Nursing Care of Autistic Children Essay

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Summary

Being at the forefront of patient care, nurses are the ones who arrange the most comfortable conditions for individuals’ stay in the hospitals, as well as carry out the necessary procedures for speeding up patients’ recovery. Lately, more and more children are diagnosed with autistic spectrum disorder (ASD), which necessitates the nursing personnel to be able to cater to such patients’ special needs when they are hospitalized for various reasons. Research indicates that clinicians’ preparedness to care for ASD children is not sufficient (Lucarelli et al., 2018). One of the most viable reasons for this is the missing or inadequate emphasis on nursing care of ASD patients in nursing universities’ and colleges’ programs.

The Academic Setting Observed

The academic setting observed for this clinical practice experience was Western University. The university was founded at the beginning of the 1900s and has continually increased the diversity and quality of its educational programs ever since. The educational institution has a substantial alumni foundation with the help of which numerous initiatives and programs are promoted. Of particular interest for this clinical practice experience (CPE) was the College of Nursing, which is the largest program at Western University. Initially, the College of Nursing offered a BSN program in 1960, adding the MSN program in 1975 and the DNP – in 2009. The patient-centered BSN program is aimed at providing students with the necessary knowledge and skills for them to be able to practice in all areas of professional nursing.

The faculty at Western University is comprised of 36 members, 15 of them working full-time, 2 – part-time, and 19 – in adjunct positions. The average age of full-time educators is 55, with only three of them being under the age of 40. As a result, it is quite complicated to promote curriculum changes since disagreements often arise in the process. The faculty member who is willing to introduce an innovative approach must work hard to substantiate the need for change and obtain colleagues’ approval.

The Curriculum Gap Identified

In reviewing the syllabi for the BSN program, a need-gap analysis was carried out, as a result of which a curriculum gap was found. Specifically, in Psych-Mental Health Nursing I, the curriculum did not include a module on nursing care for autistic children. Since this disorder is highly prevalent, and patients identified with it require specific attention, it is recommended to include a module ‘Nursing Care of the Autistic Child’ in the curriculum.

The Proposed Course

According to the data provided by the Autism and Developmental Disabilities Monitoring (ADDM) Network of the Centers for Disease Control and Prevention (CDC, 2020a), every 54^th child in the USA has been identified with ASD. Such a high prevalence indicates an additional need for pediatric nurses to be trained in identifying children’s likelihood of having ASD in order to be able to help such patients in clinical settings. However, the lack of inclusion of the ASD topic in the nursing curriculum prevents future specialists from obtaining in-depth knowledge of ASD and, as a result, leads to complications occurring in communication and treatment. Therefore, the addition of the module on Nursing Care of the Autistic Child to the curriculum will benefit students as well as will be an overall asset of the program.

The Purpose of the Curriculum Proposal Document and Its Structure

As mentioned previously, the purpose of the proposal is to fill in the gap within the Psych-Mental Health Nursing I course by including the Nursing Care of the Autistic Child module. The rationale behind the suggested change is to make sure that nursing students are qualified for handling patients with ASD when they latter are admitted to a hospital. The proposal intends to increase future nurses’ knowledge of autistic children’s behavioral patterns and the most typical challenges in working with them. The document is structured in the following way: a review of the literature and a summary of findings, the application of the ADDIE model, and the proposal analysis, design, and development phases.

Literature Review

The Importance of Literature Review

Please refer to Table 1: Literature Review Summary.

The review of literature is a highly important element of research on any topic since it allows for synthesis and analysis of what has previously been done on the issue in question. Whereas in writing research papers, the use of recent studies is usually required, a literature review is not so strict concerning the publication date range. It is so due to the fact that by reviewing scholarly papers with a wider range of publication dates, one can trace the development of the question of interest. At the same time, if no changes can be noticed within a ten-year period, the need for change will be even more evident.

The search engines utilized included PubMed, Cochrane, CINAHL, ERIC, APA PsycInfo, and Google Scholar. Keywords and phrases used were autism, autism spectrum disorder, ASD, nursing education, nursing curriculum, and pediatric nurses. Only peer-reviewed articles were selected for the purpose of a literature review. The research was further refined by setting a ten-year publication date range. Although the present proposal focuses on an American-based College of Nursing, several studies selected for the analysis included findings from different geographic locations. The findings of the articles that were most suitable for the proposal’s topic were reflected in the Literature Review Summary Table.

The Curriculum Gap Observed

The curriculum gap observed in reviewed research articles concerned nurses’ knowledge of ASD and their ability to provide care for pediatric patients admitted to a hospital. As is evident from the articles, the majority of pediatric nurses experience barriers in the way of communicating with and looking after autistic patients. Potential causes of the curriculum gap are largely connected with the faculty’s composition. As it has been mentioned, the majority of full-time professors are in their fifties or sixties. At this age, it is difficult for individuals to agree to changes. Additionally, since these faculty members received their education several daces ago when no sufficient information or statistical data on ASD was available.

At the same time, many of the students feel the gap in their preparation on a daily basis. Taking into consideration this fact, the faculty should review their position on change and allow the inclusion of the suggested course in the curriculum. Since the faculty member suggesting change is the one responsible for its implementation, it is crucial to collect the most exhaustive data to show the faculty how negatively the gap influences both the nursing students and their patients. Literature Review Summary Table, thus, serves as a tool for shedding light on the problem of ASD missing from the curriculum.

Summary of Findings

The review of literature has shown that the topic of ASD is underrepresented in nursing students’ curricula, which causes difficulties both for learners and practitioners. Along with that, the analysis of scholarly sources indicates that ASD is a prevalent condition among children not only in the USA but also in other countries. All of the studies under scrutiny argued in favor of allocating more time for preparing future nurses to provide care for children with ASD. The themes identified in the reviewed articles may be grouped under three main directions: the effect of the curriculum on students, the preparation of the faculty to teach students about autistic patients, and the knowledge of practicing nurses about autism.

Theme 1: The Effect of the Curriculum on Students and Their Knowledge of ASD

The first common theme identified in the scholarly articles is that the curriculum poses challenges for future nurses due to the insufficient time allocated to studying autism. Iannuzzi et al. (2019) note that students’ insufficient level of preparation to work with autistic individuals is the main reason for their low self-efficacy levels upon starting their practice. Research by Giarelli et al. (2011) indicated that there is a lack of formal nurse preparation for taking care of patients with ASD. Major et al. (2013) remarked that those nursing students who are beginning their professional journey immediately notice a gap in their preparation concerning autistic patients. An extensive review of the content and clinical experiences in undergraduate pediatric nursing education carried out by McCarthy and Wyatt (2014) has shown that more than half of educational programs for nurses contain only two hours or less on several crucial topics, including pediatric genetics. Since autism belongs to this category, it is evident that nursing students, including those from Western University’s College of Nursing, cannot gain a sufficient level of knowledge in the conditions of the current curriculum content.

Theme 2: The Preparation of the Faculty to Teaching Students about Autistic Patients

Another highly important topic that emerged during the review of literature is the educators’ preparation for teaching nursing students about autism. A study by Gardner et al. (2016) indicates that there is a range of problems faced by nurse educators in the way of teaching students about ASD. Specifically, the faculty reported such obstacles as limited knowledge about ASD in their educational preparation, as well as a low level of knowledge about developmental disorders. Other challenges recalled by nursing educators include a low self-reported efficacy in caring for autistic patients, little to no experience of working with such patients, and poor knowledge of communication, behavioral, and safety elements of ASD care (Gardner et al., 2016; McCarthy & Wyatt, 2014). Scholars remark that an insufficient level of experience and expertise among the faculty leads to negative outcomes for nursing students and, consequently, their patients.

Furthermore, as Garg et al. (2015) emphasize, healthcare specialists, providing care to ASD children require not only thorough preparation but also continuous education with the aim of enhancing their knowledge in accordance with the emerging trends and developments. In the reviewed articles, different suggestions were made concerning the opportunities of boosting educators’ knowledge and improving their disposition toward ASD patients (Gardner et al., 2016; McCarthy & Wyatt, 2014). However, one thing uniting all studies was that ASD should be included in the curriculum since such inclusion has the potential to help the faculty overcome numerous challenges and provide students with the best preparation for working with ASD children.

Theme 3: The Knowledge of Practicing Nurses about Autism

Finally, practicing nurses’ knowledge about autism is a crucial topic to discuss as today’s nurses are yesterday’s students, and their experience can affect the development of the curriculum in nursing colleges. Several of the reviewed studies contained information on the insufficient level of knowledge and practical skills about autism among practicing nurses (Brown & Elder, 2014; Giarelli et al., 2011; Igwe et al., 2011; Sampson & Sandra, 2018). In each of these instances, researchers emphasized the connection between poor knowledge and a gap in the curriculum. Sampson and Sandra (2018) have found that psychiatric nurses are more knowledgeable about ASD than pediatric nurses. However, these and other scholars report that overall, the level of nurses’ knowledge about autism and the ways of treating autistic patients is quite low (Igwe et al., 2011; Sampson & Sandra, 2018). Researchers emphasize that the better knowledge nurses have, the easier it is for them to identify autism in patients and to provide care for those who have already been diagnosed with this disorder.

Two of the reviewed articles contained specific pieces of advice for nurses as to how to handle pediatric patients with ASD. The most important aspect of providing ASD patients with high-quality care is the nurse’s ability to understand the diagnosis. Other crucial helpful factors, as identified by the author, include the collaboration with patients’ families and encouraging them to stay in the hospital upon admission, arrangement of a safe environment, making sure that the autistic child has consistent caregivers, and identifying the child’s emotional disturbances in order to find ways of mitigating them. Finally, researchers emphasize the utmost significance of proper communication in the process of caring for autistic children (Brown & Elder, 2014). Autistic children require special care and approaches, so teaching nurses about communication is vital for increasing changes to a successful hospital stay.

Conclusion of the Literature Review

All of the aspects identified in the process of reviewing literature require thorough preparation in the process of education, which the majority of nursing students lack. Therefore, including the course on autism in the nursing curriculum will promote the knowledge of the faculty, students, and, as a result, practicing nurses. The more knowledgeable and experienced nursing students are, the more proficient care they will be able to offer to their clients upon starting their professional journey.

Application of the ADDIE Model

The ADDIE model is the instructional design approach utilized in creating training programs. The model was first introduced in the 1970s in Florida State University’s Center for Educational Technology (Alnajdi, 2018). The model’s title is the abbreviation of its components: analysis, design, development, implementation, and evaluation. With the help of the model, educators are able to reach a high level of reliability between the learning and real-work settings (Alnajdi, 2018). The ADDIE model will be employed in the CPE to implement the Nursing Care of the Autistic Child module in the Psych-Mental Health Nursing I course in order to arrange a systematic way to conduct the revision of the curriculum.

Analysis Phase

The analysis phase involves the analysis of the current learning situation. This stage helps to obtain a clear picture of what the situation is, what gaps exist, and what can be done to improve them (Hess & Greer, 2016). Nurse educators should focus on the audience, which is composed of nursing students, and thoroughly analyze their needs. Furthermore, the faculty evaluates the learners’ readiness for curriculum change through the application of such instruments as the affinity diagram, need-gap analysis, and force-field analysis. Finally, the analysis phase involves the identification of key stakeholders who will participate in or be impacted by the curriculum change process.

Design Phase

The design phase incorporates the verification of the desired performances and suitable testing methods (Alnajdi, 2018). At this point, nurse educators decide on the instructional components that will be used to gain the established aims of the change proposal. The design stage helps the faculty to pay attention to the proposal’s details and make sure that the suggested change will promote the achievement of the desired outcomes. Nurse educators can use this stage to come up with the necessary content delivery and pedagogical methods, learning resources, and evaluation approaches that will promote students’ success in learning new course material.

Development Phase

The third phase of the ADDIE model is concerned with the development of resources that will help to meet the set objectives (Alnajdi, 2018; Hess & Greer, 2016). Nurse educators generate content and choose or create supporting materials, develop guidelines for learners and educators, and carry out formative revisions. The faculty can perform the analysis and synthesis of the materials gathered during the first two phases to create a module or program that will shed light on what students should be taught to enrich their knowledge of the identified curriculum gap. This phase also enables nurse educators to review the formative and summative assessments, as well as learning resources, activities, and lecture content.

Implementation Phase

The fourth phase of the ADDIE model involves the enforcement of the learning resources in a learning situation. At this point, students and teachers are engaged and the learning environment is prepared for change (Alnajdi, 2018). Nurse educators implement the newly created program and make the necessary alterations in the process to make sure that students obtain the maximum opportunities for successful comprehension of the new material. The implementation phase, therefore, incorporates continuous activities on analyzing, improving, and redesigning the new module. Additionally, at this stage, feedback from educators and learners is taken into account with the aim of collecting reliable data on the positive and negative aspects of the change. Such measures allow for making the program as successful as possible and beneficial for all stakeholders.

