3. Summative assessment
The summative (marked) assessment will build on your chosen vignette (case study) and comprises of a educational portfolio. This will include information from the four themes (Learning Units 1-4) that will examine legal and ethical issues representing different aspects of the module learning units. You will also be required to provide evidence of achievement for each learning outcome within your portfolio.
You must use this TEMPLATE to complete and submit your portfolio. The template is a MS Word document that consists of the following sections:
EDINBURGH NAPIER UNIVERSITY
School of Health & Social Care
NUR09722
Exploring the Theory and Application of Law and Ethical Reasoning in Nursing Practice
PORTFOLIO OF EVIDENCE
Matriculation Number
Word Count
Date of Submission
date / month / year
Resubmission
(Yes / No)
Prior to submission delete all instructions in blue in order to adhere to word count and reduce text matching.
Cover Sheet
Please use the coversheet when you have completed your learning portfolio and before you submit it to Turnitin to ensure you have included all the required information and it is correctly formatted using the guidelines below.
Learning Portfolio
• Introduction
• LE1 Vignette/Scenario Situation
• LE2 Report
• LE3 Action Plan
• Conclusion
• References
Formatting and Presentation
• Line spacing: 1.5
• Text aligned: Left
• Font type: Arial
• Font size: 12
Background
The purpose of this educational portfolio is to enable you to identify and achieve the prescribed learning outcomes of this module, NUR09722 Exploring the Theory and Application of Law and Ethical Reasoning in Nursing Practice.
Learning Outcomes
The learning outcomes are as follows:
LO1. Critically examine the relationship between law, ethics and ethical reasoning in nursing practice in Singapore.
LO2. Implement and appraise a decision-making process using legal and ethical framework or code of practice
LO3. Demonstrate critical understanding of values-based practice to a population group to inform future delivery of health care services in Singapore
LO4. Critically reflect on the way in which healthcare legislation, culture and society influence ethical nursing practice and health and well-being more broadly.
You will be required to provide evidence of achievement for each learning outcome within your portfolio.
What is an educational portfolio?
“An educational portfolio attempts to connect and relate the student’s learning experiences to professional practice and competencies. An educational portfolio may contain a collection of items that demonstrate personal reflections, skills, knowledge and accomplishments as evidence of a student’s progress and learning.” (Hill, 2014)
Educational portfolios are grounded in problem-based learning (Kunkle, 2009). This approach allows students to search and discover while they are learning. Students learn by active questioning, discussions, problem solving and critical thinking. Students search out information and assess its relevance, leading to the use of reflection.
Evidence of Achievement of Learning Outcomes
Your portfolio requires to be written in an academic style at Scottish Credit and Qualifications Framework (SCQF) Level 9. Guidance about this level of academic writing can be found on the SCQF website (see Level Descriptors section). http://scqf.org.uk/the-framework/scqf-levels/
Student services and the library also provide support around academic writing. https://monkessays.com/write-my-essay/napier.ac.uk/study-with-us/undergraduate/student-support
Academic Evidence
You must produce academic evidence within your portfolio of your achievement of the learning outcomes for this module. This should include references of nursing and health related books and journals along with reports, publications and websites from high quality, reliable sources.
Completing your Portfolio
To complete your portfolio you MUST use this template. In order to successfully populate your portfolio with evidence you will need to engage with the module content on Moodle and attend the face to face lectures, tutorials and online classroom.
Once completed, your portfolio will be submitted electronically via Turnitin. Refer to Moodle for guidance on submission of your portfolio via Turnitin (details will also be covered in tutorials).
References
• Hill, T. L. (2012). The portfolio as a summative assessment for the nursing student. Teaching and Learning in Nursing, 7(4), 140-145.
• Kunkle, J. (2009). The clinical portfolio: An assessment tool for clinical student learning. Radiologic Science and Education, 14(1), 3−8.
Learning Portfolio Assessment
Introduction
Learning Outcome 1 will be addressed by briefly examining the importance of law and ethics in nursing practice.
Word Count Guide: Approximately 300 words
Portfolio Entry 1
Ethical vignette (scenario situation). Reflect on your everyday practice and try to identify a situation which represented an ethical problem or dilemma. The situation may also involve relevant legal and/or professional issues which it may be appropriate to address.
The chosen situation should be adapted on the basis of the work you have already done for the formative assessment.
Word Count Guide: Approximately 500 words
Portfolio Entry 2
Learning Outcomes 2, 3 and 4 will be addressed by discussing, analysing and evaluating the research and evidence base that informs the discussion related to the vignette/scenario from an ethical standpoint taking into account relevant legal and/or professional issues as appropriate and with reference to supporting academic literature.
