Clinical judgment is required to interpret the complex clinical situations found in current nursing practice (Tanner, 2006).
Lack of clinical judgment poses a risk to patients and can lead to negative patient outcomes.
(Knowledge) The student will describe the value of seeing health care situations through the patient’s eyes. The student will explain how clinical forethought is used to predict potential complications.
(Skills and Attitudes) Strategy Overview Unfolding case studies as a teaching strategy are ideal for novice learners in a pre-licensure nursing program.
Stage I Unfolding Case Study: Jean is an 88-year-old widow with four grown sons and numerous grandchildren.
She was living alone, caring for her own home for the past 35 years since her husband died.Clinical forethought can be introduced using unfolding case studies that encourage students to make a patient’s values, preferences and beliefs an important factor in their care.Nurse Educators are challenged with writing case studies that require students to see how clinical judgment could facilitate safety and patient-centered care.The instructor may choose to add course content during the time between each stage.Students cannot change their answers to previous stages.After students’ complete parts of the unfolding case study, they have an opportunity to reflect on the impact nurses have on their patients.Reflecting backward on the patient trajectory highlights what clinical forethought might have predicted.She was not concerned about the cost of seeing a doctor as she had excellent health care coverage under her deceased husband’s insurance.Jean was taken to the clinic and underwent lab tests and a CT scan, for which her doctor concluded she had ovarian cancer.As students encounter additional case studies throughout the semester, they begin to recognize patient-centered care as an integral part of patient care.Successful case studies provide sequential snapshots of the patient’s illness trajectory in the context of their lived experience.