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How to Create Case Studies that Bring Clinical to Class!

Step-By-Step Guide to Writing a Nursing Case Study

You now know all the key sections you need to include in a nursing case study. You also know what exactly you need to do in each section. It is now time to know how exactly to write a nursing case study. The process detailed below should be easy to follow because you now know the typical structure of nursing case studies.

When given a nursing case study assignment, the first thing you need to do is to read. You need to read two pieces of information slowly and carefully.

First, you need to read the prompt itself slowly and carefully. This is important because the prompt will have important bits of information that you need to know, including the style, the format, the word count, and the number of references needed. All these bits of information are important to know to ensure what you are writing is the right thing.

Second, you need to read the patient scenario slowly and carefully. You should do this to understand it clearly so that you do not make any mistakes in your analysis.

• Create a rough outline

Failure to plan is a plan to fail. So do not fail to plan. In other words, do not fail to create an outline for your case study analysis. Use the template provided in this essay to create a rough outline for your nursing case study analysis.

Make sure your outline is as detailed as it can be at this stage. You can do light research to achieve this aim. However, this is not exactly necessary because this is just a rough outline.

• Conduct thorough research

After creating a rough outline, you should conduct thorough research. Your research should especially focus on providing a credible and evidence-based nursing assessment on the patient problem(s). The evidence you should use should only be from recent nursing or medical literature.

You will also need to conduct thorough research to come up with an effective intervention or nursing care plan. So when researching the patient’s problem and its diagnosis, you should also research the most suitable intervention or you should do it right after.

When conducting research, you should always note down your sources. So for every piece of information you find and what to use, you should have its reference.

After conducting thorough research, you should enhance your rough outline using the new pieces of information you have discovered. Make sure it is as comprehensive as possible.

• Write your nursing case study

At this stage, you simply need to follow your comprehensive outline to write your case study analysis. If you created a good outline, you should find it very easy to write your nursing case study analysis.

If you did not, you will find it difficult to write your nursing case study. Whenever you are stuck when writing your case study analysis paper, you should re-read the part of this article where we explain what to include in every section of your analysis. Doing so will help you know what exactly to write to continue with your essay. Writing a nursing case study analysis usually takes only a few hours.

• Reference your case study

After writing your case study, make sure you add all in-text citations if you had not added them already. And when adding them, you should make sure you follow the style/format recommended in the assignment prompt (usually APA or Harvard style).

After adding in-text citations exactly where they need to be and in the right format, add all the references you have used in a references page. And you should add them correctly as per the rules of the style you were asked to use.

Do not forget to organize your references alphabetically after you are done creating your references page.

• Thoroughly edit your case study

After STEP 5 above, you need to edit your case study. You should edit it slowly and carefully. Do this by proofreading it twice. Proofread it slowly each time to discover all the grammar, style, and punctuation errors. Remove all the errors you find.

After proofreading your essay twice, check it one more time to make sure every sentence is very easy to understand. This is what will transform your ordinary case study into an A-grade case study. Of course, it must also have all the standard sections expected in a case study.

Just to make sure your case study is absolutely perfect, check it one more time using a grammarly.com or a similar computer grammar checker. Doing this will help you catch and eliminate all the remaining errors in your work.

• Submit your case study analysis

After you are done proofreading and editing your case study analysis, it will be 100% ready for submission. Just convert it into the format it is required in and submit it.

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• Volume 21, Issue 1
• What is a case study?
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• Roberta Heale 1 ,
• Alison Twycross 2
• 1 School of Nursing , Laurentian University , Sudbury , Ontario , Canada
• 2 School of Health and Social Care , London South Bank University , London , UK
• Correspondence to Dr Roberta Heale, School of Nursing, Laurentian University, Sudbury, ON P3E2C6, Canada; rheale{at}laurentian.ca

https://doi.org/10.1136/eb-2017-102845

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What is it?

Case study is a research methodology, typically seen in social and life sciences. There is no one definition of case study research. 1 However, very simply… ‘a case study can be defined as an intensive study about a person, a group of people or a unit, which is aimed to generalize over several units’. 1 A case study has also been described as an intensive, systematic investigation of a single individual, group, community or some other unit in which the researcher examines in-depth data relating to several variables. 2

Often there are several similar cases to consider such as educational or social service programmes that are delivered from a number of locations. Although similar, they are complex and have unique features. In these circumstances, the evaluation of several, similar cases will provide a better answer to a research question than if only one case is examined, hence the multiple-case study. Stake asserts that the cases are grouped and viewed as one entity, called the quintain . 6  ‘We study what is similar and different about the cases to understand the quintain better’. 6

The steps when using case study methodology are the same as for other types of research. 6 The first step is defining the single case or identifying a group of similar cases that can then be incorporated into a multiple-case study. A search to determine what is known about the case(s) is typically conducted. This may include a review of the literature, grey literature, media, reports and more, which serves to establish a basic understanding of the cases and informs the development of research questions. Data in case studies are often, but not exclusively, qualitative in nature. In multiple-case studies, analysis within cases and across cases is conducted. Themes arise from the analyses and assertions about the cases as a whole, or the quintain, emerge. 6

Benefits and limitations of case studies

If a researcher wants to study a specific phenomenon arising from a particular entity, then a single-case study is warranted and will allow for a in-depth understanding of the single phenomenon and, as discussed above, would involve collecting several different types of data. This is illustrated in example 1 below.

Using a multiple-case research study allows for a more in-depth understanding of the cases as a unit, through comparison of similarities and differences of the individual cases embedded within the quintain. Evidence arising from multiple-case studies is often stronger and more reliable than from single-case research. Multiple-case studies allow for more comprehensive exploration of research questions and theory development. 6

Despite the advantages of case studies, there are limitations. The sheer volume of data is difficult to organise and data analysis and integration strategies need to be carefully thought through. There is also sometimes a temptation to veer away from the research focus. 2 Reporting of findings from multiple-case research studies is also challenging at times, 1 particularly in relation to the word limits for some journal papers.

Examples of case studies

Example 1: nurses’ paediatric pain management practices.

One of the authors of this paper (AT) has used a case study approach to explore nurses’ paediatric pain management practices. This involved collecting several datasets:

Observational data to gain a picture about actual pain management practices.

Questionnaire data about nurses’ knowledge about paediatric pain management practices and how well they felt they managed pain in children.

Questionnaire data about how critical nurses perceived pain management tasks to be.

These datasets were analysed separately and then compared 7–9 and demonstrated that nurses’ level of theoretical did not impact on the quality of their pain management practices. 7 Nor did individual nurse’s perceptions of how critical a task was effect the likelihood of them carrying out this task in practice. 8 There was also a difference in self-reported and observed practices 9 ; actual (observed) practices did not confirm to best practice guidelines, whereas self-reported practices tended to.

Example 2: quality of care for complex patients at Nurse Practitioner-Led Clinics (NPLCs)

The other author of this paper (RH) has conducted a multiple-case study to determine the quality of care for patients with complex clinical presentations in NPLCs in Ontario, Canada. 10 Five NPLCs served as individual cases that, together, represented the quatrain. Three types of data were collected including:

Review of documentation related to the NPLC model (media, annual reports, research articles, grey literature and regulatory legislation).

Interviews with nurse practitioners (NPs) practising at the five NPLCs to determine their perceptions of the impact of the NPLC model on the quality of care provided to patients with multimorbidity.

Chart audits conducted at the five NPLCs to determine the extent to which evidence-based guidelines were followed for patients with diabetes and at least one other chronic condition.

The three sources of data collected from the five NPLCs were analysed and themes arose related to the quality of care for complex patients at NPLCs. The multiple-case study confirmed that nurse practitioners are the primary care providers at the NPLCs, and this positively impacts the quality of care for patients with multimorbidity. Healthcare policy, such as lack of an increase in salary for NPs for 10 years, has resulted in issues in recruitment and retention of NPs at NPLCs. This, along with insufficient resources in the communities where NPLCs are located and high patient vulnerability at NPLCs, have a negative impact on the quality of care. 10

These examples illustrate how collecting data about a single case or multiple cases helps us to better understand the phenomenon in question. Case study methodology serves to provide a framework for evaluation and analysis of complex issues. It shines a light on the holistic nature of nursing practice and offers a perspective that informs improved patient care.

• Gustafsson J
• Calanzaro M
• Sandelowski M

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

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7 steps to successful nursing case study writing.

A nursing case study is a detailed study of a patient that is encountered during a nurse’s daily practice. They are usually written by nurses in training as part of their coursework, but they can also be written by experienced nurses as a way of sharing best practice.

Case studies are an important part of the nursing curriculum as they provide students with a real-life insight into the complexities of patient care. They also allow nurses to reflect on their own practice and identify areas where they could make improvements.

When writing a nursing case study, it is important to follow the instructions provided by your tutor. This will ensure that your case study is relevant and meets the required academic standards. It is also important to be clear and concise in your writing, and to use evidence-based sources to support your claims.

If you are struggling to write a nursing case study, there are a number of resources that can help you. The following books are all recommended reading for anyone wanting to write a case study:

• The Complete Guide to Case Study Research by Elaine M. Hubbell
• Nursing Case Studies: A Guide to Understanding and Writing Them by Jennifer R. Gray
• Writing Nursing Case Studies by Sally G. Reed

Once you have a good understanding of how to write a nursing case study, you will be able to produce high-quality studies that will be of benefit to both yourself and your patients.

Importance of nursing case study writing.

Nursing case studies are an important part of your nursing education. They provide you with the opportunity to apply the knowledge and skills you have learned in the classroom to real-world scenarios. Nursing case studies also allow you to develop critical thinking and problem-solving skills.

The nursing case study should be a detailed and accurate account of the care that was provided to the patient. It should be used to evaluate the outcome of that care and to identify any areas where improvements can be made.

Steps when writing a nursing case study paper.

There are various steps you should keep in mind in order to help you write a successful nursing case study.

These important steps include:

• Define the problem.
• Gathering information.
• Developing alternatives.
• Analyzing the alternatives.
• Selecting the best alternative.
• Implementing the solution.
• Evaluating the outcome.

Defining the Problem

When writing a nursing case study, it is important to first define the problem. The problem should be something that can be solved through nursing interventions. Once the problem is defined, the nursing case study can be written to discuss the interventions that were used to solve the problem.

Nursing case studies are a great way to learn about different nursing interventions and how they can be used to solve problems. By reading nursing case studies, nurses can learn about different diseases and conditions and how to treat them. Nursing case studies can also be used to teach other nurses about different interventions.

Gathering Information

When it comes to writing a nursing case study, the first and most important step is gathering information. This is where you will need to do your research and collect data from a variety of sources. Once you have all of the information you need, you can begin to write your case study.

It is crucial to gather information before starting to write your nursing case study. This ensures that you include all of the relevant information. This means including details about the patient’s medical history, symptoms, and treatment.

