Rationale...

Linking what we learn and applying it to clinical practice is crucial in the development of higher level thinking. This teaching strategy helps nurses go beyond simple recall, it requires them to use what was learned by analyzing and applying education in specific instances. Simulations help prepare students for higher level thinking. Being able to analyze, synthesize, evaluate, and apply what was learned in simulation lab requires critical thinking skills. For example, taking a patient's temperature can be taught in clinical, but actually understanding what a normal temperature is and when it is not normal, what to do clinically, and how to help the patient is significant. Taking the temperature is the basic knowledge but understanding what to do after you get an abnormal reading is where higher level thinking must be used to help evaluate what is next. Higher level thinking is critical for patient care and safety of the patient. Applying what students learn is significant in reaching a higher level of learning. When knowledge is retained and applied, it ties together important aspects of what skills are needed to be able to understand at a higher level. Flipped classroom strategy can be used in this case. Giving students information to review before class and having them apply the information, helps with getting a more thorough understanding of the information learned. Being aware of what strategies are effective and how knowledgeable the teacher is about the different strategies, also plays a vital role in the success of the strategies to improve higher level thinking. A match game could be used to show different body temperatures. Use additional cards to match what intervention is needed for the temperature shown. This clinical assessment skill can help improve advanced levels of thinking by analyzing and evaluating what needs to be done in each scenario.

I've always been educated to think on my own about a question or problem to come up with a solution. Most of the times my answers won't be right, but that's the point of the exercise. It's like a warm-up for my brain and thoughts. Once I came to my conclusion with rationales, I would then discuss with my peers or friends and discuss their thoughts. This collaborative effort helps us both with ideas and solutions that we can later report to a larger audience. I feel this method helps encourage critical thinking and prompts learners to analyze and discuss reasoning before engaging in peer discussions. It helps individuals to think on their own and requires reflection and evaluation to better understand and compare a peer's perspective. As I verbalize my thoughts and listen to others, it will help clarify my misunderstandings and develop a more reasonable judgement on the problem. I do believe this strategy may not be for everyone, but it has helped me both clinically and in classroom discussions to help with engagement and a self-awareness in learning. 

I can recall my nursing school clinical days; I was taking care of a post-op patient who had pain despite receiving pain medications by the nursing staff. I discussed this with my peer, and we each gave our thoughts and rationales. I felt that maybe the pain medications prescribed were not strong enough and the patient could use more, but my peer brought up a thought that the patient could be anxious and amplified his pain level. This is an example of how we each gave our thoughts and came away with possible reasons to the presenting problem. 

Peer Learning/Instruction

I chose this teaching method as nurses tend to rely on others when they do not know the answer to a question. Whether this information is obtained from another nurse or a physician, we always like to know the evidence-based reasoning on why things are performed a certain way. Once learned, we often share our findings with others for them to learn, and to avoid the chance of making an error. This promotes critical thinking and encourages higher-level thinking as we tend to want to know the “why” of what we are doing. Peer learning suggests that as individuals, we learn from those around us. We learn to problem solve, collaborate, develop new ideas, and to also develop socially. This method of learning creates collaboration of those who may have different viewpoints and helps learners develop confidence. Examples of peer learning include study groups, group tests, projects, and problem-solving scenarios such as a decompensating patient. This is vital in the nursing world, as without peer learning and problem solving, nurses and physicians would not be able to properly care for the needs of their patients.

Learning the "why" of why we do certain things helps the learner understand the critical reasoning behind the idea.

Drawbacks of this teaching strategy include students feeling that time is not being managed due to disinterest in the learning topic, and faculty need to frequently analyze the peer learning strategy, as a quiet and withdrawn student may not work well with a student who is independent and assertive. I feel that working in surgical services, I can use Peer Learning as we work with many members of the hospital daily. Using peer learning can help bring together different viewpoints and competencies and encourage others to learn from different perspectives, which increases higher-level learning.

