1. EVALUATION PURPOSE PROJECT DESCRIPTION IMPACT Critical Analysis in Nursing Case Management Critical Analysis in Nursing Case Management Karen Black, MSN, RN; Diane Chlebowy, PhD, RN; Vicki Hines-Martin, PhD, RN, FAAN; Patricia Martin, MSN, RN; Heather Mitchell, MSN, RN; Karen Singleton, MSN, RN; Mary Patricia Wall, PhD, RN 1 University of Louisville School of Nursing TIMELINE Each year approximately 160 students on the Louisville campus and 20 students at the Owensboro extension site participate in NURS 371 Adult Health Nursing Planned growth in Owensboro will increase impact to 40 students per year at that site Project is completed in the second semester of the junior year; student have an additional full year to apply their critical thinking skills to their undergraduate course work Recorded case management interview, although developed for use in the pre-licensure program, is also used in the RN-BSN program As program graduates enter professional practice, enhanced critical thinking skills will lead to improved patient outcomes 2005 – University leadership began to develop the university-wide quality enhancement plan (QEP) to improve student learning Spring 2007 – Ideas to Action: Using Critical Thinking to Foster Student Learning and Community Engagement (i2a) - Paul-Elder Critical Thinking Framework adopted - Implementation to start with general education courses, continue in undergraduate major courses AY 2007-2008 – Upper division curriculum revision - Development of new courses - Revision of established courses (addition of case management content to Adult Health Nursing - Realignment of courses in the curriculum Fall 2008 – SUN Grant Team convened Spring 2009 and ongoing – Case management content implemented; written case study and supplemental scenarios used as basis for group projects Summer 2009 – Case management interview recorded Fall 2009 -- Recorded case management interview and written supplemental scenarios used as basis for group projects The purpose of this innovative, multi-faceted project is to enhance development of critical thinking skills in students enrolled in the upper division, pre- licensure program at the School of Nursing. The components of the Paul-Elder Critical Thinking Framework are incorporated into the teaching of case management in NURS 371, Adult Health Nursing. Students (divided by clinical groups) complete a group project addressing client needs. Evaluation of the assignment Critical thinking assessment rubric was adapted for use as project grading rubric; reflects specific terminology for case management Student evaluation of the project led to revision of the course schedule to put case management content later in the semester (to close the time gap between didactic instruction and project completion) Faculty teaching in the final semester of the BSN curriculum report improved critical thinking skills after implementation of this project Development of the case Complex physical and mental health conditions Socioeconomic challenges representative of the adult population in our region Recorded client case management interview Standardized patient Paris Simulation Center Imaging, Television & New Media Services Creation of supplemental written scenarios describing sequelae of client’s chronic health problems Subtle signs and symptoms of some sequelae are threaded through the interview Completion of the project requires students to draw on content from both previous course work (Pharmacology, Pathophysiology, Community Health, Heath Assessment, Therapeutic Nursing Interventions) and concurrent course work (Psychiatric Mental Health Nursing and Nursing Research for Evidence-Based Practice) Clinical faculty facilitate discussion of the case in clinical post-conference REFERENCES American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author. Retrieved May 3, 2011 from http://www.aacn.nche.edu/Education/pdf/BaccEssentials08.pdf. http://www.aacn.nche.edu/Education/pdf/BaccEssentials08.pdf Dolmans, D.H.M., DeGrave, W., Wolfhagen, I.H.P., & van der Vleuten, C.P.M. (2005). Problem-based learning: Future challenges for educational practice and research. Medical Education 2005, 39, 732-741. Kuric, J.L., & White, A.H. (2005). Case management curriculum in nursing education. Lippincott’s Case Management, 10(2), 102-107. Paul, R., & Elder, L. (2008). The miniature guide to critical thinking: Concepts and tools (5 th ed.). Dillon Beach, CA: The Foundation for Critical Thinking. Williams, B. (2001). Developing critical reflection for professional practice through problem-based learning. Journal of Advanced Nursing, 34(1), 27-34. Wood, D.F. (2003). ABC of learning and teaching in medicine: Problem-based learning. British Medical Journal, 326, 328- 330. ACKNOWLEDGEMENTS This project was supported by an i2a Supporting Undergraduate iNnovation (SUN) Grant 1 Authors’ names are listed in alphabetical order