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How to Write a Nursing Case Study Paper (A Guide)

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Most nursing students dread writing a nursing case study analysis paper, yet it is a mandatory assignment; call it a rite of passage in nursing school. This is because it is a somewhat tricky process that is often overwhelming for nursing students. Nevertheless, by reading this guide prepared by our best nursing students, you should be able to easily and quickly write a nursing case study that can get you an excellent grade.

How different is this guide from similar guides all over the internet? Very different!

This guide provides all the pieces of information that one would need to write an A-grade nursing case study. These include the format for a nursing case study, a step-by-step guide on how to write a nursing case study, and all the important tips to follow when writing a nursing case study.

This comprehensive guide was developed by the top nursing essay writers at NurseMyGrade, so you can trust that the information herein is a gem that will catapult your grades to the next level. Expect updates as we unravel further information about writing a nursing case study.

Now that you know you've discovered a gold mine , let's get right into it.

What Is a Nursing Case Study?

A nursing case study is a natural or imagined patient scenario designed to test the knowledge and skills of student nurses. Nursing case study assignments usually focus on testing knowledge and skills in areas of nursing study related to daily nursing practice.

As a nursing student, you must expect a nursing case study assignment at some point in your academic life. The fact that you are reading this post means that point is now.

While there is no standard structure for writing a nursing case study assignment, some things or elements must be present in your nursing assignment for your professor to consider it complete.

In the next section, you will discover what your instructor n expects in your nursing case study analysis. Remember, these are assignments where you are given a case study and are expected to write a case analysis report explaining how to handle such scenarios in real-life settings.

The Nursing Case Study Template

The typical nursing case study has nine sections. These are:

  • Introduction
  • Case presentation (Patient info, history, and medical condition)
  • Diagnosis/Nursing assessment
  • Intervention/Nursing care plan
  • Discussion and recommendations

The Structure of a Nursing Case Study Analysis

You now know what nursing professors expect in a nursing case study analysis. In this section, we will explain what to include in each section of your nursing case study analysis to make it an excellent one.

1. Title page

The title page is essential in all types of academic writing. You must include it in your nursing case study analysis or any other essay or paper. And you must include it in the format recommended by your college.

If your college has no specific title page format, use the title page format of the style requested in the assignment prompt. In nursing college, virtually all assignments should be written in Harvard or APA format .

So, check your assignment prompt and create your title page correctly. The typical title page should include the topic of your paper, your name, the name of your professor, the course name, the date you are submitting the paper, and the name of your college.

2. Abstract

Most nursing professors require you to include an abstract in your nursing case study analysis. And even when you are not explicitly required to write one, it is good to do so. Of course, you should consult with your professor before doing so.

When writing an abstract for your paper, make sure it is about 200 words long. The abstract should include a brief summary of the case study, including all the essential information in the patient presentation, such as the history, age, and current diagnosis.

The summary should also include the nursing assessment, the current interventions, and recommendations.

3. Introduction

After writing the title page and the abstract, start writing the introduction. The introduction of a nursing case study analysis must briefly include the patient's presentation, current diagnosis and medication, and recommendations. It must also include a strong thesis statement that shows what the paper is all about.

You shouldn't just write an introduction for the sake of it. If you do so, your introduction will be bland. You need to put in good effort when writing your introduction. The best way to do this is to use your introduction to show you understand the case study perfectly and that you will analyze it right.

You can always write your introduction last. Many students do this because they believe writing an introduction last makes it more precise and accurate.

4. Case Presentation (Status of the Patient)

After introducing your nursing case study analysis, you should present the case where you outline the patient's status. It is usually straightforward to present a case.

You must paraphrase the patient scenario in the assignment prompt or brief. Focus on the demographic data of the patient (who they are, age, race, height, skin tone, occupation, relationships, marital status, appearance, etc.), why they are in the case study or scenario, reasons they sought medical attention, chief complaint, and current diagnosis and treatment. You should also discuss the actions performed on the patient, such as admission to the ICU, taking vital signs, recommending tests, etc.

In short, everything necessary in the patient scenario should be in your case presentation. You only need to avoid copying the patient scenario or case study word-for-word when writing your case presentation.

5. Diagnosis and Assessment

After the case presentation, you should explain the diagnosis. In other words, you should explain the condition, disease, or medical situation highlighted in the case presentation. For example, if the patient is a heavy smoker and he has COPD, it is at this point that you explain how COPD is linked to heavy smoking.

This is the section where you thoroughly discuss the disease process (pathophysiology) by highlighting the causes, symptoms, observations, and treatment methods. You should relate these to the patient's status and give concrete evidence. You should describe the progression of the disease from when the client was admitted to a few hours or days after they were stabilized. Consider the first indication of the disease that prompted the patient to seek further medical assistance.  

Your paper should also elucidate the diagnostic tests that should be conducted and the differential diagnosis. Ensure that each is given a well-founded rationale.

When explaining the condition, go deep into the pathophysiology. Focus specifically on the patient's risk factors. Ensure you get your explanation from recent nursing literature (peer-reviewed scholarly journals published in the last 5 years). And do not forget to cite all the literature you get your facts from.

In short, this section should explain the patient's condition or suffering.

6. Nursing Intervention

After the diagnosis and nursing assessment section, your nursing case study analysis should have an intervention section. This section is also known as the nursing care planning section. What you are supposed to do in this section is to present a nursing care plan for the patient presented in the patient scenario. You should describe the nursing care plan and goals for the patient. Record all the anticipated positive changes and assess whether the care plan addresses the patient's condition.

A good nursing care plan details the patient's chief complaints or critical problems. It then describes the causes of these problems using evidence from recent medical or nursing literature. It then details the potential intervention for each problem. Lastly, it includes goals and evaluation strategies for the measures. Most professors, predominantly Australian and UK professors, prefer if this section is in table format.

Some nursing professors regard the intervention section (or nursing care plan section) as the most critical part of a nursing case study. This is because this part details precisely how the student nurse will react to the patient scenario (which is what the nursing professors want to know). So, ensure you make a reasonable effort when developing this section to get an excellent grade.

7. Discussion and Recommendations

The intervention section in a nursing case study is followed by a discussion and recommendations section. In this section, you are supposed to expound on the patient scenario, the diagnosis, and the nursing care plan. You should also expound on the potential outcomes if the care plan is followed correctly. The discussion should also explain the rationale for the care plan or its significant bits.

Recommendations should follow the discussion. Recommendations usually involve everything necessary that can be done or changed to manage a patient's condition or prevent its reoccurrence. Anything that enhances the patient's well-being can be a recommendation. Just make sure your key recommendations are supported by evidence.

8. Conclusion

This is the second last section of a typical nursing case study. What you need here is to summarize the entire case study. Ensure your summary has at least the case presentation, the nursing assessment/diagnosis, the intervention, and the key recommendations.

At the very end of your conclusion, add a closing statement. The statement should wrap up the whole thing nicely. Try to make it as impressive as possible.

9. References

This is the last section of a nursing case study. No nursing case study is complete without a references section. You should ensure your case study has in-text citations and a references page.

And you should make sure both are written as recommended in the assignment. The style section is usually Harvard or APA. Follow the recommended style to get a good grade on your essay.

Step-By-Step Guide to Writing a Nursing Case Study

You know all the key sections you must include in a nursing case study. You also know what exactly you need to do in each section. It is time to learn how to write a nursing case study. The process detailed below should be easy to follow because you know the typical nursing case study structure.

1. Understand the Assignment

When given a nursing case study assignment, the first thing you need to do is to read. You need to read two pieces of information slowly and carefully.

