NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning

NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment paper

NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment paper

Week 5: Development of an Evolving Case Study for Clinical or Classroom Setting

Purpose: This assignment provides the opportunity for the student to develop an evolving case study that would be useful as part of a small group activity in the clinical setting. It should not be written for a simulation learning activity. Using a concept presented in Weeks 2, 3, and 4, the student incorporates the elements expected of an evolving case study as well as includes pathophysiology, pharmacology, and physical assessment.

Course Outcomes

Through this assignment, the student will demonstrate the ability to do the following.

CO 1: Synthesize educational theories and knowledge from nursing and health sciences to foster experiential learning strategies and positive healthcare outcomes. (PO 1)

CO 2: Integrate pathophysiologic mechanisms with advanced assessment and pharmacologic concepts to maximize holistic, person-centered outcomes in complex disease states. (POs 1, 2, 3, 5)

CO 3: Integrate caring and person-centered concepts within diverse practice settings to maximize healthcare and learner outcomes. (PO 2)

CO 4: Employ a spirit of inquiry to foster professional development to facilitate the achievement of educational outcomes. (PO 3)

CO 6: Promote positive health and education outcomes by fostering the use of evidence-based and interprofessional strategies in experiential settings. (PO 5)

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Description of the Assignment

This assignment requires the student to develop an evolving case study that would be useful in either the clinical or classroom setting. It is not written for a simulation learning activity. The evolving case study must focus on a concept assigned from Giddens (2017) required textbook during Weeks 2, 3, and 4. In addition, the student must identify Socratic questions related to the pathophysiology, pharmacology, and health assessment used in the evolving case study. The study demonstrates the following.

  • Initial presentation (i.e., Stage 1) regarding the health status of the patient
  • Progress to Stage 2 with the occurrence of event that requires the identification of the appropriate response from learners
  • Ends with Stage 3 that is based upon the action identified by learners

The development of Socratic questions useful for debriefing following completion of the evolving case study are required.

Criteria for Content

Overview of the assignment

The evolving case study starts with background information that provides an overview; description of the patient; and the report provided to the participants using the format of situation, background, assessment, and recommendation (SBAR). Progressing over time with a fictional patient’s health status changing, this evolving case study presents the situation in three stages. Stage 1 is the initial stage where the patient’s healthcare situation is presented, followed by a trigger, which represents a health challenge or worsening of health. Participants identify the appropriate interventions to maintain a stable health status as well as recognize via assessment the deterioration in the fictional patient’s health. Stage 2 continues the presentation of the patient with progressive decline in health status requiring the identification of appropriate actions by participants. A trigger for Stage 3 will be identified based on the stabilization of the fictional patient. An outcome of the evolving case study is suggested as part of Stage 3. Preparation for the debriefing of participants is considered by the identification of Socratic questions.

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Required content for the assignment

Part 1:  Overview of evolving case study

  • Description of the evolving case study
    • Identify the purpose
    • Identify the type of learner that case study is developed for
    • Identify the concept to be demonstrated by the fictional patient
  • Description of the setting

Part 2:  Description of fictional patient by identifying each of the following elements

  • Name
  • Gender/age/weight/height
  • Allergies
  • Past medical history
  • History of present illness
  • Social history
  • Primary medical diagnosis
  • Surgeries and/or procedures with dates

Part 3:  Develop the report that learners receive prior to the start of the evolving case study using SBAR

  • Time of report
  • Identify person providing the report
  • Identify each of the following for SBAR
    • Situation
    • Background
    • Assessment
      • Recommendation

Part 4:  Stage 1: Start of the healthcare situation with required elements

  • Evolving case study information to be presented to the learner
  • One action that a learner SHOULD identify that is APPROPRIATE for the situation
  • Socratic question for each area to ask learner at end of Stage 1
  • Pathophysiology
  • Physical assessment
  • Pharmacology
  • Trigger for Stage 2

Part 5:  Stage 2: Deterioration in fictional patient’s health status with required elements