Developing Alternatives

Once you have all of the necessary information, you can begin developing alternatives for the patient’s treatment. This will involve looking at the different options and deciding which is best based on the specific case. You will need to consider the risks and benefits of each option before making a recommendation.

Once you have developed a few different options, you can then start writing the case study. This should include an overview of the patient’s history, their current condition, and the different treatment options that were considered. Be sure to explain why you ultimately recommended the chosen course of treatment.

Analyzing the Alternatives

When you are given a nursing case study to write, the first step is to read the case thoroughly. Make sure you understand the situation and the patient’s history. Once you have a good understanding of the case, you can start to analyze the alternatives.

There are usually three alternatives in a nursing case study: nursing intervention, medical intervention, and no intervention. You will need to evaluate each alternative and decide which is best for the patient.

Nursing intervention is usually the first choice because it is the least invasive and has the least risk. Medical intervention is usually the next choice because it is more invasive but has a higher chance of success. No intervention is usually the last choice because it means doing nothing and letting the patient’s condition worsen.

Once you have evaluated the alternatives, you can start to write your case study. Remember to include all of the important information, such as the patient’s history, the alternatives you considered, and your recommendation.

Selecting the Best Alternative

When you are presented with a nursing case study, the first thing you need to do is identify the problem. Once you have identified the problem, you need to gather information about the patient. This information will help you to develop a plan of care. Once you have developed a plan of care, you need to select the best alternative.

The best alternative is the one that will best meet the needs of the patient. When selecting the best alternative, you need to consider the patient’s preferences, the severity of the problem, the risks and benefits of each alternative, and the resources available.

Implementing the Solution

Once you have selected the best alternative, you need to implement the plan of care. After you have implemented the plan of care, you need to evaluate the patient’s response. If the patient’s condition improves, you need to continue the plan of care. If the patient’s condition does not improve, you need to reevaluate the plan of care and select a different alternative.

Evaluating the Outcome

A nursing case study is a detailed account of a patient’s medical history and treatment. It is used to evaluate the outcome of a patient’s care and to identify any areas where improvements can be made.

When writing a nursing case study, it is important to include a detailed description of the patient’s symptoms and medical history. The case study should also include a discussion of the treatment that was provided and the outcome of that treatment.

It is also important to discuss any areas where improvements could be made in the care that was provided. This could include changes to the treatment plan, changes to the way that the patient was monitored, or changes to the way that the patient’s symptoms were managed.

Conclusion.

Writing a successful nursing case study can be a challenging task. However, by following the steps provided in this blog that is, first defining the problem, gathering information, developing alternatives., analyzing the alternatives, selecting the best alternative, implementing the solution and evaluating the outcome. You will be able to write a top-notch nursing case study that meets your requirements.

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Patients’ Lived Experiences During the Transplant and Cellular Therapy Journey pp 9–17 Cite as

Creating a Patient-Centered Case Study

• Jennifer Holl 5 ,
• Lisa Wesinger 6 ,
• Judi Gentes 7 ,
• Carissa Morton 8 &
• Jean Coffey 9  
• First Online: 25 August 2023

73 Accesses

Case studies provide an invaluable record of professional clinical practice and have been used in medicine since the late 1800s to describe both traditional and unusual presentations of specific disease pathologies. In medicine, case studies traditionally take a detached, objective approach to outlining the clinical course of a disease and its treatment. In keeping with the holistic approach to patient care found in nursing and using the theoretical foundations established in Jean Watson’s Theory of Human Caring as well as the Relationship-Based Care Model, this research team sought to revolutionize the case study paradigm and deconstruct the traditional case study approach, placing the patient, instead of the provider, at the center of the narrative. This new case study method intercalates the clinicians’ analysis of the case with the patient’s commentary. This chapter outlines the methods and theoretical underpinnings used to create a patient-centered case study and seeks to provide nurses with a creative alternative to the traditional, objective case study approach. Implications for future research include whether using patient-centered case studies, instead of traditional case studies, provide a valuable learning tool to educate nurses.

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Hematology/Oncology, Dartmouth Health, Lebanon, NH, USA

Jennifer Holl

Transplant and Cellular Therapy, Dartmouth Health, Lebanon, NH, USA

Lisa Wesinger

Oncology/Hematology, Dartmouth Health, Lebanon, NH, USA

Judi Gentes

Dartmouth Health, Dartmouth Cancer Center, St. Johnsbury, VT, USA

Carissa Morton

School of Nursing, University of Connecticut, Storrs, CT, USA

Jean Coffey

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Holl, J., Wesinger, L., Gentes, J., Morton, C., Coffey, J. (2023). Creating a Patient-Centered Case Study. In: Coffey, J., Hill Jr., J.M., Long, T., McGrath, E.B. (eds) Patients’ Lived Experiences During the Transplant and Cellular Therapy Journey. Springer, Cham. https://doi.org/10.1007/978-3-031-25602-8_2

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How to Write a Nursing Case Study [Examples, Format, & Tips]

✒️ case study topics for nursing students.

• 🩺️ The Basics
• 💉 Nursing Case Study: Writing Rules

📑 Nursing Case Study Format

📝 nursing case study examples.

• ⏱️ Tips on Quick Writing

🔗 References

A nursing case study is an in-depth analysis of the health situation of an individual patient.

The analysis is based on:

• medical history,
• other relevant criteria.

In most cases, you will be asked to diagnose to suggest the first aid measures. Alternatively, nurses can be asked to describe a patient in their practice and analyze the correctness of their actions. The purpose is to recreate a realistic hospital setting in the classroom and make students reflect on the treatment process from diagnosis to treatment.

• Anaphylactic shock in a teenager with peanut allergy.
• Non-compliant patient with diabetes: ways to improve adherence.
• Telehealth intervention for managing chronic disease.
• Communication strategies to address vaccine hesitancy in a rural community.
• Postpartum hemorrhage in a new mother: risk factors and interventions.
• Ways to improve recognition of dehydration in aging adults.
• The effective ways of maintaining work-life balance for nurses.
• Cultural competency in providing care to migrants and refugees.
• Why should every patient’s medical history remain confidential?
• The use of massage therapy in relieving pain.
• The challenges facing medicine in 2024.
• How does modern technology impact nursing?
• The significance of regular follow-up appointments with the healthcare provider.
• What are the primary treatments for postpartum depression?
• The use of steroids in cancer treatment.

🩺️ Nursing Case Study: What Is It About?

As a nursing student, you should understand that no two patients are the same. Each has a unique clinical record and condition. And although most nursing case study tasks will ask you to suggest a diagnosis or treatment, your focus should rest on the patient.

Busy nurses can sometimes see their patients in the framework of an illness to be treated or a procedure to be fulfilled. But you should do your best to remember that each patient is a living person with a complex set of needs, emotions, and preferences. A ready-made textbook answer is rarely the best solution for them. Moreover, it rarely helps to analyze a condition in isolation from the patient.

In a nursing case study, your task is to analyze a disorder or illness as a part of a specific medical situation. If you don’t do that, your case study becomes an essay (theoretical and generalized). It is the difference between the two assignment types.

Once again:

A case study in nursing emphasizes the particular patient’s condition. Meanwhile, a nursing essay will explore the disease, prevention methods, treatment, or possible consequences of the disease.

Even if the case is hypothetical, it should focus on the suggested reality. On the other hand, essays are usually literature-based. You are expected to do some reading for a case study too, but you should research and present the information within the context of the patient. In simple terms, a case study uses information in the actual application, and an essay uses it for the sake of generalized suggestions.

💉 How to Write a Nursing Case Study: 3 Key Rules

• Do the fieldwork. Before setting your hands to writing, you should collect all of the available materials: clinical notes, results of medical tests, x-rays, sickness records, etc. Use this information to draw a clear picture of the story. It is always helpful to ask yourself, “What is interesting or unusual about this patient’s condition?” In the course of writing, recall your answer from time to time not to get lost in words. It will help you to convey a definite and appropriate message.

• Stick to the facts. A nursing case study should be an accurate description of the actual situation. Restrain from speculating about the inherent mechanisms of the illness or the general treatment methodology. In fact, students are rarely prepared enough to discuss pathology and physiology. Leave this to reputable experts. The best result you can provide in a case study is an honest account of clinical events.
• Concentrate on the patients and their progress. Remember that a nursing case study is a story of a patient’s progress and not a narrative about their nurse. No matter how efficiently the medical specialist acted, it would be incorrect to add any praiseful remarks. The optimal way is to tell the story in its logical and time order and outline the result of treatment. In this case, the outcome will speak for itself.

Introduction

It is where you should tell the reader why this case is interesting . Place your study in a social or historical context. If, during your preliminary research, you found some similar cases, describe them briefly. If you had a hard time diagnosing the patient or your proposed treatment is complicated, mention it here. Don’t forget to cite the references to each of them!

The introduction should not exceed several paragraphs. The purpose is to explain why the reader will benefit from reading about the case.

Case Presentation

• Why did the patient seek medical help? (Describe the symptoms.)
• What is known about the patient? (Mention only the information that influenced your diagnosis. Otherwise, explain why some information is irrelevant to the diagnosis.)
• Stick to the narrative form. (Make it a story!)
• What are the variants for diagnosis? (Make a shortlist of possible disorders that fall under the patient’s symptoms. But make it specific: not just “pneumonia” but “bilateral pneumonia,” for example. Besides, this point is optional.)
• What were the results of your clinical examination? (If you saw the patient in person.)
• Explain the results of lab tests. (The words “positive” or “negative” are not always clear.)

Actions and Their Results

This section describes the care that has been provided and/or is planned. You can answer the following questions in narrative form . If some information is missing, skip the point:

• What preliminary actions have been taken? (Be specific: not just “wound care,” but “wound cleaning and dressing.”)
• How long has the patient been under care?
• Has the previous treatment given any visible result?
• Why was it suspended or finished?
• Why did the patient withdraw from treatment (if applicable)?
• How could you improve the patient’s condition if the result was negative?
• If the disease is incurable (like in the case of diabetes), which activities would stabilize the patient’s condition?
• If possible, include the patient’s reports of their own physical and mental health.

In this section, you should identify your questions about the case. It is impossible to answer all of them in one case study. Likewise, it is unreal to suggest all the relevant hypotheses explaining the patient’s condition. Your purpose is to show your critical thinking and observation skills. Finalize your conclusion by summarizing the lessons you learned from the nursing case study.

Whenever you directly or indirectly cite other sources or use data from them, add these books and documents to the references list. Follow the citation style assigned by your professor. Besides, 15 items are already too much. Try to make a list of up to 10. Using textbooks as references can be viewed as bad manners.

Include all the tables, photographs, x-rays, figures, and the journal of medication usage in this section. Unless required otherwise in the assignment, start each item from a new page, naming them “Appendix A,” “Appendix B…”.

