Ask the expert: Unfolding case scenarios teach new graduate nurses critical thinking

Staff Development Weekly: Insight on Evidence-Based Practice in Education, September 4, 2009

This week, Polly Gerber Zimmermann, RN, MS, MBA, CEN, discusses how to use unfolding case scenarios when teaching new graduate nurses how to think critically.

Q: How can I teach new graduate nurses critical thinking skills?

A: Using the technique of unfolding case scenarios is a good way to incorporate clinical critical thinking skills in a classroom setting. It provides the information in staggered amounts, punctuated by questions. The following example walks new graduates through a critical thinking exercise.

The patient is a two-day postoperative hemicystectomy and asks for something for pain. Ask the new graduate nurses, "What is essential for the nurse to ask?" You have already decided ahead of time that the patient will have a more atypical problem, such as cholelithiasis from the anesthesia and dehydration or bladder distention after the catheter is removed, so respond appropriately to the questions the nurses ask. Don't let the "patient" tell the learners giveaway symptoms. Keep going until the learners specify where the pain is and palpate a positive Murphy's sign or distended bladder.

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