CAP 6003 Module 5 Capstone Report and Portfolio Reflection Example

From Nine Minutes Toward Four: The Call Early Capstone Report, a Twelve-Student Workshop Pilot, a Faculty Presentation and a Portfolio of Specialist Work in Nursing Education

Student Name

American College of Education

CAP6003: Capstone in Education Specialist

Module 5 Assignment

Instructor Name

November 9, 2026

Executive Summary

In the final semester of a composite Arkansas nursing program, students watching a simulated patient slide into sepsis took a median of nine minutes to call for help after the warning signs appeared, and fewer than two in five called inside five minutes. This capstone defined that delay as a problem of practice, synthesized research showing that recognizing and responding are separate skills and that students' silence has social roots, designed a three-part curriculum thread called Call Early and planned an evaluation against preset targets. A pilot of the first component with twelve volunteer students produced encouraging reaction data and two design changes. Full implementation begins in January 2027.

The Problem and the Evidence in Brief

Tanner (2006) set responding apart from noticing and interpreting, and our students' difficulty lay at the step into responding. The problem is not local: when one academic medical center screened its new graduate hires for five years, under a quarter met its standard for entry-level readiness (Kavanagh & Szweda, 2017). The Module 2 synthesis found that students know they should speak up but are held back by uncertainty and by unit culture, that scripted team communication can be taught and that well-run simulation is an effective place to practice.

The Intervention

Call Early has three parts. A 90-minute third-semester workshop gives every student six rehearsed mock calls using a short SBAR opening and a rising three-step phrase of concern. Two scenarios, one new and one carried over from the program's sepsis case, set a three-minute objective for calling and use PEARLS debriefing to revisit the moment of hesitation. A pocket card prompts clinical instructors to ask students each day what would make them call and what they would say first, with each hospital's escalation route on the back. A one-hour briefing prepares adjunct instructors.

What the Pilot Showed

Because the full thread cannot run until spring, I piloted the workshop in October 2026 with twelve third-semester volunteers during an open laboratory afternoon. All twelve completed six mock calls. On the program-made confidence item, the group's mean rating rose from 4.1 before the workshop to 7.3 afterward on a ten-point scale. These are reaction data from a self-selected group of twelve with no comparison, and they show only that the workshop was acceptable and that students felt more ready, not that they will call sooner.

The pilot's more useful product was feedback. Students said the hospitalist role-play was the most valuable call because it was the one they feared, and asked for more of it. They also said the three-step phrase felt unnatural until they adapted it to their own words. The workshop will now spend half its calls on the hardest listener, and students will write their own version of the concern phrase before rehearsing it.

Evaluation Plan Summary

The spring 2027 cohort will be compared with the fall 2025 cohort on the unchanged sepsis scenario. Time to call will be measured from video, two raters will score each call on the responding dimensions of the Lasater rubric and process will be tracked through attendance and prompt-card tallies. Targets set in advance are a median under four minutes and at least 70% calling within five minutes. The comparison is historical, so the evaluation can show change but cannot by itself prove that Call Early caused it. Before any spring video is scored, the two raters will rescore the fall 2025 videos under the same rules, so baseline and follow-up are judged alike, and the cohorts' entrance examination scores will be compared to check that the groups start from similar ground.

Presenting the Capstone to Faculty

The capstone will be presented at the December faculty meeting in ten minutes with six slides: the nine-minute median and what students said in debriefing, the response-phase gap in Tanner's model, the three components, the pilot feedback and changes, the evaluation targets and the requests to faculty. Those requests are concrete: approval to replace one lecture hour with the workshop, an hour of each adjunct's time in January and agreement that early calls in clinical will be praised rather than questioned. Evidence suggests students practice what the unit rewards, so the last request matters as much as the first two.

Portfolio of Specialist Work

The portfolio gathers five artifacts. The proposal shows the ability to define a problem of practice with local data and to scope a project within one's authority. The synthesis shows critical appraisal and the discipline of turning research into design rules. The intervention design shows curriculum and simulation design grounded in theory, chiefly Bandura's account of where self-efficacy comes from (Bandura, 1977) and the NLN Jeffries simulation theory (Jeffries et al., 2015). The evaluation plan shows measurement planning and honesty about design limits. The pilot summary shows the habit of testing small before scaling. Each artifact is paired with a short note linking it to the program's outcomes in teaching, leadership, evaluation and scholarship.

Reflection

I began the capstone believing the problem was knowledge, that our students did not recognize sepsis early enough. The simulation data and the debriefing notes taught me otherwise within the first week, and the research taught me why. The most important shift in my own thinking was from treating hesitation as a student weakness to treating it as a reasonable response to an environment that has not made calling safe. That shift changed the design: the clinical prompt card and the request to faculty exist because of it.

I also learned the limits of what one coordinator can prove. Early drafts of the evaluation promised to show effects on patient safety, and my instructor's question, "How would you know?", led to a plan that measures what the program can actually measure. Specialist practice, as I now understand it, is less about knowing more than colleagues and more about defining problems precisely, using evidence well and claiming only what the data support.

Cost and Sustainability

The full first-year cost is about 30 hours of release time already assigned to simulation, roughly $900 for the adjunct briefing, a few dollars of printing and a prepaid phone line donated by a faculty member. After the first year the costs fall further, because the scenarios and cards will exist and new adjuncts can be briefed during their usual orientation. The thread's survival therefore depends less on money than on habit: whether simulation faculty keep returning the debriefing to the moment of hesitation and whether clinical instructors keep asking the two questions on the card. For that reason the report recommends naming the thread in the third- and fourth-semester syllabi and adding the prompt card to the adjunct handbook, so that it outlasts the person who designed it.

Next Steps

After the December presentation, the January briefing and pilot test of the revised scenario come first. Results from the April scenario will be reported to faculty in May. If the targets are met, the thread will become a standing part of the third and fourth semesters, and the program will repeat the evaluation with the fall 2027 cohort to see whether the result holds. If they are not met, the process data will show whether the problem lay in delivery or in the design itself.

Conclusion

The capstone ends with a tested workshop, a complete design, an evaluation the program can carry out and a clearer view of why capable students wait. Its claim is modest and specific: that a small, rehearsed habit of calling early can be built into a nursing curriculum at almost no cost, and that the program now has a way to find out whether it was.

References

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215. https://doi.org/10.1037/0033-295X.84.2.191

Jeffries, P. R., Rodgers, B., & Adamson, K. (2015). NLN Jeffries simulation theory: Brief narrative description. Nursing Education Perspectives, 36(5), 292-293. https://doi.org/10.5480/1536-5026-36.5.292

Kavanagh, J. M., & Szweda, C. (2017). A crisis in competency: The strategic and ethical imperative to assessing new graduate nurses' clinical reasoning. Nursing Education Perspectives, 38(2), 57-62. https://doi.org/10.1097/01.NEP.0000000000000112

Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204-211. https://doi.org/10.3928/01484834-20060601-04