UNIVERSITY OF CENTRAL FLORIDA - Dr. Christopher Blackwell

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1






College of Nursing



UNIVERSITY OF CENTRAL FLORIDA

COLLEGE OF NURSING



Fall

2012



Course Number:


NGR

6941


Course Title:


Advanced Practice Practicum


Credit Hours:


3 (
180

c
linical hours
)


Prerequisites or Co
-
requisites
:

Graduate Standing and Admission to the Graduate

MSN or DNP
AGNP or FNP
Program


Mode of Delivery
:


WWW,
Clinical Experience and Live Meeting Sessions



Faculty


Christopher W. Blackwell, Ph.D., ARNP, ANP
-
BC
, CNE




Associate Professor and Coordinator of

Nurse Practitioner Programs




Office:
UT: 453

(hours by appt.)




Call (407) 823
-
2744 to schedule an appt.




Office Phone: (407) 823
-
2517




Personal Cellular Phone: (407) 375
-
4334




christopher.blackwell@ucf.edu



Catalog Description
:
Supervised advan
ced clinical practice in the role of the nurse




practitioner in an individualized preceptorship.

Purpose
:


To finalize the clinical mastery of entry
-
level NP practice, begin

preparation for Board
-
certification in the NP role, and demonstrate

competenc
y in the ability to manage patient care at the advanced
nursing practice level in a safe and appropriate manner.




2

Course Objectives:

Upon completion of this course the student will:


1.

Demonstrate competence in the role of the nurse practitioner in collabor
ative


interdisciplinary relationships;

2.

Analyze professional, theoretical, cultural, legal, and ethical issues in the provision of


nurse practitioner services;

3.

Deliver comprehensive

nurse practitioner services appropriate to the health care needs


of clients in selected primary health care settings;

4.

Develop a public presentation of community project.


Teaching/Learning Strategies:


Clinical practice with a preceptor in primary care practice, written documentation, review
of client cases with faculty and peers, focused reading based on clinical problems
encountered in practice, and preparation for Board
-
certification using practice
ex
aminations and diagnostic examination evaluation. Clinical practice should occur over
at least

2/3 of the semester.


Required
Diagnostic Readiness Testing Purchase
s:
Students are required to purchase
the DRT testing program from Barkley & Associates

or fro
m Advanced Practice
Education Associates
.

The program selected will depend on availability.

The cost of the
Barkley & Associated
program is $39.95.

The APEA program is $31.95 for each exam
($63.90). Students will need to purchase the selected program on th
e day of the live class
(see course schedule) via credit card.


Distribution of Clinical Hours
:


The following may be listed as clinical hours by NP students:



Community Project
:

(
15
)

ONLY if students have not or will not take NGR 6242L
and ONLY if students

have not listed 15 hours for the community project in a
prior NGR6941 course.



On
-
line post conferences
(
5 hours per semester
)



Live Meeting Sessions (5 hours total)


BSN
-
DNP: 3 credits = 180 clinical hours

Documentation of Clinical Hours:

All clinical experiences, hours, clinical summaries,
etc. must be documented through the Typhon system.





3

Clinical Preparation and Attendance







When you go to the clinical site be sure you have:









A good stethoscope



Reflex hammer



R
uler



Black Ink pen and notebook



Other tools appropriate to the site (e.g.Pregancy wheel if in women's health)



Resources covering: health promotion of adults across the lifespan, a drug
prescribing guide, health assessment guide, and text or protocol book

for specific
clinical setting (probably an electronic
-
based program on an iPhone or Android
device)

All students are expected to prepare for each clinical experience by reading on the
types of clients you expect to see. Reading after each clinical experie
nce to review
new information and expand learning is encouraged.

Students are expected to be
present at the clinical site on the dates and on the times scheduled with the preceptor
and reported to clinical faculty.

Course Schedule


Date

Content

Assignment

Aug 20
, 201
2


UCF Classes Begin

Aug

23
, 201
2


Last to Drop/Swap Classes for
Full Refund (11:59 PM)

Aug

20
, 201
2

Students may officially
begin clinical rotations.

Make sure Dr. Blackwell and
Clinical Instructor have a
copy of your clinical schedule
for the semester by the start
of clinicals.

Aug

2
7
, 2012

Clinical Rotations

None Specific.

