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Using Reverse Case Studies for Learning in Clinical Settings
As nursing educators, we’re focused on giving our nursing students the best education, both in classrooms and during hands-on clinical experiences. Many nursing programs have been using strategies like case studies in classrooms and simulated clinical experiences in labs. But with the challenges of COVID-19, we’re forced to make changes. These innovative learning strategies are now unavailable due to the shift to online learning. This transition from physical classrooms to online platforms has been tough and time-consuming.
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Moving from Classroom to Online Learning
Shifting to online learning required quick thinking and the creation of new learning methods to meet objectives. However, the real challenge was with clinical learning. Clinical learning involves direct patient interaction and hands-on experiences. Adapting these aspects to an online format can be quite daunting.
Understanding Reverse Case Studies
A reverse case study is a method where students create scenarios about a patient using limited data. This approach has long been used to foster critical thinking and decision-making about patient care. But can we adapt this strategy for clinical learning? Beyer (2011) suggests that reverse case studies encourage collaboration, innovation, active learning, and critical thinking. These are crucial qualities for nurses who need to make clinical judgments and provide safe care.
The Value of Direct Patient Care
Direct patient care offers unique experiences for students, including patient interactions, conversations, and psychomotor skills. These experiences are essential for developing professional attributes. While these experiences are valuable, the “thinking like a nurse” skill is crucial. Other aspects of direct patient care, particularly psychomotor skills, can be addressed innovatively.
Adapting Reverse Case Studies for Clinical Learning
You can apply reverse case studies to clinical experiences in various ways. Here are two methods:
1. Brief Scenario and Medication List Approach: Provide a short scenario and a list of medications. This scenario should match the learning level and objectives. Here’s an example for different student levels:
– Sophomore/Beginning Students: A patient newly diagnosed with diabetes needs glucose testing, a diabetic diet, exercise, and insulin treatment.
– Junior/Intermediate Students: A patient with a history of diabetes requires an above-the-knee amputation. Home medications include insulin.
– Senior/Advanced Students: A long-term diabetic patient with high glucose levels is brought to the ER.
2. Actual Clinical Assignment Approach: This requires access to clinical agency records. Assign students a patient case like you would in a normal clinical setting. Students research, complete care plans, and write about their clinical day.
Guidelines for Implementation
Consider these factors before implementing reverse case studies:
– What clinical activities are approved during crises like COVID-19?
– What’s your nursing program’s stance on alternate clinical activities?
– What’s the level of your clinical group? Sophomore, Junior, Senior, etc.
– What are your clinical outcomes?
– Do you have access to electronic health records?
– Are you following HIPAA and confidentiality rules?
– Do you have a suitable web conferencing platform?
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Pre-Clinical and Post-Clinical Conferences
Before the simulated clinical day, hold a pre-clinical conference to discuss priorities. After the simulated clinical day, conduct a post-conference where students present their case studies and experiences.
Benefits and Conclusion
Using reverse case studies as a clinical learning experience is worth considering. It fosters evidence-based research and meets various learning levels. It can be used beyond crises and even as a substitute for clinical make-up. This strategy aligns with Next Generation NCLEX® Test Plan and encourages a case-based learning approach.
References
– Atkinson, T. (2014). The “Reverse Case Study:” Enhancing creativity in case-based instruction in leadership studies. Journal of Leadership Education, 13(3), 118-128.
– Beyer, D.A. (2011). Reverse case study: To think like a nurse. Journal of Nursing Education, 50(1), 48-50.
– Smallheer, B.A. (2016). Reverse case study: A new perspective on an existing teaching strategy. Nurse Educator, 41(1), 7-8.
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