Career Plan Student Name Here Walden University Career Plan Provide a brief introduction to your paper here. The title serves as your introductory heading, so there is no need for a heading titled “Introduction.” Here you will briefly discuss the purpose of the paper. Start first by writing a sentence or two on the topic in general; that is, the career planning in your desired population or setting. Then, follow up with a statement of the specific purpose or argument of this particular assignment (i.e., to illustrate a career plan designed to assist clients or students with identifying options for meaningful and desirable work). Remember, you need a minimum of three sentences to make a paragraph. At the end of your introduction, include a sentence outlining which topics will be discussed and in which order. Case Study In this section of your final project, you will develop a case study from which you will base your career plan. Do not use “Darren” from the resources. In your case study, you should briefly describe your client’s/student’s presenting problem or career concern, as well as relevant sociocultural factors that influence the case. Be sure to include all relevant information such as the client’s demographic variables (consider use of the ADDRESSING model of identity), the client’s specific career difficulties (e.g., problems maintaining adequate work/life balance, discrimination in the workplace, layoff/termination, relocation, dislike of job duties, etc.), and his or her goals for counseling. For example, in a clinical mental health setting, you might describe a 40-year-old African American woman who is seeking to explore new career options due to interpersonal difficulties at her current place of employment. In a school counseling setting, you might describe work with a 17-year-old high school senior whose parents emigrated from Mexico and is having difficulty deciding between college and the military. This section of your paper should be at least two paragraphs. Career Plan Stage 1: Exploration In this section of your final project, begin the explanation of your career plan for the case you developed above, following the Hill and O’Brien (1999) Helping Skills Model located in this week’s learning resources. For this stage, you should describe the activities you would engage in to facilitate career exploration with your client (Exploration, pp. 231–232). Be sure to provide a rationale for the activities you identify, using specific career theories as a framework. For example, if using a Holland-type career assessment, be sure to explain Holland’s ideas on the connection between personality characteristics and job titles, and how the assessment would promote career exploration in this case. Additionally, be sure to also consider other questions such as: “What techniques would you use to develop rapport, express empathy, and encourage your client/student to tell his or her story?” and “How would you broach the role of sociocultur ...

1. Career Plan
Student Name Here
Walden University
Career Plan
Provide a brief introduction to your paper here. The title serves
as your introductory heading, so there is no need for a heading
titled “Introduction.” Here you will briefly discuss the purpose
of the paper. Start first by writing a sentence or two on the topic
in general; that is, the career planning in your desired
population or setting. Then, follow up with a statement of the
specific purpose or argument of this particular assignment (i.e.,
to illustrate a career plan designed to assist clients or students
with identifying options for meaningful and desirable work).
Remember, you need a minimum of three sentences to make a
paragraph. At the end of your introduction, include a sentence
outlining which topics will be discussed and in which order.
Case Study
In this section of your final project, you will develop a case
study from which you will base your career plan. Do not use
“Darren” from the resources. In your case study, you should
briefly describe your client’s/student’s presenting problem or
career concern, as well as relevant sociocultural factors that
influence the case. Be sure to include all relevant information
such as the client’s demographic variables (consider use of the

2. ADDRESSING model of identity), the client’s specific career
difficulties (e.g., problems maintaining adequate work/life
balance, discrimination in the workplace, layoff/termination,
relocation, dislike of job duties, etc.), and his or her goals for
counseling. For example, in a clinical mental health setting, you
might describe a 40-year-old African American woman who is
seeking to explore new career options due to interpersonal
difficulties at her current place of employment. In a school
counseling setting, you might describe work with a 17-year-old
high school senior whose parents emigrated from Mexico and is
having difficulty deciding between college and the military.
This section of your paper should be at least two paragraphs.
Career Plan
Stage 1: Exploration
In this section of your final project, begin the explanation of
your career plan for the case you developed above, following
the Hill and O’Brien (1999) Helping Skills Model located in
this week’s learning resources. For this stage, you should
describe the activities you would engage in to facilitate career
exploration with your client (Exploration, pp. 231–232). Be sure
to provide a rationale for the activities you identify, using
specific career theories as a framework. For example, if using a
Holland-type career assessment, be sure to explain Holland’s
ideas on the connection between personality characteristics and
job titles, and how the assessment would promote career
exploration in this case. Additionally, be sure to also consider
other questions such as: “What techniques would you use to
develop rapport, express empathy, and encourage your
client/student to tell his or her story?” and “How would you
broach the role of sociocultural factors in your
client’s/student’s career story?”
Stage 2: Insight
For the second stage, Insight (p. 232), identify the areas
would you focus on to gain deeper meaning and understanding
of your client’s/student’s situation. How would you identify his
or her interests, abilities, and strengths? What career

