye Clinic in Sherman, Texas is aboard-certified ophthalmologist who has added new services to his practice to attract new patients and increase revenues from existingpatients. The clinic offers BOTOX ® Cosmetic, a proven prescription medicine that is injected into muscles to temporarily improve the look ofmoderate-to-severe frown lines between the eyebrows in patients from age 18 to 65. The clinic also offers CO2 laser treatment for skinrejuvenation. This treatment can help diminish brown spots and wrinkles while firming and toning facial skin. LONG VISION CENTER: DR. CLINT LONG Long Vision Center in Sherman, Texas cares about your vision. In fact we believe that it is very precious, and Dr. Long ishere to make sure you have superior quality eye care. Here at Long Vision Center, we provide general eye care, medical eyecare, surgical eye care, laser eye care, as well as Botox Cosmetic, Laser Skin Re-surfacing, and Lasik to patients in Sherman,Texas and the surrounding North Texas area. Dr. Clint Long, a State of Texas Board Certified Licensed Ophthalmologist, performs general eye examinations foreyeglasses and contact lenses, examinations for cataract and cataract surgery, lens implants, corneal surgery andtransplants, diagnosis and treatment of dry eyes, laser vision correction & surgery such as LASIK, diagnosis, medical, laserand surgical treatment of glaucoma and provide eye examinations and laser treatment for diabetic retinopathy andtreatment for age related macular degeneration. Source: http://www.longvisioncenter.com/ Retrieved November 13, 2013 (continued) While Dr. Long’s initial interest was in helping patients with skin issues around the eyes, he soon learned that patients also wanted thetreatments for other areas of their face. His investment in additional training and certification in those procedures has paid off through anexpanded customer base and increased revenues (Long Vision Center, 2013). Patient referrals are a cost-effective way of getting new patients. However, patient referrals, like other aspects of a marketing plan, must bemanaged. This means evaluating the process of new-patient referrals; that is, who is referring new patients, how is this information beingobtained and kept, and how are new patients treated by staff and made to feel welcome and valued. Many doctors will actually set up an appointment for a patient with another doctor and have the referred doctor’s office confirm theappointment. A record of each of these referrals should be maintained and the referring doctor thanked for the referral. A short note or callcan show appreciation and lead to more referrals. The cross-selling of services within a clinic is a valuable tool for referrals. Cross-selling means referring patients to other doctors or servicesoffered by the clinic. It is important that each doctor be aware of the services and qualifications of other medical staff at the clinic andcontinually reminded of the need to cross-sell, because it works both ways: I refer someone to you, and you refer someone to me. Assistance with Marketing Assignment In addition to attracting new patients, HCOs must effectively manage their existing customers to support long-term profitability. Customerrelationship management (CRM) further analyzes a targeted segment by addressing each customer’s potential for profitability. CRM isbased on the following four premises: Customers are a key asset of the organization. Customers vary in their preferences and behaviors and their value to the organization. Understanding customer needs, preferences, and behavior can improve a customer’s value. Relationships with customers must be managed. While many companies have operated on the premise that the best customers are loyal ones and have focused on segmentation by frequencyof purchase, traditional loyalty programs have neglected to analyze their profitability (Mason & Young, 2003). Instead of focusing on loyaltyalone, CRM goes one step further in finding ways to measure the company’s “cost” to maintain that customer relationship. Many companiesnow offer software for CRM programs, which, if implemented appropriately, can provide a competitive edge for an organization (Kotler,2003). These software programs involve the use of database marketing, which will be discussed in the next section. The All About Smiles dental practice in Durant, Oklahoma has learned to use several approaches to CRM. At All About Smiles, CRM beginswith new patients at the front desk, where they are greeted by office staff and made to feel welcome and appreciated. Everyone else’s job is toensure that customer appreciation continues throughout the whole treatment and payment process. The office layout is unusual for dentalpractices. For example, the Egypt room has murals of pyramids; the Jamaica room has scenes of beaches and palm trees; and a game roomcomplete with PAC-MAN ® entertains the younger patients. New patients are asked for their email addresses and mobile phone numbers so they can be sent reminders of their next appointment andalso have an opportunity to evaluate the services through an online survey, which is sent to patients a few days after their dental visit. Emailreminders are sent the day before the upcoming appointment, and text messages are sent the day of the appointment and two hours beforethe appointment time. Patients can opt out of both of these contact methods and request phone calls instead, if they prefer that type ofreminder. The office manager reports that the texts sent on the day of the appointment have significantly reduced the number of no-shows. ALL ABOUT SMILES DENTISTRY, DURANT, OKLAHOMA At All About Smiles Dentistry, we value our patient relationships, making it our priority to deliver gentle compassionatecare that you deserve from a dentist in Durant. We work hard to make you feel at ease by providing exceptional patientcare in a relaxed, convenient atmosphere. We strive to develop lifelong relationships with our patients by combining thelatest dental technology with a professional and compassionate staff. The result is a beau-tiful, healthy smile that lasts alifetime. We also believe that patients should have sufficient information to make educated deci-sions about their oral health,treatment options and choice of dentist in Durant. You’ll find all of this important information on our website, includingdirections to our Durant office, service descriptions, patient forms, patient education resources and more. Not only are we a leading dentist in Durant, we are a full-service practice providing for all of your dental needs. Ourservices include: General Dentistry Teeth Whitening Crowns Preventive Care Periodontal Exams View a Complete List of our Dental Services Should you ever need additional information about our practice, we are always available to answer your questions. Let uscare for your entire family! We look forward to meeting you. Source: http://www.durantsmiles.com/ Retrieved November 13, 2013 10.4 Database Marketing True database marketing creates customer intelligence that contributes to the development of profitable customer relationships. Databasemarketing is an organizational process that is customer research driven. The information base is dynamic and evolving, preferably with two-way dialog with the customer (Berry & Linoff, 2000). It is a measure of the importance of creating and maintaining a good database of marketinformation that Business Week devoted the cover story of its September 5, 1994 issue to the subject of database marketing, calling it “one ofthe biggest changes in marketing since ‘new and improved’” (Bloomberg Businessweek, 1994, para 5). Since that time, the concept ofdatabase marketing, coupled with new technologies, has grown to the point that a new generation of marketing professionals has beencreated. Basic information on age, gender, lifestyle, occupation, and so forth can easily be captured by HCOs through additions to the regularpatient forms filled out annually or by new patients. This information must then be entered into a software program by staff or an outsidemarketing agency. The data can then be analyzed for commonalities and trends. Assistance with Marketing Assignment Advantages of Database Marketing The new generation of database marketing professionals offer skills in four primary areas: (a) secondary data acquisition, including analysisof the value of lists; (b) database-building, including the understanding of computer hardware and software; (c) target marketing, includingmaximizing database record use; and (d) one-to-one marketing, which involves managing and refining the targeting process to customizecontacts for every customer (Kotler, 2003). The popularity of database marketing is grounded in the belief that marketing planning begins byunderstanding the customer—his or her buying and consumption patterns, location, interest, and other aspects of buying behaviordiscernible from databases—and then formulating plans that attempt to weave the firm’s product or service into the consumer’s pattern ofbehavior. The basic idea behind the use of databases is this: If that is what the consumer is doing, how can we make consumers want to dothat more often and with our product? This approach to satisfying customers adheres to the belief that the best indicator of future behavior ispast behavior. Thus, if American Express ® sees its card frequently used by a cardholder to purchase works of art, then it assumes anadvertisement for artworks in that cardholder’s monthly bill will generate a better response than it would with a cardholder who uses thecard for travel in the Caribbean (and receives advertisements for travel specials to that region). In fact, by monitoring card members’shopping, travel, and eating patterns, plus the economic and weather patterns in which they live, the database may trigger an ad to be sent tosomeone who has traveled in the past to warmer climates during a particularly inclement winter month, in a calculated effort to strike whilethe iron is hot. If an HCO learns that more and more patients are accessing its website before a visit, then ensuring that the website is up-to-date, and thatlinks to departments and services are all working, is an essential part of the use of data mining, which is discussed in the next subsection.Patient forms can simply ask about visiting the website and any additional information patients would like to be able to access on the website.Patients can also be asked whether they want to receive email or text updates of changes to the website. Data Collection and Manipulation The process of data collection and manipulation, which allows such powerful tactical marketing actions to occur, consists of several steps: Consumer action. The process begins with the consumer taking some form of action—they use a coupon, fill out a warranty card, make apurchase, enter a sweepstakes, place a toll-free call to request information, fill out a business reply card, order from a catalog, and soforth. This behavior is combined with other information in public records to identify a broad profile of each consumer in the database. Digesting the data. Sophisticated statistical techniques are used to merge data on the consumer into a coherent, consolidated database.Other software allows the marketer to “drill down” into the data to reveal patterns of behavior for classes of customers. Profiling the ideal customer. Neural networks that “learn” from the data are used to identify a model consumer, that is, the commoncharacteristics held by the high-volume customer. This allows the marketer to find customers or potential customers who share thosecharacteristics in common with the high-volume customer. Using the knowledge. This data can be used in many ways: to determine who gets which sales promotions, to develop attributes for newproducts or services with a targeted list of customers for new-product introduction announcements, to tailor ad messages and targetthem by customer groups, and so forth. Sharing data with channel members. For consumer package-goods marketers, it is possible to merge the manufacturer’s database(described in item 2 of this numbered list) with an individual store’s scanner data to help plan local promotional mailings, fine-tuneshelf displays, and design store layouts (Berry, 1994). Assistance with Marketing Assignment Modern technology has made it possible for marketers to do extensive searches through a large database, essentially mining the data. Datamining is the process of sorting through the data to find hidden patterns, potential trends, and correlations between customers or within asingle customer’s data. Data mining is predominantly accomplished through mathematical and statistical processes and is typically doneusing software developed for this purpose (Mason & Young, 2003). However, great care must be used in healthcare-related data miningbecause of the privacy concerns of patients and the need to safeguard access to patients’ medical information. While modern technology, including neural network software and parallel processor hardware, makes the use of such database marketingpossible, it is old-fashioned objectives that drive the interest in databases. Marketers seek to know their customers so well that they cananticipate their needs and provide them with desired products and services before the customers themselves know what they want. This isrelationship marketing, which is now at its most efficient evolutionary stage. Computer technology allows the marketer to acquire knowledgeof the purchasing habits of millions of individual customers and to weave relationships with them by anticipating their needs and informingthem of need-satisfying products specifically suited to their situation. By successfully weaving these relationships, the marketer makes itinconvenient or costly for the customer to switch to a competitor. Using the Data To some degree, the marketing plans of companies actively engaged in database marketing are driven by the desire to maximize the use oftheir databases and the technology that allows the manipulation of those databases. In other words, the ability to use the database in certainways means that those uses will become the implementation of the marketing plan (that is, the marketing plan conforms to fit the technologyavailable). This is not necessarily an inappropriate or backward approach to marketing, as long as marketers do not lose sight of this fact: Theultimate goal of any technology usage or marketing plan objective is to identify how an organization can gain a competitive advantage insatisfying customer needs and wants. Jackson and Wang (1994) have identified 15 ways to use a marketing database. These uses of a marketing database are described in depth intheir book and are listed as follows to illustrate the spectrum of possibilities for the use of databases in data-based marketing planning: Identify your best customers. Develop new customers. Deliver a message consistent with product usage. Reinforce consumer purchase decisions. Cross-sell and complementary sell products. Apply three-tiered communications. Improve delivery of sales promotion. Refine the marketing process. Increase the effectiveness of distribution channel marketing. Maintain equity. Establish a management resource. Take advantage of stealth communications. Conduct customer, product, and marketing research. Personalize customer service. Provide program synergy and integration. 