Evaluation Phase

In the model’s final stage, nurse educators thoroughly assess the newly implemented course change. To do so, the evaluation criteria are identified and evaluation tools are selected (Alnajdi, 2018). As a result, educators are able to assess to what extent the instructional needs have been met (Hess & Greer, 2016). The effectiveness of the program is evaluated with the help of both formative and summative assessments. The formative assessment occurs when students and teachers participate in the new module whereas the summative assessment takes place at the end of the new module. The main purposes of the evaluation phase are to check whether the goals of the new module have been reached and to establish possibilities for the module’s enhancement to provide maximum benefits for learners.

Proposal Analysis Phase

Academic Setting Description

Program Level

As previously mentioned, the academic setting for this CPE is the College of Nursing of the Western University, which is accredited by the Southern Association of Colleges and Schools. The university offers a variety of nursing programs, including a traditional pre-licensure nursing program accredited by the Commission on Collegiate Nursing Education (CCNE). The educators, researchers, and clinicians working in the College of Nursing strive to prepare future nursing leaders through the implementation of innovative practices and diversification of the healthcare environment. The university has the initiative to increase the student population’s diversity by having White, Asian, Black, and Hispanic students, as well as learners of mixed parentage placed in the category of ‘two or more races.’

Knowledge and Skills

The eligibility criteria for the pre-licensure nursing program include no previous bachelor’s degree; GPA of 3.0 overall and at least 2.5 in Biology, Anatomy and Physiology, Chemistry, and Microbiology; completion of all required courses for the College of Nursing; submission of the Test of Essential Academic Skills results. A typical learner in the academic setting from the CPE has no prior nursing education or experience. The program prepares individuals to achieve the CON benchmark on the ATI Comprehensive Predictor exam on the first attempt. Students who successfully complete the course pass NCLEX at 89% or higher on the first attempt. Overall, the knowledge and skills obtained in the selected academic setting are sufficient for individuals to work as nurses in diverse practice environments.

Learning Environment and Method of Delivery

This is a blended course requiring learners to complete online activities and carry out independent study in order to pass it successfully. The course objectives can be met via an individual study by utilizing suggested resources, participating in classroom activities, exchanging ideas with classmates and colleagues both formally and informally, and applying critical thinking skills. The methods of teaching include group work, discussions, seminars, computer-assisted instruction, audio-visual aids, an independent study of texts and other resources, clinical assignments, and return demonstration. Furthermore, post-clinical conferences and check-offs of appropriate skills and assignments are held to evaluate the students’ progress. While educators offer consultation and guidance, learners are responsible for the identification of their learning needs, demonstration of course objectives, and self-direction.

Needs Assessment and Gap Analysis Creation Procedures

Please refer to Table 2: Curriculum Need-Gap Analysis.

A need-gap analysis incorporates the process of gathering and analyzing the data contributing to the decision of promoting a curriculum change. According to Keating (2018), the first step in creating or revising the curriculum should involve the evaluation of the suggested change’s relevance for the community. In the process of needs assessment, internal and external factors should be considered. The external ones include the nursing profession, the community, demographics, characteristics of the academic setting, the need for the program, financial support, regulations and accreditation, political climate and body politic, and health care system and health needs of the populace. The internal factors are the organizational structure, the mission and goals, resources within the institution, the internal economic situation, and the potential faculty and students (Keating, 2018). Based on these factors, the need-gap analysis for the current proposal was performed.

The need-gap analysis involved comparing the current curriculum to the desired one, which resulted in the identification of the need gap. Specifically, it was found that the lack of a module on ASD in the current curriculum deprives the nursing students of a comprehensive preparation to work as nurses in pediatric units or other settings providing care to children. The need-gap analysis also included the planning of the action steps that should be taken in order to meet the need gap.

Stakeholders

Nurse Educators

The role of nurse educators in the process of analyzing the course’s gaps is linked to their professional responsibilities and expertise. Being at the forefront during the implementation of any curriculum changes, nurse educators evaluate the benefits and limitations of the suggested curriculum elements. They further employ their skills and expertise to promote and support change that is expected to enhance their students’ skills and knowledge. In order to ensure the most productive outcomes, faculty members should be included in the team carrying out the need-gap analysis. Collaborative work of all faculty members on the revision of the curriculum will allow for the identification of the most evident gaps, as well as will promote valuable feedback on the course. Nurse educators at Western University’s College of Nurses acknowledged the need for paying more attention to ASD and agreed to participate in the implementation of the new module.

Learners

Learners’ role in the need-gap analysis is in providing feedback on current educational approaches and curriculum content. Since a typical learner in the academic setting from the CPE has no prior nursing education or experience, it might be hard for them to identify deficiencies in knowledge when collaborating with ASD patients. However, students regularly analyze case studies and frequently have practical sessions at hospitals. Therefore, they are capable of sharing their experience in encountering autistic children in various professional settings and reporting on the difficulties they have faced during such occasions. Students’ involvement in the need-gap analysis is crucial since they are the final consumers of the change, and if they do not consider the change to be beneficial for them, they might feel resistant to undergoing the change process. Nursing students agreed that their knowledge of ASD was insufficient due to the lack of a module in the curriculum. Learners expressed unanimous support for the suggested change as they realized how beneficial it would be for their practice.

Local Hospitals

The role of local hospitals in the need-gap analysis is valuable since they can provide objective insight into the difficulties faced by young specialists in working with autistic children. Hospitals also serve as the clinical sites for learners, so their participation in the need-gap analysis will help to arrange more suitable settings for students’ practice. During the need-gap analysis process, local hospitals reported the need for improved knowledge and skills in nursing students in relation to both learners’ and beginning practicing professionals’ low level of understanding of how to provide care to autistic children.

Current and Desired Curriculum

Please refer to Table 2: Curriculum Need-Gap Analysis.

Based on the survey of stakeholders and analysis of the Psych-Mental Health Nursing I syllabus, the current state of the curriculum provides learners with a holistic approach to the basics of psychological disorders in adult and pediatric patients. The course covers such important topics as basic concepts, theories, and therapies; children and adolescents; legal, ethical, and cultural issues; schizophrenia, depression, anxiety, suicide, violence, sexual assault; bipolar, personality, and eating disorders. However, the topic of autism is not present in the current curriculum, which makes it incomplete in light of ADDM’s findings indicating that every 54^th child in the USA has autism (CDC, 2020a). Therefore, the curriculum should be modified to include this crucial topic.

The desired state of the curriculum is to incorporate a module on Nursing Care of the Autistic Child to the Psych-Mental Health Nursing I course. All stakeholders have agreed that the module is vital and will be beneficial for learners. The inclusion of a new module will strengthen not only students’ knowledge but also the overall structure of the course. Reports from local hospitals – external stakeholders – indicate that patients with ASD who are admitted with various diagnoses do not receive proper care and attention due to nurses’ primary focus on their physical illness, whereas their psychological state frequently remains overlooked. Therefore, the desired curriculum will eliminate such negative experiences by educating future nurses on the correct ways of communicating with ASD children and helping them to accommodate to new environments.

Curriculum Changes

Please refer to Diagram 1: Affinity Analysis and Table 2. Curriculum Need-Gap Analysis.

As previously discussed, the curriculum of the Psych-Mental Health Nursing I course did not include a module on the Nursing Care of the Autistic Child, which considerably eliminated nurse students’ preparation to manage diverse cases in practical settings. Therefore, a suggestion was made to include such a module in the curriculum, thereby enabling those taking the course to learn about the psychological challenges faced by autistic children along with the ways of coping with these barriers. First of all, the module will enable students to select the most suitable communication and treatment procedures and approaches when dealing with an ASD patient. According to research, determining the most suitable ways of communicating with autistic children and their families is a crucial aspect of arranging trustworthy relationships between the patient and nurse. As a result of positive communication, the nurse will be able to fully serve as the patient’s advocate.

Another important learner need is to understand ASD terminology and learn the types of behaviors an autistic child may have. ASD children frequently experience hypersensitivity toward different stressors, such as light, smell, or sound. Also, autistic patients may have one or several compulsions and obsessions or display some stereotypical behaviors, the knowledge of which will make it much easier for the nurse to help the patient feel comfortable in the unfamiliar environment. Therefore, adding a module on ASD o the curriculum will benefit both students and patients.

Incorporating a new module will allow students to build on their prior knowledge via the constructivist learning theory. As Shah (2019) posits, the application of the constructivist learning approach enables students to become active participants of the learning process rather than merely listeners. Hence, instead of the traditional learning approach, an innovative method of obtaining knowledge will be utilized. By doing so, students will be able to think and act creatively and take part in making decisions regarding patients’ treatment plans and other crucial arrangements. Learners will also recollect the material on other psychiatric disorders and utilize their knowledge when mastering the new module.

Collaboration with internal and external stakeholders indicated that there was a drawback in the current curriculum due to the lack of the ASD module in it. Local hospitals reported an insufficient level of nurses’ readiness to work with ASD patients. Nurse educators noted that students could significantly benefit from the detailed learning of ASD as a separate topic rather than merely mentioning it in other modules. Therefore, the curriculum changes will have a positive impact not only on learners but also on patients. As a result, Western University’s College of Nursing will gain more value among potential students and employers as they will know that learners of this institution are well-prepared to face the problems of present-day patients.

Organizational Strengths and Weaknesses

In the process of collaborating with stakeholders, a force field analysis and a thorough examination of organizational strengths and weaknesses were carried out in order to determine the situational factors that could promote or slow down the process of curriculum proposal implementation.

Please refer to Diagram 2: Force Field Analysis (Organizational Readiness for Curriculum Proposal).

Forces for the Proposal

Organizational strengths and situational factors that could support the adoption of the curriculum proposal include:

evidence-based learning experiences,
alignment with professional standards of pediatric care,
improved communication skills that will enable students to successfully operate in professional settings,
promotion of critical thinking and decision making,
the enhancement of Western University’s reputation as a nationally ranked school for higher nursing education.

Each of these factors can be used to the suggested change’s advantage as they explain the significance and benefits offered by it.

Supporting strength 1. Evidence-based learning experiences are an indisputably valuable asset for any nursing student. With the approval of the suggested curriculum change, students will be able to obtain experience working in evidence-based settings. According to Gialloreti et al. (2019), it is easier for practitioners to manage ASD patients if the former have had sufficient evidence-based experience. The external stakeholders, local hospitals, are interested in making sure that nursing students have access to real-life and evidence-based experiences since upon graduating, they will be able to provide patients with the best care.

Supporting strength 2. A standardized and streamlined course curriculum containing a module on the care of autistic children could support the adoption of the curriculum proposal since in such cases, nurse educators would be providing learners with the most recent and valuable information. The core elements in the guidelines issued by the Council of Autism Service Providers (CASP, 2020) include the ability to make decisions regarding ASD patients and communicate with caregivers. Hence, the suggested module will make it possible for the curriculum to align with the professional standards.

Supporting strength 3. The proposal is aimed at enhancing students’ communication skills, which is a valuable feature for any nursing practitioner. By improving these skills, future specialists will be prepared to find solutions to ASD patients’ issues and opportunities to meet their needs. Additionally, communicating with autistic children’s parents will be more effective, leading to better options for young patients. As a result, the module will benefit both learners and their future clients.

Supporting strength 4. Critical-thinking and decision-making skills are some of the most vital components of a successful nursing practitioner’s personality. The suggested curriculum change aims at developing nursing students’ knowledge about ASD, which will lead to a faster way of making decisions and to a more efficient way of coming up with solutions to critical cases. Hence, the suggested change will prepare students to be self-confident and offer the best level of care to their patients, as well as become valuable members of any hospital’s nursing team.

Supporting strength 5. Both potential students and employers will express more trust and respect toward Western University once it demonstrates its intention to innovate for the sake of positive development. The university is likely to grow its rating among competitors, and its graduates will have better options in the employment market. The incorporation of the new module will, therefore, demonstrate the university’s competence and indicate a goal- and safety-oriented agenda.

Forces against the Proposal

Organizational weaknesses and situational factors that could hinder the adoption of the curriculum proposal include:

time and resources to develop the new curriculum and master it to provide a superior learning experience for students,
time required to compare and contrast the current curriculum to standardized, evidence-based practices,
factoring the module into the semester time frame,
faculty’s resistance to the adoption of innovation,
added workload for students and faculty.

Impeding force 1. Whereas the new module poses great benefits for the program and all stakeholders, it might be complicated to develop it since its preparation requires time and resources. The developers of the module could face such challenges as the lack of resources or the need to work extra hours to have the change implemented. Learners may also feel the burden of working in unexpected time frames in regard to having a new module added to the curriculum.

