NRS 415 Benchmark – Creating Change Through Advocacy
As patient advocates in their different specialties, nurses seek changes to the healthcare delivery to improve access and quality of care for different patient populations and health conditions. Nurses engage elected representatives to create changes through advocacy on different healthcare issues including access to mental health and the opioid epidemic among other problems (Hughes et al., 2021). The opioid epidemic remains a critical national health concern that requires change through legislation. The purpose of this paper is to discuss nurses’ focus on creating change using advocacy by engaging elected representatives.
| Problem
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In no more than 250 words, describe the problem, who is affected, and the current ramifications. Explain the consequences if the issue continues. |
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| The United States is battling a serious opioid epidemic that threatens the future of the health system and population. The opioid epidemic is a public health issue affecting the country and causing overdose deaths. According to statistics from federal agencies like the Centers for Disease Control and Prevention (CDC), and National Institute on Drug Abuse (NIDA) (2023), more than 1 million Americans have died from drug overdoses, with an increasing share of the deaths happening from opioids. For instance, in 2022 over 100,000 individuals died from drug overdose. As such, drug overdose is now the leading cause of injury mortality in the country, and surpasses motor vehicle accidents and gun violence. Additionally, opioids account for over 83,000 deaths from overdose. According to reports fentanyl, a synthetic opioid, is the leading cause of the rising deaths among Americans aged 18 and 49 years. In their article, Truong et al. (2023) assert that the COVID-19 pandemic and economic insecurity exacerbated the situation with the opioid epidemic rising as more Americans used drugs during these times. The pandemic led to social isolation and prevented many individuals from seeking addiction treatment.
The majority of those affected by the opioid epidemic are American citizens, mostly those between 18 and 49 years. Apart from causing devastating loss of life in families and communities, the opioid epidemic accounts for close to $1 trillion in annual costs for the healthcare system and the criminal justice system (National Institute on Drug Abuse, 2024). The country also loses productive population because of premature deaths emanating from the crisis. The continuation of this issue will lead to more deaths, a rise in spending on healthcare, and more people getting addicted leading mental health issues. |
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| Idea for Addressing Solution
In no more than 250 words, outline your idea for addressing the issue and explain why legislation is the best course for advocacy. |
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| The opioid epidemic requires effective measures through a whole-of-government, society-wide approach as proposed by Truong et al. (2023) because of the multifaceted nature of the drug supply market. For instance, Fentanyl, which is responsible for over two-thirds of overdose deaths and drug abuse incidences, is mainly imported as synthetic opioid from abroad. The article notes that as a complex public health crisis and issue, the U.S. can reduce and prevent the increasing prevalence by focusing on the root causes of drug abuse, expanding access to treatment and developing harm reduction strategies. Additionally, the country can develop measures to reduce the supply of illicit opioids entering the United States from other countries. Accordingly, Congress and policymakers at different levels of government should develop measures to expand access to evidence-based community harm reduction, treatment, and recovery options (CBO, 2022). These policies should focus on the social determinants of health, improve access to treatment options, especially in the most affected areas, communities, and populations. For instance, the Centers for Disease Control and Prevention (CDC) (2023) in collaboration with health departments in 47 states, Washington DC, two territories and 16 cities and counties collects data on overdose for effective action through surveillance and prevention activities.
