Rationale for this guide. NRSG139 is a first semester first year unit and most students are new to tertiary studies. This task is due to be submitted at the end of week 4, Friday March 20th before 12 midday. For most of you it will be your first submission of a tertiary assignment. This guide is specific to NRSG139 AT 1 and designed to help you to learn how to approach and write up this assignment. A guide such as this cannot be expected for other assessment tasks especially later ones. Writing at tertiary level is very different to secondary level. The biggest difference is that you must now reference everything not your own original idea. Use of quotes is the most basic use of sources and should be kept to a minimum.
Paraphrasing is preferred. That means rewording the source in your own words and weaving it into your discussion. Do not copy from text books, journals or the internet. I have provided a step by step approach and a plan with readings on the types of content required to address each criteria of the rubric.
Read this entire guideline before commencing your assessment.
Do not leave preparing for this assignment to the last minute. Generally, for a task weighted 30% you can estimate 3 weeks preparation including understanding the topic, research, and reading about the topic, a plan and a draft, final version with in text citations, reference list and formatting the document as per APA6.
For this task you are required to perform a health assessment interview for an adult. You may utilise any heath history model or tool used in class.
The written submission must discuss, firstly how you established and maintained rapport, and secondly how you effectively questioned an adult client. Include considerations and techniques used along with rationales supported by literature. Refer to Appendix A of the unit outline for further information.
1. Review the topic in the unit outline very carefully, be clear on what the question is asking you to provide. Note due date and time, number of words and if the paper is an assignment, an essay, a case study, a report etc.
2. Read the marking rubric. The rubric for AT 1 is the Appendix of the Unit Outline. What is a rubric? A rubric is a scoring guide used to direct students when writing the assignment and to guide markers when scoring the assignment. The rubric lists the criteria to be addressed in the assignment and describes the quality of answers required for each grade category.
3. Research and read around the topic, see what information your text books have on the topic. Search for relevant peer reviewed journal articles relating to your topic. Some readings are provided for you. Links to your text books are in the Reading list on LEO in the Overview tile. The 3 text books relevant to AT 1 are at the top of the reading list and marked as core texts. I will refer to them throughout this guide as Potter and Perry (fundamentals text), Jarvis (health assessment text) and O’ Toole (communication text). I recommend you read all these readings as part of your preparation as it will help you understand the topic before you start writing.
The readings are grouped according to which criteria they address. For some assessment tasks web sites may be helpful, but only use credible sources on the internet. A credible source is current and from an established institution or organisations with expertise such as Australian Government sites, Anti Cancer Council, AIHW, ACSQHC, AHPRA etc. Never cite Better Health Channel or Wikipedia as sources to support an academic paper. This is because the authorship is anonymous, and content is not verified by experts.
4. Select a health assessment or heath history tool such as those used in laboratory class or from text books and conduct the interview. For this task you are required to perform a health assessment interview for an adult. It does not matter which tool you use, it is just to help you frame your interview questions. You may decide to develop your own health interview questions.
Food for thought - what things do you need to consider when planning and implementing your interview in order to establish rapport? E.g. physical set up, timing, location, etc. What do you have to consider about your own presentation in order to build rapport? You may find content from Jarvis Chapter 2: The Health Assessment Interview, p61 first section called Introduction helpful as it describes ’terms’ you might find helpful for framing your interview. How might these ’terms’ assist in establishing rapport?
5. Plan your answer for each section of the rubric. Decide which resources support your answer and think about how you will use the resources to support your writing. Recheck word limits, use headings, etc make sure you refer to your client in your answers when required to provide examples.
Refer to ACU APA6 referencing resources or the tool from La Trobe University found at the link below. The tab called style notes will help you to format the paper as per APA 6. The other tabs show you how to reference different resources both in text and in your reference list. Attention to detail is important here. https://www.lib.latrobe.edu.au/referencing-tool/apa-6
How to write the assignment.
Use the bolded criteria headings below for your assignment. These heading match the rubric criteria. Under each heading I have included readings from your core text books and a journal article to help focus your reading and answers. You may use these readings to help you develop your answers for each of the criteria. The list is not exhaustive. I expect students will use these readings plus one or two other sources when writing this paper. Also include examples from your interview when required to support your answers.
