PRAC 6655 Assignment Clinical Hour and Patient Logs

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PRAC 6655 Assignment Clinical Hour and Patient Logs

PRAC 6655 Assignment Clinical Hour and Patient Logs

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Clinical Hour Log

For this course, all practicum activity hours are logged within the Meditrek system. Hours
completed must be logged in Meditrek within 48 hours of completion in order to be
You may only log hours with Preceptors that are approved in Meditrek. Students with
catalog years before Spring 2018 must complete a minimum of 576 hours of supervised
clinical experience (144 hours in each practicum course). Students with catalog years
beginning Spring 2018 must complete a minimum of 640 hours of supervised clinical
experience (160 hours in each practicum course).
Each log entry must be linked with an individual practicum Learning Objective or a
graduate Program Objective. You should track your hours in Meditrek as they are
Your clinical hour log must include the following:
 Dates
 Course
 Clinical Faculty
 Preceptor
 Total Time (for the day)
 Notes/Comments (including the objective to which the log entry is aligned)
Patient Log
Throughout this course, you will also keep a log of patient encounters using Meditrek. You
must record at least 80 encounters with patients by the end of this practicum (40
children/adolescents and 40 adult/older adult).
The patient log must include the following:
 Date
 Course
 Clinical Faculty
 Preceptor
 Patient Number
 Client Information
 Visit Information
 Practice Management
 Diagnosis

 Treatment Plan and Notes: You must include a brief summary/synopsis of the
patient visit. This does not need to be a SOAP note, however the note needs to be
sufficient to remember your patient encounter.
By Day 7 of Week 7
Record your clinical hours and patient encounters in Meditrek.

Assignment 2: Focused SOAP Note and Patient Case Presentation

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Psychiatric notes are a way to reflect on your practicum experiences and connect the
experiences to the learning you gain from your weekly Learning Resources. Focused SOAP
notes, such as the ones required in this practicum course, are often used in clinical settings
to document patient care.
For this Assignment, you will document information about a patient that you examined
during the last 4 weeks, using the Focused SOAP Note Template provided. You will then
use this note to develop and record a case presentation for this patient.
To Prepare

Review the Kaltura Media Uploader resource for help creating your self-recorded Kaltura

 Select an adult patient that you examined during the last 4 weeks who presented
with a disorder other than the disorder present in your Week 3 Case Presentation.
 Create a Focused SOAP Note on this patient using the template provided in the
Learning Resources. There is also a completed Focused SOAP Note Exemplar
provided to serve as a guide to assignment expectations.
Please Note:
o All SOAP notes must be signed, and each page must be initialed by your

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PRAC 6655 Assignment Clinical Hour and Patient Logs

PRAC 6655 Assignment Clinical Hour and Patient Logs

o When you submit your note, you should include the complete focused SOAP
note as a Word document and PDF/images of each page that is initialed and
signed by your Preceptor.

o You must submit your SOAP note using SafeAssign.
Note: If both files are not received by the due date, faculty will deduct points
per the Walden Grading Policy.

 Then, based on your SOAP note of this patient, develop a video case study
presentation. Take time to practice your presentation before you record.
 Include at least five scholarly resources to support your assessment, diagnosis, and
treatment planning.
 Ensure that you have the appropriate lighting and equipment to record the
The Assignment
Record yourself presenting the complex case study for your clinical patient. In your
 Dress professionally with a lab coat and present yourself in a professional manner.
 Display your photo ID at the start of the video when you introduce yourself.
 Ensure that you do not include any information that violates the principles of
HIPAA (i.e., don’t use the patient’s name or any other identifying information).
 Present the full complex case study. Include chief complaint; history of present
illness; any pertinent past psychiatric, substance use, medical, social, family history;
most recent mental status exam; current psychiatric diagnosis including
differentials that were ruled out; and plan for treatment and management.
 Report normal diagnostic results as the name of the test and “normal” (rather than
specific value). Abnormal results should be reported as a specific value.
 Be succinct in your presentation, and do not exceed 8 minutes. Specifically address
the following for the patient, using your SOAP note as a guide:
o Subjective: What details did the patient provide regarding their chief
complaint and symptomology to derive your differential diagnosis? What is
the duration and severity of their symptoms? How are their symptoms
impacting their functioning in life?
o Objective: What observations did you make during the psychiatric
o Assessment: Discuss patient mental status examination results. What were
your differential diagnoses? Provide a minimum of three possible diagnoses
and why you chose them. List them from highest priority to lowest priority.
What was your primary diagnosis, and why? Describe how your primary
diagnosis aligns with DSM-5 diagnostic criteria and supported by the
patient’s symptoms.

o Plan: What was your plan for psychotherapy? What was your plan for
treatment and management, including alternative therapies? Include
pharmacologic and nonpharmacologic treatments, alternative therapies, and
follow-up parameters, as well as a rationale for this treatment and
management plan. Be sure to include at least one health promotion activity
and one patient education strategy.
o Reflection notes: What would you do differently with this patient if you could
conduct the session over? If you are able to follow up with your patient,
explain whether these interventions were successful and why or why not. If
you were not able to conduct a follow up, discuss what your next intervention
would be.
By Day 7 of Week 7
Submit your Video and Focused SOAP Note Assignment. You must submit two files for the
note, including a Word document and scanned PDF/images of each page that is initialed
and signed by your Preceptor.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
 Please save your Assignment using the naming convention “WK7Assgn2+last
name+first initial.(extension)” as the name.
 Click the Week 7 Assignment 2 Rubric to review the Grading Criteria for the
 Click the Week 7 Assignment 2 link. You will also be able to “View Rubric” for
grading criteria from this area.
 Next, from the Attach File area, click on the Browse My Computer button. Find the
document you saved as “WK7Assgn2+last name+first initial.(extension)” and
click Open.
 If applicable: From the Plagiarism Tools area, click the checkbox for I agree to
submit my paper(s) to the Global Reference Database.
 Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:
Week 7 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:
Submit your Week 7 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7 of Week 7

To participate in this Assignment:
Week 7 Assignment 2

What’s Coming Up in Week 8?

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Next week, you will continue your clinical hour and patient logs in Meditrek. You will also
read selections to support your confidence in assessing, diagnosing, and treating
dissociative and somatic symptom-related disorders.
Next Week

To go to the next week:
Week 8

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