When planning your report section, it may be helpful for you to consider the situation in relation to each participant e.g. the nurse, patient, relatives and other healthcare professionals as appropriate.
In your discussion it will be important to consider the law and ethical issues. We recommend that you use the bioethical principles as your ethical framework and use should also be made of the philosophical theories of deontology, utilitarianism and values-based care as appropriate.
Your discussion must be supported with academic evidence.
Word Count Guide: Approximately 1,750 words
Portfolio Entry 3
Learning Outcome 4 is addressed by reflecting on how this learning will inform future practice and you should develop an Action Plan to address what would be done if the situation arose again?
We ask you to use reflection because it will allow you to think about the things you have learned from this situation and to consider whether you were satisfied with the outcomes or whether you would handle the situation differently in the future. In order to complete the action plan of your portfolio we recommend that you consider this stage of a reflective model (see Appendix 1 & 2 for examples of reflective models).
This Action Plan should be written in the 1st person
Word Count Guide: 700 words
Conclusion
Summarise the key aspects discussed in the portfolio and the implications for future nursing practice. No references are required in the conclusion. The conclusion should be written in the third person.
Word Count Guide: approximately 250 words
References
Please include a list of the references you used in your learning portfolio here. These must follow the APA6th referencing style and be written in alphabetical order by first author’s surname. Referencing guidelines are accessible here: http://libguides.napier.ac.uk/shsc/ref
Appendix 1: Gibbs (1988) Reflective Model
Reference
• Gibbs, G. (1988). Learning by Doing: A guide to teaching and learning methods. Oxford: Oxford Polytechnic Further Education Unit.
Appendix 2: Borton’s Reflective Model (1970)
References:
Cottrell, S. (2011) Study skills: critical thinking skills: developing effective analysis and argument. London: Palgrave MacMillan.
Nicol, J. S. & Dosser, I. (2016) Understanding reflective practice. Nursing Standard. 30(36), 34-42. doi:10.7748/ns.30.36.34.s44. ISSN 0029-6570.
1. Introduction: Provide an introduction to topic and state the importance of law and ethics in nursing practice (300 word)
2. Portfolio Entry 1: Include the ethical vignette (scenario situation). Reflect on your everyday practice and try to identify a situation which represented an ethical problem or dilemma. The situation may also involve relevant legal and/or professional issues which it may be appropriate to address. (500 words)
What is a vignette
The ethical vignette aims to highlight ethical and legal issues through a record of clinical interactions. We recommend that the ethical dilemma is from a real-life situation that you have experienced, however it may be a hypothetical case based on your reading of the topic. If you are using a real-life situation please make sure the names and details of the characters, environment and situation are not identifiable (i.e. provide psuedo-names). In order to write about the case you must have a clear sense of the value of your ethical dilemma and form a clear picture of the case you wish to present. It is important to stick to the facts about the case.
The vignette ability to capture the ethical and legal issues comes from the structure, therefore it is important to divide into the sections including: introduction; case study; assessment of the ethical/legal issue; and plan. Each section will consist of a narrative describing the historical or social context of the ethical and/or legal issues. Consider what was especially challenging about the case and check if similar cases have been reported previously in the literature.
How to get started in writing your vignette/scenario:
1. Note the facts: who involved? What is the situation?
2. Identify the ethical issues: what is at stake? what values are in conflict?
3. At what point did you consider there was a ethical/legal problem/dilemma?
4. Brainstorm options available : what did they do? what could have been done?
5. It will be important to think about the message or lesson that the case will present throughout your portfolio.
When writing the vignette keep the case concise and focused. Avoid the use of jargon and abbreviations and use the same tense verbs throughout.
Vignette Example
Description of a situation which raised ethical issues in your practice
Mr Smith, aged 84 years, was admitted to hospital with a chest infection. He had known dementia, but on admission he had a higher level of confusion due to the infection. The nurses responsible for his care were becoming increasingly concerned as they were unable to administer his medication. Any attempts to administer any medication resulted in increased agitation and refusal of the medication. The nurses attempted to talk to Mr Smith about his medication in order to establish if he understood why he needed the medication and what would be the likely consequences of refusing. However, it became evident that he was unable to understand or retain the information and he was not able to communicate what would happen if he continued to refuse. Mr Smith’s daughter was extremely concerned and upset at how ill and confused her father had become and asked if the essential medication could be hidden in a drink or yoghurt.
