NURSING 773 : Advanced Assessment and Clinical Reasoning

Medical and Health Sciences

2024 Semester Two (1245) (30 POINTS)

Course Prescription

Nurses make a variety of diagnoses in their daily practice. Advanced nursing practice requires skilled health assessment, estimation of probabilities and evidence-based diagnostic reasoning. This complex cognitive process is developed in relation to skills and knowledge required for sound clinical reasoning.

Course Overview

Clinical Assessment provides the basis for advanced nursing practice. A fundamental requirement is that patient care is safe, evidenced-based care to allow nurses master a range of core and specialty-based clinical assessment skills. Within an expanding scope of practice, nurses are required to demonstrate competency to take a detailed history, undertake physical assessments, make provisional diagnoses, request and interpret diagnostic tests and prescribe therapeutic interventions and nursing care to facilitate clinical decision-making. The clinical assessment of clients requires a comprehensive approach within a nursing framework, which includes the integration of physical and psycho-social dimensions.

The paper's content is disseminated using a combination of lectures, tutorials and clinical skills teaching sessions. Lectures and tutorials allow for both knowledge dissemination and case-scenario group work to facilitate critical analysis and problem solving. Clinical skills teaching sessions involve peer examination, where students practice on each other to learn physicals assessment skills. The skills teaching session are facilitated by an experienced nurse teacher who provides real-time guidance to support learning. The aim is that students will apply the knowledge, physical exam skills and clinical reasoning process to their work-place clinical environment.

The paper is delivered face-to-face over five study days, with a Observed Structured Clinical Exam (OSCE) on day six.

Course Requirements

Restriction: NURSING 770

Course Contacts

N773 Paper Administrator: Riz Sari. Email: Phone: 09 323 1601
N773 Course Director: Michael Crossan. Email:  Phone:  09 923 8756

Capabilities Developed in this Course

Capability 1: People and Place
Capability 3: Knowledge and Practice
Capability 4: Critical Thinking
Capability 5: Solution Seeking
Capability 6: Communication
Capability 8: Ethics and Professionalism
Graduate Profile: Master of Nursing

Learning Outcomes

By the end of this course, students will be able to:
  1. Demonstrate the application of evidence based clinical decision-making in relation to diagnostic reasoning and client assessment at an advancing level within their scope of practice. (Capability 1.1, 1.2, 3.1, 3.3, 4.1, 4.2, 6.1, 6.2 and 8.1)
  2. Demonstrate the application of evidence based clinical decision-making in relation to diagnostic reasoning and client assessment. (Capability 3.1, 3.2, 3.3, 4.1, 4.2, 6.1 and 6.2)
  3. Demonstrate competence and a systematic approach in performing a focused or comprehensive client assessment (Capability 1.1, 1.2, 3.1, 3.2, 3.3, 4.1, 4.2, 6.1, 6.2, 8.1 and 8.2)
  4. Analyse a client’s health status and request appropriate laboratory and other diagnostic tests in order to establish a diagnosis (Capability 3.1, 3.3, 4.1, 4.2, 6.1 and 6.2)
  5. Interpret clinical findings in relation to underlying pathophysiological processes. (Capability 4.1, 4.2, 5.1, 6.1 and 8.1)
  6. Articulate Articulate the knowledge underlying client assessment and diagnostic test findings in order to formulate a list of differential diagnoses or formulate a diagnostic decision (Capability 1.1, 1.2, 3.1, 3.3, 4.1, 4.2, 6.1, 6.2 and 8.1)


Assessment Type Percentage Classification
Written Assignment 40% Individual Coursework
Multiple Choice Questions 15% Individual Examination
Observed Structured Clinical Exam 45% Individual Examination
Assessment Type Learning Outcome Addressed
1 2 3 4 5 6
Written Assignment
Multiple Choice Questions
Observed Structured Clinical Exam

Workload Expectations

This course is a standard [30] point course and students are expected to spend 10 hours studying per week. 

The Nursing 773 paper centres on [40] hours of lectures,  [120] hours of self-directed study and [140] hours of work on assignment and MCQ exam and OSCE preparation.

Delivery Mode

Campus Experience

Students are expected to attend for face-to-face scheduled activities including lectures/clinical skill sessions to complete the learning components of the course. Attendance on campus is required for the MCQ test and OSCE.

Each of the paper's study day's is timetabled. This gives students the opportunity to undertake pre-reading and skills preparation prior to each study day

Learning Resources

Course materials are made available in a learning and collaboration tool called Canvas which also includes reading lists and lecture recordings (where available).

Please remember that the recording of any class on a personal device requires the permission of the instructor.