First, you need to read the prompt itself slowly and carefully. This is important because the prompt will have essential bits of information you need to know, including the style, the format, the word count, and the number of references needed. All these bits of information are essential to ensure your writing is correct.

Second, you need to read the patient scenario slowly and carefully. You should do this to understand it clearly so that you do not make any mistakes in your analysis.

2. Create a Rough Outline

Failure to plan is a plan to fail. That is not what you are in it for anyway! In other words, do not fail to create an outline for your case study analysis. Use the template provided in this essay to create a rough outline for your nursing case study analysis.

Ensure your outline is as detailed as it can be at this stage. You can do light research to achieve this aim. However, this is not exactly necessary because this is just a rough outline.

3. Conduct thorough research

After creating a rough outline, you should conduct thorough research. Your research should especially focus on providing a credible and evidence-based nursing assessment of the patient problem(s). You should only use evidence from recent nursing or medical literature.

You must also conduct thorough research to develop an effective intervention or nursing care plan. So when researching the patient's problem and its diagnosis, you should also research the most suitable intervention or do it right after.

When conducting research, you should always note down your sources. So for every piece of information you find, and what to use, you should have its reference.

After conducting thorough research, you should enhance your rough outline using the new information you have discovered. Make sure it is as comprehensive as possible.

4. Write your nursing case study

You must follow your comprehensive outline to write your case study analysis at this stage. If you created a good outline, you should find it very easy to write your nursing case study analysis.

If you did not, writing your nursing case study will be challenging. Whenever you are stuck writing your case study analysis paper, you should re-read the part where we explain what to include in every section of your analysis. Doing so will help you know what to write to continue your essay. Writing a nursing case study analysis usually takes only a few hours.

5. Reference your case study

After writing your case study, ensure you add all in-text citations if you have not already. And when adding them, you should follow the style/format recommended in the assignment prompt (usually APA or Harvard style).

After adding in-text citations exactly where they need to be and in the correct format, add all the references you have used in a references page. And you should add them correctly as per the rules of the style you were asked to use.

Do not forget to organize your references alphabetically after creating your references page.

6. Thoroughly edit your case study

After STEP 5 above, you need to edit your case study. You should edit it slowly and carefully. Do this by proofreading it twice. Proofread it slowly each time to discover all the grammar, style, and punctuation errors. Remove all the errors you find.

After proofreading your essay twice, recheck it to ensure every sentence is straightforward. This will transform your ordinary case study into an A-grade one. Of course, it must also have all the standard sections expected in a case study.

Recheck your case study using a grammarly.com or a similar computer grammar checker to ensure it is perfect. Doing this will help you catch and eliminate all the remaining errors in your work.

7. Submit your case study analysis

After proofreading and editing your case study analysis, it will be 100% ready for submission. Just convert it into the format it is required in and submit it.

 Nursing Case Study Tips and Tricks

The guide above and other information in this article should help you develop a good nursing case study analysis. Note that this guide focuses entirely on nursing case scenario-based papers, not research study-based nursing case studies. The tips and tricks in this section should help you ensure that the nursing case study analysis you create is excellent.

1. Begin early

The moment you see a nursing case study assignment prompt, identify a date to start writing it and create your own deadline to beat before the deadline stated in the prompt.

Do this and start writing your case study analysis early before your deadline. You will have plenty of time to do excellent research, develop an excellent paper, and edit your final paper as thoroughly as you want.

Most student nurses combine work and study. Therefore, if you decide to leave a nursing case study assignment until late to complete it, something could come up, and you could end up failing to submit it or submitting a rushed case study analysis.

2. Use the proper terminology

When writing an essay or any other academic paper, you are always encouraged to use the most straightforward language to make your work easy to understand. However, this is not true when writing a nursing case study analysis. While your work should certainly be easy to understand, you must use the right nursing terminology at every point where it is necessary. Failure to do this could damage your work or make it look less professional or convincing.

3. Avoid copying and pasting

If you are a serious nursing student, you know that copying and pasting are prohibited in assignments. However, sometimes copying and pasting can seem okay in nursing case studies. For example, it can seem okay to copy-paste the patient presentation. However, this is not okay. You are supposed to paraphrase the verbatim when presenting the patient presentation in your essay. You should also avoid copy-pasting information or texts directly. Every fact or evidence you research and find should be paraphrased to appear in your work. And it should be cited correctly.

4. Always ask for help if stuck

This is very important. Students are usually overwhelmed with academic work, especially a month or two to the end of the semester. If you are overwhelmed and think you will not have the time to complete your nursing case study analysis or submit a quality one, ask for help. Ask for help from a nursing assignment-help website like ours, and you will soon have a paper ready that you can use as you please. If you choose to get help from us, you will get a well-researched, well-planned, well-developed, and fully edited nursing case study.

5. Format your paper correctly

Many students forget to do proper formatting after writing their nursing case study analyses. Before you submit your paper, make sure you format it correctly. If you do not format your paper correctly, you will lose marks because of poor formatting. If you feel you are not very confident with your APA or Harvard formatting skills, send your paper to us to get it correctly formatted and ready for submission.

Now that you are all set up ...

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A guide on how to structure a case presentation

This article contains...

-History of presenting problem

-Medical and surgical history

-Drugs, including allergies to drugs

-Family history

-Social history

-Review of systems

-Findings on examination, including vital signs and observations

-Differential diagnosis/impression

-Investigations

-Management

Presenting patient cases is a key part of everyday clinical practice. A well delivered presentation has the potential to facilitate patient care and improve efficiency on ward rounds, as well as a means of teaching and assessing clinical competence. 1

The purpose of a case presentation is to communicate your diagnostic reasoning to the listener, so that he or she has a clear picture of the patient’s condition and further management can be planned accordingly. 2 To give a high quality presentation you need to take a thorough history. Consultants make decisions about patient care based on information presented to them by junior members of the team, so the importance of accurately presenting your patient cannot be overemphasised.

As a medical student, you are likely to be asked to present in numerous settings. A formal case presentation may take place at a teaching session or even at a conference or scientific meeting. These presentations are usually thorough and have an accompanying PowerPoint presentation or poster. More often, case presentations take place on the wards or over the phone and tend to be brief, using only memory or short, handwritten notes as an aid.

Everyone has their own presenting style, and the context of the presentation will determine how much detail you need to put in. You should anticipate what information your senior colleagues will need to know about the patient’s history and the care he or she has received since admission, to enable them to make further management decisions. In this article, I use a fictitious case to …

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NursingStudy.org

Nursing Case Study Examples and Solutions

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  • August 17, 2023
  • Nursing Essay Examples

NursingStudy.org is your ultimate resource for nursing case study examples and solutions. Whether you’re a nursing student, a seasoned nurse looking to enhance your skills, or a healthcare professional seeking in-depth case studies, our comprehensive collection has got you covered. Explore our extensive category of nursing case study examples and solutions to gain valuable insights, improve your critical thinking abilities, and enhance your overall clinical knowledge.

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Discover a wide range of comprehensive nursing case study examples and solutions that cover various medical specialties and scenarios. These meticulously crafted case studies offer real-life patient scenarios, providing you with a deeper understanding of nursing practices and clinical decision-making processes. Each case study presents a unique set of challenges and opportunities for learning, making them an invaluable resource for nursing education and professional development.

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Critical Care Nursing Case Study Examples 

Critical care nursing demands swift decision-making, advanced technical skills, and the ability to provide intensive care to acutely ill patients. Our critical care nursing case studies encompass a range of high-acuity scenarios, including trauma, cardiac emergencies, and respiratory distress. These case studies simulate the fast-paced critical care environment, enabling you to sharpen your critical thinking skills, enhance your clinical judgment, and deliver exceptional care to critically ill patients.

