Teaching Assignments to Promote Development of Family Nurse Practitioner Student Differential Diagnosis Skills

An extensive knowledge of medical facts is not useful unless a practitioner is able to extract accurate and succinct information from a sick person about his or her illness and develop a diagnosis. Although students can and often do, learn the process of differential reasoning through intuition and experienced without direction instruction, we believe that diagnostic reasoning is a difficult task that can be deciphered and made easier for the student.  By providing students an incremental systematic framework for constructing a differential diagnosis, the task can be deciphered and made easier for students. The assignments were created by graduate nursing faculty for the purpose of assisting Family Nurse Practitioner (FNP) students in developing differential diagnosis skills. 

Description of Assignments:

Based on medical school teaching strategy, the assignments are designed around a six step process: data gathering, accurate problem depiction, developing a list of  differential diagnosis, prioritize the differential, testing the differential diagnosis, review and if necessary, reprioritizes the differential diagnosis, and retesting until a diagnosis is reached.

In the first assignment, the student is given a worksheet with a “chief complaint.” The student develops the first two step of the differential process.

In the second assignment, each student is assigned a Family Nurse Practitioner topic that relates to the lecture topic discussed in class. The student creates a PowerPoint presentation using the first four of the six step process. .   

In the final assignment, the student is given a guided case scenario and develops a six step project that incorporates the entire process.

Findings:

While evaluations are ongoing preliminary comments from students are very positive and indicate that this was a creative way to help promote clinical diagnostic reasoning.  

Clinical Relevance:

Our goal is to help students 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.