3. assessments and/or computer-assisted programs might be of
use? What changes in the world-of-work might be relevant? In
this section, be sure to consider any theories that might explain
limitations to your client’s career aspirations. For example,
using Gottfredson’s theory of circumscription and compromise,
you might explain if your client eliminated certain career
options based on his or her social class or gender. If you are
using social cognitive career theory you might consider if your
client’s career decision-making has been influenced by low self-
efficacy beliefs.
Stage 3: Action
For the final section of your career plan, the Action stage
(p. 232), identify what plans you would develop, how you
would evaluate them, and what follow-up activity you would do
with your client. The plans identified in this section should be
based on the insights you discussed at Stage 2. For example, if
you identified low self-efficacy beliefs and foreclosed
occupational options as a barrier to career decision-making for
your client, describe how might facilitate discussion of
additional options through activities such as card sorts, job
shadows, or additional career assessments. As another example,
if you identified poor job search skills as a barrier, you might
provide psychoeducation of job search skills, and use role-play
as a way to evaluate increased knowledge in this area. When
developing your action items, be sure to include your advocacy
statement from your Week 5 reflection paper and how you might
advocate with or on behalf of your client or student.
Conclusion
Your conclusion section should recap the major points you have
made in your paper. However, perhaps more importantly, you
should interpret what you have written and what the bigger
picture is. Remember, your paper should be five to eight pages,
not counting your title page and reference page. Be sure to
include at least three references throughout your paper.

4. Always include references on a separate page. APA is very
specific about punctuation and how elements of the reference
are presented. Every citation should have a reference and vice
versa. Use the APA manual to verify your format. Below you
will find many examples for you to follow. A formal paper for
Walden will require you to use all relevant resources provided
in the classroom, and also expect one or more scholarly
resources from peer reviewed journals from the Walden Library.
3
References
(Please note that the following references are intended as
examples only.)
Anderson, E. (2007). The best career activities ever. The
Journal of Ultimate Career Counseling,19, 4319-4392.
Retrieved from http://www.ultimatecareer.org
John, G., & Locke, D. (1973). Career development at any age.
Thousand Oaks, CA: Fairy Tale Publishing.
Laureate Education, Inc. (Producer). (2007). How to cite a
video: The city is always Baltimore [DVD]. Baltimore, MD:
Author.
Laureate Education, Inc. (Producer). (2010). Name of program
[Video webcast]. Retrieved from http://www.courseurl.com
Smith, G., & Johnson, N. (2008). Career counseling: Why we
need it and can’t live without it. Career Counseling for
Everyone, 25(7), 14-31. doi:10.8220/CTCE.52.1.23-91
122 MEDSURG Nursing—April 2008—Vol. 17/No. 2
versity curricula. It has been
applied at academic institutions,

5. including Harvard University’s
Beth Israel Deaconess Hospital
and Duke University Health
System’s Pediatric Intensive Care
Unit. Military operational units
continue to request training to
enhance their ability to support
any mission at a moment’s notice.
Forward surgical teams have
received training to increase the
precision of care provided both on
the battlefield and in the combat
support hospitals in Iraq and
Afghanistan. A front-page article
on TeamSTEPPS in the June 1,
2007, issue of Internal Medicine
News (Vol 40, No 11, www.internal
medicinenews.com) confirmed the
widespread attention enjoyed by
TeamSTEPPS. The prestigious M.
Scott Myers Award for Applied Re-
search from The Society for In-
dustrial and Organizational Psych-
ology went to TeamSTEPPS in 2007.
Tools and Strategies
The TeamSTEPPS program pro-
vides tools and strategies to in-
crease team awareness through a
shared mental model (see Figure 1).
It clarifies team roles and re-
sponsibilities, and creates an
atmosphere of mutual trust. Co-
hesive teamwork will enhance per-
formance through increased adapt-

