I am a student who thinks that mandatory vaccinations are a decent idea. Like any other community, American society has differing opinions on this issue. America has been a leader in the transmission rate of the coronavirus and its catastrophic effects due to its large population and close interaction. Therefore, one of the primary obligations of its citizens is to limit its spread, particularly through vaccination. The immunization issue is controversial as it involves the employment of a harmful virus. There is always a chance of negative side effects and unintended outcomes during such procedures despite their advantages. Massachusetts, New York, Connecticut, Indiana, and Arkansas passed state laws mandating vaccinations for schoolchildren in the 19th century (Childrens Hospital of Philadelphia). Therefore, compulsory immunization is relevant in the abovementioned states, where the culture of voluntary vaccination has developed due to legislative restrictions. From my standpoint, vaccination must be mandatory in all areas of public life, even when considering its drawbacks, because the benefits of its usage outweigh any potential disadvantages.
It is important to weigh the benefits and drawbacks of vaccination to demonstrate its value objectively. Certain illnesses have almost completely been eliminated by vaccination, yet vaccine-preventable infections still exist, necessitating mandatory immunization. When a significant section of a population can fight severe diseases, the viruss ability to transmit from individual to individual is constrained. This condition is known as community immunity, which stops prolonged illness in communities, shielding those vulnerable from the virus. Infectious disorders cost more healthcare expenses, hours away from employment to treat infected kids, and probable time-consuming incapacity than vaccines (Greyson et al.). However, vaccination requirements violate legally guaranteed religious liberties, and the state shouldnt meddle with peoples individual healthcare choices. The best way to ensure vaccine-hesitant parents immunize their youngsters is not through restrictions. There are several reasons why vaccination should be mandatory, including the possibility of preventing the spread of various illnesses and the assurance that everyone in society would be protected.
People can organize demonstrations, boycotts, and scientific conferences to advance their views on vaccination. Communicating with top officials through written requests or emails is also acceptable for expressing ideas. American citizens can defend their beliefs by joining public organizations. World Health Organization and the American Academy of Pediatrics are the largest pro-vaccination organizations. The advantageous attitude of medical experts responsible for forming the policy of these recognized and trustworthy organizations strengthens the need for the introduction of mandatory vaccinations.
This presentation addresses the self-care problem within the nursing industry and proposes an action plan to be implemented in the near future to enact changes and increase the nursing departments effectiveness. Firstly, the proposal utilizes the SWOT analysis to conduct a primary assessment of the plan regarding its implementations failure or success. Secondly, this project addresses each component of the action plan, including the suggested change theory model, communication plan, appropriate leadership style, and management functions that need to be utilized. Finally, the presentation analyzes the decision-making process used, examining its effective and ineffective sides and proposing the corresponding changes in the future.
Self-care is an important aspect of nursing
Nursing work is always associated with significant amounts of stress, which is why it is essential to promote self-care among nurses in order to decrease the adverse effects of their professional activity. Nowadays, the healthcare environment changes constantly and rapidly, and the stressful nature of the nursing profession might cause devastating consequences not only for nurses but also for their patients. Thereby, this project aims to develop a self-care initiative cultivating practice environments in the hospital to support nurses self-care. For the purposes of this project, Lippitts change theory, created in 1958, will be utilized. This model extends the preceding force-field framework suggested by Lewin several years earlier. Lippitts change model focuses not on the evolution of changes but on the change agents and what they must do to reach the desired outcomes.
SWOT analysis
First, it is crucial to conduct a SWOT analysis of the proposed plan before discussing its separate steps and processes since healthcare leadership requires leaders to understand a plans consequences before taking action on implementing it. The hospital will gain a significant advantage from the projects strengths if the plan is successfully implemented. They include a thoroughly analyzed implementation process, reasonably chosen change theory and leadership style, and the usage of the necessary tools, such as a communication plan, management functions, and a plan for handling potential issues. Additionally, the project will provide the hospital with opportunities to improve patient care and increase nurses effectiveness and employee satisfaction. Should the plan fail to be implemented, its weaknesses, such as the absence of information regarding each nurses unique features and emotional conditions, might endanger the hospitals activity, threatening to decrease nurses effectiveness and quality of care. However, weaknesses and threats identified during the SWOT analysis will be addressed with the help of the emotional leadership style, which will be further discussed.
The rationale for choosing Lippitts change theory
The rationale for choosing Lippitts change theory over other similar models lies in its elements that strongly correlate with the objectives of the self-care initiative. Firstly, Lippitts theory significantly relies on successfully using communication skills throughout the change process, especially during the planning phase. Those skills will be a critical part of the project for two reasons: first, they will help address the plans weaknesses; second, they are required for the communication plan, which will be discussed further. Then, the rationale for choosing Lippitts theory for this project is associated with the models steps, which include motivation assessment and change maintenance. The proposed plans success partially depends on the nurses motivation to utilize self-care concepts within their work. Furthermore, the initiatives effectiveness will significantly decrease if the hospital does not succeed in maintaining the changes once they have been established.
The rationale for implementing the program
Modern healthcare studies contain much data regarding the effect the specificities of the nursing profession can have on nurses. Working with patients during basic, complicated, and even intimate care processes can be a stressful experience, which is why medical professionals should pay significant attention to self-care to avoid distress and burnout. Furthermore, it is vital to remember that each nurse is an individual with their own feelings, emotions, and life problems that may be stressful, as well. Nurses have to deal with those issues and emotional pressures correlated with their profession simultaneously, increasing the importance of self-care in the healthcare industry. In addition, medical professionals face pain, disease, and even death on an everyday basis, which makes it challenging for nurses to cope with their working environment. Everything described above created a devastating amount of stress for nurses, and it is essential to implement the self-care initiative to help the hospitals employees and improve its performance.
Steps of the plan
According to the plan, the self-care initiative will be implemented through several stages following Lippitts change theory model. The first phase is the assessment, and the first step is already completed since the problem and opportunity were identified during this plans creation. The following step is data collection and analysis: as per Lippitts theory, it is required to assess motivation. The team working on the plans implementation will need to interview the hospitals nurses to discuss the issue of self-care. The planning stage goes next: it is necessary to ensure that nurses are ready for new ways of thinking and behaving and that the hospital, as the change agent, has enough resources and motivation to work on the plan, as per Lippitts theory. The team will use the collected data and plan various interventions to promote self-care among nurses, preparing for the implementation stage. It, in turn, will involve giving nurses information about the importance of self-care to change their perceptions and attitudes. Finally, the last stage of the plan involves evaluating its overall effectiveness and stabilizing the change. The team will evaluate how nurses attitudes to self-care will have changed and how it will have affected the hospitals performance. If the evaluation results are positive, the change maintenance will be the remaining step.