  • Evolving case study information to be presented to the learner
  • One action that a learner SHOULD identify that is APPROPRIATE for the situation
  • Socratic question for each area to ask learner at end of Stage 2
  • Pathophysiology
  • Physical assessment
  • Pharmacology
  • Trigger for Stage 3

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Part 6:  Stage 3: Stabilization of fictional patient with required elements

  • Evolving case study information to be presented to the learner
  • One action that a learner SHOULD identify that is APPROPRIATE for the situation
  • Socratic question for each area to ask learner at end of Stage 3
  • Pathophysiology
  • Physical assessment
  • Pharmacology
  • Expected ending for case study if learner’s actions are APPROPRIATE for the situation

Part 7:  Debriefing

  • Socratic Question 1 (focusing on overall Stage 1)
  • Socratic Question 2 (focusing on overall Stage 2)
  • Socratic Question 3 (focusing on overall Stage 3)
  • Socratic Question 4 (focusing on the overall case

Criteria for Format and Special Instructions

  1. The assignment should not exceed 8 pages in length excluding the title page and reference page.
  2. The use of the template for Week 5 Assignment is required.
  3. Expectations regarding graduate level include all the following elements.
    1. Correct spelling, grammar, and punctuation
    2. Exceptional writing style with clarity, flow, and organization of information throughout the paper
    3. Congruence with APA mechanics of style
    4. APA format for citing and referencing sources

NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment paper

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Directions and Assignment Criteria

Assignment Criteria Points % Description
Overview of evolving case study 10 The required content includes:

·        Description of the evolving case study

o   Identify the purpose

o   Identify the type of learner that case study is developed for

o   Identify the concept to be demonstrated by the fictional patient

·        Description of the setting
Description of fictional patient by identifying each of the following elements 10 The required content includes:

·        Name

·        Gender/age/weight/height

·        Allergies

·        Past medical history

·        History of present illness

·        Social history

·        Primary medical diagnosis

·        Surgeries and/or procedures with dates
Develop the report that learners receive prior to start of the evolving case study using SBAR

 

 20 The required content includes:

·        Time of report

·        Identify person providing the report

·        Identify each of the following for SBAR

o   Situation

o   Background

o   Assessment

o   Recommendation
Stage 1: Start of the healthcare situation with required elements 35 The required content includes:

·        Evolving case study information to be presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 1

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 2
Stage 2: Deterioration in fictional patient’s health status with required elements 35 The required content includes:

·        Evolving case study information to be presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 2

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 3
Stage 3: Stabilization of fictional patient with required elements 35 The required content includes:

·        Evolving case study information to be presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 3

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Expected ending for case study if learner’s actions are APPROPRIATE for the situation
Debriefing

 

 25 The required content includes:

·        Socratic Question 1 (focusing on overall Stage 1)

·        Socratic Question 2 (focusing on overall Stage 2)

·        Socratic Question 3 (focusing on overall Stage 3)

·        Socratic Question 4 (focusing on the overall case study)
Graduate-level writing style

 

 10 The required content includes:

·        Correct spelling, grammar, and punctuation

·        Exceptional writing style with clarity, flow, and organization of information throughout the paper

·        Congruence with APA mechanics of style

·        APA format for citing and referencing sources
Total 180 100%

Grading Rubric ONLINE NURSING PAPER WRITING HELP

 

Assignment Criteria

 Exceptional

Outstanding or highest level of performance

 Exceeds

Very good or high level of performance

 Meets

Competent or satisfactory level of performance

 Needs Improvement

Poor or failing level of performance

 Unsatisfactory

Unsatisfactory level of performance
Content : NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment paper

Possible Points =  195 Points
Overview of evolving case study  10 Points 9 Points 8 Points 4 Points 0 Points
Presentation of information was exceptional and included all the following elements:

·        Description of the evolving case study including:

o   Identify the purpose

o   Identify type of learner

o   Identify the concept to be demonstrated by the fictional patient

·        Description of the setting

 Presentation of information was good and included all the following elements but was superficial in places:

