Hawaii Pacific University Psychiatric Nurse Practitioner Program Case Study
See how an online Psych NP program used interactive, case based learning to strengthen clinical reasoning without increasing faculty workload.
Overview
Constructive learning in online NP courses
Limited time and clinical resources leave NP students with fewer opportunities for end-to-end hands-on practice. This is found particularly in psychiatry, where diagnostic accuracy depends heavily on nuanced patient interactions and clinical reasoning.
While students often report confidence in their engagements with patients, faculty at Hawaii Pacific University (HPU) recognized a persistent gap: students needed more structured practice developing differential diagnosis, asking the right follow-up questions, and selecting appropriate next steps to prepare for real-world psychiatric care and OSCE-style assessments.
The program sought astandardized, scalable case-based learning solutionthat could go beyond static application and better simulate authentic psych patient encounters without increasing instructor burden.
Overview
The challenge
Clinical reasoning challenge
The program sought a standardized, scalable case-based learning solution that could go beyond static application and better simulate authentic psych patient encounters without increasing instructor burden.
Limited time and clinical resources leave NP students with fewer opportunities for end-to-end hands-on practice. This is found particularly in psychiatry, where diagnostic accuracy depends heavily on nuanced patient interactions and clinical reasoning.
While students often report confidence in their engagements with patients, faculty at Hawaii Pacific University (HPU) recognized a persistent gap: students needed more structured practice developing differential diagnosis, asking the right follow-up questions, and selecting appropriate next steps to prepare for real-world psychiatric care and OSCE-style assessments.
The solution
Why DDx by Sketchy?
- HPU faculty were specifically looking for a tool that supported:
- Standardized case-based learning that is scalable
- Interactive, end-to-end clinical encounters
- Active development of clinical reasoning and diagnostic decision-making
DDx by Sketchy's AI-enabled, decision-driven cases aligned with constructivist learning theory, allowing students to actively build understanding through realistic clinical interactions rather than passively consuming content.
How did DDx by Sketchy fit?
DDx was piloted modularly over six weeks, with faculty assigning cases that directly aligned with the didactic material being taught each week.
Cases Included:
- Depressed mood in a 35-year-old woman
- Chest pain in a 52-year-old man
- Auditory hallucinations in a 23-year-old man
- Paranoia in a 37-year-old woman
- Agitation in a 49-year-old man
- Insomnia in a 32-year-old woman
Students engaged with DDx cases as part of their coursework, using the platform to practice:
- Depressed mood in a 35-year-old woman
- Chest pain in a 52-year-old man
- Auditory hallucinations in a 23-year-old man
- Paranoia in a 37-year-old woman
- Agitation in a 49-year-old man
- Insomnia in a 32-year-old woman
- Depressed mood in a 35-year-old woman
- Chest pain in a 52-year-old man
- Auditory hallucinations in a 23-year-old man
- Paranoia in a 37-year-old woman
- Agitation in a 49-year-old man
- Insomnia in a 32-year-old woman



The results
What was the implementation's impact?
The data below reflects the student experience following the pilot.
Testimonials
What did students say?
What is Constructivist Learning?
Constructivist learning theory emphasizes that learners build knowledge through active engagement and experience, rather than passive reception. In the context of clinical education, this means students learn best by doing—working through realistic patient encounters, making decisions, seeing consequences, and refining their approach based on feedback.
DDx embodies this philosophy by creating an interactive environment where students construct their understanding of clinical reasoning through practice.
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