10.5 Managing Real and Virtual Customer Interactions Patients develop a service script in each healthcare setting. A service script is the expected sequence of events and outcomes for thatparticular setting. When the actual experience departs from the script, the patient may be uncomfortable (Solomon, 2013). For example, adental patient may expect a visit to the dentist to include reading out-of- Assistance with Marketing Assignmentdate magazines in the waiting room, experiencing pain while a cavityis filled, and hearing the high-pitched sound of the drill. This may not be perceived as a pleasant experience, but it is, traditionally, thepatient’s expectation. A problem now faced by many HCOs is that patients gather information from social media outlets before contacting a healthcare provider(Kane, Fichman, Gallaugher, & Glaser, 2009). The information gleaned from the Internet and social media sites determines, at least in part, thepatient’s service script. A new dental patient can search the Internet or interact with friends on a site such as Facebook to find a dentist whohas a big-screen TV in the waiting room, guarantees little or no pain, and uses a quieter laser drill. This information dramatically alters thepatient’s expectations of the dental appointment. Several popular healthcare social media sites are listed in Table 10.2. Table 10.2: Healthcare social media sites Website Purpose PatientsLikeMe.com DailyStrength.org Allows patients to share real-world health experiences tohelp themselves and other patients. angieslist.com healthgrades.com RateMDs.com All of these allow patients to rate healthcare providers. CaringBridge.org Helps people who have significant health problems connectwith friends and family, making the experience easier. Sermo.com Exclusively for MDs and DOs to post observations andquestions about puzzling cases. The following subsections will discuss the use of social media by patients, the management of online community relations, gaps in expectedand delivered service, and service recovery. Social Media in Healthcare Sixty million people in the United States read or contribute to blogs, wikis, and/or social networks about healthcare (Kane et al., 2009). Often,social media is the first place patients search for information concerning specific illnesses or recommended healthcare providers. This use ofsocial media provides opportunities as well as possible pitfalls for HCOs and individual healthcare providers. The opportunities offered by social media include the ability for the HCO to communicate its mission, vision, and products or services as wellas health education. HCOs also can use social media to advertise and post patient testimonials. Finally, social media can be used to managecustomer experiences by helping to create realistic service scripts. The biggest challenge for any organization involved in social media is the ability to control the conversation ( Forbes Insights, 2013). Threatsto a firm’s reputation may be internal or external. Internally, a disgruntled employee may post information damaging to an organization, suchas protected health information about a patient. Even an act of kindness may be damaging to an organization. For example, a nurse may post arequest on Facebook for her friends and family to keep a particular hospitalized patient in their thoughts and prayers. Depending on theamount of information revealed by the post, patient confidentiality may have been breached. Assistance with Marketing Assignment Controlling the external conversation is more difficult. Online communities spontaneously appear, often with different contributors taking thelead. Further, as patients, the participants are free to discuss personal medical information without violating privacy law (Kane et al., 2009).This allows the participants to be very specific about their experiences with an HCO or a healthcare practitioner. Often, the HCO cannotrespond to such posts without violating patient confidentiality. Nonetheless, it is imperative that HCOs have personnel who constantlymonitor and respond to social media conversations—both positive and negative. Elements of a social media policy are outlined in Table10.3. Table 10.3: Social media policy ?Develop a Formal Social Media Policy · Activate network settings so only designated staff can access social media. · Define inappropriate use of social media and ramifications for policy violations. · Encourage employees to report the inappropriate use of social media by others. ?Monitor External and Internal Online Communication · Use Google Alerts, Twitter Keyword Tool, and other tools to monitor online communications. · Deputize employees to augment the team’s efforts for internal communication. Assistance with Marketing Assignment ?Engage Online Communities Create compelling social media. Use online community leaders, such as well-known bloggers and journalists, to ensure that yourmessage is understood. Communicate internally—marketing to employees unifies the organization’s message. ?Act as First Responders React quickly to negative comments, but use a team trained in public relations triage. Acknowledge legitimate criticism and mistakes. Respond forcefully to unfounded rumors. Do not engage every online community—pick and choose those with which you want to beassociated. Managing Customer Service In a recent survey, more than 300 chief marketing officers (CMOs) from a broad array of industries, including healthcare, reported thatcustomer experience was their most important priority. Customer experience was viewed as more important than new products or services,branding, or need identification. Interestingly, pricing, as a concern, came in last. To achieve an outcome of excellent customer experience,CMOs believe that marketing, strategy, finance, information technology, and social medial need to all collaborate. As the CMO of onepharmaceutical company stated, “We don’t have a silo-driven culture at all. We are highly integrated across sales, marketing, R&D, andfinance” ( Forbes Insights, 2013, p. 8). As noted earlier in this section, social media now drives the service script, or customer expectations, of the healthcare experience. Thedifference between the service expected and the customer’s perceived service quality is known as the service gap , and the management ofthis difference is known as gap analysis (Loudon, Stevens, & Wrenn, 2005). Management needs to constantly monitor customer serviceexpectations and the customer’s perceived service quality. Actual gaps in service need to be addressed by the appropriate personnel. Forexample, a stand-alone urgent care center may advertise a no-waiting policy. However, patients actually experience a 15- to 20-minute wait,and they perceive that wait to be much longer. In this case, the person in charge of the promotional message can close the service gap byadvertising “short wait times.” Frontline employees , such as admissions clerks, receptionists, and triage nurses, are also in a position to manage service gaps. Frontlineemployees, as well as other personnel who initially interact with the patient, are the first experience the patient has with the H

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EDUC 6156 Walden University Cognitive Development Discussion EDUC 6156 Walden University Cognitive Development Discussion ORDER NOW FOR CUSTOMIZED AND ORIGINAL NURSING PAPERS Can you fix this prospectus so it can be approved by the committee? Prospectus Is there a relationship between students’ level of motivation to perform academically and students’ level of academic performance in a language arts classroom? Shenita Russell EdD Doctoral Study– Educational Leadership A0004900 Prospectus: Is there a relationship between students’ level of motivation to perform academically and students’ level of academic performance in a language arts classroom? Problem Statement A lack of student motivation is a concern within public school districts in the elementary, middle and high school classroom setting (Hossainy, 2012). While a lack of student motivation is not easy to define, it is easy to observe (Thoman, 2013). Recent reports from educational researchers within the US Department of Education recognize the unmotivated student as one whose attitude toward school is a lack of interest or concern (NCES, 2010). The lack of interest or concern is demonstrated in the avoidance of school work and a level of disinterest in the educational environment (Terry, 2010). The national concern for a lack of student motivation within the educational environment prompted an action plan for the development of a model of learning. In 2010, educational researchers within the US Department of Education developed an action plan known as The National Education Technology Plan 2010 (NETP). The model of learning described in the action plan necessitates the need for engaging and empowering learning experiences for all learners. The model suggests that educators focus what and how they teach to match what students need to know, how they learn, where and when they will learn, and who needs to learn. The model was designed to incorporate state-of-the art technology into the learning environment to enable, motivate, and inspire all students, regardless of background, languages, or disabilities, to achieve, thus fostering continuous and lifelong learning (NCES, 2010). The National Center for School Engagement (NCSE) partnered with school districts, law enforcements, the courts, and state and federal agencies to support youth and their families in improving student motivation and engagement within the learning environment. In an effort to improve student motivation and resolve the issues concerning low academic achievement, the purpose of the study was to examine how motivation is defined and how to measure student motivation. The study used twenty-one instruments and focused on the age ranges of the participants of the study. Through data collection analysis, researchers were able to identify a decline in student motivation at both the middle and high school level (NCSE, 2009). Even more recently, the reports from educational researchers from state’s Department of Education across the country has determined best practices in instructional delivery as one of the essential components to motivating and preparing students for college and career readiness. Results from the reports have acknowledged the significance of student motivation for aiding student academic success in these college and career readiness programs. From 2012-2014, educational researchers within state’s Department of Education worked to develop an educational plan referred to as Task Based Learning (TBL). The framework for TBL comprised of pre-task activities, a task cycle and language focus all designed to provide instruction that is engaging and motivating. EDUC 6156 Walden University Cognitive Development Discussion The framework requires a shift from student-based to task-based learning suggesting that educators create tasks that prompt students to use and apply learning to 21st century scenarios (The Bureau of Educational and Cultural Affairs, 2015). The U.S. Department of Education reported on a study conducted by researchers from the University of Western Sydney. The focus of the report was to bring awareness to the need to consider student motivation, especially as it relates to male students. The purpose of the project study performed by researchers from the University of Western Sydney was to inform educational best practices for teachers and to aid development of school curriculum designed to address the needs of male students in the elementary and middle grades. Research participants consisted of case studies from fifteen different schools. The conceptual framework of the study was developed by University of Western Sydney researchers, Dr. Andrew Martin and Dr. Geoff Munns (Munns, 2004; Munns & Martin, 2005) was the MeE Framework. The Motivation, engagement, Engagement Framework was used as part of the project analysis of student motivation and engagement. Through data collection and analysis, researchers were able to determine key psychological and sociological factors that contributed to motivation in male students. Some of the strategies identified included learning environments in which students were given whole-class tasks to complete and learning environments in which student motivation was a school-based initiative (Munns & Martin, 2005). Currently, questions concerning why students remain unmotivated in the classroom is a focus of recent educational research with the state of Georgia (McQuown, 2011). Educational research within the Georgia Department of Education suggests that a lack of student motivation may be associated with students’ intrinsic motivation to perform well in the classroom and on high stakes assessments. The reports from the educational research indicate that whether intrinsic motivation was high or low for a student, there was some bearing on student achievement being high or low for that student (Thoman, 2013). Under the premise of student motivation and accountability, the educational researchers within the Georgia Department of Education (GADOE) worked to create a rigorous college and career readiness curriculum (adapted from Common Core) along with a teacher effective measurement system (TEMS) designed to ensure that instructional delivery was engaging and motivating for all students. EDUC 6156 Walden University Cognitive Development Discussion Results from data collection of state mandated high stakes assessments centered on standards-based instructional delivery utilizing the rigorous curriculum and teacher evaluations determined student achievement is linked to student motivation and school