Impeding force 2. Another situational factor that could hinder the adoption of the proposal is the time required to compare and contrast the current curriculum to standardized, evidence-based practices. Whereas any comparisons should be the responsibility of the persona suggesting the change, it is inevitable that all faculty members will be involved in this process. Finding time to do this may become an obstacle in the way of successful change implementation.

Impeding force 3. While all curriculum procedures have been approved for the current course, it may be complicated to factor the new module into the semester’s time frame. Naturally, some topics will be allocated fewer academic hours than before in order for the new module to fit into the curriculum. Such changes will trigger alterations in educators’ and learners’ timetables, which may not be accepted positively by many of them.

Impeding force 4. As it frequently occurs with change, the resistance of some stakeholders may impede its successful implementation. Some faculty members, especially those of advanced age, may not feel disposed toward the changes in the curriculum since it will likely pose additional complications to their work. Even despite the numerous benefits, the suggested change to the curriculum can bring, the resistance of some faculty members cannot be prevented.

Impeding force 5. The last organizational weakness and situational factor that may interfere with the successful implementation of the change is the overall added workload for students and faculty. In order to mitigate this and other impeding factors, it is necessary to create an interprofessional team where each group of stakeholders would be represented. That way, all stakeholder groups would be timely informed about the development of change and accommodate to new processes accordingly.

Syllabus Creation Procedures

In preparing the Nursing Care of the Autistic Child module to be added to the Psych-Mental Health Nursing I course, both independent and collaborative efforts with specific attention to detail were employed to make sure that learners would be provided with experiential learning activities that encouraged critical thinking and enriched professional skills.

Independent Procedures

The cultivation of the syllabus was first of all promoted with the help of research. Additionally, self-reflection was employed as a helpful method of considering one’s own philosophy of teaching and understanding the course’s importance. Self-reflection also helped to find a suitable place for the newly developed module in the existing course. Having learners’ interests as the most crucial consideration, expectations regarding the course were clearly and succinctly articulated to maximize students’ success in the course. Carrying out the research helped to provide the most up-to-date evidence-based information to learners in a well-organized manner. Upon completing research and self-reflection, collaboration with key stakeholders via meetings and emails was arranged.

Collaborative Procedures

Initially, emails concerning the intention to add the Nursing Care of the Autistic Child module to the Psych-Mental Health Nursing I course were sent to all essential stakeholders involved in the project. Emails contained a brief description of the suggested change and the rationale for its implementation. Additionally, emails contained the suggested meeting times and dates for stakeholders to gather and discuss the new module. Key stakeholders were requested and encouraged to email any concerns or address any questions they might have before the first meeting.

Meetings with stakeholders had a positive effect on the syllabus’ development. As previously mentioned, administration, nurse educators, learners, and local hospitals were all consulted to obtain multiple and versatile perspectives related to the topic of nursing care for autistic child. When working on the proposal phase, the questions received from stakeholders were taken into consideration. Before arranging the collaboration with stakeholders, meticulous drafts of the proposal were generated for every stakeholder group to find particular interest in the proposed module. At the first meeting, stakeholders’ roles and responsibilities were assigned. It was decided that two nurse educators would oversee the curriculum development project to control the alignment of the new module with the university’s vision and nurse educators’ schedules. Several meetings with stakeholders took place in order to negotiate the budget, and discuss the course content, teaching and learning approaches, time management, and resources required for the successful completion of the project.

Upon agreeing on the curriculum draft proposal, a final copy of the new syllabus, which contained the new module, was presented at the faculty meeting. A form providing all the details of the curriculum change was completed, and a rationale for the change was prepared. Upon obtaining the faculty’s approval, the syllabus was presented to the College of Nursing Curriculum Committee. Finally, the approval was obtained from the University’s Curriculum Committee, which allowed for the new module to be incorporated into the next semester’s program.

Course Description

Please refer to Appendix A: Course Syllabus.

The course description was updated to include the Nursing Care of the Autistic Child module, which was added to Week 9 of the course. The description of the course is an essential element of course materials since it explains the rationale for the module to learners, as well as contains the key concepts, activities, learning strategies, and materials. The course description was developed with the aim to communicate enthusiasm about the course, describing what students will be able to do after completing it, and outline the benefits for learners offered by the updated curriculum.

Communicating Enthusiasm

The course/module description developed for the Nursing Care of the Autistic Child module communicates enthusiasm by providing students with a holistic scope of the course and the explanation of its significance in relation to the broader scope of professional nursing practice. Furthermore, the course description communicates enthusiasm by the detailed explanation of how the course/module matches the university’s educational goals and commitment to students’ success. The description of the course/module enables learners to gain insight into the nursing care of autistic child. To enhance the effect on students, the description is presented by means of strong persuasive language, such as “Content is presented with scrupulous attention to detail and explores the psychological peculiarities of ASD children’s behavior” and “Students will be immersed in a variety of scenario-based learning activities.” The use of persuasive language offers a sense of security that implies that the course was developed with learners’ best interests in mind.

What the Learners will Be Able to Do

The course/module description outlines what the learners will be able to do upon completing the course in a clear, concise, and conscientious manner. Specifically, student learning outcomes are outlined, which include the analysis of psychological theories, the examination of various issues affecting the psychiatric health delivery system, the utilization of evidence-based practice, the comparison and contrast of mental health issues in urban and rural areas’ patients, the identification of barriers to psychological care, the selection of nursing interventions with respect for patients’ preferences, and the application of nursing research and evidence-based practices to promote mental health and provide appropriate care. The use of inspirational, logical-descriptive, and professional language in the course/module description will let the learners know that the course will be helpful in strengthening their clinical prowess. Students will appreciate the clear message in the course/module description concerning what they will learn to do.

Benefits for Learners

The course/module description emphasizes how the course and its subject matter will benefit the learners through the variety of valuable skills that they will obtain upon its completion. Of specific importance is the explanation of the purpose that guided the inclusion of a new module. It is mentioned that the new curriculum has the aim of “simplifying nursing students’ work,” which inevitably serves as an advantage. Through the inclusion of a new module, learners will obtain the information previously lacking in the program. Hence, the new generations of nurses will be more skillful and will meet fewer obstacles once immersed in professional practice. The course/module description explains how learners’ higher cognitive thinking, autonomy, and critical thinking will be enhanced.

Course Objectives

It is crucial for nurse educators to come up with effective course objectives that will provide learners with achievable and measurable goals to gain by the end of the course. Hence, course objectives should be developed in consistency with the current difficulty of the course. Furthermore, objectives should align with the overall curriculum needs and expectations, such as promoting the enhancement of students’ higher cognitive functioning. For instance, since the Psych-Mental Health Nursing I course is designed for future nurses, the development of its objectives is aligned with the higher cognitive level of Bloom’s taxonomy. The course objectives for this course/module were conceived as follows:

Analyze the baccalaureate-prepared nurse’s role in nursing care of the autistic child (cognitive level: analysis).
Examine the psychological peculiarities of autistic children and develop a treatment plan in accordance with them (cognitive level: application).
Apply knowledge of ASD to identify the issues that might hinder treatment and alleviate these issues (cognitive level: application).
Apply a holistic approach to nursing care for the autistic child (cognitive level: application).
Analyze how nursing can be assisted through computer-assisted instruction, group work, discussions, seminars, audio-visual aids, an independent study of texts and other resources, clinical assignments, and return demonstration (cognitive level: analysis).

Teaching Strategies, Instructional Delivery Methods, and Learning Materials

Nurse educators should ensure that the syllabus reflects the most contemporary healthcare needs in order to prepare students to operate effectively as competent baccalaureate-prepared nurses. Therefore, educators develop the syllabus by formulating course objectives, content, and outcomes that will support productive learning in the academic setting through evidence-based practice and current learning theories.

Please refer to Appendix A: Course Syllabus and Appendix B: Course Materials and Learning Resources.

Teaching Strategies

The teaching strategies suggested in the syllabus are underpinned by the constructivist learning theory. The selected theory enables learners to build upon the previously acquired knowledge by assembling new material in synthesis with the syllabus content. Participating in a scenario-based learning activity is a highly effective teaching strategy since it allows students to immerse in the settings most closely resembling real-life clinical situations. This teaching strategy enables learners to gain a deeper understanding of the issues encountered in nursing practice and consider possible solutions. According to Fitzgerald and Keyes (2019), case studies and role-plays allow for exploring students’ attitudes and interests, as well as developing their values and feelings. Furthermore, working in groups enhances students’ skills in collaboration and communication. Critical-thinking and analytical skills, which are the core of student-based learning, are likely to be promoted with the use of the selected teaching strategies. Therefore, the application of the constructivist learning theory and the use of case studies and team-based learning will support the educational process in the current academic setting.

Instructional Delivery Methods

The instructional delivery methods for this course incorporate a blend of lectures and resources, as well as independent and group activities. Learners can meet course objectives through active involvement in classroom activities, an individual study using the suggested resources, formal and informal exchange of ideas with peers, and clinical assignments. Information for these activities is presented to learners through video-recorded PowerPoint presentations, lectures, and discussion board posts. The constructivist learning theory and evidence-based practice support the listed instructional delivery methods since students are able to take an active part in classroom and individual work, construct new ideas, and increase the bulk of knowledge based on the previously gained experience. The format of delivering instructions allows learners to obtain a thorough understanding of the material both with the help of resources and through active communication with their peers.

Learning Materials

Learning materials for this course and module include textbook readings ( Hazen & McDougle, 2018; Iyama-Kurtycz, 2020), a scholarly peer-reviewed article (Lord et al., 2018), and information and statistics about ASD from the CDC (2020b) and the National Institute of Mental Health (NIMH, 2018). The mentioned materials are supported by the constructivist learning theory and evidence-based practice since textbook readings and academic articles provide the foundational knowledge for building learners’ nursing expertise. The use of a case study will enable students to apply theoretical concepts from readings to real-life situations upon evaluating, analyzing, and synthesizing the data. The scenario-based learning activity will enforce the constructivist learning theory by allowing students to experience collaboration in an environment close to a real-life one.

Student Learning Outcome Analysis

Student learning outcomes (SLOs) are academic goals set for learners at the beginning of the course/module. When generating SLOs, educators make sure that these align with the current course content, activities, and objectives. SLOs have to be specific and measurable and should correspond to the learners’ cognitive level of learning. The SLO selected for analysis states:

Upon successful completion of the course/module, learners will be able to identify competent, culturally sensitive, and compassionate nursing interventions and techniques for patients and their families that demonstrate respect for the patients’ preferences.

Bloom’s Cognitive Level of the SLO

Bloom’s cognitive levels of the SLO are remembering, understanding, and applying. At the remembering level, the learners will demonstrate memory of previously learned material by operating concepts, terms, and facts that will be incorporated in nursing interventions. At the level of understanding, students will exhibit the mastery of organizing and interpreting ideas for the successful arrangement of interventions. At the applying level, learners will find solutions to new situations by utilizing acquired knowledge and facts in new settings.

Expected Student Performance Level of the SLO

Learners will be expected to successfully develop a nursing intervention aimed at making the care of the autistic child effective and promoting positive collaboration with the patient’s family. It will be anticipated of students to explain the differences between culturally sensitive and insensitive approaches, as well as the discrepancies between compassionate and inconsiderate patterns of behavior. Students’ performance levels should demonstrate the highest level of respect for the patients’ preferences and needs.

How the SLO Can Be Measured

The educator can measure the SLO with formative, summative objective, and summative performance assessments. In the formative assessment, students’ SLO will be measured by responses to knowledge-based questions, which will determine whether students understand the topic’s key issues. In the summative objective assessment, learners will select an answer based on provided scenarios. Finally, in the summative performance assessment, students’ SLO will be measured through preparing a research paper on the topic of nursing care of autistic child.

How the SLO Aligns with the Course Objectives

The SLO aligns with the course objectives since the latter presupposes the analysis of autistic children’s peculiarities (objective 2), the development of treatment plans (objective 2), and the application of a holistic approach to nursing care (objective 4). All of these objectives prepare learners to identify effective interventions and demonstrate respect for patients’ needs and preferences.

Course and Grading Policies

Please refer to Appendix A: Course Syllabus and Appendix C: Assessments (Formative, Summative Objective, Summative Performance).

Course objectives were developed with the aim of describing what students should demonstrate upon completing the module. The grading policies and assessments offer mechanisms of evaluating students’ achievements and assessing to what extent they have mastered the set goals and objectives. The course syllabus includes a clear breakdown of the overall score and the impact of each assessment factor on the student’s grade. A minimum grade of 75 is required to pass the course. The grading policies support the course objectives and overall goals of the curriculum proposal since they enable nurse educators to evaluate the extent to which learners have mastered the appointed goals and requirements. Additionally, the precautions regarding plagiarism and other violations are aimed at ensuring that students work independently, utilize reliable sources, spend enough time on analyzing and synthesizing the materials, and carry out every task diligently and professionally.

