Diagnostic Reasoning Competency Assessment Tools: An Integrative Review

Abstract

Diagnostic errors are the most common cause of medical mistakes in the United States. Nurse practitioners (NPs) are critical in reducing the incidence of diagnostic errors, because diagnosis is a common competency for NPs. Although strategies for teaching diagnostic reasoning in NP education have been studied, little research has been conducted on evaluating diagnostic reasoning competencies among NP students. This integrative literature review was performed to identify and synthesize diagnostic reasoning competency assessment strategies in NP education. Data were evaluated for quality and synthesized to provide a comprehensive, actionable overview for NP educators. Although most assessments have been implemented among medical learners, most are also based on processes common to interprofessional diagnostic reasoning competencies. A small number were developed or implemented with NP learners. Current assessment methods may be used in NP education in various settings (eg, simulation education, clinical rotations) with varying reliability and validity.

Keywords: competency-based education; diagnosis; diagnostic reasoning; educational assessment; nurse practitioners.