Describe and then evaluate at least one decision or intervention or plan that you personally initiated.   Remember that an intervention can include the way you explain something (the words you choose to use)

NM701 Office Visit Simulation Reflection:

Submit this to the Drop Box no later than 3 calendar days after your Simulated Office Visit.  Before you do so, WATCH the recording of your Office Visit  (located in Sim IQ) so you can reflect on your own contributions, strengths, and challenges more deeply.  Please focus your answers on your own decisions, behaviors, and responses—not that of your group.  Please read the rubric on the last page of this document for scoring.

 Name:__Laquana Brown__________________________________________________

1. Describe the things you felt good about in this experience.  Be specific, and please focus on what you personally did well.

  I felt good asking a lot of the subjective questions. I asked for clarity when the patient stated she has 2 living kids, when it was documented in her history that she had 2 pregnancys: 1 living child and 1 abortion. I was able to get a lot of information about her gyn history. I also surprised myself on how I was able to give education and clarity on vasectomy and sterilization to the patient.

2. What new specific learning came about because of this experience? What new skill or insight was developed

I have learned that as a provider we may feel that we are actively listening from beginning to end but there was some info that the patient stated that I did not hear until I rewatched the video.

3. After reviewing the recording and thinking back on the visit, reflecting on your own actions or decisions, what specifically would you change or do differently?

I WOULD SPEAK SLOWER AND TAKE MY TIME. I WOULD ALLOW LILY TO SPEAK HER THOUGHTS. I WOULD UTILIZE SHARED DECISION MAKING MORE EFFECTIVELY.

4. Describe and then evaluate at least one decision or intervention or plan that you personally initiated.   Remember that an intervention can include the way you explain something (the words you choose to use), what you choose to teach or the order in which you decide to ask questions, what labs or diagnostics you decide to order, or which physical exam elements you decide to perform.  ANY interaction with the patient involves decisions on your part – describe one, and then evaluate how well it worked. 
   1. Describe a decision or intervention:

EXPLAINING PROCEDURE FOR VASECTOMY, STERILIZATION, AND IUD.

2. Evaluate the decision or intervention:

LILY IS INTERESTED IN ALL 3 CONTRACEPTIONS BUT WANTS TO SPEAK WITH HER SPOUSEFIRST AND SHARE THE EDUCATION SHE RECEIVED.

5.       Cultural safety is a curriculum thread throughout FNU.  In a paragraph or more, please describe your thoughts in response to the following questions in blue text.  You’ll find helpful definitions, clarifications and tips below the questions.

Consider your own values, beliefs, and social power as a clinician.  How does your own cultural background influence how you think about the clinical or other issue(s) you encountered during your Office Visit?  How might it affect how you care for this client or someone facing a similar health issue? Consider how you think or feel about issues raised in the visit, and how cultural habits of thought, or biases, might impact:

·       how and what you teach about the topic

·       how you interact with the patient

·       what you might recommend

if you were unaware of them.  Are there implications for how the patient might perceive the safety of the visit? 

Cultural Safety, per Frontier Nursing University,

Refers to the need for health professionals to consider the historical context, their own cultural background and the impact of power, privilege and their personal biases on healthcare systems and organizations and the relationships within them.

Curtis et al. (2019) expand on the concept:

 “Cultural safety requires healthcare professionals and their associated healthcare organizations to examine themselves and the potential impact of their own culture on clinical interactions and healthcare service delivery. This requires individual healthcare professionals and healthcare organizations to acknowledge and address their own biases, attitudes, assumptions, stereotypes, prejudices, structures, and characteristics that may affect the quality of care provided. In doing so, cultural safety encompasses a critical consciousness where healthcare professionals and healthcare organizations engage in ongoing self-reflection and self-awareness and hold themselves accountable for providing culturally safe care, as defined by the patient and their communities, and as measured through progress towards achieving health equity. Cultural safety requires healthcare professionals and their associated healthcare organizations to influence healthcare to reduce bias and achieve equity within the workforce and working environment”.

●   Remember that the focus here should be on your own culture, values, attitudes, and power as a clinician, not the patient’s culture or how you "should" care for them. We are not interested in a restatement of what you've learned about the importance of providing culturally competent care, but in a thoughtful exploration of your own cultural (not professional) beliefs and values and how you acquired them.  This will require a lot of "I" statements.  

●   We are not interested in a restatement of your professional values within nursing of how patients should be treated with cultural competence and respect--we assume you know that already. Rather, dig into your values and beliefs, and discover what’s there.

●    Remember that this part of the Reflection should reference some aspect of the clinical situation you encountered in this simulation, as well as a thoughtful exploration of your personal cultural background.  Are there aspects of the situation that triggered a response in you based on your personal culture or experiences?  How could your response affect a pa

Reference: Curtis, E., Jones, R., Tipene-Leach, D. et al. Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition. Int J Equity Health 18, 174 (2019). https://doi.org/10.1186/s12939-019-1082-3