6. ability, accuracy, productivity, effi-
ciency, and safety. The core of the
TeamSTEPPS framework comprises
four key principles/skills/core
competencies that are integrated
to foster delivery of safe, quality
care as a cohesive patient care
team, which includes the patient,
TeamSTEPPS: Integrating Teamwork Principles
Into Adult Health/Medical-Surgical Practice
staff satisfaction. The TeamSTEPPS
approach has met with great suc-
cess in a variety of high-risk set-
tings such as emergency depart-
ments and labor and delivery. It is
now time to embrace TeamSTEPPS
strategies in the medical-surgical
setting.
TeamSTEPPS Goal
The goal of TeamSTEPPS is to
produce highly effective medical
teams that optimize the use of
information, people, and re-
sources to achieve the best clini-
cal outcomes for patients. To
achieve this goal, the HCTCP will
work to institutionalize team-driv-
en care, solidify collaborative
partnerships, and support re-
search demonstration projects to
improve patient safety.

7. TeamSTEPPS Impact to Date
TeamSTEPPS was implement-
ed in 2005-2007 in over 68 military
treatment facilities (MTFs) world-
wide. Approximately 1,500 partici-
pants have attended the train-the-
trainer course, and over 22,000
continuing education (CE/CME)
credits have been awarded. The
train-the-trainer approach has
saved the DoD $1.4 million in train-
ing and travel costs. TeamSTEPPS
has been introduced in 24 peer-
reviewed publications and was the
topic of conversation in over 10 in-
terviews. In January 2008, the
Military Health System Conference
featured a 2-hour TeamSTEPPS
training session for over 100 par-
ticipants. TeamSTEPPS tools and
strategies have been incorporated
in simulation exercises and in uni-
In collaboration with the Healthand Human Services Agency for
Healthcare Research and Quality
(AHRQ), the Department of De-
fense (DoD) Health Care Team
Coordination Program (HCTCP)
developed an initiative that stress-
es teamwork and communication
among physicians, nurses, and
other health care personnel to
make the delivery of health care
safer for all patients. The Team
Strategies and Tools to Enhance

8. Performance and Patient Safety
(TeamSTEPPS™) principles were
designed to be incorporated into
the daily activities of patient care
provision in an effort to reduce
clinical errors, and improve pa-
tient outcomes and patient and
Sheri L. Ferguson, MSN, MBA, MSEd,
BSN, CMSRN, is a Colonel, Army Nurse
Corps, and Chief, Nursing Admini-
stration, Carl R. Darnall Army Medical
Center, Fort Hood, TX. She is also
Medical Surgical Nursing Consultant to
The Surgeon General.
Disclaimer: The opinions and views
expressed in this article are those of
the author and do not necessarily rep-
resent those of the U.S. Army Nurse
Corps, nor those of the U.S. Depart-
ment of Defense.
Note: Military nursing offers unique
practice opportunities. Share your per-
spectives on your practice as a nurse
in the Armed Forces with the readers
of MEDSURG Nursing by submitting a
manuscript in consideration for this
column. Questions and submissions
can be directed to the Editor, Dottie
Roberts, at [email protected]
Sheri L. Ferguson

9. MEDSURG Nursing—April 2008—Vol. 17/No. 2 123
direct caregivers, and those who
play a supportive role within the
health care delivery system. The
four key skill areas are:
1. Leadership. Involves the abili-
ty to coordinate the activities
of team members by ensuring
team actions are understood,
changes in information are
shared, and team members
have the necessary resources.
TeamSTEPPS tools include:
➤ Planning – Brief: A short
session prior to start to dis-
cuss team and establish
roles.
➤ Problem solving – Huddle:
An ad hoc team meeting to
share information and
adjust plans.
➤ Process improvement –
Debrief: After-action review
to provide feedback and
improve team perform-
ance.
2. Situation Monitoring. The pro-
cess by the individual of active-
ly scanning behaviors and ac-
tions of those around him or

10. her to assess the situation or
environment. Situation monitor-
ing fosters mutual respect and
team accountability, and pro-
vides a safety net for the team
and the patient. TeamSTEPPS
tools include:
➤ Cross monitoring – A process
of monitoring the actions of
other team members for the
purpose of sharing the
workload and reducing or
avoiding errors. It ensures
mistakes or oversights are
caught quickly and easily. It
is a way of “watching each
other’s back.”
➤ Shared mental model – The
perception of, understanding
of, or knowledge about a sit-
uation or process that is
shared among team mem-
bers through communica-
tion. Having team members
“on the same page” is the
desired team outcome.
3. Mutual Support. The ability to
anticipate and support other
team members’ needs through
accurate knowledge about
their responsibilities and work-
load, mutual support protects
team members from work over-

