A systematic review of selected evidence on developing nursing students' critical thinking through problem-based learning

Critical thinking and clinical skills by problem-based learning educational methods: an umbrella systematic review

INTRODUCTION

Problem-based learning (PBL), based on self-directed learning, is an instructional strategy that shifts the approach from the instructor to the student (student-centered). Notwithstanding its adoption in undergraduate and graduate medical education, its usefulness remains a topic of debate. This study aims to review current worldwide data on the efficacy and utility of critical thinking and clinical skills using PBL educational methods for teaching programs to undergraduate medical students, ursing students, dental students and medical residents.

METHODS

The search was conducted in June 2024 in PubMed, Cochrane, Embase, and Web of Science and included all publications regardless of the publication date, study design, or country of origin.

RESULTS

Thirteen meta-analyses and systematic reviews were compiled through database screening. The results showed that PBL effectively enhanced students' clinical skills and critical thinking abilities; nevertheless, further evidence is needed to confirm this finding.

CONCLUSION

PBL may be a successful and an effective instructional strategy, not only medical, but also nursing and dental education. Students can learn skills and acquire competencies useful for their medical professionalism through PBL in addition to their existing knowledge.

The effect of problem-based learning on improving problem-solving, self-directed learning, and critical thinking ability for the pharmacy students: A randomized controlled trial and meta-analysis

OBJECTIVE

This study aimed to comprehensively evaluate the effect of PBL on problem-solving, self-directed learning, and critical thinking ability of pharmaceutical students through a randomized controlled trial (RCT) and meta-analysis of RCTs.

METHODS

In 2021, 57 third-year pharmacy students from China Pharmaceutical University were randomly divided into a PBL group and a lecture-based learning (LBL) group. Mean scores were compared between the two groups for problem-solving, self-directed learning, communication skills, critical thinking, and final exam grades. Students' feedback on the implementation of PBL was also collected. A meta-analysis was subsequently performed. Two authors independently conducted a comprehensive search of two databases (PubMed and CNKI). Eligible studies with effective data were included and the valuable data were extracted for analysis. Quality of involved studies was assessed by the Cochrane Collaboration's tool. All analyses of statistics were conducted using the 'metafor' package in R software.

RESULTS

The PBL group had significantly higher mean scores for problem-solving (8.43±1.56) and self-directed learning (7.39±1.19) than the LBL group (7.02±1.72 and 6.41±1.28, respectively). The PBL group also showed better communication skills (8.86±1.47) than the LBL group (7.68±1.89). The mean level of critical thinking was significantly higher in the PBL group than the LBL group (p = 0.02). The PBL group also had better final exam grades (79.86±1.38) compared to the LBL group (68.1±1.76). Student feedback on PBL implementation was positive. The outcome of subsequent meta-analysis including 8 eligible studies involved 1819 participants showed that the use of PBL significantly improved problem-solving ability (SMD = 1.12, 95% CI = 0.25-1.99) and PBL was also associated with better performance in self-directed learning (SMD = 1.55, 95% CI = 0.64-2.45). However, there was no significant difference in the final exam score in the PBL group compared to the LBL control group (SMD = 0.23, 95% CI = -0.08-0.53).

CONCLUSION

This study found that PBL is an effective teaching method for pharmacy students.

Effectiveness of Problem-Based Learning on Development of Nursing Students' Critical Thinking Skills: A Systematic Review and Meta-analysis

BACKGROUND

Problem-based learning (PBL) is a student-centered approach to teaching that has been applied in medical and nursing education. The effectiveness of PBL in promoting critical thinking in nursing students has been studied extensively with mixed results.

PURPOSE

The meta-analysis aimed to investigate the impact of PBL interventions on critical thinking skills of nursing students.

METHODS

PubMed, Embase, Cochrane, and CINAHL databases were electronically searched. Methodological quality was examined using the Newcastle-Ottawa Scale and version 2 of the Cochrane risk-of-bias tool. Data were analyzed with 95% confidence intervals based on random-effect models.

RESULTS

Nineteen studies involving 1996 nursing students were included in the analysis. The results of the analysis demonstrated greater improvement in critical thinking skills compared with the control group (overall critical thinking scores: standardized mean difference [SMD] = 0.47, 95% CI = 0.33-0.61, P < .01).

CONCLUSIONS

The meta-analysis indicates that PBL can help nursing students to improve their critical thinking.

Critical thinking among institutional academic advisors and sociodemographic, professional and academic variables: A multicenter correlation study

BACKGROUND

In nursing education, essential skills include Critical Thinking (CT). There is scant evidence on how nurse educators could promote CT in students in a clinical context.

OBJECTIVE

To analyse the level of CT and correlated variables in healthcare nurses overseeing the clinicals of nursing undergraduates.

METHODS

The study population were all nurse educators for clinicals at hospitals with nursing undergraduates. To evaluate the CT skills of nurses the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 practice) was administered. Frequencies, percentages and measures of central tendency and scatter were obtained. A bivariate analysis was performed to analyze the correlation between the nurse educators' CT level and the sociodemographic, professional and academic levels. The nonparametric Mann-Whitney and Kruskal-Wallis tests were used to compare two independent groups. Statistical significance was defined as P < .05.

RESULTS

The total number of participants was 639. The highest mean CT level was seen in clinical nurses involved in undergraduate nursing instruction and with experience of up to 10 years (mean CT score = 372 (33.3), p = .007). Global CT levels were similar in women and men (mean CT score: 364 (31.9) in women and 358 (40.5) in men, p = .187), with statistically significant differences only observed in the intellectual and cognitive indicator (P = .022).

CONCLUSIONS

CT levels are high in teaching healthcare professionals in the clinical environment.

The impact of an integrated PBL curriculum on clinical thinking in undergraduate medical students prior to clinical practice

BACKGROUND

Problem-based learning (PBL) is a widely adopted educational approach in medical education that aims to promote critical thinking and problem-solving in authentic learning situations. However, the impact of PBL educational mode on undergraduate medical students' clinical thinking ability has been limitedly investigated. This study aimed to assess the influence of an integrated PBL curriculum on clinical thinking ability of medical students prior to clinical practice.

METHODS

Two hundred and sixty-seven third-year undergraduate medical students at Nantong University were recruited in this study and were independently assigned to either the PBL or control group. The Chinese version of the Clinical Thinking Ability Evaluation Scale was used to assess clinical thinking ability, and the students' performance in the PBL tutorials was assessed by tutors. All participants in both groups were required to complete the pre-test and post-test questionnaires to self-report their clinical thinking ability. A paired sample t-test, independent sample t-test and one-way analysis of variance test (ANOVA) were used to compare the difference in clinical thinking scores among different groups. Multiple linear regression was conducted to analyze the influencing factors correlated with clinical thinking ability.