Legislation is the best course for advocacy for this issue because of its complex nature. The implication is that having Congressional actions as advanced by many studies will enhance access to health care through strategies aimed at treatment and harm reduction as well as preventing access market to the drugs, especially imported synthetic drugs like fentanyl that is the biggest cause of abuse and the opioid crisis. Existing legislative frameworks like Comprehensive Addiction and Recovery Act, 21st Centrury Cures Act and SUPPORT for Patients and Communities Act have not been effective as expected to reduce the opioid epidemic and offer effective access to treatment and harm reduction for those addicted to the drugs. |
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| Research the Issue
Perform research and compile information for your idea. Present substantive evidence-based findings that support your idea for addressing the problem (research studies, reports, etc.). Include any similar legislation introduced or passed in other states. |
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| Evidence 1
Legislative actions are necessary to address this issue as demonstrated by an editorial article by Lancet Public Health (Standard-Lancet Commission). According to the article, having legislation that allows the use of medications like Naloxone can help reverse the effects of an opioid overdose (Health, 2022). The commission suggests that several countries like the UK, Australia and Canada have introduced naloxone as an over-the-counter medication to combat the adverse effects of opioid overdose. The article suggests that having legislations at state and federal levels which allows naloxone distribution in states where fentanyl is high can reduce the overall rates of overdose deaths. |
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| Evidence 2
The article by the Congressional Budget Office (CBO) (2022) highlights different legislative interventions through laws and measures to address the opioid epidemic. According to the article, Congress has enacted several acts to address the issue, an indication that legislative action is still the most effective way to address the epidemic since it offers interventions that implore funding and allocation of resources for the fight against opioids. |
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| Evidence 3
In their article, Klobucista and Ferragamo (2023) observe that the opioid epidemic has become one of the biggest killers, and endangers public health, the economy, and even homeland and national security. The article observes that most of the synthetic drugs enter the U.S. market through its borders. As such, legislating on a policy to stop the floodgates on fentanyl is essential since it is a foreign policy issue. Such a sensitive issue can only be addressed through legislative action at the federal level because it is a foreign policy challenge. |
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| Stakeholder Support
Discuss the stakeholders who would support the proposed idea and explain why they would be in support. |
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| Stakeholder(s) Supporting 1 | Different stakeholders will support the proposed idea. The first group comprise healthcare workers like nurses and physicians, especially those dealing with mental health and drug abuse disorders. These people will support the legislation aimed at reducing the effects of opioid, particularly overdose deaths. | |
| Stakeholder(s) Supporting 2 | Policymakers and legislators at state and federal level will support the proposed idea to strengthen the nation’s efforts to fight opioids and overdose deaths. These stakeholders are critical in passing effective legislations to reduce harm, increase access to treatment, and improve the quality of care for individuals suffering from the epidemic. | |
| Stakeholders (s) Supporting 3 | The opioid epidemic is a public health issue in the U.S. implying that it affects families, communities, and individuals. These effects like loss of life, increased cost of care, and devastating effects imply that the public will support such efforts to enhance interventions. | |
| Stakeholder Opposition
Discuss the stakeholders who would oppose the proposed idea. Explain why they would be in opposition and how you would prepare to debate or converse about these considerations. |
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| Stakeholder(s) Opposed 1 | Drug companies, especially those in the import business, may oppose the proposed idea because such measures will affect their businesses and profits. They will oppose the proposed idea to keep the status quo. However, they need to consider the negative effects of the opioid epidemic as a public health issue. They should collaborate to prevent misuse of their drugs and ensure that it does not become a source of death and devastation for many families and individuals. | |
| Stakeholder(s) Opposed 2 | Users, especially those addicted to opioids, may oppose the proposed idea as it will reduce their uptake of drugs. Users at state level may also object these measures arguing the current actions and legislative efforts are sufficient to address the issue. However, it is essential for them to understand the magnitude of the problem and support the proposed idea. | |
| Financial Incentives/Costs
In no more than 250 words, summarize the financial impact of the issue and the idea (added costs, cost savings, increased revenue, etc.). Provide support (may include references from the “Research Your Issue” section). |
