NR 622 Week 6 Outcome Evaluation Example

Outcome Evaluation: Each Heparin Titration Objective in Its Original Wording, the Same Checklist Twice, Who Completed Both and the Objective That Did Not Move as Hoped

Student Name

College of Nursing, Chamberlain University

NR 622: Nurse Educator Concluding Graduate Experience II

Instructor Name

Month Day, Year

Outcome Evaluation: Each Heparin Titration Objective in Its Original Wording, the Same Checklist Twice, Who Completed Both and the Objective That Did Not Move as Hoped

How Results Are Reported

Each objective appears as written before teaching, in its original order. Under it: the threshold, the task, results at the baseline return demonstration in week 5 and after the sessions, and how many completed both. The changes recorded in the progress report, a group session followed by individual slots and scenario set B in the second sitting, apply to every comparison.

Objective 1

As set in the plan, kept in the plan's terms: by the close of week 8, from a written case, the right nomogram row and the right new dose in units/h and mL/h, three cases running with no error, confirmed by the educator.

Threshold: three consecutive scenarios without error at the calculation steps.

Task: written scenarios, same format and checklist at both sittings.

Week 5 baseline: 5 of 9 met the threshold.

After the sessions: of the 6 who completed both measures, 6 met it; of the 1 who completed only the later measure, 1 met it.

Result: 7 of 9 met the objective by week 8; 2 have no second measure.

Objective 2

As set in the plan: by the close of week 8, on the practice pump with the live drug library, the new rate entered with no error three attempts running, watched against the eight-step checklist.

Week 5 baseline: 6 of 9 without pump errors.

After: 5 of 6 who completed both met it; 1 of 1 with only the later measure met it. Two individual slots completed only two attempts, which, strictly, falls short of three consecutive attempts; both were error-free.

Result: 6 of 9 met the objective as written; 8 of 9 had at least one error-free sitting.

Objective 3

As set in the plan: by the close of week 8, two or more real titrations on the unit, from lab value to pump, done by the new graduate while the preceptor only checks independently, recorded on the orientation checklist.

Result: 5 of 9. Of the other four, two had fewer than two titrations available on their shifts; two had preceptors who finished at least one titration themselves.

This is the objective that did not move as hoped. It depends on the unit, the patients and the preceptors, not only on the new graduates.

Same Task, Twice

Both sittings used the same eight-step checklist, the same scoring and the same scenario format. Different numbers were used in set B to avoid memorizing answers. Format differed between sittings, group first and one-to-one second, and two slots ran short; each result carries that note.

Who Completed Both

Six of nine new graduates completed both measures. Results are reported for them first, then for those with one measure, so that people who missed a sitting are not silently dropped.

A Session Is Not a Shift

Objectives 1 and 2 measure what happens in a practice room. Objective 3 measures what happens on the unit. The gap between them, 7 of 9 meeting objective 1 but 5 of 9 meeting objective 3, is the gap between skill and opportunity. The unit's checklist sign-off for item 14 at week 8 was 6 of 9, compared with 5 of 8 in the previous cohort. Pump override data for November show 4 heparin alert overrides by nurses in orientation, compared with 11 over September and October together. Both comparisons are suggestive and cannot be attributed to the project alone; staffing, patient mix and the cohort itself differed.

Errors by Type, Before and After

The checklist logs show where errors sat. At the week 5 baseline there were eleven errors in 27 attempts: five at the nomogram row, four at the conversion to mL/h and three at pump programming, with one attempt holding two. Across the second sitting there were three errors in 19 attempts: one at the row, one at conversion and one at programming. The fall is largest at the row, the step the boundary scenarios targeted. Because the second sitting was one-to-one and used set B, the comparison is of the same checklist on matched tasks, not of identical conditions.

Threats to the Comparison

Four things other than the sessions could explain the change. Practice on the unit: new graduates titrated heparin on shifts between sittings, and that experience alone builds skill, as the move from novice toward competence would predict (Benner, 1982). The format change, which gave more pump time per person. The matched but different scenarios. And attention: learners knew they were being scored. None of these can be removed now. What the design does guard against is memorizing answers and changing the scoring rules between sittings.

The Two Not Measured

Two new graduates have only one measure. One missed the group session through a day off and the second slot through a float assignment. The other was called to a rapid response at the group session. Both are reported as not measured, not as failing and not as passing. If they are counted as not meeting objective 1, the result is 7 of 9; if excluded, 7 of 7 measured. The report gives the first figure because it is the one the checklist uses.

What the Evidence Supports

That most new graduates reached the practice standard for calculation and programming by week 8; that practice with feedback was associated with fewer boundary-row errors, as deliberate practice approaches predict (McGaghie et al., 2011); and that skill in the practice room did not fully translate to independent titration on the unit, mainly for lack of opportunity and preceptor habit.

Comparison With the Previous Cohort

The March 2026 cohort had no structured practice and signed off 5 of 8 at week 8. This cohort signed off 6 of 9. The difference is one nurse, in groups of different size and makeup, and is reported only as context.

What the Evidence Does Not Support

That the project caused the improvement in sign-offs or overrides. That the skill will last. That errors on the unit will fall.

Why the Weak Objective Matters Most

Objective 3 is the one the checklist cares about and the one that protects patients. Its shortfall points to the next step: preceptor behavior and opportunity, not more practice room time. Transition programs that build structured, supported practice on the unit are the model (Spector et al., 2015).

References

Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402-407. https://doi.org/10.2307/3462928

McGaghie, W. C., Issenberg, S. B., Cohen, E. R., Barsuk, J. H., & Wayne, D. B. (2011). Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Academic Medicine, 86(6), 706-711. https://doi.org/10.1097/ACM.0b013e318217e119

Spector, N., Blegen, M. A., Silvestre, J., Barnsteiner, J., Lynn, M. R., Ulrich, B., Fogg, L., & Alexander, M. (2015). Transition to practice study in hospital settings. Journal of Nursing Regulation, 5(4), 24-38. https://doi.org/10.1016/S2155-8256(15)30031-4