The influence of concept mapping on critical thinking in baccalaureate nursing students

The effect of concept mapping in nursing education on critical thinking motivation: A path analysis

BACKGROUND

The integration of concept mapping into nursing education represents a pivotal strategy aimed at enhancing critical thinking skills, which is a necessity in navigating the complexities of healthcare. This educational tool's role in stimulating students' analytical abilities and motivation towards critical thinking has become increasingly relevant in preparing nursing professionals for the dynamic challenges of their field.

OBJECTIVES

The aim of this study is to examine how the implementation of concept mapping affects critical thinking motivation among nursing students, investigate the relationship between them, and support its use as an innovative educational strategy in the field of nursing.

DESIGN

This study was conducted using a descriptive and exploratory design.

METHODS

This research was carried out between May and June 2023, involving 435 nursing students. For data collection within an online classroom framework, the study applied a trio of tools: the Student Descriptive Information Form, the Scale for the Effectiveness of Concept Maps in Nursing Education, and the Critical Thinking Motivation Scale. The analysis of the compiled data was undertaken utilizing SPSS version 25.0 and JAMOVI software, with statistical significance set at a p-value of <0.05.

RESULTS

Engagement in social/scientific activities, library usage, and book reading habits were positively correlated with higher scores on both the Critical Thinking Motivation Scale and the Scale for the Effectiveness of Concept Maps in Nursing Education. Notably, concept mapping significantly enhanced critical thinking motivation among the participating students, as evidenced by the path analysis (β = 0.758, R = 0.563, p < 0.001).

CONCLUSION

The findings underscore the significant role of concept mapping in elevating critical thinking motivation among nursing students, suggesting its strategic inclusion in nursing curricula to meet the evolving demands of healthcare education in the twenty-first century.

Investigating the fundamental levels of a signature pedagogy in nursing education: A scoping review

BACKGROUND

A signature pedagogy is a unique approach that provides a blueprint for curricular decision-making, as it reflects how we teach (surface structures), why we teach (deep structures), and what we believe are vital concepts or values all learners should embody (implicit structures).

OBJECTIVE

To investigate what is known from the existing literature about a signature pedagogy to support undergraduate nursing education.

DESIGN

This scoping review adopted Arksey and O'Malley's framework to guide the analysis of data. Two electronic databases were used to explore studies on educational strategies, content, and values published in Arabic, English, Filipino, French, Portuguese, and Spanish between 1972 and 2022.

RESULTS

A total of 258 articles were included in this review. The analysis revealed that the majority of articles were at the surface (n = 189), followed by the deep (n = 123), with the least number examining the implicit level (n = 90) associated with signature pedagogy levels. Results reflect a limited focus on implicit level; the core concepts and values that all learners should understand and grasp for their future practice to construct their professional identity and engage in healthcare transformation.

CONCLUSIONS

The findings from this scoping review, should not be an isolated movement within nursing education. The first step is to engage in discourse amongst all stakeholders, educational and healthcare nurse leaders, regarding the state of the profession. As a profession we need to understand what is the preferred future of nursing and what are the necessary educational processes to ensure the profession is actualizing their mandate. A call to action to develop a unique signature pedagogy should provide synergy between education and practice to enhance learner's competencies as a future professional.

Concept map-based learning in an oral radiographic interpretation course: Dental students' perceptions of its role as a learning tool

OBJECTIVES

Concept mapping is used to promote critical thinking and meaningful learning in health professions education. This study aimed to evaluate dental undergraduates' perceptions of concept mapping as a learning tool for oral radiographic interpretation competency.

METHODS

A total of 39 third-year undergraduates at a dental college participated in the oral radiological interpretation session. The students received 1 hour of instruction before creating their concept map (CM). Participants were provided an assignment of four relevant clinical cases to draw an individualised CM. The students' draft and final CM were submitted. The instructor evaluated the CMs to identify whether students could analyse, connect and organise the information in a meaningful way. Among them, 37 completed the questionnaire about their experiences and responses to concept mapping.

RESULTS

Students perceived concept mapping positively. The instructor's feedback helped them recognise their misconceptions and fostered greater motivation to learn. Students attempted to integrate basic biomedical knowledge and clinical features through cross-linking. However, they also expressed negative attitudes toward concept mapping regarding time consumption and heavy burden.