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| The opioid epidemic has caused significant financial effects and costs on the healthcare sector, families, and communities. In their article Truong et al. (2022) estimates that the opioid epidemic costs the healthcare sector and the criminal justice system over $1 trillion every year. For instance, the enactment of the Comprehensive Addiction and Recovery Act (CARA) of 2016 implies that the federal government spends over $2.7 billion on Medicaid to expand access to recovery and harm reduction efforts for those suffering from the opioid overdose. The current situation means that the federal and state governments will spend more on treating patients with opioid use disorder that in most cases has comorbidities with other conditions (Health, 2022). However, implementing legislative measures that consolidate the current efforts and laws into one and integrates the different programs across the federal health system can improve access to healthcare (National Institute on Drug Abuse, 2024). More fundamentally, the country will save billions of dollars through the implementation of effective policies, especially those aimed at prevention like disruption of supply chains of the illicit synthetic drugs. Such legislations will increase the cost, risk and difficulty of producing and trafficking the products to the U.S. market. The proposed idea will reduce these costs, improve access to health care services, and enhance harm reduction efforts at state and local levels. Through this proposed idea, the U.S. will reduce opioid overdose deaths, lower the cost of care, and even get more revenue through arresting the perpetrators and arraigning them in courts. | ||
| Legislature: Information Needed and Process for Proposal
Discuss how to advocate for your proposal using legislation. Include the following: |
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| Provide the name and complete contact information for the legislator. | ||
| Describe the steps needed to present this to your legislator. | The steps will entail seeking an appointment with the legislator through his office secretary. Upon getting an appointment, I will present the proposed idea to introduce a bill in Congress on effective opioid regulation in the country. | |
| Interprofessional Collaboration in the Legislative Arena
In no more than 250 words, discuss the role interprofessional collaboration plays in advocacy through legislation. |
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| Inter-professional collaboration allows different healthcare professionals and practitioners to work together based on common and shared goals and treatment plans. At the core of inter-professional collaboration in healthcare is to approach issues from a team-based perspective or viewpoint, leading to improved patient outcomes and better workplace environment. Inter-professional collaboration is a pre-requisite in advocacy through legislation as it allows providers to work together with other stakeholders like policymakers and elected representatives to attain set goals. In this case, addressing the opioid epidemic needs shared approach and expertise, a unified voice from all stakeholders, effective implementation and continuous improvement. A shared approach in handling such issues is important as it allows different professionals bring unique perspectives and expertise to the table, especially in developing evidence-based models to prevent the increased prevalence of opioids (Alderwick et al., 2021). A collaborative approach ensures that stakeholders advance a unified voice, making the advocacy more powerful and this leads to a strong message to the policymaker concerning the significance of the issue. Inter-professional collaboration ensures that once the legislation is enacted, it is effectively implemented with each professional playing their role based on their expertise. Through collaboration, stakeholders will always communicate to understand the overall effect of the legislation and if it requires any adjustments. As such, inter-professional collaboration plays a critical role in enhancing advocacy through legislation as a fundamental part of developing interventions on the opioid epidemic. | ||
| Leadership Competencies and Styles
The American Organization of Nurse Executives (AONE) has identified leadership competencies relevant for nurse leaders to guide practice within the health care system. Describe two leadership competencies identified by the AONE that would also be necessary for a nurse to advocate for the legislative solution you have proposed. Discuss how the theory of servant leadership supports these competencies. This section should be addressed in no more than 250 words. |
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| The American Organization of Nurse Executives (AONE) implores nurse leaders to develop certain competencies that allows them to function effectively in the health care system. These competencies are necessary for nurses to interact with stakeholders; especially patients and colleagues. Imperatively, the two competencies by the AONE necessary for a nurse advocate on the proposed legislative approach to the identified issue are communication and relationship building and knowledge of the health care environment and clinical principles (Hughes et al., 2022). These competencies are essential since advocacy requires effective communication for stakeholders to embrace the proposed idea or change. Communicating with clarity and integrity builds trust among stakeholders. Again, the nurse advocate should develop relationship with all stakeholders for effective engagement and building strategic partnerships and alliances to attain a common goal (Gonzalez Garcia et al., 2022). Furthermore, the opioid epidemic affects the general public and having knowledge about the healthcare environment and clinical principles ensures that nurse advocate can guide legislators on the most effective policy interventions to tackle the issue.
