Abstract:

Nursing faculty are currently faced with challenges in developing innovative teaching methods to stimulate nursing students’ various learning desires and needs and also capture current complexity of care in healthcare settings (Vogt & Shaffner, 2016). Additionally, content-laden curricula have become an obstacle to essential transformation of nursing education for improving students’ learning (Ironside, 2015: Kaylor & Strickland, 2014). There is a need for faculty to instill narrative pedagogy in curricula where students and faculty connect as they share experiences where they “see, listen and respond” to clinical experiences that stimulate students’ understanding and deeper learning (Ironside, p. 83). The use of unfolding case studies provides students with a unique way to work with faculty and other students to link concepts with evidence-based practice; therefore, discover deeper understanding of concepts (Ironside & Valiga, 2006).

The purpose of this research study is to explore ways to integrate unfolding case scenarios that reflect students’ clinical and simulation experiences and stimulate their deeper learning of concepts throughout the nursing curriculum.

The aims of this project are to:
1. Gain students perspectives of learned concepts from unfolding case studies that build in complexity from the beginning to advanced nursing clinical courses.
2. Evaluate students’ learned concepts reflecting knowledge, application, analysis, and comprehension
3. Discover ways to use unfolding case studies that assist students’ in deeper learning that expands their knowledge, skills, and attitudes in the novice level of nursing.
4. Examine test question analyses reflecting case study content.

A mixed integrated method will be used to explore students’ perspectives and examine students’ exam question item analyses. The unfolding case study patient situations in the clinical nursing courses are video recorded and guiding questions are provided in class to stimulate students’ small group discussions about the patient situations. Students who attend each clinical class and view the video and participate in the discussion of the unfolding case study will be invited to participate in focus group sessions to share their perceptions of learning related to the case study content. The focus group sessions will be audio recorded for approximately 60 minutes. Field notes will be recorded to add clarity and insight to communication shared by the students. This study captures a new holistic inter-professional approach to end of life care where an Advanced Care Planning team is included in one of the higher level course case study scenarios. Triangulation using test question analyses for this study is intended to validate if there will be students' deeper understanding of the complexity the patient’s situation. Test questions related to content in the case studies will be taken from the comprehensive exam for each of the clinical courses. The comprehensive exam test questions reveal reliability according to a test item analysis report.

The unfolding case studies implementation and data collection are in process. The focus groups will provide interaction that not only will include the students' actual words, but also non-verbal communication that may enhance exchanging of perceptions. Test question results will reveal students' knowledge, comprehension, application, and analysis of the content.