MSC NURSING CASE METHOD

1. CASE METHOD
INTRODUCTION
In clinical teaching there are various methods of teaching in that case one of
the oldest method which is used commonly in clinical areas for nursing students.
According to Florence Nightingale the nursing students should keep a note book
containing accounts of exceptionally interesting cases and later quizzed them to find
how much they had learned.
MEANING
The data concerning an individual, his family and environment, including his
medical history that may be useful in analyzing and diagnosing his case or for
instructional purpose.
DEFINITION
Case method is a close, deep, cumulative and clinical study of a patient.
TYPES OF CASE METHOD
There are three types of case method. They are,
1. Case study
2. Case analysis method
3. Case incident method
CASE STUDY / CASE PRESENTATION
DEFINITION
Case study describe the life history of an individual or all of the factors
which affect a situation.
Case study is a close, deep, cumulative and clinical study of a patient.
Criteria for good case study
• Continuity

2. • Completeness of the data
• Validity of the data
• Confidential recording
• Analysis and Scientific synthesis
Sources of case study
• Personal documental dairies, history of previous illness
• Health team members
• Related persons
• Official records
• Subject himself
Principles of case study
• The student should make her nursing care study on patient for whose
nursing care, she is responsible.
• The selection of the patient for the student’s nursing study should be done
co-operatively by the clinical instructor and the nursing student.
• The first consideration of the student in the development of her nursing care
study will be the nursing care of the patient.
• She should study the patient’s social status, cultural back ground, economic
level, hobbies and special interest for an understanding, these factors
contribute to the patient’s welfare.
• She should study the medical aspects of the patient’s condition as this
knowledge is needed for her to give intelligent nursing care.
Stages of the case study
1). Selection of the case
Level of knowledge of the student are taken into consideration while
assigning the patients. Selection of cases should be based on the level of care
needed.

3. (eg). Wholly independent patient is not assigned for case study.

4. 2). Collection of data
i). Subjective data
All the information the patient himself gives.
ii) Objective data
Data which are documented through observation investigation or
intervention.
iii) Examination and History
Examination of patient includes anthropometric measurement, clinical
examination and dairy exam.
History relevant to present and past condition are collected using the relevant
format.
iv) Diagnosis and identification of casual factors
Through laboratory investigations and invasive procedure, the causal factors
are identified.
v) Nursing process
Nursing process include assessment of patients forming nursing diagnosis on
the basis of assessment, planning the care and implementation.
vi) Evaluation and follow up
The effectiveness of care rendered is identification here.
Types of case study
1. Oral case study
Oral case study is one which is presented by one or more students in the form
of verbal report to the clinical instructor.
2. Written case study
Case study which is in written from is known as written case study and
generally consider as best one to record in narrative form, if should be written based
on the outline here the student can use their own, initiative and creative abilities in
writing.

5. Advantages
• Case study useful for the student in planning and providing comprehensive
nursing care to the patients.
• It helps in developing the self expression in writing recording the nursing
care of patients.
• It helps the student to develop clinical knowledge by comparing the ideal
book picture with the patient condition.
• It helps the student to gain greater understanding and appreciation of human
personality and the factors that influence.
• It helps the students to learn and apply problem solving approaching in
nursing.
• It provides sources of future reference.
Disadvantages
• If is more time consuming and costly method.
• If requires great deal of time to rewrite, into an acceptable form.
• If leaves no opportunity once the study is completed, to branch out and
incorporate new ideas.
CASE ANALYSIS METHOD
DEFINITIONS
The case analysis method of teaching focuses on a central situation which
requires some decision or solution.
Purposes of case analysis method
• Students can learn from each other.
• Students can take responsibility for their own learning.
• Focusing attention on appropriate student group. Participation will result in
effective learning.

6. • Students must prepare extensively and thoroughly in advance of discussion
to participate effectively in group analysis and decision.
• Students are responsible for their own conclusions, they cannot rest on the
instructor’s judgement.
• The teacher’s role changes from one who hands down decisions from on
high to one who leads and summarizes group discussion.
Steps of problem solving
• Facing a difficulty
• Identifying and defining the problem to be solved.
• Arranging the facts and the skills necessary for handling the problem.
• Suggesting possible solutions and testing and elaborating on solutions that
seem to be best.
• Verifying the conclusions.
• Extending the solutions of a particular problem in the form of knowledge
which will enable the solution of other different problems containing similar
character.
Techniques of the case analysis
1. Establishment of atmosphere.
2. Student preparation for discussion of the case.
3. Cases grow and change during discussion
1. Establishment of atmosphere
The teacher must establish a permissive, non-authoritarian atmosphere, so
that students will feel free to put forth their ideas and their questions without the
teacher’s reacting in the form of rejection, blame or authoritarian injunctions to
think along certain lines preferred by the instructor. She will treat each student with
respect, tolerance and a will to understand with such an atmosphere students can
learn to express their ideas and gain familiarity with the difficulties in reaching
conclusions and communicating with others.