The required course text for 773 is:
 Bickley, L. S., & Szilagyi, P. G. (2021). Bates' guide to physical examination and history taking (13th ed.). Lippincott  Williams & Wilkins. We also have an extensive reading list for you to use. The majority of texts, journals articles are available online 24/7 through the university's library website. 

Student Feedback

At the end of every semester students will be invited to give feedback on the course and teaching through a tool called SET or Qualtrics. The lecturers and course co-ordinators will consider all feedback and respond with summaries and actions.

Your feedback helps teachers to improve the course and its delivery for future students.

Class Representatives in each class can take feedback to the department and faculty staff-student consultative committees.

 Student feedback re: 
-  To be more congnisant of students where English is their second language
- Constructive feedback was provided on teaching styles 
- Time-pressure to complete OSCE. The N773 teaching team will discuss this with the potential to making changes and improvements. 

Other Information

This is a highly practical course with a significant amount of content concentrated into the five teaching days. Students are strongly encouraged to plan well in advance and prioritise reading pre and post for each study day.

We are acutely aware that students have different life experiences and learning styles. We aim to facilitate as much as possible to support your learning needs through the learning resources available at the university.

A core part of learning physical assessment skills is peer examination. This requires students physically examining each other. This involves inspecting and palpating your student peer's head, chest, abdomen and legs. On each of the study days, students are asked to wear light movable clothing and sports bras to facilitates meaningful examination of the body's systems. 

Academic Integrity

The University of Auckland will not tolerate cheating, or assisting others to cheat, and views cheating in coursework as a serious academic offence. The work that a student submits for grading must be the student's own work, reflecting their learning. Where work from other sources is used, it must be properly acknowledged and referenced. This requirement also applies to sources on the internet. A student's assessed work may be reviewed for potential plagiarism or other forms of academic misconduct, using computerised detection mechanisms.

It is your responsibility to ensure the written work you submit is an original piece of academic writing, created and written by you for the N773 paper. Accessing information and not acknowledging the source and using previous student's academic work in your assignment is deemed plagiarism and is managed through the university's academic misconduct processes. The use of artificial intelligence softwear such as CHAT GPT is not permitted to support you writing your N773 written assignment. Students who plagiarise will be heavily penalised.        

Class Representatives

Class representatives are students tasked with representing student issues to departments, faculties, and the wider university. If you have a complaint about this course, please contact your class rep who will know how to raise it in the right channels. See your departmental noticeboard for contact details for your class reps.

On day one, a student is asked to volunteer to be the class representative. 

Inclusive Learning

All students are asked to discuss any impairment related requirements privately, face to face and/or in written form with the course coordinator, lecturer or tutor.

Student Disability Services also provides support for students with a wide range of impairments, both visible and invisible, to succeed and excel at the University. For more information and contact details, please visit the Student Disability Services’ website

If you do have an impairment that you feel could affect your learning experience at the university. Please let us know so we can put in place  mechanism to support your learning. 

Special Circumstances

If your ability to complete assessed coursework is affected by illness or other personal circumstances outside of your control, contact a member of teaching staff as soon as possible before the assessment is due.

If your personal circumstances significantly affect your performance, or preparation, for an exam or eligible written test, refer to the University’s aegrotat or compassionate consideration page

This should be done as soon as possible and no later than seven days after the affected test or exam date.

Learning Continuity

In the event of an unexpected disruption, we undertake to maintain the continuity and standard of teaching and learning in all your courses throughout the year. If there are unexpected disruptions the University has contingency plans to ensure that access to your course continues and course assessment continues to meet the principles of the University’s assessment policy. Some adjustments may need to be made in emergencies. You will be kept fully informed by your course co-ordinator/director, and if disruption occurs you should refer to the university website for information about how to proceed.

The delivery mode may change depending on COVID restrictions. Any changes will be communicated through Canvas.

Student Charter and Responsibilities

The Student Charter assumes and acknowledges that students are active participants in the learning process and that they have responsibilities to the institution and the international community of scholars. The University expects that students will act at all times in a way that demonstrates respect for the rights of other students and staff so that the learning environment is both safe and productive. For further information visit Student Charter


Elements of this outline may be subject to change. The latest information about the course will be available for enrolled students in Canvas.

In this course students may be asked to submit coursework assessments digitally. The University reserves the right to conduct scheduled tests and examinations for this course online or through the use of computers or other electronic devices. Where tests or examinations are conducted online remote invigilation arrangements may be used. In exceptional circumstances changes to elements of this course may be necessary at short notice. Students enrolled in this course will be informed of any such changes and the reasons for them, as soon as possible, through Canvas.