The theory of servant leadership supports the competencies as effective servant leaders should communicate well, build teams, and have sufficient knowledge on the issue under investigation. Servant leaders are empathetic and serve others to ensure that they become the best and attain expected outcomes. Servant leadership theory supports these competencies by ensuring that nurse leaders focus on the greater benefit of the people through advocating for them. |
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| Christian Principles and Nursing Advocacy
In no more than 250 words, discuss how principles of a Christian worldview lend support to legislative advocacy in health care without bias. Be specific as to how these principles help advocate for inclusiveness and positive health outcomes for all populations, including those more vulnerable, without regard to gender, sexual orientation, culture, race, religion/belief, etc. |
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| The principles of the Christian worldview include biblical values of love, compassion, justice, and respect for the dignity of all individuals, irrespective of their diversity in race, age, sexual orientation, and socioeconomic status. These principles are founded on the concept of Imago Dei or man having been created in God’s image. Therefore, all are equal and deserve inherent dignity and respect. Again, Christians have an obligation to advocate for others, just life Jesus Christ who sacrificed his life because of the love for the world. As such, these principles support legislative advocacy by demonstrating that nurses should show compassion and love, be fair, and respect those suffering from the opioid epidemic and their families (Hathaway et al., 2021). Imperatively, they should advocate for their welfare without any bias and instead be inclusive to attain positive outcomes. These principles ensures that advocacy focuses on the greater benefits of all people, irrespective for their age, gender, and race and other demographics. The implication is that the Christian worldview seeks nurses and other healthcare providers to follow the example of Jesus and love unconditionally while serving them using evidence-based practice for quality and better outcomes. The principles of Christian worldview are categorical that nurses should advocate for patients and this makes the approach to the opioid epidemic relevant to all stakeholders, including the elected representatives.
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Conclusion
The opioid epidemic remain a serious public health concern impacting millions of Americans with significant effects on the health system. As such, having legislative action to prevent opioids and ensure that there is limited supply is essential for the country to overcome the problem. Legislative advocacy is a fundamental approach that will allow stakeholders to implement better interventions, especially through primary activities like making manufacturing and distribution of synthetic drugs costly for the producers, including the drugs imported into the United States.
References:
Alderwick, H., Hutchings, A., Briggs, A., & Mays, N. (2021). The impacts of collaboration between local health care and non-health
care organizations and factors shaping how they work: a systematic review of reviews. BMC Public Health, 21, 1-16. DOIhttps://doi.org/10.1186/s12889-021-10630-Congressional Budget Office (CBO) (2022). The Opioid Crisis and Recent Federal Policy Responses. https://www.cbo.gov/system/files/2022-09/58221-opioid-crisis.pdf
Gonzalez Garcia, A., Pinto‐Carral, A., Pérez González, S., & Marqués‐Sánchez, P. (2022). A competency model for nurse executives. International Journal of Nursing Practice, 28(5), e13058. DOI: 10.1111/ijn.13058
Hathaway, W. L., & Yarhouse, M. A. (2021). The integration of psychology and Christianity: A domain-based approach. InterVarsity Press.
Health, T. L. P. (2022). Opioid overdose crisis: time for a radical rethink. The Lancet. Public health, 7(3), e195. DOI:https://doi.org/10.1016/S2468-2667(22)00043-3
Hughes, R., Meadows, M. T., & Begley, R. (2022). AONL nurse leader competencies: core competencies for nurse leadership. Nurse Leader, 20(5), 437-443. DOI:https://doi.org/10.1016/j.mnl.2022.08.005
Klobucista, C. & Mariel, F. (2023). Fentanyl and the U.S. Opioid Epidemic. https://www.cfr.org/backgrounder/fentanyl-and-us-opioid-epidemic
National Institute on Drug Abuse (2024). Drug Overdose Death Rates. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
Truong, T. Q., Gandhi, D, Rosenthal, J., Johns, M., Rashid, M., Restrepo, D., Amaning, A. & Bluthenthal, C. (2023 Sept 20). Tackling the Opioid Crisis Requires a Whole-of-Government, Society-Wide Approach.
