Learning Objective #1: The learner will understand how to apply critical, creative, problem-solving, and integrating thinking skills into Clinical Case Study III.

Learning Objective #2: The learner will realize the process of using PES and NNN with four thinking skills in the course of Clinical Case Study III.

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Many colleges and universities in Taiwan have attempted to implement critical thinking into courses in the effort to meet the demands of effective decision-making in future nursing workplace. Except for the critical thinking, creative thinking, problem-solving, and integrating skills are also very important for the professional nurses. The goal of this paper hopes to introduce the curriculum of developing critical thinking, creative thinking, problem-solving, and integrating skills into the course of clinical case study III. This 2 credit course was designed for the advanced RN-BSN students who have had clinical working experiences. Students would take professional nursing concept III, including concepts in community and psychiatric areas, by following the framework of problem, etiology, symptoms (PES) with nursing outcomes, nursing intervention, and nursing indicators (NNN) as prerequisite course. Following the professional nursing concept III course training, RN-BSN students would be guided by five instructors to probe their critical thinking, creative thinking, problem-solving, and integrating skills in the whole semester by using a small group discussion. Each faculty would ask different questions to induce students six critical thinking skills in nursing process identified as clarifying problem, validating information, crucial judgment, rational action, critical evaluation, integration and reflection. Besides, students would introduce their creative nursing interventions by explaining the original ideas, process, benefits, and barriers of creation. For problem-solving, students would use self-reflection evaluation skills to deliberate the achievement of nursing outcomes and discussion the rationale. Finally, integrating skills would be presented as accurate, consistent, and complete information of the PES and NNN, as well as the appropriate nursing interventions within client-center focused. Through the training of four thinking skills before graduation in this course, it is expected that the RN-BSN students in this school would have better clinical decision-making skills and performances in their working settings.