RESULTS

The clinical thinking ability of most third-year undergraduate medical students at Nantong University was at a high level. The PBL group had a higher proportion of students with high-level clinical thinking ability in the post-test compared to the control group. The pre-test scores of clinical thinking ability were similar between the PBL and control groups, but the post-test scores of clinical thinking ability in the PBL group were significantly higher than those in the control group. Additionally, there was a significant difference in clinical thinking ability between the pre-test and post-test in the PBL group. The post-test scores of sub-scales of critical thinking ability were significantly higher than the pre-test in the PBL group. Furthermore, the frequency of reading literature, time of PBL self-directed learning, and PBL performance score ranking were influencing factors on the clinical thinking ability of medical students in the PBL group. Moreover, there was a positive correlation between clinical thinking ability and the frequency of reading literature, as well as the scores of the PBL performance.

CONCLUSIONS

The integrated PBL curriculum model has an active impact on improving undergraduate medical students' clinical thinking ability. This improvement in clinical thinking ability may be correlated with the frequency of reading literature, as well as the performance of the PBL curriculum.

Can online learning be a reliable alternative to nursing students' learning during a pandemic? - A systematic review and meta-analysis

OBJECTIVES

To compare online learning with traditional face-to-face and blended learning, based on randomized controlled trials, to determine the impact of online learning on nursing students' learning outcomes.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

A systematic search was conducted via English (PubMed, ERIC, Embase, CENTRAL, and CINAHL) and Korean databases (RISS, DBpia, and KISS).

REVIEW METHODS

Studies published up to the first week of April 2022 were reviewed with a focus on the participants, intervention, comparison, outcome, and study design format. Following a primary screening of titles and abstracts, and secondary screening of full texts, 10 randomized controlled trial studies were selected, of which eight were included in the meta-analysis. Two researchers independently reviewed the literature, and the final selection was made in consensus.

RESULTS

Online learning had a statistically significant positive effect on nursing students' knowledge, compared with no educational intervention (standardized mean difference (SMD) = 1.63; 95 % confidence interval (CI): 1.31 to 1.95). However, there was no significant difference in the impact of online learning on knowledge compared with blended learning (SMD = -0.14; 95 % CI: -0.70 to 0.41) and face-to-face learning (SMD = 0.37; 95 % CI: -0.32 to 1.06). Furthermore, compared with blended learning (SMD = -0.18; 95 % CI: -0.43 to 0.06) and face-to-face learning (SMD = 0.05; 95 % CI: -0.31 to 0.41), there was no significant difference in the impact of online learning on attitudes toward learning.

CONCLUSIONS

Online learning in nursing education is not significantly different from blended or face-to-face learning in terms of its impact on knowledge acquisition and attitudes toward learning. The results of this review and meta-analysis highlight the need for selective application of learning methods, taking into account learning environments as well as curricular subjects and topics.

Evaluating and comparing critical thinking skills of residents of Tehran University of Medical Sciences

BACKGROUND

Today's complexities and diversity in the clinical setting have revealed the need to pay attention to strengthening critical thinking (CT) skills. The present study aimed to evaluate and compare CT skills in the residents of the Tehran University of Medical Sciences.

METHODS

This is a cross-sectional study. The study's statistical population included 284 residents in orthopedic, internal medicine, and surgery groups studying in the PGY1 to PGY4 years of residency. The data collection tool was the California Critical Thinking Skills Test (CCTST) form B. The collected data were entered into SPSS-16 software and analyzed using descriptive (mean and standard deviation) and inferential (one-way ANOVA) statistics. The significant level in all tests was considered at P < 0.05.

RESULTS

189 out of 284 residents completed and returned the questionnaire, and the response rate was 66%. The mean CT skill score of residents (M = 13.81, SD = 3.52) was lower than the optimal level (M = 17.1 SD = 5.0). Comparing the mean CT skill scores of the residents separately for the residency year revealed a significant decrease in CT scores in the 4 years. A significant difference was found between the CT skill scores in the three groups (internal medicine, general surgery, and orthopedic surgery).

CONCLUSION

The CT skills of the residents of Tehran University of Medical Sciences were generally below the optimal level. The CT score of the residents show an increase in PGY2, but a decrease in PGY3 and PGY4. Due to the emphasis of accreditation institutions, the World Federation for Medical Education, and other international educational institutions on the importance of critical thinking, it is recommended to pay more attention to the factors related to the promotion and development of CT skills in residency programs.

Outcomes of problem-based learning in nurse education: A systematic review and meta-analysis

OBJECTIVE

To investigate the effectiveness of problem-based learning (PBL) in nursing students, including recently reported trials.

DESIGN

Meta-analysis was performed to obtain summary conclusions on the influence of PBL on nursing students' learning outcomes.

DATA SOURCES

Academic Search Complete, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, and Web of Science were searched for relevant studies from the period between database inception and March 3, 2022.

REVIEW METHODS

A random-effects model was used to generate pooled standardized mean differences (SMD) for critical thinking, problem-solving, and self-confidence. The heterogeneity of each variable in the pooled estimate was determined using a random-effects model.

RESULTS

Overall, PBL had a greater positive effect than traditional learning on critical thinking (SMD: 0.44; 95 % CI: 0.14-0.73), analysis (SMD: 0.72; 95 % CI: 0.84-1.25), and evaluation (SMD: 0.33; 95 % CI: 0.05-0.61). However, the impact of PBL on problem-solving and self-confidence need further investigation.

CONCLUSIONS

PBL appears to improve nursing students' critical thinking skills, especially their ability to analyze and evaluate. The findings of this study may be used as evidence of PBL being a more effective method than traditional/conventional learning techniques for increasing students' critical thinking.

WARRIORS: An Educational Initiative Improving Clinical Judgment and Safety in Medication Administration

BACKGROUND

Medication administration requires rigorous clinical reasoning leading to sound clinical judgment for positive patient outcomes. The National Council of State Boards of Nursing is implementing a clinical judgment model for the licensure examination.

METHOD

To support the practice of clinical judgment in administering medication, improve patient safety, and better prepare nursing students for their licensure examination, a clinical reasoning initiative was developed to reflect the judgment needed for safe medication administration. An acronym, WARRIORS, captures the decision process exemplifying the knowledge, skills, and attitudes needed to keep patients safe.

RESULTS

A free training tool (https://www.youtube.com/watch?v=YkBeGymEMuQ) and an online electronic health record (http://www.nursing.pitt.edu/aliceblazeckrn/) guiding deliberate practice provide interrelated cues to support nursing students in forming a hypothesis through taking action and evaluation.