Proposal Development Phase

During the development phase, the creation of the content and learning materials based on the design phase was completed. The following course materials were developed and included as appendices to this proposal. Please refer to Appendix B: Course Materials and Learning Resources and Appendix C: Assessments (Formative, Summative Objective, Summative Performance):

Course Unit Overview
Lecture Content
Learning Resources
Learning Activities
Formative Assessment Quiz
Summative Objective Assessment Test
Summative Performance Assessment Task
Summative Performance Assessment Rubric

Course Materials Creation Procedures

In developing the Nursing Care of the Autistic Child module to be added in the Psych-Mental Health Nursing I course, both independent and collaborative efforts were taken with particular attention to detail to ensure that students were provided with effective content, dynamic assessments, and experiential learning activities with resources promoting critical thinking and encouraging a higher cognitive order of thinking.

Independent Procedures

The major independent approaches to creating content were reflection and self-reflection, which allowed for a careful and detailed analysis of what content would be the most suitable and beneficial for the course. Based on the review of the literature and need-gap analysis, it was possible to reflect on the course materials to be included in the module, such as course content, learning resources, and assessments. Reflection resulted in determining the module and course content, including the objectives and SLOs.

Self-reflection was helpful in making sure that the content was student-oriented and that it would be not only interesting but also helpful to learners. Some of the self-reflection questions that prompted the creation of course materials included the following:

How can one make the content more engaging?
In what ways can students’ earning process be better facilitated?
How can real-life situations be employed in the classroom with the greatest benefit to students?
What resources might be the most helpful to learners in the process of understanding the topic?
How can students’ knowledge and understanding of the topic be evaluated in an engaging and reliable way?

In addition to reflective and self-reflective processes, a review of the literature was carried out. Literature review allowed establishing evidence to support the module content and activities. Finally, the review of the whole syllabus allowed for singling out the most suitable assessments for the module, which were aimed at evaluating learners’ progress and identifying the areas of improvement. Independent procedures were rather useful in outlining the appropriate course content.

Collaborative Procedures

As previously mentioned, essential stakeholders received emails regarding the intention to include a new module in the Psych-Mental Health Nursing I course. These emails contained the description of the suggested module and its rationale. Key stakeholders were encouraged to express any questions and concerns about the suggested change. Further, meetings with stakeholders were held, at which the course content and materials were discussed. The meetings, as well as email communication, allowed for each stakeholder group’s expression of their suggestions on the change. Collaboration with stakeholders gave valuable feedback and presented multiple perspectives on the module and syllabus. Overall, both independent and collaborative procedures were rather beneficial in the process of creating the materials.

Learning Resources and Activities

Please refer to Appendix B: Course Materials and Learning Resources.

Learning Resources

Learning resources for this course and module include textbook readings (Hazen & McDougle, 2018; Iyama-Kurtycz, 2020), a scholarly peer-reviewed article (Lord et al., 2018), information and statistics about ASD from the CDC (2020b) and the NIMH (2018), and a PowerPoint presentation. The combination of these resources will promote the development of students’ skills and reflective practice as the selected learning content is aimed at reaching the course objectives and SLOs.

The main textbook for the course is Varcarolis’ foundations of psychiatric mental health nursing: A clinical approach (7th ed.), specifically chapters 3, 11, and 34. This book is an excellent resource for nursing learners as it contains information about mental health and illness, relevant theories, biological basis for understanding psychiatric disorders, psychiatric care settings, cultural implications, standards of care, ethical guidelines, and others. Of special interest for this module are chapters on communication and childhood and neurodevelopmental disorders. At the end of each chapter, there are review questions with an answer key, which help students to revise the information and identify the moments to which they should pay more attention.

The book edited by Hazen and McDougle (2018), The Massachusetts General Hospital guide to medical care in patients with autism, offers a variety of helpful pieces of professional advice on how to make ASD patients’ stay in the hospital comfortable and effective. The book contains valuable insights into the nursing care of pediatric autistic patients. Such crucial topics as challenges for autistic children’s inpatient care, strategies for improving care, innovative approaches, and others are discussed by the book’s contributors.

Iyama-Kurtycz’s (2020) book, Diagnosing and caring for the child with autism spectrum disorder: A practical guide for the primary care provider, is useful for learners as it contains the explanation of diagnostic obstacles, autism screening, anxiety issues, challenging behaviors, teaching positive parenting skills, and others. These topics will be of great help for learners since they will prepare future nurses to effective communication and collaboration with autistic children and their caregivers in hospital settings.

The inclusion of a scholarly article by Lord et al. (2018), “Autism spectrum disorder,” pursues two goals: providing vital data on ASD and teaching nursing learners to work with scholarly articles, which will be needed in their summative performance assessment assignment. Data and statistics provided on CDC (2020b) and NIMH (2018) websites offer relevant information about the disorder’s prevalence, diagnostic tools, risk factors, and other important issues that nursing practitioners should know. Overall, learning resources contain essential information about ASD and prepare students to encounter autistic patients in healthcare settings and provide high-quality care to them.

Learning Activities

The scenario-based learning activity created in the proposal is a case-based scenario with a role-play simulation followed by a group discussion. Students will be assigned randomly to a case study and will work independently on the given task. After they finish working on the case studies, learners will be placed in groups. Each group will discuss the case study and share individual experiences, which will enable making a common conclusion. The suggested scenario-based learning activity will support student skill development and encourage reflective practice in two ways. Firstly, students will engage in reflection and self-reflection in order to find answers to the case study’s questions. Secondly, learners will develop their skills both when working independently (professional nursing skills) and in groups (collaborative and teamwork skills). Furthermore, the activity will enhance students’ empathetic skills and emphatic communication skills. Learners will be able to practice nursing skills, communication, and interventions for promoting effective care of autistic child and making their stay at the hospital comfortable. The use of role-playing will facilitate students’ understanding of patients’ values and interests, as well as their parents’ concerns.

The other learning activity is a simulated role-play activity where each learner will be assigned a role and will have to utilize their knowledge of ASD. This activity will promote reflective practice since students will have to approach the ‘patient’ professionally and try to discern the ASD symptoms. Skill development will be promoted as learners will analyze the cases of ‘patients’ by applying all the skills mastered in the course and module.

Formative Assessment

Please refer to Appendix C: Assessments (Formative, Summative Objective, Summative Performance).

A formative assessment is a five-question quiz with five possible answers for each question. The purpose of formative assessment is to evaluate the effectiveness of learning materials and activities offered in the module. The quiz will assess learners’ comprehension of nursing care of autistic child. The success or failure to choose correct answers will indicate students’ progress or identify areas of improvement. For instance, if the majority of learners fail to answer the same question, the educator will analyze the course content and include more information on that topic to align with SLOs and course objectives. The scores of the formative assessment quiz will allow the nurse educator to make the necessary adjustments to the course. Students’ performance in the quiz will provide insight into the areas of strength and room for improvement.

The educator will provide feedback to students, so they will be able to see what content areas they have mastered well and which areas need to be given more attention. Learners will revisit the topics in which they failed to boost their knowledge and improve performance. By doing so, students will make sure that their SLOs have been met and course objectives have been achieved.

Summative Objective Assessment

Please refer to Appendix C: Assessments (Formative, Summative Objective, Summative Performance).

For summative objective assessment, learners will answer a ten-question quiz based on the material presented in the module. This assessment will allow evaluating students’ abilities to analyze, synthesize, and apply their knowledge in practice. The results of the summative objective assessment will be used as reliable data for ensuring that the curriculum is meeting the intended goals since these results will give an insight into how good the earning materials and activities are at helping learners to meet course objectives. The higher the incidence of pass rates on the summative objective assessment is, the better the objectives of the curriculum proposal are met.

On the contrary, if the incidence of pass rates is low, nurse educators will need to revise and modify the module in order to improve SLOs. Summative objective assessment is, therefore, a helpful tool utilized in the process of identifying whether the curriculum change proposal is meeting its intended goals or not. The instructors will carefully review and analyze students’ results to make solid conclusions about the success of the new module’s inclusion.

Summative Performance Assessment

Please refer to Appendix C: Assessments (Formative, Summative Objective, Summative Performance).

Summative performance assessment represents an authentic activity relevant to the selected curriculum proposal since it promotes learners’ critical thinking and clinical decision-making. Furthermore, the performance assessment is a recreation of a core professional activity corresponding to the academic setting of the curriculum proposal since it encompasses the culmination of all the skills, knowledge, and practical habits acquired by students in the form of a scholarly paper. Authenticity is justified by challenging students to employ their professional judgment rather than memorizing the material performance assessment involves research practices, collaboration, and presentation skills as important prerequisites of decision making and collaboration in real-life situations. Therefore, successful completion of summative performance assessment will signify the mastery of the course content and objectives.

References

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Brown, A. B., & Elder, J. H. (2014). Communication in autism spectrum disorder: A guide for pediatric nurses. Pediatric Nursing, 40(5), 219-225.

Centers for Disease Control and Prevention. (2020a). Data & statistics on autism spectrum disorder. Web.

Centers for Disease Control and Prevention. (2020b). What is autism spectrum disorder? Web.

The Council of Autism Service Providers. (2020). Applied behavior analysis treatment of autism spectrum disorder: Practice guidelines for healthcare funders and managers (2^nd ed.). Web.

Fernando, S., & Marikar, F. (2017). Constructivist teaching/learning theory and participatory teaching methods. Journal of Curriculum and Teaching, 6(1), 110-122. Web.

Fitzgerald, K., & Keyes, K. (2019). Teaching methods and settings. In S. B. Bastable (Ed.), Nurse as educator: Principles of teaching and learning for nursing practice (5^th ed., pp. 459-504). Jones & Bartlett Learning.

Gardner, M. R., Suplee, P. D., & Jerome-D’Emilia, B. (2016). Survey of nursing faculty preparation for teaching about autism spectrum disorders. Nurse Educator, 41(4), 212-216. Web.

Garg, P., Lillystone, D., Dossetor, D., Wilkinson, H., Kefford, C., Eastwood, J., & Liaw, S. T. (2015). A framework for developing a curriculum regarding autism spectrum disorders for primary care providers. Journal of Clinical and Diagnostic Research, 9(10), SC01-SC06. Web.

Gialloreti, L. E., Mazzone, L., Benvenuto, A., Fasano, A., Alcon, A. G., Kraneveld, A., Moavero, R., Raz, R., Riccio, M. P., Siracusano, M., Zachor, D. A., Marini, M., & Curatolo, P. (2019). Risk and protective environmental factors associated with autism spectrum disorder: Evidence-based principles and recommendations. Journal of Clinical Medicine, 8. Web.

Giarelli, E., Ruttenberg, J., & Segal, A. (2011). Continuing education for nurses in the clinical management of autism spectrum disorders: Results of a pilot evaluation. The Journal of Continuing Education in Nursing, 43(4), 169-176. Web.

Halter, M. J. (Ed.). (2014). Varcarolis’ foundations of psychiatric mental health nursing: A clinical approach (7^th ed.). Saunders.

Hazen, E. P., & McDougle, C. J. (Eds.). (2018). The Massachusetts General Hospital Guide to medical care in patients with autism. Humana Press.

Hess, A. N., & Greer, K. (2016). Designing for engagement: Using the ADDIE model to integrate high-impact practices into an online information literacy course. Communications in Information Literacy, 10(2), 264-282.

Iannuzzi, D., Rissmiller, P., Duty, S. M., Feeney, S., Sullivan, M., & Curtin, C. (2019). Addressing a gap in healthcare access for transition-age youth with autism: A pilot educational intervention for family nurse practitioner students. Journal of Autism and Developmental Disorders, 49(4), 1493-1504. Web.

Igwe, M. N., Ahanotu, A. C., Bakare, M. O., Achor, J. U., & Igwe, C. (2011). Assessment of knowledge about childhood autism among paediatric and psychiatric nurses in Ebonyi state, Nigeria. Child and Adolescent Psychiatry and Mental Health, 5(1). Web.

Iyama-Kurtycz, T. (2020). Diagnosing and caring for the child with autism spectrum disorder: A practical guide for the primary care provider. Springer.

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Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. Lancet, 392(10146), 508-520. Web.

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Major, N. E., Peacock, G., Ruben, W., Thomas, J., & Weitzman, C. C. (2013). Autism training in pediatric residency: Evaluation of a case-based curriculum. Journal of Autism and Developmental Disorders, 43(5), 1171-1177. Web.

McCarthy, A. M., & Wyatt, J. S. (2014). Undergraduate pediatric nursing education: Issues, challenges and recommendations. Journal of Professional Nursing, 30(2), 130-138. Web.

National Institute of Mental Health. (2018). Autism spectrum disorder. Web.

