Differential Diagnoses and the Family Nurse Practitioner Student

A teaching tool was created by graduate nursing faculty to assist Family Nurse Practitioner (FNP) students in developing the skill of differential diagnosis. Its purpose is to enhance the diagnostic reasoning process and take the student to the “next step” of health assessment, that is, beyond basic history and physical examination. This tool is utilized to assist both online and on campus students in obtaining essential diagnosing knowledge and enhance clinical reasoning skills. The benefit of learning differential diagnoses contributes to students' appropriate organization of information to be recalled later for use in clinical reasoning situations. Additional benefits include creating proficiencies in differential diagnoses, refine their clinical reasoning ability, and enhance students' confidence.

Each student is assigned a Family Nurse Practitioner topic that relates to the lecture topic discussed in class. Each presents the project after the corresponding lecture. Minimal topic information is given and the student is responsible to create and develop the rest of the information. An optional worksheet and sample project are provided to help guide the student through this process. The student clusters abnormal findings, analyzes and interprets the findings which culminate in the development of a list of likely or differential diagnoses. From the list of differential diagnoses the student finalizes the appropriate (or applicable) diagnoses and creates a plan for the patient. The student formats the project into a 20 minute narrated PowerPoint presentation.

The completion of this rigorous differential diagnosis tool by FNP students transferred to interactive discussion supporting and/or refuting specific diagnoses. This was evident in both online and traditional classroom settings. While evaluations are ongoing preliminary comments from students are very positive and indicate that this was a creative way to help develop the essential skill of forming differential diagnoses.  

Our goal in developing this specific teaching tool is to help the student become more efficient in exercising clinical judgment by asking the right questions, seeking pertinent information from the body of scientific evidence, and using clinical reasoning to apply the best evidence to clinical practice. This project aligns with the Practice Inquiry Competencies from National Organization of Nurse Practitioner Faculty.