accountability (Schraw, 2010). Data collection results also indicate the growing concern regarding a lack of student motivation in the middle grades (6th-8th) (GADOE, 2015). At the local level, the concern of a lack of student motivation focuses on the middle grades because the middles grades have proven to consist of being a pivotal academic time for students in which assessment scores in content areas such as language arts and classroom performance have a bearing on retention, classroom placement and college and career readiness indicators at the high school level (McQuown, 2011). Public school systems within the state of Georgia, such as, Atlanta Public Schools (APS), have worked to analyze instructional best practices designed to motivate and engage students in the content required for college and career readiness. Unfortunately, many educators are not aware of instructional strategies for measuring and fostering student motivation, especially within the middle school classroom (APS, 2014). Purpose The rationale for the correlational study is to determine if there is a relationship between student’s level of motivation and student’s level of academic achievement in middle grades language arts classroom. Significance The proposed research study is significant because it has the potential to contribute to existing theories on the correlation between levels of student motivation and levels of student academic success. Those who will benefit from the study are students, teachers, school administrators and school board officials. School board officials will benefit from the study by gaining an understanding into what motivates students and thus what them to make policy changes on curriculum mandates. If school officials make policy changes to curriculum design that takes student motivation into consideration, the potential exists for a lack of student motivation to decrease. Until changes in school policies such as No Child Left Behind (2001), Common Core (2009) and even more recently, Teacher Keys Effectiveness System (2012), school board officials did not focus on student performance (Gemberling, Smith, & Villani, 2009; Marzano & Waters, 2009). Student academic achievement and student performance was primarily under the guide of the state superintendent and staff. The paradigm shift in school accountability has moved toward localized control. School board officials now share in the responsibility of student learning and are held accountable for student academic performance, most commonly through the use of standardized testing (Gemberling et al, 2009; Marzano & Waters, 2009). Student performance results are often reported to state authorities to determine if changes to the curriculum and/or teacher training and evaluations are necessary. Additionally, performance results are shared with community members as a way of determining the effectiveness of school and board leadership. With changes to the curriculum design that take student motivation into consideration, teachers may be able to effectively implement strategies to motivate students to learn. EDUC 6156 Walden University Cognitive Development Discussion Teachers’ abilities to motivate students to learn has been termed teacher self-efficacy. Research studies on teacher self-efficacy have used the conceptual framework of Bandura’s (1994, 2002) notion of self-efficacy. Teacher self-efficacy has been defined as the level of competency and level of confidence a teacher has in his or her ability to promote students’ learning (Bandura, 1994). According to a research study conducted by Skaalvik & Skaalvik (2010), teachers with high self-efficacy will implement strategies to motivate students to learn such as providing opportunities for student communication by using a variety of learning strategies and tasks to meet the needs of all learners (working individually, in pairs, and in groups). Results from the study also indicate that teachers with high level of self-efficacy are more likely to divide the class into small groups rather than teaching the class as a whole, thereby allowing the opportunity for more individualized instruction (Tschannen-Moran, 2010) Additionally, students will benefit from a learning environment that fosters behaviors that contribute to motivating students resulting in academic success. According to Gardner’s motivation theory (1985) students are motivated to learn and achieve when they perceive their teachers care about them. Findings from the case study suggest the concept of teachers who care create learning environments that promote democratic interaction styles, developing expectations for student behavior in light of individual differences, modeling a “caring” attitude toward their own work, and providing constructive feedback. Researchers with Stanford University also conducted a research study of a learning environment that takes student motivation into consideration. Results from data collection of the case study of middle grades students showed students benefited learning environments that take student motivation into consideration. Students benefit because they are encouraged to understand the content. The learning environment and instructional strategies were designed to treat students’ misunderstandings in the subject and different visual aids were utilized in order to make the subject more enticing and meaningful. Additionally, within the learning environment, students were given opportunities to engage in conversations and were given purposeful feedback rather than non-descriptive scores on assignments (Stipek et. al., 2002). More recently, researchers for the National Education Association (NEA) conducted studies on 21st century learners with regards to student motivation (NEA, 2013). Research results indicate that a lack of student motivation is more prevalent in non-lab content areas such as language arts, thus, further research to gain knowledge of how to motivate students in the non-lab content areas is significant. Knowledge of factors contributing to student motivation in the classroom as it relates to academic success may prove useful in guiding decisions made pertaining to curriculum and instruction (NEA, 2013The proposed research study is significant in understanding the impact of student motivation on academic achievement and posing questions to guide further studies concerning student academic success. Certainly, there is a need to understand what motivates students to perform well in the classroom and on high stakes assessments. Understanding what motivates students, how they are motivated and ways educators can utilize motivational strategies within their instructional practice is valuable in the field of education (NEA, 2013). Background Literature Educational trends such as accountability, college and career readiness, along with motivating the 21st century learner have shaped the current focus of curriculum standards and instructional delivery (NEA, 2013). The U.S Department of Education along with state Departments of Education researchers work to develop curriculum standards with an emphasis on rigor and instructional strategies that move students toward self-efficacy. As part of the attempt to ensure that students move towards self-efficacy, educational systems at the state and local level also have a goal of ensuring that every child can learn (US DOE, 2011). While the educational system at the national level is aiming towards ensuring that students are successful, there is also a concern at the state and local level that student motivation to perform at proficiency is declining (GA DOE, 2013). EDUC 6156 Walden University Cognitive Development Discussion Research studies within state departments of education address the issues of moving toward self-efficacy, increasing rigor in the classroom and increasing student motivation. Student motivation defined The unmotivated student is one whose attitude toward school is a lack of interest or concern. The lack of interest or concern is demonstrated in the avoidance of school work and a level of disinterest in the educational environment (Terry, 2010). Recognizing the unmotivated student requires identifying the characteristics of a motivated student. The motivated student is one who is not afraid to try for fear of making mistakes. The motivated student will take risks and accept challenges versus viewing the sometimes routineness of learning tasks, this student will think outside of the box and produce work that is of quality. The motivated student is also one whose basic needs have been met thus equipping them to have a desire to learn and a willingness to complete the tasks at a level of proficiency. Conclusions from research suggest that student motivation can be defined on the basis of factors that contribute to motivation such as the students understanding that any amount of effort equates to a positive outcome on learning (McTigue, 2011). What causes a student to be self-motivated? A question often asked in the learning environment is how I can motivate this student to learn. The answer stems from the notion that the student must be self-motivated. Self-motivation means that the student enters the learning environment with a desire to be a part of the learning and willing to contribute to their own academic success. Research indicates that what motivates students to learn is a concept referred to as “voice and choice.” Another contributing factor to student motivation is engagement and learning tasks that pique the student’s curiosity. Research studies for varying grade levels concluded several key concepts that attribute to student motivation. The key concepts include student “voice and choice”, how relevant the learning is to the student’s interests, how involved the teacher is with the subject matter being taught, significance of feedback, varying instructional delivery and how often students are encouraged to complete tasks (Brophy, 2013) (Laskey, 2010). Intrinsic and extrinsic motivation Two schools of thought exist with regards to motivation. In other words, there are two types of motivated student. One type of motivated student is the one who is intrinsically motivated. The intrinsically motivated student is the one who wants to learn for the sake of learning. EDUC 6156 Walden University Cognitive Development Discussion Recognizing the intrinsically motivated student requires looking at the student who set goals for themselves, wants to be an integral part of the learning environment. The intrinsically motivated student comes prepared, seeks understanding and extends learning beyond the classroom. Conversely, the extrinsically motivated student is one who achieves for others. The extrinsically motivated student wants good grades to please parents or receive some reward or tangible gift. While the extrinsically motivated student will come to class prepared, the willingness to be a part of the learning environment is fostered by the desire to receive a reward for being in the learning environment versus contributing to the learning. One key concept states that when lessons appeal to a variety of learning styles and consist of varying modes of instructional delivery, students are engaged because they feel in control of their learning. Maurer, Allen, Gatch, Shankar, and Sturges (2013) examine intrinsic and extrinsic motivation in students. The participant group in the study consisted of undergraduates in three different courses. The data collection instrument was archival data final course grades along with results of the Academic Motivation Scale which included questions about study habits and efforts. The implications of the results of the study indicated that each factor had a significant impact on student motivation at varying degrees. McTigue and Liew (2011) examined student motivation in a language arts classroom. The hypothesis of the study was the use of research-based strategies that foster self-efficacy within the classroom could also motivate reluctant middle school readers to perform in a language arts classroom. Bembenutty (2012) interviewed Professor Allan Wigfield who serves as chair of the Department of Human Development at the University of Maryland. The interview focused on Wigfield’s research on children’s motivation. The conclusion of the interview indicated that Wigfield’s studies determined that children’s motivation was developed based on the expectancy-value model of motivation Keklik and Erdem-Keklik (2012) expressed an opposing view of intrinsic and extrinsic motivation. Their study examined motivation within the high school setting. A participant group of 318 high school volunteers completed motivational and learning strategies questionnaires. Results of the questionnaires along with demographical data analyzed through data collection instruments ANOVA and MANOVA indicated that student motivation factors were limited to grade level. EDUC 6156 Walden University Cognitive Development Discussion Additionally, Leaper and Brown (2012) examined student motivation when social and personal factors were present. A participant group of 579 ethnically diverse teenage girls were selected for the study. Participants completed a questionnaire about their academic achievement, beliefs about their academic ability in Math/Science based classes versus English (liberal arts) based classes and values and experiences concerning school. The hypothesis in the study indicated that student motivation would vary from a Math/Science based class in comparison to an English (liberal arts) based class. The implications of the results of the study indicated that social and personal factors can have a positive effect on student motivation. Learning environments that motivate Creating a learning environment that motivates requires establishing what is known as sustained motivation. Achieving sustained motivation requires a partnership between teacher and student. While the teacher cannot make a student self-motivate, an environment can be created that fosters natural self-motivation. The motivating environment would provide opportunities for students to feel a sense of autonomy, a sense of a connection to the classroom and school and a sense of being capable of to master the challenges of school. The research has determined that teacher-student relationships while establishing a motivating learning environment are a factor in student motivation to perform within the classroom and on high stakes assessments. Bintz (2011) inquired through the use of the exploratory research design method the question of whether or not the curriculum is the problem, solution or both