Designing Case Studies to Support the Next Generation of Nursing Students

Written by: Christi Doherty, DNP, RNC-OB, CNE, CHSE, CDP
Director of Nursing Research, Kaplan North America

Published: May 2022

The National Council of State Boards of Nursing (NCSBN) is launching the Next Generation National Council Licensure Examination (NCLEX-RN^®) in April 2023. Case studies will be associated with the new question types used to measure clinical judgment. Can you write a case study that measures clinical judgment? If you want some suggestions, join Dr. Christi Doherty and her colleague, Ms. Tonya Taylor, at the 2022 Nursing Education Accreditation Conference for an interactive presentation on how to design a case study.

The case study is designed to provide data for the student to utilize in applying the clinical judgment measurement model (CJMM) (2020 NCSBN). The six cognitive processes outlined in the CJMM include recognizing cues, analyzing cues, prioritizing hypotheses, generating solutions, taking action, and evaluating outcomes (2021 NCSBN). Nursing students must practice mastering the cognitive processes in question format before taking the high stakes NCLEX^® examination. Nurse educators can help. According to The Future of Nursing 2020‒2030, nursing education needs to change what is taught, how it is taught, and expand learning opportunities (2021 National Academy of Medicine). Additionally, the ACEN states in Standard 4.6 (for all program types) that the “curriculum and instructional process [should] reflect educational theory … and current standards of practice.” By incorporating clinical judgment case studies in the nursing curriculum, case studies written using the innovative backward-design framework will help align the instructional process with current nursing practice and concepts.

The purpose of this presentation is to demonstrate to nurse educators how to use backward curriculum design (developed by Wiggins and McTighe in their book Understanding by Design [2005 second edition]) and to align relevant content with nursing concepts. The method engages nursing students in the curriculum and allows them to achieve learning outcomes. The stages in backward design allow for the identification of outcomes, determining the acceptable evidence to achieve the outcomes, and then developing the learning experiences and instructional techniques to achieve the results (2017 Bowen; 2005 Wiggins & McTighe).

The next step is to incorporate case studies into the student learning experience. An effective case study follows the NCSBN guidelines with six questions that measure the necessary cognitive process a nursing student must develop. The presentation given at the accreditation conference will guide nurse educators through setting goals for the case study and leveling to student competencies. Strategies will be shared for telling the clinical story and using that story to bring the case alive for the student, putting them at the bedside. Then, we will walk nurse educators through deciding what matters most, what it means, and what the nurses can and should do for the patient in the story. Finally, determining what worked and how you verify that it did. This completes the design for a case study that meets NCSBN guidelines for measuring clinical judgment.

Clinical judgment is an essential component of nursing practice. Clinical judgment is needed to provide safe, competent care for the increasingly higher acuity patients in complex clinical settings. In the presentation, nurse educators will actively apply the three stages of backward design in the development of Next Generation case study questions. The practice provided will allow educators to enhance the clinical judgment skills of nursing students to prepare them for the Next Generation NCLEX-RN^® exam and the rigors of professional nursing. Come join the session!

Author Information

Dr. Doherty is a skilled researcher, valued nursing professor, experienced clinical nurse, and virtual simulation designer. She holds certifications in nursing education (CNE), healthcare simulation education (CHSE), diversity professional (CDP), and inpatient obstetrics (C-OB). Dr. Doherty has published several books and has presented both nationally and internationally on diverse subjects such as clinical judgment, pharmacology, simulation, research design and statistics, and informatics. Dr. Doherty has held national and international board of director positions in nursing leadership and education. She has over 20 years of clinical practice experience (in obstetrics and emergency nursing) as well as more than 10 years of nursing education experience in undergraduate and doctoral programs. Dr. Doherty earned her DNP from American Sentinel University, her MSNEd and BSN from Regis University, and her ADN from Grayson College.

Dr. Doherty can be reached at [email protected].