Professional Experience Practice Analysis

Assessment Task 3: Professional Experience Practice Analysis Essay (PEPAE)

 

Due date:                            Monday, one (1) week after the completion of PEP by 1000.        

Weight:                                Hurdle Assessment (must pass) 20 %

Submission:                       Online via Turnitin (a link is available on this subject’s LMS Canvas).

Word Limit:                        An overall word limit of 2,000 words (2000 words allocated to PEPAE, 500 words allocated to iEMR documentation. +/- 10%. Inclusive of in-text citations & references. Excludes reference list)

 

Assessment Outline:      The Nursing Process is a sequence of problem-solving steps used to identify and manage the health problems of patients. This assessment requires you to use the nursing process as a framework to discuss the nursing management of a patient that you have cared for whilst on PEP. Some elements (supervised head-to-toe assessment and identification of priority problems) will be completed during your PEP experience, whilst writing up and presenting your patient assessment is to be completed both during and after your PEP experience.

 

Step One – whilst on PEP

In collaboration with your Clinical Nurse Educator (CNE) or clinical preceptor, students are to identify an appropriate patient to perform a full and comprehensive systematic physical and psycho-social nursing assessment. Please ensure that you use the head-to-toe assessment guide (appendix E) when performing your assessment. Your Clinical Nurse Educator/preceptor is to witness the head-to-toe assessment and sign off the paperwork set out in appendix E, which will then be submitted as an appendix as part of your PEPAE submission. The psych-social assessment does not need to be witnessed but is essential to complete with your patient. This assessment will include past medical history, family history, current medications, social history, living arrangements and carer responsibilities.

 

Next, having completed the patient assessment, you are to sit with your CNE/preceptor and identify all priority problems for your patient and document these on appendix F. This is to be submitted as an appendix as part of your PEPAE submission. Please note that these appendices do not count towards your overall word count for this assessment.

 

Step Two – writing up your head-to-toe assessment:

The final part of this assessment requires students to write up the results of the head-to-toe assessment and develop a plan of care to address the needs of the patient. Students are to provide an overall introduction to the essay, an introduction to the patient and a written summary of the head-to-toe assessment.

 

Introduction to the patient:

  • Medical diagnosis
  • Past medical and surgical history
  • Social history
  • Relevant family medical history
  • Allergies and adverse reactions to medications
  • Current medications (You must link all medications to your patient I.e. explain clinical indication correctly. This can be presented in table format in the assignment and presented as an Appendix),
  • Summary of clinical course whilst in hospital

 

Summary of head-to-toe Assessment:

Discuss the objective (signs) and subjective (symptoms) data collated from the nursing assessment of the patient

  • This account is to utilise a head to toe system analysis/framework.
  • Normal and abnormal assessment data is to be outlined.

 

Then, using the template presented in appendix H, offer two (2) priority problems, along with their associated NANDA nursing diagnosis statement, SMART goals, evidence-based intervention and rationale, and an evidence-based outcome statement for each priority problem/NANDA diagnosis.

 

 

Diagnosis:

Identify one (1) actual and one (1) potential healthcare problems that the nurse is accountable and responsible to treat. The problems identified in this discussion are to directly link to the patient’s abnormal assessment findings outlined in the assessment data. Actual and/or potential healthcare problem MUST be written using NANDA taxonomy.

 

Planning:

Patient goals are directly related to the patient’s problem as stated in the nursing diagnosis. In clinical practice, nurses established patient goals utilising a SMART (specific, measurable, achievable, realistic and timely) approach

  • Provide a description of the expected benefit &/or intended outcomes within a timeframe of the plan of care that is to be implemented by the nurse, this needs to be supported by literature
  • One (1) SMART goal is to be outline for each nursing diagnosis.

 

Implementation:

A nursing intervention is defined as any treatment based on clinical judgement and knowledge that a nurse performs to enhance a patient’s health care status.

  • A description of one (1) independent nursing intervention and one (1) collaborative/dependent intervention to address the patient’s actual problem and one (1) collaborative nursing intervention to avert the patient’s potential problem is to be discussed and supported by literature. (*collaborative nursing interventions requiring a medical order may be discussed e.g. administration of medications, IV fluids etc)
  • The nursing interventions discussed are to be within the scope of practice of a second year first semester entry-to-practice nursing student
  • Evidenced based rationales with reference to the current literature is to be provided for each nursing intervention

 

 

Evaluation/Expected Outcomes:

In clinical practice, nurses evaluate the appropriateness of their nursing interventions i.e. have the patient’s nursing care goals been met.