CONCLUSION

This learning initiative supports nursing students' safe and accurate medication administration and can continue to be used as they move into practice. [J Nurs Educ. 2020;59(4):231-234.].

Effectiveness of problem-based learning on the professional communication competencies of nursing students and nurses: A systematic review

The objective of this systematic review was to estimate the effectiveness of problem-based learning (PBL) in developing the professional communication competences of nursing students and nurses. We have searched PubMed, EMBASE, MEDLINE, PsycINFO, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and VIP Database for Chinese Technical Periodicals to identify all the English and Chinese language studies that used PBL to determine the effectiveness of developing professional communication competences of nursing students and nurses. Then two reviewers independently assessed eligibility and extracted data. Quality assessment using the Cochrane Collaboration's risk of bias tool for randomized controlled trials and Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) for quasi-experimental studies. A total of 12 studies were included, all of which were inclined to low bias. Eleven articles showed that PBL developed the communication skills of nursing students or nurses, while only one article revealed no significant difference between PBL and the traditional method. Owing to differences in experimental design and the method and duration of intervention, some of these studies combined PBL with other methods, and the evaluation tools were different. This systematic review cautiously supports the outcomes of PBL compared with traditional learning.

Active teaching model to promote critical thinking

OBJECTIVE

To present the experience of elaboration and implementation of the Active Teaching Model to Promote Critical Thinking (MEAPC), associated to Problem-Based Learning (PBL), for undergraduate students in Nursing.

METHOD

Case report on the experience of the educational intervention (MEAPC + PBL) with undergraduate students in Nursing, in a 20-hour course on Basic Life Support (BLS). The MEAPC was validated by judges to guide the analysis of clinical cases. Critical Thinking (CT) skills were assessed using the California Critical Thinking Skills Test.

RESULT

The educational intervention took place in two phases: elaboration and implementation, allowing not only the production of knowledge about BLS, but also the development of CT and exchange of experiences for teaching-learning.

CONCLUSION

The association of the MEAPC to the PBL in the course of BLS organized the learning, gave opportunity to acquire knowledge and to stimulate the skills of the CT.

Integrated training (practicing, peer clinical training and OSCE assessment): a ladder to promote learning and training

Introduction The teaching-learning process plays an effective role in training nursing students. Devising novel methods can lead to achievement of educational objectives as well as promotion of the clinical and practical training. The present study is aimed to determine the effect of integrated training, including practicing, peer clinical training and objective structured clinical examination (OSCE) assessment. Methods The interventional study was conducted on 58 freshman students. Two groups underwent a five-stage educational process; so that, all the students were trained and practiced in the skills lab, and their practical skills were investigated via the OSCE test. Afterwards, for clinical training in hospital, they were randomly divided into two groups of routine training (n = 26) and the peer-learning method (n = 32). Subsequently, in order to investigate the outcomes of the process, the OSCE test scores of the two training groups were compared both before and after the apprenticeship course. Results Scores of all the students were increased significantly at the end of the semester, but in terms of the total score of the clinical skills (14.79 ± 1.52 vs. 18.52 ± 0.84), the difference was insignificant (p = 0.29). Conclusion Training clinical skills along with OSCE practice and assessment can improve the nursing students' learning as well as their practical and clinical performance. Improvement of the students' performance can lead to high-quality care nursing.

Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project)

BACKGROUND

The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment.

OBJECTIVE(S)

To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities.

DESIGN

Systematic review that conforms to the PRISMA statement.

SAMPLE

Master's Nursing programs that include elements of a capstone project within a university setting.

DATA SOURCES/REVIEW METHODS

MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English.

RESULTS

Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements.

CONCLUSIONS

There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice.

Impact of Enquiry Based Learning (EBL) on student midwife praxis

Midwifery training in Ireland moved to Higher Education in 2006. This shift established a physical and educational separation of theory and practice. The adoption of Enquiry Based Learning (EBL) by one Irish midwifery education institution attempted to address this division. Enquiry Based Learning (EBL) has the potential to develop student reflexivity and evidence assimilation across the career-span and may therefore enhance student praxis. EBL has been championed as an example of an educational model that supports praxis, helping to create competent practitioners through the use of authentic learning scenarios that address the theory practice divide. The current research study represents the first formal evaluation of EBL in undergraduate midwifery education in the South of Ireland. The study was a mixed-methods design that utilised focus groups, interviews and survey to ascertain the opinions of first exposure to EBL amongst a cohort of first year student midwives. Findings demonstrate the value of EBL in enhancing student midwife praxis.

Assessment of Perception and Effectiveness of Concept Mapping in Learning Epidemiology

Background and Objectives:

Current programs in medical education technology concentrate mainly upon “how-to-teach.” The focus is needed on learner's memory retention too. An innovative strategy like concept mapping might be a way forward. The study was carried out to assess its effectiveness and to know students' perceptions.

Materials and Methods:

During community medicine classes, a student-group was sensitized on how to make and use concept maps out of taught contents. At the end of epidemiology exercises sessions, this group was given additional minutes to prepare concept maps, interact, and brainstorm followed by quick QA session. Others were taught same contents in conventional way. Performances of both groups were assessed in one immediate (term-ending) and one distant (preliminary) exam. Feedback was also taken from study group.

Results:

Study group consistently scored higher in both exams. Difference in scored mean marks was highly significant in term-ending-examination (P < 0.0001, t = 5.754, df = 121.9). Largely positive feedback was received on utility of concept maps in memorizing, confidence-boosting, and understanding subject. Felt need for innovations in conventional teaching-learning (T-L) was palpable.

Conclusion:

Time has come to start focusing on enhancing students' learning. Performance-enhancing utility of concept maps is proven and should be integrated in regular T-L.

Facilitating problem-based learning among undergraduate nursing students: A qualitative systematic review

OBJECTIVES

The purpose of this study was to identify and synthesize the best available evidence on the perspective of undergraduate nursing students on facilitating elements that contribute to their success with PBL.

DESIGN

a qualitative systematic review of the literature according to meta-aggregative methodology using the JBI SUMARI system was conducted.

DATA SOURCES

Data was collected across CINAHL, Medline, Embase, Eric, Teacher Reference Center and reference lists.

RESEARCH METHODS

Out of 378 articles, 101 were retrieved for examination and eight were retained after methodological analysis.

RESULTS

51 findings, matched with a verbatim, were extracted and aggregated in five categories: 1) in PBL, the nursing tutor models clinical reasoning and leadership skills; 2) the quality of group interactions is critical to the success of nursing students with PBL; 3) nursing students go through the process of learning with PBL; 4) through PBL, nursing students acquire skills that foster clinical reasoning; and 5) when the PBL method is used as intended, nursing students understand its purpose and process. These categories were aggregated in two syntheses worded as recommendation for practice.