Below you will find case study samples for various topics. Using them as a reference will improve your writing. If you need more ideas, you are welcome to use our free title-generating tool .

• Case study: healing and autonomy.
• Sara’s case study: maternal and child nursing.
• COPD medical diagnostics: case study.
• Care standards in healthcare institutions: case study.
• Acute bacterial prostatitis: case study analysis.
• Alzheimer disease: the patient case study.
• The treatment of foot ulcers in diabetic patients: case study.
• Hypertension: C.D’s case study.
• Myocardial infarction: cardiovascular case study.
• Major depressive disorder case.
• Case study of the patient with metabolic syndrome .
• Pulmonary analysis case study .
• Older adults isolation: Case study .
• The holistic care: Case study .
• Medical ethics: Case study .
• Patient diagnoses and treatment: Case study .
• Obesity case study: Mr. C .
• Nurse Joserine: Case study problems .
• Chronic stable angina: Case study .
• Fetal abnormality: Case study .
• Researching SOAP: Case study .
• Case study for a patient with hormonal disorders .
• Obesity in the elderly: The case study .
• “Walking the Tightrope”: A case study analysis .
• ARNP approach: Case study analysis .
• Case study on biomedical ethics in the Christian narrative .
• Thermal injury: Case study .
• Ethical dilemma in nursing: Case study .
• Asthma: A case study of the patient .
• Asthma discharge plan: Mini case study .
• Case study: An ethics of euthanasia .
• Case study: Head-to-toe assessment steps .
• Pain management strategies: Case study .
• Case study: Inflammatory bowel disease .
• Sleep deprivation and insomnia: The case study .
• The case study of a heart failure .
• Porphyria cutanea tarda: Disease case study .
• Case study: Hardy Hospital case summary .
• Obesity and its complications: Case study .
• Angina disease case study .
• Nursing ethics case study .
• Case study of a patient: Assessment and treatment plan .
• Cecile case study: Mrs. J .
• Nursing power in the emergency department: Case study .
• Heart failure case study: Mrs. J .
• Application of ethics in nursing: Case study .
• Sudden visual impairment: Case study .
• Epidemiology case study: Outbreak at Watersedge — Public health discovery game .
• Wellness of senior citizens: Case study .
• Healthcare organization evaluation: Case study of Banner Health .

⏱️ Bonus: Tips on Writing a Case Study in Record Time

Need to prepare a case study on nursing or in another field? Below you’ll find a collection fo tips that will help you do it as quickly as possible!

3 Shortcuts for a Quick Start

If you’re about to start writing a case study, you should check yourself if you’re not doing any of the following:

• spending too much time on selecting a topic;
• reading too much before selecting a topic;
• making conclusions too early – creating bias.

Instead of killing time doing the three useless things discussed above, consider these:

• Choose approach. Note that there are 2 major approaches to case studies: the analytical approach (investigating possible reasons without making any conclusions) and problem-oriented approach (focusing on a particular problem and investigating it).
• Skim some sources (DON’T READ THEM). Select several sources. Simply skim abstracts and conclusions.
• Start making notes early. Simply reading is ineffective unless you’re lucky to have a phenomenal memory. Always make notes of any useful arguments.

4 Shortcuts Not to Get Stuck in the Middle

Even if you kick started your case study, it’s too early to celebrate it. Consider the following traps in the middle of the project:

• Watch the structure. The classic logical structure is your formula of success. It will help you move from one point to another without the unnecessary procrastination:
• Respect the logic. Make your case study flow – make logical transitions between the different parts and make it consistent. Avoid changing your position throughout the paper.
• Be detail-oriented. Any trifle deserves attention when you write a case study.
• Avoid bias. Be sure that all your opinions are based on the specific arguments form the case study. Avoid pouring your biased views into the project.

3 Shortcuts for a Happy Ending

• Offer a realistic solution. College case study is a rehearsal of real-life situations. Take the responsibility for your suggestions.
• Keep your conclusion short. Avoid repeating the details and don’t include any new information.
• Consider creating a Power Point. If your task is not only writing a case study, but also presenting it – why not create PowerPoint slides to help you?

As the last step on your way to a perfect nursing case study, prepare the title page. Its format usually depends on the professor’s requirements. But if you know the citation style, our Title Page Maker is a perfect tool to apply the right formatting and accelerate the process. And if you have any know-how on how to write a medical case study, you are very welcome to share it with other students in the comments below.

❓ Nursing Case Study: FAQ

What is a case study in nursing.

A nursing case study explores the condition of a patient. It is based on previous clinical records, lab reports, and other medical and personal information. A case study focuses on the patient and describes the treatment that was (or should be) applied and its (expected) outcome.

How to Write a Nursing Case Study?

• Collect the bulk of data available about the patient.
• Read literature about the diagnosed condition.
• Focus on the individual patient and their symptoms.
• Describe the situation and outline its development in time.
• Analyze the actions of the medical personnel that have been done.
• Plan further treatment of the patient.

Why Are Case Studies Good for Nursing Students?

Nursing case studies offer you a priceless opportunity to gain experience of different patient conditions and cure methods without visiting the clinic. You can think about whether the proposed treatment was appropriate or wrong and suggest a better solution. And the best thing, your teacher will indicate your mistakes (and no patient will be hurt in the process).

Why Are Case Studies Important in Nursing?

• You learn to distinguish the relevant data and analyze it.
• You learn to ask the right questions.
• You learn to evaluate the severity of symptoms.
• You learn to make better diagnoses.
• You train your critical thinking in terms of treatment methods
• Case studies are in-class simulators of authentic atmosphere in a clinical ward.
• What is a case study? | Evidence-Based Nursing
• Case Studies – Johns Hopkins Medicine
• Case Study Research Design in Nursing
• Case study report for Nursing | Learning Lab – RMIT University
• Case Study or Nursing Care Study? – jstor

Research Paper Analysis: How to Analyze a Research Article + Example

Film analysis: example, format, and outline + topics & prompts.

How to write a Nursing Case Study Analysis Paper

Writing a nursing case study is not something most nursing students look forward to. This is because it is a somewhat difficult process that is often overwhelming for nursing students. Nevertheless, by reading this guide prepared by our best nursing students, you should be able to easily and quickly write a nursing case study that can get you an excellent grade.

How different is this guide from similar guides all over the internet? Very different!

This guide provides all the pieces of information that one would need to write an A-grade nursing case study. These include the format for a nursing case study, a step-by-step guide on how to write a nursing case study, and all the important tips to follow when writing a nursing case study.

This comprehensive guide was developed by the top nursing essay writers at NurseMyGrade, so you can trust that the information herein is a gem that will catapult your grades to the next level. Expect updates as we unravel further information about writing a nursing case study.

Now that you know you’ve discovered a gold mine, let’s get right into it.

What Is a Nursing Case Study?

A nursing case study is a real or imagined patient scenario designed to test the knowledge and skills of student nurses. Nursing case study assignments usually focus on testing knowledge and skills in areas of nursing study related to daily nursing practice.

As a nursing student, you must expect a nursing case study assignment at some point in college. The fact that you are reading this post means that point is now.

While there is no standard structure for writing a nursing case study assignment, there are some things or elements that must be present in your nursing assignment for your professor to consider it complete.

In the next section, you will discover these things that your instructor n expects in your nursing case study analysis.

The Nursing Case Study Template

• • Title page
• • Introduction
• • Case presentation (Patient info, history and medical condition)
• • Diagnosis/Nursing assessment
• • Intervention/Nursing care plan
• • Discussion and recommendations
• • Conclusion
• • References

The Structure of a Nursing Case Study Analysis

You now know what nursing professors expect in a nursing case study analysis. In this section, we will explain what exactly to include in each section of your nursing case study analysis to make it an excellent one.

1. Title page

The title page is important in all types of academic writing. You must include it when writing your nursing case study analysis or any other type of essay or paper. And you must include it in the format recommended by your college.

If your college has no specific title page format, use the title page format of the style requested in the assignment prompt. In nursing college, virtually all assignments are supposed to be written either in Harvard or APA format.

So, check your assignment prompt and create your title page correctly. The typical title page should include the topic of your paper, your name, the name of your professor, the course name, the date you are submitting the paper, and the name of your college.

2. Abstract

Most nursing professors require you to include an abstract in your nursing case study analysis. And even when you are not specifically required to write one, it is good to do so. Of course, you should consult with your professor before doing so.

When writing an abstract for your paper, make sure it is about 200 words long. The abstract should include a brief summary of the case study including all the important information in the patient presentation such as the history, the age, and the current diagnosis.

The summary should also include the nursing assessment, the current interventions, and recommendations.

3. Introduction

After writing the title page and the abstract, start writing the introduction. The introduction of a nursing case study analysis must briefly include the patient presentation, the patient’s current diagnosis and medication, and the recommendations. It must also include a strong thesis statement that shows what the paper is all about.

You shouldn’t just write an introduction for the sake of it. If you do so, your introduction will be bland. You need to put in good effort when writing your introduction. The best way to do this is to use your introduction to show you understand the case study perfectly and that you are going to analyze it right.

You can always write your introduction last. Many students do this because they believe writing an introduction last makes it more precise and accurate.

4. Case presentation

After introducing your nursing case study analysis, you should present the case. It is usually very easy to present a case. You simply need to paraphrase the patient scenario. When doing this, do not forget to include all the important details in the patient scenario including the description of the patient, patient history, complaints, medical history, family history, and so on.

In short, everything important in the patient scenario should be in your case presentation. The only thing you need to avoid when writing your case presentation is copying the patient scenario or case study word-for-word.

5. Diagnosis

After case presentation, you should explain the diagnosis. In other words, you should explain the condition, disease, or medical situation highlighted in the case presentation. For example, if the patient is a heavy smoker and he has COPD, it is at this point that you explain how COPD is linked to heavy smoking.

And when explaining the condition, go deep into the pathophysiology. Focus specifically on the patient’s risk factors. Make sure you get your explanation from recent nursing literature. And do not forget to cite all the literature you get your facts from.

In short, this section should explain the patient’s condition or suffering.

6. Intervention

After the diagnosis section, your nursing case study analysis should have an intervention section. This section is also known as the nursing care plan section. What you are supposed to do in this section is to present a nursing care plan for the patient presented in the patient scenario.

A good nursing care plan is one that details the patient’s chief complaints or critical problems. It then describes the causes for these problems using evidence from recent medical or nursing literature. It then details the potential intervention for each problem. Lastly, it includes goals and evaluation strategies for the measures.

Some nursing professors regard the intervention section (or nursing care plan section) as the most important part of a nursing case study. This is because this part details exactly how the student nurse will react to the patient scenario (which is exactly what the nursing professors want to know). So make sure you put in good effort when developing this section to get an excellent grade in this section.

