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The 2021 release of The Essentials by the American Association of Colleges of Nursing (AACN) called for nursing education to transition to competency-based education (CBE). The Essentials outline 10 domains of nursing competence, each encompassing broad competencies to prepare practice-ready nurses. Entry-level subcompetencies identify the abilities required for individuals beginning their professional nursing practice, while advanced-level competencies detail the expertise necessary for advanced nursing practice (AACN, 2021). Building on The Essentials, the National Organization of Nurse Practitioner Faculties (NONPF) updated its core nurse practitioner (NP) competencies in 2022, aligning them with advanced-level subcompetencies and incorporating NP-specific subcompetencies. As a result, nursing faculty must reassess their teaching strategies and evaluation methods to effectively develop student competencies across all domains. Ensuring proficiency in physical assessment presents particular challenges.
Physical Assessment Competency
Physical assessment is a fundamental skill for evidence-based nursing practice (Morrell et al., 2021) and a core component of entry-level and advanced-level nursing curricula (AACN, 2021). However, few published studies address physical assessment competencies in nursing education. Health assessment, including history taking and physical examination, is essential for demonstrating nursing competency (Alizadeh et al., 2023). Although much of the literature focuses on psychomotor skill development, it also points to a lack of standardization in assessing affective skills. A significant challenge remains in determining physical assessment competency due to the wide range of skills taught in nursing programs (Morrell et al., 2021).
In advanced-level nursing curricula, physical assessment is a core competency that students must master before formulating differential diagnoses and making clinical decisions. However, research on assessing competencies related to health history and physical assessment remains limited (Higgins et al., 2019). Costa and Monger (2024) examined competency evaluation in simulation, often an initial step in competency development before clinical rotations. Their findings indicate a lack of standardization in competency evaluation across advanced-level programs in the United States. Additionally, existing instruments fail to comprehensively measure students' skills, attitudes, and behaviors in health history-taking and physical examinations, making accurate competency evaluation challenging (Costa & Monger, 2024; Higgins et al., 2019). As advanced-level programs increasingly incorporate more online components and nurse practitioner education transitions to the Doctor of Nursing Practice (DNP)...