CONCLUSIONS

The synthesized recommendations are: 1) tutors should be trained to effectively guide the team work of undergraduate nursing students along the PBL process in order for them to achieve its goal; and 2) nursing students should be securely introduced to PBL and experience the development of their clinical reasoning through PBL. Future research should focus on the strategies undergraduate nursing students use to succeed with PBL and the effectiveness of PBL in enhancing critical thinking and collaboration skills.

The effectiveness of concept mapping on development of critical thinking in nursing education: A systematic review and meta-analysis

OBJECTIVES

As an essential skill in daily clinical nursing practice, critical thinking ability has been an important objective in nursing education. Concept mapping enables nursing students connect new information to existing knowledge and integrates interdisciplinary knowledge. However, there is a lack of evidence related to critical thinking ability and concept mapping in nursing education. The purpose of this systematic review and meta-analysis was to assess the effect of concept mapping in developing critical thinking in nursing education.

DESIGN

This systematic review was reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).

DATA SOURCES

A search was conducted in PubMed, Web of science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health (CINAHL) and China National Knowledge Infrastructure (CNKI). Randomized controlled trials (RCT) comparing concept mapping and traditional teaching method were retrieved.

REVIEW METHODS

Data were collected by two reviewers according to the data extraction tables. The methodological quality of included studies was assessed by other two reviewers. The results of meta-analysis were presented using mean difference (MD).

RESULT

Thirteen trials were summarized in the systematic review and eleven trials were included in the meta-analysis. The pooled effect size showed that, comparing with traditional methods, concept mapping could improve subjects' critical thinking ability measured by California Critical Thinking Disposition Inventory (CCTDI), California Critical Thinking Skill Test (CCTST) and Critical Thinking Scale (CTS). The subgroup analyses showed that concept mapping improved the score of all subscales.

CONCLUSION

The result of this review indicated that concept mapping could affect the critical thinking affective dispositions and critical thinking cognitive skills. Further high quality research using uniform evaluation is required.

Kakovost problemov, obravnavanih pri problemskem učenju: ocena študentov zdravstvene nege

Uvod: Z vpeljavo problemskega učenja se je spremenil kontekst učenja. Z uporabo kakovostnih problemov v okviru problemskega učenja se spodbuja kritično mišljenje, skupinske interakcije, uporaba teorije v praksi. Namen raziskave je bil ugotoviti oceno študentov zdravstvene nege glede kakovosti problemov, obravnavanih v okviru problemskega učenja. Metode: Uporabljeno je bilo kvantitativno neeksperimentalno raziskovanje, podatki so bili zbrani s tehniko anketiranja. V raziskavi je sodelovalo 196 študentov zdravstvene nege. Za obdelavo podatkov je bila uporabljena deskriptivna statistika, t-test in korelacijska analiza. Statistično značilnost smo preverjali na ravni 5% tveganja. Rezultati: Povprečne ocene vseh trditev, ki so se nanašale na oceno kakovosti problemov, obravnavanih v okviru problemskega učenja, so bile visoke ( > 4 od 5). Glede na način študija zdravstvene nege (redni, izredni študij) (t = –1,333, p = 0,558) in spol (t = 0,236, p = 0,354) ne prihaja do razlik v oceni kakovosti obravnavanih problemov. Ugotovljene so bile razlike v oceni kakovosti obravnavanih problemov glede na zaposlenost v zdravstvu (t = 2,109, p = 0,04) ter pozitivna šibka povezanost (r = 0,190, p = 0,002) med starostjo in oceno kakovosti obravnavanih problemov. Diskusija in zaključek: Raziskava pokaže visoko oceno kakovosti problemov, obravnavanih v okviru problemskega učenja, s čimer se pri študentih spodbuja samousmerjeno učenje, povečuje zanimanje za učno enoto in izboljšujejo motivacija za delo, komunikacijske spretnosti ter kritično razmišljanje. Nadaljnje raziskave bi bilo smiselno usmeriti v spremljanje vpliva problemskega učenja na učne izide ter uvedbo problemskega učenja v vse učne enote v okviru študija zdravstvene nege.

Effectiveness of teaching strategies on the development of critical thinking in undergraduate nursing students: a meta-analysis

Abstract OBJECTIVE To evaluate the effectiveness of teaching strategies used for development of critical thinking (CT) in undergraduate nursing students. METHOD Systematic review with meta-analysis based on the recommendations of the Joanna Briggs Institute . Searches were conducted in the following databases: PubMed, CINAHL, EMBASE, Web of Science, SCOPUS, LILACS, Cochrane CENTRAL, PsycINFO, ERIC, and a database of theses from four continents. The initial selection and evaluation of studies and assessment of methodological quality was performed by two reviewers independently. RESULTS Twelve randomized clinical trials were included in the study. In the meta-analysis of the four studies included that evaluated the strategy of problem-based learning (PBL), compared to lectures, the effectiveness of PBL was demonstrated with statistical significance (SMD = 0.21 and 95% CI = 0.01 to 0.42; p = 0.0434) for the development of CT in undergraduate nursing students, and the studies were homogeneous (chi-square = 6.10, p = 0.106). CONCLUSION The effectiveness of PBL was demonstrated in the increase of overall CT scores. Further studies need to be conducted in order to develop, implement and evaluate teaching strategies that are guided in high methodological rigor, and supported in theoretical models of teaching and learning.

The Efficacy of Three Learning Methods Collaborative, Context-Based Learning and Traditional, on Learning, Attitude and Behaviour of Undergraduate Nursing Students: Integrating Theory and Practice

INTRODUCTION

Communication skills training, responsibility, respect, and self-awareness are important indexes of changing learning behaviours in modern approaches.

AIM

The aim of this study was to investigate the efficacy of three learning approaches, collaborative, context-based learning (CBL), and traditional, on learning, attitude, and behaviour of undergraduate nursing students.

MATERIALS AND METHODS

This study was a clinical trial with pretest and post-test of control group. The participants were senior nursing students. The samples were randomly assigned to three groups; CBL, collaborative, and traditional. To gather data a standard questionnaire of students' behaviour and attitude was administered prior to and after the intervention. Also, the rate of learning was investigated by a researcher-developed questionnaire prior to and after the intervention in the three groups.

RESULTS

In CBL and collaborative training groups, the mean score of behaviour and attitude increased after the intervention. But no significant association was obtained between the mean scores of behaviour and attitude prior to and after the intervention in the traditional group. However, the mean learning score increased significantly in the CBL, collaborative, and traditional groups after the study in comparison to before the study.

CONCLUSION

Both CBL and collaborative approaches were useful in terms of increased respect, self-awareness, self-evaluation, communication skills and responsibility as well as increased motivation and learning score in comparison to traditional method.

