Enhancing Health Assessment Skills in Nursing Education Through Structured Practice

Health assessment is a crucial element of nursing education, fundamental to accurately diagnosing and managing patient issues in clinical settings. Effective patient-centered care depends on nurses' ability to identify and analyze key cues, enabling them to develop appropriate solutions (^{National Council of State Boards of Nursing, 2023}). The process of identifying and analyzing these cues serves as the cornerstone of a health assessment course. In the Essentials document outlining core competencies for baccalaureate education, the American Association of Colleges of Nursing (²⁰²¹) emphasizes the integration of assessment skills into practice as a critical subcompetency necessary for providing individualized patient care. Various methodologies have been used to teach a health assessment course. One example is a self-directed learning program. Instead of traditional teaching methods, including lectures, demonstrations and practice, and skill tests, a self-directed learning program was found to promote favorable learning outcomes (^{Chen & Liao, 2024}). However, self-directed programs may be challenging for some students who have difficulty staying focused and navigating a course on their own. Another possible strategy to learn health assessment content is by unfolding case-based learning. This was found to enhance critical thinking and self-confidence among undergraduate nursing students (^{Ma & Zhou, 2022}). Although case-based studies can be effective, they are missing a structured practice approach.

Teaching strategies need to align with relevant clinical practice to be effective (Rhodes et al., 2020). What students are learning in a health assessment course needs to reflect a clinical bedside assessment. Some health assessment courses use traditional nursing students' demonstration of a comprehensive physical examination, but they may not necessarily reflect a clinical bedside assessment. In addition to content alignment, students need structured, repetitive practice to become more proficient with health assessment skills (^{Bosse et al., 2015}; ^{Marshall et al., 2012}). Repetition reinforces learning that may also contribute to the student's confidence in performing in clinical practice.

Structured Practice: An Adaptation of Deliberate Practice Principles

Deliberate practice, as defined by Ericsson and Smith (¹⁹⁹¹), involves activities specifically designed for students to engage with the material taught. It is characterized by four key criteria: (1) individual training by a qualified teacher; (2) clear objectives; (3) the student's understanding of the tasks; and...