Week 8 Course Reflection

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Course

Instructor Name

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 Week 8 Course Reflection

Course Reflection

The course laid the groundwork for my professional development as a prospective

psychiatric-mental health nurse practitioner. During the semester, I learned more about

psychiatric assessments, diagnostic reasoning, therapeutic communication, and clinical

documentation. The psychiatric case studies and assessments were of utmost importance because

they pushed me to do more than just identify symptoms and instead view the patient as a whole.

Mental status examinations, screening tools, and primary and differential diagnoses enabled me

to be more confident in my organizing clinical data skills. In addition, I started to value

psychiatric disorders much more than before; I understood how important it is to approach each

case systematically instead of making judgments based on limited information. In summary, the

course emphasized that to be a successful PMHNP, one should possess a good clinical

background, thinking, communication, and most importantly, knowledge of the particulars of

each patient’s situation.

Clinical Decision Making

My perception about clinical decision-making is from assuming that diagnosis is simply

about matching symptoms with the diagnostic criteria to understanding it as a structured process

that includes careful analysis that needs thoughtful evaluation of different data. Various case

studies motivated me to analyze symptom patterns, as well as medical history, risk factors,

environmental circumstances, and possible differential diagnoses before forming a clinical

conclusion. Mouchabac et al. (2022) outlined that cognitive bias may influence psychiatric

decisions, indicating the need for mental health professionals to be aware of the assumptions that

can influence their judgments. This perspective has outlined for me the importance of
questioning preconceived judgments and using solid evidence in decisions. As a future PMHNP,

I will make use of this approach by uniting clinical judgment and evidence-based information, as

well as aggregated assessment data and constant monitoring of patients’ responses to treatments.

Learning Objectives 1 and 2: DSM-5-TR and Critical Thinking

I achieved the first two course goals through my growing familiarity with the DSM-5 and

enhancing my critical thinking and evidence-based practice skills. The process of analyzing

psychiatric cases involved applying diagnostic criteria instead of mere memorizing of disorders.

I learned to recognize the relevant symptoms of the cases, verify that the symptoms satisfy the

criteria of diagnosis, and differentiate primary diagnosis and differential diagnosis. First et al.

(2022) mention that the DSM-5-TR made significant advancements in developing and delivering

the proper diagnostics. The experience of applying its criteria in the case-based approach helped

me gain better understanding of the full clinical picture. Despite my increased comfort with

diagnostic criteria, complicated situations with the overlapping symptoms could be areas of

further practice.

Learning Objectives 3 and 4: Holistic Assessment and Psychiatric Interviewing

Objectives 3 and 4 were addressed by acquiring useful information on how to incorporate

biopsychosocial, developmental, ethical, cultural, and environmental aspects into psychiatric

evaluations and how to use techniques of psychiatric interviewing. The course reaffirmed the

assertion that mental health symptoms cannot be regarded in isolation from the patients' life

circumstances, relationships, developmental history, cultural background, and environment.

Psychiatric interviewing exercises improved my understanding of therapeutic communication

principles, active listening, empathy, and building rapport with patients. I discovered that by

asking the right questions and creating a non-judgmental atmosphere, one could obtain
information from patients that they would otherwise not have provided. These skills are critical

because a successful assessment depends on the information acquired, as well as the willingness

of the patient to enter into a dialogue.

Learning Objectives 5 and 6: Mental Health Assessment and Coding

Through engaging in comprehensive mental health assessment practices that involve

gathering psychiatric history, conducting mental status examinations, using screening

instruments, and making clinical documentation, I have fulfilled the fifth objective. By

performing different psychiatric assessments using the SOAP method, I have learned the

importance of the subjective and objective data in making an assessment as well as a diagnosis

and treatment plan. I have achieved the sixth objective by gaining some general insights about

tracking and coding clinical encounters by working through hypothetical cases. Although these

activities have made me acquainted with assessment and coding, I still have to get more practice

in dealing with complicated cases in order to feel more confident about making an assessment.

Due to low exposure to real-life psychiatry cases, it is hard to develop one’s competence in

dealing with uncommon cases. I am going to improve my competencies concerning these issues

by studying DSM-5-TR and ICD-10-CM, using more case simulation, practicing documentation,

and obtaining feedback from faculty and clinical advisors during PMHNP training.

Cultural and Spiritual Factors

Cultural identity and spirituality might influence how medical patients perceive and

disclose their mental health issues, interpret ensuing symptoms, select treatment options, and

collate their experience with healthcare practitioners. Cultural interpretations of mental illness

might stem from different perspectives away from the biomedical paradigm, as some patients

might interpret mental suffering through traditional and religious lenses. Research conducted in
this area indicates that cultural and religious beliefs influence both causes attributed to mental

illnesses and the treatment adopted. As a result, one must approach these beliefs humbly without

making inferences or disregarding the opinions opposite to one’s. Understanding one’s beliefs

can facilitate delivery of informed and trustful treatment. Overall, this course allowed me to

develop assessment, diagnosis, communication, and decision-making skills essential for

successful PMHNP practice.

First, M. B., Yousif, L. H., Clarke, D. E., Wang, P. S., Gogtay, N., & Appelbaum, P. S. (2022).

DSM-5-TR: Overview of what's new and what's changed. World Psychiatry, 21(2), 218–

219. [Link]

Mouchabac, S., Conejero, I., Lakhlifi, C., Msellek, I., Malandain, L., Adrien, V., Ferreri, F.,

Millet, B., Bonnot, O., Bourla, A., & Maatoug, R. (2022). Improving clinical decision-

making in psychiatry: Implementation of digital phenotyping could mitigate the influence

of patient's and practitioner's individual cognitive biases. Dialogues in Clinical

Neuroscience, 23(1), 52–61. [Link]

Subu, M. A., Holmes, D., Arumugam, A., Al-Yateem, N., Maria Dias, J., Rahman, S. A., Waluyo,

I., Ahmed, F. R., & Abraham, M. S. (2022). Traditional, religious, and cultural

perspectives on mental illness: A qualitative study on causal beliefs and treatment use.

International Journal of Qualitative Studies on Health and Well-Being, 17(1), 2123090.

[Link]