Description

General Instructions

VISE topic: Independent practice

For the NR667 VISE video conference, the faculty member will choose one of the top 25 diagnoses and give a scenario to the student. This final virtual evaluation builds upon skills learned in the previous clinical courses and emphasizes the ability to independently gather appropriate data, make a correct diagnosis, and develop an appropriate management plan.

1. Be prepared to assess, diagnose, and treat any of the following diagnoses:
   • hypertension
   • hyperlipidemia
   • type 2 diabetes
   • back pain
   • anxiety
   • obesity
   • allergic rhinitis
   • reflux esophagitis
   • upper respiratory infection
   • hypothyroidism
   • osteoarthritis
   • fibromyalgia/myositis
   • benign prostatic hyperplasia
   • knee pain
   • shoulder pain
   • hip pain
   • acute laryngopharyngitis
   • acute maxillary sinusitis
   • acute bronchitis
   • asthma
   • depressive disorder
   • nail fungus
   • tinea corporis
   • eczema
   • urinary tract infection
2. Be equipped with video and audio capability and a volunteer present who is older than 12 years and can act as a client for the focused physical exam.
3. Be equipped with the following equipment during the VISE:
   • ophthalmoscope
   • otoscope
   • reflex hammer
   • pocket Snellen chart
   • stethoscope with a diaphragm and bell
   • additional materials may include:
     • a pencil and paper for notes
     • a clinical pharmacology reference to check dosages when formulating the treatment plan

4. At the start of the call, the faculty member will provide the age, sex, and chief complaint of a client with one of the top 25 diagnoses. Address the following during the call:

1. 1. Conduct a client interview to obtain a health history with the volunteer. If the volunteer is unable to participate in the interview, the faculty member will respond as the client. The health history must include past medical history, surgical history, allergies, medications, immunizations, habits, occupation, and review of systems.
   2. Perform a focused physical examination addressing the chief complaint on your volunteer using correct techniques. The faculty will provide pertinent physical exam findings.
   3. Formulate a diagnosis and rule out any
   4. Create an evidence-based management plan including diagnostic tests, medications with prescriptions, referrals, education, and follow-up.

Grading Criteria

For each criterion in the VISE assessment, faculty will rate performance as proficient, average, or needs improvement. Students who do not achieve 80 points or greater on the first VISE attempt will be placed on a clinical Performance Improvement Plan [PIP] and given a second attempt after 14 days to pass the VISE before the end of the course. If the student does not achieve a score of 80 points or greater on the second VISE attempt, the score for this assessment will be recorded as zero. The grading criteria include:

1. Clinical situation
   • conducts comprehensive client interview
   • performs focused physical examination using correct equipment and techniques
   • formulates appropriate diagnosis and differentials diagnoses appropriate to the chief complaint and exam findings
2. Professional communication and interaction
   • obtains detailed information necessary for recommendations
   • provides clear and detailed explanations and answers
   • responds to simulated client professionally using appropriate terminology

3. Professional standards of practice
   • utilizes professional standards of practice to create an evidence-based management plan including diagnostic tests, medications with prescriptions, referrals, education, and follow-up