Buy this Article for $10.95

Have a coupon or promotional code? Enter it here:

When you buy this you'll get access to the ePub version, a downloadable PDF, and the ability to print the full article.


differential diagnosis, doctor of nurse practice (DNP) program, nurse practitioner students, objective structured clinical examination (OSCE), online/hybrid education, physical assessment



  1. Champlin, Andrea M. MPH, MAEd
  2. Roberts, Lisa R. DrPH, MSN, RN, FNP-BC, CHES, FAANP
  3. Pueschel, Robin D. DNP, APRN, AGACNP-BC, RNFA
  4. Saunders, Jasmine S.D. MPH
  5. Huerta, Gloria M. DNP, FNP-C, NHDP-BC, CNS, RN
  6. Yang, Joanna DNP, FNP-BC, ACNP-BC, ANVP-BC, RN


Background: Advanced health assessment is a required course in advanced practice RN (APRN) education, essential to providing the foundation for differential diagnosis (DD) skills and the ability to formulate a plan of care.


Problem: Feedback from clinical preceptors revealed that our doctor of nursing practice (DNP) students struggled to make a DD.


Approach: This educational quality improvement project collected data from 7 cohorts of DNP students in either the Family Nurse Practitioner or Adult Gerontology Nurse Practitioner program to evaluate their readiness for clinical practicums and to inform necessary curriculum revisions.


Outcomes: Data revealed that students' ability to identify 3 DDs correctly during the summative health assessment objective structured clinical examination was inconsistent. Qualitative data revealed students lacked understanding on how to use results from the physical assessment to formulate a DD.


Conclusion: The findings of this project corroborate those from the literature that suggest we should teach APRN students DD skills explicitly.