1. Englund, Heather PhD, RN

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Many of the case studies used in teaching medical-surgical content are somewhat prescribed in that students are provided all the information and questions in advance. Both anecdotal and quantitative evidence suggests that this static learning modality may not foster the development of critical thinking or prioritization skills. To address this issue, I developed multiclient unfolding case studies, each taught over the course of 2 class periods. For example, the multiple-cardiac client case study takes place in the emergency department (ED). Before class, students are given access to all relevant information for the first client, who has been in the ED for an hour. A second patient is then introduced as having just been seen by an ED provider, and a third patient will be coming by ambulance shortly. For the second class period, the case study takes place on the medical-surgical unit where students are reintroduced to one of the patients seen in the ED who was admitted to the unit. The students receive report on 3 additional patients who all require morning medications, assessments, interventions, and/or diagnostic testing. Over the course of 2 class periods, I introduce laboratory values, provider orders, cultural needs, complications, and new clients to the case study. I then posit a series of questions that require students to think critically, prioritize, and evaluate the changing status of each client. Feedback from students indicate that this learning methodology is interactive and dynamic and fosters a higher order of cognitive thought.