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selected and used in the process to aid the scholar to thoroughly investigate problems.
In addition, experts are identifi ed and used as the project is planned and implemented.
These experts provide the scholar with addi- tional insight into the project topic. These networking connections are deliberately selected to augment information provided in conjunction with the mentor.
Capstone projects provide support and engagement with students to develop an in-depth evidence-based learning outcome.
An expectation of the capstone project is the commitment to lifelong learning through the use of decision making and evidence-based practice.
American Association of Colleges of Nursing (AACN). (2006). The essentials for doc- toral nursing for advanced nursing practice.
Washington, DC: Author.
Clarke, S. P. (2013). Practice-academia col- laboration in nursing: Contexts and future directions. Nursing Administration Quarterly, 37(3), 184–193.
Great Schools Partnership. (n.d.). Capstone project. Retrieved from http://edglossary.
org/capstone-project/
Newland, J. A. (2013). DNP scholarly projects change practice. The Nurse Practitioner, 38(4), 6.
Overcash, J. (2013, August). Nursing research:
Speaking up for the value of small proj- ects. Oncology Nurse Advisor, 21–23.
Rutledge, C. M., & Renaud, M. (2013). Back to school! Selecting a DNP program. Nursing Management, 44(11), 30–36; quiz 36. doi:
10–1097/01.NUMA.0000436363.14645.15 Carol Boswell
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that is proposed or presented. Therefore, in teaching the concept of caring, it is key to understand the assumptions and world- view of the caring theory (Smith, 1999).
The fi ndings from research studies exploring student nurses’ and nurses’ per- ceptions of caring show that the clinical aspects of caring are rated highly. In addi- tion, knowing what to do and technical com- petency were rated high (Omari, AbuAlRub,
& Ayasreh, 2013; Papastavrou et al., 2012;
Zamanzadeh, Azimzadeh, Rahmani, &
Valizadeh, 2010). However, practicing a caring approach goes beyond clinical com- petence, and includes creating a healing environment. Therefore, teaching from a theoretical framework that includes caring is a moral imperative.
RECOMMENDATIONS
It is recommended that a caring philosophy should be integrated throughout the cur- riculum of a nursing program. Integration can be accomplished through a theoretical framework on caring that makes explicit the caritas processes of practicing loving kind- ness, honoring others, nurturing individual beliefs, developing helping/trusting rela- tionships, listening, creative decision mak- ing, respecting human dignity, and being open to mystery.
Cohen, J. A. (1991). Two portraits of caring: A comparison of the artists, Leininger and Watson. Journal of Advanced Nursing, 16(8), 899–909.
Kitson, A. L. (1987). A comparative analysis of lay-caring and professional (nursing) caring relationships. International Journal of Nursing Studies, 24(2), 155–165.
Leininger, M. (1977). The phenomenon of caring. Part V. Caring: The essence and central focus of nursing. Nursing Research Report, 12(1), 2, 14.
Omari, F. H., AbuAlRub, R., & Ayasreh, I. R.
(2013). Perceptions of patients and nurses towards nurse caring behaviors in coro- nary care units in Jordan. Journal of Clinical Nursing, 22(21–22), 3183–3191.
described by Watson (1985) are practicing loving kindness, honoring others, nurtur- ing individual beliefs, developing helping/
trusting relationships, listening, creative decision making, respecting human dig- nity, and being open to mystery. Caring is a value, an attitude, a will, an inten- tion, and a commitment (Watson, 1985).
Thus, caring is a moral imperative focus- ing on maintaining dignity and respect of patients. Caring is an intersubjective process involving humanistic aspects ini- tialized through the demonstration of the caritas processes.
APPLICATION
The teaching of caring is central to nurse education. According to Watson and Smith (2002), knowledge about caring is the key to understanding human health, healing, and quality of life. Caring is being present with the patient in the here and now. The use of a theory to guide the teaching of caring is crucial for nursing and knowledge develop- ment. Caring theories fall into the category of middle-range theories and are best suited to teach caring because these theories can directly be applied to practice. There are several teaching strategies available to assist the teaching of caring. Such strategies include the use of case studies, refl ection, caring scenarios, objective structured clini- cal examinations, and role-play.