  • This section will describe the expected patient’s subjective and objective data after nursing actions have been implemented i.e. it will outline the observed patient response to nursing care in line with the established objectives
  • When writing outcomes, the nurse should ensure that the outcome statement is written in measurable behavioural terms. A useful mnemonic here is RUMBA i.e. the outcome statement should be realistic, unambiguous, measurable, behavioural and achievable. The outcome statement should be written sequentially, and with timeframes

 

Conclusion:

A conclusion to the essay is also needed. This will summarise the major points covered in your submission.

 

Additional Points

Generally, the PEPA in this subject should have at minimum 8 -10 peer reviewed references, no older than 7 years old. Please remember that entry-to-practice students are required to practise in accordance with legislation affecting nursing practice and health care. No identifying personal/contextual information in relation to the selected patient/hospital setting is to be outlined in the assignment. Please review the Code of Conduct for Nurses (NMBA, 2018) prior to submitting your assessment.

 

Appendix E: Clinical Assessment E-portfolio Part B: Head-to-toe assessment guide for PEPAE

Students are required to complete a full head-to- toe assessment on a patient they have been caring for whilst on clinical placement. This assessment must be supervised by either a CNE or preceptor, must be signed once completed and then attached as an appendix as part of your PEPAE submission. Please note that this document (appendix E) does not count towards the overall wordcount for this assessment. Once you have completed your patient head-to-toe assessment students, should sit with their CNE/preceptor and identify the patient’s priority problems, documenting these on appendix F.

Directions for CNE/preceptor: Please consider the students Scope of Practice when assessing their head-to-toe assessment. All points highlighted bold must be completed without prompting. All points highlighted red are outside of the scope of practice of a first year, first semester MNSC student. It is advised that CNE/preceptor read the UoM students Scope of Practice document when preparing to assess the student.

Nursing Physical Assessment Using a Body System Approach CNE/Preceptor assessed

Y/N

Identify indication or rationale for medication administration (Oral)

·         Confirm patient identity

·         Determines need to undertake a nursing physical assessment

·         Identify appropriate timing for performing the assessment

 
Therapeutic relationship

·         Initiate communication by introductions and clarification of patient’s immediate needs and problems

·         Clarify patient knowledge and provides education where necessary

·         Explain actions and potential discomfort at all stages of the procedure

·         Gain patient consent

 
Assess patient

·         Assess patient comfort and provides analgesia where appropriate

·         Performs a rapid visual assessment of the patient and their environment for important cues.

The primary survey below may assist with this rapid review and should be performed every time you attend to your patient but is not to be included in your PEPAE submission.

Primary survey

Airway – Is the airway clear?

·         Listen for noisy or obstructed breathing

·         Feel for airflow over the mouth

·         If indicated, assesses whether artificial airway is patent and secure (e.g. Guedel, nasopharyngeal, tracheostomy, endotracheal tube, non-invasive mask)

Breathing – Is the patient breathing spontaneously?

·         Look for rise and fall of the chest

Circulation – Does the patient have adequate circulation?

·         Observe skin colour

·         Feel for a pulse

Disability – What is the patient’s level of consciousness?

·         Determine if the patient is alert, responsive to voice, responsive to pain, or unresponsive (unconscious)

Exposure– Performs a quick head-to-toe scan of the patient and their environment:

·         Does the patient look well, sick or critical?

·         What treatments are in progress and how might these affect your assessment findings (e.g. medications, infusions, oxygen)?

·         What monitoring devices or equipment are attached to the patient or in their environment, what do they reveal?

