Lawrence S. Bloomberg Faculty of Nursing

Advanced Health Assessment and Clinical Reasoning in Primary Health Care: A Review for Nurse Practitioners

Fall 2018

8 week online course

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Course Description
Course Schedule
Course Format
  • Course Description

    This course for Nurse Practitioners and/or nurse practitioner students offers a focused review of advanced health assessment. 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.  Aspects of clinical reasoning will be investigated and critically reviewed in application to pediatric and adult case studies. 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 advanced clinical reasoning and decision-making skills, especially in the area of health assessment and diagnosis of clients across the lifespan and along the health/illness continuum.

    Course Objectives

    The course objectives are based on the Canadian Nurse Practitioner Core Competency Framework (Canadian Nurses Association, 2010).

    Upon completion of the course, the learner will be able to:

    1. Incorporate knowledge of developmental and life stages, pathophysiology, epidemiology, infectious diseases, environmental exposures, behavioural sciences, psychopathology, demographics and family processes when performing health assessments and making a diagnosis.
    2. Incorporate knowledge of the clinical manifestations of normal health events, acute illness/injuries, chronic diseases, comorbidities and emergency health needs, including the effects of multiple etiologies in the assessment and diagnosis of a variety of acute and chronic conditions.
    3. Perform an advanced and focused health assessment and a complete health history appropriate to the client’s situation, including physical, psychosocial, emotional, ethnic, cultural and spiritual dimensions of health.
    4. Incorporate the use of clinical guidelines, systematic reviews and other sources of evidence in clinical decision-­making.
    5. Synthesize health assessment information, using critical inquiry and clinical reasoning, formulate differential diagnoses and identify health needs with consideration of the client’s response to the health/illness experience.
    6. Demonstrate an understanding of how to order appropriate diagnostic investigations.
    7. Anticipate and diagnose emergent, urgent and life-threatening situations.
    8. Differentiate pathophysiologic from normal processes, identifying the clinical signs, symptoms and appropriate investigations.
  • Course Schedule

    pd-advanced-health-assessment-schedule-2017-thumbnailThe course schedule is available as a printable PDF. Updated January 9, 2018

  • Course Format and Expectations

    This course is offered on-line course through the University of Toronto Learning Portal over an 8-week period. There is one week for course introduction, 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 the use of case studies. Participants must actively participate each week in the learning activities through the Discussion Board in the Learning Portal. Participation is essential to assist you in enhancing and refining your advanced health assessment and clinical reasoning skills.

    In order to successfully complete and pass the course, participants will be evaluated by 3 methods:

    1. Quality and consistency of participation in faculty led weekly case studies.
    2. Written submission of a case study from the participant’s practice; and participation in providing feedback on another participant’s submission (Week 7).
    3. Conducting a focused physical and health assessment on a volunteer client based on an assigned case (Week 8). This evaluation will be conducted by Skype or Zoom and will be scheduled with the course faculty during specific times during week 8.

    Course Texts

    (Other resources will be identified on the Learning Portal)

    Recommended Texts

    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., Browne, A., MacDonald-Jenkins, J., & Luctkar-Flude, M. (2014). Physical examination & health assessment (2nd Canadian ed). Toronto: Saunders Elsevier

    Jarvis, C. (2016). Physical Examination and Health Assessment (7th ed). Toronto: Saunders

    Bickley, L. (2012) Bates guide to physical examination and history taking (11th 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.

    Hall, J., Piggott, K., Vojvodic,M. & Zaslavsky, K.  (2013) Essentials of clinical examination handbook (6th 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.

    Jovaisas,B. (Ed.). (2014). Compendium of Therapeutic Choices (7th 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)

  • Course Faculty

    Willi Kirenko NP-PHC, NP-Adult, MN
    Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing

  • Registration Information

    Earlybird Price (ends February 2, 2018) $572 + HST
    Regular price (starts February 3, 2018)
    $635 + HST
    U of T Nursing Alumni save 15%* $540 + HST
    U of T Nursing Faculty save 15%** $540 + HST


    • Registration is limited.
    • Advanced registration is required. You must register by February 23, 2018.
    • U of T Nursing Alumni discount is available to participants who hold a BScN, MN, PMNP Diploma, MScN or PhD from the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto.
    • U of T Nursing Faculty discount is available to participants who hold 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.
    • This is an integrated, 8-week course; partial registrations are not available.
    • Refund Policy – To withdraw from the course and receive a refund, your written request must be emailed to by February 2, 2018. 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.
    • 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 arrangements, travel fees, or any expenses incurred by you.

    Payment method options

    You have two payment options:

    1. Register online with a credit card.
    2. Register by mail with a certified cheque or money order.

    Credit Card:

    You can register and pay online with a credit card.

    Certified cheque or money order:

    You can register and pay by mail.

    Step 1: Type your information onto the online form and then print the page (i.e. don’t click “Confirmation and Payment”. Don’t pay by online credit card).
    Step 2: Obtain a certified cheque or money order payable to “University of Toronto” for the registration fee plus 13% HST. No personal cheques. No debit cards.

    Fees (including HST)

    Earlybird Price
    (ends September 8, 2017)
    $646.36 incl. HST
    Regular Price
    (starts September 9, 2017)
    $717.55 incl. HST
    U of T Nursing Alumni save 15%* $610.20 incl. HST
    U of T Nursing Faculty save 15%** $610.20 incl. HST
    Step 3: Mail the paper registration form with payment (no personal cheques, no cash, no credit cards, no debit cards) to:

    Centre for Professional Development
    Lawrence S. Bloomberg Faculty of Nursing
    University of Toronto
    Suite 130, 155 College Street,
    Toronto, ON M5T 1P8

    Step 4: When we receive your registration form we will email a confirmation notice.
  • Contact Us

    Phone: (416) 978-7688
    Address: Centre for Professional Development (PD)
    Lawrence S. Bloomberg Faculty of Nursing
    University of Toronto
    155 College Street, Suite 130
    Toronto, ON  Canada M5T 1P8

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