Communication plan
The success of the self-care initiative depends on how the employees perceive it, making the communication plan a critical part of the project, as the nurses should receive the information properly to avoid ambiguity. Lippitts theory emphasizes the importance of communication, making it easier to conduct an appropriate communication plan for this project. Firstly, the project team will need to establish a strict context of the instructions: the follower will not understand the leader if they do not have a clear mind on the plan. Secondly, nurses positive attention is significant since it is vital to ensure that any factors interfering with perceiving instructions need to be eliminated. Thirdly, the instructions need to be clear and concise, given in an inoffensive and non-defensive style to establish mutual understanding between the leader and the nurses. Then, verification should be conducted through feedback to ensure that the hospitals employees have understood the instructions as expected. Finally, follow-up communication is required throughout the project to maintain the instructions clearance and answer the nurses questions, if any occur.
Emotional leadership
Successful implementation of the plan will depend on using an appropriate leadership style. Emotional leadership is the framework that corresponds with the projects goals entirely. The primary reason for choosing this model is one of emotional intelligences main components, personal competence. It includes self-awareness, the knowledge related to the self-care issue, and self-management, the ability to utilize the instructions given and act and behave correspondingly. Additionally, emotional leadership correlates with Lippitts change theory in terms of assessing peoples motivation. This leadership model will allow the project team to understand the nurses better, gaining a clear insight into their attitudes and values. The emotional connection established between the nurses and the leader will ease the promotion of self-care, improve nurses motivation to behave according to the plan, increase their job satisfaction, and achieve positive results at the stage of the plan implementation.
Management functions
Management functions that will be utilized for the purposes of this project include planning, organizing, directing, and controlling. The first function will mainly be implemented during the planning stage as it is associated with establishing goals, evaluating the current situation and resources, and formulating a plan to implement it further. Then, the organizing function will be utilized to create an efficient system of giving instructions to the nurses. The following function, directing, will help the nurses to adjust to the initiatives principles, motivating them to self-care through effective communication. Finally, the controlling functions will be utilized to compare the projects actual results with the intended ones to evaluate the plans effectiveness.
Budget requirements
This projects primary goal is to inform the hospitals employees about the importance of self-care and promote self-care and correlated activities among the nurses. Therefore, the project does not require major financial investments since it is not associated with any high costs. However, the variable budget approach is recommended for this initiative as some potential adjustments to the budget may be required during the plan implementation.
A workgroup
One of the ways to announce changes in the hospital is by using a workgroup. A team of people with a specific task can be trusted with it, and they can help the nurses who have some questions right after presenting the information to them. However, such a group will require several people, meaning that additional workforces must be utilized in order to complete the assignment. Moreover, that group will have to take some time before every nurse in the hospital has been informed.
An e-mail
Another way to inform personnel about the upcoming changes is to send them an e-mail using the mailing distribution system. It will not require an additional workforce and can inform every staff member quickly. However, e-mails can be unreliable since there is no guarantee that all the nurses will read them on time, and someone may not even receive it. Furthermore, the nurses who have questions about the changes will not be able to get answers immediately, which may undermine the communication plans effectiveness. Considering the advantages and disadvantages of the analyzed methods, it is recommended to use both workgroups and e-mails to inform the hospitals personnel.
Handling potential issues
Potential issues that may occur during the project include non-compliance, late majority, laggards, and rejecters. However, each of these problems can be handled utilizing a single method explaining the importance of self-care to the nurses. This initiative primarily intends to improve the nurses well-being, and increasing the hospitals effectiveness is only a second priority. Therefore, it is in the employees interest to accept this program and adjust to it. The managing task, in this case, is to help the nurses understand how they can benefit from the upcoming changes, encouraging the hospitals personnel to comply.
Evaluating the Projects effectiveness
Several factors will demonstrate whether the project will be effective. Firstly, high levels of acceptance among the nurses will mean the success of the programs implementation. Secondly, the hospitals employees will be asked to give feedback regarding the self-care initiative, and a positive response will signify the plans effectiveness. Finally, further long-distance improvements in patient outcomes, quality of care, and the hospitals overall performance will be the last and the most important factor illustrating the success of the self-care initiative.
Decision-making process
The decision-making process used to create the self-care initiative involved several stages. They included problem identification, consideration of different methods to enact changes, creation of the plan draft based on a particular change theory, assessment of the advantages and disadvantages of that plan, and the final evaluation. The decisions at each stage of the process were made based on the projects primary objectives, the nature of the environment (the hospital), and the potential benefits the hospital and its nurses could gain from this initiative. (Utilizing a change theory and applying a specific leadership style were effective decisions that helped create a thoroughly analyzed and detailed change plan. However, the comparison of informing methods, namely work groups and e-mails, was ineffective as the decision to utilize both methods was made. The plans creation process should be more accurate in the future to avoid taking unnecessary steps and wasting time.)
The development and analysis of nursing rubric is a rather sophisticated, but an important process that is aimed at providing nursing students with viable learning solutions. There are many types of programs and course that are destined for improving students skills and knowledge as well as techniques and approaches for the assessment of those programs. The nursing rubric is one of those specific tools that will be carefully devised and analyzed in this term paper. The rubric provides and assessment of the program outcomes and its influence on students skills and level of proficiency.
Program Description
The program under consideration seeks to present holistic care in nursing schools for students to be able to use patient-centered care with regard to evidence-based practice. This program can be considered as a call for nurse educators because there is great controversy between patient-centered care and evidence-based practice (Hasnain-Wynia, R. 2006, p.2). Hence, evidence-based practice, which can also be called empirically-supported treatment, is often based on statistical analysis carried out by special agencies providing the evidence of the effectiveness of a particular treatment (Arora, 2009, p. 2). In other words, this concept implies the introduction of standardized medicine. However, the concept of patient-centered care is based on the recognition of cultural diversity within healthcare setting and on the evaluation of individual preferences (Mor, 2005, p. 334).
