Proposal, DNP Project, Concept Map, Capstone, Care Plan, SOAP Notes and PICO: How and When Each Is Done in Nursing School

Introduction

Nursing education builds clinical reasoning step by step. Early in the program, students learn to organize patient care through care plans and concept maps. They learn to ask answerable clinical questions with PICO. Nurse practitioner students document advanced assessments and diagnoses in SOAP notes. By the end of a program, students design and lead change through a proposal and a capstone or DNP project. Each assignment has a different purpose and format, but together they build the competencies set out in the AACN Essentials (American Association of Colleges of Nursing [AACN], 2021).

When each assignment is done

1. Nursing care plan

What it is

A nursing care plan is a written plan that applies the nursing process (ADPIE): Assessment, Diagnosis, Planning, Implementation and Evaluation. It guides individualized care for a patient. It uses standardized nursing diagnoses, usually from NANDA International (Herdman et al., 2024), which describe the patient’s response to a health problem rather than the medical diagnosis.

When

From the first clinical course onward, often one care plan per clinical week. In early semesters care plans are long and detailed. By the final year they become shorter and more focused.

How to do it

1. Assessment: gather subjective and objective data, including vital signs, labs, physical exam findings, medications and patient statements.
2. Diagnosis: write a nursing diagnosis in PES format (problem, etiology, signs and symptoms).
3. Planning: set patient-centered, SMART goals.
4. Implementation: list nursing interventions with evidence-based rationales.
5. Evaluation: state whether the goal was met, partly met or not met, and revise the plan.

How to succeed

• Prioritize with Maslow and the ABCs: airway, breathing and circulation diagnoses come first.
• Write diagnoses about the patient’s response (“Acute pain”), not the medical condition (“Pneumonia”).
• Make goals measurable and patient-centered (“Patient will…”, not “Nurse will…”).
• Give every intervention a rationale with a citation.
• Use your actual patient’s data. Generic, copied care plans are easy for instructors to spot.

2. Concept map

What it is

A concept map is a visual diagram of a patient’s care. The central medical diagnosis or reason for admission connects to nursing problems, assessment data, medications, labs, pathophysiology and interventions. It shows relationships that a linear care plan can hide, which builds clinical reasoning (Schuster, 2020).

When

In ADN and BSN clinical courses, especially medical-surgical. It is often prepared the evening before clinical as preparation, then completed after the shift.

How to do it

1. Put the patient’s main medical diagnosis or reason for admission in the center.
2. Draw branches for 2–4 priority nursing problems.
3. Under each problem, list the supporting data: abnormal assessment findings, labs and vital signs.
4. Add interventions and rationales for each problem.
5. Draw connecting lines between related problems. For example, immobility links to both risk for pressure injury and constipation.
6. Add medications and labs, linked to the problems they treat or reflect.
7. Note the evaluation for each problem.

How to succeed

• Start with the pathophysiology: understanding why the disease causes each symptom makes the links obvious.
• Use colors or shapes consistently, for example blue for data and green for interventions.
• Explain every connecting line; the connections are what instructors grade.
• Keep it readable. Use digital tools such as Lucidchart, Canva or Word SmartArt, or a large sheet of paper.
• For an example of the format, see our pharmacology concept maps.

3. PICO(T) question

What it is

PICO(T) is a format for writing a focused, answerable clinical question that guides a literature search (Melnyk & Fineout-Overholt, 2023):

• P: Patient or population
• I: Intervention or issue of interest
• C: Comparison
• O: Outcome
• T: Time frame (optional)

When

In BSN research or evidence-based practice courses, then again at the start of every capstone, proposal and DNP project. It is also used in clinical courses for EBP assignments.

Examples by question type

How to succeed

• Keep it narrow: one population, one intervention, one main outcome.
• Make the outcome measurable, such as a fall rate, HbA1c or length of stay.
• Use your PICO terms as search keywords, combined with AND/OR.
• Use the question type that fits. “Meaning” questions are answered by qualitative research and may have no comparison.

4. SOAP note

What it is

A SOAP note is the standard format for provider documentation of a patient encounter (Podder et al., 2023):

• S – Subjective: what the patient reports: chief complaint, history of present illness (often using the OLDCARTS mnemonic), past history, medications, allergies, social and family history and review of systems.
• O – Objective: what you observe and measure: vital signs, physical examination, labs and diagnostics.
• A – Assessment: your clinical reasoning: the primary diagnosis and differential diagnoses with justification.
• P – Plan: diagnostics, treatment (medications with dose, route and frequency), patient education, referrals and follow-up.

When

Mainly in NP programs at the MSN or DNP level, in advanced health assessment and every primary care, family, pediatric, women’s health or psychiatric clinical rotation, usually weekly. Some BSN courses use a simplified version.

Short example

How to succeed

• Keep subjective and objective data separate. A common error is putting exam findings in S.
• Include at least three differential diagnoses and explain why each is more or less likely.
• Base the plan on current clinical guidelines and cite them.
• Use correct medical terminology and pertinent positives and negatives.
• Never include identifying patient information. Use age and sex only.

5. Project proposal

What it is

A proposal is a formal plan for a capstone, DNP project or research study that must be approved by faculty, the project team or committee, and often the clinical site, before the project begins. In many DNP programs, it is presented at a proposal defense.

