This document discusses the use of case studies in nursing education. It provides background information on case studies, noting that they encourage students to more fully understand content by building on learned material. Case studies are commonly problem-based, requiring students to develop solutions to scenarios. Like clinical practice, case studies aim to develop critical thinking and problem-solving skills through complex, ambiguous scenarios. The document then covers various aspects of implementing case studies, including appropriate audiences, time requirements, level of detail, student roles, classroom applications, and variations in case study design.

1. CASE STUDIES
Jaclyn Stratman, RN-BC, BSN
Clinical Nurse, Captain USAF
Nurs8082 Learning- Centered Teaching
April 2014

2. “The case study builds on learned material
that encourages students to more fully
understand the content being presented”
(Sprang, 2010)

3. “The most common type of case study is
problem based, which requires learners to
develop solutions to a given scenario”
(Snyder & McWilliam, 2003; Sprang, 2010)

4. “Similar to clinical practice, case studies are
often designed to be complex and ambiguous,
offering the learner an opportunity to build
critical-thinking and problem-solving abilities.”
(Plack & Santasier, 2004; Sprang 2010)

5. AUDIENCE
 Case studies can be used in all levels of nursing,
medicine, law and business education.
 Used in lecture-based or discussion-based
classes
 Group size can include: trios, quads, or larger.

6. TIME
Case studies can vary in length of time
Time on task
Duration of groups

7. DETAIL
Simple VS complex
Solution VS identify

8. STUDENTS
Note taking
Personal shared experience
Resources

9. IMPLEMENTATION
Classroom
Clinical post conference
Simulation lab

10. VARIATION
Bullet cases
Mini cases (vignettes)
Continuous case
Sequential-interactive case

11. SCIENTIFIC EVIDENCE
Orlando’s Theory
Watson’s Theory of Human Caring

12. OBJECTIVE
The student will be able to correctly assess,
identify, and chart the postoperative patients
sedation level, with adhering to the ASPAN
standards and regulations

13. OBJECTIVE
The student will be able to appropriately
administer analgesics based on the pt GSC,
Aldrete score, and pain/comfort level

14. OBJECTIVE
The student will be able to effectively
maintain an airway

15. OBJECTIVE
The student will be able to recognize and
identify signs and symptoms of hemorrhagic
shock

16. OBJECTIVE
The student will be able to verbalize how
they feel about their ability and comfort level
on how to care for a critical postoperative
patient and the care that they would have
provided.

17. CASE OVERVIEW
Amanda Box is a 23 y/o female G1P1 who
gave birth to a healthy 6lb 7oz baby girl 6
days ago. She delivered vaginally. She called
the clinic utilizing the on call telephone
triage nurse..

18. CASE OVERVIEW
By the telephone triage report, Amada states
she has a fever, increased abdominal
cramping, and a foul vaginal odor. The nurse
requested that Amanda comes in
immediately to be seen by the provider.

19. CASE OVERVIEW
When Amanda arrives at the clinic, her VS:
HR 62, BP 110/56, R 14, T 101.7, O2 100%
RA

20. CASE OVERVIEW
After an examination by the physician, it is
determined that Amanda still has remains of the
placenta inside her. She is immediately rushed to
surgery for a dilation and curettage (D&C) of
the remaining placenta.

21. SCENARIO
You are the PACU nurse receiving Amanda
directly after surgery.

22. OR NURSE REPORT
“ She had a D&C of the placental remains. They
had to try four times to completely get all the
remains out, so it took a while. I placed a peri pad
on her and she wasn’t bleeding when I placed it. She
lost 800cc of blood. That’s it!”

23. PATIENT PRESENTATION
Amanda comes out awake and shows facial
grimacing. She is c/o nausea and the
anesthesiologist is holding an emesis basin
under her chin.

24. ANESTHESIOLOGIST REPORT
“ She had a total of 50mcg of Fentanyl, 0.4mg
of Dilaudid, 4mg of Zofran, some Propofol,
and Versed, 500mL of normal saline, a dose of
Doxycycline IV, and I think that is it!”