Sep

3
, 2012

Clinical Rotations

None Specific.

Sep 10, 2012

First Live
Post
-
Conference Session

on
Sep 14, 2012.

UT: 434:

1300
-
1500:

FNP or ANP Board
Certification Pre
-
Test

1500
-
1600: Exam de
-
briefing

1600
-
1630: Clinical discussion

Sep

17
, 2012

Clinical Rotations

SOAP #1 Post and Response
Due by 2355 on
9
/
23
/12.

Sep 24
,
2012

Clinical Rotations

None Specific.

Oct 1, 2012

Clinical Rotations

None Specific.

Oct 8, 2012

Clinical Rotations

None Specific.

Oct 15, 2012

Clinical Rotations

None Specific.



4


Oct 22, 2012

Clinical Rotations

SOAP #2

Post and Response
Due by 2355 on
10
/
28
/12.

Oct 29, 2012

Clinical Rotations

None Specific.

Nov 5, 2012

Clinical Rotations

None Specific.

Nov 12, 2012

Clinical Rotations

None Specific.

Nov 19, 2012

Clinical Rotations

SOAP #
3

Post and Response
Due by 2355 on
11
/
25
/12.

Nov 26, 2012

Clinical Rotations

None Specfic.

Dec
3, 2012

Second Live Post
-
Conference Session


*All Clinical Rotations
must be completed

by
12/2
/12.


* All documents (see
below) must be
submitted by 2355 on
12
/
2
/12.

All documents (see below) must
be submitted no later

than 2355
on August 3, 2012.

UT: 434:

1300
-
1500:

FNP or ANP Board
Certification Post
-
Test

1500
-
1600: Exam de
-
briefing

1600
-
1630: Clinical discussion





Evaluation Methods


1.
3

SOAP Posts/Responses



S/U

2.
Completion of Clinical Hours



S/U

3.
Preceptor Evaluation of Performance

S/U

4
.
Faculty Evaluation of Performance

S/U

5
.
Completion of Site Evaluation


S/U

6.
Attendance at ALL live sessions


S/U

7
.
Completion of Pre
-

and Post
-

Board


Certification
Examination
s



S/U

8. Complete
documentation of clinical data


in Typhon
R
eporting
S
ystem


S/U








S/U*/**


Grading System:

Student must earn a

satisfactory grade on

all

items 1
-
8

above to
receive an overall Satisfactory grade in the course.


*/** Unacceptable, non
-
passi
ng grades:


**
-

Not acceptable for progression in the Master of Science in Nursing or DNP
Program.





5

***

All assignments are due on their noted DUE DATE. Late assignments will be
significantly penalized.
It is recognized that a student may have an
emergency
-

students may request an extension for an assignment.


Extensions are negotiated
individually. Vacations are not acceptable reasons for late assignments
-

students
will need to make provisions for web access. Web Courses assignments are due at
M
idnight of Due Date.
**


Summary of Assignments


Live Sessions Attendance
: Students must plan to attend BOTH live sessions of the
practicum course. The purpose of these live sessions is to
administer the Barkley DRT
NP Board Certification Examination Preparation Program in addition to discussing topics
related to practice transition and current practicum clinical experiences. See the course
schedule for the dates and times of the live sessio
ns.
Absence from either session will
result in failure in the course.


SOAP Notes
: Students must complete the required number of SOAP notes for the course
and these notes must be submitted by the due date and time. Failure to submit any SOAP
notes or unacc
eptable documentation of the SOAP notes

will result in failure in the
course.


Instructions for SOAP Notes:



Do not put any identifying data on the client in the SOAP. In general, this
means no client, preceptor, or practice names and the use of initials di
fferent
from the client's initials.



Be sure the
Subjective

contains only subjective data, the
objective

only objective
data, the
assessments

(diagnoses or symptoms) are all supported by the subjective
and objective data, and the
plan

is clearly related to the assessments and the
specific client situation. This includes clear indication of all laboratory and
diagnostic tests being done either at or after the visit, health promotion and
disease prevention activities, referrals, consulta
tions, and patient education.



The SOAP should provide all data needed for another provider to follow you,
know what has been done, and continue the plan of care. These will be longer
than those you would write in the practice because they are being used fo
r
teaching and learning not simply documentation of care.