This scenario raises the ethical concern that by treating Mr Smith’s chest infection the nurses were being asked to disguise his medication in food and drink, therefore it would be given to him without his knowledge or consent. (194 words)
Identification of the ethical and/or legal issues within the situation, include references (minimum of 2) using APA 6th citation method.
Between 22% to 89% of patients with dementia may have delirium superimposed on their dementia as a result of another condition or infection (Fick, Steis, Waller and Inouye, 2013). This can present challenges when administering medications. The ethical principle that persons have “autonomy” makes it clear that patients have the right to make decisions about their consent to treatment and this should be respected (Beauchamp and Childress, 2007). However, the likely consequence of Mr Smith refusing medication increases the risk of significant harm as a result of his chest infection. The nurses and his daughter clearly wish to act in a “beneficence” manner to provide him with the best care and treatment, therefore it was suggested that the medication should be given covertly. Indeed, there is widespread use of giving patients with dementia medications covertly and it is reported that as many as 17% of patients in institutional care receive their medications disguised in food and drink (Haw and Stubbs, 2010).
Before covert administration of the medications can be considered, decisions and actions must be carried out under the Mental Capacity Act (2008) to determine the patient’s decision-making capacity. Although, Mr Smith’s discussion with the nurses suggests that he may not have the capacity to make a decision around taking his medication, it is a requirement to establish the cause of this impairment before proceeding with giving covert medication. It is also important to be aware that capacity may vary depending on the time of day, the persons mood, and the level of familiarity of people and surroundings (Darby and Dickerson, 2017).
This portfolio will further explore the interests of the person who refuses treatment and lacks capacity to consent in order to consider the best course of action for them.
(293 words)
Beauchamp, L., Childress S. (2007) Principles of Biomedical Ethics. 5th ed. Oxford: Oxford University Press
Darby, R.R., Dickerson, B.C. (2017). Dementia, Decision Making, and Capacity. Harvard Review of Psychiatry, 25(6), 270-278.
Fick, D. M., Steis, M. R., Waller, J. L., Inouye, S. K. (2013). Delirium superimposed on dementia is associated with prolonged length of stay and poor outcomes in hospitalized older adults. Journal of Hospital Medicine, 8(9), 500-555.
Haw C., Stubbs J. (2010) Covert administration of medication to older adults: a review of the literature and published studies. Journal of Psychiatric Mental Health Nursing. 17(9), 761-768
Singapore Statues Online. Mental Capacity Act (2008) Retrieved from: https://sso.agc.gov.sg/Act/MCA2008.
2. Portfolio Entry 2 (report): you should then discuss this scenario from an ethical standpoint taking into account relevant legal and/or professional issues as appropriate and with reference to supporting academic literature. When planning your Portfolio it may be helpful for you to consider the situation in relation to each participant e.g. the nurse, patient, relatives and other healthcare professionals as appropriate. This can help you to see the ethical issues and when combined with an ethical framework e.g. the bioethical principles approach will be helpful in developing your discussion and use should also be made of the philosophical theories of deontology, utilitarianism and values-based care as appropriate.( 1,750 words)
3. Action Plan: Reflect on how this learning will inform future practice. (700 words)
4. Conclusion: Summarise the key legal and ethical points from the portfolio. (250 words)
5. References: following APA 6th guidelines
Word count
The word count includes all your written text from the beginning of the introduction to the end of the conclusion (excluding the assessment questions). The word count does not include the reference list or appendices at the end.
Please note that if the word count is more than 10% over the word limit of 3,500 words, then you could be penalised according to the university regulations.
3.1. What is an educational portfolio
Portfolios are used to illustrate the range of the activities undertaken over time in the development of written products throughout the module and relevant to the learning units. Educational portfolios are grounded in problem-based learning.
This approach will allow you to search and discover while you learn. Throughout the portfolio you will be encouraged to undertake active questioning, discussions, problem solving and critical thinking. It will be important to search out information and assess its relevance, leading to the use of reflection. All content of the learning portfolios must be linked to the learning outcomes.
3.2. Evidence of achievement of learning outcomes
Your portfolio requires to be written in an academic style at Scottish Credit and Qualifications Framework (SCQF) Level 9. Guidance about this level of academic writing can be found on the Moodle site under the Study section above.
Student services and the library also provide support around academic writing. http://my.napier.ac.uk/New-Students/Support/Pages/Support.aspx
Academic Evidence
You must produce academic evidence within your portfolio of your achievement of the learning outcomes for this module. This should include references of nursing and health related books and journals along with reports, publications and websites from high quality, reliable sources.