The evidence for 'flipping out': A systematic review of the flipped classroom in nursing education

BACKGROUND

The flipped classroom has generated interest in higher education providing a student-centred approach to learning. This has the potential to engage nursing students in ways that address the needs of today's students and the complexity of contemporary healthcare. Calls for educational reform, particularly in healthcare programs such as nursing, highlight the need for students to problem-solve, reason and apply theory into practice. The drivers towards student-based learning have manifested in team, problem and case-based learning models. Though there has been a shift towards the flipped classroom, comparatively little is known about how it is used in nursing curricula.

OBJECTIVES

The aims of this systematic review were to examine how the flipped classroom has been applied in nursing education and outcomes associated with this style of teaching.

DATA SOURCES

Five databases were searched and resulted in the retrieval of 21 papers: PubMed, CINAHL, EMBASE, Scopus and ERIC.

REVIEW METHODS

After screening for inclusion/exclusion criteria, each paper was evaluated using a critical appraisal tool. Data extraction and analysis were completed on all included studies.

RESULTS

This systematic review screened 21 titles and abstracts resulting in nine included studies. All authors critically appraised the quality of the included studies. Five studies were identified and themes identified were: academic performance outcomes, and student satisfaction implementing the flipped classroom.

CONCLUSIONS

Use of the flipped classroom in higher education nursing programmes yielded neutral or positive academic outcomes and mixed results for satisfaction. Engagement of students in the flipped classroom model was achieved when academics informed and rationalised the purpose of the flipped classroom model to students. However, no studies in this review identified the evaluation of the process of implementing the flipped classroom. Studies examining the process and ongoing evaluation and refinement of the flipped classroom in higher education nursing programmes are warranted.

Nursing education research in Finland--A review of doctoral dissertations

OBJECTIVES

The aim of this literature review was to describe the focus of nursing education research in Finnish doctoral dissertations in the field of nursing and caring sciences between the years 1979-2014. In addition, the characteristics (methods, study informants and reporting of validity, reliability, and research ethics) of the dissertations were described.

METHODS AND DATA

A literature review was carried out. Altogether 51 Finnish doctoral dissertations of nursing and caring sciences focusing on nursing education research were included in the final analysis. The dissertations were published in 1990-2014. The data were analyzed by content analysis both deductively and inductively.

RESULTS

Finnish nursing education research was focused on four main areas: structural factors in nursing education, nurse teacherhood, teaching activities, and learning and learning outcomes in nursing education. The most central focus was learning in nursing education whereas nurse teacherhood and structural factors in nursing education were studied the least. Students were the predominant study informant group while nurse staff including nurse mentors were next and nurse educators only the third. Surveys and interviews were the most common data collection methods. In the findings there were a lot of similarities with international nursing education research.

CONCLUSIONS

Finnish nursing education research has been relatively student-centered yet studies focusing on the education of other nursing-based professions are rare. Future research about nurse teacherhood, curricula and structural factors in nursing education is recommended also. In addition, nursing education research should focus on the central phenomena of nursing education and working life. All in all, more nursing education research is needed. Nursing education dissertations cover only 12.3% of all the dissertations of nursing and caring sciences in Finland.

Critical thinking in nursing: Scoping review of the literature

This article seeks to analyse the current state of scientific knowledge concerning critical thinking in nursing. The methodology used consisted of a scoping review of the main scientific databases using an applied search strategy. A total of 1518 studies published from January 1999 to June 2013 were identified, of which 90 met the inclusion criteria. The main conclusion drawn is that critical thinking in nursing is experiencing a growing interest in the study of both its concepts and its dimensions, as well as in the development of training strategies to further its development among both students and professionals. Furthermore, the analysis reveals that critical thinking has been investigated principally in the university setting, independent of conceptual models, with a variety of instruments used for its measurement. We recommend (i) the investigation of critical thinking among working professionals, (ii) the designing of evaluative instruments linked to conceptual models and (iii) the identification of strategies to promote critical thinking in the context of providing nursing care.

Not just ticking all the boxes. Problem based learning and mental health nursing. A review

BACKGROUND

The practice and policy of mental health nursing are changing. Integration of health and social care, an increased emphasis on wellness and recovery and greater expectation of involvement from both service users and carers require competence in both group and interpersonal working. The active and dynamic processes of problem based learning provide the ideal environment to achieve proficiency in these skills.

OBJECTIVES

The aim of this review was to understand those programme elements that best support the delivery of a problem based learning module.

DATA SOURCES

This study utilised a standard module evaluation.

REVIEW METHODS

A systematic analysis of completed module evaluations allowed key themes to be established.

RESULTS

Problem based learning helps develop the skills and attributes that mental health nursing need in an increasing collaborative and wellness focused practice environment. Successful integration of PBL is more likely to occur when student centred approaches are already incorporated within a programme. Creating the right conditions for learning are key to successful facilitation of PBL groups.

CONCLUSIONS

Successful implementation of PBL requires identification of relevance to practice by students, a programme approach that is compatible with the aims and philosophy of PBL and a form of facilitation that encourages development of student autonomy.

Zadovoljstvo študentov zdravstvene nege s problemskim učenjem

Uvod: Problemsko učenje predstavlja premik v izobraževalni paradigmi, saj predstavlja na posameznika usmerjeno učenje, ki spodbuja razvijanje samostojnosti, znanj, spretnosti in lastnosti, potrebnih za delovanje v zdravstveni negi. Namen raziskave je bil ugotoviti zadovoljstvo študentov rednega in izrednega študija zdravstvene nege s problemskim učenjem. Metode: Uporabljeno je bilo kvantitativno neeksperimentalno raziskovanje, podatki so bili zbrani s tehniko anketiranja. V raziskavi je sodelovalo 196 študentov zdravstvene nege. Za obdelavo podatkov je bila uporabljena deskriptivna statistika, t-test in korelacijska analiza. Statistično značilnost smo preverjali na ravni 5% tveganja. Rezultati: Povprečne ocene vseh trditev, ki so se nanašale na zadovoljstvo študentov s problemskim učenjem, so bile zelo visoke (> 4 od 5). Glede na način študija zdravstvene nege (t = –0,818, p = 0,414) in spol (t = –0,002, p = 0,998) ne prihaja do razlik v oceni glede zadovoljstva s problemskim učenjem, vendar se je pokazal pozitiven vpliv delovnih izkušenj pri študentih izrednega študija, zaposlenih v zdravstvu. Ugotovljena je bila povezanost med starostjo študentov in zadovoljstvom s problemskim učenjem (r = 0,198, p = 0,006). Diskusija in zaključek: Raziskava pokaže, da problemsko učenje pri študentih zdravstvene nege izboljšuje motivacijo za delo ter spodbuja tako samostojen študij kot delo v skupinah. Nadaljnje raziskave bi bilo potrebno usmeriti na problemsko učenje v klinični praksi in aplikacijo teoretičnih znanj v klinično okolje.

