Skip to main content
Failure Analysis

Why Candidates Fail the Communication and Patient Rights (Indirect Care) Skill

Indirect care covers the communication and dignity behaviors that wrap every skill. These are often penalized silently — the evaluator marks you down without stopping you.

How this skill is evaluated

The evaluator scores each skill on a pass/fail checklist. You do not get partial credit. A single critical error — or several minor ones — will fail you on this skill entirely. You must pass all 5 randomly selected skills to pass the clinical exam.

The 5 Most Common Failure Points

1

Failing to explain the procedure before starting — always ask permission first.

Why it gets caught: Evaluators follow a written checklist with this item explicitly listed. Unlike technique errors that require interpretation, checklist omissions are binary — either it happened or it didn't. There is no partial credit.
2

Leaving without placing the call light within reach.

Why it gets caught: Evaluators follow a written checklist with this item explicitly listed. Unlike technique errors that require interpretation, checklist omissions are binary — either it happened or it didn't. There is no partial credit.
3

Forgetting to lower the bed to the lowest position at the end.

Why it gets caught: Evaluators follow a written checklist with this item explicitly listed. Unlike technique errors that require interpretation, checklist omissions are binary — either it happened or it didn't. There is no partial credit.
4

Talking over or around the resident rather than directly to them.

Why it gets caught: Evaluators follow a written checklist with this item explicitly listed. Unlike technique errors that require interpretation, checklist omissions are binary — either it happened or it didn't. There is no partial credit.
5

Not ensuring privacy before beginning a procedure.

Why it gets caught: Evaluators follow a written checklist with this item explicitly listed. Unlike technique errors that require interpretation, checklist omissions are binary — either it happened or it didn't. There is no partial credit.

Exactly What the Evaluator Is Watching

These are the specific checkpoints on the evaluator's score sheet for this skill.

  • Candidate knocks and introduces themselves before beginning.

  • Resident is addressed by name and treated with dignity throughout.

  • Procedure is explained before it is started.

  • Privacy is maintained with curtain, door, or draping.

  • Call light is within resident's reach before leaving.

  • Bed is returned to the lowest position before leaving.

How to Avoid These Mistakes on Exam Day

These tips come from the most common failure patterns in Communication and Patient Rights (Indirect Care).

  • Think of indirect care as the "wrap" around every skill — it applies to all 25 procedures.

  • Always state the resident's name, your name, and the procedure before touching anything.

  • Memorize the ending: lower bed → call light within reach → thank resident → wash hands.

  • A warm, respectful tone matters — evaluators observe your demeanor, not just your technique.

Practice the written exam too

The written NNAAP test covers the knowledge behind every clinical skill. 501 free questions.

Take the Practice Test →