Learners Evaluation
The program will be focused on facilitating the relations between those two controversial concepts. In particular, students will be required to select a particular clinical issue or case that caused conflict or problems while providing patient-centered care. Students should rely on the Quality department to evaluate the scope of the problem and to meet patients individual needs. Additionally, the learners will have to develop a team for working on the problem and developing a new evidenced-based technique. For this, they will have to cooperate with difference professionals to provide their evidence-based scheme. Once the program is completed, students should provide a presentation on the conclusions and concepts they have been studying and analyzing.
Measurable Program Outcomes
Active and mutual cooperation with professionals will help student to be fully engaged in the learning process and achieve better results in delivering a consistent program. Working in a team will provide students with better comprehension of the problem. The presented program is closely connected with the quality of patient treatment and introduction of effective strategies to ethical issues. Through the application of this program, student will be able to evaluate their personal skills and capabilities and high level of proficiency needed for the accomplishment of a clinical task. Second, due to the fact the program presents a poorly investigated area of nursing education, student will able to conduct independent researches under the auspices of highly-qualified professionals. Third, as it is team project where a group of students is planned to work on the one clinical task, the program allow to enhance students communicative skills and decision-making skills in critical situations. Finally, the program at issues will greatly assist nursing students in maintaining their integrity and providing high quality services, the content of which will be evaluated in rubric.
Identification of Philosophy and Rubric Supported With Arguments and Theories
In order to guarantee the effective program outcomes, we are going to apply to innovative teaching provided by Nueman et al (2009). The researchers believe that contemporary strategies of teaching should be based on the using knowledge for creating new methods and services so as to transform the existing systems and approaches. With regard to this, the students will rely on each others learning experience to introduce fresh insights and theoretical shifts to the existing concepts and definitions. In other words, our task is to focus the learners attention on what they know and to involve them in their own learning experiences.
The significance of introducing innovative teaching approaches to the program is enormous because it can greatly contribute transformation in clinical teaching and education. In particular, if students are encouraged to explore new knowledge and provide independent research, there are much more changes for them to introduce insights and effective strategies to learning process (Phillips and Vinten, 2010, p. 227). Therefore, this kind of process allows to introduce alternative perspective for further development of nursing education and to enhance the final outcomes of the program.
Identification of Rubric and Rationale for Its Use
In order to evaluate the program accomplishment, a rubric will be developed, which will assess the outcomes of a project and the results of working in team. The effectiveness of evaluation will depend on the extent to which the nursing rubric covers all issues of the program. In this regard, we believe that holistic type of rubric will fit best in assessing the efficiency of students work and the level of their knowledge. This type of rubric is composed of a number of specific criteria defining different levels of achievement. They are applied in the learning process for assessing the performance and the outcomes of programs and courses (Hammerman, 2008, p. 20). It should also be stressed that the rubric is presented as single entity encompassing all aspects of judgment and evaluation.
The application of the holistic design, therefore, will provide information on the project will include the assessment of team work and stages of the program accomplishment. This means that all the above-enumerated factors will be assessed in accordance with five criteria. This approach to evaluation is beneficial for our program because it is more focused on the performance rather on the analysis of each learners results.
Rubric Development
The holistic rubric is designed for evaluating learners performances, including the level of their knowledge and skills as presented by the professionals in the sphere of nursing. The performance analysis is analyzed to identify the extent which it corresponds to the above established requirements. Hence, in order to properly develop holistic rubrics, it is, first of all, necessary to conduct research addressing known standards, and analyze the quality of work carried out the professionals participating in the program at issue.
Holistic rubrics provide general guidelines that highlight the criteria according to which students work should be evaluated (Mueller, 2010, n. p.). We are planning to introduce the scoring holistic rubrics in the form of matrix to provide a student with clearer understanding concerning students tasks. Rubrics also assist the teacher in thinking through the expectations of behaviors, products and processes. The rubric is also a necessary piece to help teachers help students to be successful. It is an excellent reference tool for providing feedback to students. In addition, students can use the rubric to guide the progress that is being made on the project.
Holistic Rubrics Evaluating the Program on the Analysis of Patient-Centered Care and Its Correlation with Evidence-Based Practice
4-Exceeds Criteria A
3-Meets Criteria B
2-Progressing to Criteria C
1-Below Expectations D
Has determined a suitable project based on a clinical issue and can show reasoning behind choice Qualitative
Determines suitable project and understands why
Determines suitable project but is unable to verbalize why this project was chosen
Does not seem committed to project or understand why choice was made
Provides ample supporting details and innovative approaches to knowledge application
Quantitative
Organization pattern seem logical and conveys completeness and wholeness with few lapses
Achieves little completeness and wholeness through organization attempted
Incomplete in plan and organization
Uses effective language in describing the project, assuring that audience will understand Qualitative
Uses effective language and appropriate word choice in describing project
Makes us of limited and predictable vocabulary and not appropriate for intended audience
Has limited inappropriate English for the audience
Effectively Applies Theoretical Frameworks for Presenting High Performance in Practice Qualitative
Makes use of some theoretical concepts and presents good performance
Generally use some theoretical information
Does not Apply to Theoretical Frameworks
Works collaboratively with unit staff to determine need for process change Quantitative
Uses only part of the collaborative staff available in determining the need for change
Not able to determine fully who the stakeholders are to include in determining this process
Actively participate in analyze and research patients behavior to construct a theoretical foundation for innovative evidence-based practice Qualitative
Provides Some Information Patients behavior and makes moderate contribution to the research. Provides sufficient foundation for further analysis of evidence practice
Slightly contributes to the exploration of evidence-based practice
Does not provide adequate research
Research done is from peer reviewed academic sources using library often Qualitative
Research done is from academic sources using the library often.
Research done is most often from internet sources and library is seldom used
Poor research with no peer reviewed articles. Articles are found on web.
Project is complete, well documented, and turned in on time Qualitative
Project is complete, well documented but somewhat late
Project is complete, documentation is poor and in on time
Project is not complete, documentation needs work or late
Scoring
40-36 A 35-30 B 20-18 C 10-17 D Below 10 is failing
Use of the Rubric
Upon the project termination, the evaluator should use this rubric to grade the overall performance of learners and impact of the designed program on learners skills and learning experience. The major focus should be made on the analysis of how a learner makes use of his/her experience for providing innovative insights to the problem of patient-centered care and evidence-based practice. There are nine categories according to which the instructor should point out learners performance and achievements.