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Nursing Leadership Case Studies

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Examples

Nursing Case Study

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ScienceDirect posted a nursing ethics case study where an end-stage prostate cancer patient, Mr. Green, confided to nursing staff about his plan to commit suicide. The patient asked the nurse to keep it a secret. The ethical problem is whether the nurse should tell the health care team members about the patient’s thought without his permission. The best ethical decision for this nursing case study was to share this critical information with other health care professionals, which was the action the nurse took. The team adhered to the proper self-harm and suicide protocol. The appropriate team performed a palliative therapy. As a result, the patient didn’t harm himself and died peacefully a few months after he was discharged.

What Is a Nursing Case Study? A nursing case study is a detailed study of an individual patient. Through this type of research, you can gain more information about the symptoms and the medical history of a patient. It will also allow you to provide the proper diagnoses of the patient’s illness based on the symptoms he or she experienced and other affecting factors. Nursing students usually perform this study as part of their practicum, making it an essential experience because, through this research methodology , they can apply the lessons they have learned from school. The situation mentioned above was an excellent example of a nursing case study.

Nursing Case Study Format

1. introduction.

Purpose: Briefly introduces the case study, including the main health issue or condition being explored. Background: Provides context for the patient scenario, outlining the significance of the case in nursing practice. Objectives: Lists the learning objectives or goals that the case study aims to achieve.

2. Patient Information

Demographics: Age, gender, ethnicity, and relevant personal information. Medical History: Past medical history, including any chronic conditions, surgeries, or significant health events. Current Health Assessment: Presents the patient’s current health status, including symptoms, vital signs, and results from initial examinations.

3. Case Description

Clinical Presentation: Detailed description of the patient’s presentation, including physical examination findings and patient-reported symptoms. Diagnostic Findings: Summarizes diagnostic tests that were performed, including lab tests, imaging studies, and other diagnostic procedures, along with their results. Treatment Plan: Outlines the initial treatment provided to the patient, including medications, therapies, surgeries, or other interventions.

4. Nursing Care Plan

Nursing Diagnoses: Identifies the nursing diagnoses based on the assessment data. Goals and Outcomes: Establishes short-term and long-term goals for the patient’s care, including expected outcomes. Interventions: Describes specific nursing interventions planned or implemented to address each nursing diagnosis and achieve the stated goals. Evaluation: Discusses the effectiveness of the nursing interventions, including patient progress and any adjustments made to the care plan.

5. Analysis

Critical Analysis: Analyzes the case in depth, considering different aspects of patient care, decision-making processes, and the application of nursing theories and principles. Reflection: Reflects on the nursing practice, lessons learned, and how the case study has impacted the understanding and application of nursing knowledge.

6. Conclusion

Summary: Provides a concise summary of the key points from the case study, including the patient outcome and the nursing care impact. Implications for Practice: Discusses the implications of the case for nursing practice, including any changes to practice or policy that could improve patient care. Recommendations: Offers recommendations for future care or areas for further study based on the case study findings.

Examples of Nursing Case Study

Management of Acute Myocardial Infarction (AMI) Introduction: A 58-year-old male with a history of hypertension and smoking presents to the emergency department with chest pain. This case study explores the nursing management for patients with AMI. Patient Information: Demographics: 58-year-old male, smoker. Medical History: Hypertension, no previous diagnosis of heart disease. Current Health Assessment: Reports severe chest pain radiating to his left arm, sweating, and nausea. Case Description: Clinical Presentation: Patient appeared in distress, clutching his chest. Diagnostic Findings: ECG showed ST-elevation in anterior leads. Troponin levels were elevated. Treatment Plan: Immediate administration of aspirin, nitroglycerin, and morphine for pain. Referred for emergency coronary angiography. Nursing Care Plan: Nursing Diagnoses: Acute pain related to myocardial ischemia. Goals: Relieve pain and prevent further myocardial damage. Interventions: Monitoring vital signs, administering prescribed medications, and providing emotional support. Evaluation: Pain was managed effectively, and the patient was stabilized for angiography. Analysis: The timely nursing interventions contributed to stabilizing the patient’s condition, showcasing the critical role nurses play in acute care settings. Conclusion: This case highlights the importance of quick assessment and intervention in patients with AMI, emphasizing the nurse’s role in pain management and support.
Managing Type 1 Diabetes in a Pediatric Patient Introduction: A 10-year-old female diagnosed with type 1 diabetes presents for a routine check-up. This case study focuses on the nursing care plan for managing diabetes in pediatric patients. Patient Information: Demographics: 10-year-old female. Medical History: Diagnosed with type 1 diabetes six months ago. Current Health Assessment: Well-controlled blood glucose levels, but expresses difficulty with frequent insulin injections. Case Description: Clinical Presentation: Patient is active, engaging in school activities but struggles with diabetes management. Diagnostic Findings: HbA1c is 7.2%, indicating good control. Treatment Plan: Insulin therapy, carbohydrate counting, and regular blood glucose monitoring. Nursing Care Plan: Nursing Diagnoses: Risk for unstable blood glucose levels. Goals: Maintain blood glucose within target range and increase patient comfort with diabetes management. Interventions: Education on insulin pump use, dietary advice, and coping strategies. Evaluation: Patient showed interest in using an insulin pump and understood dietary recommendations. Analysis: This case emphasizes the importance of education and emotional support in managing chronic conditions in pediatric patients. Conclusion: Effective management of type 1 diabetes in children requires a comprehensive approach that includes education, technological aids, and psychological support.
Elderly Care for Alzheimer’s Disease Introduction: An 82-year-old female with Alzheimer’s disease presents with increased confusion and agitation. This case study examines the complexities of caring for elderly patients with Alzheimer’s. Patient Information: Demographics: 82-year-old female. Medical History: Alzheimer’s disease, osteoarthritis. Current Health Assessment: Increased confusion, agitation, and occasional aggression. Case Description: Clinical Presentation: Patient exhibits signs of advanced Alzheimer’s with memory loss and disorientation. Diagnostic Findings: Cognitive tests confirm the progression of Alzheimer’s. Treatment Plan: Non-pharmacological interventions for agitation, memory aids, and safety measures in the home. Nursing Care Plan: Nursing Diagnoses: Impaired memory related to Alzheimer’s disease. Goals: Reduce agitation and prevent harm. Interventions: Use of calming techniques, establishing a routine, and environmental modifications. Evaluation: Agitation was reduced, and the patient’s safety was improved through environmental adjustments. Analysis: The case underscores the need for tailored interventions to manage Alzheimer’s symptoms and improve the quality of life for the elderly. Conclusion: Nursing care for Alzheimer’s patients requires a multifaceted approach focusing on safety, symptom management, and patient dignity.

Nursing Case Study Topics with Samples to Edit & Download

  • Telehealth Nursing
  • Mental Health and Psychiatric Nursing
  • Geriatric Nursing Care
  • Palliative and End-of-Life Care
  • Pediatric Nursing
  • Emergency and Critical Care Nursing
  • Chronic Disease Management
  • Nursing Ethics and Patient Rights
  • Infection Control and Prevention
  • Oncology Nursing
  • Nursing Leadership and Management
  • Cultural Competence in Nursing
  • Substance Abuse and Addiction Nursing
  • Technological Innovations in Nursing
  • Nursing Education and Training

Nursing Case Study Examples & Templates

1. nursing case study template.