7. Discussion and recommendations

The intervention section in a nursing case study is followed by a discussion and recommendations section. In this section, you are supposed to expound on the patient scenario, the diagnosis, and the nursing care plan. You are also supposed to expound on the potential outcomes if the care plan is followed properly. The rationale for the care plan or its important bits should also be explained in the discussion.

The discussion should be followed by recommendations. Recommendations usually everything important that can be done or changed to manage patient condition or prevent its reoccurrence. Basically, anything that enhances the patient’s well-being can be a recommendation. Just make sure your key recommendations are supported by evidence.

8. Conclusion

This is the second last section of a typical nursing case study. What you need here is to summarize the entire case study. Make sure your summary has at least the case presentation, the nursing assessment/diagnosis, the intervention, and the key recommendations.

At the very end of your conclusion, add a closing statement. The statement should wrap up the whole thing nicely. Try to make it as impressive as possible.

9. References

This is the last section of a nursing case study. No nursing case study is complete without a references section. You should make sure your case study has both in-text citations and a references page.

And you should make sure both are written as recommended in the assignment. The style section is usually Harvard or APA. Follow the recommended style to get a good grade in your essay.

Step-By-Step Guide to Writing a Nursing Case Study

You now know all the key sections you need to include in a nursing case study. You also know what exactly you need to do in each section. It is now time to know how exactly to write a nursing case study. The process detailed below should be easy to follow because you now know the typical structure of nursing case studies.

When given a nursing case study assignment, the first thing you need to do is to read. You need to read two pieces of information slowly and carefully.

First, you need to read the prompt itself slowly and carefully. This is important because the prompt will have important bits of information that you need to know, including the style, the format, the word count, and the number of references needed. All these bits of information are important to know to ensure what you are writing is the right thing.

Second, you need to read the patient scenario slowly and carefully. You should do this to understand it clearly so that you do not make any mistakes in your analysis.

• Create a rough outline

Failure to plan is a plan to fail. So do not fail to plan. In other words, do not fail to create an outline for your case study analysis. Use the template provided in this essay to create a rough outline for your nursing case study analysis.

Make sure your outline is as detailed as it can be at this stage. You can do light research to achieve this aim. However, this is not exactly necessary because this is just a rough outline.

• Conduct thorough research

After creating a rough outline, you should conduct thorough research. Your research should especially focus on providing a credible and evidence-based nursing assessment on the patient problem(s). The evidence you should use should only be from recent nursing or medical literature.

You will also need to conduct thorough research to come up with an effective intervention or nursing care plan. So when researching the patient’s problem and its diagnosis, you should also research the most suitable intervention or you should do it right after.

When conducting research, you should always note down your sources. So for every piece of information you find and what to use, you should have its reference.

After conducting thorough research, you should enhance your rough outline using the new pieces of information you have discovered. Make sure it is as comprehensive as possible.

• Write your nursing case study

At this stage, you simply need to follow your comprehensive outline to write your case study analysis. If you created a good outline, you should find it very easy to write your nursing case study analysis.

If you did not, you will find it difficult to write your nursing case study. Whenever you are stuck when writing your case study analysis paper, you should re-read the part of this article where we explain what to include in every section of your analysis. Doing so will help you know what exactly to write to continue with your essay. Writing a nursing case study analysis usually takes only a few hours.

• Reference your case study

After writing your case study, make sure you add all in-text citations if you had not added them already. And when adding them, you should make sure you follow the style/format recommended in the assignment prompt (usually APA or Harvard style).

After adding in-text citations exactly where they need to be and in the right format, add all the references you have used in a references page. And you should add them correctly as per the rules of the style you were asked to use.

Do not forget to organize your references alphabetically after you are done creating your references page.

• Thoroughly edit your case study

After STEP 5 above, you need to edit your case study. You should edit it slowly and carefully. Do this by proofreading it twice. Proofread it slowly each time to discover all the grammar, style, and punctuation errors. Remove all the errors you find.

After proofreading your essay twice, check it one more time to make sure every sentence is very easy to understand. This is what will transform your ordinary case study into an A-grade case study. Of course, it must also have all the standard sections expected in a case study.

Just to make sure your case study is absolutely perfect, check it one more time using a grammarly.com or a similar computer grammar checker. Doing this will help you catch and eliminate all the remaining errors in your work.

• Submit your case study analysis

After you are done proofreading and editing your case study analysis, it will be 100% ready for submission. Just convert it into the format it is required in and submit it.

Nursing Case Study Tips and Tricks

The guide above and other pieces of information in this article should help you to develop a good nursing case study analysis. The tips and tricks in this section should help you to ensure that your nursing case study analysis you create is an excellent one.

• Begin early

The moment you see a nursing case study assignment prompt, identify a date to start writing it and create your own deadline to beat before the deadline stated in the prompt.

If you do this and then start writing your case study analysis early before your deadline, you will have plenty of time to do excellent research, to develop an excellent paper, and to edit your final paper as thoroughly as you want to.

Most student nurses combine work and study. So if you decide to leave a nursing case study assignment until late to complete it, something could come up and you could end up failing to submit it or submitting a rushed case study analysis.

• Use the right terminology

When writing an essay or any other academic paper, you are always encouraged to use the simplest language possible to make your work easy to understand. However, this is not the case when writing a nursing case study analysis. While your work should certainly be easy to understand, you are required to use the right nursing terminology at every point where it is necessary. Failure to do this could water down your work or make it look less professional or convincing.

• Avoid copying and pasting

If you are a serious nursing student, you obviously know that copying and pasting is not allowed or tolerated in assignments. However, sometimes copying and pasting can seem okay in nursing case study. For example, it can seem okay to copy-paste the patient presentation. However, this is not okay. You are supposed to paraphrase the verbatim when presenting the patient presentation in your essay. You should also avoid copy pasting information or texts directly. Every fact or evidence you research and find should be paraphrased to appear in your work. And it should be cited correctly.

• Always ask for help if stuck

This is very important. Students are usually overwhelmed with academic work, especially a month or two to the end of the semester. If you are overwhelmed and you think you will not have the time to complete your nursing case study analysis or to submit a quality one, ask for help. Ask for help from an assignment help business like ours and you will soon have a paper ready that you can use as you please. If you choose to get help from us, you will get a well-researched, well-planned, well-developed, and fully edited nursing case study.

• Format your paper correctly

Many students forget to do proper formatting after they are done writing their nursing case study analyses. Before you submit your paper, make sure you format it correctly. If you do not format your paper correctly, you will lose marks because of poor formatting. If you feel you are not very confident with your APA or Harvard formatting skills, send your paper to us to get it correctly formatted and ready for submission.

Last words - where to get help if overwhelmed

In the last few years, our company has been one of the best-rated nursing assignment help companies . Thousands of students have benefitted from our many academic writing guides. Many more have benefitted from direct help given by our experts.

We’ve got dozens of nursing experts available every day of the week to provide nursing assignment help. They can easily research and write virtually any type of nursing assignment, including a nursing case study. So, if the information provided in this article isn’t making you feel any optimistic about writing an excellent nursing case study, get help from us.

Get help by ordering a custom nursing case study through this very website. If you do so, you will get a 100% original paper that is well-researched, well-written, well-formatted, and properly referenced. Since the paper is totally original, you can use it anywhere without encountering any problem.

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Writing Tips

A comprehensive nursing case study writing guide.

Aug. 4, 2023 • 7 min read

Nursing Case Study Writing Step-By-Step Guide

Nursing case studies play a vital role in the education and training of aspiring nurses in the USA, UK, UAE, and Canada. These real-life scenarios provide students with a unique opportunity to apply theoretical knowledge to practical situations, enhancing their critical thinking, clinical reasoning, and decision-making skills. In this guide, we'll walk you through the essential steps to creating effective and insightful nursing case studies that meet the academic standards of these countries.

1. Choosing a Relevant Case

The foundation of a successful nursing case study is the selection of an appropriate case. Look for scenarios that align with your course's learning objectives and reflect the wide range of healthcare challenges that nurses may face. Select cases involving ethical quandaries, complex patient interactions, or situations requiring interdisciplinary collaboration.

2. Gathering Information

Thorough research is key to crafting a detailed and accurate nursing case study. Collect data from reputable sources such as medical journals, textbooks, and evidence-based practice guidelines. Ensure that the patient's medical history, current condition, and relevant clinical data are well-documented. Protect patient confidentiality by de-identifying information.

3. Setting the Stage

Introduce the case by providing basic details on the patient, the healthcare setting, and any other relevant information. Describe the patient's demographics, medical history, current symptoms, and reason for seeking medical help. This establishes the context for readers to comprehend the situation and its significance.

4. Clinical Assessment

Detail the nursing assessment process, including physical examinations, diagnostic tests, and the collection of subjective and objective data. Highlight the nurse's role in observing, interviewing, and evaluating the patient's condition. Discuss the data collected and its implications for the patient's care.

5. Diagnosis and Planning

Based on the assessment, outline the nursing diagnoses and collaborative problems. Clearly explain the rationale behind each diagnosis and present a well-reasoned plan of care. Discuss short-term and long-term goals, potential interventions, and the expected outcomes of nursing interventions.

6. Implementation and Evaluation

Describe how the nursing care plan was executed and the interventions that were implemented. Include details about the nurse's interactions with the patient, families, and other healthcare team members. Evaluate the effectiveness of the interventions, discussing any changes in the patient's condition, responses to treatment, and unexpected challenges.

7. Reflection and Learning

Encourage critical thinking by incorporating a reflection section. Invite students to analyze the case, consider alternative approaches, and reflect on what they have learned from the experience. Discuss the ethical, cultural, and emotional aspects of the case, promoting a holistic understanding of patient care.

8. References and Citations

Maintain academic integrity by properly citing all sources used in your case study. Follow the appropriate citation style (such as APA, MLA, or Chicago) as required by your institution.

Writing nursing case studies is an essential skill for nursing students in the USA, UK, and Canada. Through these case studies, students can bridge the gap between theory and practice, preparing them for the complex and dynamic healthcare environments they will encounter in their careers. By carefully selecting cases, conducting thorough research, and presenting well-structured and reflective analyses, nursing students can create case studies that not only meet academic standards but also contribute to their growth as competent and compassionate healthcare professionals.

Our platform has been giving quality services to our students from the very beginning, all thanks to our highly-trained and professional Nursing case study helpers, who complete every task with utmost sincerity and dedication by applying all their knowledge to your projects so that you can raise your head confidently while presenting in front of your class. TutorGenix has always been ranked as the Best Nursing Case Study help in the USA, the UK, Canada, and the UAE. Our Nursing project writers will complete your academic reports, essays, homework, and whatnot, so just order us and we will help with everything we’ve got. You will get instant solutions for nursing homeworks or any other subject homework you need help with, as we have 24/7 available tutors.

