Why KeithRN?

Join the movement to transform how nursing is taught using innovative tools and evidence-based teaching strategies to improve practice readiness.

Lack of Clinical Judgment in Graduate Nurses

To ensure that graduate nurses can deliver safe patient care, they must master clinical judgment skills. Unfortunately, recent research has shown that despite new graduates passing the NCLEX licensure examination, the majority don’t start practice with the crucial skill of clinical judgment (Kavanagh & Sharpneck, 2021).

As a result, patient outcomes can be adversely impacted leading to severe patient complications and even death.

Why are so many new nurses unprepared for practice?

Some educators are forced to cover so much content in a limited time that students memorize material simply to pass a test, not understanding how it applies to providing safe patient care.

The current COVID-19 epidemic has resulted in limited clinical experiences and challenges moving to online instruction for classroom teaching. As a result, students are unable to apply needed knowledge when they care for patients.

It doesn’t have to be this way. Change is needed, but to better prepare students for practice and licensure, educators must be willing to change and teach differently. The solution will show you how easy it can be…

Use Case Studies to Develop and Practice Clinical Reasoning

The answers to resolving this crisis in competency are found in educational research and best practices:

  1. Contextualize textbook content to the bedside of patient care.
  2. Integrate classroom and clinical learning.
  3. Emphasize the thinking-in-action skill of clinical reasoning (Benner, Sutphen, Leonard, & Day, 2010).

How I Transformed My Teaching

When I started teaching nursing, I gave my students long PowerPoint lectures with too much information and not enough context. Instead of fully understanding concepts, my students studied for the test.

Recognizing the need to change how I was teaching after reading Educating Nurses: A Call for Radical Transformation, I realized that unfolding case studies derived from my lens of current clinical practice would implement all three of these important changes in my classroom!

My students saw the value and relevance of case studies as a meaningful, active learning tool and asked for more. I created additional innovative unfolding case studies to develop clinical judgment skills with my students and created KeithRN.com to serve as a resource for other nurse educators.

Why Case Studies?

Case studies are one of the most effective strategies to teach nursing because they simulate real-world practice so clinical judgment can be practiced (McLean, 2016). The Next Generation NCLEX exam, beginning in 2023, will use case-based scenarios and questions similar to KeithRN case studies.

Why KeithRN Case Studies?

ATI Infographic Integration CJMKeithRN clinical reasoning case studies provide educators with the following innovations that make them valuable tools for developing clinical judgment:

  • Provide a consistent framework of higher-level, open-ended questions (no multiple choice!) that use the nursing process with Tanner’s Clinical Judgment Model (2006), a valid and reliable practice-based framework.
  • Tanner’s CJM (outer circle) aligns with the NextGen model, an evaluation/test framework that does not need to be taught directly (inner circle) so students are prepared for the upcoming NextGen NCLEX (ATI infographic-used with permission).
  • Use complex, real-world patient scenarios as a case-based, low-fidelity simulation that unfold sequentially, just like real-world practice.
  • Replicate clinical decision-making in the classroom without using manikins or a simulation skills lab.
  • Include comprehensive answer keys with multiple levels of complexity.
    • SKINNY Reasoning level: Concise and versatile level that can be used across all levels in class and clinical post-conference to apply knowledge and make learning active!
    • UNFOLDING Reasoning level: Increased complexity with an unfolding change of status that is best suited for advanced students or use as a clinical replacement activity.

Be part of the solution by joining thousands of other educators who are transforming how nursing is taught by taking the next step…