Fresno State University NP Program Case Study
See how a structured DDx pilot helped NP students practice diagnostic thinking in a safe, simulated clinical environment.
Overview
A high-impact, digital simulation for NP Students
As Nurse Practitioner students transition into clinical practice, developing strong diagnostic reasoning and clinical confidence is essential. Fresno State University piloted DDx to provide students with a structured, conversational environment to practice these skills. The goal was to offer a low-risk, high-impact simulation that bridges the gap between traditional learning and real-world clinical encounters.
Overview
The challenge
NP students need more than passive learning to build diagnostic confidence
The NP program sought a scalable case-based learning solution that would allow students to practice clinical reasoning and diagnostic decision-making through realistic patient encounters in a safe, simulated environment.
As NP students move closer to clinical practice, building strong diagnostic reasoning skills becomes critical — yet traditional learning tools rarely replicate the complexity of real-world patient interactions. Students need opportunities to practice history-taking, navigate diagnostic uncertainty, and make meaningful clinical decisions before entering the field.
Fresno State University recognized this gap and sought a solution that could bridge the distance between traditional coursework and the hands-on demands of clinical care — without adding burden to faculty or overwhelming students.
The solution
Why DDx by Sketchy?
Provided 49 NP students with access to case-based clinical simulations designed to reflect real-world practice; Cases allowed students to practice history-taking, diagnostic thinking, and decision-making in a safe, simulated environment; The conversational format was specifically evaluated for meaningfulness compared to traditional resources; Platform was assessed for alignment with students' current stage of clinical training and perceived value versus existing tools
How did DDx by Sketchy fit?
DDx was piloted as a highly effective tool for developing clinical reasoning in a low-risk environment. By providing a realistic, conversational simulation, DDx clearly differentiated itself from traditional learning modalities. The platform's ability to mirror real-world encounters and build confidence in students' diagnostic approach drove a strong and consistent positive response across every measured outcome.
Cases Included:
- NP specific DDx cases
The results
High marks across every measure of clinical impact and educational Value
Students consistently found DDx cases relevant to real-world clinical practice (85-90%), reported increased confidence in clinical reasoning and diagnostic thinking (75-85%), and agreed that the simulation format supported safe practice of clinical decision-making (>85%). 80-90% found the conversational format meaningfully different from traditional resources. On educational value, 70-80% agreed DDx was more effective than other tools for developing clinical reasoning, and 80-90% found it more clinically realistic than traditional static or linear platforms. Approximately 85-90% would view case-based simulation as a valuable complement to current instructional methods, and 75-85% expressed interest in continued or expanded use.
Testimonials
What did students say?
Confidence built. Gaps bridged. Students ready for real world practice.
The Fresno State NP Program pilot demonstrated that DDx is a highly effective tool for developing clinical reasoning in a low-risk environment. With high learner acceptance, a strong desire for continued use, and consistently strong ratings across all dimensions of clinical impact and educational value, DDx has proven to be a valuable addition to the NP curriculum — enhancing both student confidence and clinical readiness.
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