Importance of Reliability and Validity for Assessment
As it has been mentioned before, holistic rubrics analyze the main characteristics to identify the general quality of learners performance. This rubric has certain advantages. However, there are some limitations in terms of validity and reliability, which can be problematic when the rubric is used by more than one evaluator (Lund and Kirk, 2010, p. 56). Therefore, it is important to critically estimate all pros and cons of the rubric as the issue of validity and reliability are the main indicators of the quality and objectivity of scoring.
Methods For Evaluating The Reliability Of This Test
According to Johnson, Penny, and Gordon (2008), the reliability of holistic rubric is lower as that of analytical rubric. However, this type of rubric scoring is more efficient for social studies task, which implies that the choice of assessment is reliable enough. With regard, to this the choice of scoring rubric is quite successful.
Methods For Evaluating The Validity Of This Test
It should be admitted that the validity of the scoring rubric implies valid evaluation with the help of a comprehensive framework for approving the rubric. The underpinning for this potential consists in the fact that holistic rubric, like any other types of scoring, explicitly presents criteria and expectations, which foster the process of self-assessment (Jonsson and Svingby, 2006).
Checklist for Scoring Rubric
It has been discussed that there should be a way to score the rubric that is used to meet the needs of a teacher and a student. The list is presented as follows:
Behavioral outcomes list
Yes/No
Is the behavior outcomes tied to approved standards?
Is there a feasible amount of behavioral outcomes?
Are the behavioral outcomes measurable?
Is the behavioral outcome list congruent with the objectives?
Is the behavioral outcomes list obvious and accompanied by a useful label?
Sequencing scales and levels
Are there an even number of leveling and sequencing? Is there an even number of levels?
Does the highest achievement level corresponding to an excellent showing of behavioral outcomes?
Is each of the levels on the scale purposeful and objective/ non subjective?
Description
Is the language of description is appropriate and scientific?
Are the descriptions precisely communicated in a way to leave no doubt?
Is the diversity among the descriptions apparent? Do the descriptions concisely communicate expectations to the students?
Is there a sequencing of improvement among the different descriptions?
Are the following elements present in the rubric: Behavioral outcomes list, sequencing scale and leveling, and different levels of acheivement with accompanying descriptions?
Is the rubric feasible and useful for students and instructors? Have other faculties, students, instructors, or colleagues analyzed this rubric?
Conclusion
In conclusion, the holistic rubric is aimed at evaluating and scoring collaborative practice projects on the relation between patient-centered care and evidence-based practice. The program is aimed at improving learners knowledge on theoretical and practical frameworks in nursing to provide a high quality treatment for patients. The program will be evaluated in accordance with nine criteria presented in the holistic rubric. The relevance is this evaluation is high because the rubric is focused on assessing the performance and students achievements.
Reference List
Arora, N. K. (2009). Importance of Patient-Centered Care in Enhancing Patient Well-Being: A Cancer Survivors Perspective. Quality of Live Research. 18(1), 1-4
Hammeman, E. L. (2008). Formative Assessment Strategies for Enhanced Learning in Science. US: Corwin Press.
Hasnain-Wynia, R. (2006). Is Evidence-Based Medicine Patient-Centered and Is Patient-Centered Care Evidence-Based. Health Research and Education Trust. 41(1), 1-8.
Johnson, R. L., Penny, J. A., and Gordon, B. (2008). Assessing Performance: Designing, Scoring, and Validating Performance Task. US: Guildford Press.
Jonsson, A., and Svingby, G. (2006). The Use of scoring rubrics: Reliability, validity and educational; consequences. Sweden: School of Teacher Education.
Lenburg, C.B., Klein, C., Abdur-Rahman, V.,Spencer, T., and Boyer, S. (2009). The COPA Model: A comprehensive framework designed to promote quality care and competence for patient safety. Nursing Education Perspectives, 30 (5), 312-317.
Lund, J. L. and Kirk, M. F. (2010). Performance-Based Assessment for Middle and High School Physical Education. US: Human Kinetics.
Mor, V. (2005). Improving the Quality of Long-Term Care with Better Information. The Milbank Quarterly. 83(3), 334-364
Mueller, J. (2010). Rubrics. Authentic Assessment Toolbox. Web.
Nueman, L. H., Pardue, K. T., Grady, J. T, Grady, M. T., Hobbins, B. Edelsten, J. and Herman, J. W. (2009). What Does an Innovative Teaching Assignment Strategy Mean to Nursing Students? Nursing Education Perspectives.
Phillips, J.M. and Vinten S. A. (2010). Why Clinical Nurse Educators Adopt Innovative Teaching Strategies: A Pilot Study. Nursing Education Perspectives. 31(4), 226-229.
Mr. X, a 42-year-old man, appears at a primary care clinic today with complaints of low back pain (LBP) that he has been experiencing since a skiing accident ten years ago. Mr. X has Type 2 diabetes, which is well-controlled with metformin (HGA1c = 5.6). On the recommendation of a friend, he began taking two over-the-counter medications: kava kava for what he calls anxiety and CoEnzyme Q10. Mr. X has been a pack-a-week smoker for 15 years. He reports low back stiffness and discomfort with movement, as well as intermittent spasms associated with movement in certain directions. This paper discusses Mr. Xs pharmacological treatment and non-pharmacologic approach, taking into account probable drug-drug interactions and side effect patterns.
Diagnosis of the Patient
Mr. X claims that he has suffered from persistent low back pain since a skiing accident around ten years ago. Sprains and strains of lumbar (lower back) muscles are the most prevalent causes of low back pain. The lower back is prone to muscle strains since it bears the weight of the whole upper body and is engaged in movement, turning, and bending. A lumbar muscular strain is caused by abnormally stretched or damaged muscle fibers. A lumbar strain is triggered by the separation of ligaments from their attachments. Both of these conditions might occur from an acute injury or from prolonged usage. Lumbar strain is thus the most probable diagnosis for Mr. X.
The rationale for the diagnosis of Mr. Xs condition as lumbar strain is based on his clinical presentation. Acute mechanical back strains might be caused by physical or non-physical action, with lifting as the most frequently reported occurrence (Moustafa El Sayed & Callahan, 2022). After moving boxes three days earlier, he felt a pulling feeling in his lower back. The clinical manifestations of a lumbar strain include a lumbar muscular ache or non-specific pain. Acute pain is intense in the first 24 to 48 hours after an injury. For the subsequent twenty-four hours, Mr. Xs pain severity steadily grew. Active spasms and passive stretching of the affected muscle might worsen the discomfort while standing and twisting, hence exacerbating the pain.
