Impacts of Unfolding Case-Study Learning on Nursing Students' Performance Outcomes: A Scoping Review

The unfolding case study is an innovative teaching strategy that structures patient scenarios over time to enhance learner engagement and improve outcomes. However, its effectiveness in nursing education classroom settings worldwide remains underexplored. This review aimed to synthesize evidence on the impact of unfolding case-study learning on nursing students' knowledge, critical thinking, and self-efficacy.

A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Scoping Reviews (PRISMA-ScR) guidelines. Searches covered CINAHL (EBSCOhost), Cochrane Library (Wiley), Embase (Elsevier), ERIC (IES), MEDLINE (via PubMed), Scopus (Elsevier), and Web of Science Core Collection (Clarivate) for English-language studies published from January 2012 to September 2025. Study appraisal used the Mixed Methods Appraisal Tool (MMAT, 2018) and NHMRC levels of evidence for quantitative designs.

The initial search identified 550 studies, of which 19 were included after rigorous screening. Findings indicated that unfolding case studies positively influenced knowledge acquisition by promoting active learning, enhancing integration of theory into practice, strengthening collaborative learning and communication, and improving long-term knowledge retention and recall. Evidence also supported improvements in critical thinking skills and self-efficacy among nursing students.

Integrating unfolding case-based learning into undergraduate nursing education offers substantial advantages in developing essential skills, particularly knowledge acquisition, critical thinking, and self-efficacy.