to factors relating to student motivation. The purpose of the study was to examine whether or not “way-in” books are an effective means to supplement curriculum requirements to motivate students in the middle school language arts classroom. Little (2012) analyzed the curriculum framework compared to gifted student motivation. EDUC 6156 Walden University Cognitive Development Discussion The implications of the results of the study concludes with findings to answer the question of which strategies and learning environments best motivate students receiving advanced learning instruction. Thoman, Smith, Brown, Chase and Lee (2013) examined the correlation between student motivation and stereotyping. The study focuses on how stereotyping of underrepresented and over-stigmatized students effects their motivation in the classroom and beyond. The significance of the study expressed the connection between self-efficacy and feelings of a sense of belonging to the learning environment. Participants in the study were observed over long periods of time and it was determined that positive or negative experiences within the learning environment had a lasting effect on student motivation. McQuown (2011) examined factors that contributed to student academic success. The study participants included six fifth grade students who took part in pullout enrichment activities. Students selected for the study were ones who at the start of the experiment lacked motivation and focus. Data was collected in the form of teacher observations, student surveys, and tests. Results of the study were used to indicate whether or not being placed in an enrichment room was essential enough in increasing motivation and focus to yield student academic success. Hossainy, Zare, Hormozi, Shaghaghi and Kaveh (2012) conducted a study with a university undergraduate participant group of thirty-four randomly selected psychology majors. The purpose of the study was to test the hypothesis that situated learning would increase learning and student motivation. The data collection process consisted of archival data from school achievement tests and questionnaire. The implications of the results of the study indicated that situated learning did increase learning and motivation when compared to lecture-based learning. Inkaya, Boz, and Erdur-Baker (2012) investigated the use of case-based learning (CBL) versus traditional chemistry instruction as a means of increasing student motivation. The participant group of forty-five 10th grade high school chemistry students was randomly selected. 25 students were a part of the experimental group (case-based learning) and 20 were a part of the control group (traditional instruction). As part of the study, both groups were given pre and posttests along with classroom instruction. The data collection instrument used to determine the results was a one-way MANOVA and a motivation questionnaire. The implications of the results of the study indicated that the use of CBL students showed gains in test scores and the questionnaire indicated that those experimental group participants were more motivated to learn in the classroom. Kucuk and Sahin (2013) examined the concept of learning centers in the context of a learning community as a means of increasing student motivation. The conceptual framework examined in the study was the Community of Inquiry (CoI) Framework as both a face to face and a blended (online and face to face) learning model. The participant group consisted of 109 undergraduate students who took part in the face to face (control) or blended (experimental) learning model. As part of the data collection process, students were given pre and posttests and an analysis of the content being delivered was conducted. Based on the results of the study, data collected did not indicate a significant difference in control group versus experimental group academic success; however, there was some significant difference in student motivation. Shankar-Brown explained in a research study the impact of incorporating photo journals as part of learning tasks within all content areas. The study’s participant group consisted of randomly selected middle school students who were identified as being reluctant learners. The study results were used to indicate the implications of utilizing photo journals as a learning tool and the impact they had on students, teachers and researchers. Shumow, Schmidt, and Zaleski (2013) discussed in their research study the correlation between student motivation and academic success during lab activities versus other classroom activities. The participants in the study were high school students. Each student was observed and work for the learning task was analyzed. Results of the study showed a comparison between student engagement and motivation when completing a lab-based activity versus a lecture-based activity. The results were also used to determine the increase in student learning was more present during lab-based activities as compared to lecture-based activities. Velez and Cano (2012) described the correlation between verbal and nonverbal cues and student motivation. The purpose of the study was to examine the relationship between the importance of the task as related to students through verbal and nonverbal cues from the teacher compared to student motivation to complete the task. The significance of the study was to demonstrate to teachers that there was a positive relationship between verbal cues of the importance of the task and the increase in student motivation. The results of the study indicate the more teachers express the importance of a learning task; the more likely students were motivated to complete the task.EDUC 6156 Walden University Cognitive Development Discussion Ziegler and Moeller (2012) examined self-regulating learning. The purpose of the study was to determine if the incorporation of portfolio-based assessments would increase self-regulated learning. The participant group consisted of 168 undergraduate students in either a French or Spanish class. The research design was quasi-experimental and was conducted over one semester. Students were given pre and post questionnaires to determine whether or not the incorporation of portfolios motivated students to actively participate in the learning process. The data collection results were used to analyze student performance on the portfolio assessments versus student performance on unit tests. The implications of the study results promote the use of portfolios to aid in student self-regulated learning. According to the literary review, teacher-student relationships are also essential in providing instructional strategies that motivate students to achieve self-efficacy. The research provides insight into the use of instructional strategies. Instructional strategies are designed to provide learning experiences that include rigor to move students toward self-efficacy and performing at proficiency on high-stakes assessments. In terms of student motivation, the literature review describes studies that determine the need for instructional strategies that provide students with choice and a voice as to the learning experiences they take part in. Framework The theoretical framework for this study will be Maslow’s Motivation Theory (1954). Maslow’s theory addresses both extrinsic and intrinsic motivation based on a hierarchy of needs. Maslow’s theory is relevant in education due to the desired goal of wanting all students to learn. Based on the framework of Maslow’s theory, both extrinsic and intrinsic motivation would exist for students whose needs were being met. In a classroom setting, these needs may consist of a student feeling safe and accepted in the learning environment along with the sense that their voice will be heard, they have choices, they understand what they gain from what is being required and they sense that the teacher is also invested in their learning. The conceptual framework for this study will be the self-efficacy model (Bandura, 1977). Bandura’s theory is relevant in education based on the belief that individuals have the ability to exhibit behaviors that yield successful performance. The self-efficacy model is based on the belief in one’s own abilities to understand and complete a task aside from intrinsic or extrinsic motivation (McTigue, 2011). Both the theoretical and conceptual frameworks explanation of the need for student motivation in a middle grades classroom presents a validation that a lack of student motivation in a middle grades classroom is an educational concern. The concern stems from a rise in increasing school accountability and school improvement. Studies indicate that there is an impact that high stakes assessments has had on student achievement. Research also indicates the results of the effect of high stakes assessments on student achievement are linked to student motivation and school accountability. Research Question Research question (quantitative) Is there a relationship between students’ level of motivation and students’ level of academic success in middle grades classrooms? Null Hypothesis There is no relationship between students’ level of motivation and students’ level of academic success in middle grades classrooms. Alternative Hypothesis There is a positive correlation between students’ level of motivation and students’ level of academic success in the middle grades classrooms. Research Methodology and Design A correlational research design will be used for this study. Utilizing a quantitative research approach is beneficial for the purposes of this study. EDUC 6156 Walden University Cognitive Development Discussion Quantitative research tests and validates already existing theories about how and why a phenomenon occurs. In general, a correlational study is a quantitative method of research in which the researcher has two or more quantitative variables from the same group of subjects, and they are trying to determine if there is a relationship (or covariation) between the two variables (a similarity between them, not a difference between their means). In theory, any two quantitative variables can be correlated (for the purposes of this study, students’ level of motivation and students’ level of academic success) as long as the researcher has scores on these variables from the same participants. The researcher must take into consideration that it is not feasible to collect and analyze data when there is little reason to think these two variables would be related to each other. Another factor in increasing the validity of the research is to have at least thirty participants. In a correlational research design, the researcher’s hypothesis will be that there is a positive correlation (for the purposes of the proposed study, students’ level of motivation and students’ level of academic success), or a negative correlation (for the purposes of this study, students’ level of motivation and students’ performance on high stakes assessments). In a correlational research design, a positive correlation would be an r = +1.0 and a negative correlation would be an r= -1.0, while no correlation would be r = 0. In a correlational research design, perfect correlations would almost never occur with the exception of correlations much less than + or – 1.0. The researcher must take into consideration that correlation cannot prove

Nursing

N522PE-20A Advanced Physical Assessment Assignment Papers N522PE-20A Advanced Physical Assessment Assignment Papers Module One: Introduction to the Course & Implementing Clinical Reasoning in Practice Discussion 1 Post to the discussion board a planned approach to communicating with someone who speaks another language. What type of questions will you need to ask ? N522PE-20A Advanced Physical Assessment Assignment Papers. Was there any communication issues discussed this week in Shadow Health? How does communication impact the concept of clinical reasoning in nursing? Please discuss the issues completely, citing your sources so that your classmates can reference the information. Include one insight gained this week from your readings or interaction in Shadow Health. Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria. N522PE-20A Advanced Physical Assessment Assignment Papers Assignment 1 Assignment Instructions: Write a three-page paper on the use of clinical reasoning in developing and applying advanced health history and physical assessment skills at the graduate level. Consider contemporary nursing literature on the development of clinical reasoning and decision-making. How does the use of the nursing process enhance critical thinking, clinical reasoning, and clinical judgment in professional nursing practice at the graduate level. Please use the submission parameters and rubric below to guide you when completing this assignment. Permalink: https://nursingpaperessays.com/ n522pe-20a-advan…ssignment-papers / ? Submission Parameters: For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 3 pages, which does not include the cover page and reference page(s). I. Introduction (including purpose statement) II. Clinical Reasoning Describe how clinical reasoning is used in developing and applying advanced health history and physical assessment skills at the graduate level. III. Nursing Process Describe how the use of the nursing process enhance critical thinking, clinical reasoning, and clinical judgment in professional nursing practice at the graduate level. IV. Clinical Example Discuss an example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. Discuss how nursing care is provided when each of these concepts are evidenced in nursing care of the patient. V. Conclusion VI. References (consider contemporary nursing research studies or reliable electronic sources) In regards to APA format, please use the following as a guide: Include a cover page and running head (this is not part of the 3 pages limit) Include transitions in your paper (i.e. headings or subheadings) Use in-text references throughout the paper Use double space, 12 point Times New Roman font Apply appropriate spelling, grammar, and organization Include a reference list (this is not part of the 3 pages limit) N522PE-20A Advanced Physical Assessment Assignment Papers Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP) Assignment 1 Rubric Competency 30 27 25 0 Points Define, compare and contrast clinical reasoning and decision-making. How is this related to critical thinking and clinical judgment in graduate level nursing practice? Defines, compares, and contrasts clinical reasoning and decision-making with cited references in addition to course readings for Week 1. Answers posed questions. N522PE-20A Advanced Physical Assessment Assignment Papers Defines, compares, and contrasts clinical reasoning and decision-making with cited references from course readings for Week 1. Answers posed questions. Describes clinical reasoning and decision-making. Briefly answers how is this related to critical thinking and clinical judgment in graduate level nursing practice? Does not define, compare and contrast clinical reasoning and decision-making. Does not answer how is this related to critical thinking and clinical judgment in graduate level nursing practice? /30 30 27 25 0 Consider contemporary literature and apply the concept of clinical reasoning to advanced physical assessment in nursing. Considers contemporary literature and applies the concept of clinical reasoning to advanced physical assessment in nursing. Considers textbook literature and references within text book without further consideration of external literature support. Considers and applies concept of clinical reasoning to advanced physical assessment in nursing without reference to expert opinion or research literature. Does not consider and apply concept of clinical reasoning to advanced physical assessment in nursing. /30 30 27 25 0 Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. How is nursing care provided or modified when each of these concepts are evidenced in nursing care of the well-adult, family, and one special population? Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. Discusses how nursing care was provided or modified when each of these concepts were evidenced in nursing care of the well-adult, family, and one special population. Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. Discusses how nursing care was provided or modified when each of these concepts were evidenced in nursing care of the well-adult, family, or one special population. Demonstrates the nurse’s use of critical thinking, clinical judgment, or clinical reasoning. Discusses how nursing care was provided or modified when these concepts were evidenced in nursing care of the well-adult, family, or one special population. Does not demonstrate the nurse’s use of critical thinking, clinical judgment, or clinical reasoning. Does not discuss how nursing care was provided or modified when these concepts were evidenced in nursing care of the well-adult, family, or one special population. /30 10 9 8 0 APA Format, grammar, punctuation and spelling. APA Format, grammar, punctuation and spelling is accurate with no errors. APA Format, grammar, punctuation and spelling is accurate with less than two types of errors. N522PE-20A Advanced Physical Assessment Assignment Papers APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors. APA Format, grammar, punctuation and spelling is accurate with more than five types of errors. /10 Module Two: HEENT and Skin Assessment Discussion 2 – N522PE-20A Advanced Physical Assessment Assignment Papers This week you have studied advanced physical assessment of the eyes, ears, nose, throat, head, neck and skin (HEENT). Describe the classification of rashes. What additional resources for HEENT advanced health assessment skills have you found beneficial in developing your knowledge and psychomotor skills this week? Post a concept to the discussion board that you have had difficulty with and note where you are with resolution of your difficulties. Please describe the issue completely, citing your sources so that your classmates can reference the information and provide additional “clinical pearls”. In other words, please include primary sources and/or reliable electronic sources to support your arguments. Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria. Module Three: Cardiovascular, Peripheral Vascular System & Respiratory Assessment Discussion 3 This week you have studied cardiovascular, peripheral vascular, and respiratory advanced physical assessment. What additional resources for these advanced health assessment skills have you found beneficial in developing your knowledge and psychomotor skills this week? Post a concept to the discussion board that you have had difficulty with and note where you are with resolution of these difficulties. Please describe the issue completely, citing your sources so that your classmates can reference the information and provide additional “clinical pearls”. In other words, please include primary sources and/or reliable electronic sources to support your arguments. Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria. N522PE-20A Advanced Physical Assessment Assignment Papers Sample Solution Approach An additional resource that I found helpful with this weeks Shadow Health experiences, in addition to our textbooks, was the American Academy of Allergy, Asthma, and Immunology (AAAAI). The algorithm for the diagnosis and management of asthma, assisted my clinical reasoning when performing an exam on Tina. This algorithm helped guide me to ask the appropriate questions when trying to find what lead on Tina’s symptoms, if there was a strong family history, the response to her current inhaler, and next steps that an advanced practice nurse would consider, like changing to a new inhaler. I would recommend to see Tina in clinic for a follow up within one month to see how her new inhaler is working and to make sure she is compliant with it, as we know she has not been the most compliant with her diabetes medications. One area of difficultly that I had this week was matching heart sounds to the physiologic features of the heart. The pattern of auscultation of heart sounds can either start from the apex to the base or vice versa. According to Bickley et. al. (2017) either is appropriate as long as you are stopping at all 6 listening spots, using the sternum as my landmark to guide me. If you are assessing a patient for the first time, or a change in their cardiac status, like Tina, it is important to have the patient lay on their left side to assess for mitral stenosis as this can bring the left ventricle closer to the chest wall for providers to hear better. I feel that with more practice hands on I will be able to thoroughly understand/communicate the 6 auscultation spots and explain what I am hearing systole vs. diastole, S1-S4, and/or murmurs. Bickley, L. S. (2017). Bate’s guide to physical examination and history taking (12th ed.). Philadelphia, PA: Wolters Kluwer Health | Lippincott Williams & Wilkins. Dains, J., Baumann, L., & Scheibel, P. (2016). Advanced health assessment & clinical diagnosis in primary care (5th ed.). St. Louis, MO: Mosby Elsevier. Li, J. T., Pearlman, D. S., Nicklas, R. A., & Lowenthal, M. (1998, November). Algorithm for the diagnosis and management of asthma: A practice parameter update. Retrieved from https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/diagnosis-and-management_1.pdf 382 words Permalink In reply to Alissa Heeman Re: Discussion 3 by Dona – Wednesday, October 7, 2020, 6:43 AM Well done. Describe the cause of JVD and what to look for on exam. 14 words Permalink Show parent In reply to Alissa Heeman Re: Discussion 3 by Ihuoma – Wednesday, October 7, 2020, 9:28 AM Allssa, I am with you on this too, after talking to Ms. Jones on shadow health clinic, I admired her, at least she knows what her triggers are. My father died of a massive heart attack, but his biggest huddle was Asthma. Am not sure if he had any knowledge of his triggers, but he sure knows what calms his attack down, not inhaler, not medication of any sort, but raw palm oil. Yes, it works like magic for him. He gets his attacks one or two times a year, and after all those years, I was able to pick on the signs and symptoms and the wheezing sounds that sound like a whistle and it stocked to my brain even before I went to nursing school here in America. So, whenever I hear those whistly sound coming from any of my patient room or another patient, right there, I know there is trouble trying to erupt. And I will quickly apply my critical thinking and decision making. With other sounds, am getting better, using my clinical reasoning in differentiating the sounds and looking out for other signs and symptom such as shortness of breath, tightness on the chest area, difficulty sloping, coughing and more wheezing with exhaling. Reference Mayo Clinic, (2020). Asthma. Retrieved from https://www.mayoclinic.org/diseases- Condition/asthma/symptoms-causes/syc-20369653 N522PE-20A Advanced Physical Assessment Assignment Papers 224 words Permalink Show parent In reply to Alissa Heeman Re: Discussion 3 by Merima – Wednesday, October 7, 2020, 6:01 PM Hi Alissa, Great discussion points. I too found AAAAI website very helpful. Since I have been diagnosed with allergy induced asthma many years ago, I keep searching for more information to try to manage both my allergies and prevent asthma exacerbations. From personal experience, patient experience, and all the research I have done it is very obvious that asthma management and attacks are not ‘one size fits all’ approach. I have had 2 attacks in the last 20 years, completely unknown triggers, where some patients have obvious triggers like our patient Tina with allergies to cats, and attacks could be frequent. I also found that educating patients, especially young adults, need to be with very unique approach. American Lung Association has very good educational materials that are easily understood by all. They go into details, but in very simple terms, about importance of keeping track of your exacerbations and logging your spirometry values at home to anticipate exacerbation. I, as a patient, found it extremely informative and used it for patient education when I was a bedside nurse. American Lung Association. (2020). Managing Asthma. https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/living-with-asthma/managing-asthma 193 words N522PE-20A Advanced Physical Assessment Assignment Papers Assignment 2 Assignment Instructions: For this 4-5 page assignment, you will conduct a focused health history and physical assessment based upon your Practice Experience work in Shadow Health. Particularly, you will complete a focused assessment on Danny, a child who is complaining of a cough. Please submit your summary documentation in MS Word. Use the submission parameters and rubric below to guide you in completion of this written assignment. Submission Parameters: For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s). Introduction (including purpose statement) Focus of the assessment Describe the focus of this particular assessment on the patient complaining of a cough Subjective Component Describe the ROS, PMH, and other relevant data in this section. Objective Component Describe the physical examination findings including techniques of examination Documented evidence to support clinical reasoning Describe the list of differential diagnoses Plan of care Describe the plan of care individualized to findings, life-span stage of development with culturally specific considerations for each focused area of assessment. Conclusion References (use primary and/or reliable electronic sources) In regards to APA format, please use the following as a guide: Include a cover page and running head (this is not part of the 4-5 pages limit) Include transitions in your paper (i.e. headings or subheadings) Use in-text references throughout the paper Use double space, 12 point Times New Roman font Apply appropriate spelling, grammar, and organization Include a reference list (this is not part of the 4-5 pages limit) Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP) Competency 20 18 16 0 Points Earned Focus of the Assessment is identified with Special Considerations including Documented Focused Health History Documentation clearly shows student has completed a focused assessment with identified special considerations including a well-documented focused health history. N522PE-20A Advanced Physical Assessment Assignment Papers Documentation supports the student has completed the focused assessment with minimal identification of special concerns. The focused health history is documented. Documentation supports the student has completed the focused assessment without identification of special concerns. The focused health history is documented and lacks depth and specificity of weekly topic. Documentation supports the student attempted to complete the focused assessment without identification of special concerns. The focused health history is briefly documented and lacks depth and specificity of weekly topic. /20 20 18 16 0 Documented Physical Examination Findings including Techniques of Examination Documentation clearly shows student has completed the physical examination and accurately describes the techniques of examination for the week. Documentation supports the student has completed the physical examination and describes the techniques of examination for the week. Documentation supports student completed some of the physical examination for the focused assessment of the week. Documentation is accurate but lacks depth. No evidence that the student is applying read concepts of advanced focused physical assessment. Documentation lacks depth and may lack coherence for understandability of tasks completed in this week. /20 20 18 16 0 Documented Evidence to Support Clinical Reasoning with External Course Resources Discourse clearly shows the student has studied the topic and has given thought to the focused assessed topic and documentation for the week. Discourse supports the student has studied the topic and has given thought to the focused assessment topic and documentation for the week. Discourse supports student studied some of the topic for the focused assessment topic this week. Discourse is accurate but lacks depth. No evidence that that student has read or studied the topic. Discourse lacks depth. May be presented in a rambling manner. Content is inaccurate &/or is unclear. /20 20 18 16 0 Individualized Plan of Care Based Upon Clinical Findings Accurately presents an individualized plan of care based upon clinical findings. Presents an individualized plan of care based upon clinical findings. Some minor omissions are noted. Presents a plan of care that is not individualized based upon the clinical findings. A plan of care is not presented or the plan of care presented lacks demonstration of competency or is irrelevant to the clinical findings. /20 5 4 3 0 Developmentally and Culturally Specific Accurately documents a developmentally and culturally specific assessment and plan of care for the selected