Nursing Case Study Template

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5. Printable Nursing Health Case Study Example

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6. Fundamentals of Nursing Case Study Example

Fundamentals of Nursing Case Study Example

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7. Sample Nursing Case Study Example

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8. Nursing Research Case Study Example

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9. Standard Nursing Case Study Example

Standard Nursing Case Study

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10. Nursing Disability Case Study Example

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11. Nursing care Patients Case Study Example

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12. School of Nursing Case Study Example

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13. Evaluation of Nursing Care Case Study Example

Evaluation of Nursing Care Case Study Example

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Nursing Case Study Segments

Typically, a nursing case study contains three main categories, such as the items below.

1. The Status of a Patient

In this section, you will provide the patient’s information, such as medical history, and give the current patient’s diagnosis, condition, and treatment. Always remember to write down all the relevant information about the patient. Other items that you can collect in this stage are the reasons for the patient to seek medical care and the initial symptoms that he or she is experiencing. After that, based on the gathered information, you will explain the nature and cause of the illness of the patient.

2. The Nursing Assessment of the Patient

In this stage, you will need to prepare your evaluation of the patient’s condition. You should explain each observation that you have collected based on the vital signs and test results. You will also explain each nursing diagnosis that you have identified and determine the proper nursing care plan for the patient.

3. The Current Care Plan and Recommendations

Describe the appropriate care plan that you can recommend to the patient based on the diagnosis, current status, and prognosis in detail, including how the care plan will affect his or her life quality. If needed, you can also evaluate the patient’s existing care plan and give recommendations to enhance it. It is also crucial to cite relevant authoritative sources that will support your recommendations .

Objectives of Nursing Case Study

Nursing case studies are integral educational tools that bridge theoretical knowledge with practical application in patient care. They serve several key objectives essential for the development of nursing students and professionals. Here are the primary objectives of nursing case studies:

1. Enhance Critical Thinking and Clinical Reasoning

Case studies encourage nurses to analyze complex patient scenarios, make informed decisions, and apply critical thinking skills to solve problems. They simulate real-life situations, requiring nurses to evaluate data, consider multiple outcomes, and choose the best course of action.

2. Improve Diagnostic Skills

Through the detailed analysis of patient information, symptoms, and diagnostic results, nursing case studies help improve diagnostic skills. They allow nurses to practice interpreting clinical data to identify patient conditions and understand the underlying causes of symptoms.

3. Facilitate Application of Theoretical Knowledge

Nursing case studies provide a direct bridge between classroom learning and clinical practice. They offer a practical venue for applying theoretical knowledge about anatomy, physiology, pharmacology, and nursing theories to real-world patient care situations.

4. Promote Understanding of Comprehensive Patient Care

These studies emphasize the importance of holistic care, considering the physical, emotional, social, and psychological aspects of patient well-being. Nurses learn to develop comprehensive care plans that address all facets of a patient’s health.

5. Encourage Reflective Practice and Self-Assessment

Reflecting on case study outcomes enables nurses to evaluate their own decision-making processes, clinical judgments, and actions. This self-assessment promotes continuous learning and professional growth by identifying areas for improvement.

6. Foster Interdisciplinary Collaboration

Case studies often involve scenarios that require collaboration among healthcare professionals from various disciplines. They teach nurses the value of teamwork, communication, and the integration of different expertise to achieve optimal patient outcomes.

7. Enhance Patient Education and Advocacy Skills

By working through case studies, nurses improve their ability to educate patients and families about health conditions, treatment plans, and preventive measures. They also learn to advocate for their patients’ needs and preferences within the healthcare system.

8. Prepare for Real-Life Challenges

Nursing case studies prepare students and new nurses for the unpredictability and challenges of real-life clinical settings. They provide safe, controlled environments to practice responses to emergencies, ethical dilemmas, and complex patient needs without the risk of actual harm.

Steps in Nursing Process

Whether you are handling a patient with schizophrenia, pneumonia, diabetes, appendicitis, hypertension, COPD, etc, you will need to follow specific steps to ensure that you are executing the critical nursing process.

1. Assess the Patient

The first step of the nursing process requires critical thinking skills as it involves gathering both subjective and objective data. Subjective data includes verbal statements that you can collect from the patient or caregiver. In contrast, objective information refers to measurable and tangible data, such as vital signs, height, weight, etc. You can also use other sources of information, such as electronic health records, and friends that are in direct contact with the patient.

2. Diagnose the Patient

This critical step will help you in the next steps, such as planning and implementation of patient care. In this step, you will formulate a nursing diagnosis by applying clinical judgment. As a nurse, the North American Nursing Diagnosis Association (NANDA) will give you an up-to-date nursing diagnosis list, which will allow you to form a diagnosis based on the actual health problem.

3. Plan for a Proper Patient Care Plan

This part is where you will plan out the appropriate care plan for the patient. You will set this goal following the evidence-based practice (EDP) guidelines. The goal you will set should be specific, measurable, attainable, realistic, and timely ( SMART ).

4. Implement the Plan

In this stage, you can execute the plan that you have developed in the previous step. The implementation may need interventions such as a cardiac monitor, medication administration, etc.

5. Evaluate the Results

It is crucial to remember that every time the team does an intervention, you must do a reassessment to ensure that the process will lead to a positive result. You may need to reassess the patient depending on his progress, and the care plan may be modified based on the reassessment result.

Where to find nursing case studies?

Nursing case studies can be found in a variety of academic, professional, and medical resources. Here are some key places to look for nursing case studies:

  • Academic Journals : Many academic journals focus on nursing and healthcare and publish case studies regularly. Examples include the “Journal of Clinical Nursing,” “Nursing Case Studies,” and “American Journal of Nursing.”
  • University and College Libraries : Many academic institutions provide access to databases and journals that contain nursing case studies. Libraries often have subscriptions to these resources.
  • Online Medical Libraries : Websites like PubMed, ScienceDirect, and Wiley Online Library offer a vast collection of nursing and medical case studies.
  • Professional Nursing Organizations : Organizations such as the American Nurses Association (ANA) and the National League for Nursing (NLN) often provide resources, including case studies, for their members.
  • Nursing Education Websites : Websites dedicated to nursing education, such as Lippincott NursingCenter and Nurse.com, often feature case studies for educational purposes.
  • Government Health Websites : The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) sometimes publish case studies related to public health nursing and disease outbreaks.
  • Nursing Textbooks and eBooks : Many nursing textbooks and eBooks include case studies to illustrate key concepts and scenarios encountered in practice.
  • Online Nursing Forums and Communities : Forums and online communities for nursing professionals may share or discuss case studies as part of their content.
  • Conference Proceedings : Nursing and healthcare conferences often include presentations of case studies. Many of these are published in the conference proceedings, which may be accessible online.

Carrying out a nursing case study can be a delicate task since it puts the life of a person at stake. Thus, it requires a thorough investigation. With that said, it is essential to gain intensive knowledge about this type of study. Today, we have discussed an overview of how to conduct a nursing case study. However, if you think that you are having problems with your writing skills , we recommend you to consider looking for an essay writing service from the experts in the nursing department to ensure that the output follows the appropriate writing style and terminology.

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How to Present a Nursing Case Study

What Is a Case Study in Nursing?

What Is a Case Study in Nursing?

A nursing case study is an in-depth examination of a situation that a nurse encounters in her daily practice. The case study offers a safe way for the nurse to apply theoretical and actual knowledge to an actual or potential patient scenario. She can employ her decision-making skills, use critical thinking to analyze the situation, and develop cognitive reasoning abilities without harming a patient. Nursing case studies are commonly used in undergraduate nursing programs, graduate schools offering a master’s of science degree in nursing (MSN), and orientation programs for new graduate nurses. They may be presented in written form, online, or live in a classroom setting.

Choose a topic. According to Sigma Theta Tau International, the topic should be focused, based in reality, and relevant. It should demonstrate current best practices that are supported by nursing research. The nurse may choose to discuss a situation from his past experience, or delve into something in his current job.

