Nailing the Diagnosis: Using Screen-Based Simulation to Improve Factors of Diagnostic Reasoning in Family Nurse Practitioner Education

•A 5-week screen-based simulation intervention increased diagnostic reasoning.•There were significant increases in all diagnostic reasoning factors (p < .001).•Evidence that supports simulation for clinical education and diagnostic skills. Providers’ diagnostic skills and reasoning are essential to the health and safety of patients and the healthcare system. Simulation is a promising modality for improving diagnostic reasoning, with the ability to practice, receive feedback, and reflect in a safe learning environment. This study used a quasi-experimental, pretest/posttest one group design to investigate the effect of a 5-week intervention screen-based simulation intervention on metacognitive awareness, knowledge, and diagnostic reasoning factors in family nurse practitioner students in their final semester of clinical coursework. Univariate descriptive statistics were used to describe demographic data and study variables. Paired sample t-tests were used to examine differences in the three study variables pre- and postintervention. In the study sample of 72 students, there were statistically significant increases (p < .001) in knowledge, metacognitive awareness, and diagnostic reasoning scores from pretest to posttest after a screen-based simulation intervention. Findings of this study suggest that the overall improvement in students’ metacognition and knowledge led to an improvement in diagnostic reasoning, which could lead to accurate diagnosis and prevent errors.