Sampson, W.-G., & Sandra, A. E. (2018). Comparative study on knowledge about autism spectrum disorder among paediatric and psychiatric nurses in public hospitals in Kumasi, Ghana. Clinical Practice & Epidemiology in Mental Health, 14, 99-108. Web.

Shah, R. K. (2019). Effective constructivist teaching learning in the classroom. Shanlax International Journal of Education, 7(4), 1-13. Web.

Table 1: Literature Review Summary

First Author (Pub Year)	Title	Purpose	Context	Findings	Relevance	Strength of Evidence Strengths & Weaknesses
Brown (2014)	“Communication in autism spectrum disorder: A guide for pediatric nurses”	The authors’ focus was on the identification of communication issues emerging in pediatric nurses’ work with autistic children. The purpose of the study was to explain the possible ways of relieving the frustration developed due to the lack of effective communication.	The study involved an overview of the main milestones in children’s development of verbal and non-verbal communication. The authors described three major theories explaining the functioning of ASD brain, as well as outlines practical applications of handling ASD children’s outbursts.	The scholars found the lack of theory of mind, the weak central coherence theory, and the weak executive function theory to be the most effective in explaining the functioning of ASD brain. They also found that the main factor in providing effective care to autistic children was obtaining a history of communication. Adaptations to the environment and dealing with communication breakdowns were reported to have a positive impact on nurses’ work with ASD children.	The article is relevant to the proposal since its authors discuss the difficulties encountered by nurses in the process of caring about autistic patients. Hence, the source justifies the need to include a new topic to the syllabus.	Level VII Expert Opinion Strengths: – the authors focus on such a crucial component of professional management of ASD as communication; – relevant data is reflected in the form of tables, synthesizing the most important aspects; – theoretical and practical aspects of ASD are discussed. Weaknesses: – no experiment was conducted by the scholars to prove the effectiveness of suggested approaches; – the study has a rather descriptive character, whereas it would have been useful if the authors provided some practical examples and/or comparisons of applying different approaches to nurse-patient communication.
Gardner (2016)	“Survey of nursing faculty preparation for teaching about autism spectrum disorders”	The purpose of the study was to evaluate the level of nurse faculty’s competence in providing care to ASD patients. The authors focused their research on gaining relevant data concerning nurse faculty’s abilities to work with ASD patients as an opportunity to overcome the obstacles of incorporating the topic into the curriculum.	The authors utilized a survey method to obtain information from 295 faculty members, 76% of whom reported to be conducting clinical teaching. Nearly half of respondents admitted having not received any prelicensure preparation to work with autistic patients. Participants were requested to evaluate their level of readiness to teach students about ASD patients.	Less than one-fifth of the participants reported a moderate to high level of readiness to teach students about autistic patients. 47% of respondents admitted that their courses did not include any information about ASD.	The source is highly relevant to the proposal since its findings demonstrate that there is a pressing need to change the curricula by adding the topic of ASD. since the findings indicate that educators’ abilities to teach students about ASD are insufficient, it is evident that the proposed curriculum change is important.	Level IV Non-Experimental (Quantitative, Descriptive Study) Strengths: – the authors involved a large sample of participants and a range of their levels of preparation and clinical specialties; – the urgent need for adding the ASD topic to the curriculum was proved with the help of a comprehensive survey. Weaknesses: – because scholars used a convenience sampling technique, it is impossible to consider findings as viable to be generalized; – respondents’ ASD knowledge was not evaluated by scholars since the latter only asked the former to self-assess their competence.
Garg (2015)	“Framework for developing a curriculum regarding autism spectrum disorders for primary care providers”	The purpose of the article was to find evidence to such domains of ASD in educational practice as general knowledge and surveillance. The researchers also aimed at integrating the essential contents for general practitioners’ educational programs on ASD.	The authors carried out a confirmatory factor analysis on their original survey data, as well as conducted a systematic review of literature to single out critical educational themes. The original survey encompassed 191 general practitioners who answered 12 true/false questions on the knowledge of ASD. The review of literature incorporated scholarly studies published before January 2014, which were located via PsychINFO, PubMed, and Google scholar databases.	For the general knowledge domain, the following ASD alerts were identified: familiarity with typical surveillance tools, discussing the diagnosis with parents, referring patients to specialists prior to confirming the formal diagnosis, and recognition of vulnerabilities for identifying supporting mechanisms. Meanwhile, for the surveillance domain, such red flags were established: assisting the families through transition stages and acknowledging the role of psychopharmacology (medications for co-morbidities and sleep disturbances).	The article is relevant to the proposal since it defends a growing need for helping primary care providers to identify ASD and refer patients to specialists related to the health issue. The study also defends the need for broadening educational activities for future practitioners.	Level I Systematic Review Strengths: – the authors have outlined the need for improving learning activities for nursing educators; – the use of two methods enabled the researchers to obtain more reliable results. Weaknesses: – the sample size was too small to have sufficient power; – the differences between practitioners’ knowledge of general knowledge and surveillance domains were not sufficiently researched.
Giarelli (2011)	“Continuing education for nurses in the clinical management of autism spectrum disorders: Results of a pilot evaluation”	The authors’ focus was on the evaluation of the perceived value of an education program on ASD to nurses. The importance of continuing education for nursing practitioners was also assessed. Researchers also aimed at collecting feedback on the nursing care of ASD patients.	At first, a two-day workshop was offered to the participants in 2010. Thirty-seven practitioners took part in the program, out of which 35% were engaged in adult care, 35% – in child care, and 30% were administrators. In a half year’s time, 77% of the participants reported having applied the obtained knowledge in practice, whereas 23% admitted that they had not had a chance to incorporate their newly acquired skills.	It was found that workshops educating practitioners on ASD patients’ care were highly valuable and crucial. Researchers noted an increase in the level of nursing practitioners’ readiness to help ASD patients adjust to new settings, as well as their ability to discern the signs and symptoms of the disorder. Hence, it was found the educational interventions were rather helpful for nurses.	The study is relevant to the proposal since it explains the inadequate level of nurses’ knowledge of ASD and preparation to work with autistic patients. Therefore, the article serves as additional proof of the importance of adding ASD to the curriculum.	Level IV Non-Experimental (pilot evaluation, purposeful sampling) Strengths: – researchers substantiated the necessity of educating nursing practitioners about ASD; – it was found that those professionals who possess valuable knowledge of ASD can share it with colleagues, thus eliminating the gap in nurse-patient and nurse-family communication. Weaknesses: -the sample size was rather small, which did not allow for generalization of findings; – there was no randomization of sampling, which undermined the study’s reliability.
Iannuzzi (2019)	“Addressing a gap in healthcare access for transition-age youth with autism: A pilot educational intervention for family nurse practitioner students”	The purpose of the study was to evaluate the efficacy of an educational intervention for family nurse practitioner students in improving the process of meeting ASD patients’ healthcare needs. Specifically, researchers focused on transition-age youth patients with ASD.	Fourteen nursing students, all from the University of Massachusetts Medical School’s Graduate School of Nursing’s Doctor of Nurse Practice FNP program, participated in the study. They were divided into two groups: the waitlist control one (eight participants) and the intervention one (six participants). Students were assigned randomly, and their awareness of ASD was evaluated before and after the intervention in such dimensions as self-efficacy, knowledge, and attitudes.	The authors found that participation in an educational intervention had the potential to boost nursing students’ knowledge and increase their self-efficacy concerning ASD transition-age patients. However, researchers were surprised to find that the participants’ attitudes toward ASD patients became more prejudiced after the intervention.	The source is relevant to the proposal since it analyzes the effect of curriculum change on nursing students. The study’s findings indicate that not only is it crucial to include ASD in the curriculum, but it is also important to select the educational content carefully since if done inappropriately, such selection may lead to an increase in prejudiced attitudes toward ASD patients rather than decreasing them.	Level II Randomized Control Trial (pilot study) Strengths: – participants were assigned into groups randomly, which increases the opportunity for results’ reliability; – the inclusion of both quantitative and qualitative data allowed for both quantitative assessment of key outcomes’ changes and qualitative analysis of respondents’ experiences. Weaknesses: – the sample was rather small; in addition, all students were from the same university, which minimized the opportunity for results’ generalizability; – the intervention was limited in time, and it did not presuppose any follow-up measures, which did not allow for evaluating progress in knowledge, self-efficacy, and attitudes over some time period(s).
Igwe (2011)	“Assessment of knowledge about childhood autism among paediatric and psychiatric nurses in Ebonyi state, Nigeria”	The aim of the study was to evaluate pediatric and psychiatric nurses’ knowledge about autism in Ebonyi State, Nigeria, as well as establish the aspects that might affect such knowledge.	With the help of random sampling, eighty nurses (forty pediatric and forty psychiatric) were selected from healthcare facilities of the selected region. Respondents were requested to fill out two questionnaires: 1) on the knowledge about childhood autism among healthcare workers (KCAHW) and 2) a socio-demographic one. The KCAHW contained 19 questions with three options for each. The socio-demographic questionnaire collected data on participants’ age, ethnicity, gender, marital status, and work experience.	Nurses who had previous experience of working with autistic children scored higher than those who had no prior experience. Also, psychiatric nurses demonstrated a better knowledge of ASD than pediatric nurses. However, the total mean score was 12.56 ± 3.23 out of a total of 19 possible, which could not be considered sufficient.	The article is relevant to the proposal since it demonstrates an insufficient level of ASD knowledge among nurses in Ebonyi state, Nigeria. Hence, the suggestion to include ASD in the curriculum could be justified by the study’s findings.	Level IV Single Non-Experimental Designs: Cohort comparison Strengths: – randomized sampling allowed for a diverse pool of participants with different backgrounds and experiences; – the diversity of respondents’ demographic characteristics enables tracing differences in ASD knowledge among various types of specialists with various backgrounds. Weaknesses: – the sample was too small to provide a substantial amount of data for analyzing the differences between ASD knowledge among nurses depending on their age, gender, ethnicity, and other characteristics; – a questionnaire is a tool with a rather low level of reliability, so the study’s findings cannot be considered highly significant; – the questionnaire only gave the point assessment of knowledge; – no evaluation of etiological explanations or respondents’ cultural beliefs was carried out.
Jolly (2015)	“Handle with care: Top ten tips a nurse should know before caring for a hospitalized child with autism spectrum disorder”	The study’s purpose was to offer helpful tips that pediatric nurses could utilize when encountering patients with ASD in their practice. The author noted that ASD children were much more likely to address healthcare facilities than children without such a diagnosis. Hence, the scholar believed that pediatric nurses needed extra advice on how to minimize personnel injury and maximize little patients’ comfort while staying at the hospital.	The author gives ten pieces of advice for pediatric nurses, which, in her opinion, should help these specialists in their practice of working with ASD children. The first of the steps is understanding the diagnosis of ASD as a crucial prerequisite for arranging work successfully. Other tips given by the author include encouraging the involvement of children’s parents in collaboration, selecting the most effective ways of communication, mitigating the challenges posed by hospitalization, scheduling consistent caregivers for autistic children, creating a safe environment, checking for emotional disturbances, utilizing a multidisciplinary team of professionals, and supporting children’s families to encourage their staying. Finally, the author suggested that nurses should write down the steps necessary for communicating with autistic children in order to make collaboration easier both for healthcare professionals and families.	Since the study did not include any experimental or research work, no findings can be reported. However, based on a case scenario provided by the author, it was demonstrated that upon utilizing the tips given in the article, healthcare professionals managed to make the hospital stay of an autistic child more comfortable.	The study is relevant to the proposal since it demonstrates that there are many issues lacking in nurses’ preparation to work with autistic children. Therefore, the article serves as a supporting argument for including ASD in the curriculum in order to avoid crucial knowledge gaps among future nurses.	Level VII Expert Opinion Strengths: – the author has provided a comprehensive list of recommendations on how to work with autistic children in hospital settings; – the problem of pediatric nurses’ insufficient knowledge of ASD patients was raised. Weaknesses: – no clinical trial was performed and no evidence was collected on the positive effect of the author’s tips; – the pieces of advice were not arranged systematically, whereas such an arrangement could simplify nurses’ understanding and memorizing of information.
Major (2013)	“Autism training in pediatric residency: Evaluation of a case-based curriculum”	The purpose of the study was to evaluate the effectiveness of a case-based curriculum focused on autism training for pediatric nursing students.	The curriculum contained seven case-based modules, including early signs of autism, screening for ASD, communication issues, diagnosis, education and intervention, autism treatments, and autism-related guidance. Two types of subjects participated in the study: facilitators (n=34) and learners (n= 191). Learners were pediatrics students, medical students, and other medical professionals. All of the learners belonged to educational institutions in which facilitators worked.	The researchers found significant improvements in learners’ knowledge about autism after getting acquainted with the curriculum. The scholars also found that pediatric nursing students and other medical residents considered ASD education a crucial component of their professional preparation.	The study is relevant to the proposal since it both outlines the significance of ASD education for nursing students and the potential of a special ASD curriculum to provide learners with important knowledge. The authors of the article found that many pediatric students felt that their knowledge about ASD was insufficient, which confirms the positive effect of curriculum changes.	Level IV Non-Experimental (descriptive, cross-sectional study) Strengths: – a variety of educators’ students’ professional directions allowed for researching a diverse field of practice in regard to ASD knowledge; – conducting pre- and post-tests allowed for a better comparison of participants’ levels of knowledge about ASD. Weaknesses: -the study allowed only for short-term change evaluation, whereas long-term knowledge alterations were not researched; – the sample was too small to allow researchers to compare data concerning different modules of the curriculum (each facilitator had one of seven modules at their disposal).
McCarthy (2014)	“Undergraduate pediatric nursing education: Issues, challenges and recommendations”	The purpose of the research was to collect data on the content of undergraduate pediatric nursing education. Specifically, scholars aimed at singling out barriers (actual and potential) to implementing the pediatric curriculum. Additionally, researchers sought recommendations for the improvement of the curriculum.	The sample was composed of the American Association of Colleges of Nursing member programs (n=596). 460 responses to the 39-point survey were obtained, and 344 remained upon the removal of duplicate responses and elimination based on demographic characteristics. The survey consisted of five sections: demographics, the faculty, clinical experiences, didactic curriculum content, and perceived barriers to the implementation of pediatric learning objectives.	It was found that the current pediatric curriculum is largely focused on acute care, whereas pediatric genetics is not given proper attention. Furthermore, researchers report that most nursing programs lack access to clinical practice sites. Hence, the curriculum requires changes in order to prepare pediatric nursing students for their future work in the most effective way.	The study is relevant to the proposal in that it substantiates the need for the inclusion of child-specific health issues in the curriculum of pediatric nursing education. Researchers emphasize the insufficient number of academic hours allocated to pediatric genetics, child nutrition, and environmental health.	Level IV Single Non-Experimental Designs Strengths: – a large sample allowed for gathering a sufficient amount of data from participating institutions, which increased the generalizability and reliability of findings; – the combination of open-ended and close-ended questions in the survey minimized the risk of questions being misunderstood by respondents. Weaknesses: – the survey did not specify the participants’ level of knowledge, on which the results might have depended, and which could have affected the findings’ quality; The question on the number of undergraduate faculty with pediatric teaching responsibilities included an option “5+,” which did not allow for accurate calculation of such faculty.
Sampson (2018)	“Comparative study on knowledge about autism spectrum disorder among paediatric and psychiatric nurses in public hospitals in Kumasi, Ghana”	The purpose of the study was to evaluate the knowledge of ASD among pediatric and psychiatric nurses working in public hospitals of Kumasi, Ghana. The authors aimed at assessing these specialists’ readiness to work with ASD children and singling out the major barriers to successful work.	130 pediatric and 93 psychiatric nurses from five public hospitals in the selected area participated in the study. The researchers utilized the KCAHW questionnaire to assess the participants’ knowledge of ASD.	Findings indicated that psychiatric nurses’ knowledge of ASD was more profound than that of pediatric nurses. The findings referred both to the questionnaire in general and to each dimension (social interaction impairments; communication impairments; obsessive and compulsive behavior patterns; general knowledge of ASD and comorbid conditions) in particular. However, the level of knowledge about ASD among both groups of nurses is too low to be considered sufficient.	The study is relevant to the proposal since its findings indicate that ASD should be included in the clinical training curriculum in order to enhance nurses’ knowledge of ASD and ability to provide effective care and comfortable conditions to autistic patients.	Level IV Single Non-Experimental Designs: Cohort comparison Strengths: – the inclusion of both pediatric and psychiatric nurses allowed for comparing the differences in these specialists’ knowledge about ASD; – the authors substantiated the fact that the nursing curriculum should be altered through the inclusion of the ASD-related topics. Weaknesses: – the study was rather limited in demographic terms (all participants were from one geographic location), which indicates a low level of generalizability; – the use of a questionnaire as a research method decreases the study’s reliability since self-administered questionnaire typically have a low level of credibility and objectiveness.

