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      Implementation of case studies in undergraduate didactic nursing courses: a qualitative study

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          Abstract

          Background

          The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students’ levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies.

          Methods

          Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process.

          Results

          The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC).

          Conclusion

          Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

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          Most cited references12

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          Thinking like a nurse: a research-based model of clinical judgment in nursing.

          This article reviews the growing body of research on clinical judgment in nursing and presents an alternative model of clinical judgment based on these studies. Based on a review of nearly 200 studies, five conclusions can be drawn: (1) Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand; (2) Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as an engagement with the patient and his or her concerns; (3) Clinical judgments are influenced by the context in which the situation occurs and the culture of the nursing care unit; (4) Nurses use a variety of reasoning patterns alone or in combination; and (5) Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the development of clinical knowledge and improvement in clinical reasoning. A model based on these general conclusions emphasizes the role of nurses' background, the context of the situation, and nurses' relationship with their patients as central to what nurses notice and how they interpret findings, respond, and reflect on their response.
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            Orientations to Teaching and Their Effect on the Quality of Student Learning

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              • Article: not found

              A crisis in critical thinking.

              Aggregate results for competency assessment of new registered nurses using the Performance Based Development System indicate that most new graduates do not meet expectations for entry-level clinical judgment ability.This article discusses implications for nursing education and offers recommendations for developing clinical judgment in nursing students.
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                Author and article information

                Journal
                BMC Nurs
                BMC Nurs
                BMC Nursing
                BioMed Central
                1472-6955
                2013
                4 July 2013
                : 12
                : 15
                Affiliations
                [1 ]College of Health and Human Services, Department of Nursing, California State University, Fresno, 2345 East San Ramon Avenue M/S MH25, Fresno, CA 93740-8031, USA
                Article
                1472-6955-12-15
                10.1186/1472-6955-12-15
                3704825
                23826925
                5beb52b9-92eb-4b21-900b-a993ab44ec90
                Copyright ©2013 Dutra; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 September 2012
                : 3 July 2013
                Categories
                Research Article

                Nursing
                case studies,critical thinking,facilitative learning,learner centered,nurse educators,pedagogy,scenario-based case studies,unfolding case studies

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