Abstract
Chemistry is a prerequisite course required by most nursing programs. Chem 5 is a one-semester general, organic, biochemistry (GOB) course for pre-nursing students at CSU Sacramento (CSUS). It is a fast-paced class requiring students to quickly grasp many difficult chemical concepts. Case-based instruction was introduced to bridge conceptual gaps, improve retention of chemistry concepts, improve cognitive and critical thinking skills, and to improve safety in the laboratory. The case study format was chosen specifically for its ability to increase active learning in Chem 5 while introducing pertinence of chemical concepts to nursing. Cases use real world problems that put theoretical principles in a context more easily conceptualized and retained by learners. This is particularly helpful in a course such as Chem 5 where the pace of concept introduction is accelerated. Cases require students to work collaboratively in groups, utilize a constructivist design, and build incrementally towards more complex situations that require higher order thinking and problem solving skills, similar to situations encountered in nursing practice. The value of case-based instruction is further illustrated by its long use in medical education, including nursing education. Two case study laboratories were introduced to Chem 5. The story topics of the case studies were the bends (decompression sickness) and diabetic ketoacidosis. The anchoring concepts that the cases were designed to address include intermolecular forces and gas behavior, acid/base chemistry and equilibrium, and quantitative analysis/stoichiometry (math) skills. An action research methodology coupled with mixed method analysis was employed in this study. Case study efficacy was determined through triangulating the learning outcomes from quantitative (quizzes, exams, and finals) and qualitative (student survey) data sets. A retrospective approach was used by comparing student performance in spring and fall 2014 (the implementation semesters) to three preceding semesters. Student learning of gas laws using the bends case study was comparable to that of the traditional gases lab. Student learning of acid/base and equilibrium concepts was improved by the diabetes case study. Case studies were found to be an effective way to include more active learning in the chemistry curriculum. Student comments regarding case studies showed that they were considered to be effective at introducing real world problems pertinent to their long-term educational and career goals. Finally, the bends case study was an effective way to increase student safety in the lab.