A Comprehensive Geriatric Assessment Simulation for the Primary Care Nurse Practitioner Student
Overview
This resource is a simulation activity which provides an experiential learning opportunity for both Family and Adult-Gerontology Primary Care Nurse Practitioner students to perform a comprehensive geriatric assessment on a Standardized Patient (SP). Students are expected to identify risk factors, formulate a differential diagnosis based on presenting symptoms, and determine priorities for further evaluation and/or intervention.
How to Use
- Prior to the simulation activity, learners should be directed to review any course or program materials pertaining to comprehensive geriatric assessment, geriatric syndromes, dementia, and depression care in the elderly.
- Review case with the SP and laboratory/simulation assistants.
- Each learner is provided 45 minutes to perform the comprehensive geriatric assessment on one SP.
- On the day of simulation, learners will have the opportunity for their simulation to be recorded, if they wish. Recording is not required. Faculty will observe the learner-SP interaction via a one-way mirror.
- Patient vital signs are provided prior to the learner entering the examination room for their assessment.
- If the learner chooses to complete any cognitive testing, depression screenings, etc., the SP will provide the learner with the test/screening scores (if they select those which are appropriate for their patient scenario.).
- Each learner may briefly step-out of the simulation space, once, to review any class or online resources to help formulate an evidence-based plan of care.
- Once the plan of care is complete, each learner will return to the examination room to review the plan with the SP and answer any questions.
- Learners are evaluated on their professionalism, collection of pertinent subjective and objective data, communication techniques and the ability to use a shared decision-making approach to guide SMART goals and the patient’s overall plan of care.
- During the debriefing session, faculty should use a script to facilitate the discussion.
- After the simulation and debriefing, learners draft a SOAP note and submit it to the faculty. This should be submitted no later than midnight on the day that the simulation activity was completed.
Integrative Learning Strategies
This is an experiential learning activity that requires advanced practice nursing students to demonstrate their ability to create a differential diagnosis based on an SP’s presenting symptoms, complete an appropriate history and physical exam, accurately conclude the diagnosis, and develop a reasonable plan of care. Standardized Patients are utilized to provide the learners with a patient-encounter that mimics a real-life scenario. Feedback is provided to learners during the debriefing session and following submission of the SOAP note.
Assessment Strategies
Faculty provide individualized feedback on the SOAP note and the observed simulation using a rubric. Learners are expected to evaluate their own performance during the debriefing session.
Exemplars
Comprehensive Geriatric Assessment Exemplar Paper
Comprehensive Geriatric Assessment Simulation Case
Possible Courses
- Adult-Gerontology Primary Care Nurse Practitioner Clinical Courses
- Family Nurse Practitioner Clinical Courses
- Advanced Health Assessment
Additional Resources/Publications
Comprehensive Geriatric Assessment Rubric
May, Win, Joo Hyun Park, and Justin P. Lee. “A Ten-Year Review of the Literature on the Use of Standardized Patients in Teaching and Learning: 1996–2005.” Medical Teacher 31, no. 6 (June 2009): 487–92. https://doi.org/10.1080/01421590802530898.
Nilson, Linda B. “14: Coordinating Experiential Learning.” Essay. In Teaching at Its Best, 170–74. San Francisco, CA: Jossey-Bass, 2016.
Sub-competencies for advance-level professional nursing education:
1.1f Demonstrate the application of nursing science to practice.
1.2g Apply a systematic and defendable approach to nursing practice decisions.
1.3d Integrate foundational and advanced specialty knowledge into clinical reasoning.
2.1e Foster caring relationships.
2.3h Demonstrate that one’s practice is informed by a comprehensive assessment appropriate to the functional area of advanced nursing practice.
2.4f Employ context driven, advanced reasoning to the diagnostic and decision-making process.
2.4g Integrate advanced scientific knowledge to guide decision-making.
9.2k Model professional expectations for therapeutic relationships.
9.2l Facilitate communication that promotes a participatory approach.
Posted: January 22, 2025
Submitted by:
Carli Ann Carnish, DNP, RN, APRN-CNP, Assistant Professor, Case Western Reserve University
Eric Baum, PhD, DNP, RN, APRN-CNP, Lecturer, Case Western Reserve University