Ann Proctor
Teaching Strategy: Case Study Investigation
Background: I share a position as clinical educator for the Oncology Service Line at York
Hospital. My co-worker and I are responsible for quarterly education sessions for
all of the RN’s (outpatient infusion, radiation oncology, gyn oncology, inpatient
nurses) in our service line.
We were discussing topics for our session and thought it would be fun to do
something around a case study topic. We continued to brain storm the idea and
reviewed our previous seminar evaluations for topics the staff wanted to learn
about. Around that time, York Hospital performed a Cesium-131 mesh seed
implant on a lung cancer patient. We had found our topic!!
We wanted to make it fun and interactive and decided to approach it as a CSI
(Case Study Investigation) and chose lung cancer as our primary diagnosis. We
tried very hard to keep the diagnosis a secret – but education services used one of
our main course objectives on the computer sign up program. Oh well!! We had
a lot of fun planning it, researching, and presenting.
Case Studies: In our text “Teaching Strategies for Nurse Educators”, DeYoung points out that
“a case study is an analysis of an incident or situation in which characters and
relationships are described, factual or hypothetical events transpire, and
problems need to be resolved or solved” (p.148). Case studies are used to apply
critical thinking skills. It exposes the learner to real-world situations and teaches
systematic thought processes (DeYoung, p.148).
CSI Oncology: Case Study Investigation: We have a format that we use for our education
sessions. We have three 1-hour sessions that include lecture and a question and
answer period. We provide a15-minute break between sessions. We offer a repeat
session in the afternoon. We videotape the morning session for those who cannot
attend and videoconference our afternoon session to the Adams County Cancer
Center for nurses from the Infusion Room and Radiation Center as well as
Nurses from Gettysburg Hospital’s oncology unit.
We wanted our session to be fun and interactive. We centered our topic around the
idea of putting a puzzle together. After all –that is what a case study is –
piecing it all together. We used the puzzle piece pictured below as a running
theme: You need to anticipate what your patient needs, understand the
diagnosis and plan for the patient, respond to the patient’s needs and questions,
and educate the patient, family, staff, and self.
We had fun dressing up as Sherlock Holmes (I am the one on the left).
The first hour Linda presented the case study on our patient with lung cancer who
had radiation seed implants in her thoracic area. She presented it through power
point, but wove in information about small-cell vs. non-small cell lung cancer,
diagnosis, staging, and treatment options for lung cancer. She used actual x-ray,
CT, and PET scan images to help in the case study presentation. Linda used
questions throughout her presentation to engage the audience. We wanted to
engage both the visual and auditory learners!!
One of our radiation oncologists presented for the next hour. It can be risky using
a physician to discuss a nursing topic!! But he did an excellent overview of the
history of radiation therapy techniques and also spoke on what we may see in
the future. He talked about our case study patient since he was the radiation
oncologist involved in the decision to treat her with the mesh implants.
I presented the third hour. My focus was “Nursing Care of the Lung Cancer
Patient”. Below is the slide showing my topics. This section was more
interactive – we had people come forward to demonstrate how to set up a chest
tube, and use the Pleur-x catheters. I presented 2 oncology emergencies – superior
vena cava syndrome and spinal cord compression.
Putting the Puzzle Together
• VATS
• Chest Tubes
• Nursing Care of the
Brachytherapy
Patient
• Pleur-x Catheters
• Oncology
Emergencies and
Lung Cancer
RESPOND
EDUCATE
UNDERSTAND
ANTICIPATE
Evaluation: Overall, it was a success. We had very positive comments from the nurses. The
program appealed to people with different learning styles. We kept a running theme
that tied the pieces together. Case studies are a great learning tool – even for the
most experienced nurses!! The best part- I had enjoyed putting it together, I learned
a great deal from my research, and I had fun presenting it!