Each SOAP should be independently written. Do not use a template or cut and
paste from another source (e.g. an EMR or a sample SOAP in class notes or a
text.) SOAP notes based on a template or simil
ar document will not be counted.
Each SOAP should be independently written. Do not use a template or cut and
paste from another source (e.g. an EMR or a sample SOAP in class notes or a
text.) SOAP notes based on a template or similar document will not be c
ounted.



Each SOAP posting must be from a clinical experience this semester and can not
be one posted for a concurrent or prior course.







6


S (CC, HPI (OLD CART), PMH, FH, SH, ROS)


O


PE and any labs at visit, results of any assessment tools


A (must be suppo
rted by S and O above; should include health promotion and chronic
disease management if relevant to this client)


P


(must be related to each A item). Should include patient education and other items
listed above



Each SOAP should be independently written.
Do not use a template or cut and
paste from another source (e.g. an EMR or a sample SOAP in class notes or a
text.) SOAP notes based on a template or similar document will not be counted.
To ensure you address all problems, put the plan for each diagnosis
or health
promotion/ maintenance item next to the diagnosis or health /promotion item.
Since some interventions (e.g. doing a CMP) may be related to two diagnoses
(e.g. HTN and Type 2 DM) you may need to list them twice.



Students in pediatric clinical site
s should also include development assessment,
anticipatory guidance and other SOAP components unique to the care of children.



Medication orders
must

include the drug name (generic or brand), route, dose,
number of pills or volume or amount per dose (as app
licable), specific amount of
medication to be dispensed (e.g. number of pills), and number of refills.



After the SOAP the student should briefly address

topics such as ethical concerns,
the impact of culture on this client’s care, facilitators and barriers to care,
genomics, epidemiology, and/ or financial , health promotion, and/or access to
care


issues a
s applicable to the case



The student should then pose
at least two questions
related to the case e.g.



"We decided on giving Ampicillin but were thinking that Cipro may have been a



better choice, what do you think?" or "We were reall
y concerned she could not get



the MRI because of fear. How would you have handled it?"



Both the initial postings and all responses should reflect use of evidence
-
based
clinical resources to allow fuller exploration of the issues or problems bei
ng
raised. Give sources using as much APA style as possible in a webcourses post.
Be sure to indicate the type of citation according to the code below. It is expected
most resources will be levels 1


5.



Students must reply to questions from instructors an
d group members regarding
their postings and be an active participant in the resultant discussion as long as
there are posts related to each of their SOAPs.



All postings should be thoughtful so that participants can learn as a result of the
discussion. Sel
f
-
reflection on performance as a future NP (e.g. what you see that
you could have done different/better OR how you might better prepare in the
future) is encouraged



All subsequent postings related to a particular SOAP should be in response to an
existing t
hread for that SOAP. (This will keep all the discussions on each case
together.) Do not respond using the create a new message tab.



Postings with little substance (“great job”) may be deleted.



SOAP notes are due by the dates listed above.






7



No SOAPS or re
sponses can be a simple cut and paste information of
material obtained elsewhere
(e.g. on the web, in a course text, from a journal
article). Paraphrase unless the material MUST be quoted (e.g. to show a tool.) If
the original source has a lot in it that o
ther students would want to read, the
readers can go to the URL of the on
-
line source that should be in the reference,
(Be sure the URL works!!)


Required Documentation
:


Each item MUST be verified by clinical instructor
prior to a student receiving a
S
ati
sfactory grade:


Required Clinical Item

Date of
Completion

Grade Assigned: Satisfactory/
Unsatisfactory and Any Additional
Comments

Completion of Clinical
Hours



Evaluation of Clinical
Performance (Faculty)



Mid
-
Term
Evaluation of
Clinical
Performance
(Preceptor)



Evaluation of Clinical
Performance (Preceptor)



Evaluation of Clinical Site
by Student



SOAP #1



SOAP #2



SOAP #3




Required Typhon Entry and Completion
: All clinical data that are required for
completion of the system must be submitted through the Typhon Data Management
System.
Students who fail to document all required clinical information through the
Typhon System will receive an Unsatisfactory grade i
n the course
.