11. load situations that may reduce
effectiveness and increase the
risk of error. TeamSTEPPS tools
include:
➤ Task assistance – Team
members foster a climate
where it is expected that
assistance will be actively
sought and offered.
➤ Feedback – Information for
the purpose of improving
team performance should be
timely, respectful, specific,
directed toward improve-
ment, and considerate.
➤ Advocacy and assertion –
Invoked when team mem-
bers’ viewpoints do not
coincide with that of a deci-
sion maker. The team mem-
ber asserts a corrective
action in a firm and respect-
ful manner.
➤ Two-challenge rule – Invoked
when an initial assertion is
ignored. It is the team mem-
ber’s responsibility to voice
his or her concern asser-
tively at least two times to
ensure that it has been
heard. The member being

12. challenged must acknow-
ledge the challenge; if the
outcome is still not accept-
able, a stronger course of
action, such as notifying the
supervisor, must be taken.
➤ Collaboration – Achieves a
mutually satisfying solution
resulting in the best out-
come. The patient care team
(individual team members,
team, and patient) all win!
➤ DESC script – A constructive
approach for managing and
resolving conflict. Ultimate-
ly, consensus shall be
reached.
• D – Describe the specific
situation.
• E – Express your concerns
about the action.
• S – Suggest other alterna-
tives.
• C – Consequences should
be stated.
4. Communication. A process by
which information is clearly and
accurately exchanged among
team members. TeamSTEPPS

13. strategies for providing clear
and accurate communication
include:
➤ SBAR – a technique that
requires immediate atten-
tion and action concerning a
patient’s condition.
• S – Situation
• B – Background
• A – Assessment
• R – Recommendation
➤ Call-out – A strategy used to
communicate important or
critical information. Exam-
ple: resuscitations.
Figure 1.
TeamSTEPPS Teamwork Training System
PATIENT CARE TEA
M
PERFORMANCE
SKILLS
KNOWLEDGE ATTITUDES
Communication SituationMonitoring
Leadership
Mutual
Support

14. 124 MEDSURG Nursing—April 2008—Vol. 17/No. 2
➤ Check-Back – A process of
employing closed-loop com-
munication to ensure that
information conveyed by
the sender is understood by
the receiver as intended. Ex-
ample: all verbal orders.
➤ Handoff – The transfer of
information (along with
authority and responsibili-
ty) during transitions in
care across the continuum;
to include an opportunity
to ask questions, clarify,
and confirm responses. Ex-
amples: shift changes, phy-
sicians transferring com-
plete responsibility, and pa-
tient transfers.
TeamSTEPPS Transforms
Culture
The AHRQ and DoD are
engaged in an extensive awareness
campaign targeted at hospitals,
hospital associations, health care
trade associations, professional
organizations, and medical and
nursing schools. As TeamSTEPPS
and team training are embraced by

15. MTFs across the military health
system (MHS), they also have real-
ized considerable growth in the
private sector since their release
to the public domain on November
2, 2006. The ability to export
TeamSTEPPS to many different
health care settings and popula-
tions is an indication that team-
work can transform the culture of
an organization through a variety
of different ways:
1. Establishes names for behav-
iors and a common language
for talking about communica-
tion failures.
2. Bridges the professional divide
and levels the hierarchy often
seen in health care.
3. Provides teachable-learnable
skills and actions to practice.
4. Increases mindfulness, or
“knowing what is going on
around you.”
5. Enlists the patient as a valued
team member.
TeamSTEPPS in the Medical-
Surgical Setting
Medical-surgical health care

