Evaluation of health assessment skills

This article presents the reliability and validity data on a checklist used to evaluate health assessment skills. In 1982, the nurse practitioner faculty at a large midwestern university acknowledged that health assessment skills were basic to the preparation of all nurses and made the decision to require these skills for entry into the graduate program. Because of the varying ways in which health assessment skills are acquired, the faculty saw the need to standardize the expected level of performance. An objective, three-page instrument to measure student competence in performing and recording a health history and physical examination for a client of any age is administered prior to beginning the nurse practitioner sequence of courses. The 91 objective items for this instrument are based on the traditional outline for writing up a client history and physical examination. Criteria for the items are located in an accompanying manual. The student achieves a "Yes" rating on an item if all the components of the item are performed and written according to the criteria. Reliability of the tool was assessed by 12 faculty members who participated in a simulated evaluation. The tool has been used to evaluate the skills of 165 nurses. Of these, 149 nurses were enrolled in a continuing education course, and 16 nurses tested out of a health assessment course.