Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

Assessment Tools and Diagnostic Tests

Advanced practice nurses use various diagnostic tests and assessment tools which help in determining the health condition of a patient. These health professionals should however be mindful of the reliability, validity, and sensitivity of the assessment tools used. This move is ensuring that the results of the assessment will be correct.  It will also help ensure that young and adult patients are diagnosed in the right manner to avoid making wrong diagnostic decisions in the two groups of patients. One of the commonly used diagnostic tools is the Mammogram. This diagnostic tool is used to examine the human breast for diagnosis and screening and it uses low-energy X-rays (Suresh et al., 2018). It is a tool used by health care providers to detect breast cancer, especially among women. The major purpose of mammograms is that this tool helps in the early detection of breast cancer among women. This tool is effective in the detection of breast cancer in the mammalian breast which helps in early diagnosis. This diagnostic tool helps doctors diagnose a patient and commence a treatment plan as early as possible.  Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

 

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When carrying out the mammogram tests, the patient is required to stand in front of the diagnostic tool. The tool includes a special X-ray that helps in examining the breast. The doctor will then press the breast as required in between two plates which help hold the breast for screening. The breasts are flattened by the plates and then the X-ray is taken. The doctor might take more X-ray samples which help in examining the possibility of a patient having breasts cancer. This explains how the mammogram diagnostic test is conducted.

The mammogram diagnostic tool gathers numerous kinds of information. The tool gathers information about the presence of tumors in the breast. This information helps the doctor evaluate if this patient is suffering from breast cancer or if the patient is in a position of contracting breast cancer.  The tool also gathers information about calcium deposits which helps the health caregiver determine if the patient has breast cancer. The tool also helps provide images that contain information about the state of the patient’s breast. Such information will lead to an effective diagnosis of the patient’s condition and an effective treatment plan will be developed to help the patient recover from breast cancer. The tool is also effective in collecting information concerning breast pain, nipple discharge, breast size and shape, and thickening of the breast. Such information is paramount in the diagnosis of possible breast cancer. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

The mammogram tool has a high reliability and validity percentage. The fact that the tool can be between 80% and 98% effective in diagnosing breast cancer makes it a reliable and valid diagnostic tool. Heath professionals evacuate the validity and reliability of a diagnostic tool or test before choosing to use such a tool. A mammogram is a tool that can be used to help treat and save more patients who are suffering from breast cancer (LAA, 2018). If a tool is not reliable, it might lead to wrong or inaccurate findings. Evaluating the validity and reliability of any diagnostic tool is therefore paramount in the health sector.

Concerning sensitivity, mammography has a high sensitivity of about 97% among its patients (What is a mammogram, 2020).  This fact makes the tool effective in finding breast cancer in women. It also means that the tool is effective and can be used by health professionals to help women fight against breast cancer. The sensitivity of mammography is however high in female patients aged above 50 years as compared to patients who are below this age. However, the diagnostic tool remains effective and helps come up with proper diagnoses among the patients. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

There are no major issues with the reliability of this diagnostic tool. This move makes the tool more effective in health centers. The only issue with mammography is that it is not a perfect tool to use in diagnosing breast cancer. The mammogram can fail to detect breast cancer which is hidden by normal breast tissue.  This fact leads to false results known as false negatives and is ineffective in diagnosing breast cancer among women. The diagnostic tool can also lead to the identification of cancer symptoms which could turn out to be just normal breast tissues. The diagnostic tool, therefore, becomes unreliable as it might produce unreliable results.