SYNOPSIS
The teaching of caring is fundamental to nursing. Caring is the essence of nursing, a core professional value, and a paradigm unique to nursing (Cohen, 1991; Kitson, 1987; Leininger, 1977; Roach, 1998; Schwerin, 2004; Swanson, 1993; Watson, 1979). Caring is defi ned and conceptualized in various ways. Teachers who have a solid grasp on the meaning of caring and practice a caring way of being, make a unique contribution to nursing education. Caring is defi ned according to the theoretical perspective
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learning during instruction of course mate- rial (Rowles, 2012). Case scenarios encourage critical thinking through application of the- ory and didactic content to real or simulated life situations. The term case scenario is used interchangeably with case study, case problem, case report, and research case. Attributes of case scenarios may be exemplifi ed through socio- drama and role-play methodologies that incorporate theatrical presentation of class- room theory.
APPLICATION
Development of critical thinking and clini- cal reasoning is essential to the education of nurses. Clinical reasoning encompasses refl ection (Benner, Sutphen, Leonard, & Day, 2010) and ability to use critical thinking skills to accommodate the ever-changing nature of clinical environments (Rowles, 2012).
Throughout history, nurse educators have relied on clinical rotations to provide experi- ential learning for students; however, clinical learning opportunities vary depending on care needs of patients and available clinical sites. Considering the impact of multiple vari- ables on clinical learning, there is a call for nursing education to be transformed through the use of active teaching and learning strate- gies, one of which is the case scenario. Many students learn through inductive rather than deductive reasoning; they learn better from examples, and benefi t from applying what they have learned in the classroom to real world situations. Case scenarios, written from rich clinical experiences, may be used as an adjunct to a minilecture or customized to assist students with applying course-spe- cifi c theory to real life in an active learning environment. Multiple case scenarios incor- porated in a classroom setting allow smaller groups of students to identify similarities and differences among cases. Well-designed cases should illustrate critical concepts in a nonthreatening environment to ensure active student participation. Engagement in case study discussion promotes development of analytical and problem-solving skills and improves students’ decision-making abilities Papastavrou, E., Efstathiou, G., Tsangari, H.,
Suhonen, R., Leino-Kilpi, H., Patiraki, E., . . . Merkouris, A. (2012). A cross- cultural study of the concept of caring through behaviours: Patients’ and nurses’
perspectives in six different EU coun- tries. Journal of Advanced Nursing, 68(5), 1026–1037.
Roach, M. S. (1998). Caring ontology: Ethics and the call of suffering. International Journal for Human Caring, 2(2), 30–34.
Schwerin, J. I. (2004). The timeless caring con- nection. Nursing Administration Quarterly, 28(4), 265–270.
Smith, M. C. (1999). Caring and the science of unitary human beings. Advances in Nursing Science, 21(4), 14–28.
Swanson, K. M. (1993). Nursing as informed caring for the well-being of others.
Image—The Journal of Nursing Scholarship, 25(4), 352–357.
Watson, J. (1979). Nursing: The philosophy and science of caring. Boston, MA: Little Brown. Reprinted/republished 1985.
Boulder: Colorado Associated University Press.
Watson, J. (1985). Nursing: Human science and human care—A theory of nursing. New York, NY: National League for Nursing.
Watson, J., & Smith, M. C. (2002). Caring sci- ence and the science of unitary human beings: A trans-theoretical discourse for nursing knowledge development. Journal of Advanced Nursing, 37(5), 452–461.
Zamanzadeh, V., Azimzadeh, R., Rahmani, A., & Valizadeh, L. (2010). Oncology patients’ and professional nurses’ percep- tions of important nurse caring behaviors.
BMC Nursing, 9, 10.
