The fifth in a series of six clinical courses, this course providers additional opportunities for the Primary Care Nurse Practitioner student to increase expertise in the role of an independent practitioner in the provision of primary health care. Emphasis is placed on greater refinement of techniques that assist in reaching a diagnosis, including obtaining a history, performing an appropriate physical exam and applying principles of differential diagnosis in primary care or specialty clinics. There is a focus on a more independent role of the development, implementation, and evaluation the plan of care for patients in the management of episodic and chronic disease. Incorporation of health promotion concepts as well as interpretation of clinical findings and laboratory results is expected. The focus also includes a more independent role of the development and implementation of skills in leadership/policy/quality improvement.