This project explored how an audience response system (clickers), combined with case-based questions, resulted in increased student engagement, attention, and participation in an introductory clinical nursing course. Clicker questions and ensuing discussion were designed to enable students to practice reasoning through patient situations before entering the clinical setting. Findings suggest that nuanced discussion of all possible answers encouraged students to think more deeply about their initial answers and opened them up to new reasoning processes.

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The care of children in the U.S. with life-limiting illnesses is inadequate. Misallocated resources, flawed assumptions and models of care, and a lack of appropriate professional education foster a costly, inefficient system that falls short of its true potential. This article details the evolution of a regional, shared approach to address these issues, the District of Columbia Pediatric Palliative Care Collaboration (DCPPCC), and includes its evolution, preliminary clinical results, and assessment of barriers encountered.

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