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How to Write a Case Study Paper for Nursing

A well-written case study paper for a nursing program requires some planning and consideration. All too often, students begin writing before they complete appropriate, preliminary steps. Ideally, before you start a paper, you should already have determined the focus and format of it. You will then follow this up with a fact-gathering step in which you will gather and collate the content of your paper. Finally, there is the construction/execution step in which you will write the paper in a standard format (such as the APA style) and edit it.

A nursing case study paper contains several sections that fall into three categories:

1. The status of the patient

• Demographic data
• Medical History
• Current diagnosis and treatment

2. The nursing assessment of the patient

• Vital signs and test results
• Nursing observations (i.e., range of motion, mental state)

3. Current Care Plan and Recommendations

• Details of the nursing care plan (including nursing goals and interventions)
• Evaluation of the current care plan
• Recommendations for changes in the current care plan

Patient Status

The first portion of the case study paper will talk about the patient — who they are, why they are being included in the study, their demographic data (i.e., age, race), the reason(s) they sought medical attention and the subsequent diagnosis. It will also discuss the role that nursing plays in the care of this patient.

Next, thoroughly discuss any disease process. Make sure you outline causes, symptoms, observations, and how preferred treatments can affect nursing care. Also, describe the history and progression of the disease. Some important questions for you to answer are: 1) What were the first indications that there was something wrong, and 2) What symptoms convinced the patient to seek help?

Nursing Assessment

When you are discussing the nursing assessment of the patient, describe the patientΓÇÖs problems in terms of nursing diagnoses. Be specific as to why you have identified a particular diagnosis. For example, is frequent urination causing an alteration in the patientΓÇÖs sleep patterns? The nursing diagnoses you identify in your assessment will help form the nursing care plan.

Current Care Plan and Recommendations for Improvement

Describe the nursing care plan and goals, and explain how the nursing care plan improves the quality of the patientΓÇÖs life. What positive changes does the nursing care plan hope to achieve in the patientΓÇÖs life? How will the care plan be executed? Who will be responsible for the delivery of the care plan? What measurable goals will they track to determine the success of the plan?

The final discussion should be your personal recommendations. Based on the current status of the patient, the diagnosis, prognosis, and the nursing care plan, what other actions do you recommend can be taken to improve the patientΓÇÖs chances of recovery? You must support your recommendations with authoritative sources and cite appropriately per APA style guidelines.

Creating a well-written nursing case study paper doesnΓÇÖt need to be a grueling challenge. It can be gratifying, and itΓÇÖs good practice for assessing patients while out in the field, too. Keep in mind that your instructor will not only grade you on the quality of the content of your paper but by how you apply the APA style, as well. If you find that you are spending too much time formatting your paper, consider using formatting software as a helpful tool to ensure accuracy, so you donΓÇÖt lose points on a well-written paper because of some formatting errors.

For more information about APA or MLA formats, contact us today.

David Plaut

David Plaut is the founder of Reference Point Software (RPS). RPS offers a complete suite of easy-to-use formatting template products featuring MLA and APA style templates, freeing up time to focus on substance while ensuring formatting accuracy. 

Reference Point Software is not associated with, endorsed by, or affiliated with the American Psychological Association (APA) or with the Modern Language Association (MLA).

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Next Generation NCLEX Case Study Sample Questions

One of the big changes on the Next Generation NCLEX exam is a shift toward case studies. Case studies often require a deeper level of critical thinking, and understanding diseases on a more in-depth level (especially the pathophysiology) will make these types of questions easier to answer.

In this article, you’ll be able to watch a free video to help you prepare for the new Next Generation NCLEX case study format. Nurse Sarah will walk you step-by-step through each scenario and help you understand how to use critical thinking and nursing knowledge to answer these types of questions.

Next Generation NCLEX Case Study Review Questions Video

NGN Case Study Sample Questions and Answers

First, let’s take a look at our case study summary below:

Case Study Summary:

A 68-year-old male is admitted with shortness of breath. He reports difficulty breathing with activity, lying down, or while sleeping. He states that in order to “breathe easier,” he has had to sleep in a recliner for the past week. The patient has a history of hypertension, myocardial infarction (2 years ago), and cholecystectomy (10 years ago). The patient is being transferred to a cardiac progressive care unit for further evaluation and treatment.

Question 1 of 6: The nurse receives the patient admitted with shortness of breath. What findings are significant and require follow-up? The options are listed below. Select all that apply.

To answer this first question in the NGN case study, let’s look at the information provided in the nursing notes and vital signs tabs provided:

This question is asking us to identify findings that are significant and require the nurse to follow-up. In other words, what is presenting that we can’t ignore but need to investigate further.

Therefore, let’s comb through the nursing notes and vital signs to see what is abnormal and requires follow-up.

First, the patient arrived to the room via stretcher. That’s fine and doesn’t necessarily require follow-up.

Next, the patient is alert and oriented x 4 (person, place, time, event). This tells us that the patient’s neuro status is intact so far. Therefore, the shortness of breath isn’t affecting the patient’s mental function yet (we have enough oxygen on board right now for brain activity).

However, the nurse has noticed the shortness of breath with activity and talking, which should not normally happen. This tells us something is wrong and is significant enough to require follow-up. We want to know why is this happening, is it going to get worse, etc.

The patient’s weight and vital signs were collected (this is good). Weight is 155 lbs. and BMI is within a healthy range (doesn’t tell us too much but may be useful later). The patient is also connected to a bedside monitor, so they need to be monitored constantly like on a progressive care unit.

The monitor shows sinus tachycardia . This is significant because it seems the patient’s shortness of breath is causing the heart to compensate by increasing the heart rate to provide more oxygen (hence the lungs may be compromised).

Then we find out that the lungs are indeed compromised because crackles are heard in both lungs , and this may be why our patient is short of breath. This is significant (could the patient have pulmonary edema?)

Then we find out the nurse has noted an S3. This is an extra heart sound noted after S2. And what jumps out to me about this is that it is usually associated with volume overload in the heart like in cases of heart failure . However, S3 may be normal in some people under 40 or during pregnancy, but that’s not the case with our patient based on what we read in the case summary.

Therefore, based on everything I’m reading in this case study, I’m thinking this patient may have heart failure, but we need those test results back (especially the echo and chest x-ray, and hopefully a BNP will be in there too).

We are also told that the patient has an 18 gauge IV inserted (which is good thing to have so we can give medications if required), orders have been received, labs drawn, and testing results are pending.

Now let’s look at the “Vital Signs” tab above, and ask yourself what is normal vs. abnormal for this patient (adult male).

• The heart rate is high at 112 (tachycardia), and should normally be 60-100 bpm (see heart rhythms ).
• Blood pressure is higher than normal (normal is 120/80), which indicates hypertension.
• Oxygen saturation is 94% (this is on the low side as we’d normally want around 95% or higher, and the patient is on 4 L nasal cannula, which tells us the lungs are not okay).
• Respiratory rate is increased (26 breaths per minute)…normal is 12-20 breaths per minute.

Based on the information we were provided, I’ve selected the answers below. These findings are significant and definitely require follow-up by the nurse.

When answering these NGN case study questions, it’s helpful to think of the ABCDE (airway, breathing, circulation, etc.) as all of these fall into that category. If we don’t follow-up on the shortness of breath, crackles, respiratory rate, o2 saturation (94% on 4 L nasal cannula), the respiratory system can further decline.

In addition, the sinus tachycardia, S3 gallop, and hypertension could indicate fluid overload in the heart. This may cause the heart to tire out and lead the lethal rhythm. On the other hand, temperature, pain, weight, and BMI are not abnormal and do not require follow-up.

See the Complete Next Generation NCLEX Case Study Review

Each question in the case study builds on the previous question. To see how these questions evolve based on the patient’s condition and labs, watch the entire Next Generation NCLEX Case Study Review video on our YouTube Channel (RegisteredNurseRN).

NCLEX Practice Quizzes

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Nurse Sarah’s Notes and Merch

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Understanding The Different Types Of Case Studies In 2023

Case studies are an invaluable tool for researchers and students across various disciplines, providing a real-world perspective and allowing them to apply theoretical concepts to practical scenarios.

In this blog, we will delve into various case study types, ranging from exploratory to descriptive, explanatory, and more. Join us as we unlock the insights and nuances of various case study methodologies, uncover their unique features, and highlight their significance in today's ever-evolving landscape.

If you're a nursing student looking to enhance your clinical skills and knowledge, nursing case studies are an invaluable tool. They offer a real-world perspective to researchers and students, allowing them to apply theoretical concepts to practical scenarios.

Whether you're a seasoned researcher or a nurse student getting ready for your nursing license exam , this blog will provide you with valuable insights into the diverse world of case studies in 2023. So let's dive in.

Different case study types

Case studies are research methods used in various fields, such as business, social sciences, healthcare, and more, to investigate and analyze a particular subject or phenomenon. There are several types of case studies, each with its own unique characteristics and purposes. Here are some common case study types:

1. Unfolding Case Study

The first and most common case study type is the unfolding one. An unfolding case study is a dynamic, multi-faceted scenario that gradually reveals information and unfolds over time , presenting a complex situation for analysis and decision-making. 

It is designed to simulate real-world situations and challenges that professionals may encounter in their field of practice. Unfolding case studies typically present information in a sequential and progressive manner , allowing learners to actively engage with the evolving scenario and make decisions based on the information provided.

As the case study progresses, new information and challenges may arise, requiring learners to adapt their approaches and strategies. Unfolding case studies are often used to promote critical thinking skills, clinical reasoning, and problem-solving abilities in professional and clinical settings.

2. Standalone or Descriptive Case Study

A descriptive case study, also known as a standalone case study, on the other hand, is a self-contained, static scenario that provides a comprehensive overview of a specific issue, problem, or situation. 

It typically includes a detailed description of the case, relevant background information, and relevant data or facts for analysis. Descriptive case studies do not evolve over time and are presented in their entirety upfront , without any new information or challenges being introduced during the learning process. Learners are expected to analyze the given information and apply their critical thinking skills and knowledge to make decisions or recommendations based on the case study. 

This case study type is commonly used in academic settings for teaching and learning purposes, as it allows learners to apply theoretical concepts to real-world situations and develop problem-solving skills.

3. Exploratory Case Study

An exploratory case study is like the unfolding case study type, used when the researcher wants to investigate a new or understudied area. It involves conducting preliminary research to gather information and generate hypotheses or research questions about the case. Exploratory case studies are often used to identify potential variables, factors, or relationships that can be further investigated in future research.

4. Explanatory Case Study

An explanatory case study aims to understand the cause-and-effect relationships between variables or factors in a particular case. It involves investigating the underlying reasons or mechanisms that explain why certain events or outcomes occurred. Explanatory case studies are often used to test hypotheses or theories and establish causal relationships.

5. Instrumental Case Study

In an instrumental case study, the researcher selects a case that is considered typical or representative of a larger population or phenomenon . 