·        Description of the evolving case study including:

o   Identify the purpose

o   Identify type of learner

o   Identify the concept to be demonstrated by the fictional patient

·        Description of the setting

 Presentation of information was noted in all the following elements but was only minimally demonstrated:

·        Description of the evolving case study including:

o   Identify the purpose

o   Identify type of learner

o   Identify the concept to be demonstrated by the fictional patient

·        Description of the setting

 Presentation of information in one or two of the following elements fails to meet expectations:

·        Description of the evolving case study including:

o   Identify the purpose

o   Identify type of learner

o   Identify the concept to be demonstrated by the fictional patient

·        Description of the setting

 Presentation of information is unsatisfactory in three or more of the following elements:

·        Description of the evolving case study including:

o   Identify the purpose

o   Identify type of learner

o   Identify the concept to be demonstrated by the fictional patient

·        Description of the setting
Description of fictional patient by identifying each of the following elements 10 Points   9 Points 8 Points  4 Points 0 Points
Presentation of information was exceptional and included all the following elements:

 

·        Name

·        Gender/age/weight/ height

·        Allergies

·        Past medical history

·        History of present illness

·        Social history

·        Primary medical diagnosis

·        Surgeries and/or procedures with dates

 Presentation of information was good and included all the following elements but was superficial in places:

 

·        Name

·        Gender/age/weight/ height

·        Allergies

·        Past medical history

·        History of present illness

·        Social history

·        Primary medical diagnosis

·        Surgeries and/or procedures with dates

 Presentation of information was noted in all the following elements but was only minimally demonstrated:

 

·        Name

·        Gender/age/weight/ height

·        Allergies

·        Past medical history

·        History of present illness

·        Social history

·        Primary medical diagnosis

·        Surgeries and/or procedures with dates

 Presentation of information in one or two of the following elements fails to meet expectations:

 

·        Name

·        Gender/age/weight/ height

·        Allergies

·        Past medical history

·        History of present illness

·        Social history

·        Primary medical diagnosis

·        Surgeries and/or procedures with dates

 Presentation of information is unsatisfactory in three or more of the following elements:

 

·        Name

·        Gender/age/weight/ height

·        Allergies

·        Past medical history

·        History of present illness

·        Social history

·        Primary medical diagnosis

·        Surgeries and/or procedures with dates

 
Develop the report that learners receive prior to start of the evolving case study using SBAR

 

 20 Points  18 Points   16 Points  8 Points 0 Points
Presentation of information was exceptional and included all the following elements:

 

·        Time of report

·        Identify person providing the report

·        Identify each of the following for SBAR

o   Situation

o   Background

o   Assessment

o   Recommendation

 

 Presentation of information was good and included all the following elements but was superficial in places:

 

·        Time of report

·        Identify person providing the report

·        Identify each of the following for SBAR

o   Situation

o   Background

o   Assessment

o   Recommendation

 Presentation of information was noted in all the following elements but was only minimally demonstrated:

 

·        Time of report

·        Identify person providing the report

·        Identify each of the following for SBAR

o   Situation

o   Background

o   Assessment

o   Recommendation

 Presentation of information in one or two of the following elements fails to meet expectations:

 

·        Time of report

·        Identify person providing the report

·        Identify each of the following for SBAR

o   Situation

o   Background

o   Assessment

o   Recommendation

 Presentation of information is unsatisfactory in three or more of the following elements:

 

·        Time of report

·        Identify person providing the report

·        Identify each of the following for SBAR

o   Situation

o   Background

o   Assessment

o   Recommendation
Stage 1: Start of the healthcare situation with required elements 35 Points 31 Points 28 Points 13 Points 0 Points
Presentation of information was exceptional and included all the following elements:

 

·        Evolving case study information presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 1:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 2

 

 Presentation of information was good and included all the following elements but was superficial in places:

 

·        Evolving case study information presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 1:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 2