A case-based, problem-based learning approach to prepare master of public health candidates for the complexities of global health

Global health is a dynamic, emerging, and interdisciplinary field. To address current and emerging global health challenges, we need a public health workforce with adaptable and collaborative problem-solving skills. In the 2013-2014 academic year, the Hubert Department of Global Health at the Rollins School of Public Health-Emory University launched an innovative required core course for its first-year Master of Public Health students in the global health track. The course uses a case-based, problem-based learning approach to develop global health competencies. Small teams of students propose solutions to these problems by identifying learning issues and critically analyzing and synthesizing new information. We describe the course structure and logistics used to apply this approach in the context of a large class and share lessons learned.

The effect of simulation courseware on critical thinking in undergraduate nursing students: multi-site pre-post study

BACKGROUND

The use of simulations has been considered as opportunities for students to enhance their critical thinking (CT), but previous studies were limited because they did not provide in-depth information on the working dynamics of simulation or on the effects of the number of simulation exposures on CT.

OBJECTIVES

This study examined the effect of an integrated pediatric nursing simulation used in a nursing practicum on students' CT abilities and identified the effects of differing numbers of simulation exposures on CT in a multi-site environment.

DESIGN

The study used a multi-site, pre-test, post-test design.

PARTICIPANTS AND SETTINGS

A total of 237 nursing students at three universities enrolled in a pediatric practicum participated in this study from February to December 2013.

METHODS

All three schools used the same simulation courseware, including the same simulation scenarios, evaluation tools, and simulation equipment. The courseware incorporated high-fidelity simulators and standardized patients. Students at school A completed one simulation session, whereas students at schools B and C completed two and three simulation sessions, respectively. Yoon's Critical Thinking Disposition tool (2008) was used to measure students' CT abilities.

RESULTS

The gains in students' CT scores varied according to their numbers of exposures to the simulation courseware. With a single exposure, there were no statistically significant gains in CT, whereas three exposures to the courseware produced significant gains in CT. In seven subcategories of critical thinking, three exposures to the simulation courseware produced CT gains in the prudence and intellectual eagerness subcategories, and the overall simulation experience produced CT gains in the prudence, systematicity, healthy skepticism, and intellectual eagerness subcategories.

CONCLUSIONS

Simulation courseware may produce positive learning outcomes for prudence in nursing education. In addition, the findings from the multi-site comparative study may contribute to greater understanding of how patient simulation experiences impact students' CT abilities.

The influence of undergraduate education on professional practice transition: a comparative descriptive study

BACKGROUND

Graduates from Problem/Context Based Learning (CBL) undergraduate nursing programs often express concern that they may not be as well prepared for transition to graduate nursing practice as their colleagues from more traditional lecture-based programs.

AIMS

To determine if there is a difference in how graduates from CBL and non-CBL programs describe their transition to graduate practice within the first 2 years of graduation.

METHODS

This was a comparative descriptive study that involved the use of a web-based survey. A convenience sample of 163 graduate nurses with 1 to 2 years of experience consented to be part of the study. They completed a researcher-designed questionnaire, which consisted of 26 items based on entry to practice competencies identified by the provincial professional nursing organization.

RESULTS

There was no significant difference in the transition experience of graduates from CBL and traditional education programs within their first 2 years following graduation. These results confirm the findings of authors who compared transition among CBL and non-CBL graduates who had graduated anywhere from six months to several years following graduation.

CONCLUSIONS

It is clear that CBL programs do prepare graduates to successfully transition into graduate nurse practice. Graduates from both CBL and non-CBL programs indicated a need for more formal agency sponsored orientation and transition assistance programs at the beginning of their initial employment.

Comparison of knowledge, confidence in skill performance (CSP) and satisfaction in problem-based learning (PBL) and simulation with PBL educational modalities in caring for children with bronchiolitis

BACKGROUND

In most nursing curricula, simulation and problem-based learning (PBL) are used separately as individual learning methods. Nursing educators are in a unique position to improve students' clinical performance and critical thinking skills by utilizing varied educational modalities.

PURPOSE

This study attempted to compare changes in nursing students' knowledge, confidence in skill performance (CSP), and satisfaction resulting from training using three educational modalities.

PARTICIPANTS

Data from a convenient sample of 205 senior nursing students from three nursing schools in Seoul and Chuncheon, South Korea, was obtained between September 1 and December 10, 2013.

METHODS

This comparison study used three groups: the PBL group, simulation with the PBL group, and the control group. For data analysis, descriptive statistics, paired t-test, one-way ANOVA, and post-hoc tests (Duncan test) were performed.

RESULTS

No significant difference in the students' baseline knowledge of patient care for patients with bronchiolitis was found. There were significant differences in the mean scores of knowledge (F=14.718, p<.001), CSP (F=12.693, p<.001), and students' satisfaction (F=93.471, p<.001) among the three groups.

CONCLUSION

The positive impact of PBL and a combined learning method in this study suggests that it can be an effective approach in pediatric nursing practice. These results provide a much-needed template and starting point for educators introducing active learning approaches for pediatric nursing courses.

Influence of simulated and actual community vaccination clinics on student empowerment and self-efficacy for public health nursing competencies

OBJECTIVES

To examine students' structural empowerment during simulated learning and actual nursing practice, and assess students' self-efficacy for public health nursing competencies (PHNC) after involvement in a mass influenza vaccination clinic as a community practice experience.

DESIGN

A nonexperimental survey design was used with a sample of year three baccalaureate nursing students.

METHODS

Students completed a demographic form after the simulated clinic experience, they were assessed for perceptions of empowerment after being involved in the simulated and actual clinic settings, and self-efficacy was assessed after the actual clinic experience.

RESULTS

Students perceived themselves as structurally empowered after completing the simulated and actual community vaccination clinics. Students reported a high level of self-efficacy for PHNC after their actual community vaccination clinic involvement. There was a significant correlation between empowerment and self-efficacy, which suggests that when students have access to empowering structures, they feel more confident to enact PHNC that align with practice in the clinics.

CONCLUSION

This study suggests that nursing students acquired the necessary knowledge and skills for safe vaccination administration through the combination of simulated practice and participating in an actual public health vaccination clinic.

Do problem-solving skills affect success in nursing process applications? An application among Turkish nursing students

PURPOSE

This study aimed to determine the relationship between problem-solving and nursing process application skills of nursing.