Completing your Portfolio
To complete your portfolio you MUST use the template provided. In order to successfully populate your portfolio with evidence you will need to engage with the module content on Moodle, attend the lectures and tutorials.
3.3. Submission Guidance
When you have completed your portfolio (3500 words) you should submit electronically via the Final Tunitin dropbox.
The date of submission is Thursday 15/08/18 at 12 mid-day via the Final TURNITIN dropbox
Please remember to check the similarity index via the Originality TURNITIN dropbox prior to submission (note that TURNITIN may not produce more than one similarity report within a 44 hour period). Updated School guidelines state that you may only check this consistency once prior to final submission: https://guides.turnitin.com/01_Manuals_and_Guides/Instructor/Instructor_User_Manual/21_Similarity_Check
Please note TURNITIN asks you to declare the work is your own so no front cover is required.
The final assessment word limit excludes any appendices and references and the maximum word limit should not exceed 3500 words. Please note that if the word count is more than 10% over the word limit for each component then you will be penalised:
0-10% 11-20% 21-40% 41-60% 61-80% 81-100% >100%
Penalties for Marking No penalty -10 -20 -30 -40 -50 Not marked
If you have specific questions please feel free to contact your academic supervisor well before you submit your final summative assessment.
3.4. Academic writing information
This assignment requires you to look critically at the information sources that you have selected in order to explore your chosen psychosocial issue. There are a range of resuources which are helpful.
Get ready for university study – critical thinking
https://www2.napier.ac.uk/getready/managing_information/critical_thinking.html How to study section
There are several resources available to you to help you think about how to write your assignment.
Get ready for university study -essay writing
https://www2.napier.ac.uk/getready/writing_presenting/essays.html How to study section
Prior to commencing work on your essay please re-read the Guidelines for written work available in your Programme Handbook particularly the level 9 criteria. Please also read the Academic Code of Conduct.
The submission must be your own work – the following web link offers information re plagiarism: https://www2.napier.ac.uk/ed/plagiarism/
Turnitin- Turnitin is a text matching software which is used by the Edinburgh Napier University to aid in the prevention and detection of plagiarism. You will have the opportunity to submit a draft of your work through Turnitin prior to your final submission. This will allow you to review your work using the guide to interpreting your originality report (see below). Your final submission will also be submitted through Turnitin.
A student guide to Turnitin available from: https://www2.napier.ac.uk/ed/plagiarism/students-TurnitinUK.htm#do
Guide to Interpreting your Turnitin report available from:
https://www2.napier.ac.uk/ed/plagiarism/students-tutorials.htm
Citation Method – The assignment must be referenced throughout using the APA 6th Referencing System, and you should provide an appropriate Reference list at the end. You will be awarded marks for the appropriateness, accuracy & detail in your referencing technique.
You should be feeling confident with your referencing technique by now or, from feedback on your discussion assignment, know the areas that you can improve.
Bibliographies and referencing guidelines available from:
https://libguides.napier.ac.uk/shsc/ref
If you require help in how to search for information you will find the following web link useful
https://libguides.napier.ac.uk/shsc/litrev
Word Count: The maximum word limits must be adhered to. If you are exceeding the word limit you should check that your writing is still relevant and concise.
The word count includes all the text from the beginning of the introduction to the conclusion/recommendations and the references included in this text. The word count does notinclude appendices, reference list or bibliography.
No marking penalty will be applied to this assignment.
Presentation – Please pay attention to your grammar, spelling and academic style; you will be awarded marks for these elements of your assignment. The following are suggested guidelines for layout and presentation.
1) Font size Arial 12
2) Double spacing or 1.5 spacing must be used.
3) Pages should be single sided and clearly numbered.
It is good practice to:
a) check grammar, spelling and punctuation.
b) get work proof-read before submission.
c) ensure that words mean what you think they do – use your dictionary!
3.5. Level 9 marking criteria and feedback
To mark the assignment academic supervisors are provided with Level 9 marking guidelines/rubric and feedback is supported by commentary related to the each the sections of the abstract and research proposal is provided using Turnitin grademark and can be found in the overall comments box, whereas quick marks will be used to highlight specific areas of text.
4. Unit discussions
The four Unit Homework help – Discussions are topic-related and you are expected to contribute to theme. The unit discussions will help you build your understanding of law and ethics and will contribute considerably to your understanding and to the preparation of the assignment.
We strongly recommend that you submit your online discussions as an appendix with the educational portfolio (the final summative assessment).
