Comprehensive Exam Orientation

1. Comprehensive Exam Orientation Spring 2014 Roxanne Garbez, RN, PhD, ACNP-BC, CNS Mark Hawk, RN, MSN, AG ACNP-BC

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

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

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

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

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

7. The Handbook • You can download a copy of the Comprehensive Examination Handbook from the UCSF School of Nursing website • Handbook will be available starting September 2014.

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

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

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

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

12. Know the Important Dates- Spring 2014 • Number pick up date: • Between April 8 and April 21 • Submit comp by Noon • April 22 • Notification of results • May 22

13. Formatting Expectations APA 6th Edition format Margins 1 inch on all 4 sides of page Can separate syllables at the end of a line 20 pages of text, not counting title page, reference list and appendices Title should reflect content No abstract Double-spaced, 12 point uncompressed font (Acceptable font examples: Times New Roman, Arial)

14. Submission Requirements • Completed face sheet • Separate paper with student’s name, address, home and work number, and other pertinent information that facilitates the student being contacted if necessary • It is the student’s responsibility to ensure that the comprehensive exam is submitted by 12 noon on the due date • One single-sided original of the comprehensive examination in PDF format

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

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

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

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

21. Vital Resources • Vital resource—Department Administrative Assistants • CHS • PN • FHCN • SBS • Comprehensive Exam Coordinators • CHS Beth Phoenix & Dana Drew-Nord • PN Roxanne Garbez • FHCN Karen Duderstadt & Mary Lynch • SBS Susan Chapman

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

23. Comprehensive Exam2014-2015 SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG Identifying the phenomenon of interest • Advance to Candidacy: Before end of Winter Quarter • Pick up Comp # from Departments: From 4/08/14 to 4/21/15 • Submit Comp to Departments: 4/22/14 Topic generation Faculty input re: topic Literature review Refine topic outline Faculty input re: topic outline Advance to Candidacy Draft #1 Pick up Comp # Colleagues read paper for clarity and organization Draft #2 Submit Comp Edit

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

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

26. Comprehensive Exam overview

27. Choosing a Theory • Applicable to critical literature review, research proposal and problem solving comp • A theory should further clarify, support and explain your topic • Nursing theory not required • Explain your theory in the text—don’t depend on diagrams in the appendix

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

29. Concept or Phenomenon • Possible Mechanisms Underlying the Increased Risk of Type 2 Diabetes in People on Atypical Psychotrophics

30. Potential Theoretical Frameworks

31. Research Literature Summary Critique Table Organize your literature into a table to compare and contrast different components of the critique Briefly describe each study in the paper

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

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

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

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

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

38. Proposed White Paper

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

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

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

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

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

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

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

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

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

49. Scoring Areas I - IV I: Quality of Writing – 30 points II: Topic or Issue – 50 points III: Literature Review - 150 points IV: Discussion & Application – 100 points

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