Table 2. Curriculum Need-Gap Analysis

Instructional Objectives	Current Curriculum	Desired Curriculum	Need Gap	Action Steps to Meet the Need Gap
Throughout this module, students will be able to: – examine the role of the baccalaureate-prepared nurse in the care of autistic children; – analyze various treatment modalities depending on ASD child’s peculiarities; – discuss proper nursing interventions for the care of autistic children; – apply effective communication techniques aimed at arranging pediatric patients’ comfortable stay in the hospital; – demonstrate critical thinking in assessment and care planning.	1. Current curriculum educates students on the basics of psychological disorders in children and adults; 2. The curriculum does not include a module on ASD, thus leaving a gap in learners’ preparation.	Introduction of the Nursing Care of the Autistic Child module to the Psych-Mental Health Nursing I course to promote nursing students’ knowledge about ASD patients and prepare them to planning and utilizing the most effective practices when working with such patients.	– nursing students should be prepared to provide high-quality care to ASD patients; – learners should be capable of identifying ASD behaviors and their types in patients; – students should be able to address the emotional and physical needs of ASD patients; – learners should be prepared to arrange effective communication with pediatric ASD patients and their parents/caregivers to create the most effective plan of care.	1. Prepare a proposal to submit for faculty’s approval. 2. Present the proposal to stakeholders. 3. Arrange the collaboration of stakeholders. 4. Apply the ADDIE model for the proposal’s implementation.

Diagram 2. Force Field Analysis (Organizational Readiness for Curriculum Proposal)

Appendix A: Course Syllabus

NAME University

College of Nursing

Psych-Mental Health Nursing I

Instructor:

Instructor Email:

Office Location: College of Nursing

Office Hours: As posted and by appointment

Phone: 000-000-0000

Course Information

Prerequisite:

Co-requisite: XXX, or permission of instructor

Course Description: (5 credit hours):

This course is designed to provide learners with an opportunity to apply theories and implement evidence-based care for clients with psychiatric/mental health issues, including psychosocial concepts; cultural, ethical, and legal influences; and wellness of individuals and family groups. Students will also be able to develop their professional role in psychiatric/mental health nursing. The process of correct treatment of autistic patients is included in the course with the aim of simplifying nursing students’ work. Based on the course, learners will be able to manage the challenges and barriers existing in communication with ASD children. As a result, nursing students will determine the best practices for managing autistic children’s needs and apply them in their work. Content is presented with scrupulous attention to detail and explores the psychological peculiarities of ASD children’s behavior, including compulsions, obsessions, and communication barriers. Students will be immersed in a variety of scenario-based learning activities promoting critical thinking, autonomy, and collaboration.

Course Objectives:

Upon successful completion of this course, learners will be able to:

Analyze the baccalaureate-prepared nurse’s role in nursing care of the autistic child.
Examine the psychological peculiarities of autistic children and develop a treatment plan in accordance with them.
Apply knowledge of ASD to identify the issues that might hinder treatment and alleviate these issues.
Apply a holistic approach to nursing care for the autistic child.
Analyze how nursing can be assisted through computer-assisted instruction, group work, discussions, seminars, audio-visual aids, independent study of texts and other resources, clinical assignments, and return demonstration.

Student Learning Outcomes:

Analyze selected nursing and psychological theories used in psychiatric/mental health settings.
Examine the legal, economic, sociocultural, and ethical issues impacting the psychiatric/mental health delivery system and apply them in the clinical setting.
Discuss clinical modalities and psychiatric terminology as it relates to psychiatric/mental health nursing practice.
Utilize principles of evidence-based practice in psychiatric mental health nursing.
Compare and contrast the difference in mental illnesses in clients in urban and rural geographic areas.
Identify barriers to care for patients with psychiatric illnesses in the rural setting.
Identify competent, culturally sensitive, and compassionate nursing interventions and techniques for patients and their families that demonstrate respect for the patients’ preferences.
Apply the nursing process, nursing research, and evidence-based practices to provide nursing care and promote health and wellness among autistic children.

Materials- Textbooks, Readings, Supplementary Readings

Textbook(s) Required:

Halter, M. J. (Ed.). (2014). Varcarolis’ foundations of psychiatric mental health nursing: A clinical approach (7th ed.). Saunders.
Hazen, E. P., & McDougle (Eds.). (2018). The Massachusetts General Hospital guide to medical care in patients with autism. Humana Press.
Iyama-Kurtycz, T. (2020). Diagnosing and caring for the child with autism spectrum disorder: A practical guide for the primary care provider. Springer.

Other Resources:

Centers for Disease Control and Prevention. (2020b). What is autism spectrum disorder? Web.

Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. Lancet, 392(10146), 508-520. Web.

National Institute of Mental Health. (2018). Autism spectrum disorder. Web.

Course Requirements

Instructional / Methods / Activities Assessments

This is a blended course without lecture requiring students to complete online activities and independent study to be successful. Course objectives may be met through individual study using suggested resources, active involvement in classroom activities, formal, and informal exchange of ideas with classmates and colleagues regarding specific topics as well as utilizing critical thinking skills. Teaching methods include seminar, discussion, small group work, independent study of texts and library resources, computer-assisted instruction, audio-visual aids, return demonstration, clinical assignments and supervision, post clinical conferences and check-off of appropriate skills and the assignments listed. While the professor will provide guidance and consultation, the student is responsible for identification of learning needs, self-direction, seeking consultation and demonstration of course objectives.

Grading

Grades will be determined as follows:

Grading Scale:

A = 90-100
B = 80-89
C = 75-79
D = 67-74
F = 66 and Below

A minimum grade of 75 is required to pass the course.

The Course grade will be earned as follows:

Exams (3-16% each)	48%
Online Case Studies (7 @ 5%)	35%
Online Quizzes (5 @ 1%)	5%
Group Presentation	8%
Class/Clinical Experience Paper (2 @ 2%)	4%
NXCLEX Practice Exam	Cr/NC
HESI Practice/HESI Exam	Cr/NC
TOTAL	100%
Clinical	PASS/FAIL

Specifics on course assignments for both class and clinical are in the assignments listed below. The HESI Psychiatric/Mental Health Exam must be passed with a score of 850 or greater. If you do not achieve this score, you will have to undergo remediation and retesting as indicated in the Student Guide.

The clinical component is PASS/FAIL and must be passed in order to pass the course. To receive a passing grade in clinical you must achieve at least 75% on the clinical assignments and receive a satisfactory clinical evaluation.

Technology Requirements

This course will be enhanced using eCollege, the Learning Management System used by NAME University. To login to the course, go to: XXXXXXXX.

You will need your WUID and password to log in to the course. If you do not know your WUID or have forgotten your password, contact Technology Services at 903.468.6000 or [email protected].

The following hardware and software are necessary to use eCollege.

Internet access/connection-high speed recommended (not dial up)
Word Processor (MS Word, or Word Perfect)

Our campus is optimized to work in a Microsoft Windows environment. This means our courses work best if you are using a Windows operating system (XP, Vista, 7 or 8) and a recent version of Microsoft Internet Explorer (6.0, 7.0, 8.0, or 9.0).

Your courses will also work with Macintosh OS X or better along with a recent version of Safari (5.1 is now available). Along with Internet Explorer and Safari, eCollege also supports the Firefox browser (3.0) on both Windows, and Mac operating systems.

It is strongly recommended that you perform a “Browser Test” prior to the start of your course. To launch a browser test, login to eCollege, click on the “myCourses” tab, and then select the “Browser Test” link under Support Services.

Communication and Support

Interaction with Instructor Statement:

It is expected that you will check your eCollege course and email at least DAILY for communication from the instructor.

Communication between faculty and students is primary and taken seriously. Preferred communication methods are individualized office hours, email, or via office phone. If a phone call is not answered please leave a message and send an e-mail using the direct e-mail link on the course home page. You will be treated with collegial respect and you are expected to communicate likewise in a professional manner.

Course and University Procedures/Policies

Class

Class Cancellation: If a class is canceled, the student is expected to do the readings and complete the objectives for that day. The content will still be included on examinations. The material in this syllabus and dates identified in the Course Calendar are subject to change.
Class attendance is expected. The students should notify course faculty in advance of any absence.
Exam dates are listed in each course syllabus, and the student is expected to be present for exams. If the student will be absent, the course instructor must be notified in advance. Failure to do so will result in the student receiving a zero for the missed exam or quiz. Review NAME University catalog for excused absence criteria.
As an adult learner and responsible professional, the student is responsible for reading and completing assignments prior to class and for being prepared to participate in discussions over the assigned material. It should not be expected that all material will be covered in class. Students are expected to come to class prepared.
Assignments must be handed in on time. Assignments submitted late without prior arrangement with the classroom instructor will receive a zero.