 Presentation of information was noted in all the following elements but was only minimally demonstrated:

 

·        Evolving case study information presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 1:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 2

 Presentation of information in one or two of the following elements fails to meet expectations:

 

·        Evolving case study information presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 1:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 2

 Presentation of information is unsatisfactory in three or more of the following elements:

 

·        Evolving case study information presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 1:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 2

 
Stage 2:  Deterioration in fictional patient’s health status with required elements 35 Points 27 Points 25 Points 11 Points 0 Points
Presentation of information was exceptional and included all the following elements:

 

·        Evolving case study information presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 2:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 3

 

 Presentation of information was good and included all the following elements but was superficial in places:

 

·        Evolving case study information presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 2:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 3

 

 Presentation of information was noted in all the following elements but was only minimally demonstrated:

 

·        Evolving case study information presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 2:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 3

 

 Presentation of information in one or two of the following elements fails to meet expectations:

 

·        Evolving case study information presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 2:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 3

NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment paper

 Presentation of information is unsatisfactory in three or more of the following elements:

 

·        Evolving case study information presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 2:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Trigger for Stage 3

 

 
Stage 3: Stabilization of fictional patient with required elements 35 Points 27 Points 25 Points 11 Points 0 Points
Presentation of information was exceptional and included all the following elements:

 

·        Evolving case study information to be presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 3:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Expected ending for case study if learner’s actions are APPROPRIATE for the situation

 

 Presentation of information was good and included all the following elements but was superficial in places:

 

·        Evolving case study information to be presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 3:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Expected ending for case study if learner’s actions are APPROPRIATE for the situation

 Presentation of information was noted in all the following elements but was only minimally demonstrated:

 

·        Evolving case study information to be presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 3:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Expected ending for case study if learner’s actions are APPROPRIATE for the situation

 Presentation of information in one or two of the following elements fails to meet expectations:

 

·        Evolving case study information to be presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 3:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Expected ending for case study if learner’s actions are APPROPRIATE for the situation

 Presentation of information is unsatisfactory in three or more of the following elements:

 

·        Evolving case study information to be presented to the learner

·        One action that a learner SHOULD identify that is APPROPRIATE for the situation

·        Socratic question for each area to ask learner at end of Stage 3:

o   Pathophysiology

o   Physical assessment

o   Pharmacology

·        Expected ending for case study if learner’s actions are APPROPRIATE for the situation

 
Debriefing

 

 25 Points   22 Points  20 Points   10 Points 0 Points
Presentation of information was exceptional and included all the following elements:

 

·        Socratic Question 1 (focusing on overall Stage 1)

·        Socratic Question 2 (focusing on overall Stage 2)

·        Socratic Question 3 (focusing on overall Stage 3)

·        Socratic Question 4 (focusing on the overall case study)

 

 Presentation of information was good and included all the following elements but was superficial in places:

 

·        Socratic Question 1 (focusing on overall Stage 1)

·        Socratic Question 2 (focusing on overall Stage 2)

·        Socratic Question 3 (focusing on overall Stage 3)

·        Socratic Question 4 (focusing on the overall case study)

 Presentation of information was noted in all the following elements but was only minimally demonstrated:

 

·        Socratic Question 1 (focusing on overall Stage 1)

·        Socratic Question 2 (focusing on overall Stage 2)

·        Socratic Question 3 (focusing on overall Stage 3)

·        Socratic Question 4 (focusing on the overall case study)

 Presentation of information in one or two of the following elements fails to meet expectations:

 

·        Socratic Question 1 (focusing on overall Stage 1)

·        Socratic Question 2 (focusing on overall Stage 2)

·        Socratic Question 3 (focusing on overall Stage 3)

·        Socratic Question 4 (focusing on the overall case study)

 Presentation of information is unsatisfactory in three or more of the following elements:

 

·        Socratic Question 1 (focusing on overall Stage 1)

·        Socratic Question 2 (focusing on overall Stage 2)