Treatment Plan
Non-Pharmacological
All recommendations suggest including a progressive activity and exercise regimen in non-pharmacological treatments. It has been shown that exercise regimens diminish kinesiophobia and fear-avoidance attitudes (Ketenci, 2021). The most popular workout routines are those that target the motor regulation of the stabilizing abdominal muscles. Loss of lumbar spinal stability is seen as a risk factor for the development of low back pain. The transversus abdominis, the innermost abdominal muscle, is crucial for maintaining the lumbopelvic area (Moghadam et al., 2019). Hence, it is believed that reduced activation of this muscle is connected with the incidence and development of low back pain.
The outcome of therapy for low back pain is influenced by psychosocial aspects like pain catastrophizing, the patients self-efficacy, and kinesiophobia. In situations when patient education is inadequate to retain mobility and assure involvement in everyday activities, including employment, which are crucial parts of the initial therapy, psychosocial techniques are used. It has been shown that multidisciplinary rehabilitation programs comprising regulated exercise therapy and concomitant medication administration are more successful (Foster et al., 2018). Yet, it should be remembered that manual therapy, craniosacral therapy, physical therapy, exercise, and kinesiotaping also help with pain management and lessen discomfort and phobia of movement.
Pharmacological
Acute low back pain is first treated with nonsteroidal anti-inflammatory medications (NSAIDs) and muscle relaxants. The NSAIDs give some functional enhancement and temporary alleviation of lower back discomfort. Considering the potential for adverse effects (renal, cardiovascular, and gastrointestinal), a number of recommendations support the use of NSAIDs for individuals with lower back pain (Oliveira et al., 2018). It is advised that NSAIDs be taken at the lowest feasible dosage for the shortest term feasible. In addition, myorelaxants are often administered when the myofascial origin of low back pain is suspected, and their combination with paracetamol and NSAIDs is commonly utilized in clinical settings (Oliveira et al., 2018). Patients with acute, frequent muscular spasms accompanied by persistent lower back pain are advised to use these medications for brief durations.
Use of OTC Products
Mr. X utilizes over-the-counter (OTC) medications, such as Kava Kava and CoEnzyme Q10. Kava Kava is a component of the pepper family with psychoactive and pain-relieving qualities, as well as a muscle relaxant activity. At regular amounts, it has been found to aid in sleep, while in lower levels, it acts as a stimulant (Timbo et al., 2018). Due to the danger of weight loss, starvation, apathy, and serious liver diseases such as cirrhosis, hepatitis, and liver failure, the FDA issued a consumer alert about kava dietary supplements (Timbo et al., 2018). Kava may amplify the actions of central nervous system (CNS) depressants like benzodiazepines, which are used to treat sleep disorders or anxiety.
Coenzyme Q10 is a crucial vitamin-like component necessary for the normal functioning of several organs and chemical processes in the body. Coenzyme Q10 should be administered with caution in large dosages to patients with liver disease, bile duct obstruction, or liver dysfunction (Mantle & Hargreaves, 2019). Doses of more than 300 mg per day may influence liver enzyme levels. CoQ10 must be taken with caution in patients on warfarin since it may diminish the efficacy of the anticoagulant. When used as indicated, CoQ10 supplements seem to be safe and have few negative effects. Minor adverse effects may include digestive issues, such as upper stomach discomfort and appetite loss.
Education Plan
Stretching activities, enough rest, and ergonomic exercises must be stressed to patients. Workouts are vital for those with a lumbar strain since they enhance flexibility and decrease muscular stiffness, reducing discomfort and preventing future damage. These workouts may involve hip, hamstring, and back exercises (Ketenci, 2021). It is essential to do stretching exercises properly since poor technique might result in more damage. Rest is also essential for those suffering from lumbar strain. Resting the injured region reduces inflammation and promotes the healing of the tendons, muscles, and ligaments. However, during rest time, it is essential to discourage exercises that may worsen the injuries, including lifting heavy objects or high-impact workouts.
Ergonomic workouts entail modifying ones work or home surroundings in order to alleviate back strain. This may include employing correct lifting methods, altering overall body posture when seated or standing, and utilizing supporting equipment like ergonomic seats or standing workstations. Ergonomic workouts assist in preventing future injuries and enhancing general comfort. The patient must be educated on the necessity of smoking cessation and given assistance to help them stop. Cessation of smoking may lessen the signs of lumbar strain by enhancing circulation, lowering inflammation, and increasing tissue repair. In addition, cessation of smoking can help in preventing other diseases, such as lung cancer.
Furthermore, Mr. X has a BMI of 27, which is a high value. The normal BMI range is between 18.5 to 24.9, according to the CDC (2022). Thus, it is essential to educate the individual on the significance of weight loss. This may lead to the onset or worsening of lumbar strain. Reducing weight may aid in reducing this extra strain and may lower the likelihood of developing or exacerbating lumbar strain. In addition, weight reduction may enhance general physical fitness by bolstering the core muscles that stabilize the lower back. Moreover, this may help prevent or treat lumbar strain and increase overall fitness.
Conclusion
Mr. Xs most likely diagnosis is lumbar strain. A lumbar muscular strain is caused by abnormally stretched or damaged muscle fibers. Non-pharmacological therapeutic alternatives, such as exercise therapy, physical therapy, and psychological measures, may aid in the decrease of pain. Similarly, pharmacological therapy alternatives, including nonsteroidal anti-inflammatory medications and muscle relaxants, may aid in managing chronic pain.
References
CDC. (2022). About Adult BMI. Centers for Disease Control and Prevention. Web.
Foster, N. E., Anema, J. R., Cherkin, D., Chou, R., Cohen, S. P., Gross, D. P., Ferreira, P. H., Fritz, J. M., Koes, B. W., Peul, W., Turner, J. A., Maher, C. G., Buchbinder, R., Hartvigsen, J., Cherkin, D., Foster, N. E., Maher, C. G., Underwood, M., van Tulder, M., & Anema, J. R. (2018). Prevention and treatment of low back pain: Evidence, challenges, and promising directions. The Lancet, 391(10137), 23682383. Web.