patient. Documents a developmentally and culturally specific assessment and plan of care. N522PE-20A Advanced Physical Assessment Assignment Papers Presents a developmentally and culturally specific assessment or plan of care and one or both are not based upon the selected patient. A developmentally and culturally specific assessment and plan of care are not presented or based upon the selected patient’s findings. /5 5 4 3 0 Demonstration of Compliance with Ethical and Legal Standards of Professional Nursing Practice Compliance with the ethical and legal standards of professional nursing practice is explicitly stated in the documentation of the focused physical assessment. Compliance with the ethical and legal standards of professional nursing practice is stated in the documentation. Compliance with the ethical and legal standards of professional nursing practice is briefly implied in the documentation of the focused physical assessment or inaccuracies are evidenced in the written assessment. Compliance with the ethical and legal standards of professional nursing practice is not included in the documentation of the focused physical assessment. /5 10 9 8 0 Grammar, Spelling, and Punctuation APA Format APA Format, grammar, punctuation and spelling is accurate with no errors. APA Format, grammar, punctuation and spelling is accurate with less than two types of errors. APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors. APA Format, grammar, punctuation and spelling is accurate with more than five types of errors. /10 COMMENTS: TOTAL: /100 Module Four: Gastrointestinal, Breast and Axilla Assessment Discussion 4 – N522PE-20A Advanced Physical Assessment Assignment Papers As you know, abdominal pain can be a challenging patient complaint because it is frequently benign, but can also herald serious acute pathology. The history and physical examination are critical to narrowing the differential diagnosis of abdominal pain and guiding the evaluation. Acute abdominal pain frequently requires urgent investigation and management. Some patients may require the assessment of their airway, breathing, and circulation, followed by appropriate resuscitation. Many patients will require analgesics, which can be administered judiciously without compromising the physical assessment of peritoneal signs. That said, what are the common differential diagnoses of abdominal pain in emergency situations? Also, does your healthcare institution have a specific policy, algorithm and/or protocol on how to assess, manage, and treat abdominal pain? Please share an example of the protocol for abdominal pain from practice or the literature. Module Five: Neurological & Musculoskeletal Assessment Discussion 5 This week you have studied neurological and musculoskeletal advanced physical assessment. While a diverse set of advanced physical assessment skills where do you place your greatest level of confidence and what areas need more development. What methods do you use to remember assessment of cranial nerves, mental status, or other important clinical assessments of persons with neurological or musculoskeletal problems? Of these areas of advanced physical assessment what psychomotor skill is most challenging for you to accomplish? Why? Post a concept to the discussion board that you have had difficulty with and note where you are with resolution of these difficulties. Please describe the clinical issue completely, citing your sources so that your classmates can reference the information and provide additional “clinical pearls”. In other words, please include primary sources and/or reliable electronic sources to support your arguments. Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria. N522PE-20A Advanced Physical Assessment Assignment Papers Assignment 3 Assignment Instructions: For this 4-5 page assignment, you will conduct a focused health history and physical assessment based upon your Practice Experience work in Shadow Health. Particularly, you will complete a focused assessment on Brian, an adult who is complaining of chest pain. Please submit your summary documentation in MS Word. Use the submission parameters and rubric below to guide you in completion of this written assignment. N522PE-20A Advanced Physical Assessment Assignment Papers Submission Parameters: For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s). Introduction (including purpose statement) Focus of the assessment Describe the focus of this particular assessment on the patient complaining of chest pain Subjective Component Describe the ROS, PMH, and other relevant data in this section. Objective Component Describe the physical examination findings including techniques of examination Documented evidence to support clinical reasoning Describe the list of differential diagnoses Plan of care Describe the plan of care individualized to findings, life-span stage of development with culturally specific considerations for each focused area of assessment. Conclusion References (use primary and/or reliable electronic sources) In regards to APA format, please use the following as a guide: Include a cover page and running head (this is not part of the 4-5 pages limit) Include transitions in your paper (i.e. headings or subheadings) Use in-text references throughout the paper Use double space, 12 point Times New Roman font Apply appropriate spelling, grammar, and organization Include a reference list (this is not part of the 4-5 pages limit) Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP) Competency 20 18 16 0 Points Earned Focus of the Assessment is identified with Special Considerations including Documented Focused Health History Documentation clearly shows student has completed a focused assessment with identified special considerations including a well-documented focused health history. N522PE-20A Advanced Physical Assessment Assignment Papers Documentation supports the student has completed the focused assessment with minimal identification of special concerns. The focused health history is documented. Documentation supports the student has completed the focused assessment without identification of special concerns. The focused health history is documented and lacks depth and specificity of weekly topic. Documentation supports the student attempted to complete the focused assessment without identification of special concerns. The focused health history is briefly documented and lacks depth and specificity of weekly topic. /20 20 18 16 0 Documented Physical Examination Findings including Techniques of Examination Documentation clearly shows student has completed the physical examination and accurately describes the techniques of examination for the week. Documentation supports the student has completed the physical examination and describes the techniques of examination for the week. Documentation supports student completed some of the physical examination for the focused assessment of the week. Documentation is accurate but lacks depth. No evidence that the student is applying read concepts of advanced focused physical assessment. Documentation lacks depth and may lack coherence for understandability of tasks completed in this week. /20 20 18 16 0 Documented Evidence to Support Clinical Reasoning with External Course Resources Discourse clearly shows the student has studied the topic and has given thought to the focused assessed topic and documentation for the week. Discourse supports the student has studied the topic and has given thought to the focused assessment topic and documentation for the week. Discourse supports student studied some of the topic for the focused assessment topic this week. Discourse is accurate but lacks depth. No evidence that that student has read or studied the topic. Discourse lacks depth. May be presented in a rambling manner. Content is inaccurate &/or is unclear. /20 20 18 16 0 Individualized Plan of Care Based Upon Clinical Findings Accurately presents an individualized plan of care based upon clinical findings. Presents an individualized plan of care based upon clinical findings. Some minor omissions are noted. Presents a plan of care that is not individualized based upon the clinical findings. A plan of care is not presented or the plan of care presented lacks demonstration of competency or is irrelevant to the clinical findings. /20 5 4 3 0 Developmentally and Culturally Specific Accurately documents a developmentally and culturally specific assessment and plan of care for the selected patient. Documents a developmentally and culturally specific assessment and plan of care. N522PE-20A Advanced Physical Assessment Assignment Papers Presents a developmentally and culturally specific assessment or plan of care and one or both are not based upon the selected patient. A developmentally and culturally specific assessment and plan of care are not presented or based upon the selected patient’s findings. /5 5 4 3 0 Demonstration of Compliance with Ethical and Legal Standards of Professional Nursing Practice Compliance with the ethical and legal standards of professional nursing practice is explicitly stated in the documentation of the focused physical assessment. Compliance with the ethical and legal standards of professional nursing practice is stated in the documentation. Compliance with the ethical and legal standards of professional nursing practice is briefly implied in the documentation of the focused physical assessment or inaccuracies are evidenced in the written assessment. Compliance with the ethical and legal standards of professional nursing practice is not included in the documentation of the focused physical assessment. /5 10 9 8 0 Grammar, Spelling, and Punctuation APA Format APA Format, grammar, punctuation and spelling is accurate with no errors. APA Format, grammar, punctuation and spelling is accurate with less than two types of errors. APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors. APA Format, grammar, punctuation and spelling is accurate with more than five types of errors. /10 COMMENTS: TOTAL: /100 Module Six: Mental Health Assessment & Male and Female Urinary and Reproductive Systems. N522PE-20A Advanced Physical Assessment Assignment Papers Discussion 6 This week you have studied mental health (psychological); urinary and reproductive systems of the male and female in advanced physical assessment. While this is a diverse set of advanced physical assessment skills where do you place your greatest level of confidence and what areas need more development. Of these areas of advanced physical assessment where to you struggle in your nursing practice most when providing patient-centered education? Please cite sources for additional knowledge, skill development, or professional development related to reproductive health and provide additional “clinical pearls” learned this week. In other words, please include primary sources and/or reliable electronic sources to support your arguments. Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria. N522PE-20A Advanced Physical Assessment Assignment Papers Assignment 4 Assignment 4 Assignment Instructions: For this 4-5 pages assignment, you will conduct a focused health history and physical assessment based upon your Practice Experience work in Shadow Health. Particularly, you will complete a focused assessment on Esther, an elderly patient who is complaining of abdominal discomfort. Please submit your summary documentation in MS Word. Use the submission parameters and rubric below to guide you in completion of this written assignment. N522PE-20A Advanced Physical Assessment Assignment Papers Submission Parameters: For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s). Introduction (including purpose statement) Focus of the assessment Describe the focus of this particular assessment on the patient complaining of abdominal discomfort. Subjective Component Describe the ROS, PMH, and other relevant data in this section. Objective Component Describe the physical examination findings including techniques of examination Documented evidence to support

Worldview Analysis and Personal Inventory Paper Worldview Analysis and Personal Inventory Paper Based on the required topic study materials, write a reflection about worldview and respond to following: In 250-300 words, explain the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism within health care. Worldview Analysis and Personal Inventory Paper In 250-300 words, explain what scientism is and describe two of the main arguments against it. In 750-1,000 words, answer each of the worldview questions according to your own personal perspective and worldview: What is ultimate reality? What is the nature of the universe? What is a human being? What is knowledge? What is your basis of ethics? What is the purpose of your existence? Remember to support your reflection with the topic study materials. