1. Writing a Clinical Exemplar
“Write your story as it needs to be written. Write it honestly, and tell it as best
you can. I’m not sure that there are any other rules. Not ones that matter.”
– Neil Gaiman
UM BWMC Professional Development Council/Clinical Ladder (2016)

2. What is a clinical exemplar?
 A clinical exemplar is a story written
in your own words about a
meaningful clinical experience. It is a
way of sharing your experience with
the reader.

3. Why do I need to write a clinical exemplar?
 A clinical exemplar is part of the
application process for advancement
on the UM BWMC Clinical Ladder.
 There are aspects of your nursing
practice that cannot be adequately
captured by tools and charts. The
clinical exemplar provides you with
the opportunity to share those
experiences in a way that highlights
those areas.

4. How do I write a clinical exemplar?
 Your clinical exemplar should answer
the following questions:
1. What is a recent moment in my
nursing practice that was meaningful
to me?
2. Why is my story worth sharing?
3. How has my practice changed
because of my experience?

5. What is a recent moment in my clinical
practice that is meaningful to me?
 Reflect on your recent patient interactions and identify a moment that touched you
or where you feel that you have made a difference in the life of a patient or
colleague or learned something new.
 Write an account of what happened, do not worry about grammar or punctuation
at this point, focus on telling your story clearly and completely
 WHO: Who are the main players in the story? What role do they play? Remember to
protect patient privacy by using a pseudonym and excluding patient identifiers that are
not needed to tell the story.
 WHERE: Where does the story take place? If the story takes place on your unit, try to see
it in the eyes of a patient or visitor. Are there things that would appear to be scary or
confusing to an outsider? Are there smells that are associated with your unit that you no
longer notice that might be considered unpleasant to others?

6. What is a recent moment in my clinical
practice that is meaningful to me?
 Write an account of what happened, do not worry about grammar or punctuation
at this point, focus on telling your story clearly and completely
 WHAT: Describe what happened; use active sentences instead of passive ones. Include
outcomes of any interventions taken. Be as detailed as possible and focus on the external
factors (your observations and assessments) as well as the internal factors (your thoughts
and feelings).
 INSTEAD OF “I entered Mr. P’s room and saw that he was in distress,” TRY “When I entered Mr.
P’s room, I saw that he was breathing rapidly and clutching his chest.”
 INSTEAD OF “As the code started on Mr. P, I was afraid,” TRY “I willed myself to steady my
hands as I placed the defibrillator pads on Mr. P’s chest; my heart was racing as the code team
poured into the room to aide in the resuscitation efforts.”

7. What is a recent moment in my clinical
practice that is meaningful to me?
 Write an account of what happened, do not worry about grammar or punctuation
at this point, focus on telling your story clearly and completely
 WHEN: Does timing play a role in the story? Try to think beyond the physical time (time
of day, season of the year) but also think about when this story occurs in your lives:
 YOUR PATIENT: Are they at the beginning or the end of their life? Have they been newly
diagnosed with a condition or are they dealing with a recurring issue? Have they recently
experienced any major life events (birth of child/grandchild, graduation, marriage, loss of
employment, loss of loved one, etc.)
 YOUR LIFE: Remember that your experiences color your perception of an event. Were you
going through any major life events when the story occurred? Were you a new nurse or a
veteran nurse? Were you new to your unit/practice area?

8. What is a recent moment in my clinical
practice that is meaningful to me?
 Write an account of what happened, do not worry about grammar or punctuation
at this point, focus on telling your story clearly and completely
 HOW: How do the events unfold? Do things happen quickly or do they take place over
an extended period of time? Were there complications or quick saves?
 WHY: Why does this moment resonate with you? What does it touch inside of you? Do
you feel like you made a genuine patient connection? Did you learn something that will
enhance your practice going forward? Did you learn something new about yourself?

9. How else can I make sure my story is clear
and complete?
 Once you have drafted your story, record yourself telling the story aloud. Listen to the
playback and write down your story as you heard it. Did you make any changes in the
way you told the story from the way you wrote it? Did you modify your phrasing to
make parts of the story easier to follow or to understand? Is any element of the story
missing?
 Share your story with…
 A colleague who is familiar with the situation: Do you share the same memories of the
event? Do they remember elements that you forgot to include?
 A colleague who is unfamiliar with the situation: Are they able to easily follow your story?
Are there gaps that you need to fill?
 A friend or family member who is not in healthcare: Do you use terms that are overly
technical? Are there items or elements that you can describe in more detail?
 Attend a clinical exemplar training session to have your exemplar reviewed by a writing
coach.

10. Why is my story worth sharing?
 Your clinical exemplar should illustrate how you have been incorporating the UM
BWMC Nursing Domains and the Relationship-Based Care Standards into your practice.
Keep them in mind while you are writing however you should not reference them
explicitly in your story.
 The UM BWMC Nursing Domains
 Professional Practice
 Professional Development
 Organizational Innovation
 Leadership
 The Relationship-Based Care Standards
 Care of Patient and Family
 Care of Self
 Care of Health Care Team
Patient
and
Family
Self
CARE
Health
Care
Team
Relationship-Based Care Standards

11. How has my practice changed because of
my experience?
 Did you form a committee to address a
patient care issue? Were you inspired to
go back to school or pursue a specialty
certification?
 What have you learned or gained from
the experience? How have you used that
knowledge in your practice? How have
you shared that knowledge with your
colleagues?
 Did the experience change your
perspective on an issue? Did the
experience help you discover your
passion?

12. How should I format my clinical exemplar?
 Your exemplar should be
 Typed, double spaced, simple 12-pt font
 No longer than 5 pages
 Have an interesting title that reflects your story

13. References
 American Association of Critical-Care Nurses. (2016). Putting your chapter’s best
face forward: Tips for writing your exemplar. Retrieved from
http://www.aacn.org/wd/memberships/content/2013-coe-chapter-
exemplars.pcms?menu=membership
 Massachusetts General Hospital Patient Care Services. (n.d.). Clinical recognition:
Describing practice through clinical narratives. Retrieved from
http://www.mghpcs.org/ipc/Programs/Recognition/Describing.asp
 Pacini, C.M. (2006). Writing exemplars [PDF document]. Retrieved from
http://med.umich.edu/nursing-PDE/framework/docs/writingExemplars.pdf
 UCLA Department of Nursing. (n.d.). Magnet readiness can be as easy as 1,2,3:
Magnet appraiser site visit prep: 3 unit exemplars directions & templates
[PowerPoint slides]. Retrieved from
http://nursing.uclahealth.org/workfiles/RRMagnet/3thingsupdated.pdf