My greatest weakness in this essential is the essential in totality. Even in my fifteen years as a nurse , I have had very little exposure and/or interest in health policy and advocacy let alone coding and reimbursement. My strength in this essential is knowledge and concern for HIPPA. My master's education has helped me tremendously in this area.

     In Social, Cultural and Political Perspectives on Healthcare and Delivery Systems, many assignments helped give me knowledge about using political competence to improve health outcomes. One specific assignment was a letter to a policy maker in which I had to articulate and interpret the significance of a specific health care issue to elected and appointed officials in order to influence change. I chose full practice authority since it was a topic that I did not have a full understanding of yet is at the forefront of APRN care delivery today.      

      Another assignment that helped me test my knowledge in this area was an online health reform quiz  http://www.kff.org/quiz/health-reform-quiz  which I did better on than I would have originally thought. But then, to further increase my knowledge in this area, the Health Reform Discussion Scenario Assignment is included to show my competency. In this assignment, we had to choose a scenerio from fourteen different cases and explain how the affordable care act would affect it. I chose "You are a recently graduated nurse who is considering going back to school for a graduate degree. Based on your interest and previous nursing experience, you are considering being a nurse practitioner, but you are wondering what role a nurse practitioner would have based on the health reform legislation." For this assignment, I completed a screen cast as my presentation. 

     The Health Plan Case study is another example of my competency in this essential. For this assignment, we had to view the documentary "Sicko" and critically analyze a national health plan that is presented. I had to include in my written analysis of a description of the nation’s health coverage, access to care, cost, and emphasis on prevention. The country I chose was Great Britain and it was a very good assignment that facilitated my knowledge in health plans overall and what to look for in evaluating them. 

     Finally, the Billing and Coding assignment that I completed in Practice Management and Advanced Role Development helped me understand this essential skill for advanced practice nursing.