1. Online Interactive Case Studies Melanie A Kroger-Jarvis DNP MSN CNS APRN Assistant Professor of Clinical College of Nursing University of Cincinnati

2. Literature Review Online education increasing in popularity. Challenges exist: engagement, reflective and critical thinking (Johnson, 2008). Principles for good practice in online teaching (Chickering and Ehrman, 1996).

3. Literature Review Discussion Boards promote learning and interaction between faculty and peers (Smith, Passmore, & Faught, 2009).

4. Literature Review Clinical scenarios using a computerized model were found to promote critical thinking and problem solving (Feingold, Calaluce, & Kallen 2004). Case studies foster critical thinking and an avenue for assessment (Smith, Heindel & Torres-Ayala, 2008).

5. Background Information Two case studies were created by a colleague(Amanda Zemmer MSN CNS) and myself teaching the other section of the course. Gerontology Nursing Course Pain and Legal Ethical Issues were chosen as the topics.

6. Background Information Case Studies were in word developed and created in animation by instructional design and a graphic artist.

7. Hypothesis Students will demonstrate learning, reflection, engagement, and critical thinking after completing the case studies.

8. Method IRB Approval Convenience sample of RN to BSN students in two sections of Spring 13 Gerontology Course. 45 students viewed case studies and answered 3 questions on each case study on discussion board.

9. Questions 1.What did you learn form this case study? 2.How did your answers compare to the Nurse Practitioner's response? 3.How can you apply what you learned to your nursing practice?

12. Results Legal Ethical Issues/ SafetyYesNo Learn from the Case Study405 Similar to Nurse Practitioner's Response3510 Able to Apply What You Learned to Practice2520

13. Results cont. Pain Case StudyYesNo Learn from the Case Study369 Similar to Nurse Practitioner's Response378 Able to Apply What You Learned to Practice2223

14. Student Comments “ I am surprised that some of my answers were so different that what theirs were.” “I was thinking differently than the nurse practitioner as well.” “Some of my answers didn’t reflect the big picture of the case study”.

15. Student Comments “I can now apply this knowledge to my nursing practice”. “I can apply this knowledge to help me understand the need to take into account the patient’s health history”. “I learned that we should look at the entire patient as well as their health surgical history”.

16. Professor Observations “Students were engaged and wrote more and reflected on the case studies”. “Students used other resources to reflect on what they learned in the case studies and cited the sources”.

17. Discussion Convenience sample with no randomization. Study is not generalizable Research suggests use of case studies and reflection promotes critical thinking.

18. Discussion More research is needed to assess the use of case studies and reflection in the online environment.

19. Limitations Limited Time Frame Convenience Sample Only Qualitative Data

20. Jonathon Zemmer Amanda Zemmer

21. References Chickering, A. & Ehrmann S.C.(1996). Implementing the seven principles: technology as lever. AAHE Bulletin, 10, 3-6. Feingold, C.E., Calaluce, M. & Kallen M.A. (2004). Computerized patient model and simulated clinical experiences: evaluation with baccalaureate nursing students.Journal of Nursing Education, 43(4),156-63. Johnson, A. (2008). A nursing faculty’s transition to teaching online. Nursing EducationPerspectives., 29 (1), 17-22. Smith, G.G. Heindel, A.J., & Torres-Ayala, A.T. (2008). E-learning commodity or Community: Disciplinary differences between online courses. Internet and Higher Education, 11, 152-159.doi: http://dx.doi.org/10.1016/http://dx.doi.org/10.1016/ j.iheduc.2008.06.008