Date of Award

Spring 2023

Document Type

Project – Full Written

Degree Name

Doctor of Nursing Practice (DNP)

Committee Chair

Cindy Miller


There is a crisis in competency among new nurses in the United States. Prelicensure nursing education prepares them to pass the NCLEX-RN, but it does not provide the necessary foundation for sound clinical decision-making. Mistakes in the clinical setting can lead to failure to rescue, resulting in the third leading cause of death: medical error. A radical change is needed to prepare nurses with the clinical judgment skills necessary for patient care. Educators must be mindful of the academic-practice gap and adopt evidence-based improvements, including active learning with unfolding case studies. This quality improvement project involved a four-part unfolding case study in lieu of a traditional lecture to teach content to first-semester nursing students. A significant improvement (p < 0.05) in the Clinical Application Thinking Skills subsection of the ATI RN Content Mastery Series® 2019 Proctored Fundamentals Test resulted.

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Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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