·        Socratic Question 3 (focusing on overall Stage 3)

·        Socratic Question 4 (focusing on the overall case study)
         NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment

ONLINE NURSING PAPER WRITING HELP paper                                                                                                                                                                                                  Content Subtotal _____ of 170 Points
Format

Possible Points =  15 Points
Scholarly writing at the graduate level

 

 10 Points   6 Points   5 Points 3 Points 0 Points
1–2 errors or exceptions to the rules of APA citation style, grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA Manual

 

 3–4 errors or exceptions to the rules of APA citation style, grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA Manual

 

 5–6 errors or exceptions to the rules of APA citation style, grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA Manual

 

 7–8 errors or exceptions to the rules of APA citation style, grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA Manual

 

 9 or more errors or exceptions to the rules of APA citation style, grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA Manual
                                                                                                                                                                 Format Subtotal _____ of 10  Points
Total Points _____ of 180 Points

Concepts Being Reviewed

 Week 2 starts a series of three weeks where selected concepts are reviewed. The focus for this review will be on pathophysiology, pharmacology, and physical assessment. Rather than reviewing the facts for each concept, the information will be used as part of the required assignments within NR536. While the entire units of hemostasis/regulation and sexuality/reproduction (Giddens, 2017) are required for review, the emphasis will be on the concept you select for Week 3’s assignment. Prior to developing the critical-thinking questions for your future learners, you need to be knowledgeable regarding the facts that comprise the selected concept. The focus will be to develop the critical thinking skills of your future learners in the areas identified by the concepts.

Using Concepts While Presenting Content

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NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment paper

As nurse educator, you are challenged to present information in a manner that a learner can understand, retain, and apply in a practice setting. This role is not limited to academic programs, but also includes nurses transferring to a different practice area or understanding new medications or new interventions. Don’t overlook how overwhelmed a patient and family may feel when challenged to start self-injections or peritoneal dialysis in the home setting, if your educational focus is patients. All learners often feel overwhelmed when large amounts of content is quickly presented.

A concept is a term that is generalized from specific facts and represents information/facts that can be presented in a concise manner. So, instead of stating all of the individual facts that make up a concept, you can say the concept. For example, “AM care” is a concept. It is composed of individual interventions—bathing, combing hair, brushing teeth, cleaning finger nails, and changing bed linen. With a fundamental student, the educator would have to list each of these interventions so that the learner would know what was expected. Later, as a senior student or nurse, someone can say “AM care,” and the expected interventions would be demonstrated. The same is true for “neuro checks.” Again, this concept is composed of several different actions that are generalized or grouped together into one concept. Consider the concept of “homeostasis.” Once more, there are a great many intracellular and extracellular facts that are represented by the concept of homeostasis.

The use of concepts by an educator can convey large amounts of information in a concise manner; however, the educator should select the concepts to be used based upon the knowledge level of the learner. As an educator, telling a student nurse on the very first day of one’s clinical experience to demonstrate “neuro checks” would be overwhelming, but by the last clinical course in the curriculum, the educator expects the student to know the information related to the concept.

For an experienced nurse transferring to the intensive care unit from a general medical practice area, there are concepts that are commonly used that the nurse is unfamiliar with. This also applies to educators teaching patients and/or families. All too often the educator will use a concept or even a term that the patient does not understand and the patient then becomes overwhelmed and discouraged about learning self-care actions. The nurse educator needs to understand how and when to use concepts to convey information.

As part of this course, a review of pathophysiology, pharmacology, and physical assessment related to specific concepts will occur. The concepts selected are based upon the work of Dr. Jean Giddens, who is acknowledged for her work in this area of nursing education. The reference she authored, Concepts for Nursing Practice (2017), is required for this course in order to provide the information you will need for assignments related to concepts. The information from this reference will not be a re-presentation of facts (i.e., will not repeat your courses in undergraduate education), but will focus on incorporating pathophysiology, pharmacology, and physical assessment along with concepts. You will then take this information and develop specific teaching methods that have the goal of improving clinical decision making in all types of learners. Remember, patients and families often make decisions regarding self-care!