Barkley
& Associates or APEA

Diagnostic Readiness Testing
: This course will utilize the
Barkley Diagnostic Readiness Testing Program

or the Advanced Practice Education
Associated Testing Program
. This program is designed to assess students’ r
eadiness to
successfully pass the Board
-
Certification examinations for Family Nurse Practitioners
and Adult
-
Geriatric Nurse Practitioner
s
. The program consists of a pre
-
test and post
-
test,
both of which provide diagnostic information

related to the student
s’ performance on the
exam. The diagnostic information details which content area(s) students need to focus on
to successfully pass the exam and an overall examination score to help determine if the
student
would pass or fail their Board Certification e
xam
ination. In addition, a
comparison analysis between the pre
-
test and post
-
test is provided

through Barkley &
Associates
. Students also have the ability to review the test items, correct answers, and


8

rationales for incorrect answers. The cost of the program

is $39.95

(Barkley &
Associates) or $31.95 ($63.90)

and directions will be provided
at the start of the semester
on how to register for the program

and make the proper payment
.



Access to the WebCourses Site


Required On
-
line Resources:


1) WebCourses

Course Site: WebCourses will be used for communication of class
announcements and correspondence between faculty and students and among class
members. In addition, the WebCourses will be used for lecture enhancements,
discussions, etc. To send a note to t
he faculty member, choose class mail and choose my
name or instructor. This note will go only to the faculty member the reply will go only to
the student who wrote the initial question. To send a note to the whole class (e.g. to ask
for clarification on a
class topic, a question about the paper etc) use the bulletin
board/forum section so the note and answer will go to everyone.



WHAT IS MY NID?

The NID is the “Network ID” used to identify UCF students to several central
computing systems for LAN access (p
ublic computer labs), email and web pages
(Pegasus) and WebCourses for web classes. The NID will be the same for each system
but the passwords for each system are maintained by each separate system.

The format of the NID is:

ffnnnnnn


where ‘ff’ is the fi
rst two letter of the student’s first name (lowercase), and
‘nnnnnn’ is a six
-
digit number that is randomly generated. If only one character for the
first name is available, that character will be duplicated for the two letters.

The format of the default (
initial) password of the NID is:


PYYMMDD


where ‘P’ is the letter ‘P’ (uppercase) and the remaining information is your
birthdate in ‘YY’ (year) ‘MM’ (month) and ‘DD’ (day) format. You will be able to obtain
the NID from the main PeopleSoft logon screen i
n the near future.



For example, if a student’s first name is Jim, his birthday is April 19, 1980, and
his random number is 500241 then his NID information would be:



NID: ji500241


Password: P800419



9

Note: You will ne
ed to register for this course:


Student Self
-
Registration

for


Nursing


Preparation for Professional Practice (NGR 6941: Practicum)


Warning:

Your NID password is scrambled at the end of each term. You
may reset your password from the
https:/
/webcourses.ucf.edu

URL. Click on
the “changing your NID password” link immediately below the Log In box.
You will NEED your UCF ID card to reset your password.



Here are the instructions for students to register in the
Nursing
-

Clinical Placement
Planning webcourses

course.


This has replaced ngrclinic site on WebCT


1.

Go to:
https://webcourses.ucf.edu

2.

DO NOT LOG IN: instead look at the bottom of the left column for Course List.

Click on the blue underlined “Course List.”

3.

For the
Nursing


Preparation for Professional Practice

website, click on the
following series of links to find the course: DO NOT CLICK ON College of
Nursing at this point, instead click on:

4.

Special Programs,

then

5.

Student Support ; then

6.

Student Support (that is correct, two different screens)

7.

Next, click on the green arrow before the word Nursing to see the list of courses
available to nursing students. You get a menu list;

8.

Look for the “
Nursing
-

Preparation
for Professional Practice
” course and
click on the self
-
registration image:


Here is a picture of that image:



9.

A window will open to register for the course. Enter your NID and password.
Then, click “Register” button.

a.

Warning:

Your NID passw
ord is scrambled at the end of each term. You
may reset your password from the
https://webcourses.ucf.edu

URL. Click
on the “changing your NID password” link immediately below the Log In
box. You will NEED your

UCF ID card to reset your password.



10


Communication Protocols


Communication with faculty will occur in three ways.



Course mail should be used for private questions.



