Integrating Clinical and Systems Reasoning Through a Cross-Track Case in DNP Education.

BACKGROUND

Medication-related harm in older adults often reflects cumulative system vulnerabilities rather than isolated prescribing errors. Doctor of Nursing Practice (DNP) programs emphasize systems-based practice; however, strategies integrating specialty expertise with shared accountability remain limited.

METHOD: A cross-track unfolding case was implemented during a required 2-day DNP immersion at a large academic institution. Advanced practice and systems leadership learners engaged sequential phases of a longitudinal medication-related harm case across out-patient and acute contexts. Evaluation data included Likert-scale ratings and open-ended comments.

RESULTS

Ninety-seven learners completed the evaluation. Ratings were high for organization (M = 6.03), engagement (M = 6.02), and understanding of the DNP role (M = 5.94). The unfolding case received a mean session rating of 3.75 (5-point scale). Open-ended comments reflected appreciation for cross-track integration.

CONCLUSION

A cross-track unfolding case may offer a practical strategy for integrating clinical reasoning and systems accountability in DNP education.