CONCLUSIONS

Concept mapping motivated students' directed learning and gave them the opportunity to recognise their misconceptions. This study suggests the potential use of CMs as an adjunctive learning strategy in the oral radiographic interpretation class.

A Blueprint for Becoming a Successful Clinical Nursing Professor, Promoting Health and Wellness in the Clinical Environment to Produce Emerging Nurse Leaders

Clinical professors are a particularly important determinant of student success in becoming a proficient nurse. The clinical professor is responsible for helping students apply didactic knowledge to clinical skills. This article discusses strategies clinical professors can use to maximize undergraduate nursing students' skills and competencies and to raise awareness of healthy behaviors affecting patient care. Applying effective and fun strategies can help students decrease anxiety, apply critical thinking, develop autonomy, and learn time management. These applied strategies help students develop delegation skills required to be professional, competent nurses, while promoting health and well-being.

A BEME realist synthesis review of the effectiveness of teaching strategies used in the clinical setting on the development of clinical skills among health professionals: BEME Guide No. 61

Background: Literature describing the effectiveness of teaching strategies in the clinical setting is limited. This realist synthesis review focuses on understanding the effectiveness of teaching strategies used in the clinical setting.Methods: We searched ten databases for English language publications between 1 January 1970 and 31 May 2017 reporting effective teaching strategies, used in a clinical setting, of non-procedural skills. After screening, we used consensus to determine inclusion and employed a standardised instrument to capture study populations, methodology, and outcomes. We summarised what strategies worked, for whom, and in what settings.Results: The initial search netted 53,642 references after de-duplication; 2037 were retained after title and abstract review. Full text review was done on 82 references, with ultimate inclusion of 25 publications. Three specific teaching strategies demonstrated impact on educational outcomes: the One Minute Preceptor (OMP), SNAPPS, and concept mapping. Most of the literature involves physician trainees in an ambulatory environment. All three have been shown to improve skills in the domains of medical knowledge and clinical reasoning.Discussion/conclusions: Apart from the OMP, SNAPPS, and concept mapping, which target the formation of clinical knowledge and reasoning skills, the literature establishing effective teaching strategies in the clinical setting is sparse.

Using Interactive Nutrition Modules to Increase Critical Thinking Skills in College Courses

OBJECTIVE

To understand how the addition of an evidence-based framework to an online nutrition module influences college students' critical thinking decision making (CT-DM).

DESIGN

Students were individually randomized into an intervention group or a control group. The nutrition modules focused on 2 topics related to different types of eating behavior. Students completed a CT-DM activity to generate a score.

PARTICIPANTS

College students, between 18 and 24 years old, recruited from introductory nutrition and agriculture science courses at 2 universities.

INTERVENTION

Intervention and control received 2 nutrition modules. The intervention added a CT-DM framework that framed the topic as a problem, incorporated activities, and provided scaffolding.

MAIN OUTCOME MEASURES

CT-DM was scored using a validated rubric to assess the use of critical thinking skills when making a food-related decision. Green eating and critical thinking disposition were measured.

ANALYSIS

Hierarchical linear regression and t tests were used to assess outcomes.

RESULTS

A total of 431 students participated (intervention = 203; control = 228). After controlling for university, the intervention group scored significantly higher on CT-DM (18.1 ± 7.6) compared with the control (15.4 ± 8.4); F (3,428) = 14.58, P < .001.

CONCLUSIONS AND IMPLICATIONS

The results show that an evidence-based framework using nutrition topics encourages CT-DM skills. Future higher-education nutrition interventions should use frameworks to enhance student learning.

Critical thinking skills of nursing students: Observations of classroom instructional activities

Aim

Critical thinking (CT) is vital for nursing practice. Nursing schools should provide learning experiences that enable nursing students to acquire CT skills. Yet, these authors are not aware of any study that has directly observed instructional activities related to CT skills acquisition in the classroom environment. The aim of this study was to explore instructional activities in the classroom environment in relation to acquisition of CT skills of students.

Design

Qualitative non-participant observation.