The
Clinical Planning
discussion forum should be used to notify the instructor of
the dat
es and times you will be at your clinical site.


semester")



If a date is listed, you must go to clinical that date unless you notify your
preceptor and have contacted your faculty member before the start of the day.
While a need to cancel due to illness,
family emergency, and changes in the
preceptor's schedule is recognized, repeated cancelations or changes in schedule
could be a reason for a failure in the clinical course.



If the clinical faculty has confirmed a site visit you must be present that date
u
nless you have confirmed a new date with your clinical instructor. Failure to do
this may mandate an additional clinical date for the site visit. Please notify your
preceptor and the office manager (or other person the preceptor suggests) of the
date(s) th
e faculty member will be at the site in advance of their visit.



The
SOAP Note
discussion forum will be used for on
-
Line post conference
discussions of SOAP notes:

o

All students in each clinical group will participate with their clinical
instructor and other

members of this and possibly other clinical courses in
an ongoing on
-
line clinical conference throughout the semester through a
discussion of cases as presented in SOAP notes.

o

Start a new thread for each new SOAP with the following subject line:
Your Last
NameSOAPNumberTopic (e.g. WinkSOAP2BreastPain). All
updates and responses about that SOAP would go in that thread.

o

SOAPs should be on commonly occurring problems, not zebras. If the
situation or problem sends most of the staff to their resources and has
th
em saying things like " I have to look this up" and "I never saw this
before" it is probably a zebra. Put in the zebra section (see below) and use
another patient encounter for your SOAP.

o

SOAPs should be on a variety of topics. Students are expected to rev
iew
those already posted and choose a different topic unless the client situation
is a unique one. (For example, if there is already a SOAP on BV (bacterial
vaginosis) do not post a note on that topic. But, if the original note was on
a 22 year old with BV

for the first time and your client was 30 with
recurrent BV unresponsive to standard treatment that would be OK.)

o

Student SOAP notes must be on different topics. (For example, do not
write three SOAP notes on routine well pregnancy visits or two on well
w
omen visits or all on women with breast pain.)







11


o

Each student will post
at least
three (for 3 and 4 credit courses) OR five
(for 7 caredit courses)
detailed SOAP notes in the post conference
discussion group for their clinical section on the
Clinical
Planning

webcourses site. These should be posted in the body of the message
and

as
an attachment.

The SOAPs and SOAP discussions must occur throughout
the semester. Failure to post on time and/or failure to engage in ongoing
discussion will result in an in
complete in the course. See course schedule
for a list of dates/times for the due dates for the SOAP Notes.

o

The clinical faculty member will critique of the note either using the
version of the SOAP attached to the discussion posting or to the whole
post c
onference group.

o

If the SOAP notes are not at the standard expected, additional SOAP note
submissions may be required by the clinical faculty

o

All students are to read all posted SOAPs:



Students are expected to be actively engaged

in the critique and
discussion of clinical cases presented via the SOAP notes. This
must occur over the course of the semester with discussion in each
of the SOAP note posting periods listed above. These posts should
include providing answers to questions

posed by the poster of the
SOAP. Active engaged discussion is NOT a single post or sets of
posts occurring on only a single dates a few times during the
semester.



The clinical faculty member may ask questions or comment on
individual SOAP notes in the ope
n discussion.



Each student is expected to be involved in all discussions of their
SOAP note. This includes providing answers to faculty questions if
these if not answered by a group member.











12

Guidelines for Preceptors


Practicum focuses on the full
scope of practice of the family nurse practitioner. Students have
already completed courses in Advanced Health Assessment, Nursing Theory, Pathophysiology,
Health Promotion, Pharmacology and dialectic and
most or all
clinical courses in their specialty
NP

tract. This practicum will complete their clinical hours in the nurse practitioner program.

The
number of hours the student will be working with you should be confirmed with the student since
this varies based on the number of credits the student is taki
ng and the number of sites in which
they are working.


As a preceptor, you play a significant role in the education of these future nurse practitioners. The
following is provided as a guide for those of you new to the role or seeking a review.


1.

Provide ac
cess to patients

at your practice site.

a.

The student may accompany you if you make rounds in an acute care (hospital
setting). However the student may not provide care or count these hours towards
this course.

b.

Students should see about
6
-
10

patients per day

although slight more is
appropriate in some settings


2.

Provide direct clinical supervision by seeing patients with the student as needed and
validate their findings.