25. QUESTION 1
What is your first step after hooking
Amanda up to the monitors?

26. SITUATION CONTINUED
Amanda’s nausea and pain has subsided and she is
now resting comfortably and her VS are stable.
Another patient comes out of the OR and you help
“land the patient”. You left Amanda to sleep for 15
minutes, when you arrive back at her bedside she is
c/o continuous pain.

27. QUESTION 2
What is your next step?

28. SITUATION CONTINUED
Amanda is medicated per your mar and her pain
is not touched. You check her peri pad because
she states, “I feel wet down there”. Your
assessment reveals a soaked peri pad with bright
red blood.

29. QUESTION 3
When/would you notify the MD of
Amanda’s bleeding?

30. SITUATION CONTINUED
You notified the MD who is currently in
another OR case, and she tells you to just
keep monitoring Amanda, and does not
seem too concerned.

31. QUESTION 4
What signs and symptoms should you be
looking for in hemorrhagic shock?

32. SITUATION CONTINUED
10 minutes later Amanda states that she is “
Itching like crazy”, and you get a VORB to
give 25-50mg of Benadryl IV x1 now.
Amanda continues to c/o pain and feeling
wet.

33. QUESTION 5
What adverse signs and symptoms are
possible from the medications that Amanda
has received?

34. SITUATION CONTINUED
A few minutes later Amanda c/o having
difficulty breathing, she becomes tachycardic
HR 150 and her BP drops, BP 98/49.

35. QUESTION 6
What is your next step?

36. SITUATION CONTINUED
You call a Rapid Response and the
Anesthesiologist and several staff are by
your side to help. The Anesthesiologist starts
to give orders…

37. QUESTION 7
What are some orders the Anesthesiologist
would give?

38. SITUATION CONTINUED
The MD is now out of surgery and at the
patient’s bedside. At this time the MD decides
to take the patient back to the OR. The OR
team takes over and takes Amanda back to
surgery.

39. QUESTION 8
Was there anything that you could have done
to prevent Amanda from going back to
surgery?

40. QUESTION 9
What things would you consider to discuss
in a debrief?

41. SUMMARY

42. REFERENCES
Abdoli, S., & Safavi, S. S. (2010). Nursing students’ immediate responses to distressed clients based on Orlando’s theory. Iranian Journal of
Nursing and Midwifery Research, 15(4). pp. 178-184. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093185/
Academichelp.net. (n.d.) How to write a case study. Retrieved from http://academichelp.net/academic-assignments/write-case-study.html
Carnegie Mellon. (n.d.) Design & teach a course. Retrieved from
https://www.cmu.edu/teaching/designteach/teach/instructionalstrategies/casestudies.html
Delpier, T. (2006). Cases 101: Learning to teach with cases. Nursing Education Perspectives, 27(4). pp. 204-209. Retrieved from
http://web.b.ebscohost.com.proxy.libraries.uc.edu/ehost/pdfviewer/pdfviewer?sid=e7fb7606-547c-4156-b37a-
0e59b9de7ea2%40sessionmgr112&vid=2&hid=122

43. REFERENCES
Eisenhardt, K. M. (1989). Building theories from case study research. Academy of Management Review, 14(4). pp. 532-548. Retrieved from
http://www.buseco.monash.edu.au/mgt/research/acrew/eisenhardt.pdf
National League for Nursing. (n.d.). Faculty programs & resources. Retrieved from
http://www.nln.org/facultyprograms/facultyresources/aces/millie.htm
Nilson, L. B. (2010). The case method. Nilson, L. B. (Eds.), Teaching at its best: A research-based resource for college instructors (3rd ed, pp.181-185).
San Francisco, CA: Jossey-Bass.
Noel, D. L. (2010). Occupational health nursing practice through the human caring lens. American Association of Occupational Health Nurses
Journal, 60(3). pp. 97-103. doi: 10.3928/08910162-20091216-02
Sprang, S. (2010). Making the case using case studies for staff development. Journal for Nurses in Staff Development, 26(2). pp. E6-E10.
Retrieved from http://www.nursingcenter.com/lnc/static?pageid=1071277