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Permalink: https://nursingpaperessays.com/ worldview-analys…-inventory-paper / ? Study Materials Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care Foundational Issues in Christian Spirituality and EthicsBy David W. Bogue and Michael Hogan Without a biblical worldview, all the great teaching goes in one ear and out the other: There are no intellectual pegs … in the individual to hang these truths on. So they just pass through. They don’t stick. They don’t make a difference [in how humans interpret existence and order their lives]. George Barna (as cited in Colson & Pearcey, 1999) Worldview Analysis and Personal Inventory Paper. Essential Questions What difference does your worldview make in daily life, and in how you perceive your future? What is the definition of spirituality from a Christian perspective? How does this compare to your own definition of spirituality? How would you categorize your worldview: atheism, pantheism, or theism? After reading this chapter, does your current worldview pass the three tests (coherence, correspondence, and practical)? If not, what might you need to change? How does ethics influence one’s worldview? Does right or wrong depend on individual subjective opinions or is it about something deeper? How does ethics relate to medicine and health care? Can one know what is right or wrong or is it just what one is feeling in the moment? Introduction The world is complex and sometimes confusing. Information is created and disseminated at a rate no one can completely comprehend. It is like trying to drink from a fire hose. Ethical dilemmas clamor for resolution. How can one make decisions that are right and morally good, beneficial and not harmful? How does one make sense of this fast-moving world’s experiences and events? Medical practitioners make decisions every day that are laden with moral and ethical importance. Patients’ lives may be at stake, such as the elderly whose last days are near, children who are born with severe disabilities, the unborn and their anguish-filled mothers, and people who suffer from chronic pain or mental illnesses. Ethical questions abound, such as is euthanasia a morally acceptable choice? If not, then why not? If yes, then on what basis? Is it ethical to remove life-saving treatment from a dying patient and administer palliative care if needed? Is abortion a moral and ethical option, and if so, what limits, if any, should be imposed? Medical professionals at all levels of decision-making face these dilemmas regularly. How are nurses, with direct access to patients’ needs, to decide what is right and wrong? How one answers these questions matter in all areas of life. Professional morals cannot be separated from personal conduct. The importance of having a foundation and a framework from which to make true and good ethical decisions in both one’s personal and professional lives is the reason for ethical and spiritual decision-making in health care. This chapter will help nurses think through how they view and interpret the world and the events and experiences of life. Nurses will come to understand how to answer ethical questions and address patients, families, and others when crises arise. The first questions to ask include: What is a worldview ? What is my worldview? How does my worldview shape my spirituality ? Worldview Analysis and Personal Inventory Paper The next questions often include: How do the three major worldviews, atheism , pantheism , and theism , see the world? How can one determine one’s worldview using the six basic worldview questions? How is one to test one’s worldview for coherence , practicality , and correspondence ? What is the basic Christian view of the world (i.e., the Christian worldview)? What is the foundational meaning of the biblical narrative, which is the heart of the Christian worldview? Following these initial questions, one must further ask, what are ethics in general and what is the basis of Christian ethics portrayed in the biblical narrative? What is the Christian moral order in the practice of medicine, and how does the resurrection of Jesus Christ inform this unique moral order in a holistic manner? These, and many other concepts, will provide valuable tools, in the form of understanding worldviews and ethics, to enrich and bring clarity to one’s life, and to benefit patients who need thoughtful, ethically-informed medical practitioners to assist them. What Is a Worldview? A worldview is a point of view for understanding one’s personal experiences and the events of societies and history (Vidal, 2008). Every person who has ideas about what reality is and how to interpret the experiences of the world is operating out of a worldview. This is true whether the person understands his or her worldview or not; everyone has one (Taves, Asprem, & Ihm, 2018). Worldview Analysis and Personal Inventory Paper Think of the lens of a camera: A photographer places the lens against his or her eye and views the world through the lens. The photographer assigns meaning to what the lens reveals. A worldview is not a physical lens but, rather, a philosophical and intellectual lens though which a person sees and interprets everything one encounters. It helps a person accumulate and interpret how human beings gain knowledge , the area of study known as epistemology , and what one knows to be true about the world, others, and oneself. Worldview determines what one does and does not value and find meaningful in life. A worldview includes underlying, often unconscious, assumptions about reality that a person holds. These assumptions inform how a person determines what thoughts and actions are morally right and wrong. They also influence whether a person has positive or negative thoughts about the future. Sandy Gibson (2011) conducted a study on male prisoners of various ages and discovered that internally held worldview assumptions informed how they viewed both their present circumstances and future possibilities. To put it simply, worldview will influence one’s sense of hopefulness or lack thereof. Why do some people look forward to the future while others do not? Such worldview assumptions are shaped over a lifetime (Gibson, 2011) and may be additionally influenced by adult experience, such as religious experiences or traumatic events. Other studies conducted by Edmonson, Chaudoir, Mills, Park, and Bartkowiak (2011) and others demonstrate that trauma can play a significant role in worldview formation. When a person cannot integrate a traumatic event in his or her worldview, then posttraumatic stress disorder may occur, which can change the person’s ability to handle daily activities and shape how the person interprets events and assigns meaning to experiences (Edmonson et.al., 2011). According to Clément Vidal (2008), those who possess coherent, practical, and consistent worldviews tend to experience less stress, are more open to encountering others in the world, and have a greater sense of trust and hope (Vidal, 2008). Hence, it is important to think through and hold a worldview that is clear, consistent, and matches reality. Worldviews come under two broad categories: religious and nonreligious. This text has further divided those two worldview categories into three: atheism, pantheism, and theism. Most people hold worldviews compatible with these three. Atheism The word atheism comes from two words: A , which means “lack of” or “no,” and theism , which means “God.” The simple rendering of the word is “no God.” Atheism is a philosophical worldview, the central feature of which is a lack of belief in a deity. Atheists come from a variety of backgrounds and may hold divergent views from one another; they do not always agree with each other in the areas of politics, ethics, and cultural issues (American Atheists, n.d.a). For example, the atheist response to religion is not unified. Some atheists are indifferent to religion and are not disturbed that others believe in a deity. Others are adamant and assert the nonexistence of a God (Coleman, Hood, & Streib, 2018) and make it a cause to disprove the existence of God. According to the American Atheists (n.d.a), “The only common thread that ties all atheists together is a lack of belief in gods” (para. 13). Some atheists claim that their worldview is not a belief system or religion. They state, “If Atheism is a religion, then not collecting stamps is a hobby” (American Atheists, n.d.a, para. 3); however, Coleman et al. (2018) disagree with this assessment because a belief system is a part of every worldview. It simply means that a person has particular beliefs about the world, meaning that believing that there is no God is a belief about the world. Beliefs shape how a person assigns meaning to the world and the events of life. In the atheistic worldview, there is no God. The belief that no deity exists is, in fact, a lens for viewing the world, and it shapes how atheists interpret life events (Coleman et al., 2018). Looking at the world through the lens of a godless existence, atheists believe that the material world is all that exists; there are no outside forces or entities influencing the world. Whereas Christians hold that a personal God created everything that exists, atheists believe that the world came into existence as a result of natural forces alone. If there is no God, then there is no Creator. If there is no Creator, then how did the universe come into existence? To answer this question, atheists hold to the concept of naturalism , which states that the physical universe is the entirety of existence (reality); therefore, only what can be discovered through the empirical sciences can be called truth. Atheism holds that there is no life beyond the physical world. This means that atheists believe that humans themselves invent morals and ethics, thus determining what is right and wrong. There is no God to reveal and teach right from wrong. For example, Caldwell-Harris (as cited in Coleman et al., 2018) says, “Without belief in any divine authority, atheists are more likely to view morality and meaning in life as self-constructed” (p. 204). Atheists look to culture and human reason, including science, to construct a moral and ethical framework; therefore, unlike theists, who look to a deity to learn about right and wrong, good and bad, atheists look to themselves to create such values and virtues. Humans, then, are responsible only to themselves. Ancient philosopher Protagoras reflects this perspective in his still famous phrase, “Man is the measure of all things” (Taylor & Lee, 2015, para. 4). If human beings are the highest authority (the measure of all things), then humanity must create its own morals and values, which the atheistic worldview, in fact, advocates (Coleman et. al., 2018). This leads to the charge against the Atheist worldview of moral relativism. Moral relativism holds that no truth applies to all people. This view claims that truth is created from one’s circumstances and culture; therefore, what is true varies across cultures and groups. Moral relativism states that one group may not be qualified to judge the ideas of another group because the first group has not experienced life in the same way as the group they are judging. This view becomes problematic, for example, when dealing with issues of life and death. If one group or culture believes that it is right to murder people of different ethnicities or religions, then those who hold to moral relativism have no ground to argue that this kind of action is genuinely wrong. Because that particular culture believes murder is right, that belief is true relative to them. Because there are no broader standards by which to judge besides that which is relative, moral relativism is, on its face, a dangerous view to hold (Davis, 2016). Worldview Analysis and Personal Inventory Paper Many atheists deny that their worldview leads to moral relativism, asserting that their worldview possesses the foundation for objective morality . Objective morality refers to moral codes that apply to all people in all times and places, regardless of culture or religion. The website for the Atheist Alliance International (n.d.) states, “there are objective moral truths that can be discovered using reason (and science), and the process does not require belief in a god” (para. 20). Arguably, the assertion that God is not needed for the existence of an objective morality is hard to maintain. If humans formulate their own morality, then humans are free to change what is right and wrong as they wish, which is arguably the logical outcome of the atheist worldview. And if humans are free to change what is right and wrong, then oppression of an unwanted minority group in a culture can be justified by those in the majority. For example, if a religious or ethnic group that makes up the majority of a population decides to rid their society of a minority religious or ethnic group, then on what grounds can one say that this is wrong? Humans decide based on their own subjective preferences and nothing deeper. Consider the oppression people endured in Germany under the Nazi regime, the African nation of Uganda under Idi Amin, or the North Korean nation under Kim Jong Un because human beings determined what is right and wrong without the guidance of God. This demonstrates the importance of one’s worldview when considering human value. Christians believe that every human is made in the image of God , which causes human individuals, regardless of race, ethnicity, or socioeconomic status, to possess innate dignity and worth. These unique traits of dignity and value are given by God, and they cannot be removed. When there is no outside authority (i.e., God) who assigns human beings’ their value, then assigning human worth is left to other persons. Although atheists might claim to assign value based on science, there is not an actual basis to do so. Science is limited to claims about what may be tested using empirical methods. Values cannot be tested using scientific instruments or mathematics. Atheistic attributions of value work well when those who make such assignments are good and a positive influence on individuals and societies. It has had tragic consequences when leaders are tyrants who rule their people with absolute power. When human worth is assigned by God, it cannot be taken away. When it is assigned by human authorities, it is never secure. Pantheism Pantheism is a family of worldviews that focuses on the intertwining of God and nature. The word pantheism is a composite of two Greek words: pan, which means “all,” and theism, from the Greek theos , which means “God.” The intent here is to say that God and nature are one and the same. In other words, nature is god (Drees, 2017). According to pantheism, mountains, trees, rivers, and anything one may encounter in nature are deities. In the pantheistic worldview, God is nature, such that God’s action is simply the natural operations of nature. This means that because nature is malleable, God is also malleable. As nature changes, God also changes. As nature progresses and evolves, God also progresses and evolves. This means that God is incomplete and still growing. One outcome of this view is that God cannot ensure a particular future, either good or evil. The world might end in a perfect paradise, in a fiery disaster, or in a quiet, slow death as its energy dissipates. Likewise, God may sympathize with human suffering, but God is unable to intervene and relieve that suffering. In the pantheistic worldview, God is loving, but is not all powerful. Although morals and ethics and right and wrong may come from God, because God is constantly in flux, as is nature, notions of right and wrong will also change over time. With the evolution of nature and the accompanying evolution of God, what was once immoral may become moral. Pantheism is not consistent with a Christian biblical worldview, which holds that God is transcendent and not enmeshed with creation . God is sovereign and omnipotent . God does not change, nor do God’s commandments. Theism Theism is a worldview that focuses on the existence of a knowable, personal deity to whom humans are accountable and with whom they may have a relationship. Judaism, Islam, and Christianity are examples of theistic religions. God is perfect in essence and morality. God is omnipresent , omniscient , omnipotent, all-good, and eternal (Swinburne, 2016). God is not in process but is complete in Himself. God is in no way limited, unlike the view of God in the pantheistic worldview. God is outside of time-bound creation, although He exercises providential authority and guidance over all things and creatures He has made. This separateness from the creation is called God’s transcendence (Pinto, 2018). As Creator, God is never to be confused with what He has created. God’s sovereign rule of the universe and all creatures in it comes from the mind and person of God, which is distinct from what God created. Christians look to the Bible to understand the attributes of God, in which there are numerous supporting passages that speak to God’s independence from the creation, including His independence from human beings. 