Write objectives. There should be at least three learning objectives, or outcomes, that identify what the learner will gain from completing the case study. Learning objectives are written as clear, measurable behaviors, such as “Identify five risk factors for falls in older adults.”

Write an introduction. This should be a one- or two-paragraph overview that describes the patient, the situation, and circumstances relevant to that situation. The introduction can also include a little about the patient’s history leading up to the situation.

Integrate more history and background. The next 1 to 2 paragraphs provide the learner with in-depth information to analyze the situation, such as lab values, diagnostic study results, findings from the nurse’s assessment of the patient, and a more detailed patient history.

Formulate questions. Nursing case studies are interactive scenarios that stimulate analysis and critical thinking. The questions typically require the learner to use the nursing process (assessment, nursing diagnosis, planning, intervention, and evaluation) and to anticipate what will happen next in the situation.

Give feedback. According to Sigma Theta Tau, the nursing case study provides the learner with two types of feedback: informational and reinforcing. Informational feedback lets the learner know if she has answered questions correctly, and gives her an idea of how she is progressing through the patient scenario. Reinforcing feedback gives the learner additional information about her responses to the questions. If she answers the question correctly, she’ll be given the rationale behind her right answer. If she gives the wrong answer, reinforcing feedback lets her know why that answer is wrong.

Provide references. It’s important to point the learner toward additional learning opportunities in print or on the web.

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Sandy Keefe, M.S.N., R.N., has been a freelance writer for over five years. Her articles have appeared in numerous health-related magazines, including "Advance for Nurses" and "Advance for Long-Term Care Management." She has written short stories in anthologies such as "A Cup of Comfort for Parents of Children with Special Needs."

Student Doctor Network

How To Present a Patient: A Step-To-Step Guide

Last Updated on June 24, 2022 by Laura Turner

Updated and verified by Dr. Lee Burnett on March 19, 2022.

The ability to deliver oral case presentations is a core skill for any physician. Effective oral case presentations help facilitate information transfer among physicians and are essential to delivering quality patient care. Oral case presentations are also a key component of how medical students and residents are assessed during their training.

At its core, an oral case presentation functions as an argument. It is the presenter’s job to share the pertinent facts of a patient’s case with the other members of the medical care team and establish a clear diagnosis and treatment plan. Thus, the presenter should include details to support the proposed diagnosis, argue against alternative diagnoses, and exclude extraneous information. While this task may seem daunting at first, with practice, it will become easier. That said, if you are unsure if a particular detail is important to your patient’s case, it is probably best to be safe and include it.

Now, let’s go over how to present a case. While I will focus on internal medicine inpatients, the following framework can be applied to patients in any setting with slight modifications.

Oral case presentations are generally made to a medical care team, which can be composed of medical and pharmacy students, residents, pharmacists, medical attendings, and others. As the presenter, you should strive to deliver an interesting presentation that keeps your team members engaged. Here are a few things to keep in mind:

  • Be confident: Speak clearly at the loudest volume appropriate to protect patient privacy, vary your tone to emphasize the most important details, and maintain eye contact with members of your team.
  • Don’t fidget : Stand up straight and avoid unnecessary, distracting movements.
  • Use your notes : You may glance at your notes from time to time while presenting. However, while there is no need to memorize your presentation, there is no better way to lose your team’s attention than to read your notes to them.
  • Be honest: Given the importance of presentations in guiding medical care, never guess or report false information to the team. If you are unsure about a particular detail, say so.

The length of your presentation will depend on various factors, including the complexity of your patient, your audience, and your specialty. I have found that new internal medicine inpatients generally take 5-10 minutes to present. Internal medicine clerkship directors seem to agree. In a 2009 survey , they reported a range of 2-20 minutes for the ideal length of student inpatient presentations, with a median of 7 minutes.

While delivering oral case presentations is a core skill for trainees, and there have been attempts to standardize the format , expectations still vary among attending physicians. This can be a frustrating experience for trainees, and I would recommend that you clarify your attending’s expectations at the beginning of each new rotation. However, I have found that these differences are often stylistic, and content expectations are generally quite similar. Thus, developing a familiarity with the core elements of a strong oral case presentation is essential.

How to Present a Patient

You should begin every oral presentation with a brief one-liner that contains the patient’s name, age, relevant past medical history, and chief complaint. Remember that the chief complaint is why the patient sought medical care in his or her own words. An example of an effective opening is as follows: “Ms. X is a 78-year-old female with a past medical history of chronic obstructive pulmonary disease who presents to the hospital after she felt short of breath at home.”

Following the opener, elaborate on why the patient sought medical care. Describe the events that preceded the patient’s presentation in chronological order. A useful mnemonic to use when deciding what to report is OPQRST , which includes: • The Onset of the patient’s symptoms • Any Palliative or Provoking factors that make the symptoms better or worse, respectively • The Quality of his or her symptoms (how he or she describes them) • The Region of the body where the patient is experiencing his or her symptoms and (if the symptom is pain) whether the patient’s pain Radiates to another location or is well-localized • The Severity of the symptoms and any other associated Symptoms • The Time course of the symptoms (how they have changed over time and whether the patient has experienced them before) Additionally, include any other details here that may support your final diagnosis or rule out alternative diagnoses. For example, if you are concerned about a pulmonary embolism and your patient recently completed a long-distance flight, that would be worth mentioning.

The review of systems is sometimes included in the history of present illness, but it may also be separated. Given the potential breadth of the review of systems (a comprehensive list of questions that may be asked can be found here ), when presenting, only report information that is relevant to your patient’s condition.

The past medical history comes next. This should include the following information: • The patient’s medical conditions, including any that were not highlighted in the opener • Any past surgeries the patient has had and when they were performed • The timing of and reasons for past hospitalizations • Any current medications, including dosages and frequency of administration

The next section should detail the patient’s relevant family history. This should include: • Any relevant conditions that run in the patient’s family, with an emphasis on first-degree relatives

After the family history comes the social history. This section should include information about the patient’s: • Living situation • Occupation • Alcohol and tobacco use • Other substance use You may also include relevant details about the patient’s education level, recent travel history, history of animal and occupational exposures, and religious beliefs. For example, it would be worth mentioning that your anemic patient is a Jehovah’s Witness to guide medical decisions regarding blood transfusions.

Once you have finished reporting the patient’s history, you should transition to the physical exam. You should begin by reporting the patient’s vital signs, which includes the patient’s: • Temperature • Heart rate • Blood pressure • Respiratory rate • Oxygen saturation (if the patient is using supplemental oxygen, this should also be reported) Next, you should discuss the findings of your physical exam. At the minimum, this should include: • Your general impressions of the patient, including whether he or she appears “sick” or not • The results of your: • Head and neck exam • Eye exam • Respiratory exam • Cardiac exam • Abdominal exam • Extremity exam • Neurological exam Additional relevant physical examination findings may be included, as well. Quick note: resist the urge to report an exam as being “normal.” Instead, report your findings. For example, for a normal abdominal exam, you could report that “the patient’s abdomen is soft, non-tender, and non-distended, with normoactive bowel sounds.”

This section includes the results of any relevant laboratory testing, imaging, or other diagnostics that were obtained. You do not have to report the results of every test that was ordered. Before presenting, consider which results will further support your proposed diagnosis and exclude alternatives.

The emergency department (ED) course is classically reported towards the end of the presentation. However, different attendings may prefer to hear the ED course earlier, usually following the history of present illness. When unsure, report the ED course after the results of diagnostic testing. Be sure to include initial ED vital signs and any administered treatments.

