Bridging Theory

North Island College faculty created an evidence-based, active learning strategy to help create a realistic environment for nursing students learning clinical skills. Funding from the Western North-Western Region Canadian Association of Schools of Nursing allowed for faculty release time to evaluate this initiative. The researchers presented the project findings at the annual WNRCASN conference in Calgary in 2018, and published a peer-reviewed article on the project in January, 2019.

Project Dates: Fall 2016 – Fall 2018
Funding Amount: $5000 - WNRCASN Innovation in Education Award, 2016

A hands-on assessment of the patient is part of every unfolding case session.

Project Summary

Jan Meiers and Martha Russell, Bachelor of Science in Nursing (BSN) faculty, developed and implemented a semester long unfolding clinical case to provide a constructivist framework for teaching psychomotor skills in the nursing lab. This project introduces an unfolding case to support critical thinking and clinical decision making skills in student nurses. Throughout the semester, the unfolding case study utilizes a blend of live actors and human patient simulators as students learn to care for a patient with chronic health challenges through admission and hospitalization.

To evaluate this initiative, focus groups were conducted with students and faculty that revealed strong engagement with the unfolding case process. Student focus group members unanimously agreed that the unfolding case method should be used in all courses in the skills learning stream, as they felt the continuity provided by this approach supported skill retention. Students reported an increased confidence and familiarity in the clinical setting after completing the unfolding case course. Faculty commented the unfolding case approach “brought the material to life”, and that it provided an excellent foundation for students as they developed their clinical skills while providing a safe environment for students to learn. Faculty appreciated the method was well supported by evidence and they were excited to be part of the evolution of the course. Faculty who taught in both nursing lab and practice felt the unfolding case study pedagogy enhanced their experience as clinical instructors, and they were able to make strong connections between the two courses.

Research Team

Martha Russell
Martha Russell, Lead Faculty
Martha is Learning Centre Coordinator and nursing instructor in the Bachelor of Science in Nursing (BSN) program at North Island College. A graduate of the BSN program at NIC, she practiced as an RN in the maternal/child unit of St. Joseph’s Hospital in Comox before coming to work for NIC in the fall of 2010. Martha's academic interests include psychomotor skills learning in BSN students, the role of simulation in nursing education, and supporting scholarly writing in nursing students.
Jan Meiers
Jan Meiers, Lead Faculty
Jan worked in the acute care setting for 12 years prior to teaching in the BSN Program at North Island College in January in 2000. In 2006, she completed a Master of Nursing degree at Athabasca University. During this program, Jan focused her work on fostering student success and integration of technology into nursing education and practice. Jan’s academic interests include the role of simulation in nursing education, supporting student success, and nursing leadership and advocacy.

Project Outcomes

  1. Implementation of this evidence-informed pedagogy in all nursing lab courses to align with the NIC BSN concept-based curriculum
  2. Sharing of methods and resources with BSN partners at VIU, as well as sharing with educators at other sites across Canada
  3. Publication of a peer-reviewed scholarly article: Meiers, J., & Russell, M. (2019). An unfolding case study: Supporting contextual psychomotor skill development in novice nursing students. International Journal of Nursing Education Scholarship, 16(1). doi:10.1515/ijnes-2018-0013
  4. Presentation of the project at international, national, and regional nursing education conferences.


Martha Russell
Martha Russell, Lead Faculty