The instrumental case study purpose is not to understand the case itself but to use it as a means to gain insights into a broader phenomenon. Instrumental case studies are often used to generalize findings to a larger population or to support the validity of a theory or model.

6. Intrinsic Case Study

In an intrinsic case study, the case itself is of particular interest, and the researcher aims to understand the unique characteristics, behaviors, or experiences of the case. 

The focus of an intrinsic case study is not on generalizing findings to a larger population, but on gaining an in-depth understanding of the case itself . Intrinsic case studies are often used in qualitative research to explore complex and unique phenomena.

7. Comparative Case Study

A comparative case study involves comparing two or more cases to identify similarities and differences between them. It aims to understand the variations in outcomes, behaviors, or characteristics among cases and identify factors or variables that may explain the differences. 

Comparative case studies are often used to analyze multiple cases in a specific context , such as different organizations, countries, or time periods.

8. Longitudinal Case Study

A longitudinal case study involves studying a case over an extended period of time to observe changes, developments, or trends over time. It requires collecting data at multiple time points to analyze how the case evolves or changes over time. 

You can often see examples of case studies of this type in investigating processes, patterns, or trends that occur over time, such as organizational changes, social developments, or individual behaviors.

9. Multiple Case Study

Here is another common case study type. A multiple case study, also known as a collective case study, involves studying multiple cases within a single research project . 

The cases may be similar or different, and they are analyzed collectively to identify patterns, trends, or commonalities among them . Multiple case studies are often used to compare and contrast cases, validate findings across cases, or provide a broader understanding of a phenomenon by examining it from multiple perspectives.

10. Embedded Case Study

An embedded case study involves studying a specific case within a larger context or setting. The focus is on understanding the dynamics, interactions, and relationships between the case and its broader environment. Embedded case studies are often used to investigate how a case is influenced by its context or how it influences the context in which it is embedded.

11. Critical Case Study

A critical case study involves studying an extreme or unique case that challenges or confirms existing theories, assumptions, or beliefs . The purpose is to provide a critical examination of a particular phenomenon or challenge existing knowledge. This case study type is often used to explore rare or unusual cases that can shed new light on a topic or challenge established theories.

12. Historical Case Study

A historical case study involves studying a past event, era, or phenomenon to understand its historical context, significance, and implications. It often involves case analysis of historical documents, records, and artifacts to reconstruct the past and draw insights from historical events. 

Historical case studies are often used in fields such as history, archaeology, and cultural studies to explore the past and its relevance to the present.

13. Ethnographic Case Study

An ethnographic case study involves conducting in-depth observations and analysis of a particular culture, group, or community to understand their customs, beliefs, behaviors, and social dynamics. 

It often involves living among the participants and immersing oneself in their culture or community to gain a deep understanding of their way of life. Ethnographic case studies are often used in anthropology, sociology, and cultural studies to explore and describe different cultures and social groups.

14. Problem-oriented Case Study

Here is the last case study type on our list. A problem-oriented case study involves studying a specific problem or challenge in depth, with the goal of understanding its causes, effects, and possible solutions. 

The case study may involve investigating real-world issues, such as environmental problems, social issues, or organizational challenges, and it often requires a multidisciplinary approach to problem-solving. 

This type of case study is often used in fields such as nursing, environmental science, public policy, or management to understand and address complex problems.

These are some common case study types, each with its own features. The choice of case study type depends on the research questions, objectives, and context of the study. Researchers need to carefully understand the case study definition of different types and examine different case study examples to carefully choose the most appropriate types of case studies for their research design.

Benefits of using case studies in nursing education

There are different case study types, each offering so many benefits to students and researchers of all fields. The use of case studies, in nursing education offers several benefits as well. Here are some of the most significant benefits:

1. Real-world application of nursing knowledge :

Case studies provide students with the opportunity to apply their theoretical knowledge to real-world scenarios. This helps them understand how nursing concepts and principles are applied in clinical settings, preparing them for their future nursing practice. Case studies allow students to see the practical implications of their learning, helping them bridge the gap between theory and practice.

2. Development of clinical reasoning skills:

Case studies require students to analyze complex patient scenarios, interpret data, and make clinical judgments. This helps them develop critical thinking and clinical reasoning skills, which are essential for providing safe and effective patient care. Through case studies, students learn to collect and analyze data, identify relevant information, and develop appropriate nursing interventions.

3. Enhancement of decision-making abilities:

Case studies challenge students to make decisions based on limited information, similar to what they will encounter in real clinical situations. This helps them develop their decision-making abilities, learn to prioritize patient needs, and make sound nursing judgments. Case studies also expose students to ethical dilemmas, helping them develop ethical decision-making skills and understand the ethical implications of their actions.

4. Promotion of collaborative learning:

Case studies encourage collaboration among nursing students, allowing them to work together in teams to analyze and solve complex patient problems. This promotes active engagement, discussion, and exchange of ideas, leading to enhanced learning. Through collaborative learning, students also develop communication and teamwork skills, which are vital for effective nursing practice in interdisciplinary healthcare settings.

In summary, using case studies in nursing education offers numerous benefits, which contribute to the overall preparation of nursing students for their future roles as competent and compassionate healthcare professionals.

Challenges and tips for using case studies in nursing education

Case studies are widely used in nursing education to promote critical thinking, clinical reasoning, and problem-solving skills among nursing students. However, their effective integration into nursing curricula can present challenges and require careful consideration. Let’s check some challenges and tips to effectively utilize different case study types and get prepared for real-world clinical practice.

Lack of real-world context

To ensure that case studies are realistic and relevant to real-world nursing practice, consider using cases based on actual patient scenarios or incorporating authentic clinical experiences. You can also involve practicing nurses or other healthcare professionals as guest speakers or mentors to provide real-world insights.

Engaging students

To keep students engaged and actively participating in the learning process, consider using interactive and student-centered approaches such as problem-based learning, role-playing, or small group discussions. Incorporate multimedia, visual aids, and other interactive tools to make case studies more dynamic and stimulating.

Time management

To overcome challenges in finding adequate time to incorporate case studies, carefully plan and prioritize the use of case studies within the nursing curriculum. You can select relevant and impactful case studies that align with the learning outcomes and eliminate redundant content. Also, consider integrating case studies across different courses or using them as an ongoing thread throughout the nursing program. Smart’n is a great source, full of different case study types to help nursing students pass their NCLEX exam. Start your membership now and get access to more than 2,500 practice questions and 60+ hours of NGN NCLEX-style nursing case studies.

Assessment and evaluation

Assessing student learning from case studies can be complex. Consider using a rubric that includes criteria for evaluating not only knowledge but also critical thinking, clinical reasoning, and decision-making skills. Provide clear guidelines and expectations for students, and use formative and summative assessments to provide timely feedback for improvement.

Ethical considerations

To address ethical dilemmas presented in case studies, incorporate discussions on ethical reasoning and decision-making skills into the nursing curriculum. Provide opportunities for students to reflect on ethical issues and engage in ethical discussions with peers and faculty. Encourage students to consider diverse perspectives and apply ethical principles in complex clinical situations.

Multicultural sensitivity

To promote cultural competence, use case study research examples that reflect diverse cultural perspectives and patient populations. Incorporate discussions on cultural awareness, sensitivity, and humility into the case study activities. Encourage students to reflect on their own cultural biases and engage in respectful communication with patients from diverse backgrounds.

Interdisciplinary integration

To promote interdisciplinary integration and collaboration, use case studies that require students to work collaboratively with peers from different healthcare disciplines. Foster an inclusive and collaborative learning environment where students can learn from each other's expertise and perspectives. Incorporate opportunities for interdisciplinary discussions, group projects, or simulations.

Technology and resources

Take advantage of advancements in technology to enhance case study learning. Use digital tools, online resources, and simulation software to create immersive and interactive case study experiences. Provide training and support to both faculty and students to effectively use technology in case study activities.

Faculty development

Provide professional development opportunities for faculty to enhance their knowledge and skills in designing and implementing effective case studies. Offer workshops, seminars, or mentoring programs to help faculty create engaging and relevant sample case study activities.

Collaboration and communication

Use case studies as opportunities to develop teamwork, collaboration, and communication skills among nursing students. Assign students to work in pairs or small groups to analyze and discuss case studies collaboratively. Provide feedback on their teamwork and communication skills and encourage reflection on their collaborative experiences.

By addressing these subheadings, nursing educators can effectively navigate the challenges and leverage the tips to create meaningful and engaging different case study types for nursing students, facilitating their critical thinking, clinical reasoning, ethical decision-making, and interprofessional collaboration skills development, ultimately preparing them for real-world nursing jobs .

In conclusion, understanding the different case study types in 2023 is essential for leveraging their benefits in research and practice. Case studies are powerful tools that may evolve with technology and societal changes. However, conducting high-quality case studies requires careful planning, ethical considerations, and rigorous analysis. By utilizing case studies effectively, you can gain insights, inform decisions, and contribute to positive changes. Staying updated with emerging trends and best practices is crucial as you continue to utilize case studies in your respective fields.

1. What are the various types of case studies?

2. What is the most important part of a case study?

The most important part of a case study is the analysis and discussion of the findings, where you interpret the data, draw conclusions, and provide recommendations for future research or actions.

5 Nursing Case Study Examples + Answer Guide

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A mixed methods study using case studies prepared by nursing students as a clinical practice evaluation tool

Ana maría palmar‐santos.

1 Nursing Department, Faculty of Medicine, Autonomous University of Madrid, Madrid Spain

2 Member of the Nursing and Health Care Research Group of the Health Research Institute “Puerta de Hierro‐Segovia de Arana” (IDIPHISA), Majadahonda Spain

Cristina Oter‐Quintana

Ricardo olmos.

3 Social Psychology and Methodology Department, Faculty of Psychology, Autonomous University of Madrid, Madrid Spain

Azucena Pedraz‐Marcos

4 Health Care Research Unit, Institute of Health Carlos III; Nursing Department, Faculty of Medicine, Autonomous University of Madrid, Spain

Juana Robledo‐Martin

5 Member of the Gregorio Marañon Health Research Institute, IiSGM, Madrid Spain

Associated Data

Data available on request from the authors: The data that support the findings of this study are available from the corresponding author upon reasonable request.

To identify the presence of variability in the evaluation of case studies prepared by nursing students during their primary care rotations based on the existing evaluation rubric. To explore the difficulties experienced by link lecturers and students in preparing and evaluating case studies.

A mixed methods study.

The scores for the rubric items and the final grades for the case studies were collected from a sample of 132 cases. Qualitative information was collected by conducting open‐ended interviews with lecturers and a focus group session with students.

Statistically significant differences were identified between the lecturers' mean final grades [ F (5.136) = 3.984, p  = 0.002] and a variety of items in the evaluation rubric ( p  < 0.05). In addition, effect sizes [ η 2 (≈0.14)] of considerable magnitude were found.