7. 2.Student preparation for discussion of the case
• Identifying the important event or events in the case.
• Setting the stage for analysis of the case by choosing an appropriate frame of
reference or conceptual model. (eg). A theory which focuses on persons or
their attitudes.
• Identifying and classifying the parts or elements in the case.
• Specifying relevant attributes or variables in these elements these may be
quantitative or qualitative.
• Relating these elements to one another to see if any type of sequence or
correlation or pattern emerges.
• Explaining these connections or patterns by going deeper than merely
establishing connections or correlations.
• Examining critically the concepts or the themes used to determine their
adequacy and to suggest possible alternatives and revisions.
• Applying knowledge and the understanding gained through the case analysis
by suggesting how decisions and actions in the case could have been
improved.
3. Cases grow and changes during discussion
The background of knowledge, skills and experiences of each student
influences the way in which she deals with each case.
One student may identify herself with a character in the case, another may
project her own feelings and attitudes into the situation, while a third student may
deal with stereotypes rather than with the people in the case. Skill another students
may respond more to what the teacher says or to her classmate’s reactions,
irrelevant tangents, simply repeat ideas. All these phenomena are typical and have
to be dealt with if the rapport of the class is to be maintained and if learning is to
result. The instructor can help the students by teaching particular subject matter.
She will have to deal patiently with the case as it develops, it takes time and
patience and much of both to lead students through case analyses to making of
decisions.

8. Principles of case analysis
• Case should provide enough information for analysis with out directing the
students thinking in a particular direction.
• Case developed first than when the question to be presented in the clinical
situation.
• So student should have experience in analysis the case.
• Sensitive and responsiveness to patients culture, age, enter and disability.
Advantages
• It helps to develop analytic thinking approach to clinical situation
• It helps to know and apply the basic and clinically supportive science which
are appropriate to the patients.
• It helps in making the judgement and informal decision about the case.
• It helps to develop and carry out the patients management plans.
• It facilitates the learning of students about the case (disease) and treatment.
• It helps to develop critical problem solving skills.
Disadvantages
• It needs mentership (giving training) from the clinical instructor’s.
• Students need listening and clarifying skills.
• It needs higher level of skills like application, analysis, synthesis and
evaluation.
• It needs guidance in applying the knowledge to the real problems.
CASE INCIDENT
DEFINITION
The case incident method of teaching is a modification of the case analysis
method, it focuses on a clinical or crucial incident in a case or situation which
requires immediate decision and action.

9. The case analysis method is modified by,
• Using a brief statement of a clinical incident relative to the current lift
situation faced by the learner that requires an immediate decision.
• Group analysis of individual statement to clarify and summarize decisions
reached.
• Application of major findings to the immediate situation along with making
generalizations regarding the implications of the findings for the total milieu
of the incident.
Steps of case incident
1. Studying an incident
The incident provided by the seminar leader (teacher or student) is studied
individually to determine significant factors to be pursued, leading to the decision to
be made.
2. Gathering and organizing information on the case as a whole
Individuals armed with their own ideas regarding background information
meet together to question the leader about the kind of facts needed and to plan
constructive action on underlying issues.
3. Formulating an issue for decision and action
Group members use the summary of facts to identify key factors of the
incident. Visual diagrams of these factors assist the group in interpreting there
interrelationships to the incident as a whole.
(eg). What kind of medication he is getting, or if the patient does not take his
medication at this time, what serious consequences may result, such as a diabetic
patient refusing insulin.
4. Decision and reasoning
• The decision regarding the incident along with reasoning underlying it is
written by individual participants and used as background information for
further group study.
• Small groups collaborate in discussing a decision to be made and reasons for
the decisions.

10. • Each small groups either reports or role-plays their feelings for the total
group.
• The group leaders describes the actual decision, action taken and immediate
results of the incident at the time of its occurrence by comparing to the
suggestions of each small group.
5. Reflecting on the case as a whole
The group examines the final decision and reasoning regarding the incident
in terms of its broad application to other major issues linked to, yet beyond, the
immediate problem.
Advantages
• It determines the fact of the case.
• It helps to understand the dynamics of the situation
• It defines the presenting problems and determines the problem to be solved.
• It helps to generate possible solution for the problem.
Disadvantages
• Students needs better understanding level.
• It is not useful for the larger group.
• The case incident should be complete enough the problem can be defined.
SUMMARY
So for we seen about case method and its types like case study, case analysis
and case incident method.
CONCLUSION
Case method is one of the important method in clinical teaching, which helps
the students to gain greater understanding and appreciation of human personality.

11. BIBLIOGRAPHY
• Basavanthappa .B.T. (2003), “Nursing education”, 1st
edition, Jaypee
brothers publication, New Delhi, Pp. 387-389.
• Heidgesken .E.L. (2000), “Teaching and learning in schools of nursing”, 3rd
edition, Konark publishers, Delhi, Pp. 489-502.
• Neeraja .K.P. (2007), “Text book of nursing education”, 1st
edition, Jaypee
brothers publication, New Delhi, Pp. 317-319.
• Sankaranaryan .B, (2003), “Learning and teaching nursing”, 1st
edition,
Brainfill, Mangalore, Pp. 163-165.
Internet
• John (2001), Recent perspective of clinical teaching, Medical education,
Volume 35 No (4), Pp. 409-414.
• Karen .L (2002), Why use cases, Teaching resource centers, Pp. 82-91.
DINESH G.G
MSC NURSING 720460190