The purpose of this study was to investigate the effectiveness of cooperative learning techniques combined with case study on nursing students' selfperception of problem-solving and decision making skills in comparison with other teaching-learning methods. A quasi-experimental pre-test to post-test static group comparison design was used to determine the influence of the different teaching methodologies. Three associate degree colleges provided a convenience sample of nursing students (N = 123). An experimental group (n = 31) was taught through cooperative learning and case study. One comparison group, was taught through lecture and large group case study (n = 46) and another comparison group was taught through lecture only (n = 24). A third comparison group taught through lecture and occasional use of non-cooperative learning groups using continuing case study (n = 22) was used as a post-test only control group. No two groups were significantly different at the 0.5 level. The results, however, showed that the experimental group obtained scores indicating somewhat better self-perception of both problem-solving and decision making skills. (c) 2005 Elsevier Ltd. All rights reserved.