1. Viveiros, Jennifer PhD, RN, CNE
  2. Medeiros, Kiley MS, RN

Article Content

Using case studies in a synchronous online classroom is an active learning strategy designed to engage students in applying knowledge in patient care. Word clouds provide real-time opportunities to uncover students' clinical reasoning and encourage their participation. A free web-based polling platform ( was used in this activity. Students (n = 49) in a synchronous online course were provided with a case study and asked to anonymously state the most concerning clinical data via open-ended responses through the Slido platform. To avoid students following suit with answers that were populating the cloud first, the instructor's screen was not shared until all students participated. As with all word clouds, the most frequent response is identified with the largest font (Supplemental Digital Content, Figure, As the case study progressed, students were also asked, "What is the priority intervention?" and "What would be important follow-up clinical data?" Their answers generated word clouds that represented the clinical reasoning responses from participants. The authors were able to gauge the students' understanding of key information in real time. Using free-text answers versus multiple-choice selections demonstrated students' clinical reasoning and language mastery. Faculty were able to respond to misconceptions that might have previously gone undiscovered. Additionally, students who are usually not inclined to participate publicly could submit their decisions without being singled out. Free technology-based word cloud platforms can be operationalized to uncover nursing students' clinical reasoning in online classes.