Inspiring Critical Thinking through the Use of a Culturally Based Perinatal Case Study

Purpose for the program:

Educating future nursing students poses many challenges in the 21^st century. During this time, the nursing profession has faced critical shortages of nurses and nurse educators, and an economic recession. Due to heavy competition to obtain “traditional clinical experiences” in local hospitals, non-traditional clinical experiences became necessary. Nursing educators are forced to “think outside of the box” with innovative and creative instructional design. Lack of qualified educators and traditional clinical experiences in the perinatal area compels educators to educate future nurses differently than how they were educated. Nurses now more than ever are required to think critically. A comprehensive case study guided by a critical thinking model addresses the challenges educators face today.

Proposed change:

Due to constraints faced at a Metropolitan University, the course coordinator developed a comprehensive perinatal case study. Course objectives became challenging to meet with traditional clinical experiences. By developing a comprehensive, culturally based perinatal family case study, each student is able to meet the course objectives while gaining imperative critical thinking skills. The social, medical, psychosocial, and financial challenges the Gonzalez family faces are realistic of potential clients that a nursing student may encounter.

Implementation, outcomes and evaluation:

The Gonzalez family was introduced to the students enrolled in the Childbearing Family Nursing course the fall semester in 2009. A critical thinking grading rubric was developed using the Paul-Elder critical thinking model. Since its initiation, both the case study and the grading rubric have been revised to better meet the student’s. Comprised of three parts, the family case study addresses cultural awareness, family dynamics, disaster preparedness, prenatal care, labor and delivery, postpartum, neonatal, and breastfeeding. The class average on each of the case studies ranged from high B to low A. Students commented that the assignment was “time consuming” and “forced them to think” and were able to use the concepts in the case study to pass exams. The assignment required the student to consider varying view points and cultural practices different from their own.

Implications for nursing practice:

Students enrolled in maternity courses in undergraduate nursing programs may not care for a pregnant woman and her family during the course of a pregnancy, labor, birth, postpartum, neonatal, and breastfeeding experience. Using a case study exposes a student to a realistic client a nurse may face in today’s world. A case study using critical thinking elements enhances a nurse’s ability to safely care for mothers, babies, and families.

Keywords: Critical thinking, case study, culturally based, perinatal