You should conclude your presentation with the assessment and plan. This is the most important part of your presentation and allows you to show your team how much you really know. You should include: • A brief summary (1-2 lines) of the patient, the reason for admission, and your likely diagnosis. This should also include information regarding the patient’s clinical stability. While it can be similar to your opener, it should not be identical. An example could be: “Ms. X is a 78-year-old female with a past medical history of chronic obstructive pulmonary disease who presents with shortness of breath in the setting of an upper respiratory tract infection who is now stable on two liters of supplemental oxygen delivered via nasal cannula. Her symptoms are thought to be secondary to an acute exacerbation of chronic obstructive pulmonary disease.” • A differential diagnosis . For students, this should consist of 3-5 potential diagnoses. You should explain why you think each diagnosis is or is not the final diagnosis. Be sure to rule out potentially life-threatening conditions (unless you think your patient has one). For our fictional patient, Ms. X, for example, you could explain why you think she does not have a pulmonary embolism or acute coronary syndrome. For more advanced trainees, the differential can be more limited in scope. • Your plan . On regular inpatient floors, this should include a list of the patient’s medical problems, ordered by acuity, followed by your proposed plan for each. After going through each active medical problem, be sure to mention your choice for the patient’s diet and deep vein thrombosis prophylaxis, the patient’s stated code status, and the patient’s disposition (whether you think they need to remain in the hospital). In intensive care units, you can organize the patient’s medical problems by organ system to ensure that no stone is left unturned (if there are no active issues for an organ system, you may say so).

Presenting Patients Who Have Been in the Hospital for Multiple Days

After the initial presentation, subsequent presentations can be delivered via SOAP note format as follows:

  • The  Subjective  section includes details about any significant overnight events and any new complaints the patient has.
  • In the  Objective  section, report your physical exam (focus on any changes since you last examined the patient) and any significant new laboratory, imaging, or other diagnostic results.
  • The  Assessment  and  Plan  are typically delivered as above. For the initial patient complaint, you do not have to restate your differential diagnosis if the diagnosis is known. For new complaints, however, you should create another differential and argue for or against each diagnosis. Be sure to update your plan every day.

Presenting Patients in Different Specialties

Before you present a patient, consider your audience. Every specialty presents patients differently. In general, surgical and OB/GYN presentations tend to be much quicker (2-3 minutes), while pediatric and family medicine presentations tend to be similar in length to internal medicine presentations. Tailor your presentations accordingly.

Presenting Patients in Outpatient Settings

Outpatients may be presented similarly to inpatients. Your presentation’s focus, however, should align with your outpatient clinic’s specialty. For example, if you are working at a cardiology clinic, your presentation should be focused on your patient’s cardiac complaints.

If your patient is returning for a follow-up visit and does not have a stated chief complaint, you should say so. You may replace the history of present illness with any relevant interval history since his or her last visit.

And that’s it! Delivering oral case presentations is challenging at first, so remember to practice. In time, you will become proficient in this essential medical skill. Good luck!

case presentation format nursing

Kunal Sindhu, MD, is an assistant professor in the Department of Radiation Oncology at the Icahn School of Medicine at Mount Sinai and New York Proton Center. Dr. Sindhu specializes in treating cancers of the head, neck, and central nervous system.

2 thoughts on “How To Present a Patient: A Step-To-Step Guide”

To clarify, it should take 5-10 minutes to present (just one) new internal medicine inpatient? Or if the student had 4 patients to work up, it should take 10 minutes to present all 4 patients to the preceptor?

Good question. That’s per case, but with time you’ll become faster.

Comments are closed.

How to make an oral case presentation to healthcare colleagues

The content and delivery of a patient case for education and evidence-based care discussions in clinical practice.

case presentation format nursing

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A case presentation is a detailed narrative describing a specific problem experienced by one or more patients. Pharmacists usually focus on the medicines aspect , for example, where there is potential harm to a patient or proven benefit to the patient from medication, or where a medication error has occurred. Case presentations can be used as a pedagogical tool, as a method of appraising the presenter’s knowledge and as an opportunity for presenters to reflect on their clinical practice [1] .

The aim of an oral presentation is to disseminate information about a patient for the purpose of education, to update other members of the healthcare team on a patient’s progress, and to ensure the best, evidence-based care is being considered for their management.

Within a hospital, pharmacists are likely to present patients on a teaching or daily ward round or to a senior pharmacist or colleague for the purpose of asking advice on, for example, treatment options or complex drug-drug interactions, or for referral.

Content of a case presentation

As a general structure, an oral case presentation may be divided into three phases [2] :

  • Reporting important patient information and clinical data;
  • Analysing and synthesising identified issues (this is likely to include producing a list of these issues, generally termed a problem list);
  • Managing the case by developing a therapeutic plan.

case presentation format nursing

Specifically, the following information should be included [3] :

Patient and complaint details

Patient details: name, sex, age, ethnicity.

Presenting complaint: the reason the patient presented to the hospital (symptom/event).

History of presenting complaint: highlighting relevant events in chronological order, often presented as how many days ago they occurred. This should include prior admission to hospital for the same complaint.

Review of organ systems: listing positive or negative findings found from the doctor’s assessment that are relevant to the presenting complaint.

Past medical and surgical history

Social history: including occupation, exposures, smoking and alcohol history, and any recreational drug use.

Medication history, including any drug allergies: this should include any prescribed medicines, medicines purchased over-the-counter, any topical preparations used (including eye drops, nose drops, inhalers and nasal sprays) and any herbal or traditional remedies taken.

Sexual history: if this is relevant to the presenting complaint.

Details from a physical examination: this includes any relevant findings to the presenting complaint and should include relevant observations.

Laboratory investigation and imaging results: abnormal findings are presented.

Assessment: including differential diagnosis.

Plan: including any pharmaceutical care issues raised and how these should be resolved, ongoing management and discharge planning.

Any discrepancies between the current management of the patient’s conditions and evidence-based recommendations should be highlighted and reasons given for not adhering to evidence-based medicine ( see ‘Locating the evidence’ ).

Locating the evidence

The evidence base for the therapeutic options available should always be considered. There may be local guidance available within the hospital trust directing the management of the patient’s presenting condition. Pharmacists often contribute to the development of such guidelines, especially if medication is involved. If no local guidelines are available, the next step is to refer to national guidance. This is developed by a steering group of experts, for example, the British HIV Association or the National Institute for Health and Care Excellence . If the presenting condition is unusual or rare, for example, acute porphyria, and there are no local or national guidelines available, a literature search may help locate articles or case studies similar to the case.

Giving a case presentation

Currently, there are no available acknowledged guidelines or systematic descriptions of the structure, language and function of the oral case presentation [4] and therefore there is no standard on how the skills required to prepare or present a case are taught. Most individuals are introduced to this concept at undergraduate level and then build on their skills through practice-based learning.

A case presentation is a narrative of a patient’s care, so it is vital the presenter has familiarity with the patient, the case and its progression. The preparation for the presentation will depend on what information is to be included.

Generally, oral case presentations are brief and should be limited to 5–10 minutes. This may be extended if the case is being presented as part of an assessment compared with routine everyday working ( see ‘Case-based discussion’ ). The audience should be interested in what is being said so the presenter should maintain this engagement through eye contact, clear speech and enthusiasm for the case.

It is important to stick to the facts by presenting the case as a factual timeline and not describing how things should have happened instead. Importantly, the case should always be concluded and should include an outcome of the patient’s care [5] .

An example of an oral case presentation, given by a pharmacist to a doctor,  is available here .

A successful oral case presentation allows the audience to garner the right amount of patient information in the most efficient way, enabling a clinically appropriate plan to be developed. The challenge lies with the fact that the content and delivery of this will vary depending on the service, and clinical and audience setting [3] . A practitioner with less experience may find understanding the balance between sufficient information and efficiency of communication difficult, but regular use of the oral case presentation tool will improve this skill.

