Advanced Health Assessment and Clinical Reasoning in Primary Health Care: A Review for Nurse Practitioners
7 week course
Delivery Format: Online
This online course for Nurse Practitioners and/or nurse practitioner students is a review of advanced health assessment in primary health care. Emphasis will be placed on the clinical reasoning and decision-making skills required to accurately assess and diagnose clients typically seen in a primary health care setting across the lifespan. Participants will enhance their physical assessment skills; as well as improve their understanding and expertise in the collection of data and diagnostic formulation. Clinical, theoretical and scientific knowledge will be synthesized through the identification and management of existing and potential client states of health and illness across the lifespan.
Nurse Practitioners and nurse practitioner students who have identified a need to strengthen their clinical reasoning and decision-making skills, especially in the area of health assessment and diagnosis of clients across the lifespan.
The course objectives are based on the Entry Level Competencies for Nurse Practitioners (CNO, 2018).
Upon completion of the course, the learner will be able to:
- Perform initial observational assessment of the client’s condition.
- Ask pertinent questions to establish the context for client encounter and chief presenting issue.
- Identify urgent, emergent, and life-threatening situations.
- Collect health history information.
- Perform a relevant physical examination based on assessment findings and specific client characteristics.
- Integrate laboratory and diagnostic results with history and physical assessment findings.
- Analyze and interpret multiple sources of data.
- Generate differential diagnoses.
- Determine most likely diagnoses based on clinical reasoning and available evidence.
The Fall 2020 course schedule is not available yet but the Winter 2020 schedule is available for reference as a printable PDF. Updated November 21, 2019.
Course Format and Expectations
This course is offered on-line course through the University of Toronto Learning Portal (Quercus) over a 7-week period. There are 5 weeks of course work, and two weeks of evaluation. There is one virtual classroom session during week one at the start of the course to introduce the participants to the course format and expectations. (This session will also be available as a recording.)
Course work is focused on application of knowledge and clinical reasoning through the use of case studies. Participants must actively participate each week in the learning activities through the Quercus Learning Portal. Participation is essential to assist in enhancing and refining advanced health assessment and clinical reasoning skills.
In order to successfully complete and pass the course, participants will be evaluated by 3 methods:
- Quality and consistency of participation in faculty led weekly case studies.
- Written submission of a case study from the participant’s practice; and participation in providing feedback on another participant’s submission (Week 6).
- Conducting a focused physical and health assessment on a volunteer client based on an assigned case (Week 7). This evaluation will be conducted by grading a submitted video recording.
(Other resources will be identified on the Learning Portal)
We expect that NPs taking this course will already have access to their own up-to-date resources that they utilize in clinical practice and we encourage incorporation of these resources into this course. In addition, we strongly recommend learners have access to the following textbooks:
Any one of the following health assessment textbooks (or previous versions):
Jarvis, C. Edited by .Browne, A., MacDonald-Jenkins, J., & Luctkar-Flude, M. (2019). Physical examination & health assessment (3rd Canadian Ed.). Toronto: Saunders Elsevier
Jarvis, C. (2019). Physical Examination and Health Assessment (8th ed). Toronto: Saunders
Bickley, L. (2017) Bates guide to physical examination and history taking (12th Ed.).Philadelphia: Wolters Kluwer
Dains, J.E., Bauman, L.C., Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th Ed.). St. Louis, Mosby: Elsevier
Shi, Y., Sohani, Z, Tang, B. & Teoderascu, F. (2013) Essentials of clinical examination handbook (8th Ed.). New York – Stuttgart: Thieme.
In addition to a text on health assessment:
Anti-infective Review Panel. (2013). Anti-infective guidelines for community-acquired infections. Toronto: MUMS Health.
Mums Health App for Anti-Infective Guidelines. Available as an app for $24.99 for iPhone or iPad. Includes a Fall/Winter 2018 Update.
Jovaisas,B. (Ed.). (2019). Compendium of Therapeutic Choices (8th Ed.). Ottawa: Canadian Pharmacists Association
Williamson, M.A., & Snyder, L. (2014). Wallach’s interpretation of diagnostic tests (10th Ed.). Philadelphia, PA: Lippincott, William & Wilkins (or another recent textbook on interpretation of diagnostic tests)
Willi Kirenko NP-PHC, NP-Adult, MN
Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing
Earlybird Price (ends January 10, 2020) $650 + HST Regular price (starts January 11, 2020) $720 + HST U of T Nursing Alumni save 15%* $615 + HST U of T Nursing Faculty save 15%** $615 + HST
- Refund Policy – To withdraw from the course and receive a refund, your written request must be emailed to email@example.com by January 10, 2020. No refunds will be given after this date. All refunds are subject to an administration fee of $100 + tax. As an alternative, a colleague may attend in your place. Please send your substitution request at least 7 days before the course.
- Advanced registration is required. Registration deadline: February 3, 2020.
- *U of T Nursing Alumni discount is available to BScN, MN, PMNP Diploma, MScN or PhD graduates of the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto.
- **U of T Nursing Faculty discount is available to individuals with a faculty position, adjunct or status appointment, or are a Clinical Instructor (current academic year only) at the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto.
- Applicable taxes (13% HST) will be added to the registration fees.
- Course Cancellation Policy – The University reserves the right to cancel courses due to unavailability of instructors, facilities or insufficient enrolment. Decisions on course cancellations are made at least 15 calendar days prior to the course starting date, so early registration is recommended. If you enroll in a course that is subsequently cancelled, you may transfer to another section of that course if an alternative is available; or you may receive a full refund. We are not responsible for travel fees or any expenses incurred by you.
Email: firstname.lastname@example.org Website: bloomberg.nursing.utoronto.ca/pd Phone: (416) 978-1784 Address: Centre for Professional Development
Lawrence S. Bloomberg Faculty of Nursing
University of Toronto
155 College Street
Canada M5T 1P8