Date Approved


Degree Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department or School


Committee Member

Laurie Blondy, PhD, RN

Committee Member

Barbara Scheffer, EdD, RN

Committee Member

Robert Carpenter, PhD

Committee Member

Linda Myler, DNP, RN


Nursing education reform is needed for today’s generational mix of pre-licensure nursing students to prepare them to effectively care for clients’ ever-evolving healthcare needs. This mixed-methods, quasi-experimental study was designed to measure if the use of unfolding case studies (UCS) in a traditional classroom setting (TCS) would (a) enhance critical thinking skills of the experimental group more than the control group as measured by the Health Science Reasoning Test (HSRT), (b) explore if course content examinations were higher in the experimental group versus the control group, (c) explore the perceptions of a subset of Bachelor of Science Nursing (BSN) pre-licensure students to determine if the use of multimodal learning (visual, auditory, reading, and kinesthetic) opportunities throughout UCS improved CTS in the classroom setting, clinical setting, and preparing for course content exams and, (d) explore if the above-mentioned subset of BSN students perceived greater engagement during the learning process. A convenience sample (N = 70) of BSN pre-licensure students participated in the quantitative portion of this research study. A subset of BSN pre-licensure students (n = 8) from the experimental group volunteered for a 1-hour focus group session. Quantitative data results showed no statistical significance between the experimental and control groups’ HSRT overall and subscale scores (p > .05) and only a statistical significance for Exam I (p < .05). Qualitative data from participants’ verbatim showed nursing faculty should use multimodal learning opportunities throughout UCS in the TCS because this pedagogy fostered classroom engagement and development/enhancement of CTS through evolving client scenarios.