Tailoring case presentations to your audience

Most case presentations are not tailored to a specific audience because the same type of information will usually need to be conveyed in each case.

However, case presentations can be adapted to meet the identified learning needs of the target audience, if required for training purposes. This method involves varying the content of the presentation or choosing specific cases to present that will help achieve a set of objectives [6] . For example, if a requirement to learn about the management of acute myocardial infarction has been identified by the target audience, then the presenter may identify a case from the cardiology ward to present to the group, as opposed to presenting a patient reviewed by that person during their normal working practice.

Alternatively, a presenter could focus on a particular condition within a case, which will dictate what information is included. For example, if a case on asthma is being presented, the focus may be on recent use of bronchodilator therapy, respiratory function tests (including peak expiratory flow rate), symptoms related to exacerbation of airways disease, anxiety levels, ability to talk in full sentences, triggers to worsening of symptoms, and recent exposure to allergens. These may not be considered relevant if presenting the case on an unrelated condition that the same patient has, for example, if this patient was admitted with a hip fracture and their asthma was well controlled.

Case-based discussion

The oral case presentation may also act as the basis of workplace-based assessment in the form of a case-based discussion. In the UK, this forms part of many healthcare professional bodies’ assessment of clinical practice, for example, medical professional colleges.

For pharmacists, a case-based discussion forms part of the Royal Pharmaceutical Society (RPS) Foundation and Advanced Practice assessments . Mastery of the oral case presentation skill could provide useful preparation for this assessment process.

A case-based discussion would include a pharmaceutical needs assessment, which involves identifying and prioritising pharmaceutical problems for a particular patient. Evidence-based guidelines relevant to the specific medical condition should be used to make treatment recommendations, and a plan to monitor the patient once therapy has started should be developed. Professionalism is an important aspect of case-based discussion — issues must be prioritised appropriately and ethical and legal frameworks must be referred to [7] . A case-based discussion would include broadly similar content to the oral case presentation, but would involve further questioning of the presenter by the assessor to determine the extent of the presenter’s knowledge of the specific case, condition and therapeutic strategies. The criteria used for assessment would depend on the level of practice of the presenter but, for pharmacists, this may include assessment against the RPS  Foundation or Pharmacy Frameworks .

Acknowledgement

With thanks to Aamer Safdar for providing the script for the audio case presentation.

Reading this article counts towards your CPD

You can use the following forms to record your learning and action points from this article from Pharmaceutical Journal Publications.

Your CPD module results are stored against your account here at The Pharmaceutical Journal . You must be registered and logged into the site to do this. To review your module results, go to the ‘My Account’ tab and then ‘My CPD’.

Any training, learning or development activities that you undertake for CPD can also be recorded as evidence as part of your RPS Faculty practice-based portfolio when preparing for Faculty membership. To start your RPS Faculty journey today, access the portfolio and tools at www.rpharms.com/Faculty

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[1] Onishi H. The role of case presentation for teaching and learning activities. Kaohsiung J Med Sci 2008;24:356–360. doi: 10.1016/s1607-551x(08)70132–3

[2] Edwards JC, Brannan JR, Burgess L et al . Case presentation format and clinical reasoning: a strategy for teaching medical students. Medical Teacher 1987;9:285–292. doi: 10.3109/01421598709034790

[3] Goldberg C. A practical guide to clinical medicine: overview and general information about oral presentation. 2009. University of California, San Diego. Available from: https://meded.ecsd.edu/clinicalmed.oral.htm (accessed 5 December 2015)

[4] Chan MY. The oral case presentation: toward a performance-based rhetorical model for teaching and learning. Medical Education Online 2015;20. doi: 10.3402/meo.v20.28565

[5] McGee S. Medicine student programs: oral presentation guidelines. Learning & Scholarly Technologies, University of Washington. Available from: https://catalyst.uw.edu/workspace/medsp/30311/202905 (accessed 7 December 2015)

[6] Hays R. Teaching and Learning in Clinical Settings. 2006;425. Oxford: Radcliffe Publishing Ltd.

[7] Royal Pharmaceutical Society. Tips for assessors for completing case-based discussions. 2015. Available from: http://www.rpharms.com/help/case_based_discussion.htm (accessed 30 December 2015)

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TEACHING TIPS: TWELVE TIPS FOR MAKING CASE PRESENTATIONS MORE INTERESTING *

1. set the stage.

Prepare the audience for what is to come. If the audience is composed of people of mixed expertise, spend a few minutes forming them into small mixed groups of novices and experts. Explain that this is an opportunity for the more junior to learn from the more senior people. Tell them that the case to be presented is extremely interesting, why it is so and what they may learn from it. The primary objective is to analyze the clinical reasoning that was used rather than the knowledge required, although the acquisition of such knowledge is an added benefit of the session. A “well organized case presentation or clinicopathological conference incorporates the logic of the workup implicitly and thus makes the diagnostic process seem almost preordained”.

A psychiatry resident began by introducing the case as an exciting one, explaining the process and dividing the audience into teams mixing people with varied expertise. He urged everyone to think in ‘real time’ rather than jump ahead and to refrain from considering information that is not normally available at the time: for example, a laboratory report that takes 24 hours to obtain be assessed in the initial workup.

2. PROVIDE ONLY INITIAL CUES AT FIRST

Give them the first two to live cues that were picked up in the first minute or two of the patient encounter either verbally, or written on a transparency. For example, age, sex race and reason for seeking medical help. Ask each group to discuss their first diagnostic hypotheses. Experts and novices will learn a great deal from each other at this stage and the discussions will be animated. The initial cues may number only one or two and hypothesis generation occurs very quickly even in the novices. Indeed, the only difference between the hypotheses of novices and those of experts is in the degree of refinement, not in number.

It is Saturday afternoon and you are the psychiatric emergency physician. A 25-year-old male arrives by ambulance and states that he is feeling suicidal. Groups talked for 4 minutes before the resident called for order to commence step three.

3. ASK FOR HYPOTHESES AND WRITE THEM UP ON THE BLACKBOARD

Call for order and ask people to offer their suggested diagnoses and write these up on a board or transparency.

The following hypotheses were suggested by the groups and the resident wrote them on a flip chart: depression, substance abuse, recent social stressors-crisis, adjustment disorder, organic problem, dysthymia, schizophrenia, bipolar affective disorder. The initial three or four bits of information generated eight hypotheses.

4. ALLOW THE AUDIENCE TO ASK FOR INFORMATION

After all hypotheses have been listed instruct the audience to ask for the information they need to confirm or refute these hypotheses. Do not allow them to ‘jump the gun’ by asking for a test result, for example, that would not have been received within the time frame that is being re-lived. There will be a temptation to move too fast and the exercise is wasted if information is given too soon. Recall that the purpose is to help them go through a thinking process which requires time.

Teachers participating in this exercise will receive much diagnostic information about students’ thinking at this stage. Indeed, an interesting teaching session can be conducted by simply asking students to generate hypotheses without proceeding further. There is evidence to suggest that when a diagnosis is not considered initially it is unlikely to be reached over time, Hence it is worth spending time with students to discuss the hypotheses they generate before they proceed with an enquiry.

Directions to the group were to determine what questions they would like to ask, based on gender, age and probabilities, to support or exclude the listed diagnostic possibilities. A sample of question follow:

  • Does he work? No, he's unemployed.
  • Does he drink? one to three beers a week.
  • Why now? He's been feeling worse and worse for the last 3 weeks.
  • Social support? He gives alone. Has no girlfriend.
  • Appearance? Looks his age. Not shaved today. No shower in 3 days.
  • Cultural background? Refugee from Iraq. Muslim.
  • How did he get here? He spent 4 years in a refugee camp after spending 4 months walking to Pakistan from Iraq. He left Iraq to avoid military service.
  • Suicide thoughts? Increasing the last 3 weeks. He was admitted in December and has been taking chloral hydrate.

