Unique Use of Case Studies in Nurse Practitioner Education

The objective was to create an atmosphere of interactive learning in which nurse practitioners students actively participate in case study presentations as patients, nurse practitioners, and preceptors. The use of unfolding case studies (in which case study elements are revealed over time) addresses the need to promote learning, develop critical thinking skills, increase student participation and, in accordance with The Carnegie Foundation for the Advancement of Teaching’s national study, integrates classroom and clinical learning. Using an unfolding case study approach to teaching in both our Diagnosis and Management of Common Conditions and Diagnosis and Management of Chronic Conditions courses began to bridge the gap between classroom learning and clinical application. Although class participation during unfolding case presentations increased as students were required to question the “patient” about history, perform a “physical examination,” develop an appropriate list of differential diagnoses, “order” proper tests, make an assessment, and provide “treatment” and patient education, the group nature of the process allowed some students to mostly observe while others were more active participants. However, all students demonstrated a greater ability to integrate classroom learning in clinical settings. Therefore, the purpose of this presentation is to present a unique use of unfolding case studies in nurse practitioner education. In the first course (Diagnosis and Management of Common Conditions), each student takes the role of patient and is randomly assigned a disease process requiring development of a detailed case study (subjective data, objective data, and test results). In class, a “nurse practitioner” is randomly chosen. The student-patient then presents the disease as the student-nurse practitioner elicits the patient’s chief complaint, history, physical findings, and test results, develops a differential diagnosis, decides on the actual assessment, provides a treatment plan, and offers patient education. During the second course (Diagnosis and Management of Chronic Conditions), the role of preceptor is added requiring the student-nurse practitioner to make an oral presentation of the patient encounter. This case study format has increased student preparation for class, participation in class, and confidence and readiness for clinical experiences.