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Strategy Submission

Unfolding Case Study to Teach Assessment and Care of the High-Risk Newborn


Elizabeth Riley



Clinical Assistant Professor


Nicole Ward, PhD, APRN, WHNP-BC, RN; Leslie McCormack, MSN, CNM, RN; Natalie Capps, MNSc, RN


University of Arkansas for Medical Sciences – College of Nursing


Competency Categories:

Evidence-Based Practice, Patient-Centered Care, Safety

Learner Level(s):

Pre-Licensure ADN/Diploma, Pre-Licensure BSN

Learner Setting(s):

Classroom, Skills or Simulation Laboratories

Strategy Type:

Case Studies

Learning Objectives:

1. The student will identify the major complications requiring care in infants born to diabetic mothers (IDM) to promote patient safety. (Knowledge) 2. The student will describe the pathophysiological basis of the major complications in IDM for early assessment and patient-centered care. (Knowledge) 3. The student will recommend the patient-centered care provided to high-risk newborns who are IDM based on risk factors and individualized patient information (labs & assessment) using evidence-based guidelines. (Skills)

Strategy Overview:

Research shows that unfolding case studies can be used as formative assessment technique to aid with experiential learning (Kaylor & Strickland, 2015). The purpose of this assignment was to create an unfolding case study scenario that students could complete as an alternative clinical assignment that would use a formative assessment method, similar to a clinical experience. Case studies have been discussed in the literature as a method for alternative clinical assignments to promote critical thinking and ensure students make connections between didactic knowledge and clinical experience (Bowman, 2017). This case study can be completed by students asynchronously or synchronously as a group and can be implemented in both the face-to-face classroom or online environments. The case study should be implemented in parts, utilizing the identified sections (1, 2, and 3). For synchronous environments (face-to-face or online), students should be instructed to identify, describe, and examine their answers to each question with the instructor providing support and guidance throughout the entire unfolding case. For asynchronous environments (online), students can complete their answers to the case study and receive individualized instructor feedback upon submission. Students can meet the learning objectives by using the resources (provided or instructor chosen, ex: textbook) to answer the questions within each scenario. Answers should be thorough and provide enough information that covers all pertinent areas of management and care of the IDM with emphasis on safety, patient-centered care, and evidence-based guidelines. Safety should be addressed through student identification of abnormal lab values, signs/symptoms requiring further assessment, and discussing the RN’s role to ensure safe patient care to the IDM in the specific scenario. By addressing these aspects of safety, students will examine their role in communication and implementing interventions to ensure reduced risk of patient harm. Patient-centered care is addressed through standards of care for the IDM and the use of communication and patient teaching for the parents of the IDM. Evidence-based practice will be addressed by the use of guidelines and resources (provided in references) to determine the best clinical practice and management of the newborn in the scenario.

Additional Materials:

Evaluation Description:

The strategy evaluation of this assignment is through formative assessment in either face-to-face or online environments as an asynchronous or synchronous activity. The use of formative assessment allows the instructor to assess students’ performance during the learning activity in a face-to-face format by walking through the students’ responses to the questions synchronously during class time. If utilized in the online environment, the case study can be implemented formatively following a recorded lecture asynchronously. Through the online format, instructors can require students to submit their written answers to the case study to be formally reviewed by the instructor with individualized feedback. The case study should evaluate the students’ learning related to the pathophysiological presentation, evidence-based care, and management of IDM. Students should reference evidence-based guidelines, such as The S.T.A.B.L.E. textbook (gold standard for hypoglycemia and airway management for newborns), referenced journal articles, and organizational websites (American Diabetes Association [ADA], 2020; Karlsen, 2012; Mimouni, Mimouni, & Bental, 2013; Rubarth, 2015), to answer the case study questions from each scenario section.
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