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Assessment Description
The purpose of this assignment is to identify a problem or concern in your organization, local community, or state in which change can occur through advocacy and legislation.
Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system.
Identify a problem or concern in your organization, local community, or state. Examples of problems relevant to nursing include, but are not limited to, title “nurse” protection, sharps injury prevention, nursing shortage, nurse well-being, valuation of nursing services, etc. Research the issue you selected and use the attached “Creating Change Through Advocacy” template to complete this assignment.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies and professional standards:
RN-BSN
9.4: Comply with relevant laws, policies, and regulations.
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns to AACN Core Competencies 3.2, 3.4, 3.5, 4.3, 9.4.
Attachments
NRS-415-RS-T3-Creating Change Through Advocacy.d
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Benchmark – Creating Change Through Advocacy – Rubric
| Criterion | 1. Unsatisfactory | 2. Insufficient | 3. Approaching | 4. Acceptable | 5. Target |
|---|---|---|---|---|---|
| Problem
Describe a health care problem that has the capacity for advocacy through legislation and the consequences if the issue continues. |
0 points
A description of a health care problem that has the capacity for advocacy through legislation and the consequences if the issue continues is not present. |
9.75 points
A description of a health care problem that has the capacity for advocacy through legislation and the consequences if the issue continues is incomplete or incorrect. |
11.25 points
A description of a health care problem that has the capacity for advocacy through legislation and the consequences if the issue continues is present but lacks detail. |
12.75 points
A description of a health care problem that has the capacity for advocacy through legislation and the consequences if the issue continues is detailed. |
15 points
A description of a health care problem that has the capacity for advocacy through legislation and the consequences if the issue continues is thorough and includes relevant supporting details. |
| Research the Issue
Identify a minimum of three research studies, reports, or similar pieces of legislation passed in other states within the last 5 years. |
0 points
Identification of at least of three research studies, reports, or similar pieces of legislation passed in other states within the last 5 years is not present. |
14.63 points
Identification of at least of three research studies, reports, or similar pieces of legislation passed in other states within the last 5 years is incomplete or incorrect. |
16.88 points
Identification of at least of three research studies, reports, or similar pieces of legislation passed in other states within the last 5 years is present but lacks evidence of the identified issue or falls outside of the five-year limit. |
19.13 points
Identification of at least of three research studies, reports, or similar pieces of legislation passed in other states within the last 5 years is present and provides evidence of the identified issue. |
22.5 points
Identification of at least of three research studies, reports, or similar pieces of legislation passed in other states within the last 5 years is present and provides substantive evidence of the identified issue. |
| Idea for Addressing Solution (B)
Explain an idea for addressing the issue and why legislation is the best course for advocacy. (C9.4) |
0 points
An explanation of an idea for addressing the issue and why legislation is the best course for advocacy is not present. |
14.63 points
An explanation of an idea for addressing the issue and why legislation is the best course for advocacy is not present. |
16.88 points
An explanation of an idea for addressing the issue and why legislation is the best course for advocacy is present but lacks support from research. |
19.13 points
An explanation of an idea for addressing the issue and why legislation is the best course for advocacy is detailed and provides support from research. |
22.5 points
An explanation of an idea for addressing the issue and why legislation is the best course for advocacy is thorough and provides detailed support from research. |
| Stakeholder Support
Discuss the stakeholders who would support the proposed idea and why. |
0 points
A discussion of the stakeholders who would support the proposed idea and why is not present. |
9.75 points
A discussion of the stakeholders who would support the proposed idea and why is incomplete or incorrect. |
11.25 points
A discussion of the stakeholders who would support the proposed idea and why is present. |
12.75 points
A discussion of the stakeholders who would support the proposed idea and why is detailed. |
15 points