The rationale behind SBL is that it provides a safe environment for students to make mistakes and learn from them without putting real patients at risk. This hands-on, immersive experience pushes students beyond basic memorization into higher-order skills, such as synthesizing information and evaluating interventions. Additionally, it can be adapted for both novice and advanced learners and provides opportunities for interprofessional collaboration. Simulation is an invaluable tool for reinforcing critical thinking and preparing students for real-world clinical challenges.

What if Scenarios?

One teaching strategy that I have found helpful in the past when working with students or precepting nurses is the “What if?” scenario. This scenario is an inquiry-based learning strategy where you propose a hypothetical situation, often counter to or a significant alteration of a known problem. Students then have to explore the potential consequences of this change. For example, someone might ask what you would do if your patient's neurological assessment were not regular. What if the patient's blood pressure was too low? The latter scenario would require an understanding of why a patient's blood pressure might be low and what potential treatments are available for this condition. This would require an understanding of different patient disease processes, how medication can affect blood pressure, whether the patient is experiencing bleeding, and whether the patient needs fluids or medication. This involves higher-level thinking because a student must first deeply understand the existing situation and concept before beginning to synthesize the change. They must break down the components of the original scenario to determine how this event would alter the scenario. They must evaluate the potential likelihood of different outcomes. They need to make judgments about which consequences are most impactful and be able to justify their reasoning. This also requires higher-level thinking, as the student must understand whether any pre-existing algorithms or protocols can assist in their reasoning. They must also see if these protocols would benefit the patient's current situation. Often, what-if scenarios can push students to consider situations from different perspectives. This requires them to step outside their viewpoint and consider the motivations and constraints of the new scenario. I like to use these assessments with students as they foster intellectual curiosity and encourage students to see concepts not as static, but as part of a dynamic system.

For my higher-level learning strategy, I chose case studies. I have enjoyed the exercise of case studies both as a nursing student and now as an RN, for their engaging nature. Case studies can be beneficial, as they allow nursing students to take information they have learned and apply it to real-world or realistic situations or scenarios. Students are challenged to not only to recall information, but to utilize and engage with the material to solve the problem(s) of the case. They require reflection of choices made by the learner, which aligns with metacognition, which is thinking about thinking. Additionally, students are able to solve problems without any harm to patients. Another benefit is that there are limited barriers to the utilization of case studies, as they are accessible to in-person and virtual learning, and are not prohibitively expensive. Attached to this post, I have included an example of an online virtual case study. In this example, audio explaining the scenario is given, followed by questions to prompt learners. Students are able to click through the different stages of the case study, following the development of the patient’s condition. As educators, we can utilize this format in the classroom to guide students towards set points in the study, encouraging students to reach those points through independent thinking and class discourse. When paired with a safe learning environment, case studies can promote retention and even future application of knowledge in future real-life situations.  

For this assignment, I found many of the learning and teaching strategies to be quite interesting, but for this assignment I chose using collaborative or cooperative learning. Collaborative learning is student centered and is defined as students organizing a faculty-led assignment, whereas cooperative learning is more faculty centered (Billings & Halstead, 2024). Some examples of collaborative or cooperative learning include stump your partner, fishbowl debate, think-pair-share, graffiti wall and jigsawing. After reading about all these examples, I was most fascinated with jigsawing, which is a technique in which classroom activities are organized in a way that students depend on each other to be successful (Billings & Halstead). In jigsawing, students are placed into groups where they need to solve an aspect of an assignment and then present to the class. Once every group is finished, they will collaborate to synthesize results (Billings & Halstead). Implementing this teaching strategy involves breaking students into “home groups” consisting of three to give students and then assigning an expert in each group. The “expert groups” can consist of three-ten members, and there should be time designated for them to become experts in their topic to then go back to their “home units” to share what they learned. Applying this type of teaching strategy when teaching about a code or emergency situation could be very beneficial. When I first read about this strategy, it strikes me as what real-life nursing can look like during a code or an emergency, each team member is working on their task at hand and coming together to synthesize their collaborative efforts. 