 

 
Performs Hand Hygiene

·         Performs social handwash

·         Adheres to 5 moments for hand

·         Wear appropriate PPE

 
Gather equipment

·         Blue/black pen, relevant documentation

·         Penlight torch

·         Pulse oximeter

·         Stethoscope

·         Sphygmomanometer

·         Thermometer

 
Prepare Equipment

·         Consider privacy and appropriateness of setting (Inclusion of family, friends, NOK)

·         Position patient comfortably

 
Perform Clinical Procedure- Neurological

·         Assesses level of consciousness and mental status

o    If indicated, performs a focused neurological assessment including Glasgow Coma Scale, pupil size and reaction, limb strength and vital signs

o    If indicated, performs a mental state assessment

·         Assesses for pain or discomfort

o    If indicated, performs a focused pain assessment using a pain assessment tool

 

 
Perform Clinical Procedure- Cardiovascular

·         Inspect and palpates skin colour, temperature and capillary refill

·         Palpates peripheral pulses for rate, rhythm and strength

·         Measure blood pressure

·         Auscultate apical pulse and heart sounds

·         Palpate calves for tenderness

·         Palpate for oedema in feet and dependent areas (e.g. sacrum)

o    If indicated, performs a focused cardiovascular assessment

 

Other considerations: Within SoP

·         Observe and interprets the electrocardiogram (ECG)

·         Observe for permanent pacemaker (PPM), pacing wires, external pacing, implantable defibrillator

·         Observe for compression stockings and sequential compression devices

 
Perform Clinical Procedure- Respiratory

·         Inspect chest and work of breathing

·         Measure respiratory rate, rhythm and depth

·         Assess ability to cough; examines sputum if indicated

·         Auscultate lung sounds

·         Measure oxygen saturation

o    If indicated, performs a focused respiratory assessment

 

Other considerations: Within SoP

·         Observe for intercostal catheters and underwater seal drains.

·         Is catheter/drain swinging, bubbling and/or draining freely? Is there wall suction?

·         Identify the colour and volume of any drainage from chest drains

 
Perform Clinical Procedure- Gastrointestinal

·         Inspect the abdomen for symmetry, masses or distension

·         Auscultate for bowel sounds

·         Palpate the abdomen lightly noting any tenderness, guarding or rigidity; feels for any masses or pulsations

·         Assess most recent and frequency of bowel action

o    If indicated, performs a focused abdominal assessment

·         Assess mucous membranes (looking for redness, ulceration, dental cavity)

·         Assess for nausea and vomiting

·         Assess weight (recent gain/loss)

 

Other considerations: Within SoP

·         Check if the patient is nil by mouth (NBM)? If oral diet: normal soft, smooth/minced? Assesses percent of meal eaten. Is the patient on a food and/or fluid balance chart

·         Observe for enteral feeding tubes (e.g. nasogastric or orogastric tube (NGT/OGT)), percutaneous endoscopic gastrostomy (PEG) tube. Continuous, intermittent or bolus feeds? Central or parenteral total parenteral nutrition (TPN)?

·         Observe for stomas. Pink? Active? Consistency and volume of effluent. Intact faecal containment device? Integrity of surrounding skin?

 
Perform Clinical Procedure- Renal

·         Observe current intake and output, 24-hour fluid balance.

·         Assess and interpret fluid status

o    If indicated, measures and compares daily weight to determine fluid balance

·         Measure and observes urine output, colour, presence of sediment

o    If indicated, palpates bladder for distension

o    If indicated, performs urinalysis

 

Other considerations: Within SoP

·         Observe and interprets blood urea and electrolytes

·         Assess and interprets fluid status

·         Observe for urostomy, indwelling urinary catheter (JDC), suprapubic catheter (SPC)

·         Observe for peritoneal or haemodialysis. Arteriovenous fistula thrill/ bruit? Fluid and sodium restrictions?

 
Perform Clinical Procedure- Musculoskeletal

·         Inspect major joints for range-of-motion

·         Assess muscle strength and compares sides

·         Observe safe use of mobility aids

·         Observe ability to transfer and mobilise

o    If indicated, perform a focused musculoskeletal assessment

 
Perform Clinical Procedure- Integumentary

·         Inspect and palpate the skin for general colour, temperature, moisture and turgor and capillary refill

·         Inspect and palpate for signs of pressure injury such as non-blanchable redness, localised heat, oedema and induration

·         Observe any wounds, dressings and drains for warmth, redness, swelling, exudate and odour

o    If indicated, performs a focused wound assessment (see Chapter 26t) If indicated, performs a focused skin

 

Other considerations: Within SoP

·         Observes invasive lines (e.g. peripheral intravenous catheter (IVC), central venous catheter (CVC), peripherally inserted central line (PICC))

 

 

 

