Concept-based teaching intends to assist students to expand their thinking and apply information to concepts (Giddens, Caputi, & Rodgers, 2020). Integrative learning that supports conceptual teaching provides an opportunity for students to attain deeper learning by synthesizing concepts and applying them to situations (Budwig, 2019). Unfolding case studies provide an opportunity for students to reflect on concepts during stories about unpredicted patient situations through time (Kaylor & Strickland, 2014; NLN, 2016). The use of unfolding case studies is one way to transform teacher-centered to student-centered learning where students can guide their own learning (Peery, 2015). Providing deeper learning experiences for students can occur when students apply their own experiences to an unfolding case study that grows in nursing care complexity. Although conceptual teaching is well known in the literature, integration and evaluation methods for using unfolding case studies need investigation for assuring best teaching methods (Herreid, 2013). Specifically, there is a gap in the literature about using an unfolding case study in a nursing concept-based curriculum. The purpose of this research is to uncover students’ perspectives about their learning experience from an unfolding case study that enhances in complexity throughout a nursing curriculum.
Methods:
A video recording of a simulated patient situation using a live person has been uniquely designed as a case study that becomes more complex for each nursing clinical course in an undergraduate nursing program. The case study recording for each class is presented to all of the students during their clinical nursing courses. Benner's novice to expert theory (1982) provided guidance for developing questions presented in each of the classes to stimulate students’ small group discussions about the patient situation. A cohort of students who attended each clinical class, viewed the videos, and also agreed to participate in the in-class discussions about the unfolding case study were invited to participate in focus group sessions to share their learning perspectives about each case study. A within-case, iterative content analysis (Creswell, 2007) is in process for each case study that has been presented. Upon the conclusion of the this research in April 2020, a cross-case analysis will be used to interpret the overall unfolding case study.
Results:
Within-case, iterative analysis thus far reveals 45 codes reflecting students’ enhanced self-confidence in patient assessment, and knowledge and application of nursing care concepts. Students expressed feeling more assured in performing nursing tasks and seeing themselves in the nurse role after participating in the case study sessions presented thus far. Students also described ways to enhance the case study by increasing diagnostic information and focusing on patient care during the dying process. Reduction of the data will continue to reflect the students' actual words from the focus group sessions.
Conclusion:
The within-case analysis of student perspectives thus far shows increased self-confidence in the novice-beginner nurse role and identification of areas for additional teaching focus within the case study. The findings will generate ideas for developing an unfolding case study integrated throughout a newly adopted concept-based nursing curriculum.