This teaching strategy promotes higher level thinking as it is active and reflective learning and encourages teamwork. It helps build comprehension, improves communication skills, and problem-solving skills (Billings & Halstead, 2024). Jigsawing also promotes self-efficacy and confidence as students are required to problem solve at a smaller level, to educate and synthesize on a larger scale. The development of these skills helps the student with higher level learning and are crucial in future nursing practice. 

Billings, D. M., & Halstead, J. A. (2024). Teaching in nursing: A guide for faculty. Elsevier.

The Socratic teaching strategy is a method of engaging students through open-ended questions that promote deeper thinking and reflection. This strategy puts an emphasis on dialogue and critical thinking. Exploration of complex ideas is encouraged by challenging student assumptions and encouraging students to consider the possibilities that may not have aligned with their original assumptions.

Rationale:

Critical thinking is the foundation of nursing practice, and the Socratic teaching strategy would encourage student’s analytical thinking, specifically regarding what is being taught, whether clinically or in the classroom. Nurse educators can prompt students, through open-ended questions, to consider different perspectives that could challenge their own assumptions.  This, in turn, would encourage students to self-reflect and assess their own beliefs and values. Socratic questioning also encourages students to articulate how they are thinking through and analyzing situations. Clinical reasoning skills are enhanced, and collaboration skills are developed. Students are actively engaged, leading to higher retention and increased understanding of complex processes. I see this teaching strategy working well when discussing patients, either through case studies or in the clinical setting through clinical debriefing, who have different socioeconomic statuses or cultural backgrounds than the student. Pushing students to challenge their own assumptions or beliefs would position nurses to provide holistic patient-centered care in an increasingly diverse population.

One teaching strategy that has significantly shaped my approach to clinical education is the Socratic Method—a form of inquiry-based instruction that fosters higher-order cognitive engagement through disciplined questioning. Rooted in classical philosophy, this strategy involves posing purposeful, open-ended questions to guide learners in articulating their reasoning, examining assumptions, and refining their understanding of complex concepts.

While I know the Socratic Method of inquiry can be controversial—sometimes perceived as intimidating or overly confrontational if not done thoughtfully—it can be incredibly effective when used in a psychologically safe environment. In nursing education, particularly in clinical or simulation-based settings, this method challenges learners to go beyond rote memorization and engage in deeper reflection, application, and synthesis of knowledge.

For example, instead of asking, “What medication would you administer for hypotension?” I might ask, “What physiological mechanisms might be contributing to this patient’s hypotension, and how do they inform your treatment priorities?” This approach taps into critical thinking domains—analyzing, evaluating, and applying knowledge—skills essential for developing sound clinical judgment.

The Socratic Method aligns closely with Bloom’s Taxonomy by encouraging learners to move beyond remembering and understanding toward analysis, evaluation, and creation. It also complements Benner’s “From Novice to Expert” framework by fostering reflective practice and encouraging progressive clinical reasoning. When facilitated with empathy and respect, this method nurtures intellectual curiosity, diagnostic agility, and professional confidence.

In my experience, learners often report that this method helps them better understand why they make certain decisions, not just what to do—a distinction that often leads to more autonomous and safe nursing practice.

This approach promotes higher-level thinking by highlighting the value of partial information, which prevents students from relying solely on memorized answers. Instead, each new detail prompts them to analyze what has changed, reassess their initial strategy, and integrate this new understanding with what they already know. The dynamic process helps them work through an ever-changing scenario and moves them beyond simple recall into higher-level thinking, where they learn to connect ideas and make decisions even in the face of uncertainty. The method realistically reflects how nurses think in practice, where they must adapt continuously as circumstances change. 

If you’re interested in learning more, the National League for Nursing provides free resources on unfolding case studies. Visit their website at https://www.nln.org/education/teaching-resources/professional-development-programsteaching-resourcesace-all/how-to-use-an-unfolding-case-da0fb15c-7836-6c70-9642-ff00005f0421

I’d like to hear your thoughts: Do you think learners benefit more from cases that unfold gradually, or is it better to start with simpler, one-step scenarios?