While the grandparents were young, they watched TV commercials that promoted smoking as being healthy for anyone. The problem of smoking and its serious consequences for health has become extremely relevant during the COVID-19 pandemic. After all, smokers, whose lungs were usually depleted of nicotine and resins, were at increased risk of infection. In addition, their weakened immune system and frequent and chronic problems with the respiratory system, for example, asthma, could not cope with the virus on their own. Therefore, such infected persons were more likely to suffer from severe consequences. The efforts of many medical professionals over many decades have been directed at destroying a business empire built on extremely unhealthy products and resulted in harm reduction doctrine. However, this empire always managed to strike back. Therefore, through mechanisms of authorized legislative and law enforcement bodies using medical research, society should solve the tobacco problem.
I have spectated cases of severe effects from alcohol consumption and lung cancer caused by smoking. This influenced my worldview and desire to change the existing state because I believe any child should not have to see the horrors caused by the inability to give up bad habits. Hazard minimization is a supplement to stopping tobacco consumption and making it easier to attain cessation rather than taking precedence over them (Hatsukami & Carroll, 2020). A shift in the conception of tobacco products regulation is required because, in my opinion, the current and widely accepted harm reduction philosophy has not lived up to the expectations put on it.
Statistics are an unquestionable indicator of how devastating and deadly the effects of smoking are on ones health. The majority of deaths in the USA that may be prevented are caused by tobacco smoking, which accounts for about $175 billion in yearly medical expenses in the country. Many respiratory conditions, such as lung cancer, respiratory failure, and progressive inflammatory pulmonary illness, result from tobacco use. Almost 16 million individuals in the US live with a tobacco-related illness, with the proportion of tobacco consumption among people in the country in 2019 being 34.1 million (Eakin et al., 2022). The social repercussions of smoking are especially significant since passive smoking jeopardizes the lives of the smokers loved ones and himself. The smell of smoke and cigarettes is rather revolting, which may lead to family arguments and the persistent urge to smoke. Frequently going out can sabotage many crucial interactions and occasions.
Critics of the abovementioned viewpoints cite the economic impact of nicotine addiction. The quantity of taxes paid is spectacular in terms of budgetary income because the tobacco sector is one of the most lucrative ones, but the majority of these monies are used for medical treatment to treat smoking-related illnesses. Although using tobacco has no economic advantage for the consumer, there are large expenses associated with the habit, so if the user stops, his quality of living will likely improve dramatically on all fronts, not just his health (Eakin et al., 2022). According to the principles of state regulation of private spheres of a persons life, his rights and freedoms allow him to do whatever he wants without going beyond the legal boundaries. Because of this, even when bad habits are harming a persons health, they have the right to spend money that they have earned legitimately.
Thus, it is required to implement a system of measures to address the issue of tobacco products, which should be based on new legislation to assure compliance. All scented smoking goods, including those with peppermint, must be taken off the industry. According to the World Health Organization, tax rates on nicotine consumption must be raised. Any location must strictly control cigarette or vape marketing targeting young people and underprivileged communities. These prohibitions serve as instructive examples of the newly developed ideology, which intends to completely ban the use of tobacco products by the general public. The popularization of medical and governmental advice is essential to achieving this aim since it depends on societys acceptance and compliance.
Client hearing instrument fitting is done to help the functionality of the ear. This assists in the amplification of acoustic signs to the extent that it enables a person with hearing difficulties to make use of the left capabilities effectively. The instrument is fitted to the patients ear and the acoustic performance is then evaluated (Harvey, 2001).
This paper is therefore going to focus on Mrs. W, who has hearing problems. The paper will conclude by giving an insight into these rehabilitative strategies.
In the first mention, speech scores are not expected, the audiogram shows that both ears are the same and speech scores should be about the same. This client may not benefit fully from this aid in both ears due to poor discrimination scores. The left ear is slightly disadvantaged and needs an ENT for determination on aid and amplification fitting.
In the second mention, the hearing aid-fitting can be paused once the ENT provides medical clearance. If the problem persists though, hearing aids should be fitted. The patient should be subjected to speech rudimentary, binaurally as well as monaurally. If binaural results are good, then binaural fitting will be recommended if not, right ear amplification will be recommended. This is because binaural inhibition effects can be realized, which are responsible for shaping frequency selectivity of single neurons in the inferior calculus (Gooler, 2000).
The recommended hearing aid is the Phonak Certena. This aid has a fitting range for Mrs. W. The products frequency compression is recommended as; HF sounds can be audible to her without the aid being at uncomfortable levels. Frequency compression is highly advisable because, in this aid, high frequencies (above 1600Hz) are amplified in addition to a lowered frequency without shifts (Simpson, 2005). Phonak-Certena-BTEs are the most economical aids that have this. BTEs suit high-frequency hearing loss because it is designed to amplify and modulate sound for the wearer and can connect to assistive listening devices (Simpson, 2005). The patient needs BTEs and Hard Acrylic Skeleton molds since soft molds deteriorate and needs replacement frequently. Once more, acoustic feedbacks with short models are likely to be problematic. Skeleton molds are more comfortable, reduced, easy to insert and are made with extended helix for better retention (Hayes, 2004)
As shown by Simpson (2005), 1.5 mm vents are reliable for the first time because of low-frequencies, prevention of occlusions, and hearing of own voice, hence the small vent. Alternatively, if still intolerable, audiologists can increase vent size in the clients ear-mold. Considering the gain needed at 4000-Hz, the Libby horn which leaves the amplifier available for future gain-increase is recommended should the patients hearing decrease (Valante, 2007).
In the third mention, the patient is highly motivated to use a hearing aid. If she cannot take this up because of poor management, assistive listening devices would come in handy. The ALDs would be helpful with the TV, phone, and doorbell. These devices are fitted with flashlights and are priced at 130$ (Rudisill, 2009).
The patient has an OHS voucher meaning, she is eligible for subsidized hearing aids that can even have Tele-coil programs for phones. With dexterity issues, she might again have difficulties in using these gadgets. Top-up aids might also fit her as she only meets partial costs. This will happen in the fourth mention.
In the fifth mention, the patient will be fitted with aid that has frequency compression, most probably the economical Phonak Certena-BTEs. Speech testing will be done after which subsidized options would be put into consideration according to client preference and speech scores.
If the above remedies are ineffective and the patient still wants something else, then Hybrid Cochlear Implant would be advisable. The advantages of this option are that she will benefit from government funding, they do well with speech and she can easily hear the TV, phone, and doorbell. These Implants might be costly but due to government intervention, they are relatively cheap. They are recommended where other aids have failed as they replace natural hearing by digitizing electrical-impulses sent to the brain, the brain then interprets the sound (Briggs, 2008). This is also suitable for Mrs. W as she has a problem with TV, phone and doorbell.