METHODS

This is a longitudinal and correlational study. The sample included 71 students. An information form, Problem-Solving Inventory, and nursing processes the students presented at the end of clinical courses were used for data collection.

FINDINGS

Although there was no significant relationship between problem-solving skills and nursing process grades, improving problem-solving skills increased successful grades.

CONCLUSIONS

Problem-solving skills and nursing process skills can be concomitantly increased.

CLINICAL REVELANCE

Students were suggested to use critical thinking, practical approaches, and care plans, as well as revising nursing processes in order to improve their problem-solving skills and nursing process application skills.

Graduate nurses' learning trajectories and experiences of problem based learning: a focused ethnography study

BACKGROUND

Problem-based learning seeks to foster active, collaborative and self directed learning. It is increasingly utilized in health professional education; however, it is difficult to ascertain effectiveness. Empirically, student satisfaction does not match academic achievement but the reasons for this are unclear.

OBJECTIVE

To explore the experience trajectories and satisfaction of graduates who had completed an undergraduate problem-based learning nursing program.

DESIGN AND METHODS

Qualitative focused ethnography using individual and group semi-structured interviews. Categories and themes were identified using inductive constant comparison. A comparative matrix analysis of differing levels of the two core processes illuminated specific experience profiles.

PARTICIPANTS AND SETTING

Forty five program graduates who had graduated between one and nine years previously from a Western Canadian program offered at four academic sites. The sample was mostly female (n=37), aged 26-30 years (n=23) and graduated 5-8 years previously (n=20).

RESULTS

Levels of satisfaction with the program varied markedly. Two core processes contributed to this: "understanding" and "valuing" problem-based learning. Specific experience profiles included: "Happy as fish in water" which represents those who understood and valued the approach, and flourished; "I'll do it but I won't like it" reflects those who understood and could adjust to the academic context but did not particularly value it; "I just want to be a nurse" characterized those who consistently disliked and resisted the process but endured in order to graduate. Each profile was characterized by attitudes, intentions, learning preferences and program satisfaction.

CONCLUSIONS

We theorize an underlying mechanism explaining these diverse levels of satisfaction are differing orientations to studying. This approach to understanding how students typically approach learning is strongly linked to perceptions of academic quality and program satisfaction in higher education research, although it has been neglected in nursing problem-based learning research. Orientations to studying include reproductive surface learning, deep learning for understanding and meaning, and strategic approaches to maximize desired objectives. These orientations are congruent with the descriptive typologies developed in this research. This provides an effective explanation as to why some students adapt easily and flourish in problem-based learning contexts, while others continually struggle to adapt. Further research is needed to determine the relationship between deep, surface, and strategic orientations to study and student satisfaction in nursing programs.

Effects of problem-based learning vs. traditional lecture on Korean nursing students' critical thinking, problem-solving, and self-directed learning

BACKGROUND

Problem-based learning (PBL) is a method widely used in nursing education to develop students' critical thinking skills to solve practice problems independently. Although PBL has been used in nursing education in Korea for nearly a decade, few studies have examined its effects on Korean nursing students' learning outcomes, and few Korean studies have examined relationships among these outcomes.

OBJECTIVES

The objectives of this study are to examine outcome abilities including critical thinking, problem-solving, and self-directed learning of nursing students receiving PBL vs. traditional lecture, and to examine correlations among these outcome abilities.

DESIGN

A quasi-experimental non-equivalent group pretest-posttest design was used.

PARTICIPANTS/SETTING

First-year nursing students (N=90) were recruited from two different junior colleges in two cities (GY and GJ) in South Korea.

METHODS

In two selected educational programs, one used traditional lecture methods, while the other used PBL methods. Standardized self-administered questionnaires of critical thinking, problem-solving, and self-directed learning abilities were administered before and at 16weeks (after instruction).

RESULTS

Learning outcomes were significantly positively correlated, however outcomes were not statistically different between groups. Students in the PBL group improved across all abilities measured, while student scores in the traditional lecture group decreased in problem-solving and self-directed learning. Critical thinking was positively associated with problem-solving and self-directed learning (r=.71, and r=.50, respectively, p<.001); problem-solving was positively associated with self-directed learning (r=.75, p<.001).

CONCLUSION

Learning outcomes of PBL were not significantly different from traditional lecture in this small underpowered study, despite positive trends. Larger studies are recommended to study effects of PBL on critical student abilities.

Nursing students' critical thinking disposition according to academic level and satisfaction with nursing

BACKGROUND

The development of critical thinking dispositions has become an important issue in nursing education in Korea. Nursing colleges in Korea have developed teaching strategies and curricula that focus on developing critical thinking dispositions. It is an imperative step that evaluates the changing pattern and development of students' critical thinking dispositions.

OBJECTIVES

This study identified critical thinking dispositions of Korean nursing students according to academic level and satisfaction with nursing.

METHODS

A cross-sectional questionnaire survey was conducted among 1074 students in four colleges who completed the self-reported Critical Thinking Disposition Scale. Descriptive and univariate general linear model analyses were performed.

RESULTS

The critical thinking disposition score increased according to academic level until junior year, after which it decreased in the senior year. Nursing students who were satisfied with nursing reported higher levels of critical thinking than those who were not satisfied or who responded neutrally.

CONCLUSIONS

The critical thinking scores of nursing students not satisfied with nursing dropped greatly in the senior year. These results suggest the importance of targeting the development of curriculum and teaching methods for seniors and students who have a lower level of satisfaction with nursing to increase their critical thinking dispositions.

Concept map analysis in the assessment of speech-language pathology students' learning in a problem-based learning curriculum: a longitudinal study

The aim of this study was to track students' critical thinking performance longitudinally through concept map analysis in a problem-based learning (PBL) curriculum. Concept map analysis has been employed in the assessment of students' critical thinking in medical education. Little is known concerning concept mapping (CM) in speech-language pathology (SLP) education. In this quantitative study, students in a 4-year SLP education program (N = 38) were followed until the completion of a fully-integrated PBL curriculum from Years 1 to 3. Students' concept maps were analyzed using a tool developed for this study, the Concept Map Assessment Profile (CMAP). There was an increase in concept map scores across the 3 years at the beginning of the academic year. The CM performance over the 3 years predicted 21.0% to 33.6% of variance in three measures of learning outcomes. The CMAP is a reliable measure, with strong inter-rater and intra-rater reliability (r = 0.85 and r = 0.96, respectively). In addition to its use as an assessment tool, the CMAP might be used to facilitate students' learning as feedback concerning strengths and weaknesses in the development of critical thinking can be provided.

Effective in-service training design and delivery: evidence from an integrative literature review

BACKGROUND

In-service training represents a significant financial investment for supporting continued competence of the health care workforce. An integrative review of the education and training literature was conducted to identify effective training approaches for health worker continuing professional education (CPE) and what evidence exists of outcomes derived from CPE.

