One of the best ways to illustrate something we are teaching is to provide an example. Since we cannot always be in the clinical setting, case studies can be very useful in bringing "life" to the content. And yet, these are not always easy to find. Sure, there are many case studies on the internet but often they address less common diagnoses and/or take a very narrow medical approach.
This case study bank is a beginning resource to help nurse educators get a running start in creating more nursing oriented cases for students. It's far from perfect! There will be lots of kinks to work out but I am hoping you will share your thoughts, comments, and ideas along the way. This bank will hopefully morph into a resource for faculty that will help to lighten class prep time while providing relevant learning experiences for students.
IMPORTANT NOTES ABOUT THIS CASE STUDY BANK
1. These case studies are NOT intended for direct student use! Rather, they are compiled for nurse educators who can then use them as they prepare content for classes and/or exams.
2. These should be considered case study "shells" that educators can tweek in many and varied ways to suit their particular needs.
3. Diagnoses and plans are NOT included for two specific reasons. First, students will invariably find their way onto this website, even though it is not intended as a learning resource for them. Second, and perhaps even more importantly, educators using these case study shells are encouraged to shape them in ways that focus on the content they are teaching. The majority of these cases have various issues that can be minimized, eliminated or embellished upon depending on particular learning objectives. Again, this case study bank is intended to provide shells for you to shape, reshape and mold into appropriate and targeted scenarios for your particular teaching agenda.
5. I did not use dates since this is an ongoing resource. You might want to insert them as appropriate.
Ideas for how to use these case studies in your teaching
An unfolding case study is one that takes the student step by step through the process of clinical thinking and decision making. I have used this method for years in nurse practitioner programs and it is very effective. Oddly enough, it appears to be the hottest new thing in nursing education! The case studies posted on this web site, however, are not set up as unfolding. You will find both subjective and objective data presented in a traditional history and physical format, largely because, well, that's what I have on hand to share
. They have been posted so they are easily downloaded into a Word document for you to edit and customize. They are meant to be the raw materials that you can shape into "stories" and unfolding cases, depending on your particular students and learning objectives.
For example, the following are some questions you might like to inject in a story about an older person. In creating these questions, I was guided by the AACN core competences for undergraduate geriatric nursing
, which closely follows the essentials document. Next to each, I've listed the number to reference. For several reasons, it's a good idea to make a note of where you are addressing these competencies in your case studies. Trust me, it comes in handy when you are preparing for accreditation!
In reviewing the following sample questions, remember, they are NOT a template for all unfolding case studies. This is just one example. The beauty of using this approach is the opportunity to create stories that have the potential of going in many different directions, depending on how you design it. Think about the case study bank as the clay for these unfolding case studies. You are the artist who can take that clay and shape it in ways that address your specific objectives and student population.
Example questions for a Gero case study "story" as it unfolds.
1. What tools might you use to further fine tune your assessment at this point (5)? You can follow this question with some assessments that were done as well as their results, prompting the students to address those findings.
2. Would a home visit be helpful/appropriate or should you first consider gathering more data (6)? You can add a home visit to your story and embellish on what was found. Again, this adds contextual data that the student then needs to incorporate into their thinking and deal with in addition to what is already known.
3. What community resources might help (7)? An example might be something found or observed in the home that triggered the need for home health aides. Or perhaps there is a need for respite care. In any case it is information that is added to this unfolding story that the student needs to address regarding this particular person and situation.
4. Identify risk factors that might contribute to this persons functional decline and where possible, ways that these risks can be minimized (11). Isolation quickly comes to my mind with many cases involving home bound seniors. Did the student identify this? Or perhaps this person is at risk for falling. If your story has enough hints to lead the student to this conclusion, they will need to come up with a strategy to address it, perhaps a help alert button if the person is living alone. If the student does not catch this risk after reading enough clues from the unfolding story, a follow up paragraph might have this person discovered on the floor by a family member! Given that new information, the student will be confronted with the outcome resulting from the failure to recognize this risk and the need to deal with the consequences.
5. What complimentary/integrative practices might you offer or suggest at this point in the case as it unfolds (26)? I try to integrate this when using case studies since I feel strongly that nursing was always at the forefront of many of these interventions. Again, depending on the emerging details of a particular story, the student might suggest music therapy to decrease anxiety in a person who has perhaps previously enjoyed certain types of music.
6. In what ways might you involve other family members in the care of this person (8,28)? Following the question above, one possibility might be to involve family members, either in the playing of music or perhaps something totally different, such as learning hand massage to use with their loved one when they are especially anxious.
7. Identify acute and chronic conditions that this person is experiencing. How will these interact and contribute or complicate this person's recovery and/or quality of life (15)? At the end of a case, I like to view the unfolding story of this person as though I were looking through a kaleidoscope, looking at the details as well as the whole picture, and considering how this will ultimately affect recovery and/or quality of life.
For more information, I found an excellent 2 part series produced by Kaiser Permanente
which provides more in depth instruction and examples to help you create these unfolding case studies! Originally it was available as a webinar, but now it is available as a download syllabus
. It features Molly Sutphen PhD, Co-Director, Carnegie Foundation for the Advancement of Teaching, National Study of Nursing Education. You can also apply for continuing education for this program. Well worth your time!Part 1Part 2
I hope this gives you a running start in your prep for classes!
Let me know if you have any ideas for ways to improve this resource.