Benner, et al. (2010) present several strategies throughout the text, “Educating Nurses: A Call for Radical Transformation”, for integrating classroom and clinical learning. It is interesting that the subject of unfolding case studies emerges here, as I have brought this up previously during a discussion with my collagues on teaching for a “sense of salience”. I will attempt to expound on the unfolding case study along with the addtional strategies of case presentations and imagination.
Strategy 1: Unfolding Case Studies
In reference to integrating classroom and clinical learning, case studies and simulation are great tools and environments for facilitation. Unfolding cases, as Benner, et al. (2010) states, derive from problem based learning (PBL). PBL has been used in the discipline of medicine for several years as a strategy to help students work through the trajectory of a patient’s illness rather than a primary problem diagnosis (Tomey, 2003). In the paradigm case, Benner, et al. describe how Day brings in student’s clinical experiences into the classroom when using unfolding cases. I think an excellent illustration that is made that actually refers back to “who” is responsible and the concept of Adult Learning is when Day describes how she “knows” her students. She identifies during preparation that some students will have prior experiences that help certain topics to hit home and take ownership of learning more, whereas some students may not, and it is her role to integrate clinical learning experiences of the students and their colleagues when utilizing case studies.
Strategy 2: Case Presentations
Another strategy I feel brings together classroom and clinical learning is using a structured case presentation. I can remember in Adult Health I we had an extensive case presentation on the patient of our choice, but then in Peds, we had to do a very structured short 3-5 page case study. This got us prioritizing. This was a clinical assignment and forced us to take our patient’s clinical presentation and go backwards and integrate the disciplines of social sciences, pathophysiology, psychology, growth and development, philosophy and ethics and nursing into a focal plan of care.
Strategy 3: Questioning, Dialogue, and Imagination
Starting with imagination and piggy backing on the case presentation would be to have the student integrate a current patient’s clinical presentation with an related or unrelated current topic from the classroom—sort of a case presentation of an unfolding case study. For the students who may not have patients with presentations of current class discussions, the educator could use critical imagination to help the student see how (unwildingly at times) a patient could develop with a presentation of what they are learning in class. In real-life, this is essentially how patients end up in the ICU from the floors! I think helping the student develop this type of imagination can also help them in anticipating a patient’s trajectory and prioritizing what is important of the plethora of what the diagnoses a patient may have during a hospital admission.
Benner, P., Sutphe, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Josey-Bass.
Tomey, A. M. (2003). Learning with cases. The Journal of Continuing Education in Nursing, 34(1), 34-38.
Brandon Rachal 