A discussion of the stakeholders who would support the proposed idea and why is thorough. |
| Stakeholder Opposition
Discuss the stakeholders who would oppose the proposed idea and why. |
0 points
A discussion of the stakeholders who would oppose the proposed idea and why is not present. |
9.75 points
A discussion of the stakeholders who would oppose the proposed idea and why is incomplete or incorrect. |
11.25 points
A discussion of the stakeholders who would oppose the proposed idea and why is present but lacks detail on how to debate these considerations. |
12.75 points
A discussion of the stakeholders who would oppose the proposed idea and why is detailed and includes some detail on how to debate these considerations. |
15 points
A discussion of the stakeholders who would oppose the proposed idea and why is thorough and includes relevant detail on how to debate these considerations. |
| Financial Incentives/Costs
Explain the financial impact of the issue and the solution. |
0 points
An explanation of the financial impact of the issue and the solution is incomplete. |
9.75 points
An explanation of the financial impact of the issue and the solution is incomplete or incorrect. |
11.25 points
An explanation of the financial impact of the issue and the solution is present but lacks detail from research. |
12.75 points
An explanation of the financial impact of the issue and the solution is detailed and includes some supporting detail from research. |
15 points
An explanation of the financial impact of the issue and the solution is thorough and includes relevant supporting detail from research. |
| Legislature: Information Needed and Process for Proposal
Discuss how to advocate for the proposal using legislation. |
0 points
A discussion of how to advocate for the proposal using legislation, including contact information for the legislator and the steps needed to present the proposal, is not present. |
9.75 points
A discussion of how to advocate for the proposal using legislation, including contact information for the legislator and the steps needed to present the proposal, is incomplete or incorrect. |
11.25 points
A discussion of how to advocate for the proposal using legislation, including contact information for the legislator and the steps needed to present the proposal, is present but lacks substantial detail from research. |
12.75 points
A discussion of how to advocate for the proposal using legislation, including contact information for the legislator and the steps needed to present the proposal, is detailed and includes some detail from research. |
15 points
A discussion of how to advocate for the proposal using legislation, including contact information for the legislator and the steps needed to present the proposal, is thorough and includes substantial detail from research. |
| Christian Principles and Nursing Advocacy
Discuss how principles of a Christian worldview lend support to legislative advocacy in health care without bias. |
0 points
A discussion of how principles of a Christian worldview lend support to legislative advocacy in health care without bias is not present. |
9.75 points
A discussion of how principles of a Christian worldview lend support to legislative advocacy in health care without bias is incomplete or incorrect. |
11.25 points
A discussion of how principles of a Christian worldview lend support to legislative advocacy in health care without bias is present but lacks detail regarding inclusiveness and positive health outcomes for all populations. |
12.75 points
A discussion of how principles of a Christian worldview lend support to legislative advocacy in health care without bias is detailed and includes some detail regarding inclusiveness and positive health outcomes for all populations. |
15 points
A discussion of how principles of a Christian worldview lend support to legislative advocacy in health care without bias is thorough and includes substantial detail regarding inclusiveness and positive health outcomes for all populations. |
| Mechanics of Writing
Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc. |
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout. |
4.88 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent. |
5.63 points
Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted. |
6.38 points
Few mechanical errors are present. Suitable language choice and sentence structure are used. |
7.5 points
No mechanical errors are present. Appropriate language choice and sentence structure are used throughout. |
| Format/Documentation
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline. |
0 points
Appropriate format is not used. No documentation of sources is provided. |
4.88 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident. |
5.63 points
Appropriate format and documentation are used, although there are some obvious errors. |
6.38 points
Appropriate format and documentation are used with only minor errors. |
7.5 points
No errors in formatting or documentation are present. |