Catrina Heffernan
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ASES
CENARIOSDEFINITION
A case scenario is a comprehensive analysis of a real-life situation used to promote active
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and critical thinking, when combined, have been described as the thinking required in nursing (Kuiper & Pesut, 2004). Participation in a case study discussion promotes formu- lation of varied and unique ideas at both the individual and collaborative levels, thus broadening the knowledge integration per- spective (Linn, 2006).
SYNOPSIS
Learning involves a relatively permanent change in cognition that results from experi- ence and directly infl uences behavior. Active learning strategies such as case scenarios that prepare students for challenges of the health care environment are supported by the American Association of Colleges of Nursing (AACN, 2009). Benner et al. (2010) support radical transformation in learning, whereby educators promote clinic-like experiences that inspire students to apply knowledge and practice thinking to changing situa- tions to improve patient health outcomes.
According to Benner’s theory, students’ per- ceptual awareness of emerging clinical prob- lems closely parallels their level of clinical competency (Larew, Lessans, Spunt, Foster,
& Covington, 2006). Case scenarios can be written for simulated learning opportunities, designed to emphasize various nursing con- cepts, and utilized in collaborative education environments at multiple levels of learning (Hannah & Oliver, 2011). This evidence-based teaching methodology promotes exchange of ideas between information and practice, and assists students with identifying “practice evidence” on which they can base care of cli- ents in the future.
RECOMMENDATIONS
Nurse educators have a professional respon- sibility to incorporate established standards and clearly articulated student learning and program outcomes consistent with contem- porary practice in the educational preparation of students (Accreditation Commission for Education of Nurses [ACEN], 2013). Benner et al. (2010) and the National League for in complex situations. Comprehension of con-
cepts may be reinforced by pairing the case with a reading assignment and/or through utilization of concept maps, chalkboards, and electronic resources.
Use of a framework to foster develop- ment of clinical reasoning promotes integra- tion and application of theory to practice in the clinical setting. The concept of case-based reasoning (CBR), born of research in the 1980s, suggested that individuals not only organize different types of knowledge through iden- tifying schema-like knowledge structures, they also simultaneously make inferences determined by those knowledge structures (Kolodner, 2006). Researchers’ observations further indicated that there are processes that allow a reasoner to reason on the basis of previous experiences. Considering these fi ndings, the use of a framework based on principles of CBR has potential for designing learning environments, including adult edu- cation, K–12 classrooms, and undergraduate education.
In CBR, a case includes a setting, actors and actors’ goals, sequence of events, expected results, and explanations that link outcomes to goals and means; intelligent behavior is determined by a person’s ability to identify signifi cant features of a new situation and apply previous experiences to solve prob- lems (Kolodner, 2006). Although refl ection on learning has been linked to more complex thinking, particularly in the practice dimen- sion of clinical reasoning, students must actively engage with the theoretical, psy- chomotor, and affective content inherent in nursing to transform information into their own knowledge (Rowles, 2012). Students use focused refl ection to reason on the basis of previous experiences and critical thinking to fi nd answers they will not fi nd in a book. Use of a holistic nursing knowledge base allows nurses to think through patient situations and provide individualized evidence-based care as opposed to following a routine proce- dure. Nurses engage in metacognition (refl ec- tive thinking), a self-communication process, before, during, and after performance of a task or skill (Rowles, 2012). Metacognition
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Benner’s theory in an interactive patient care simulation. Nursing Education Perspectives, 27(1), 16–21.
Linn, M. C. (2006). The knowledge inte- gration perspective on learning and instruction. In R. Keith Sawyer (Ed.), The Cambridge handbook of the learning sciences (pp. 243–264). New York, NY: Cambridge University Press.
National League for Nursing. (2005). Core competencies of nurse educators. Retrieved from http://www.nln.org/profdev/pdf/
corecompetencies.pdf
Rowles, C. J. (2012). Strategies to promote crit- ical thinking and active learning. In D. M.
Billings & J. A. Halstead (Eds.), Teaching in nursing: A guide for faculty (4th ed., pp. 258–
284). St. Louis, MO: Elsevier Saunders.
Vicki Sullivan Hannah