 
Perform Clinical Procedure- Analysing data

·         Compare assessment findings with patient’s baseline assessment data

·         Analyse for important changes or trends over time

 
Clean and dispose of equipment appropriately

·         Dispose of used equipment in appropriate reciprocal

·         Place call bell within reach

·         Leave room clean and clear of clutter

·         Perform hand hygiene

·         Clean any equipment used

 
Complete Documentation

·         Documents assessment findings in patient’s healthcare record following a structured nursing assessment framework

·         Reports any significant abnormal data to senior nurse and/or medical officer

 

 

Signed by CNE/Preceptor: ­­­­­­­­­­­­­­­­……………………………………………………………………….   Date………………………………………………

 

 

Appendix F: Clinical Assessment E-portfolio Part B: Problem sheet template for PEPAE

Using the data gathered from your head-to-toe assessment, students together with their CNE/preceptor, are to identify all priority problems for the patient and document these on the appendix F document. These priority problems should be ordered by priority and identify whether it is an actual or potential problem. Once again, appendix F is to be submitted as an appendix as part of the PEPAE submission.

Please note that this document (appendix F) does not count towards the overall wordcount for this assessment.

Priority problem/s.

Make sure to order from actual to potential and in order of priority

Supportive Findings/Evidence Probable Causes Collaborative Management Plan
       

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix G: Template for PEPAE submission- Priority Problem Template

Use this template to present your priority problem, NANDA nursing diagnosis statements, interventions, rationale RUMBA statements and supportive evidence. Please ensure that you present this as part of your PEPAE submission along with your introduction to essay, introduction to your patient, a written summary of your head-to toe assessment, summary of all pharmacology for your patient (can be presented as a table) and ensuring that you link all medications to your patient I.e. explain clinical indication correctly, and finally an overall essay conclusion. You must also present a complete reference list using APA 7th ed.

Priority Problem One:
Related NANDA statement:
SMART Goal:
Independent Nursing Intervention Rationale Expected Outcome (RUMBA format) Supportive Evidence (APA 7th Edition)
       
Collaborative Nursing Intervention Rationale Expected Outcome (RUMBA format) Supportive Evidence (APA 7th Edition)
       
Priority Problem Two:
Related NANDA statement:
SMART Goal:
Collaborative Nursing Intervention Rationale Expected Outcome (RUMBA format) Supportive Evidence
       

 

 

 

 

 

 

Appendix H: Clinical Assessment E-portfolio Part B: Marking Rubric PEP (Essay)

Criteria for Marking Weighting Excellent Good Satisfactory/Pass Not satisfactory
Writing style:  Sequencing, APA referencing, Spelling, Grammar

 

2 marks 2 1.5 1 *0.9-0
Paper reads fluently without interruption. The meaning of key concepts is evident meaning is very clear. A range of highly relevant professional language used throughout response.

High level of attention to detail with in-text citations, consistent with APA.

Well-structured, correct reference list.

Within word count.

Paper reads fluently with occasional interruption, though the message and meaning of key concepts is evident. Relevant professional language used. In-text citations generally consistent and correct throughout. Reference list correct with minor errors.

Within word count.

 

Paper reads mostly fluently with some interruptions; however key concepts and message are not always clear. Occasional inconsistencies in the use of professional language and range could have been greater. APA referencing style generally correct however there are some errors in citations throughout the paper and the reference list. Within word count or slightly outside. Little to no evidence of clear sentence structure or paragraph structure. Message and meaning is not clear. Grammatical and spelling errors detract significantly from message.

APA referencing style not applied or not used correctly with many errors evident. Well outside of +/- word count

Introduction to patient:

 

 

 

 

2 marks 2 1.5 1 *0.9-0
The following elements were discussed i.e. patient’s medical Dx, past Hx, Social Hx, Family Hx, allergies and/or current medications. A comprehensive and succinct outline of the patient’s clinical course whilst in hospital is provided. The following elements were discussed i.e. patient’s medical Dx, past Hx, Social Hx, Family Hx, allergies and/or current medications. An adequate outline of the patient’s clinical course whilst in hospital was provided A small number of vital elements were discussed i.e. patient’s medical Dx, past Hx, Social Hx, Family Hx, allergies and/or current medications Minimal outline of the patient’s clinical course whilst in hospital was provided. Insufficient data was provided concerning the treatment plan and outcomes. Many vital elements were not discussed i.e. patient’s medical Dx, past Hx, Social Hx, Family Hx, allergies and/or current medications A brief outline of the patient’s clinical course whilst in hospital was not provided There is a breach of code of conduct and or scope of practice  which has resulted in a fail  in this element
Focused Assessment:  An outline of the relevant patient’s normal and abnormal assessment findings is succinctly and logically provided.

