Closing the Theory-Practice Gap for the Nursing Head-to-Toe Assessment

nursing head-to-toe assessmentOn average, recently matriculated RNs reported performing a physical assessment 3.98 times during their last shift. So are newly minted graduates prepared to do a nursing head-to-toe assessment?

Not many.

According to a study published in Nursing Education, “only 11 of 40 RN graduates entering the transition program scored 70% or better on physical assessment skills testing.” While this represents a small sample size, the authors believe this roughly represents “the competencies of typical new graduates.”

Only 11 of 40 RN graduates entering the transition program scored 70% or better on physical assessment skills testing Click To Tweet

Want to better prepare your nursing students? Download our head-to-toe assessment checklist that highlights the most regularly performed skills in an entry-level practice. 

Closing the theory-practice gap in nursing is a complicated problem, but professors and departments are discovering helpful tools to address the problem head-on. A tool for closing the preparation-practice gap for the nursing head-to-toe assessment is student videos.

The Advantages of Nursing Assessment Videos

Utilizing student videos to teach nursing assessments isn’t a new idea—especially when it comes to teaching the health assessment in nursing.  

The advantages of student videos stretches back several decades. In 2003, a group of faculty members at Central Missouri State University baccalaureate school of nursing (CMSU) published an article about incorporating video recordings as a technique to teach the nursing head-to-toe assessment.

From that early time (even with limited budget and equipment) the CMSU educators found that video “alleviate[d]” a lot of the “problems with traditional one-on-one validation of skills.”

7 benefits from using student videos to teach the head-to-toe assessment Click To Tweet

Namely, video technology facilitated more specific and detailed feedback. As a result, educators noticed that student assessments and specific psychomotor skills improved. Students also reported “better skill acquisition and increased self-confidence.”

(Oh, and did I mention that filming the head-to-toe assessment gave educators a lot of flexibility when it came to observing and grading?)


Fast forward to 2018, Christina Purpora and Susan K. Prion found similar results surveying students that completed a head-to-toe assessment video assignment. They observed that their “nursing students felt able to apply classroom learning of this skill to clinical practice, and the process encouraged the development of their self-reflection skills.”

So to summarize the advantages of using student videos for the nursing head-to-toe assessment:

  1. Increased flexibility for students and faculty
  2. Increased opportunities for students to repeat and practice
  3. Students see their mistakes
  4. Students can correct their mistakes without an evaluation
  5. More effective feedback
  6. Increased student confidence
  7. Improved student awareness and self-reflection

The Challenges of Nursing Video Assessments

Yet that’s not to say that using video for a nursing head-to-toe assessment is without challenges. In 2003, CSMU students and faculty faced technology-related issues. Technology and logistics continues to cause challenges for instructors today, which is curious because technology has advanced so practically every teacher and student has a phone in their pocket.


Whether it’s figuring out how students will access video recording technology (the university video lab or cell phones), determining how students will turn it in (flash drive, online website, cloud software), making sure you’ve downloaded compatible software to watch all the student submissions, or devising an effective accompanying feedback method (google docs, excel, or word).

In 2017, Dr. Michael Bumbach encountered these types of issues when he assigned students to submit their head-to-toe videos through Canvas, the learning management system (LMS) used at UF. 

Luckily, solutions exist today that remove the technological and logistical friction in assigning a head-to-toe assessment video.


The Video Software Solution

For Dr. Bumbach, the solution was GoReact. In a case study published about Dr. Bumbach’s experience, he outlines how this tool solved his headaches when assigning a health assessment student video.

Smaller Video Files

Video submissions are automatically compressed and accessible to the professor.

Simple Equipment

Students can film themselves with their own smartphones and laptops. Students can access an easy-to-use tools to pause, clip, or re-film a segment.

Integrated Feedback

Professors can give time-stamped feedback and customized markers directly on the student submitted video.

Accessible Feedback

Immediately after a professor finalizes their review, students can access and respond directly to their professor’s feedback.

So the right tool can help mitigate historic challenges in assigning a head-to-toe assessment video. Also keep in mind that even in the early 2000s, nursing educators believed the benefits of a student video health assessment far outweighed these early challenges. That means there is even less reason for nursing educators today to not employ the student video for the physical assessment in nursing.

Bridge the Gap with Video

To return to where this article started, the theory-practice nursing gap puts nursing students in a difficult if not perilous situation. That’s why nursing educators should be doing everything within their power to bridge this gap.

Since evidence shows that student videos can help bridge the nursing gap, nursing educators should seriously consider a student video for teaching the nursing head-to-toe assessment. Newly graduated RNs perform this assessment far too often during their work day for nursing educators to not provide every advantage possible.

Whether you use GoReact or another video tool, nursing professors must seriously consider video to help bridge the gap in teaching the nursing head-to-toe assessment.

If you’d like to learn more about resources for nursing educators, you may also enjoy our article, What to Include in a Head-to-Toe Checklist.

Head-to-Toe Assessment Download


Crawford, Smith. “Report of Findings from the 2002 RN Practice Analysis Update.” NCSBN.
Berman, Beazley, Karshmer, Prion, Van, Wallace, West. “Competence Gaps Among Unemployed New Graduates Entering a Community-Based Transition-to-practice Program.” Nursing Education.
Winters, Hauck, Riggs, Clawson, Collins. “Use of Videotaping to Assess Competencies and Course Outcomes.” Journal of Nursing Education.
Purpora, Prion. “Using Student-Produced Video to Validate Head-to-Toe Assessment Performance.” Journal of Nursing Education.
Top Nursing Program Tackles Shortage of Nurses in New Technology.” GoReact.



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