References
Briggs, H. (2008). Comparing advantages of hearing aid. Journal on cochlear implantation 8 (4), 82-97.
Gooler, M. (2000). Binaural Inhibition. Journal of binaural inhibition effects 24 (2), 62-69.
Harvey, D. (2001). Hearing Aids. Sydney: boomerang Press.
As Doomerholt (pp. 1-2) states, myalgia generally means muscle pains. Hence, considering the fact that there exist many causes of muscle pains, Myogia is more of a warning indication of many underlying and undiagnosed health complications or disorders. Muscle pains can be an indication of numerous undiagnosed health complications, for example, autoimmune disease, multiple sclerosis, and Devics disease.
Depending on their causative agents and duration of existence without being attended to, the muscle pains can be chronic or temporary Therefore, because muscle pains can be caused by numerous factors or diseases that have common symptoms, it is important for individuals to seek quick medical attention once they experience chronic muscle pains, to avoid the wrong prognosis, which may complicate the underlying disorder or disease.
Causes of Myalgia
There exist numerous causes of muscle pains, which vary from the simple overstraining of muscles to complex health complications, for example, lupus, dengue fever, polio, and fibromyalgia. Medically, although certain genetically inherited medical complications can cause muscle pains, Myalgia is not a genetic condition, but rather it may indicate the presence of many underlying genetic anomalies in individuals; hence, making it an acquired condition.
Primary causes of Myalgia include injury and sprain to muscles overuse of muscles; mostly in prolonged exercises scenarios, and shock. Muscle pains are also common in individuals who use certain drugs, for example, cocaine, statins (cholesterol-reducing drugs), and ACE inhibitors (commonly used by patients with blood pressure anomalies).
Further, muscle pains can also be a result of mineral electrolyte imbalances, for example, potassium. Other common causes of Myalgia include autoimmune anomalies, for example, multiple sclerosis, metabolic defects such as Conns syndrome and hyperthyroidism, and health complications such as Rhabdomyolyis, Polymyolisis, polio, muscle abscess, influenza, dermatomyositis, hermohhagic fever, and Lyme disease (Gill and Quisel 182-184).
Symptoms of Myalgia
Common indications of muscle pain include sharp aches of certain muscles, pain within joints, extreme body weakness and fatigue, intermittent headaches, abnormal heartbeat rate (common in scenarios when heart muscles have been affected), persistent hearing and vision problems, respiratory distress, numbness or tickling feeling on somebody parts such as the face and legs (Health Central 1).
Diagnosis
Due to numerous cases of Myalgia, individuals should avoid the self-diagnosis, as this may complicate any underlying problem. The first step of diagnosis is an examination of the physical condition of the patient and analyzing the historical development of the condition.
This should be followed with lab tests that may include Myoglobin, thyroid function, glucose, aldolase, urinalysis, CBC (complete blood count), erythrocyte Sedimentation rate, Creatinine, electrolytes, and creatine kinase tests. Diagnosis can also include the use of electromyography to check the presence or absence of myopathy, Magnetic Resonance imaging, and muscle biopsy (for assessing any existing cases of inflammatory myopathies) (New Medical Information Health Information: NMIHI Para 5-9).
Treatment
Depending on the outcomes of the diagnosis, there exist a number of remedies to Myalgia. If the condition was caused by an underlying disease or disorder, then individuals have to take medication to cure the disorders or infections, by use of antimicrobial, steroids, immunosuppressive therapies, or in extreme cases surgery of the affected body part. In addition, individuals can treat the symptoms by stopping the use of certain drugs, resting accompanied with controlled exercising and taking medicines to correct mineral imbalances (Breast Cancer Organization 1).
Prognosis
Because, determining the underlying causes of Myalgia is hard without medical help, and considering the fact that some causes of Myalgia are fatal if unattended to, it is of significance for individuals to seek immediate medical attention once they experience continuous muscle and joint pains. Proper prognosis of Myalgia depends on correct diagnosis, and adoption of appropriate treatment remedies to alleviate the likelihood of any complication resulting.
Therefore if a correct prognosis is done, the likelihoods of providing lasting solutions to the underlying diseases or disorders are high. This is of great significance for the maintenance of a healthy body; hence, a quality life. However, if a wrong prognosis is done, the probability of the adopted treatment remedy complicating the underlying disorder or disease is high; hence, greatly impairing ones wellbeing and quality of life (New Medical Information Health Information: NMIHI Para 9-11).
Works Cited
Breast Cancer Organization. Muscle pain (Myalgia). Breast cancer Organization. 2010. Web.
Gill, James, and Quisel, Anna. Fibromyalgia and diffuse Myalgia. Clinics in Family Practice, 7.2 (2005): 181-190. Web.
Health Central. Myalgia symptoms. Health Central. 2010. Web.
Patient Anna, 26 years old, has been suffering from diabetes of the second degree for 20 years. In the last 3 years, her well-being began to deteriorate as she began to live independently and moved away from her parents. The girl is experiencing anxiety disorder, eating disorders, as well as neurosis as a consequence of her chronic diagnosis.
Discussion
Throughout her life, the patient has shown a lack of conscientiousness in following doctors orders. She was tested less frequently than required, her insulin levels were monitored, and she did not follow her prescribed diet well. In the last week, the girl was admitted to the hospital after fainting because she had been without access to insulin for an extended period of time. This was the reason for hospitalization, but after the normalization of her condition, it was discovered that the patient was not familiar with the basic rules of diabetes self-care, which was the main reason for starting an educational program.
The patients main need is to gain knowledge and skills on the most favorable regime for living with this diagnosis and to increase literacy in the area of necessary medications. Moreover, it is important to show the girl what methods of psychological self-help she can use to reduce the manifestations of her disorders. The basic method that best suits the girl is the method of an informed, interactive conversation in which she can ask clarifying questions and share her own experiences. The patients education will be based on the fact that she has a sufficient level of education to understand some basic medical terms. Moreover, given her declining quality of life, Anna has a high level of motivation, which translates into great engagement and the ability to concentrate throughout the conversation. The girl also has good computer skills and no current complaints of pain, which greatly increases the chance that the training will be effective.
