Unfolding Cases Research Articles

Using clinical simulations in geriatric nursing continuing education

Accompanying an increased number of older adults in the population is the need for knowledgeable and clinically competent nurses to provide care for this group, especially those experiencing sudden changes in health status. A continuing education program was designed to improve geriatric nursing competencies through the use of clinical simulations. Three-day nurse educator institutes and one-day workshops for registered and licensed practical nurses were offered to 312 nurses. The clinical simulations that were developed specifically focused on acute health events or conditions. Specific geriatric clinical competencies were also emphasized. Different types of clinical simulations included unfolding cases, use of a human patient simulator, and online case studies. Geriatric nursing knowledge significantly increased and clinical simulations were well-received. Clinical simulations involving the human patient simulator were highly rated. Clinical simulations are an excellent teaching strategy to help nurses increase knowledge and skill in caring for older adults.

Assessing Dynamic Mental Models

Excellence in critical thinking skills requires well-developed situational mental models: integrated knowledge of how concepts and principles relate to a specific client's condition and care. The authors describe the use of unfolding case studies as a strategy for eliciting and evaluating students' changing mental models. Unfolding cases offer a practical method for capturing the dynamic nature of situational mental models and revealing significant errors in students' problem-solving cognitions that would not otherwise be obvious.

Unfolding cases: an experiential learning model.

The focus of education has changed from teaching to learning. This educational model stresses student outcomes that include critical thinking, effective communication, and students' ability to reflect their own learning. This article describes "unfolding cases," a comprehensive plan of learning that allows student practice time to solve individually and collectively problems they may encounter in clinical situations. It combines a variation and extension of the frequently used strategy of case study with multiple cooperative learning strategies, culminating in an individual reflective writing experience.