Author: Allison Younger, MSN, RN
Title: Clinical Instructor
Institution: Stephen F. Austin State University
Patient-Centered Care: Recognize the patient as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
– Assess patient values, preferences, and needs as part of the clinical interview
-Interpret relevant assessment data of the patient with cardiac disease.
– Create an individualized teaching plan for a patient with cardiac disease.
-Manage care of the patient with cardiac disease, taking into consideration specific patient values and preferences.
Teamwork and Collaboration: Function effectively within nursing teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.
-Discuss assessment findings and how they relate to specific patient care.
-Integrate the contributions of team members to provide complete patient education and assessments.
The Unfolding Case Study with Live Role Play is a teaching strategy designed to help students practice individualized, patient-centered care and strengthen teamwork and collaboration skills by utilizing the nursing process within a flipped classroom setting. Students achieve meaningful learning by connecting new concepts to previous knowledge and by practicing these new concepts in an acted scenario. By doing so, students become more confident in the clinical setting and are prepared to deliver a higher level of quality nursing care. This strategy addresses all learning types by providing written material for visual learners, in-depth discussion for auditory learnings, and acting out physical client care for tactile and kinesthetic learners, and thus increases the quality of the education environment.
The students prepare for class by reading the assigned text and reviewing the posted lecture content. Note that the PowerPoint presentation included here is not the lecture content that the students have access to prior to this activity. The lecture they are provided is a voice-over presentation that provides content they are required to know and understand for this unit. They are encouraged to bring their text and lecture content to class with them to use as a reference during the active learning scenarios. The PowerPoint presentation that is included in this activity is an instructor-only presentation that is used to guide the activity as the case study unfolds in the classroom. Students do not have access to it and only see it during class to help summarize information during discussions.
The instructor introduces the patient (a fellow instructor playing the role) to the class and guides them through the nursing process of caring for the patient throughout the progression of the disease process, through assessment, planning, interventions, and evaluation. This activity was designed for a BSN medical-surgical course specific to cardiac disease. However, this strategy can be adapted to fit a wide variety of disease processes and patients along a spectrum of health-care needs. The original activity followed the care of a patient with newly diagnosed hypertension to the progression of coronary vascular disease with stable angina, to outpatient angioplasty, and finally to an introductory level of managing the care of acute coronary syndrome. Students assessed and interviewed the patient, performed necessary interventions (including appropriate patient-centered teaching), and evaluated the outcomes along the spectrum of care as the patient progressed in the disease process.
This activity involved whole-class discussions as well as smaller group work with the instructor frequently summarizing and clarifying concepts along the way. The posted documents describe when whole class discussions were used and when students were divided into groups. After each phase (assessments as a large group, education as small groups, interventions as small groups, and evaluation as large groups) the instructor uses the PowerPoint to summarize and clarify the information.
Pillow (placed under patient’s clothes to show obesity)
Wig to show advanced age
Pack of cigarettes
Spray bottle with water to mimic diaphoresis
Empty medication bottles (Nitroglycerin, aspirin, morphine)
Evaluation of this innovative teaching strategy is performed with a post-survey tool and direct observation. 100% of post-surveys showed that this teaching strategy improved confidence in application of the nursing process and ability to individualize care plans based on specific patient needs. Instructors present during this activity observed respectful teamwork/collaboration and delegation of tasks among all participants. Students also provided voluntary feedback in support of this type of flipped classroom and voiced appreciation of how it helped connect concepts to actual patient care.