Implementation of case studies in undergraduate didactic nursing courses: a qualitative study

BACKGROUND: The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students’ levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. METHODS: Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. RESULTS: The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). CONCLUSION: Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience

Commentary: Are Emergency Nurses SBIRT-Ready to Assist Vets and other Chronic Non-Cancer Pain Patients?

Emergency Department (ED) Registered Nurses (RNs) spend significant time treating chronic pain patients. Chronic pain affects up to 100 million Americans (Simon, 2012) and as much as 30% of all opioid pain medications in the United States (US) are prescribed from EDs (Todd, Cowan, Kelly, & Homel, 2010). Abuse of these prescription drugs is America’s fastest growing drug problem (Paulozzi, Jones, Mack, & Rudd, 2011). For veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND), chronic non-cancer pain is the most frequent diagnosis (Higgins et al., 2014), and it is closely associated addiction disease. RNs often use the stigmatizing label “drug-seeking” for certain key patient behaviors and may lack confidence to constructively intervene with these patients (McCaffery, Grimm, Pasero, Ferrell, & Uman, 2005). Screening Brief Intervention and Referral to Treatment (SBIRT) is a successful evidence-based, non-stigmatizing approach for managing patients with substance abuse issues (Agerwala & McCance-Katz, 2012) that can be conducted by nurses (Finnell, 2012). In this commentary article, we advocate for RN-led SBIRT in both veteran and civilian EDs. Based on results of our SBIRT-readiness survey of ED nurses at one large urban Northern California ED, we found the need for increased RN training on addiction disease with 61% of nurses admitting to using stigmatizing terminology towards these patients, and 53.1% percent stating they given repeat chronic pain patients lower priority

Commentary: Are Emergency Nurses SBIRT-Ready to Assist Vets and other Chronic Non-Cancer Pain Patients?

Emergency Department (ED) Registered Nurses (RNs) spend significant time treating chronic pain patients. Chronic pain affects up to 100 million Americans (Simon, 2012) and as much as 30% of all opioid pain medications in the United States (US) are prescribed from EDs (Todd, Cowan, Kelly, & Homel, 2010). Abuse of these prescription drugs is America’s fastest growing drug problem (Paulozzi, Jones, Mack, & Rudd, 2011). For veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND), chronic non-cancer pain is the most frequent diagnosis (Higgins et al., 2014), and it is closely associated addiction disease. RNs often use the stigmatizing label “drug-seeking” for certain key patient behaviors and may lack confidence to constructively intervene with these patients (McCaffery, Grimm, Pasero, Ferrell, & Uman, 2005). Screening Brief Intervention and Referral to Treatment (SBIRT) is a successful evidence-based, non-stigmatizing approach for managing patients with substance abuse issues (Agerwala & McCance-Katz, 2012) that can be conducted by nurses (Finnell, 2012). In this commentary article, we advocate for RN-led SBIRT in both veteran and civilian EDs. Based on results of our SBIRT-readiness survey of ED nurses at one large urban Northern California ED, we found the need for increased RN training on addiction disease with 61% of nurses admitting to using stigmatizing terminology towards these patients, and 53.1% percent stating they given repeat chronic pain patients lower priority