How did your program teach physical assessment?

djmatte, ADN, MSN, RN, NP · Feb 14, 2019

Our physical assessment class was online. But my school (Frontier) had school house sessions that had in person check offs for head to toe examinations for adult, infant, and male/female GU. We also had specialized workshops in various other assessments such as musculoskeletal areas. These weren't simple checks where someone guided us through the process. They were blind exams where we drew three random cards and had to go through the motions of those specific areas on the fly in under 10 minutes. The infant though was head to toe with all reflex tests for everyone. We were not allowed to proceed with clinical without these passed. IMO in person demonstration (not previously recorded) should be a base standard for any school.

NICUmiiki, DNP, NP · Feb 14, 2019

I've taken a heath assessment course (lifespan) and I'm currently in a neonatal assessment course.

The health assessment course was part of FNP program at a state school. Most course work was online. This course had clinical hours and was a combination of a simulation program online and in person lab days at the school and we were checked off in person.

In my NNP program, the neonatal assessment course has true clinical hours that we spend in a hospital with a preceptor assessing babies.

allnurses Guide · Feb 14, 2019

Mine was face to face. I attended a 100% on campus program. We had to do a complete adult and pediatric exam within a set time to pass the class.

allnurses Guide · Feb 14, 2019

3 hours ago, Ready2GradMay09 said:
I am curious to learn how your NP program taught the advanced physical/health assessment course? Were there any face-to-face requirements, or was it done online? How were you checked off? Did you feel prepared? I precept NP students, and am trying to get a better understanding of how other programs teach this. If you could let me know what school you attended that would help too!

It really varies by program when it comes to non-B&M programs. Without face-to-face instruction by the program there is no way to effectively teach physical assessment, other than a rudimentary memorization. This burden is moved from the program on to the preceptor.

From personal experience, I mistakenly took a student from a poor-reputed online program once because I they were paying preceptors $2000/student-rotation. I had to back out because there was no way I had time in clinic to “precept” an NP student that had no idea how to take a history or do a provider-level exam. I went back to taking students from programs that invest in their students.

Ready2GradMay09, ASN, BSN, MSN, NP · Feb 15, 2019

Thank you all for your responses. It seems the general consensus is that those who had live/face-to-face evaluations felt better prepared. I know online programs have become more popular, but I wonder how adequately students are being prepared for the clinical setting? What are your thoughts on the preceptor teaching these assessment skills during clinicals?

NICUmiiki, DNP, NP · Feb 15, 2019

1 hour ago, Ready2GradMay09 said:
Thank you all for your responses. It seems the general consensus is that those who had live/face-to-face evaluations felt better prepared. I know online programs have become more popular, but I wonder how adequately students are being prepared for the clinical setting? What are your thoughts on the preceptor teaching these assessment skills during clinicals?

After people posted after me, I realized that I should add to mine. My NNP program is B&M with in person classes. The neonatal assessment class is in person, but there is only so much assessment you can master on a doll. In adult assessment courses, you can be checked off on an instructor or on a classmate with the instructor present. In babies, you really need a baby in front of you and the university just doesn't have any lying around, lol. In my lifespan course, we had small segments of infant and pediatric assessment, but never checked off on it. How prepared are FNP students really to assess those populations? I'm assuming that in the end, it got pushed off on their preceptors in later courses. At least my preceptors (neonatologists and NNPs) know that I'm in an assessment course and my clinical hours are strictly for learning to assess real babies.

Angeljho, MSN, NP · Feb 16, 2019

Mine was a hybrid course. There was an online portion, but we also had on campus classes that were required. Our final was also on campus where we did a complete exam on an actor with a random health problem(s).

MSNrunner · Feb 16, 2019

I went to a B&M school that had a lab where we practiced our skills. Then we went to a med school close by that had volunteer patients. We were checked off on a full head to toe assessment, a sick patient visit, a pelvic exam, and a DRE with a doctor watching us. They gave us feedback at the end.

allnurses Guide · Feb 19, 2019

On 2/15/2019 at 5:29 PM, NICUmiiki said:
How prepared are FNP students really to assess those populations? I'm assuming that in the end, it got pushed off on their preceptors in later courses.

FWIW, the FNP program I went to and the program I teach for now use an entire semester of faculty supervised professional patients ("paid patients") for both adults and pediatrics, including infants. Students must pass this prior to heading out to preceptorships.

Oldmahubbard · Feb 19, 2019

I went to a B and M school some 20 years ago. We practiced on each other and there was no pelvic or rectal exam. There was a lot of rote memorization to it as I recall. It was not good preparation, but at least I had my extensive RN experience to back me up. I can't imagine trying to do this mostly online.

NICUmiiki, DNP, NP · Feb 19, 2019

4 hours ago, Hyperflycemia said:
FWIW, the FNP program I went to and the program I teach for now use an entire semester of faculty supervised professional patients ("paid patients") for both adults and pediatrics, including infants. Students must pass this prior to heading out to preceptorships.

That sounds amazing, but I wouldn't think it's common.