Two themes emerged from the qualitative data: (1). the challenge of preparing the case studies and (2). the variable nature of the evaluations.

1. INTRODUCTION

Clinical training of nursing students is an essential part of the nursing degree curriculum. In the European context, this training is determined by a European Union directive and accounts for ‘at least one half of the minimum duration of the training’. The same directive states that ‘this training shall take place in hospitals and other health institutions and the community, under the responsibility of nursing teachers, in cooperation with and assisted by other qualified nurses’ (Directive 2005/36/EC of the European Parliament,  2005 ). Evaluating skills in a real‐life environment with a multitude of different professionals accompanying the students' learning process poses a challenge for institutions training future nursing professionals (Almalkawi et al.,  2018 ; Pramila‐Savukoski et al.,  2020 ).

Evaluating the acquisition of clinical practice skills is an ongoing task for clinical mentors that poses a constant challenge (Tuomikoski et al.,  2020 ). Although clinical mentors have improved the evaluation procedures and rubrics at their disposal (Stanley et al.,  2020 ), they continue to call for greater communication with universities (Bos et al.,  2015 ). At most institutions, this continuous evaluation process is supplemented by reflective evaluation in an attempt to measure not only performance but also the thought processes leading to that performance, that is, critical thinking and decision‐making. Various methods and tools have been used for this purpose, including portfolios (Buckley et al.,  2009 ), reflective journals (Hwang et al.,  2018 ), case scenarios and 360‐degree evaluations (González‐Gil et al., 2020 ) and performance checklist and assessment tests, like in the Objective Structured Clinical Examination (OSCE) (Sabzi et al.,  2018 ). These methods have all proven effective in evaluating nursing students' clinical practice and are considered not only evaluation tools but also learning tools (Driessen,  2017 ).

2. BACKGROUND

Case studies have been widely used in nursing theory training because they help students to build on the basic knowledge taught and to collect information and analyse it to make diagnoses and support interventions (O'Rourke & Zerwic,  2016 ). In addition, there is considerable research on the use of case studies in simulation settings, which are practical environments where students gain confidence before moving on to clinical practice (Wong & Kowitlawakul,  2020 ). Case studies have been included in OSCEs as part of the final evaluation of skills acquired through clinical practice (Kelly et al.,  2016 ) and as tools for learning critical thinking and decision‐making skills in healthcare institutions (Englund,  2020 ). At our university, the students study the nursing process and the standardised nursing languages (North American Nursing Diagnosis Classification (NANDA), Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC)) in the first year. In the second and third years, the students are asked to prepare a clinical case consisting in designing a care plan for a person or a family in their clinical practice unit. The students must develop the different phases of the nursing process: assessment, diagnosis, planning, implementation and evaluation of their care plan. They must use the standardised nursing languages too. To guide this process, the student is supervised by a link lecturer, who can be an academic lecturer (full lecturer) or a clinical lecturer (assistant lecturer), who combines their teaching work at the university with clinical activity. The grade obtained in the clinical case is part of the overall evaluation of the clinical practice module, which also includes other components such as being assessed by the clinical nurse responsible for mentoring them at the clinical placement and a self‐evaluation component. This kind of summative assessment with several tools used in direct patient care and simulated practice, which are marked using a multi‐level observational rubric, supplemented by self‐evaluation of clinical performance, is in line with the findings of Clemett and Raleigh ( 2021 ) in their systematic review.

Despite the wide use and positive outcomes gained from cases studies, students still feel that the evaluation of their clinical practice varies depending on the clinical nurse mentor, who decides what is relevant in ‘the real world’ and the link lecturer, who, despite being relatively invisible to students during their clinical practice, has a major influence on their final grade (Foster et al.,  2015 ; Helminen et al.,  2016 ).

3. THE STUDY

The aim of this study is twofold. On the one hand, to identify the presence of variability in the evaluation of case studies prepared by nursing students during their primary care rotations based on a module's existing evaluation rubric. On the other hand, to explore the difficulties experienced by link lecturers and students in preparing and evaluating case studies.

4.1. Design

A mixed methods design was used, analysing the scores given to the case studies during the evaluation and qualitative information on link lecturers' and students' assessments of the evaluation process.

4.2. Population and sample

The study was carried out during the 7‐week rotation of third‐year students on primary care clinical placements during the 2018–2019 academic year. The study population included 132 students, who prepared a case study during their rotation in primary care, and 6 link lecturers, who assessed their case studies. Each case study was evaluated by the link lecturer responsible for monitoring that student during the clinical practices in that period. During the 2018–2019 academic year, evaluation of the primary care case studies was undertaken by six link lecturers.

4.3. Data collection

Data were collected in the following ways: the scores awarded to the 132 case studies by the various link lecturers, a focus group session with the participating students and in‐depth interviews with the lecturers involved in their evaluation.

Data were collected on the following variables: the link lecturer responsible for evaluating each student, the final grade for each student's case and the grades awarded to each of the items in the evaluation rubric. This rubric (see Annex  1 ) is the tool usually used by link lecturers to correct clinical cases. This evaluation tool was developed by a group of nursing professors with extensive experience in the preparation of clinical cases but has not been subjected to a formal validation process.

Four of the six link lecturers were interviewed since two of the link lecturers had participated in the development of the research project and their participation in the interviews was not considered appropriate. Of the four link lecturers interviewed: one was an academic lecturer (full lecturer) and three were clinical lecturers (who combine clinical care with teaching). An interview script covering the following topics was used: experience in evaluating case studies; the influence of the aspects they value most and least on the grades they award; difficulties in using the rubric and recommendations for improvement (see Annex  2 ). The interviews lasted between 40 and 60 min and took place in a space chosen by each participant. They were audio‐recorded and then transcribed for analysis.

Students with the highest and lowest grades in the case study were invited to participate in a focus group session. To ensure the heterogeneity of the group, students evaluated by different link lecturers were represented. For the focus group session, a thematic script was created, addressing aspects relating to the preparation of students' case studies during their clinical placements and recommendations for improvement (see Annex  3 ). Five students participated in the focus group, which was led by a moderator accompanied by an observer who took notes during the development of the session. All students actively participated in the discussion. The focus group session lasted 90 min and was audio‐recorded and transcribed for subsequent analysis, after obtaining informed consent from all participants.

4.4. Data analysis

The data from the case study evaluation were statistically analysed to assess any differences between link lecturers in the final grade they awarded to each case study and the grades they awarded to each of the items in the evaluation rubric. To analyse the data, a between‐subjects one‐factor ANOVA model was used (one lecturer representing one factor) using the total score given by the lecturer (the sum of all the rubric items) and each rubric item separately as the dependent variable. This was used to assess whether the average scores differed. Pairwise comparisons of lecturers were performed to establish whether lecturers differed in the average scores awarded using Tukey's method (controlling for the type I error rate). The statistical significance threshold for all analyses was set at 0.05. In addition, the assumptions of normality and homoscedasticity were fulfilled for the dependent variables. Normality was assessed using the Kolmogorov–Smirnov test. The assumption of homoscedasticity was assessed using Levene's test. When the assumption of the equality of variances was not met, Welch's corrected F ‐statistic was used. The non‐parametric Kruskal–Wallis test was also used to analyse whether the results were sensitive to the statistical model. The data were analysed using SPSS (version 25) software from IBM.

The qualitative data from the interviews and focus group sessions were analysed thematically using Braun and Clarke method ( 2006 ). All authors read and underlined the interview and focus group transcripts to familiarise themselves with the data and to identify the first emerging codes. At a series of analytical meetings, the authors identified potential themes by clustering the codes and created a relationship map to refine and link the themes found. This refinement of the themes led to the final report, which included quotes from participants and analytical notes on each theme.

4.5. Ethical considerations

This study is part of a teaching innovation project entitled ‘Strategies for harmonising clinical practice evaluation standards’, approved by the Autonomous University of Madrid Teaching Innovation Ethical Committee, involving internal and external evaluators, with reference number M_015.18_INN.

All individuals involved in the study participated voluntarily, were informed about the study objectives and signed an informed consent form. Students were assured that their participation would have no impact on their grades. To this end, double anonymisation was carried out at the time of recruitment and during transcription.

A total of 132 case study evaluations were collected from 6 lecturers, with the number of cases evaluated by each lecturer ranging between 18 and 26 (see Table  1 ).

Means, standard deviations and number of students ( N ) per lecturer based on final grades and rubric items.

Table  2 shows the results comparing the means of the six lecturers. The results of the parametric ANOVA model and the non‐parametric Kruskal–Wallis model are also provided, with a sensitivity analysis performed in consideration of the fact that the assumptions required by the ANOVA are not always met. The results suggest that the two statistical models are robust and consistent with one another. In virtually all items of the rubric (in addition to the final grade), there are statistically significant differences in the mean grades awarded between the lecturers. The items in which significant differences were identified between the lecturers using both statistical models were information analysis, planning, follow‐up of the individual's progress and written communication. In the final assessment and literature review, differences were detected only in the non‐parametric test. Furthermore, in the final grade, the effect size measure, η 2 , exhibited a considerable magnitude according to Cohen's criteria ( 1988 , ps. 280–287), where 0.01, 0.07 and 0.14 are set as criteria for weak, moderate and strong effect sizes respectively. Table  2 shows that in four of the eight items evaluated, the effect size was high.

Significance of ANOVA tests based on final grades and rubric items.

Note: Bold values indicate the statistical significance of p < 0.05.

Pairwise comparisons between all lecturers were also assessed and one lecturer was found to differ significantly from two other lecturers ( p  < 0.05). Lecturer 6, in particular, awarded significantly higher averages than lecturers 1 and 4 (see Table  1 ). Finally, the six lecturers were grouped into two categories according to their job category (academic lecturer or clinical lecturer) in order to analyse whether academic and clinical lecturers used the rubric differently. The T ‐test for independent samples was used to compare the averages. The results showed no significant differences in any of the items analysed or in the total, except for written communication. In this item, the group of academic lecturers ( M  = 0.38, SD = 0.12) awarded significantly lower average scores than the group of clinical lecturers ( M  = 0.47, SD = 0.06): T (93) = 5.281, p  < 0.001.

Regarding the qualitative phase of the study, the thematic analysis of the discourses from the interviews with the link lecturers and the focus group with the students generated two core categories:

• The challenge of preparing the case study
• The variable nature of the evaluations

5.1. The challenge of preparing the case study

The link lecturers participating in the study viewed case studies as an opportunity to integrate theory and practice. However, they highlighted students' difficulties in incorporating theory into the case they are working on. They also pointed out that students tended to focus their attention on the physical problems of the people they care for. They stressed that a reductionist, superficial nursing assessment will not lead to a deep understanding of the social and emotional problems of the individual under their care.