Subjective and objective data is included.

The account utilizes a head to toe system analysis/framework.

Head-to-toe template is attached as an appendix

Priority problem template completed and presented as an appendix

6 marks 6 4.5 3 *2.9–0
A comprehensive summary of the patient’s normal & abnormal assessment data presented. There is a complete outline of the relevant subjective and objective data. All body systems affected by presenting condition/illness are explored comprehensively and in relevant detail. Associated pharmacology is explored in sufficient detail

Signed head-to-toe assessment and priority problem worksheet is presented as an appendix

Discussion of the patient’s normal & abnormal assessment data related to the illness and outline of the subjective and objective data are provided though there are some clear gaps or imbalances in the data. Most body systems affected by presenting condition/illness are briefly explored with some detail, though may have been developed further. Exploration of associated pharmacology presented though not always linked to the patient.  Signed head-to-toe assessment and priority problem worksheet is presented as an appendix Discussion of the patient’s normal & abnormal assessment data related to the illness and an outline of the subjective and objective data is provided though lacks detail/has missing elements &/or is imbalanced. Body systems affected by condition/illness explored superficially with little detail provided and/or some systems may be missing. Pharmacology explored at a basic level with little linkage to the patient. Either signed head-to-toe assessment and priority problem worksheet is missing form submission. Discussion attempts to describe the patient’s normal & abnormal assessment data pertaining to the illness, however, is inaccurate in parts, missing key elements &/or lacks detail. There is limited subjective and objective data outlined. The discussion does not follow a systematic focused body system framework. Associated pharmacology is not included &/or there is s breach in nursing scope of practice in in this element which has resulted in a fail in this element
Priority Problems and Nursing Diagnosis- Identify one actual and one potential Nursing Diagnoses (problems) that the nurse is accountable and responsible to treat.

NANDA is utilised.

1 mark 1 0.75 0.5 0
One actual and one potential problems/diagnosis selected clearly relate to the patient’s condition and demonstrate significant links to the patient’s issues. Nursing diagnoses are concisely stated according to priority. Patient’s subjective and objective data relating to their condition is correctly interpreted in detail. NANDA is correctly utilised.

 

One actual and one potential problems/diagnosis selected mostly related to the patient’s condition and demonstrate links to the patient’s issues, though this may have been further explored – some gaps are evident, e.g. imbalance in detail regarding problems. Nursing diagnoses are stated though may have been prioritised more successfully.  Patient’s subjective and objective data relating to their condition is interpreted with some minor inaccuracies or gaps; may lack detail. NANDA is utilised though may have been more so. Problems/diagnosis selected relate to the patient’s condition and demonstrate some links to the patient’s issues, though this needed to have been further explored – gaps are evident, e.g. one problem may be missing, or response lacks balance. Nursing diagnoses are stated though needed to have been prioritised more successfully.  Patient’s subjective and objective data relating to their condition is attempted though gaps are evident and may lack detail. NANDA is utilised though needed to have been more so. Problems/diagnosis selected lack clear relationship to the patient’s condition and links to the patient’s issues are not clear or needed to have been further explored – major gaps are evident, e.g. one of more problems are missing. Nursing diagnoses may not be stated or needed to have been prioritised more successfully.  Patient’s subjective and objective data may be missing or lack key detail. NANDA may not be utilised or not used effectively.

 

Planning- Planning for care:  Set patient goals are directly related to the actual and potential Nursing Diagnosis.

The patient goals are SMART and achievable.

 

 

3 marks 3 2 1.5 *1-0
The patient centred goals identified are realistic and holistic.

The goals identified reflect outstanding analysis of the envisaged improvements required in the patient’s condition.

The patient’s goals meet all of the SMART criteria -specific, measurable, achievable, realistic and timely.

The patient centred goals identified are realistic and holistic.

The goals identified reflect adequate analysis of the envisaged improvements required in the patient’s condition.

The patient’s goals meet some of the SMART criteria -specific, measurable, achievable, realistic, and timely.

There are patient centred goals identified.

The goals identified reflect limited analysis of the envisaged improvements required in the patient’s condition.