3.

Listen to student’s case presentation, after their initial patient intera
ction, and provide
critique
, guidance, and clinical knowled
ge gained from practice.

4.

Ask
lots

of questions to help the NP student refine their ability to assess clients
appropriately, carry out clinical decision making, and implement care



What did you
hear, see, assess?



What does this mean to you?



How do non physical factors impact this patient?



What other data do you need?



What will you do next?



Why are you doing that

diagnostic
test,
selecting that
medication,
implementing that
teaching, doing that r
eferral
?



What more do you need to study to better care for this patient or others like them?
Where will you find such information?

5.

Collaborate with the student in planning care for the patient explaining rationale for
treatment choices if needed.

6.

Encou
rage the study of written resources and other clinical guides
relevant to the patients
they see.

7.

Allow
the
students to
document

as much as possible in your practice.
This includes review
of their notes, suggesting revisions or making additions, and cosigni
ng the student’s
documentation.

8.

Allow the student to observe

patient

interactions
which

you feel
would be of educational
value
.

9.

Supervise procedures student

perform
s
. These should be consistent with the student
’s

learning objectives.

10.

Spend a few minutes
with the student at the end of the clinical day to review the student’s
progress. Encourage them to identify their learning needs and develop a plan to address
those needs. This could include reading, study and identification of patients with problems
whic
h will help meet those needs.




13

Statements, Policies, and Regulations Regarding Academic Honesty/ ADA



Office of Student Rights and Responsibilities

University of Central Florida


YOUR ENROLLMENT STATUS MAY BE AT RISK!

Academic Dishonesty in any form will

not be tolerated!!!


The University of Central Florida has recently started an account with turnitin.com., an
automated system which instructors can use to quickly and easily compare each student's
report to billions of web sites, as well as an enormous d
atabase of student papers that
grows with each submission. After submission of the paper, instructors receive a report
that states if and how another author's work was used.


Violations of student academic behavior standards are outlined in The Golden Rule
, the
University of Central Florida's Student Handbook. See
http://www.ucf.edu/goldenrule/

for further details.


1. Cheating whereby non
-
permissible written, visual or oral assistance including that
obtained from another student is utilized on examinations, course assignments or
projects. The unauthorized possession or use of examination or course related
material s
hall also constitute cheating.

2. Plagiarism whereby another's work is deliberately used or appropriated without any
indication of the source. Thereby attempting to convey the impression that such work
is the student's own. Any student failing to properly

credit ideas or materials taken
from another has plagiarized.

3. A student who has assisted another in any of the aforementioned breach of standards
shall be considered equally culpable.

ACADEMIC ACTION

* Taken by Instructor, Chair, or Dean of College*

1
. Counseling

2. Loss of credit for specific assignment, examination or project.

3. Removal from course with a grade of "F" and/or

CONDUCT REVIEW ACTION

*Taken by the Office of Student Conduct*

1. Warning

2. Probation

3. Suspension

4. Expulsion

5.

Permanent conduct record with UCF accessible by other institutions by request.

For more information, please contact the Office of Student Conduct at 823
-
2851.


NUR3825f01.doc

DW/dw 8/8/98

rev
12/14/13



14

American Nurses Association

The
Code of Ethics

for Nurses 2001


Just as our behaviors are held to a University of Central Florida

and College of Nursing

ethical standard
s
, we are also he
ld to our standards as professional nurses
. The ANA
Code of Ethics does apply to all efforts undertak
en as a part of this course. To review
those standards please use the following web link:


http://www.nursingworld.org/MainMenuCategories/EthicsStand
ards/CodeofEthicsf
orNurses.aspx


If you cannot
access the document directly, please copy and paste the link into your web
browser.


15

Persons With Disabilities:
The University of Central Florida is committed to
providing reasonable accommodations for all per
sons with disabilities.


Students who
need accommodations must be registered with Student Disability Services (SDS), Student
Resource Center Room 132, phone (407) 823
-
2371, TTY/TDD only phone (407) 823
-
2116, before requesting accommodations from the profes
sor.


Students who are registered
with SDS and need accommodations in this course must contact the professor at the
beginning of the semester to discuss needed accommodations.


No accommodations will
be provided until the student has met with the professor

to request accommodations.


This
syllabus is available in alternate formats upon request.