Mammography is believed to have a high accuracy level of about 80%. However, the issue with the productivity of this tool is that the tool has a positive predictive value of 89% as compared to a negative predictive value of 90.9% (What is a mammogram, 2020). The diagnostic tool is however accurate and produces results that can be reliable and useful to health professionals. The prediction of positive results against cancer in patients aids in the early treatment of the disease. This tool has helped improve the lives of many patients. Early detection of breast cancer accelerates the treatment of patients and a patient can easily recover from the health condition. To avoid negative predictions, repeated tests are conducted to ensure that the health professional can make informed decisions based on the results of the mammography. This move helps avoid any errors Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

 

References

LAA, A. (2018). Comparison between the mammogram and Tomosynthesis for the evaluation of replacing FFDM mammogram with Tomosynthesis. Austin Journal of Radiology5(2). https://doi.org/10.26420/austinjradiol.2018.1082

Suresh, R., Rao, A. N., & Reddy, B. E. (2018). Improving the mammogram images by intelligibility mammogram enhancement method. 2018 2nd International Conference on Inventive Systems and Control (ICISC)https://doi.org/10.1109/icisc.2018.8398954

What is a mammogram? (2020, September 14). Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm

 

Week 3: Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children

 

Many experts predict that genetic testing for disease susceptibility is well on its way to becoming a routine part of clinical care. Yet many of the genetic tests currently being developed are, in the words of the World Health Organization (WHO), of “questionable prognostic value.”

—Leslie Pray, PhD

 

Obesity remains one of the most common chronic diseases in the United States. As a leading cause of United States mortality, morbidity, disability, healthcare utilization and healthcare costs, the high prevalence of obesity continues to strain the United States healthcare system (Obesity Society, 2016).  More than one-third (39.8%) of U.S. adults have obesity (CDC, 2018). The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight (CDC, 2018). Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

According to the Centers for Disease Control and Prevention (CDC), the rate of childhood obesity has tripled in the past 30 years, with an estimated 13.7 million children and adolescents considered obese (CDC, 2018). When seeking insights about a patient’s overall health and nutritional state, body measurements can provide a valuable perspective. This is particularly important with pediatric patients. Measurements such as height and weight can provide clues to potential health problems and help predict how children will respond to illness. Nurses need to be proficient at using assessment tools, such as the Body Mass Index (BMI) and growth charts, in order to assess nutrition-related health risks and pediatric development while being sensitive to other factors that may affect these measures. Body Mass Index is also used as a predictor for measurement of adult weight and health.

Assessments are constantly being conducted on patients, but they may not provide useful information. In order to ensure that health assessments provide relevant data, nurses should familiarize themselves with test-specific factors that may affect the validity, reliability, and value of these tools.

This week, you will explore various assessment tools and diagnostic tests that are used to gather information about patients’ conditions. You will examine the validity and reliability of these tests and tools. You will also examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

Learning Objectives

Students will:

  • Evaluate validity and reliability of assessment tools and diagnostic tests
  • Analyze diversity considerations in health assessments
  • Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment
  • Apply assessment skills to collect patient health histories

Learning Resources

Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)

Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

Photo Credit: Getty Images/Hero Images

For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

To Prepare

  • Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
  • By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.
  • Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
  • Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
  • If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
    • Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
    • Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment

Assignment (3–4 pages, not including title and reference pages):

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:

  • A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
    • What is its purpose?
    • How is it conducted?
    • What information does it gather?
  • Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

Assignment Option 2: Child Health Case:
Include the following:

  • An explanation of the health issues and risks that are relevant to the child you were assigned.
  • Describe additional information you would need in order to further assess his or her weight-related health.
  • Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
  • Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
  • Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.
By Day 6 of Week 3

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK3Assgn1+last name+first initial.(extension)” as the name.
  • Click the Week 3 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 3 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn1+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment
Grading Criteria

To access your rubric:

Week 3 Assignment 1 Option 1 Rubric

To access your rubric:

Week 3 Assignment 1 Option 2 Rubric

To check your Assignment draft for authenticity:

Submit your Week 3 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 6 of Week 3

To participate in this Assignment:

Week 3 Assignment 1


Assignment 2: Digital Clinical Experience (DCE): Health History Assessment

A comprehensive health history is essential to providing quality care for patients across the lifespan, as it helps to properly identify health risks, diagnose patients, and develop individualized treatment plans. To effectively collect these heath histories, you must not only have strong communication skills, but also the ability to quickly establish trust and confidence with your patients. For this DCE Assignment, you begin building your communication and assessment skills as you collect a health history from a volunteer “patient.”

