Back Up That Case: A New Perspective on the Reverse Case Study

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Primary Author:</td>
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Benjamin A. Smallheer, PhD, RN, ACNP-BC, CCRN</td>
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Co-Principal Investigators/Collaborators:</td>
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N/A</td>
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Organization:</td>
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Vanderbilt University</td>
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Abstract</h2>
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Purpose</h3>
<p>Instituting the reverse case study provides a rich academic challenge while adequately representing the responsibilities of the bedside nurse.</p>
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Background</h3>
<p>The utilization of case studies allows learning organizations to develop a culture of quality and safety in the classroom setting. Diverse methods of challenging student cognition and critical thinking are needed while incorporating higher levels of Bloom’s Taxonomy.</p>
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Materials & Methods</h3>
<p>The reverse case study was presented as an in-class assignment in a Pharmacology III course. The students were provided with minimal information to allow for free thinking and rationalization of decisions. Students were placed in small groups with ANY and ALL resources available to them. The patient was presented by EMS and unable to provide sufficient information. A brown paper bag containing numerous prescription medication bottles, each containing an empty drug blister pack to a medication with prescribing instructions, was given to the students. Students were given one hour to develop an admission medication reconciliation, identify potential drug-drug interactions with physiologic manifestations, develop a probable past medical history list, and probable reason for admission. During the second hour of the class, the students were given the patient’s hospital course, and required to identify medications appropriate for discharge along with discharge teaching points. </p>
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Results</h3>
<p>This variation to the reverse case study encouraged collaboration, teamwork, prioritization, and critical thinking. Students reported feeling challenged, stressed, intrigued with the unknown history, and responsible for the patient’s wellbeing at discharge. The students gained a perspective of the bedside nurse’s responsibility when admitting a patient who cannot give a clear history.</p>
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Conclusion</h3>
<p>Variable approaches to learning will better prepare students for not only the alternative format questions posed by NCLEX, but also the complex nature of quality and safety required of a licensed provider. Reverse case studies allow students to utilize the higher domains of applying, analyzing, evaluating, and creating in Bloom’s Taxonomy to demonstrate the full spectrum of the taxonomy.</p>
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Bibliography</h3>
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Beyer, D.A. (2011). Reverse case study: to think like a nurse. Journal of Nursing Education, 50(1), 48-50.</li>
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Harrison, E. (2012). How to develop well-written case studies: the essential elements. Nurse Educator, 37(2), 67-70.</li>
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Thomas, J.S. (2012). A reverse case study of mechanical failures [Abstract]. Proceedings of the 2012 Midwest Section Conference of the American Society for Engineering Education, USA.</li>
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<p>© Improvement Science Research Network, 2012</p>
<p>The ISRN published this as received and with permission from the author(s).</p>