A head-to-toe assessment is a staple in the nursing profession. In fact, a NCSBN survey found that newly licensed RNs performed 3.98 physical assessments during their last shift.A NCSBN survey found that newly licensed RNs performed 3.98 physical assessments during their last shift. Click To Tweet
So what are the most effective methods to prepare nursing students for administering health assessments? Here are five tips for teaching the head-to-toe assessment.
1. Present a Clinical Perspective
It always helps to situate knowledge, assignments, and tasks within a clinical perspective. This includes telling your students personal anecdotes about administering a physical exam. It can also include asking, discussing, and answering these questions:
- What’s the purpose of a physical assessment in healthcare?
- Where do most health assessments take place?
- When will you be performing a physical exam?
- How often will you do them?
- What tools will you need?
- What documents will you be filling out?
- What are the most common physical assessment tasks a practice will ask you to perform?
These types of questions get students to think critically. For example, you could host a debate whether their head-to-toe assessment checklist should include the 100+ items from their nursing textbook or just focus on the most commonly performed items at an entry-level practice.
Split up the 100+ items in the nursing textbook checklist among the students. Each student can investigate and quickly present half a dozen specific tasks on the list. From there, students can debate which tasks to include on their rubric. To illustrate the debate, give your students two rubrics focusing on the most regularly performed skills in an entry-level practice by downloading our Head-To-Toe Assessment Checklist.
2. Do a Demonstration
After introducing the physical assessment to your class, your students might be wondering to themselves, “So, what does a physical assessment look like?”
You can show them right then and there. Demonstrations are an excellent pedagogical tool for teaching psychomotor skills—like physical examination methods.
Consider bringing in additional nursing professionals to perform health assessments so students can see some variety. This will encourage thoughtful questions about why one nurse does something differently than another.
3. Assign a Script
Have your students write a script for the head-to-toe assessment. Tell them that they’re creating a script for a movie, and they’ll be more motivated to play the glamorous roles of screenwriter and director. This assignment will help students think about assessments in terms of narrative and dialogue.
With so many items to check off in a physical assessment, it’s easy to forget one or two things. By writing a script, students organize the story of a head-to-toe assessment in an order that makes the most sense to them. When the story of a head-to-toe makes sense, it’s easier to remember every step and not leave something out.
Discuss the different ways they can organize health assessment checklist items. For example, their narrative could revolve around working their way from head to toe. Or they could organize by a patient’s position—supine, sitting, etc.
Students can write out the conversation between the patient and the provider to reinforce that this is more than working through a checklist. It’s an interaction with a real person.
Students can easily focus too much on the psychomotor skills and forget about the human interaction of a physical assessment. This assignment can imbue students with confidence and perhaps even save them from the embarrassment of being tongue-tied the first time they role play. They can draft, revise, and memorize phrases they’ll say to the patient.
Encourage students to consider various scenarios. Would they phrase things differently if they’re dealing with a cranky patient or a squirmy twelve-year-old?
Also, as with any writing assignment, it’s always a great idea to engage students by doing a peer review. Have students share their scripts with a partner and then give their partner feedback. Maybe their partner found a better way to ask a patient “to assume a supine position.” Who knows?
4. Flip Your Classroom
The flipped classroom is a successful strategy for promoting active learning in the nursing classroom. If you’re not familiar with the term, a flipped classroom just switches the items traditionally done at home and in the classroom.
Instead of using class time to lecture or watch demonstrations, students watch lectures or demonstrations at home. Then they use class time to practice the skills they learned at home. A flipped classroom is all about mediated practice—and that’s why it’s a perfect exercise for teaching the head-to-toe assessment.
To use this technique, simply record your lecture or send students a recorded head-to-toe demonstration. After watching this at home, when they come to class they role-play performing a physical assessment. You can roam the room and give individual and collective feedback.
If you upload a short lecture and a head-to-toe assessment demonstration, consider uploading an imperfect example. With an imperfect physical assessment, you can assign students to identify two checklist items done well and two items that were skipped or performed incorrectly.
At the beginning of class, have students write their findings on the board. Quickly review their findings with them so students start to think critically. This will model how they can extend this reflection and critical thinking during their role-playing.
If you’re still nervous about trying a flipped classroom, read “5 Simple Steps to Create Your Own Flipped Classroom.”
5. Assign a Student Video
Students will dramatically improve if you assign a student head-to-toe assessment video. For this assignment, simply ask students to record themselves performing a health assessment on a friend or fellow classmates. Students submit the video and you provide them with individual and specific feedback.
Here’s the fabulous bit: the feedback you give is reinforced with visual evidence! That’s why students become more self-aware and reflective. They’ll also improve at a rapid pace. In fact, these are the results Dr. Michael Bumbach witnessed when he assigned student videos for the head-to-toe assessment.
The results improve even more if you use the right video software. For example, GoReact is an excellent resource for student videos. GoReact embeds feedback directly in the video, which makes feedback more accessible and effective for instructors and students. It also saves you time grading!
Check out the gif below to see how GoReact works.
To access more resources about the benefits of assigning a student video, read “Assigning a Student Head-to-Toe Assessment Video.”
Finish with Simulation
By following these tips, you’ll provide your students with a clinical perspective on the physical assessment, a solid demonstration, a script to follow, practice, and individual feedback.
In other words, your students will be ready for simulation. And in the simulation lab, your students’ performance will significantly improve in checking all those boxes on the head-to-toe assessment checklist. Better yet, your students will be more prepared in the future to perform 3.98 head-to-toe assessments during a shift.
If you’re interested in ways you can improve your students’ simulation experiences, read 4 Surefire Ways to Boost Nursing Simulation.
Crawford, Smith. “Report of Findings from the 2002 RN Practice Analysis Update.” NCSBN.
Oligschlaeger. “Physical Examination Methods: Training Your Students.” GoReact.
Huston, et al. “The Academic-Practice Gap: Strategies for an Enduring Problem.” Nurse Forum.
Seamons. “Top Nursing Program Tackles Shortage of Nurses with New Technology.” GoReact.
Hillary is a trained literary scholar and university writing instructor who traded Shakespeare and Cavendish for content marketing. She loves all things design, art, theatre, travel, and literature.