This step took 13 minutes.

5. HAVE THE AUDIENCE RE-FORMULATE THEIR LIST OF HYPOTHESES

After enough information has been gained to proceed, ask them to resume their discussion about the problem and reformulate their diagnostic hypotheses in light of the new information. Instruct them to discuss which pieces of information changed the working diagnosis and why. Call for order again and ask people what they now think.

After allowing the group to talk for a few minutes, the resident asked them if there was enough information to strike off any hypotheses or if new hypotheses should be added to the list. One more possibility was added, post-traumatic stress disorder (PTSD). One group's list of priorities was major affective disorder with psychosis, schizophrenia, personality disorder. Another group also placed affective disorder first followed by organic mood disorder.

This step took 25 minutes.

6. FACILITATE A DISCUSSION ABOUT REASONING

Alter the original lists of hypotheses on the board in light of the discussion, or allow one member from each group to alter their own lists. By the use of open-ended questions encourage a general discussion about the reasons a group has for preferring one diagnosis over another.

A general discussion ensued about reasons for these priorities. Then the list was altered so that it read: schizophrenia, personality disorder, PTSD, major affective disorder with psychosis, organic mood disorder.

7. ALLOW ANOTHER ROUND OF INFORMATION SEEKING

Continue with another round of information and small-group discussion or else allow the whole group to interact. By giving information only when asked for and only in correct sequence, each person is challenged to think through the problem.

More information was sought, such as: form of speech? eye contact? affect? substance use? After 5 minutes the resident asked if there were only lab tests they would like. The group asked for thyroid stimulating hormone, T4, electrolytes and were given the results. They also asked for the results of the physical examination and were told that the pulse was 110 and the thyroid was enlarged. At this point some hypotheses were removed from the list.

8. ASK GROUPS TO REACH A FINAL DIAGNOSIS

When there is a lull in the search for information, ask the groups to reach consensus on their final diagnosis, given the information they have. Allow discussion within the groups.

9. CALL FOR EACH GROUP'S FINAL DIAGNOSIS

On each group's list of hypothesis, star or underline the final diagnosis.

The group decided that the most likely diagnosis was affective disorder with psychosis, the actual working diagnosis of the patient.

10. ASK FOR MANAGEMENT OPTIONS

If there is enough time, ask them to form small groups again to discuss treatment options, or conduct the discussion as a large group. Again ask for the reasons why one approach is preferred over another. Particularly ask the experts in the room for their reasoning so that the novices can learn from them.

11. SUMMARIZE

By the time the end is in sight the audience will be so involved that they will not wish to leave. However, 5 minutes before time, call for order and summarize the session. Highlight the key points that have been raised and refer to the objective of the session.

We are now at the end of our time. You have all had the opportunity to use your clinical reasoning skills to generate several hypotheses which are shown on the board. Initially you thought it possible that this man could have any one of a number of diagnoses including depression, substance abuse, adjustment disorder with depressed mood, organic mood disorder or post-traumatic stress disorder. With further information the possible diagnosis shifted to include schizophrenia and personality disorder as well as depression with psychotic features. Finally the diagnosis of depression or mood disorder with psychosis was most strongly supported because of the history of consistently depressed mood over several months, along with disturbed sleep, poor appetite, weight loss, decreased energy and diminished interest in most activities. The initially abnormal thyroid test proved to be a red herring so organic mood disorder related to hyper- or hypo-thyroidism was excluded. Additionally absence of vivid dreams involving a traumatic event made a diagnosis of post-traumatic stress disorder unlikely. Although a diagnosis of schizophrenia could not be totally excluded, this seemed less likely given the findings.

12. CLOSE THE SESSION WITH POSITIVE FEEDBACK

In some respects, but only some, teaching is like acting and one should strive to leave them not laughing as you go, but feeling that they have learned something.

The more novice members of the group have learned from the more experienced and all your suggestions have been valid. It has been interesting for me to follow your reasoning and compare it with mine when I actually saw this man. You have given me a different perspective as you thought of things I had not, and I thank you for your participation.

Although case presentation should be a major learning experience for both novice and experienced physicians they are often conducted in a stultifying way that defies thought. We have presented a series of steps which, if followed, guarantee active participation from the audience and ensure that if experts are in the room their expertise is used. Physicians have been moulded to believe that teaching means telling and, as a consequence, adopt a remote listening stance during case presentations. Indeed the back row often use the time to catch up on much needed sleep! Changing the format requires courage. We urge you to try out these steps so that both you and your audience will learn from and enjoy the process.

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Effective case presentations--an important clinical skill for nurse practitioners

  • PMID: 2631925
  • DOI: 10.1111/j.1745-7599.1989.tb00738.x

Effective case presentations are an important component of the nurse practitioner's skills, yet very little literature exists to guide the development of this skill, and frequently little priority is given to teaching this skill during the education of the nurse practitioner. This report discusses the importance of effective case presentations, describes the organization of the presentation, and outlines the appropriate information to be included. The main components of a case presentation--introduction, history of the present illness, physical examination, diagnostic studies, differential diagnosis, management, and summary of the case--are discussed in detail. Examples of a formal and an informal case presentation are presented and used to illustrate key points in the text.

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  • The case presentation as argument. Brown LH. Brown LH. J Am Acad Nurse Pract. 2006 Sep;18(9):395-6. doi: 10.1111/j.1745-7599.2006.00155.x. J Am Acad Nurse Pract. 2006. PMID: 16958769 No abstract available.
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    FINALS. Case Pre sentation - Level 3 Nursing Student. Guidelines and format for the case study and pr esentation. 1. Overview of the Existing Health Problem (can be based on the book and other related. study or literature) 2. Profile of the Patient (include the socio-economic condition, health history) 3.

  16. Teaching Tips: Twelve Tips for Making Case Presentations More

    1. SET THE STAGE. Prepare the audience for what is to come. If the audience is composed of people of mixed expertise, spend a few minutes forming them into small mixed groups of novices and experts. Explain that this is an opportunity for the more junior to learn from the more senior people. Tell them that the case to be presented is extremely ...

  17. Effective case presentations--an important clinical skill for nurse

    Effective case presentations are an important component of the nurse practitioner's skills, yet very little literature exists to guide the development of this skill, and frequently little priority is given to teaching this skill during the education of the nurse practitioner. This report discusses the importance of effective case presentations ...

  18. Free templates for Google Slides and PPT about Nursing

    Nursing Presentation templates They draw your blood when you have a blood test. They give you vaccinations. They assist doctors with critical tasks and help the elderly if they need it. ... In that case, we have the perfect template for you! These slides will make your presentation super calm and attractive:... Medical. 16:9 / Like . Download ...

  19. Sample of Case Presentation

    SAMPLE OF CASE PRESENTATION - Free download as PDF File (.pdf), Text File (.txt) or read online for free. This document provides background information on a case study being conducted on the Fernandez family in the Philippines. It includes an introduction outlining the significance of community health nursing and the family as the basic unit of society.

  20. Clinical Case 01-2023 Google Slides and PowerPoint Template

    Features of this template. Available in five colors: pink, yellow, green, blue and orange. Includes 1000+ icons divided into 11 different themes for customizing your slides. Designed to be used in Google Slides, Canva and PowerPoint. 16:9 widescreen format suitable for all types of screens. Includes information about fonts, colors, and credits ...