Teaching dual-process diagnostic reasoning to doctor of nursing practice students: problem-based learning and the illness script

J Nurs Educ. 2014 Nov 1;53(11):646-50. doi: 10.3928/01484834-20141023-05. Epub 2014 Oct 23.

Abstract

Accelerating the development of diagnostic reasoning skills for nurse practitioner students is high on the wish list of many faculty. The purpose of this article is to describe how the teaching strategy of problem-based learning (PBL) that drills the hypothetico-deductive or analytic reasoning process when combined with an assignment that fosters pattern recognition (a nonanalytic process) teaches and reinforces the dual process of diagnostic reasoning. In an online Doctor of Nursing Practice program, four PBL cases that start with the same symptom unfold over 2 weeks. These four cases follow different paths as they unfold leading to different diagnoses. Culminating each PBL case, a unique assignment called an illness script was developed to foster the development of pattern recognition. When combined with hypothetico-deductive reasoning drilled during the PBL case, students experience the dual process approach to diagnostic reasoning used by clinicians.

MeSH terms

  • Clinical Competence
  • Diagnosis, Differential
  • Education, Nursing, Graduate*
  • Humans
  • Nursing Education Research
  • Nursing Evaluation Research
  • Nursing Methodology Research
  • Problem-Based Learning*
  • Students, Nursing / psychology*
  • Teaching / methods*
  • Thinking