Physical examination competence as a predictor of diagnostic reasoning among new advanced practice nurse students: a cross-sectional study

Aim: To investigate levels of diagnostic reasoning among new APN students as well as students’ characteristic affecting such reasoning levels. Design: a descriptive correlational design. Methods: One hundred fourteen APN students in an advanced health assessment course self-assessed their competene in performing examination. The students’ self-reported Diagnostic Reasoning Assessment scores were used to categorize them into pre-novice, novice, advanced beginner, and competent levels. Ordinal logistic regression analysis was used. Results: Only physical examination competence significantly predicted the students’ diagnostic reasoning levels. Being in a higher diagnostic reasoning level relative to being in a pre-novice, novice, or advanced beginner level was 16.1, 2.6, and 1.9 times greater in the physical examination competence, respectively. Conclusions: Promoting physical examination competence can be an effective teaching strategy for enhancing the diagnostic reasoning of newly enrolled APN students, especially for students who have poor diagnostic reasoning performance.