Diagnostic reasoning in the RN-to-NP transition: an interpretive description study.

Diagnostic reasoning skills acquisition is central to advanced nursing practice. This Canadian interview study explores how registered nurses develop diagnostic reasoning as they transition to nurse practitioner roles. The results identify four areas of emphasis: structured sense-making tied to professional identity shifts; prior RN experience as both help and hindrance; diagnostic reasoning developing amid complexity and constraint; and scaffolded, iterative paths to diagnostic skill. The findings identify educational and experiential factors that support increasingly sophisticated clinical reasoning, with implications for workforce development and diagnostic safety.