Remember, that as a future educator, you will be developing assignments FOR learners and that is the focus of this course—developing assignments that foster critical thinking and clinical decision making in all types of learners—nursing students, nurses, and patients.

Clinical Decision Making

NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment paper

The first specific topic related to concepts and experiential learning is clinical decision making. While there are a huge number of skills that must be learned by every student, nurse, and patient, being able to make appropriate decisions must be toward the top of any list regarding importance! Unfortunately, there are numerous terms that are associated with clinical decision making. These include, but are not limited to, critical thinking, clinical reasoning, and clinical judgement. While many authors take great care to separate each of these as components, for this course, the focus will be on clinical decision making and the role of critical thinking in decision making.

As an educator, you are concerned about both; critical thinking and decision making. Why? Critical thinking is used within clinical decision making. There are numerous definitions of critical thinking and clinical decision making. For this course, a composite description of the terms will be used.

Critical thinking (or thinking about thinking) goes back to ancient Greece and philosophers such as Socrates, Plato, and Aristotle. Critical thinking is a process that includes collecting facts, analyzing the information, and using it to make a decision. While critical thinking focuses on the cognitive domain, attitudes and values, as well as culture, it has an impact upon considering the information in order to make a decision. The level of the learner is important because of the information retained over time as well as previous experiences in analyzing the information for quality.

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Critical Thinking Skills

The skills necessary for critical thinking, as noted by Scheffer & Rubenfeld (2000), are the following.

  • Analyzing: separating information into parts; then studying the parts
  • Applying standards: professional nursing standards, but also the standards of the State Board of Nursing, while not overlooking the standards of the agency
  • Discrimination: determining the similarities and differences in the information
  • Information seeking: using facts or information that is research-based or evidence-based practice
  • Logical reasoning: could be inductive or deductive

Socratic Questions

NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment paper

As part of the educational process, asking learners meaningful questions is an important aspect of the role of the nurse educator. Oral questions can foster learning, but can also produce anxiety within the student. Questions should be designed to assist the learner to think rather than repeat memorized facts. In other words, some questions will help learners develop critical thinking and clinical decision making, and it is these questions that are the goal of the nurse educator.

Questions are often divided into two large categories: lower level and higher level. Lower level questions focus on knowledge and comprehension of information. There is limited, if any, application of the information to a situation. The learner simply repeats memorized information. For example, a lower level question would be, “What are the four chambers of the heart?” Lower level questions can be appropriate based upon the situation and the level of the learner. Lower level questions may be very appropriate in a fundamental course, or when there is only one correct answer.

Higher level questions require students to use multiple bits of learned information and then weave the information into an appropriate response using logical reasoning. Higher level questions focus on the application, evaluation, and synthesis levels of learning, as well as encourage critical thinking. The use of critical thinking is of prime importance within healthcare situations where individuals are required to integrate knowledge from multiple sources (i.e., assessment, diagnostic, professional standards, and evidence-based practice) in order to make clinical decisions that foster positive outcomes. The higher level questions assist the learner to

  • think analytically;
  • reflect on possible outcomes;
  • creatively consider appropriate interventions; and
  • challenge assumptions so nothing is overlooked.

As an educator in an experiential setting, you need to create an environment or atmosphere that encourages questions. A safe environment is developed by providing positive reinforcement when the learner asks questions (i.e., “That is an excellent question!”) and allows for uncertainty in the answers or even misinformation. The nurse educator does not want to undermine the confidence of the learner by interrupting the learner’s answer—especially with another question! In addition, the educator needs to allow “think” time, especially with higher level questions. Some students will “wait-out” the educator; knowing that after a few seconds of silence, the educator will answer the question posed.

Let’s take a look below at some additional techniques.