Photo Credit: Sam Edwards / Caiaimage / Getty Images

To Prepare

  • Review this week’s Learning Resources as well as the Taking a Health History media program, and consider how you might incorporate these strategies. Download and review the Student Checklist: Health History Guide and the History Subjective Data Checklist, provided in this week’s Learning Resources, to guide you through the necessary components of the assessment.
  • Access and login to Shadow Health using the link in the left-hand navigation of the Blackboard classroom.
  • Review the Shadow Health Student Orientation media program and the Useful Tips and Tricks document provided in the week’s Learning Resources to guide you through Shadow Health.
  • Review the Week 4 DCE Health History Assessment Rubric, provided in the Assignment submission area, for details on completing the Assignment. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

 

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DCE Health History Assessment:

Complete the following in Shadow Health:

Orientation (Required, you will not be able to access the Health History without completing the requirements). 

  • DCE Orientation (15 minutes)
  • Conversation Concept Lab (50 minutes, Required)

Health History

  • Health History of Tina Jones (180 minutes)

Note: Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve total score of 80% or better(includes BOTH DCE and Documentation), but you must take all attempts by the Week 4 Day 7 deadline.

Submission and Grading Information

No Assignment submission due this week but will be due Day 7, Week 4.

Grading Criteria

To access your rubric:

Week 4 Assignment 2 DCE Rubric


What’s Coming Up in Module 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 3, you will examine advanced health assessments using a system focused approach.

Next week, you will specifically explore how to assess the skin, hair, and nails, as well as how to evaluate abnormal skin findings while conducting health assessments. You will also complete your first Lab Assignment: Differential Diagnosis for Skin Conditions as well as complete your DCE: Health History Assessment in the simulation tool, Shadow Health.

Week 4 Required Media

Photo Credit: [fergregory]/[iStock / Getty Images Plus]/Getty Images

Next week, you will need to view several videos and animations in Seidel’s Guide to Physical Examination as well as other media, as required, prior to completing your Lab Assignment. There are several videos in varied lengths. Please plan ahead to ensure you have time to view these media programs to complete your Assignment on time. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment

Next Module

Excellent Good Fair Poor
In 3–4 pages, address the following:

A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
o What is its purpose?
o How is it conducted?
o What information does it gather?

30 (30%) – 35 (35%)
The response clearly, accurately, and with specific detail describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment
24 (24%) – 29 (29%)
The response accurately describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
18 (18%) – 23 (23%)
The response vaguely and/or with some inaccuracy describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
(0%) – 17 (17%)
The response is inaccurate or missing descriptions of how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values.
45 (45%) – 50 (50%)
The response accurately and thoroughly evaluates the test or tool’s validity and reliability, and explains any issues with clear sensitivity, reliability, and predictive values. Student’s research is clear, accurate, and appropriate for the evaluation.
39 (39%) – 44 (44%)
The response accurately evaluates the test or tool’s validity and reliability, and explains any issues with sensitivity, reliability, and predictive values. Student’s research is somewhat clear, accurate,and appropriate for the evaluation.
33 (33%) – 38 (38%)
The response vaguely and/or with some inaccuracy evaluates the test or tool’s validity and reliability, and explains any issues with some sensitivity, reliability, and predictive values. Student’s research is vague or inaccurate for the evaluation.
(0%) – 32 (32%)
“The response is inaccurate and/or missing evaluations of the test or tool’s validity and reliability, with explanations of any issues missing or lacking sensitivity, reliability, and predictive values. Student’s research is missing, inaccurate, or lacking for the evaluation.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
(5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
(4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.
(3%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.
(0%) – 2 (2%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
(5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
(4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
(3%) – 3 (3%)
Contains several (3 or 4) grammar, spelling, and punctuation errors.
(0%) – 2 (2%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.
(5%) – 5 (5%)
Uses correct APA format with no errors.
(4%) – 4 (4%)
Contains a few (1 or 2) APA format errors. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment
(3%) – 3 (3%)
Contains several (3 or 4) APA format errors.
(0%) – 2 (2%)
Contains many (≥ 5) APA format errors.
Total Points: 100
Excellent Good Fair Poor
In 3–4 pages, address the following:

An explanation of the health issues and risks that are relevant to the child you were assigned.