Heading 1 - Introduction
Approx. 90 words 5 marks
Make sure you provide an introduction that meets the purpose of an introduction, that is clearly informs the reader what will be discussed and in what order. The introduction should provide some general statements about the topic, and in this case, it is very helpful to include a definition of rapport as it is a key term used throughout the assignment. You should have a clear understanding of what rapport is in the context of your role as a health professional. An introduction should be clear, concise and entice the reader to want to read more.
(15 marks) (Approx 240 words) What factors did you need to consider when attempting to establish and maintain rapport with your adult client? Provide evidence and examples to support your discussion.
Note here are 2 parts to address in this criterion. Refer to the rubric to make sure you discuss the factors and provide evidence or examples from the interview you did.
O’Toole, Chapter 1 p3-7 Factors to consider when defining effective communication.
O’Toole, Chapter 11 Awareness of different environments that can affect communication. The physical environment p137. Sections headed …. physical appearance: dress and odour, Rooms: furniture placement and physical comfort, avoiding distractions and interruptions, temperature, understanding cultural differences are most helpful.
Jarvis, Chapter 5 The health assessment interview. Section on p 61 Internal factors (personal qualities and abilities) and section on p62 External factors (environment and other issues).
Heading 3 - Techniques used to establish and maintain rapport
(15 marks) (Approx 240 words) Discuss communication techniques used to establish and maintain rapport. Provide evidence to support your discussion.
Evidence means literature, text books, journal article etc, it means you must use academic sources for example, text books or journal articles to support why a particular technique was helpful for building rapport.
(General point of note - The focus of most of the readings for criteria 2 is facilitative communication skills, whereas the for criteria 3 (questioning techniques) is authoritative communication skills.) Potter and Perry Chapter 12 box 12-3 Classification of communication techniques according to therapeutic intension is helpful as it separates facilitative communication interventions used to establish and build rapport (criteria 2) from authoritative communication techniques used for effective questioning (criteria3).
O’Toole, Chapter 3 The specific goals of communication for health professionals 1. Introduction and providing information. P21 -27. In particular the sections – making verbal introductions, introducing oneself and the associated role.
Potter and Perry, Chapter 12 Placing communication at the centre of person centred care , section called Elements of professional communication. P222-223. This section identifies the importance of courtesy and use of names, privacy and confidentiality, trust and respect as essential ingredients for the establishment of rapport.
Potter and Perry, Chapter 12 Placing communication at the centre of person-centred care. Go to section called Facilitative communication interventions just below box 12.3 Relevant material is from using silence to using touch.
Jarvis, Chapter 5 The health assessment interview. Section called Responses assisting the narrative (that means facilitative communication interventions) p64 and the section titled Nonverbal skills p66
Heading 4 - Effective questioning techniques.
(15 marks) (Approx 240 words) What therapeutic communication techniques did you use when questioning your client for the purposes of health assessment interview? Provide evidence and examples to support your discussion. Do not include establishing and maintaining rapport in this response
When answering this section make sure you include examples from your health interview and do not mention any of the techniques used for establishing rapport. Once again evidence is needed to support your writing.
There are many sources and journal articles related to effective questioning techniques. Do not include techniques mentioned in the previous sections relating to rapport. Focus on authoritative communication interventions avoiding repeating any previously mentioned techniques.
As state above … Potter and Perry, Chapter 12 box 12-3 Classification of communication techniques according to therapeutic intension is helpful as it separates facilitative communication interventions used to establish and build rapport (criteria 2) from authoritative communication techniques used for effective questioning (criteria3).
Potter and Perry, Chapter 12 Placing communication at the centre of person-centred care. Go to section from asking relevant questions to and including authoritative communication interventions. P229-231
O’Toole, Chapter 4 The specific goals of communication for health professionals 2 Questioning, comforting and confronting. Section on from p33-38 Types of questions and the information they gather, from closed to leading.
Heading 5 - Conclusion
(5 marks) (Approx 90 words)
A conclusion summarises what has been covered in the assignment it does not introduce any new content.
Academic writing. Reread the rubric section re academic writing. Write for clarity, generally shorter sentences improve clarity and longer rambling sentences are less clear. Please proof read your work prior to submitting.
Lastly try to mark your work against the rubric criteria
NRSG139 Assessment Task 1
The purpose of the assignment is to focus on the interviewing skills and how to establish and maintain a rapport along with questioning effectively an adult client. The main aim is to have a better rapport and secondly how to have an effective and engaging question with the adult client (Campbell, 2017). In the given case, the situation is on the adult men who smoke and the approach is how to build rapport and trust during the interview process to fulfill the meeting purpose. While interviewing, it is important to follow the Clinical reasoning Cycle (CRC) framework to evaluate the patient condition.