The link lecturers participating in the study explained that the limitations of the case study were due, on the one hand, to the incorporation of the nursing process into the computer system, which simplifies the approach of a comprehensive vision of said process, and on the other hand, to the internalisation of care models that fail to take a holistic view of the individual by nursing students during their placements.

So, I think that this may be influencing a lot […] that they are influenced a lot by the computer systems, which, in some way, shape how you think, or your own mentalization. But, sometimes, what I am seeing is that there are students who do not go further. (E1)

(They are preparing) a case with a mentor, who almost always has a hospital background, who is not teaching them a holistic approach to patients. (E4)

During the focus group, the students stated that the clinical nurse mentors helped them in choosing a patient and support them in preparing their case. However, they pointed out that sometimes the clinical nurse mentors failed to fully understand the work they must carry out, even questioning the practicality of this type of exercise for their future professional practice.

I've even heard that. They [clinical nurse mentors] say “but this is a waste of time, you're never going to do this…” If the person who is above you, so to speak, comes to you and says: “don't do that, it's nonsense” or “it's no use”, they're not exactly going to be of much help. (FG)

In the focus group, the students identified the lack of precise, uniform instructions from all link lecturers as to the structure and basic contents of the case study as one of the main difficulties involved in the process. This prompts them to prioritise the creation of their own case study, ‘the model case study’, for which they resort to the following: 1. reviewing learning materials from previous modules in their academic training; 2. using available bibliographic resources; and 3. compiling case studies carried out by colleagues or by themselves that have already been corrected. The students expressed that they felt that some of the instructions provided by link lecturers were contradictory and wondered whether those instructions reflect personal inclinations rather than academic criteria.

The link lecturers who participated in the study also pointed to the lack of a precise, standardised structure and content as particularly problematic when it came to helping them guide the student in the development of the clinical case. They considered that the fact that the students could receive different indications from each link lecturer contributed to generating confusion among them.

Yes, I see the fact that you can have a tutor every year as an inconvenience, […]each tutor asks you really one thing. Maybe it's not worth it, even if it's well done, it's not worth it, because they wants… "No, I don't want this, I want you to develop this pattern more for me", "I don't like this, remove it" , and then, suddenly, the following year, or in the following practice, you get another one, and it's the other way around, they likes what you had done at the beginning better. (FG)

I really don't think the problem is that students aren't trying hard enough, it's that they're quite disoriented. We're giving them different instructions if you like. (E2)

During the focus group, the students complained that case studies were expected to meet certain requirements without considering the reality in which they carry out their clinical placements, such as requiring the case study to be carried out in a home environment or demanding that the care plan designed to be put into practice. This last point is also noted by the interviewed link lecturers.

The students and link lecturers mentioned that they sometimes resorted to ‘embellishing’ the real case study with fictitious content as a way of fulfilling the requirements, or to taking more simplistic approaches enabling them to obtain results in the short term.

I understand that the student may have difficulty understanding that we propose a care plan, and an evaluation, above all […], but the evaluation is very difficult, an evaluation in three weeks [the duration of the internship], in primary care. It is that sometimes not even in three weeks is a wound managed, nor is a therapeutic eating plan managed, nor is a grieving coping plan managed, nor do you manage… it is that practically very little. (E4)

But to comply with all the requirements, I think that I personally, in some cases, and I think other people too, end up having to make something up in the end. And just for that, for a good grade, when in reality it's not entirely true. (FG)

5.2. The variable nature of the evaluations

Despite the evaluation rubric, the students participating in the focus group perceived differences in the demands made by different link lecturers. They believed that there was variability in the grading of the cases that was intrinsic to the lecturers themselves and did not reflect the quality of their work. Students felt evaluation discrepancies as ‘unfair’, indicating the need to establish common, precise standards in line with the level of skills to be acquired.

Really, I've had classmates whose cases would have been graded a 9 (by the mentors that I've had), but if I'd handed over my case to their mentor, my case would've got a 5 instead of an 8. That's unacceptable. (FG)

Link lecturers participating in the study viewed the rubric as an instrument that could sometimes ‘constrict’ the evaluation process by requiring a separate grade for each item, overlooking the fact that the final grade was based on the overall quality of the student's work rather than on the sum of the individual parts of the rubric.

The rubric (…) was a bit constricting, I mean, it didn't allow me (…) to be consistent with my impressions after evaluating the student and after adjusting the items to the main dimensions of the rubric. (E2)

The link lecturers reported that the tool displays a central tendency in grades, causing difficulties in the evaluation of the case studies when it comes to minimum and maximum grades. They also believed that there were items in the rubric that needed to be changed and that, in order to reduce variability, certain adjectives should be more specific, for example, ‘complete’, ‘consistent’ and ‘appropriate’. They argued that the fact that not all link lecturers were experts in nursing methodology, and evaluation strategies resulted in the rubric not being used properly or in each link lecturer using it ‘in their own way’ in the evaluation process.

Each of us evaluators evaluate in a different way, from a different perspective. I think we try to do it in the same way, but we end up doing it in a different way. We all have different professional experience, or different academic experience (…). Each one of us might add a different nuance to it. (E3)

Link lecturers also mentioned that students failed to take on board their recommendations for improvement, partly due to discrepancies as to what was considered relevant in each case study.

6. DISCUSSION

The results of our study suggest that, despite the availability of a rubric for evaluating case studies, there are statistically significant differences in the mean grades given by the sample of lecturers. This echoes the findings of previous studies suggesting that, although the availability of rubrics reduces between‐lecturer variability, rubrics fail to eliminate all differences attributable to lecturer idiosyncrasies (Bearman & Ajjawi,  2021 ).

The benefits of using rubrics include the possibility of directing students' efforts towards core aspects of learning. When teachers' expectations are made explicit to students, they are more likely to be met (Panadero & Jonsson,  2013 ). No mention was made of the utility of the rubric as a ‘guide’ for the learning process by the participating students. Rubrics have been justified in academia as a way of ensuring transparency in evaluation. However, without student participation in their development and use, they provide little support for student learning and evaluation (Bearman & Ajjawi,  2021 ; Kilgour et al.,  2020 ).

Case studies have been incorporated into nursing degrees as a tool for learning to apply critical reasoning to nursing diagnoses, outcomes and interventions. Most of the experiences reported refer to the use of case studies designed by teachers and incorporated into clinical practice by students (Popil,  2011 ) or in comparison with other methods, such as simulated patients (Karadag et al.,  2016 ). Several studies analysing the development of care plans by students based on real patients highlight the importance of nursing taxonomies (NANDA, NIC and NOC) in incorporating evaluation criteria into the case study objectives and improving nursing interventions of a less technical nature (Palese et al.,  2009 ). However, as in our study, students report that nurses working at the healthcare facilities where they are carrying out their clinical placements make marginal use of the nursing methodology. Link lecturers also highlight the biological approach occasionally permeating case studies. Echoing these findings, Türk et al. ( 2013 ) explain the significant presence of physiological diagnoses in care plans made by students based on Benner's Novice to Expert Model. To these authors, the fact that ‘novices’ tend to identify problems of a biological nature results from their limited capacity to understand the situation of the individual being cared for as a whole, to apply critical thinking and to take a holistic approach. It is expected that novices will develop these skills with experience as they become experts. At the same time, identification of psychosocial problems requires a level of communication skill that is not available to students in the early stages of their training.

In our study, students and link lecturers both said that the case study script lacked clarity and specificity. In this sense, students and mentors said that having a follow‐up structure, with specific tasks relating to the preparation of the case study, could be a viable avenue for improvement. This is consistent with a study by Brugnolli et al. ( 2011 ), where students reported that gradual, experiential and guided learning was the most appropriate mentoring tool for their learning process. Palese et al. ( 2008 ) found that students who had received more intensive mentoring in the development of critical thinking skills made fewer errors in the initial formulation of hypotheses in case studies.

Furthermore, in a review by Flott and Linden ( 2016 ), the interaction between mentors and students in clinical practice learning, along with the physical space where learning takes place and the organisational culture, were considered essential components of the clinical learning environment (CLE). Student ‘exposure’ to clinical practice conditions echoes existing findings in the literature regarding the gap between theory and practice. Solutions include greater involvement of link lecturers in the acquisition of clinical skills and experimentation with the realities of practice, as well as a greater presence of clinical mentors in theory training, allowing them to build more meaningful bonds with students (Masterson et al.,  2020 ). This is especially relevant in primary care, where the gap between the hospital setting and the academic environment has been highlighted by various authors (Peters et al.,  2015 ; Valaitis et al.,  2020 ).

Finally, in our study, students and link lecturers feel that they are expected to produce work in accordance with requirements that are far removed from the reality of care. The theory taught at educational institutions aims to provide general practice guidelines that may be meaningless when they materialise in the dynamic, changing world of clinical care, causing feelings of frustration and futility (Salifu et al.,  2019 ).

6.1. Limitations

This study has some limitations. First, for the exploration of the difficulties expressed by the students, only one focus group was conducted with nursing students. This affects the possibility that different student profiles could be represented within the group. Nevertheless, an attempt was made to ensure a certain heterogeneity of the attendees in terms of experiential characteristics considered relevant to the phenomenon under study, such as grades obtained in the clinical case and specific primary health centre of clinical practice. Another limitation of the study is the number of cases evaluated by each teacher, which made it necessary to use non‐parametric tests. It should also be noted that the participants were recruited from a single university institution. This limits transferability to other academic contexts. On the other hand, it should be noted that the rubric used in the elaboration of the clinical cases was developed by a group of expert teachers in this teaching methodology, and has not been subjected to a formal validation process. This prevents knowing the reliability and validity of the instrument to evaluate the clinical cases prepared by the student.

7. CONCLUSION

The use of case studies based on real individuals cared for by students during their practical training as an evaluation tool poses several challenges. Students and link lecturers point out the complexity of the process of preparing a case study and consider that having uniform, clear criteria in line with the reality of clinical settings is essential to facilitate this task. The use of case studies as an evaluation tool requires the availability of rubrics that concisely reflect lecturers' expectations as to the work to be carried out, which can be used by students as a roadmap in preparing their case study.

CONFLICT OF INTEREST STATEMENT

Acknowledgements.

This study is part of a teaching innovation project entitled ‘Strategies for harmonising clinical practice evaluation standards’, approved by the Autonomous University of Madrid Teaching Innovation Ethical Committee, involving internal and external evaluators, with reference number M_015.18_INN. We would like to thank the students and link lecturers for their collaboration in the study.

Rubric for evaluating case studies.

Interview guide for link lecturers., focus group guide..

Palmar‐Santos, A. M. , Oter‐Quintana, C. , Olmos, R. , Pedraz‐Marcos, A. , & Robledo‐Martin, J. (2023). A mixed methods study using case studies prepared by nursing students as a clinical practice evaluation tool . Nursing Open , 10 , 6592–6601. 10.1002/nop2.1919 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

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