Nursing Skills Laboratory

Students are responsible for assigned readings in textbooks and completing DVD and other assignments prior to lab. Participation in discussions over the assigned material is expected. Failure to prepare will result in an unsatisfactory for the lab session. All lab sessions must be completed satisfactorily to progress to the clinical setting.

Students must adhere to the clinical dress code for skills laboratory sessions. Refer to the Nursing Student Guide for policy information.

Students with Disabilities:

The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides comprehensive civil rights protection for persons with disabilities. Among other things, this legislation requires that all students with disabilities be guaranteed a learning environment that provides for reasonable accommodation of their disabilities. If you have a disability requiring an accommodation, please contact: Office of Student Disability Resources and Services NAME University-Commerce Gee Library Room XXX Phone (XXX) XXX-XXXX Fax (XXX) XXX-XXXX [email protected]

Student Conduct Code – Refer to the BSN Student Guide

Students must adhere to standards of professional and academic conduct Academic misconduct involves any activity that tends to compromise the academic integrity of NAME University, or subvert the educational process, including, but not limited to, cheating, plagiarism, falsifying academic records, misrepresenting facts and any act designed to give unfair academic advantage to the student or the attempt to commit such an act. Students are responsible for their own academic honesty and for reporting violations of academic honesty by others.

Course Outline / Calendar

Week	Content	Reading Assignments Varcarolis	Class Meetings/Class Assignments/Exams
1 1/13	Course Overview	Syllabus	Orientation @ 12:30 pm
2 1/20	Basic Concepts/ Effective Communication	Chapters 1, 3, 7 (120-21), 35	Facility Orientation 1/21 @ 0800 Simulation 1/21 @ 1000 Experience Paper due 1/24
3 1/27	Theories & Therapies	Chapters 2, 33
4 2/3	Legal, Ethical & Cultural	Chapter 4, 5. 6	Class Meeting 2/6 @ 0800 Quiz due 2/7
5 2/10	Schizophrenia	Chapters 12, 3 (applicable portion)	Psychosis Case Study due 2/14 Schizophrenia Case Study due 2/14
6 2/17	Bipolar	Chapters 13, 3 (applicable portion)	Class Meeting 2/20 @ 0800 Quiz due 2/21
7 2/24	Depression	Chapters 14, 3 (applicable portions)	Exam 2/28 @ 0800 Depression Case Study due 2/28 Major Depression Case Study due 2/28
8 3/3	Anxiety	Chapters 10, 15, 3 (applicable portions)	Class Meeting 3/6 @ 0800 Quiz due 3/7
3/10	Spring Break
9 3/17	Children & Adolescents	Chapters 11, 34, 3 (applicable portions)	ADHD Case Study due 3/21 Autism Case Study due 3/21
10 3/24	Suicide	Chapter 25, 26	Class Meeting 3/27 @ 0800 Quiz due 3/28
11 3/31	Personality	Chapters 24, 3 (applicable portions)	Exam 4/4 @ 0800
12 4/7	Violence	Chapters 27, 28	Class Meeting 4/10 @ 0800-Group 1 & 2 Quiz due 4/11
13 4/14	Addictive	Chapters 22, 3 (applicable portions)	Alcoholism Case Study due 4/18
14 4/21	Sexual assault	Chapter 16, 29	Class Meeting 4/24 @ 0800-Group; 3 & 4 NCLEX Questions due in class
15 4/28	Eating	Chapters 18, 3 (applicable portions)	Exam 5/2 @ 0800 Eating Disorders Case Study due 5/2 Experience Paper due 5/2
16 5/5	Finals Week		HESI Practice exam due 5/6 HESI Exam 5/9 @ 0800

Lecture Assignments

Examinations

48% total, 16% each 2/28; 4/4; 5/2

There are a total of three examinations in this class on the dates identified. They will cover all the topics covered in class as of one week prior to the examination date. The examinations will include terminology from the applicable chapters in the textbook. The questions will be in multiple formats: multiple choice, multiple answer, matching, etc.

Online Case Studies

35% of grade, 5% each

There are seven case studies to be completed and submitted either on Evolve or in the Dropbox by 2359 on the date indicated. You will receive the score that you receive when you complete the case study:

Evolve Case Study-Psychosis 2/14
Evolve Case Study-Schizophrenia 2/14
Evolve Case Study-Depression 2/28
Evolve Case Study-Major Depression 2/28
Evolve Case Study-ADHD 3/21
Evolve Case Study-Autism 3/21
Evolve Case Study-Alcoholism 4/18
Case Study-Eating Disorders 5/02

Online quizzes

5%, 1% each 2/7; 2/21; 3/7; 3/28; 4/11

There are five quizzes on eCollege on the important terminology for the indicated modules. These are due by 2359 on the date indicated

Group Presentation 8%

4/10 or 4/24

Students will be divided into groups and each group will be assigned a theatrical movie that deals significantly with a psychiatric or mental illness. The movies are all available for rental and/or streaming. They include: The Soloist; Black Swan; Silver Linings Playbook; and Side Effects. Each member of the group is to watch the movie. As a group, describe what mental illness or illnesses were portrayed and if it was appropriate to the illness based on the accepted signs and symptoms of the condition. Analyze why you feel the changes were made or not made to the illness for purposes of the movie. Discuss how this portrayal influences society’s view of psychiatric and mental illnesses. There is no paper for this assignment.

The group will present informally to their classmates and lead a discussion with the following information on the assigned date:

Summary of the movie, including illness in the movie
Were the illness (es) portrayed accurately? Why and/or why not?
Why were changes made, if any, for the movie?
How does the movie influence society’s view of mental illness?

This presentation is a group or team project. All members of the group receive the same grade, see grading rubric on eCollege. However, a student can be removed from his/her group if the other students in the group come to the instructor and report that a student is not doing his/her fair share of the work. If that happens, the student will be notified in writing by the instructor. The student will then be responsible for doing the assignment on his/her own.

Class/Clinical Experience Paper 2%

1/24

Write a paper that includes the following: 1) Discuss at least three (3) aspects of the upcoming class/clinical experience that you are looking forward to. Analyze what factors in these experiences make you feel positive about them; 2) Describe at least three (3) aspects of the

upcoming class/clinical that you are most apprehensive or uncertain about. Analyze the factors in these experiences that are influencing your reaction; 3) Identify at least three (3) SPECIFIC actions you can take throughout the semester to reduce your apprehension or uncertainty.

The paper should be no less than two (2) and no more than three (3) pages typed double spaced in APA format. Place your name at the top of the first page. You do not have to have a title page or reference page. See grading rubric on eCollege. Submit it by 2359 on the due date on eCollege.

Class/Clinical Experience Paper Evaluation 2%

5/2

Write a paper that evaluates the results of your experience in class/clinical during the semester. Refer to the paper you wrote at the beginning of the semester. Analyze both the positive and negative experiences you were expecting.

NCLEX Review Questions

Cr/NC

4/24

To assist in preparing students for the HESI examinations and the NCLEX examination, you are required to complete a total of 250 NCLEX questions related to psychiatric/mental health and/or therapeutic communication during the semester. NCLEX review questions must be taken via computer (CD-ROM or any other computer application) and must be completed and submitted as one grade. The printed form showing the score and the number of questions completed should be brought and shown to the classroom instructor on class days. All questions must be completed by April 24th.

HESI Psych/Mental Health Practice Examination Cr/NC

5/6

Complete online non-proctored exam by May 6th with a score of 90% or better to receive credit.

HESI Psychiatric/Mental Health Examination Cr/NC

5/9

Complete proctored exam on May 9th with a score of 850 or better to receive credit. If you receive below 850, you will have to complete remediation and re-take the examination to receive credit. For scores on the HESI of 900-949, you will receive 1 extra point for your grade; for scores of 950-999, you will receive 2 extra points and for scores of 1000 and greater, you will receive 3 extra points.

Curriculum Map

Course objectives	AACN BSN Essentials
1. Analyze the baccalaureate-prepared nurse’s role in nursing care of the autistic child.	I, II, III, VIII, IX
2. Examine psychological peculiarities of autistic children and develop a treatment plan in accordance with them.	III, VI, VII, VIII
3. Apply knowledge of ASD to identify the issues that might hinder treatment and alleviate these issues.	I, II, III, IV, IX
4. Apply a holistic approach to nursing care for the autistic child.	I, III, VI, VII, IX
5. Analyze how nursing can be assisted through computer-assisted instruction, group work, discussions, seminars, audio-visual aids, independent study of texts and other resources, clinical assignments, and return demonstration.	I, IV, IX

Course Content Outline

Course Objective	Course Content	Key Concepts
1. Analyze the baccalaureate-prepared nurse’s role in nursing care of the autistic child.	Standards and scope of practice in pediatric and psychiatric nursing	Baccalaureate-prepared nurse’s role in nursing care of the autistic child
2. Examine psychological peculiarities of autistic children and develop a treatment plan in accordance with them.	Introduction to nursing care of the autistic child; Complex psychiatric nursing	ASD signs and symptoms, typical ASD behaviors, obsessions, and compulsions
3. Apply knowledge of ASD to identify the issues that might hinder treatment and alleviate these issues.	Care delivery models for autistic pediatric patients	Psychological peculiarities of ASD children Difficulties in the assessment of ASD children
4. Apply a holistic approach to nursing care for the autistic child.	Holistic nursing care for the autistic child	Incorporating ‘the whole person’ approach while providing care: preferences, family, values
5. Analyze how nursing can be assisted through computer-assisted instruction, group work, discussions, seminars, audio-visual aids, independent study of texts and other resources, clinical assignments, and return demonstration.	Safety considerations; Communication and collaboration	Lifelong education Professional development Enrichment and enhancement of skills

Appendix B: Course Materials (including PowerPoint presentation)

Course Unit Overview

This course is designed to provide learners with an opportunity to explore nursing care of the autistic child using evidence-based standards across the continuum of care. The psychological peculiarities of autistic children’s behavior are reviewed along with the risk factors influencing this patient group’s health and well-being in order to determine the best nursing practices for managing these risks. Content is presented with scrupulous attention to detail, which allows for the thorough exploration of autistic children’s developmental and psychosocial characteristics associated with health promotion and maintenance. The module is focused on nursing care for the autistic child, along with the approaches to communicating with caregivers and collaborating with healthcare specialists from various disciplines. Students will be immersed in opportunities that will enable them to translate theory to practice at the baccalaureate level.

Lecture Content

Learning Resources

Textbook(s) Required

Halter, M. J. (Ed.). (2014). Varcarolis’ foundations of psychiatric mental health nursing: A clinical approach (7^th ed.). Saunders.

Hazen, E. P., & McDougle (Eds.). (2018). The Massachusetts General Hospital guide to medical care in patients with autism. Humana Press.

Iyama-Kurtycz, T. (2020). Diagnosing and caring for the child with autism spectrum disorder: A practical guide for the primary care provider. Springer.

Other Resources

Centers for Disease Control and Prevention. (2020b). What is autism spectrum disorder? Web.

Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. Lancet, 392(10146), 508-520. Web.

National Institute of Mental Health. (2018). Autism spectrum disorder. Web.

Learning Activities

Scenario-Based Learning Activity

Overview: Students will be assigned randomly to one of two different case studies available to them via the module’s online resources. Each learner will work independently on the case study assigned to them. Upon completing their case studies, students will be placed in groups based on the case study assigned to them. Group discussions about the individual experiences and findings will promote the development of learners’ skills and encourage their reflective practice via collaborative learning with peers. Group work will enable students to engage in active collaboration that will help them to process and apply information, as well as analyze and synthesize it to facilitate a student-centered learning process.

Directions

Part 1: working independently. Work on the case study assigned to you. Complete all work independently. Analyze how the nurse in the scenario should develop a patient care plan in order to gain the best patient outcomes and serve as a patient advocate. Think about the specialists you would include in the interprofessional team to work with the patient. Consider the ways of communicating with the patient’s parents/caregivers. At the end of the scenario, there are questions that will guide your work on the case study.

Part 2: group work. Discuss your findings/assumptions/conclusions. What did your peers plan to do similarly? What did they do differently? Who do you think would have gained the best patient outcomes? Now that you have listened to your peers’ ideas, would you change yours? What have you learned from your peers’ experiences? Is there anything you would suggest to them?

Prepare a discussion board post based on your discussions. Share your post with the other groups and respond to one another’s scenarios and findings.

Scenario

N. is a nine-year-old girl admitted to the hospital with sharp pain in the chest. The girl’s mother says that it is possible that N. has swallowed a small piece of a toy, so the doctor needs the girl to have an X-ray. Upon seeing the doctor and hearing that she should undergo some unknown procedure, N. starts crying and throwing tantrums, which is bad both for her physical and psychological state. The girl’s mother is devastated and says they should probably go home. However, if the girl has indeed swallowed something, it is quite dangerous to let them go.