Considerations for establishing and maintaining rapport
To build rapport with the patient, it is important to work on internal and external parameters and the environment. O’Toole (2016, Chapter 1) has defined in his literature, how to have effective communication and interaction with the patient. It can be factors attributed to effective communication through closely following the-:
Physical appearance: One should be professionally dressed and needs to check the body odor to avoid any uncomfortable situation
Rooms: It should be well lit and needs to have the perfect furniture placement along with comfortable physical comfort. There should be minimum distractions along with any unprecedented interruptions (O'Toole, 2016). The room temperature should be timely monitored and while interviewing it is important to focus on the cultural differences.
Jarvis (2019, Chapter 5) has defined an in-depth about the health assessment interview. Particularly, the Section on p 61 internal factors focuses on the personal qualities and the abilities that can help to interview the person and derive information. The external factors which can be affecting the situation would be the distractions or the lack of room temperature or control.
The examples to support are while conducting the interview, it is important to have set criteria and a rightful frame of mind. Such as, the setup should be rightful and involve a pre-planned interview set up along with having a good environment, in which the interview would be scheduled. Next action was to call the interviewer, explain and take consent for the personal meet. During the personal meeting, while questioning and interviewing, to understand interview lifestyle and health issues (Rizzo, 2016). To prepare internally, it is important to focus on planned questions, have a sense of confidence and overcome the feeling of anxiety.
Techniques used to establish and maintain
The communication techniques used to approach and interview the individual was to focus on the listening, rightfully asking the question, having clarity and concision and then relating it with the open-mindedness.
Toole (2016, Chapter 3) has identified how the specific goals related to the communication for health professionals should begin with the introduction of the information and how to begin introducing oneself, approaching the matter and to define the associated role and cause of the meeting.
As per the Potter and Perry (2015, Chapter 12), the classification of communication techniques has to be in accordance to the therapeutic intention that can be effective in separating the facilitative communication interventions which is required to establish and build rapport (criteria 2) which would be different from the authoritative communication techniques as required to approach the effective questioning (criteria3).
To approach the interview, the focus was on the facilitative type of communication rather than to have an authoritative communication skill (Campbell, 2017). As per the facilitative skills it is associated with clients become to become self-reliant and responsible while identifying the care. In comparison, authoritative communication has preconceived notions, forms a confirmation bias and self-deception.
The evidence while interviewing was to have the rightful frame of mind, preparing with the planned questions and empathically listening to the interview viewpoints. At no point, personal opinion or biasedness was shown (Bakker‐van Gijssel, 2019). The communication had an easy, concise flow, where both interviewer and the interview can transparently share their thoughts and opinion. There was no biasedness.
Effective questioning techniques
The therapeutic communication techniques were used such as active listening, open and closed questions, and building rapport through the consistent questions, asked with confidence and clarity. For example, while questioning the individual, the focus was on the level of engagement, body behavior and leading the questions in a planned direction. Some of the authoritarian approaches such as cutting the interview talks, imposing own personal opinions and asking direct questions were avoided.
As per the Potter and Perry (2015 Chapter 12), which emphasis in the classification of communication should be based on the techniques, that can work in accordance to the therapeutic intention and it needs to be separate from the therapeutic is to support the facilitative communication interventions to have a healthy built rapport (criteria 2). It should not follow the authoritative communication techniques which would be ineffective, biased and have a low engaging question (criteria3).
Further, O’Toole (2016, Chapter 4), has identified how the goals of communication-related to health professionals should follow the approach of questioning, comforting and confronting. The technique of the SOLAR health assessment tool was used, such as the
S- Sit square
O – To have an open posture
L -: Lean forward while asking next question or showing a keenness to hear
E- Looking into the eyes and avoiding any sort of distractions
R-: Relaxed and well planned.
The questions were asked in a confident and planned manner to avoid any complexities or disengagement from the main topic (Campbell, 2015).
To conclude, while interviewing it is important to have the CRC framework while interviewing and understanding the patient's condition. While interviewing, it is important to focus on building rapport, through consistent external and internal factors. As an interviewer the techniques should be attentive listening, having clarity of thoughts and having personal engagements.The techniques and the approaches should be well planned and aligned with the purpose of the interview. To have a good rapport, the interview should be systematic and the interviewer should be approachable.