Collaboration readiness: Developing standards for interprofessional formative assessment.

BACKGROUND: Graduate nursing education strives to promote collaborative practice on interprofessional teams. However, measuring collaboration during formative stages of professional development is rare. Few assessments are available to determine whether graduates of nursing education programs have met the required accreditation benchmarks. This project evaluates two performance standards for assessing collaboration during formative assessments. METHOD: Formative assessment of communication and collaboration skills was explored for 62 entry-level Master's students in nursing, using a team-based objective structured clinical examination (OSCE) involving two patient simulations and assessment checklists, and comparing normative (relative standard) and criterion-referenced (absolute standard) methods. RESULTS: Mean percentages of behaviors using the normative approach indicated a range of performance levels for particular communication and collaboration behaviors. Criterion-referenced standards were higher than normative standards from actual student performance. CONCLUSION: This method improves assessment of collaboration through OSCEs using normative and criterion-referenced standards. We recommend using both methods jointly when setting standards or qualifying scores.

HFE-associated hereditary hemochromatosis: overview of genetics and clinical implications for nurse practitioners in primary care settings.

PURPOSE: HFE-hemochromatosis is one of the most common genetic disorders in the United States among Caucasians of Northern European ancestry. The purpose of this article is to discuss HFE-associated hereditary hemochromatosis (HH), including the genetics, pathophysiology, phenotype and genotype, diagnostics, and management utilizing a case-based format as an exemplar. DATA SOURCES: Online genetic resources; professional guidelines; review; and scientific articles. CONCLUSION: HFE-HH is an autosomal recessive disorder and two major genes C282Y and H63D are associated with HH (iron overload) susceptibility particularly C282Y/C282Y mutations. It has a variable penetrance and expression. Individuals who develop iron overload may develop broad symptoms, including joint discomfort, fatigue, decreased libido, and abdominal pain; and if left untreated, HFE-HH has the potential of developing end-organ disease including liver fibrosis, cirrhosis, and cancer; cardiac arrhythmias or heart failure; and diabetes. Suspicion of the disorder begins with personal and family history, transferrin saturation, and ferritin levels, and if high, genotyping to confirm the disorder. Management consists of correcting iron overload to prevent/delay end-organ damage often consisting of intermittent phlebotomy. IMPLICATIONS FOR PRACTICE: Knowledge of HFE-HH is essential so that nurse practitioners can identify individuals at risk and to provide appropriate management of care and referral.