In the classroom and in clinical areas, knowing how to learn, reason, reflect, think creatively, generate and evaluate ideas, make decisions, and solve problems have been identified as key elements of critical thinking. However, to be successful in the current health care arena, caregivers cannot be satisfied with possessing the ability to solve problems and simply meet preestablished "outcomes" (Alfaro-LeFevre, 1998). It is necessary to improve knowledge and practice applications and to explore the best ways to do things within a work group. This qualitative study evaluated the experiences of senior-level nursing students using case-based instruction in a course titled, Leading and Managing in Nursing. It is a replication and extension (Phase II) of an original case-based instruction study, completed with senior physical therapy students (Phase I). Phase III of this study trajectory is the creation of an interdisciplinary case-based course that addresses either or both clinical collaborative care issues or leadership and management issues for health care profession students. From this Phase II study, six thematic groupings emerged as distinct student experiences in case-based instruction-motivation, real world, learning, knowledge development, emerging from within, and group dynamic issues.