The use of unfolding case studies: Innovation in online undergraduate nursing education

Abstract

Background: Educational strategies are needed to prepare nurses to become sophisticated consumers of information and to apply that information in practice. Expertise in problem solving and clinic decision making skills is necessary if nurses are to function effectively in an increasingly complex health care environment. RNs entering programs leading to bachelor degrees (RN-BSN) have basic skills but need opportunity to develop higher level creative problem solving and critical thinking skills. The purpose of this article is to investigate the use of the “unfolding case study” as an innovative strategy to increase clinical decision making and problem solving skills in participants in a public health course in an online nursing program. Methods: Participants in a public health nursing course were assigned to develop a case study over time integrating concepts of chronic illness with public health nursing. This problem based learning method supported adult learning principles of motivation, autonomous learning, and application to practice, all elements of online learning. The unfolding case studies were evaluated using a rubric to insure that participants completed course objectives. A survey, administered at the end of the course, provided feedback on perceptions of learning using this strategy. Results: All students successfully completed the unfolding case study over a four week period through which they demonstrated integration of knowledge and application in the clinical setting. Feedback provided by participants confirmed an increase in knowledge of public health nursing, creative problem solving, and the ability to apply concepts of chronic illness using a public health framework. Conclusions: The “unfolding case study” in this public health nursing course served as a means of increasing nurses’ knowledge, complex critical thinking and problem solving skills in an online program for RN-BSN participants. While participants presented initially with a wide range of abilities in problem solving and clinical decision making, they demonstrated an increase in problem solving, awareness and application to practice through the use of the unfolding case study.