Health assessment validation: Challenging tradition

Undergraduate health assessment courses aim to prepare nursing students to conduct systematic physical assessment of patients. Competency in the undergraduate health assessment course is traditionally validated by student demonstration of a memorized, comprehensive physical examination.

Often, this validation requires performance of an exhaustive list of physical examination skills rather than the typical physical assessment performed by the generalist nurse in the hospital setting. This precedent to "do it all" does not align with competency-based education and may cause students to be ill-prepared for clinical practice.

Faculty in a 12-month second-degree accelerated BSN program adapted the comprehensive physical assessment validation to better reflect a clinically relevant bedside assessment. The process, results, challenges, and recommendations are described. Here, the redefined comprehensive physical assessment included evaluation of the patient's general appearance, activity, vital sign measurements, pain, and key assessment of the neurologic, respiratory, cardiovascular, integumentary, gastrointestinal, and genitourinary systems. In alignment with the AACN recommendations, students were also validated on focused assessments.

This change improved the students transition to clinical practice. We challenge faculty to prepare students for real-world nursing assessment by adapting validations to closely mirror bedside practice.