The patient’s goals do not meet any of the SMART -specific, measurable, achievable, realistic and timely.

There are no patient centred goals identified.

The patient’s goals do not meet any of the SMART criteria -specific, measurable, achievable, realistic and timely.

Implementation of interventions

A description of one (1) independent and one (1) collaborative nursing intervention supported by evidence-based literature to manage Priority problem/Nursing Diagnosis #1. (actual).

A description of one (1) collaborative nursing interventions supported by evidence-based literature to manage Priority problem/Nursing Diagnosis #2. (potential)

Critique of the scientific rationale that supports the adoption and implementation of the independent nursing intervention with discussion of implementation.  Incorporates evidence-based literature.

3 marks 3 2 1.5 *0.9-0
Clear, concise, detailed description of one (1) independent nursing intervention to manage Nursing Diagnosis #1 (actual) and one (1)   collaborative nursing intervention to manage Nursing Diagnosis #2 (potential) outlined. The interventions are realistic, complete and appropriate to the plan of care.   An in-depth critique of the scientific rationale that supports the intervention is provided drawing on a range of relevant, current evidence-based literature.

 

A description of one (1) independent nursing intervention to manage Nursing Diagnosis #1 (actual) and one (1)   collaborative nursing intervention to manage Nursing Diagnosis #2 (potential) outlined though this may lack balance with more detail offered in one over the other. The interventions are mostly realistic, complete and appropriate to the plan of care, with minor questions in some of these areas.  A critique of the scientific rationale is attempted drawing on evidence-based literature, though it may have been more critically engaging or drawn on a greater range of relevant literature. A description of one (1) independent nursing intervention to manage Nursing Diagnosis #1 (actual) and one (1)   collaborative nursing intervention to manage Nursing Diagnosis #2 (potential) outlined though lacks balance with more detail offered in one area; detail may be missing. The interventions are somewhat realistic, complete and appropriate to the plan of care, though may evidence issues in these areas. A critique of the scientific rationale is attempted, though it is more descriptive than critical. It draws on evidence-based literature, though it needed to have been more critically engaging or relies on a limited range of literature

 

Description of one (1) independent nursing intervention to manage Nursing Diagnosis #1 (actual) and one (1)   collaborative nursing intervention to manage Nursing Diagnosis #2 (potential) not provided or are superficial and lack key detail or are imbalanced; detail is missing. The interventions may not be realistic, complete or appropriate to the plan of care.  A critique of the scientific rationale that supports the intervention is not attempted or not carried out successfully with little sense of critique evident. Evidence-based literature may be missing or lacking in quantity and quality.
Outcome/Evaluation: Evaluate the effectiveness of the interventions provided in relation to SMART objectives in line with the established objectives.

A “RUMBA” outcome statement should be realistic, unambiguous, measurable, behavioural and achievable. The outcome statement should be written sequentially with time frames.

2 marks 2 1.5 1 *0.9-0
A clear, in-depth evaluation is provided which critically discusses and analyses the effectiveness of the intervention with clear relationship and links to the SMART goals set. There is a clear evaluation of whether the goals were realistic, successful and appropriate, and includes a detailed discussion of the patient’s response to the intervention. An evaluation is attempted which describes the effectiveness of the intervention. Links to SMART goals set are provided but may have been explored more. There is an evaluation of whether the goals were realistic, successful and appropriate, but may have been more detailed. Discussion of the patient’s response to the intervention offered but brief An evaluation is attempted which briefly describes the effectiveness of the intervention. Links to SMART goals set may be provided but needed to be explored more. There is a superficial discussion of whether the goals were realistic, successful and appropriate, but lacks detail. Discussion of the patient’s response is brief. An evaluation is either not attempted or is very brief and non-critical. Links to SMART goals are not clear or not made. There is a lack of discussion of whether the goals were realistic, successful and appropriate. Discussion of the patient’s response is brief or missing.
Conclusion: Provides a concise summary of main points covered 1 mark 1 0.75 0.5 0
Provides a detailed but concise summary that covers all the major points of the submission. Provides a summary that covers most of the major points of the submission but may have been more concise or may have missed some elements. Provides a summary that covers most of the points of the submission, but may have been more concise, or too brief, or may have missed some key elements. No conclusion is evident, or it misses the main points of the summary or is too brief and superficial.