When

Usually the term before implementation: in the final year of a BSN or MSN, or partway through a DNP program.

Typical sections

1. Title and abstract
2. Problem statement, background and significance, with local and national data
3. Needs assessment
4. PICO(T) question, purpose and objectives
5. Review and synthesis of the literature
6. Theoretical or EBP framework
7. Methods: setting, population, intervention, data collection, measures and analysis plan
8. Timeline, resources and budget
9. Ethical considerations and IRB plan
10. Evaluation and sustainability plan

How to succeed

• Choose a feasible, focused problem that your clinical site cares about.
• Build your case with data: why this problem, here, now.
• Make sure every section aligns. The problem, PICOT, objectives, intervention and outcome measures should all match.
• Get early feedback from your faculty and site mentor, and revise often.
• Write in the future tense (“will implement”), and follow APA style exactly.

6. Capstone project

What it is

The capstone is the culminating project of a BSN or MSN program. Students identify a practice problem, usually from the practicum, appraise the evidence, and propose or implement an evidence-based solution. It typically ends in a scholarly paper and a poster or presentation.

When

In the final semester, alongside the practicum or preceptorship.

How to do it

Follow nine steps: identify, validate, ask a PICOT question, find and appraise evidence, choose a framework, plan, implement, evaluate, and sustain and share. Our full guide covers these: Development of a Capstone Project from Practicum Experience.

How to succeed

• Start early. Keep a practicum journal from the first shift to find your topic.
• Involve your preceptor and nurse manager from the start.
• Use baseline data so you can show improvement.
• Choose a small, measurable change rather than a hospital-wide overhaul.
• Practice your presentation, and design a clear, uncluttered poster.

7. DNP project

What it is

The DNP project is the final scholarly work of the Doctor of Nursing Practice degree. Unlike a PhD dissertation, which generates new knowledge through research, the DNP project translates existing evidence into practice to improve health care outcomes at the system or population level (AACN, 2015). Common types are quality-improvement initiatives, EBP implementation projects, program development and evaluation, and practice-change or policy projects.

When

Across the final 1–2 years of the DNP program, integrated with the practice hours. DNP graduates complete at least 1,000 post-baccalaureate practice hours. The process usually follows these phases: topic and team selection → proposal and proposal defense → IRB and site approval → implementation → evaluation → final paper and defense → dissemination, such as a manuscript or the DNP project repository.

How to succeed

• Choose a topic linked to a real organizational priority with a committed site mentor.
• Think system-level: aim to change processes and outcomes, not only to educate staff.
• Use rigorous QI methods such as PDSA cycles, run charts and statistical process control, and report with SQUIRE 2.0 (Ogrinc et al., 2016).
• Plan for sustainability and handover from the start.
• Manage the project like a project: use a Gantt chart, hold regular meetings with your chair, and set realistic deadlines.
• Aim to publish or present your work. Dissemination is an expected DNP outcome (Moran et al., 2024).

How the assignments connect

Skills learned early carry forward. A strong PICO question becomes the core of your proposal. The clinical reasoning in your care plans and concept maps becomes the assessment and plan in your SOAP notes.

General tips for success in nursing school assignments

• Read the rubric first and use it as a checklist before submitting.
• Use current, scholarly evidence, usually peer-reviewed sources from the last 5 years, plus current clinical guidelines.
• Master APA 7th edition formatting and citation.
• Protect patient privacy: never include names, birth dates or record numbers.
• Start early and break large projects into weekly tasks.
• Ask for feedback from instructors, preceptors and the writing center.
• Keep your own voice. Templates and examples are for learning; your submission must be your own work and reflect your own patient and setting.

Conclusion

Care plans and concept maps teach students to think like nurses at the bedside. PICO questions teach them to ask the right questions of the evidence. SOAP notes build provider-level reasoning, and proposals, capstones and DNP projects develop the leadership to change practice. Knowing what each assignment is for, when it appears in the program, and what instructors expect helps students complete it well and turn each one into a lasting professional skill.

References

American Association of Colleges of Nursing. (2015). The doctor of nursing practice: Current issues and clarifying recommendations. AACN.

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. AACN.

Herdman, T. H., Kamitsuru, S., & Lopes, C. T. (Eds.). (2024). NANDA International nursing diagnoses: Definitions and classification, 2024–2026 (13th ed.). Thieme.

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

Moran, K., Burson, R., & Conrad, D. (2024). The doctor of nursing practice project: A framework for success (4th ed.). Jones & Bartlett Learning.

Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., & Stevens, D. (2016). SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process. BMJ Quality & Safety, 25(12), 986–992. https://doi.org/10.1136/bmjqs-2015-004411

Podder, V., Lew, V., & Ghassemzadeh, S. (2023). SOAP notes. In StatPearls. StatPearls Publishing.

Schuster, P. M. (2020). Concept mapping: A critical-thinking approach to care planning (5th ed.). F. A. Davis.

Shulman, S. T., Bisno, A. L., Clegg, H. W., Gerber, M. A., Kaplan, E. L., Lee, G., Martin, J. M., & Van Beneden, C. (2012). Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 55(10), e86–e102.