20 (20%) – 25 (25%)
The response clearly, accurately, and in detail explains the relevant health issues and risks for the assigned child.
19 (19%) – 24 (24%)
The response accurately explains the relevant health issues and risks for the assigned child.
18 (18%) – 23 (23%)
The response vaguely and with some inaccuracy explains the relevant health issues and risks for the assigned child.
(0%) – 17 (17%)
The response is inaccurate and/or missing explanations of the relevant health issues and risks for the assigned child.
Describe additional information you would need in order to further assess his or her weight-related health.
20 (20%) – 25 (25%)
The response clearly and accurately describes detailed additional information needed to further assess the child’s weight-related health.
19 (19%) – 24 (24%)
The response accurately describes additional information needed to further assess the child’s weight-related health.
18 (18%) – 23 (23%)
The response vaguely and with some inaccuracy describes additional information needed to further assess the child’s weight-related health.
(0%) – 17 (17%)
The response is inaccurate and/or missing a description of additional information needed to further assess the child’s weight-related health.
Identify and describe any risks, and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
18 (18%) – 20 (20%)
The response clearly and accurately identifies and describes in detail any risks to the child’s health. The response clearly and accurately identifies and describes in detail further information needed to gain a full understanding of the child’s health, with a detailed explanation of how to gather that information in a way that is sensitive to the child.
16 (16%) – 17 (17%)
The response accurately identifies and describes any risks to the child’s health. The response accurately identifies and describes further information needed to gain a full understanding of the child’s health, with a clear explanation of how to gather that information in a way that is sensitive to the child.
14 (14%) – 14 (14%)
The response vaguely and with some inaccuracy identifies and describes any risks to the child’s health. The response vaguely identifies and describes further information needed to gain a full understanding of the child’s health, with a vague explanation of how to gather that information in a way that is sensitive to the child.
(0%) – 13 (13%)
The response identifies inaccurately and/or is missing descriptions of any risks to the child’s health. The response identifies inaccurately and/or is missing descriptions of further information needed to gain a full understanding of the child’s health, with an inadequate or missing explanation of how to gather that information in a way that is sensitive to the child.
Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
10 (10%) – 10 (10%)
The response clearly and accurately lists three or more specific questions that would gather more information about the child. Specific questions are carefully worded to clearly demonstrate sensitivity to the parent(s) or caregiver(s) of the child. Assessment Tools and Diagnostic Tests in Adults and Children Case Study Assignment
(9%) – 9 (9%)
The response lists three specific questions that would gather more information about the child. Specific questions are worded to demonstrate sensitivity to the parent(s) or caregiver(s) of the child.
(8%) – 8 (8%)
The response lists three questions with wording that is vague and lacking specificity for gathering more information about the child. Some wording of the questions lacks sensitivity to the parent(s) or caregiver(s) of the child.
(0%) – 7 (7%)
The response lists two or fewer confusing or inadequate questions, or is missing questions, for gathering more information about the child. Wording of questions provided lacks sensitivity to the parent(s) or caregiver(s) of the child.
Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.
(5%) – 5 (5%)
The response clearly describes two or more detailed strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.
(4%) – 4 (4%)
The response describes at least two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.
(3%) – 3 (3%)
The response vaguely describes two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.
(0%) – 2 (2%)
The response inadequately describes one strategy or is missing strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
(5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
(4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.
(3%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.
(0%) – 2 (2%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
(5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
(4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
(3%) – 3 (3%)
Contains several (3 or 4) grammar, spelling, and punctuation errors.
(0%) – 2 (2%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.
(5%) – 5 (5%)
Uses correct APA format with no errors.
(4%) – 4 (4%)
Contains a few (1 or 2) APA format errors.
(3%) – 3 (3%)
Contains several (3 or 4) APA format errors.
(0%) – 2 (2%)
Contains many (≥ 5) APA format errors.
Total Points: 100