16. personnel often operate in silos
and become frustrated because
their voices and opinions are not
heard. Their priorities may be dif-
ferent, often causing frustration.
The interdisciplinary plan of care
often is difficult to orchestrate
when nurses, physicians, respira-
tory therapists, and other health
care personnel do not have a
shared mental model. The tools
found in TeamSTEPPS can advance
culture change by providing the
health care workforce with a
shared simple set of words to
describe critical communication
behaviors. As TeamSTEPPS is
spread to large numbers of health
care workers, the issues that are
supporting those silos begin to dis-
appear and culture change is seed-
ed. With a common language and
focus, the introduction to a series
of common behaviors gives health
care workers a way to break out of
constraints of current cultures and
express what they see and think
more freely; the cultural outcome
is collective mindfulness.
Implementation across an
organization is one thing; sustain-
ability is more difficult. For a
change to a shift of culture to be

17. successful, a powerful group must
lead the change, and members of
that group must work together as a
team. Culture change is hard work.
It takes leadership commitment,
time resources, and focused im-
provement. Medical-surgical nurs-
es are a powerful group of profes-
sionals who, in collaboration with
other health care providers, can
lead that change.
Order materials:
http://www.ahrq.gov/qual/teamstepps/
Preview materials and check for updates:
http://dodpatientsafety.usuhs.mil/teamstepps
http://www.health.mil/
Table 1.
Resources Available
TeamSTEPPS™ Instructor Guide. [TeamSTEPPS™: Team
Strategies & Tools to
Enhance Performance and Patient Safety; developed by the
Department of
Defense and published by the Agency for Healthcare Research
and Quality.]
AHRQ Publication No. 06-0020. Rockville (MD): Agency for
Healthcare Research
and Quality; September 2006.
TeamSTEPPS™ Pocket Guide. [Team Strategies & Tools to
Enhance Performance
and Patient Safety; developed by the Department of Defense and

18. published by the
Agency for Healthcare Research and Quality.] AHRQ
Publication No. 06-0020-2.
Rockville (MD): Agency for Healthcare Research and Quality;
June 2006.
TeamSTEPPS™ Multimedia Resource Kit. [TeamSTEPPS™:
Team Strategies &
Tools to Enhance Performance and Patient Safety; developed by
the Department
of Defense and published by the Agency for Healthcare
Research and Quality.]
AHRQ Publication No. 06-0020-3. Rockville (MD): Agency for
Healthcare Research
and Quality; September 2006.
TeamSTEPPS™ Guide to Action. [TeamSTEPPS™: Team
Strategies & Tools to
Enhance Performance and Patient Safety; developed by the
Department of
Defense and published by the Agency for Healthcare Research
and Quality.]
AHRQ Publication No. 06-0020-4. Rockville (MD): Agency for
Healthcare Research
and Quality; September 2006.
TeamSTEPPS™ Poster. [TeamSTEPPS™: Team Strategies &
Tools to Enhance
Performance and Patient Safety; developed by the Department
of Defense and
published by the Agency for Healthcare Research and Quality.]
AHRQ Publication
No. 06-0020-5.Rockville (MD): Agency for Healthcare
Research and Quality;
September 2006.

19. Table 2.
TeamSTEPPS Citations
MEDSURG Nursing—April 2008—Vol. 17/No. 2 125
TeamSTEPPS in the Military Health System
The MHS mission is to provide optimal health
services in support of the nation’s military mission
(see Tables 1 & 2). The MHS is prepared to respond
anytime, anywhere, with comprehensive medical
capability to military operations, natural disasters,
and humanitarian crises around the globe, and to
ensure delivery of world-class health care to all DoD
service members, retirees, and their families. Effective
teamwork and communication are vital to the success-
ful completion of this mission. A part of the MHS vision
is to have an integrated team ready to go in harm’s way
to meet the nation’s challenges at home or abroad; with
the help of TeamSTEPPS, the vision has become reali-
ty. As a source of innovative education, medical train-
ing, research, technology and policy, the MHS strives
to provide a bridge to peace. Dr. M. Ward Casscells,
assistant secretary of Defense for Health Affairs,
reported at the end of 2006 that “medical teams were
still saving an unbelievable 90% of soldiers wounded
in battle...They did so through a commitment to mak-
ing a science of performance, rather than waiting for
new discoveries. And they did it under extraordinari-
ly demanding conditions and with heroic personal
sacrifices.” Exceptional teamwork has resulted in the
unprecedented outcomes that military health care
has achieved during this most recent conflict. The
MHS leadership believes such impressive results are a

20. consequence of a culture based on innovation, service
to others, and an unrelenting persistence to achieve
excellence. ■
Reproduced with permission of the copyright owner. Further
reproduction prohibited without permission.