The patient already knows that the course will consist of conversations aimed at increasing her self-care and self-help skills; she is not told about a detailed lesson plan by the staff. As with any training, sessions with the girl will be based on cognitive, psychomotor, and affective domains. The first involves all the elements of consciousness involved in the process, including memory, specificity of thinking, quality of attention, and concentration. Psychomotor encompasses physical conditions, which include the form of interaction with the student, body position, and level of fatigue. Finally, affective domains are based on the emotional component of learning, taking into account mood, motivation, and psychological microclimate. In Annas case, the psychomotor aspect would be the most important, because her well-being is not always stable and will greatly influence the other two components.
Conclusion
Within the diagnosis of Knowledge deficient, the goal for the patient is to teach the girl all available self-help tools for 1 month, which will be tracked by the final testing. During the month, 50-minute classes will be held twice a week, with the inclusion of self-training. Rationale: repetition and self-study are critical for effective learning of patients having problems with self-care skills (Monroe & Wilkerson, 2022). Talks will be set up in a well-lit study room, in the absence of family and friends, as the goal is to increase self-help skills. Teaching materials such as Assessment of self-care and education in patients with type 2 diabetes mellitus will be used (Monroe & Wilkerson, 2022). As part of the control of the effectiveness of the course conducted, a final test will be organized to test the theoretical knowledge. From a practical point of view, it will be evaluated how the patient is able to provide care to other clients of the clinic with the same diagnosis. If it were necessary to evaluate the work of another specialist, I would use the same evaluation tools.
Reference
Monroe, K. & Wilkerson, A. (2022). Assessment of self-care and education in patients with type 2 diabetes mellitus. Routhledge.
In order to treat patients with type 2 diabetes, a comprehensive approach is essential. It involves educating the patient, assessing them for related issues, achieving near-normal blood glucose levels, and reducing the risk of cardiovascular problems through appropriate medications (Wexler & Nathan, 2022). The goals for blood sugar control must be tailored to each patient, simultaneously considering the possibility of hypoglycemia and other side effects and the expected decrease in microvascular complications over time. Generally, an A1C of d7 percent is a reasonable target, though it may be increased for elderly adults and those with other conditions or limited life expectancy (Wexler & Nathan, 2022). Better regulation of sugar levels in the blood has a protective effect against microvascular complications in type 2 diabetes and a beneficial effect on macrovascular outcomes.
In a clinical setting, this information can apply to patients with newly diagnosed type 2 diabetes. Healthcare providers can use this information to develop a personalized treatment plan tailored to the individual patients needs, goals, and health status. It is crucial to consider the patients age, comorbidities, and life expectancy when setting treatment goals for glycemic management. Moreover, the healthcare professional should prioritize managing cardiovascular risks, including helping people quit smoking and recommending aspirin for those with atherosclerotic cardiovascular disease or after discussing the potential benefits and risks with the patient.
Healthcare practitioners must consider the ethical, cultural, and societal consequences when managing those with type 2 diabetes. One relevant moral issue is the possibility of hypoglycemia and other unwanted treatment effects, which must be balanced with the advantages of glycemic control. Additionally, caregivers must acknowledge cultural and social aspects, like the patients dietary inclinations and lifestyle habits, when developing a tailored care plan. Furthermore, nurses should be mindful of disparities in healthcare access and understanding, which may significantly affect specific groups of patients. To sum up, healthcare providers must treat type 2 diabetes with consideration and awareness of each patients unique needs and circumstances.
The key points of treating the diabetes 2 include the following:
Mindfulness-based interventions can improve nurse well-being by reducing stress, anxiety, and burnout while also increasing job satisfaction.
Mindfulness-based interventions can lead to better patient outcomes such as reduced pain, anxiety, and length of hospital stay.
The use of mindfulness-based interventions in a clinical setting should consider ethical, cultural, and social implications, as well as accessibility for nurses from diverse backgrounds.
Health professional education often uses Millers pyramid as a model or taxonomy of knowledge and skill levels. However, Miller asserted that the standard method of assessing medical students focused too much on evaluating their knowledge and too little on evaluating how the student might behave in a real-life consultation (Miller, 1990).
Discussion
As a result of the Miller pyramid, medical education moved away from the traditional Flexnerian model, which was primarily based on knowledge assessments, to a clinical-based examination system.
Millers Pyramid, which is a model for classifying levels of learning outcomes, can be applied in physical therapy education in the following ways (Kumar et al., 2021):
Knowledge: In physical therapy education, students must have a strong foundation of knowledge in anatomy, physiology, and kinesiology. This can be assessed through exams, quizzes, and written assignments that test their understanding of the basic sciences.
Comprehension: After acquiring knowledge, students must demonstrate an understanding of the material by applying it to real-life scenarios. This can be assessed through case studies, simulated patient encounters, and practical exams that test their ability to apply their knowledge in a clinical setting.
Application: To become competent physical therapists, students must be able to apply their knowledge and skills in real-life situations. This can be assessed through clinical rotations, internships, and supervised patient encounters where students can demonstrate their ability to apply their knowledge safely and effectively.
Analysis: At the highest level, physical therapy students should be able to analyze complex cases and develop effective treatment plans based on their knowledge and experience (Al-Jarshawi & Al-Imam, 2022). This can be assessed through case-based discussions, written assignments, and final exams that test their ability to critically analyze a patients condition and develop a comprehensive treatment plan.
Synthesis: The top-level focus is synthesizing and integrating information to create something new. This could involve developing new physical therapy techniques, designing research studies, and creating innovative approaches to patient care.
In Physical therapy, Millers pyramid is more applicable to assessing clinical reasoning. It must be able to apply all three clinical reasoning levels to provide adequate patient care. In 1990, Miller outlined a method for assessing clinical competence. At the lowest level of the pyramid is knowledge (knows), followed by competence (knows how), performance (shows how), and action (does) (Norcini, 2003).
Following Millers method for assessing clinical competence, a PT should be able to recognize problems during diagnostics and formulate practical treatment recommendations based on findings at both the problem and diagnosis levels. Further, these skills must be applied across various age groups and populations in a clinical environment.
Conclusion
Nevertheless, Millers Pyramid emphasizes the cognitive elements of competency to develop an evaluation method that recognizes the relevance of diagnostic reasoning. Considering the value of good diagnostic reasoning abilities for effective clinical practice, students must be tested on this ability to verify that they have the skill set required to practice safely (Witheridge et al., 2019). Using Millers Pyramid, physical therapy educators can ensure that students progress through various learning outcomes, from basic knowledge to advanced critical thinking skills (Al-Jarshawi & Al-Imam, 2022). This model helps ensure that physical therapy students are well-prepared to provide safe and effective patient care.