1 Chronicles 29:11 (English Standard Version) states: “Yours, O Lord, is the greatness and the power and the glory and the victory and the majesty…. Yours is the kingdom, O Lord, and you are exalted as head above all [emphasis added].” Psalm 8:1 says, “O Lord, our Lord, how majestic is your name in all the earth! You have set your glory above the heavens [emphasis added].” In Isaiah 55:8, God speaks to the people of Israel, “For my thoughts are not your thoughts neither are your ways my ways.” While God may reveal Himself through creation, “The heavens declare the glory of God; the skies proclaim the work of this hands” (Psalm 19:1), God is not to be confused with nature. Worldview Analysis and Personal Inventory Paper Nevertheless, this generic form of theism requires more information. The views of the nature and character of God in theism are different from religion to religion. William Drees (2017) is right to state that the generic concept of God does not offer much practical or spiritual help unless God is described. Theism believes in only one God, and a Judeo-Christian understanding of God is that God is personal, transcendent, and love. Islam also believes in one God, but this God does not have a son and did not come to sacrifice himself for the sins of the people. The God of Islam, known as Allah (the Arabic word for God), is not known as a God of love nor is he known as Father. Both are distinctive descriptions of God as a person in the Bible. Muslim theology emphasizes obedience of human beings to gain Allah’s favor. There is no emphasis on Allah’s love and grace as a free gift. The Qu’ran, the Islamic sacred text, does not explicitly promise individual salvation. Rather Allah sent prophets, the foremost and final of which was Mohammed, and the Qu’ran to teach his followers obedience and proper worship (Schirrmacher, 2012). The Christian faith is described far differently. Christians believe that God is one, and this is similar to the Islamic understanding of God; however, Christians believe that God has revealed himself through both the created world and the Bible, which contains both the Old and New Testaments. God brings individual salvation through the sacrifice of his Son, Jesus, on the cross. Through the incarnation of his Son and the coming of the Holy Spirit, God revealed his triune nature. The above description demonstrates the need, as theists, to define and describe the specific attributes and teachings of one’s God. This text will focus on the Christian understanding of God. The transcendence of God evokes awe and worship from God’s people. As Christians worship God, they can experience an uplift of spirit and sense the wonder of the transcendent God (Sproul, 2012). Christians believe they can approach God with the deepest respect and stand in awe of His holiness and majesty because God is both the creator of life and complete essence of love. Christians know God through the experience of holy and redeeming love in relationship with the spiritual presence of God. The opening paragraph of the Nicene Creed (325 AD) speaks of the Christian view of God: “We believe in one God, the Father almighty, maker of heaven and earth, of all things visible and invisible” (Christian Classics Ethereal Library, n.d.). Although God is separate from the world, the world relies upon God for all of life. God is intimately involved with the world, and God’s Son, Jesus, holds the universe together with the power of his word (Colossians 1:17, Hebrews 1:3). This close involvement of God is known as God’s immanence , meaning that God has come near in order to save His people who have fallen into sin and death. God’s immanence is demonstrated throughout the Bible, when God communicated directly to human beings, such as Adam and Eve (Genesis 1-3), Abraham (Genesis 17), and Moses (Exodus 3). The central example of God’s immanence is seen in the birth, life, and death of Jesus Christ. Christians believe that Jesus is God come in a human nature and form. In this way, God enters fully into the broken world of humanity. At this point, a more in-depth study of the Christian worldview will provide a fuller understanding of how Christians view the world and find meaning in the events of life. Worldview Analysis and Personal Inventory Paper The Foundations of Christian Spirituality The Christian worldview is founded upon certain ideas about God and humankind. This chapter will examine each of these ideas briefly. The Trinity Christianity is a monotheistic religion. Adherents looks to what is called the Shema , the Hebrew word for “listen” or “hear,” based on the first word in Deuteronomy 6:4, “Hear, O Israel: The Lord our God, the Lord is one.” This is considered to be the central monotheistic declaration of the Bible. This is the clarion call of both Judaism and Christianity. For Christians, there is only one God, the God revealed in the Bible. In ancient Israel, the monotheistic declaration stood against the polytheistic religions in the ancient Near East. Christians believe in this same God, but over time and through the study of the Bible, they came to comprehend the one God as three distinct persons known as the Father, Son, and Holy Spirit: God in three persons. Through the incarnation of his Son, God revealed his triune nature, and by God sending the Holy Spirit, the three persons of the Trinity are made evident. Theologian Wayne Grudem (1994) explains that each of these three statements is true and essential to a Christian understanding of God: God is three persons. Each person is fully God. There is one God. Christians describe God as one essence in three persons, not gods. An essence is an entity about which something can be said. A person is a distinct bearer of an essence. Applied to the Trinity, it means that Father, Son, and the Spirit are distinct persons, each with his own personal attributes, while each share equally the attributes of deity (i.e., the divine essence). (Horton, 2011, p. 97) The Nature of Jesus Christians believe that Jesus is both the Son of God and fully God at the same time. This understanding of the nature of Jesus Christ is described in more detail in the Chalcedonian Creed from 451 A.D.: We, then, following the holy Fathers, all with one consent, teach men to confess one and the same Son, our Lord Jesus Christ, the same perfect in Godhead and also perfect in manhood; truly God and truly man, of a reasonable [rational] soul and body; consubstantial [co-essential] with the Father according to the Godhead, and consubstantial with us according to the Manhood; in all things like unto us, without sin; begotten before all ages of the Father according to the Godhead, and in these latter days, for us and for our salvation, born of the Virgin Mary, the Mother of God, according to the Manhood; one and the same Christ, Son, Lord, only begotten, to be acknowledged in two natures, unconfusedly, unchangeably, indivisibly, inseparably; the distinction of natures being by no means taken away by the union, but rather the property of each nature being preserved, and concurring in one Person and one Subsistence, not parted or divided into two persons, but one and the same Son, and only begotten, God the Word, the Lord Jesus Christ; as the prophets from the beginning [have declared] concerning Him, and the Lord Jesus Christ Himself has taught us, and the Creed of the holy Fathers has handed down to us. (Monergism, 2013) Simply put, the Chalcedonian Creed describes the unity of the three persons of the Trinity. It describes the Father, Son, and Holy Spirit as coequal with one another. It defines the nature of the Son, Jesus Christ, as possessing both fully human and fully divine attributes. These attributes cannot be separated. They are both always a part of who Jesus is. Michael Reeves (2012) uses the Gospel of John as an example of trinitarian unity: John wrote his gospel, he tells us, so states, “but these are written so that you may believe that Jesus is the Christ, the Son of God, and that by believing you may have life in his name” (John 20:31). But even that most basic call to believe in the Son of God is an invitation to a Trinitarian faith. Jesus is described as the Son of God. God is his Father. And he is the Christ, the one anointed with the Spirit. When you start with the Jesus of the Bible, it is a triune God that you get. (p. 37) The person of Christ is known as the second person in this unity of persons, within what is also called the Godhead. Jesus is described as the “word made flesh” (John 1:14), that is, God’s active voice that brought all of creation into existence from the beginning of time. Jesus had always existed as the second person of the Trinity having no beginning or end; however, He was known as the Christ, which is the Greek word for the Hebrew word Messiah , until his incarnation. The incarnation was when Jesus the Christ was introduced into the world, to save the world, allowing God full access to all peoples who would believe. The Christian understanding of the Trinity then, is the basic doctrine for the Christian faith (Horton, 2011). From this understanding of God comes the Christian view of how the Trinity exists and interacts with human beings through the person of Christ in both an individual and corporate experience. Now, consider how God reveals himself through the Christian sacred text: the Bible. Worldview Analysis and Personal Inventory Paper Christian Scripture The scriptures of the Christian worldview are called the Bible. The Bible is a collection of 66 books, comprised of the Old Testament and New Testament. Christians view the scriptures as the sacred Word of God, a special means by which God has revealed himself to the world. The scriptures bear witness to God’s Creation of the world, the fall of humanity through sin, the redemption of sinful humans through Christ, and the restoration of all things to come in Christ. In the scriptures, a true, but not exhaustive, picture of God is found. Through the Bible, the attributes of God, the great works of God, and the commands and love of God can be learned. One can learn what God loves and what he does not love. Knowledge about God’s Son, Jesus, and his work on behalf of humanity, as well as the power and work of the Holy Spirit in the world and in the lives of people is given. Knowing this, God’s Word is sufficient for the Christian believer, bringing hope when facing all challenges, including evil and suffering in the world. Christians believe that God inspired human authors to write both for their own time and historical setting and, in some cases, for future generations. The scriptures are the most authoritative source from which Christian morals and ethics can be learned (Horton, 2011). According to 2 Timothy 3:16, “All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness.” The Bible serves as the primary authority and representative of God’s Word and will, (Horton, 2011). The Christian Biblical Narrative Creation Christian believers who believe in the Bible as God’s Word believe that God created the universe ex nihilo (from the Latin meaning “out of nothing”), meaning God did not use already existing materials to bring the creation into existence. Genesis 1–2 describe the events of creation. (Grudem, 1994). God created the universe to display his glory. The created world is of such magnificence and complexity that human observers stand in awe of what God has made. A sense of the grandeur of God, his power and creativity, is seen in creation. Creation also gives a sense of how worthy God is of worship and gratitude. In the creation, God provided an environment in which all of his creatures could prosper and enjoy a relationship with him. Psalm 29:1–2 says, “Ascribe to the Lord, O heavenly beings, ascribe to the Lord glory and strength. Ascribe to the Lord the glory due his name; worship the Lord in the splendor of holiness.” When God first created humanity, he set them in the Garden of Eden (Genesis 1 & 2). The Garden was perfect in every way and stands as a metaphor for the perfection that existed between God and God’s highest order of creation, human beings, fashioned after God’s own likeness. This was intended to be a life that served God’s desire to love and brought forth everything that was delightful and right for all time. This Garden contained all plant and animal life necessary to sustain life in all aspects. In this perfect place, there was no pain, illness, or wrongdoing to cause anxiety or suffering . The first humans, Adam and Eve, enjoyed a life of peace and harmony with the earth, all animals, and with God. God and the first humans enjoyed a close personal relationship unmarred by sin and death. Life in the Garden overflowed with more than physical abundance; it was full of spiritual satisfaction, as nothing came between Adam and Eve and their Creator. None of the sin and wrongdoing that interferes with human peace and joy was present. Human beings did not argue or hurt one another. They experienced no guilt or shame because no sin existed in the Garden to destroy God’s magnificent work. Instead, truth, beauty, and the loving ways of God saturated life in this glorious place God created for the benefit of humanity. The created order was truly good in every sense of the word. Unfortunately, this ideal state would not last. Worldview Analysis and Personal Inventory Paper The Fall Genesis 3 records the occasion on which temptation, sin, and death entered the perfect world. Adam and Eve disobeyed God. God had told Adam and Eve to enjoy the fruit of every tree in the garden, except one: the Tree of the Knowledge of Good and Evil. God told Adam and Eve that they would die if they ate of the forbidden tree, but by obeying God, they would