This study is hypothetical

Introduction to Case Study Research

Merriam defined a case study as “an in-depth description and analysis of a bounded system” (Merriam, 2009, p. 40). According to Merriam (2009) a case study investigates modern phenomenon with real-life contexts, especially when the boundary between a phenomenon and context are blurred. The case study approach is best utilized when a holistic, in-depth investigation is needed and when how and why questions must be answered. A case study is able to explore a phenomenon using a variety of data sources and can be done from the participant’s perspective (Baxter & Jack, 2008). In addition, a case study explores a bounded system or case over a period of time using in-depth and comprehensive data collection. To better understand the concept of a bounded system or case Merriam advises to think of the concept as a single entity with boundaries to fence in what is to be studied.

Research Problem Statement

During clinical, the quintessence of where nurses learn about nursing (Madhavanpraphakaran, Shukri, & Balachandran, 2014; Paton, 2010), nurses function as preceptors for undergraduate nursing students. The preceptor is a nurse who teaches and supports the student nurse and is seen as pivotal to student learning within the clinical environment. Qualitative researchers have found experienced nurse preceptors learn about the patient and the environment as part of the clinical situation. According to Paton (2010) nurse preceptors use different factors which include personal achievement through struggles, self-critical reflections, and a unique set of teaching skills and expertise that go beyond clinical expertise and relational skills (Paton, Thompson-Isherwood, & Thirsk, 2009). In addition, preceptors teach from a repertoire of skills and knowledge acquired through years of experience.

Purpose of the Research

The purpose of the proposed study is to explore an exceptional nurse preceptor who was recommended as the best in the school. Verification of exceptional preceptor skills is evidenced by daily work, in-service presentations, articulation of competency and evaluation expectations, and finding creative ways to teach and incorporate best evidence from the nursing literature into clinical practice. The focus of the study is to gather information on what the recommended preceptor does by observing the preceptor’s teaching, by interviewing students she precepts, and by conducting a review of artifacts. Findings that emerge from the case study will allow nurse educators to better understand the instructional process used by the recommended exceptional preceptor to teach nursing students in the clinical setting.

Need and Benefits

A study of exploring an exceptional preceptor’s instructional process will contribute to closing the theory-practice gap; which will ultimately lead to nursing graduates who are better prepared to become sound, autonomous practitioners when they enter the workplace. Understanding the instructional process from the perspective of an exceptional nurse preceptor will assist educators to understand what is needed to support and facilitate the instructional process of nursing students’ clinical training. Additionally, understanding how one exceptional preceptor teaches and nurtures students in the clinical environment will facilitate the development of instructional strategies for faculty, preceptors, and students to use in order to promote and develop clinical skills in caring for patients. Finally, if nurse educators understand the instructional process utilized by exceptional nurse preceptors, curricular materials can be developed to train other preceptors to become examples of exceptional preceptors.

Central Research Question

What instructional process is utilized by an exceptional nurse preceptor to teach nursing students in the clinical setting?

Description of the Case and Data-Collection Procedures

The exploratory case study approach of Merriam (2009) will be used to explore the instructional process utilized by the recommended exceptional nurse preceptor to teach nursing students in the clinical setting. This is because it will provide the opportunity for an in-depth look through the use of various information-rich sources. The case under study is, what instructional process is utilized by an exceptional nurse preceptor to teach nursing students in the clinical setting.

Purposive sampling will be used for this study. The main goal of purposive sampling is to focus on particular characteristics of a population that are of interest in order to enable the researcher to answer the research questions. Usually, the sample being investigated is small. The sample for this case study will be one exceptional nurse preceptor and 6 nursing students that are taught by the nurse preceptor in the clinical setting. The nursing students are enrolled in their first clinical rotation on a medical-surgical unit at a Magnet teaching hospital in Oklahoma. The students will provide direct patient care under the supervision of the nurse preceptor for 2, 8-hour shifts for a total of 16 hours per week for a 12-week term. The case will be bounded by the clinical setting and time on the medical-surgical unit. All clinical training will be taught by the exceptional nurse preceptor assigned to the students. The instructional process will be observed during these clinical training times between the preceptor and nursing students. Observation of the instructional process will be focused on students and preceptor providing direct patient care.

The purpose of the proposed study is to explore an exceptional preceptor recommended as the best in the school in order to explore the instructional process that influences her role of precepting student nurses in the clinical setting. A key characteristic of case study research is the use of multiple data sources. Qualitative researchers utilize multiple data sources as a strategy to gain understanding, to ensure completeness, and to confirm findings (Merriam, 2009). The multiple resources are used to answer the research question and are a valuable tool for understanding human behavior. This study involves semi-structured interviews, focus groups, and a review of curricular materials to ensure that the conclusions drawn from the different sources of data are convincing and accurate.

Defense of Research Design

The use of a case study enables the researcher to fully explore an exceptional preceptor’s instructional process. The case study approach is best utilized when a holistic and in-depth investigation is needed, and when the how and why questions must be answered. A case study is able to explore a phenomenon using a variety of data sources and from the participants’ perspectives (Merriam, 2009). In addition, a case study explores a bounded system or a case over a period of time using in-depth and comprehensive data collection.

Case study research differs from a basic qualitative research design in several ways. For one, a key characteristic of a case study research is the use of multiple data sources to investigate a current phenomenon within its real-life context; when the boundaries between phenomenon and context are not clearly evident. The basic qualitative research design, on the other hand, utilizes interviews, observations, and/or document analysis for data collection. Another difference between a basic qualitative study and a case study is that a qualitative research study focuses on one or more individuals whereas a case study involves the study of an issue explored through one or more cases within a bounded system such as an event, program, or activity involving more than one individual (Merriam, 2009). The case study design is the best fit for this research intentions because it investigates a current phenomenon within its real-life context; when the boundaries between phenomenon and context are not clearly evident.

A big challenge with the case study design is identifying the case and deciding which bounded system to study and use, as well as deciding the beginning and end points in setting boundaries to adequately surround the case.

Was this exercise helpful to build a frame of reference in understanding a case study research?

References

Baxter, P., & Jack, S. (2008). Qualitative case study methodology: Study design and implementation for novice researchers. The Qualitative Report, 13(4), 544-559.  Retrieved from http://nsuworks.nova.edu/tqr/vol13/iss4/2

Madhavanpraphakaran, G. K., Shukri, R. K., & Balachandran, S. (2014). Preceptors’ perceptions of clinical nursing education. The Journal of Continuing Education in Nursing, 45(1), 28-34. doi:10.3928/00220124-20131223-04

Merriam, S. (2009). Qualitative research: A guide to design and implementation (2nd ed.). San Francisco, CA: Jossey-Bass.

Paton, B., Thompson-Isherwood, R., & Thirsk, L., M.N. (2009). Preceptors matter: An evolving framework. Journal of Nursing Education, 48(4), 213-216.

Paton, B. (2010). The professional practice knowledge of nurse preceptors. Journal of Nursing Education, 49(3), 143-149. doi:10.3928/01484834-20091118-02