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HealthSeptember 23, 2020

Flipped classroom: A case study-based approach in the classroom

By: Shelly Morgan, MSN, RN-BC, CMSRN
Are your students prepared for discussion? Who has read the textbook? If your students are walking in with minimal effort applied and expecting to be given the content from your lecture, maybe it is time to shake things up in the classroom! Being a self-motivated learner is an essential characteristic of any successful nurse. Let’s develop this skill in our students!

Flipping the focus

Designing your theory delivery to include student questioning forces the student to bring a baseline knowledge level of the content to the classroom. The traditional classroom setting focuses on the instructor in the front of the room presenting information while the students take notes. By providing a case study approach with concept mapping outlining the necessary thought process and care, we can develop the student’s ability to apply the knowledge. This ensures that the students are adequately prepared for clinical and practice.

The case study

The students are provided the case study information. A volunteer client is then selected to act out the role of the patient and the students complete the patient interview. Depending on the point in the student’s learning within the course, the volunteer client is either asked to fabricate information for the questioning or may be provided with index cards stating laboratory values, assessment findings, or diagnostic testing that may be helpful in the scenario.

Example Case Study: You are caring for an 83-year-old male admitted for acute confusion. The patient was found in his car at a local grocery store, and he was disoriented to place, time, and situation. The patient’s labs show an elevated WBC and the UA showed many bacteria present, and the urine culture is pending at this time. The patient is currently oriented to person, place, time and situation. The patient’s family is concerned with the patient’s living situation and the ability to care for oneself.

The concept map

The class is provided with a template concept map to ensure that all the aspects of care are considered. Concept mapping is encouraged to ensure the student is learning from their studying. If the student is simply taking notes, the student may take an overabundance of notes that allows the student to simply memorize the notes. However, with concept mapping, the student is asked to condense the material into one page. This ensures the student truly understands the material. If the student does not understand the condensed form of the material, the student is forced to go back to the textbook to review and reinforce the content.

Student interaction

The students work together to assess and interview the volunteer client and form the concept map. By completing this activity, the students are developing teamwork and recognizing strengths and weaknesses for themselves and others. The ability to evaluate both strengths and weaknesses is vital in performing on a healthcare team successfully.

Clinical application

The case study approach can be used to prove and demonstrate safe clinical practice. For instance, if skin integrity and wound care are being covered in theory, the students would be provided a case study that requires demonstration of safe patient positioning, determining risk factors for frequency of repositioning and demonstration of proper body mechanics of the student. By providing the opportunity to demonstrate clinical skills in the classroom, the student has the ability to develop confidence with the skill and ask questions in a non-clinical space.

Peer feedback

When requesting students to provide peer feedback, often, instructors are faced with the “atta girl!” response. By providing a format to use for peer feedback and setting the precedence, all students receive feedback in the same manner. This helps to pull adequate, helpful information from the student and encourage open communication within the classroom environment. By requesting a positive comment at the start and finish of the peer feedback, this reinforces constructive information being shared.

Peer feedback:

  • You are good at this:
  • You could improve this:
  • You could add this:
  • You are good at this:


Creating self-motivated learners starts in the classroom. From classroom to clinical, nursing is a great journey for all of us!

Shelly Morgan, MSN, RN-BC, CMSRN
Expert Insights Contributor for Wolters Kluwer, Nursing Education
Lippincott Nursing Education
Preparing today’s students to become tomorrow’s nurses.