METHODS

A literature review was conducted from multiple databases including PubMed, the Cochrane Library and Cumulative Index to Nursing and Allied Health Literature (CINAHL) between May and June 2011. The initial review of titles and abstracts produced 244 results. Articles selected for analysis after two quality reviews consisted of systematic reviews, randomized controlled trials (RCTs) and programme evaluations published in peer-reviewed journals from 2000 to 2011 in the English language. The articles analysed included 37 systematic reviews and 32 RCTs. The research questions focused on the evidence supporting educational techniques, frequency, setting and media used to deliver instruction for continuing health professional education.

RESULTS

The evidence suggests the use of multiple techniques that allow for interaction and enable learners to process and apply information. Case-based learning, clinical simulations, practice and feedback are identified as effective educational techniques. Didactic techniques that involve passive instruction, such as reading or lecture, have been found to have little or no impact on learning outcomes. Repetitive interventions, rather than single interventions, were shown to be superior for learning outcomes. Settings similar to the workplace improved skill acquisition and performance. Computer-based learning can be equally or more effective than live instruction and more cost efficient if effective techniques are used. Effective techniques can lead to improvements in knowledge and skill outcomes and clinical practice behaviours, but there is less evidence directly linking CPE to improved clinical outcomes. Very limited quality data are available from low- to middle-income countries.

CONCLUSIONS

Educational techniques are critical to learning outcomes. Targeted, repetitive interventions can result in better learning outcomes. Setting should be selected to support relevant and realistic practice and increase efficiency. Media should be selected based on the potential to support effective educational techniques and efficiency of instruction. CPE can lead to improved learning outcomes if effective techniques are used. Limited data indicate that there may also be an effect on improving clinical practice behaviours. The research agenda calls for well-constructed evaluations of culturally appropriate combinations of technique, setting, frequency and media, developed for and tested among all levels of health workers in low- and middle-income countries.

The longitudinal effect of concept map teaching on critical thinking of nursing students

Concept map is a useful cognitive tool for enhancing a student's critical thinking by encouraging students to process information deeply for understanding. However, there is limited understanding of longitudinal effects of concept map teaching on students' critical thinking. The purpose of the study was to investigate the growth and the other factors influencing the development of critical thinking in response to concept map as an interventional strategy for nursing students in a two-year registered nurse baccalaureate program. The study was a quasi-experimental and longitudinal follow-up design. A convenience sample was drawn from a university in central Taiwan. Data were collected at different time points at the beginning of each semester using structured questionnaires including Critical Thinking Scale and Approaches to Learning and Studying. The intervention of concept map teaching was given at the second semester in the Medical-Surgical Nursing course. The results of the findings revealed student started with a mean critical thinking score of 41.32 and decreased at a rate of 0.42 over time, although not significant. After controlling for individual characteristics, the final model revealed that the experimental group gained a higher critical thinking score across time than the control group. The best predictive variables of initial status in critical thinking were without clinical experience and a higher pre-test score. The growth in critical thinking was predicted best by a lower pre-test score, and lower scores on surface approach and organized study. Our study suggested that concept map is a useful teaching strategy to enhance student critical thinking.

Post-basic nursing students’ reflections on their experiences of dialogic mediation

This article presents post-basic nursing students’ reflections on the way they experienced the pedagogy of dialogic mediation. The study addressed current debates about appropriate teaching methodologies for students in such a degree course and the role of the nurse educator in this regard. The authors used a qualitative research approach and posed the following research question: What are students’ reflections of their experiences of dialogic mediation and the influence of this on their ideas of teaching and learning? The study involved a cohort of students (n = 248) who were enrolled in a semester-long course in a post-basic nursing degree at a South African university. They were asked to respond to three open-ended questions regarding their experiences of a course that required engagement with a new teaching and learning strategy which expected active involvement. Data were collected from students’ written reflections and were analysed by searching for recurring themes and patterns. The findings revealed that students experienced extreme levels of frustration at the beginning of the course as their existing ideas about teaching and learning were challenged. They also found the new teaching techniques associated with this pedagogy to be demanding. However, once they understood the underlying principles and ideas, they began to understand the implications for their own learning and teaching practices.Hierdie artikel handel oor nabasiese-verpleegstudente se nadenke oor die wyse waarop hulle die pedagogie van dialogiese bemiddeling ervaar het. Hierdie studie het aandag gegee aan huidige debatte oor geskikte onderrigmetodologieë vir studente in so ‘n graadkursus en die rol van die verpleegkundige-opvoeder in hierdie opset. Die outeurs het ’n kwalitatiewe navorsingsbenadering gebruik en het die volgende navorsingsvraag gestel: Wat is studente se nadenke oor hul ervarings van dialogiese bemiddeling en die invloed daarvan op hul idees van onderrig en leer? Die studie het ’n spesiefike kohort studente (n = 248) wat ingeskryf is by ’n semesterkursus in ’n nabasiese verpleeggraadprogram aan ’n Suid-Afrikaanse universiteit ingesluit. Hulle is gevra om op drie oop vrae te reageer oor hul ervarings van ’n kursus wat betrokkenheid by ’n nuwe onderrig- en leerstrategie vereis en waar aktiewe deelname verwag word. Data is uit studente se skriftelike nadenke ingesamel en is ontleed deur vir herhalende temas en patrone te soek. Die bevindings het getoon dat studente uiterste vlakke van frustrasie aan die begin van die kursus ervaar het, aangesien hul bestaande onderrig en leer uitgedaag is. Hulle het ook die nuwe onderrigtegniek wat met hierdie pedagogie gepaardgaan veeleisend gevind. Nadat hulle egter die onderliggende beginsels en idees verstaan het, het hulle begin om die implikasies van hul eie leer- en onderrigpraktyke te verstaan.

Concept mapping in a critical care orientation program: a pilot study to develop critical thinking and decision-making skills in novice nurses

BACKGROUND

Newly graduated registered nurses who were hired into a critical care intensive care unit showed a lack of critical thinking skills to inform their clinical decision-making abilities.

METHODS

This study evaluated the effectiveness of concept mapping as a teaching tool to improve critical thinking and clinical decision-making skills in novice nurses. A self-evaluation tool was administered before and after the learning intervention.

RESULTS

The 25-item tool measured five key indicators of the development of critical thinking skills: problem recognition, clinical decision-making, prioritization, clinical implementation, and reflection. Statistically significant improvements were seen in 10 items encompassing all five indicators.

CONCLUSION

Concept maps are an effective tool for educators to use in assisting novice nurses to develop their critical thinking and clinical decision-making skills.