Concepts Related to Mood and Cognition as Well as Maladaptive Behavior

NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment paper

It is important to recall that the professional nurse is concerned with the holistic health of individuals and population groups. Health is more than physical functioning; health also includes mental, social, and spiritual elements. This week, the concepts that are being emphasized are psychosocial. When using the term psychosocial, you are identifying the close relationship between psychological and social elements of health. Psychological elements would include cognitive and emotional development. Social refers to relationships as well as cultural norms. All of these elements—psychological and social—influence human thoughts and behavior within an individual context as well as a community context.

Mood is explained as a temporary state of feeling that lasts longer than an emotion. Moods are identified to be either positive or negative. An individual experiencing a positive mood can have improved

  • problem solving;
  • creativity; and
  • resistance to behaviors, such as smoking.

In contrast, a negative mood can impact

  • problem solving; and
  • perception of objects and/or events.

Often a negative mood is considered to be non-constructive. While many elements can alter one’s mood, some of the more common influences include amount of sleep, nutrition, as well as alcohol ingestion. Examples of mood disorders include bipolar, postpartum depression, and major depressive disorder.

Cognition refers to the mental processes used by an individual to acquire knowledge and/or understand. In other words, it is the ability to process information. Several cognitive functions have an impact upon one’s ability to think, including memory, reasoning, and language. When considering cognition, it is referred to as being either intact or impaired. Cognition can be altered by factors such as

  • age;
  • environmental (i.e., lead in the drinking water);
  • congenital conditions; and
  • health conditions (i.e., medications, hypoglycemia).

Cognitive impairments include delirium and learning disabilities.

The concepts being emphasized this week included mood and cognition, as well as maladaptive behaviors (Giddens, 2017). These concepts will be woven into evolving case studies along with pathophysiology, physical assessment, and pharmacology.

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Evolving Case Studies

NR536 Advanced Pathophysiology, Health Assessment and Pharmacology for Nurse Educators: Experiential Learning Essay Assignment paper

Case studies have been used within nursing education for a very long time because they serve as a bridge between practice and theory. By presenting a case study that is realistic and consistent with the level of the learner, previously acquired knowledge can be applied in order to develop clinical decision-making skills. Within interprofessional experiences, communication among the disciplines can be fostered. Case studies are an example of active learning because participants must work through and consider all elements being presented. At the end, they are to resolve the healthcare concern being presented by identifying a plan of action. While case studies can vary in length and complexity, they foster the development of

  • problem solving;
  • decision making; and
  • analytical skills.

These educational outcomes make the case study very attractive to the nurse educator as a teaching method.

In 1997, Glendon and Ulrich identified a variation on the traditional case study referred to as the evolving case study. With the traditional case study, all of the information regarding the individual and the healthcare situation is presented completely and at one time. With the evolving case study, incomplete information is initially provided to the participant(s), with additional information provided as the situation “evolves” or “unfolds” over time. This often adds an additional element of priority setting to the evolving case study.

The evolving case study has been used within numerous educational settings including didactic, experiential, and simulation. These studies reflect the real-world progression of events such as deteriorating health status, or an unexpected event such as a visitor falling. The evolving case study can be presented in writing with the educator adding more information when asked by participants or after a specific time interval. Questions can also be built into the scenario. Based upon the responses and/or actions of the participant, the clinical situation will progress over time. Simulation scenarios can be seen as a type of evolving case study and are frequently used with interprofessional learning activities. Especially if the evolving case study is used with simulation, debriefing should be used to foster self-reflection of knowledge and actions.

While there are many suggested ways to write an evolving case study, the nurse educator should consider all of the following areas when developing the study.

  • Purpose of the case
  • Learning objectives writing
  • Biographical data
  • Context (environment, situation at hand, historical information, resources available, cultural perspective, nurse’s frame of reference)
  • Content (pathophysiologic features, treatments, medications, health promotion/prevention concepts, legal/ethical issues, lab data, teaching/discharge planning)
  • Focused questions
  • Cooperative learning strategies
  • Reflective writing

Evolving Case Study