As a nurse, what are your actions? How could the situation have been prevented? How should the doctor have presented the procedure? What can you do to make the mother stay and let the doctor have the girl examined? What communication strategies would you employ? What specialists, if any, would you engage in solving this situation?

M. is a seven-year-old boy who has been admitted to the hospital two weeks ago with pneumonia. The boy has a repetitive behavior which is manifested in ordering his toy cars in the same way on a tray that is placed in his bed. When it is time to do some procedures, the nurse waits for the boy to have the cars arranged, which makes him calm down and allows him to tolerate the necessary hospital routine. This morning, a new doctor arrives, who has not been informed about the boy’s ASD diagnosis. The doctor is in a hurry because he has an appointment planned with the hospital administration. He decides that “the boy is too old to be allowed to play during serious procedures” and takes away the tray with the cars. The boy immediately becomes enraged and pulls out all the tubes and monitors attached to him and his bed. As a nurse, what are your actions? How can you help the boy calm down and agree to continue treatment? How will you explain the situation to his parents? Do you think the doctor should continue working with this patient? If yes, how should they arrange their cooperation? If no, why, and what should the new doctor do to arrange a friendly relationship with the boy?

Activity

Overview of activity: Upon reviewing course materials, students’ understanding and knowledge of child autism will be evaluated via participating in a simulated activity. This assignment will allow learners to apply their knowledge, evaluate their readiness to work with autistic children, discern the signs and symptoms of ASD in pediatric patients, and come up with solutions to treatment.

Directions: Learners will be divided into groups of three for this assignment. Every student will assume a role of a nurse for the purpose of the activity. For each group, there will be a ‘patient’ (a student from a different group so that every student could participate in the activity not passively but actively). The patient will present some signs and symptoms, which the ‘nurses’ should carefully analyze and decide whether the ‘patient’ has ASD and what his main signs and symptoms are. Every ‘nurse’ should take notes and write down the diagnosis. Students will have two days for the activity: one day for working with the ‘patient’ and making notes, and another day for discussing them. The group should decide whether the ‘patient’ is an autistic child or not, come up with differential diagnoses, and back up their decision with scholarly resources. The educator will assess each group’s findings and evaluate students depending on such factors:

the correctness of the diagnosis
the ability to work in a team (quality of discussion, application of analysis and persuasion)
the knowledge of ASD and similar disorders and the ability to discern one from the other.

Appendix C: Assessments (Formative, Summative Objective, Summative Performance)

Formative Assessment

Directions: Students will do a five-question quiz. For each question, they will choose one answer: A, B, C, D, or E. In question 4, they will choose ‘all that apply.’

Questions

SELECT ALL THAT APPLY. Which of the following is a typical behavior of an ASD child?

avoiding eye contact
showing a lot of interest in peers
lining up toys in a particular order
repeating the same words or phrases over and over
focusing on specific parts of objects

Which of these characteristics is the most typical of autistic children?

delayed language skills
delayed cognitive skills
delayed movement skills
all of the above
none of the above

When should autism-specific screening occur?

at the 9-, 18-, and 24- or 30-month visits
at the 9- and 24-month visits
at the 18- and 24- or 30-month visits and whenever a concern is expressed
at the 18- and 24- or 30-month visits
at the 24- and 30-month visits and whenever a concern is expressed

SELECT ALL THAT APPLY. What social communication skills are the most typical for an autistic child?

does not respond to his/her name by the age of 9 months
does not use gestures such as waving goodbye by the age of 12 months
shows the surprised face by the age of 9 months
likes looking at what a parent is pointing by the age of 18 months
does not play simple interactive games by the age of 9 months

Which of the following are the most typical comorbidities of ASD?

anxiety disorders
attention-deficit/hyperactivity disorder
depression
all of the above
none of the above

Answer Key:

a, c, d, e
d
c
a, b, e
d

Summative Objective Assessment

This objective assessment contains a total of 10 items, each of them worth 10 points, for a total of 100 points. Students must answer a minimum of 8 out of 10 questions correctly to score at a passing grade of 80% or better.

You are a nurse taking care of an autistic child. You have noticed that the child refuses to eat the food brought to the ward. What should you say to the patient to improve the situation?

Don’t you know that you should eat to stay healthy?
Would you mind telling me about your favorite food?
If you don’t eat, you will need an injection of glucose to keep your organism working properly.

You are working a night shift, and an autistic child asks you to stay with them. What is the correct way of behavior in this situation?

You tell the child you have to help all patients and cannot stay in their ward
You tell the child you will check on him or her from time to time to make sure they are comfortable
You make sure your beeper is working correctly in case any other patient needs you and stay in this child’s ward

A child is admitted on your shift. You notice some signs of ASD, but there is no indication of the disorder in the child’s EHR. How do you approach parents?

You tell them their child most likely has autism and ask why it is not mentioned in the EHR.
You notice that the child behaves in a strange way and ask whether it is a typical behavior.
You cautiously and gently ask parents about the things that you consider ASD symptoms. E.g. “I can see that your daughter is covering her ears when I am speaking. Am I talking too loud for her comfort level?”

The head nurse announces that starting from tomorrow, rotation in the ward where an autistic child is staying will occur every 12 hours. The child has been at the hospital for a week and is scheduled to be discharged the next day. What are your actions?

You ask the head nurse to reconsider her decision
You prepare the schedule and inform all nurses about their shifts
You ask the nurses to change their shifts so that the same nurses stay with the autistic child irrespective of the new order.

When making rounds, you notice that an autistic child, who had been playing with his toy cars all day long yesterday, is very sad and quiet. You still have several wards to check. What are your actions?

You continue making rounds since it is your primary duty.
You continue making rounds but try to find someone who will cheer the child.
You ask your team members to continue without you and stay with the boy to inquire into the matter.

A four-year-old girl is admitted to your unit with sharp ear pain. Along with that, parents are concerned about the girl’s psychological health. What are your steps in trying to identify whether she has autism?

You perform a thorough analysis of the child’s behavior by observing her for several minutes.
You observe the child for several hours.
You conduct a parent interview and interact with the child directly.

As a nurse taking care of an autistic child staying in a ward with a non-autistic child, what should you ensure?

That the autistic child has the opportunity to engage in his routine tasks.
That the non-autistic child does not disturb the autistic child.
That both children have plenty of opportunities for communication.

Out of these three children, which one would you consider to have the highest risk for autism?

The child sits in one position, becomes afraid when the bright light is on, and loves to arrange toys by size.
The child loves reading books, is fidgety, and gets upset easily.
The child is constantly rocking, arranges toys by size or color, and avoids the company of peers.

As a nurse, what is your position when the parents of an autistic child want to interrupt the treatment and to take the child home?

Let them go on condition that they will continue treatment at home.
Try to convince the parents that the child is safer at the hospital where he is under constant supervision.
Try to persuade the parents that by disrupting the treatment process, they will deteriorate his psychological condition.

A 12-year-old boy, who was admitted yesterday, is staying in your hospital unit. You notice that some of the crucial questions were missed upon the child’s arrival, and at the moment, parents are not available. How do you obtain the crucial information?

Ask the child since he is old enough to answer those questions.
Call the boy’s parents and request them to come immediately.
Wait till the parents come to visit their son and ask them everything you need.

Answer Key:

B (new foods can cause anxiety, so you must make sure the child receives the food he/she is accustomed to).
C (autistic children often have trouble getting to sleep. If not supported, they may not fall asleep at all, which will deteriorate both their psychological and physical conditions)
C (it may come as a shock to parents. You should be extremely gently and polite).
A (you should act as a patient advocate and protect the child from excessive anxiety)
C (routine is extremely important for ASD children. It is necessary to find out what has happened as soon as possible and return the child into his habitual environment)
C (the most comprehensive approach should be used)
A (the most important thing for autistic children is their routine – hence, you must make sure they have an opportunity to maintain it)
C (these are the most typical characteristics of ASD children)
B (you should first of all care about the patient’s interests: you need to make sure that the disease with which the child was hospitalized has been cured before discharging the patient)
C (autistic children, when if seeming mature, are likely to develop anxiety in critical situations. The child may become afraid of questions, so it is best to wait for the parents).

Summative Performance Assessment: Care for the Autistic Child Research Paper

Directions: Throughout the module, you have had an opportunity to explore the peculiarities of nursing care for the autistic child using evidence-based standards, textbook readings and other resources, scenario-based learning activities, and other activities that enriched your knowledge of ASD and prepared you to apply it in practice. For this assignment, your task will be to conduct research and develop a scholarly paper related to an autistic child. This will help you to be prepared to encountering ASD patients when working as a nurse. In this scholarly paper, you will be investigating and discussing the signs and symptoms of ASD, clinical manifestations, and nursing interventions. You will also provide a nursing care plan and prepare a thoughtful reflection based on your knowledge, skills, and attitudes about ASD before and after completing this module. APA7 and professional communication are required for the successful completion of this assignment. Please review all learning resources and activities and refer back to the grading rubric to make sure that you have followed all the requirements. In case you need clarification on any part of the assignment, feel free to contact your nurse educator.

Description of Assessment: You will write a six-page paper on ASD following the given outline:

Introduction/Background: Provide an introduction to the topic. Explain its significance and relevance.
Pathophysiology: Explain the pathophysiology of ASD.
Clinical Manifestations and Diagnostics: Describe clinical manifestations of ASD and the diagnostic tools that can help in the identification of the issue.
Medical Management: Describe the medical approaches to managing the topic. Analyze in what cases medical management is applicable and on what occasions it is better to avoid it.
Nursing Interventions: Suggest at least two nursing interventions that could be employed in managing an ASD child’s case. Provide a rationale for your choice of interventions.
Reflection: Discuss your knowledge and attitudes toward ASD prior to the completion of this module versus upon completion. Analyze your self-awareness related to nursing practice with ASD children. Dwell on how your current nursing practice has changed or will change after the completion of this module. Discuss how you can be an advocate for ASD children’s and their families’ needs at your workplace. If not currently employed, discuss how you plan to advocate for change in ASD management at your future workplace.
References: A minimum of five peer-reviewed journal articles is required. Sources must be from the past five years.
APA Guidelines: Follow APA guidelines strictly when developing your scholarly paper. Ensure title page, font, paragraph format, page numbers, line spacing, headings, and subheadings conform to APA7 guidelines.

Rubric

Task	Exemplary	Very good	Poor	Fail
1. Introduction/ Background	A highly engaging introduction to the topic. Exceptional explanation of the topic’s significance and relevance.	Very good explanation of the topic’s significance and relevance.	Significance/relevance is not described; the introduction contains general information with no insight into the topic.	Introduction is absent.
2. Pathophysiology	Pathophysiology is thoroughly described ad discussed. It is backed up with scholarly sources.	Pathophysiology is discussed thoroughly, with at least one source used to back up the material.	Only a few sentences are provided on pathophysiology. No supporting materials are used.	The discussion is poor or absent. The student does not understand the pathophysiology of ASD.
3. Clinical Manifestations and Diagnostics	A thorough discussion is provided, including examples and supporting arguments from scholarly resources.	A thorough discussion is provided, including either examples or supporting arguments.	The discussion is poor. The student discusses either manifestations or diagnostics. No examples are given.	The discussion lacks coherence. The student does not understand how to diagnose ASD.
4. Medical Management	A thorough discussion and analysis of the medical management of ASD are provided. The learner is aware of all possible management practices and their side effects. The student understands the need for a careful selection of medications.	A thorough discussion and analysis of the medical management of ASD are provided. The learner is aware of the majority of possible management practices and their side effects.	The medical management is discussed very briefly, and the discussion does not reflect a deep understanding of the topic.	The discussion of medical management practices is absent.
5. Nursing Interventions	The student provides two or more nursing interventions with a thorough description and rationale of their choice.	The student provides two nursing interventions with a sufficient description and a rationale.	The student provides at least one intervention but does not support it with the description or rationale.	The student does not provide any interventions.
6. Reflection	The student provides an exceptionally thoughtful and engaging self-reflection with a deep analysis of the skills gained and missing.	The student provides a highly competent self-reflection.	The self-reflection is rather brief or poorly structured.	The self-reflection is both brief and poorly structured.
7. References	Five peer-reviewed articles published within the past five years are used.	Five peer-reviewed articles are used. One of them was publisher earlier than within the past five years.	Two or three articles are used. One or two of them are outdated.	The student violates the requirements concerning the number or publication date in three or more sources.
8. APA Guidelines	The paper contains no grammatical or stylistic mistakes. All APA requirements have been followed.	The paper contains 1-2 minor mistakes. All APA guidelines have been followed.	The paper contains 5-10 grammatical mistakes and 3-5 format violations.	APA has not been followed. The paper contains many grammatical and stylistic mistakes.

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