Diagnostic Reasoning Outcomes in Nurse Practitioner Education: A Scoping Review

Abstract

Background: Diagnostic reasoning is the process of collecting, considering, and analyzing information to determine a diagnosis. Educational strategies that structure diagnostic reasoning exposure, experience, and evaluation are hypothesized to improve diagnostic safety. However, few studies measure diagnostic reasoning outcomes in nurse practitioner education. This review sought to identify the educational interventions intended to improve diagnostic reasoning competency, determine which components of reasoning are evaluated, and examine how they are measured. Method: Four databases were searched, and 12 studies were identified that met the inclusion criteria. Results: Simulation was the most common intervention. The most frequently measured diagnostic reasoning components were information gathering, differential diagnosis, and leading diagnosis. Checklists and patient management problems were the most used assessment method. Conclusion: More studies are needed to assess the reasoning processes of hypothesis generation, problem representation, and diagnostic justification. Within simulation, methods capable of capturing these components include think-aloud, global assessments, checklists, and note evaluation. [ J Nurs Educ . 2022;61(10):579–586.]