Methods

Using a purposive sampling, 10 classroom teaching sessions were observed and mediating factors of CT skills acquisition of students noted. Data were analysed thematically. Data were collected from October-December 2017.

Results

Three key themes of instructional activities relating to acquisition of CT skills of students emerged, namely educators' behaviour, students' characteristics and university-wide factors/administrative support. Class sizes ranged from 34-162 students with an average of 95.

Reflective and critical thinking in nursing curriculum

Objective:

to evaluate the teaching of transversal competence of the Reflective and Critical Thinking that is fundamental in the decision-making and solution of nursing problems, in degree programs of public and private institutions in the Andean region.

Method:

multi-center, cross-sectional, exploratory-descriptive study, with mixed approach in 5 countries.

Results:

76 nursing programs participated in the study. The Reflective and Critical Thinking was found as a subject, subject content and didactic strategies. Of the 562 subjects reviewed, this type of thinking is found in 46% of the humanities area and 42% in the area of research and professional discipline. It is important to train teachers to achieve coherence between the pedagogical model approach, teaching strategies and evaluations.

Conclusion:

nursing programs in the Andean region contemplate the critical thinking as cognitive and personals skills of communication. They also use real situations analysis, supervised practice, simulation labs and specifically learning based in problems to develop the capacity to solve them, decision-making and develop communication skills, including analysis, synthesis and evaluation.

A critical integrative review of complementary medicine education research: key issues and empirical gaps

Background

Complementary Medicine (CM) continues to thrive across many countries. Closely related to the continuing popularity of CM has been an increased number of enrolments at CM education institutions across the public and private tertiary sectors. Despite the popularity of CM across the globe and growth in CM education/education providers, to date, there has been no critical review of peer-reviewed research examining CM education undertaken. In direct response to this important gap, this paper reports the first critical review of contemporary literature examining CM education research.

Methods

A review was undertaken of research to identify empirical research papers reporting on CM education published between 2005 and 17. The search was conducted in May 2017 and included the search of PubMed and EBSCO (CINAHL, MEDLINE, AMED) for search terms embracing CM and education. Identified studies were evaluated using the STROBE, SRQP and MMAT appraisal tools.

Results

From 9496 identified papers, 18 met the review inclusion criteria (English language, original empirical research data, reporting on the prevalence or nature of the education of CM practitioners), and highlighted four broad issues: CM education provision; the development of educational competencies to develop clinical skills and standards; the application of new educational theory, methods and technology in CM; and future challenges facing CM education. This critical integrative review highlights two key issues of interest and significance for CM educational institutions, CM regulators and researchers, and points to number of significant gaps in this area of research. There is very sporadic coverage of research in CM education. The clear absence of the robust and mature research regarding educational technology and e-learning taking place in medical and or allied health education research is notably absent within CM educational research.

Conclusion

Despite the high levels of CM use in the community, and the thriving nature of CM educational institutions globally, the current evidence evaluating the procedures, effectiveness and outcomes of CM education remains limited on a number of fronts. There is an urgent need to establish a strategic research agenda around this important aspect of health care education with the overarching goal to ensure a well-educated and effective health care workforce.

The impact of combining concept-based learning and concept-mapping pedagogies on nursing students' clinical reasoning abilities

BACKGROUND

Integrating contemporary teaching strategies into the nursing curriculum is an effective approach to enhance undergraduate clinical-judgment and reasoning abilities.

OBJECTIVE

This study aims to document the impact of blending the teaching strategies of concept-based learning and concept-mapping to enhance nursing students' clinical-reasoning abilities.

DESIGN

A quasi experimental design is used to guide data collection from second year students.

SETTING AND PARTICIPANTS

A consecutive sample of all students undertaking adult health nursing courses at a private university in Jordan and meeting the eligibility criteria resulted in (N = 40).

METHOD

Data was collected via a questionnaire and observation to reveal students' independence in both clinical-reasoning and clinical-judgment. General Clinical-Reasoning Behavior Scale, Independence in Clinical-Reasoning and Clinical-Judgment scales were completed by the students at the beginning and end of the courses.

RESULTS

Despite requesting extensive preparation time, concept-based learning and concept-mapping as student-centered approaches enabled the move away from a content laden approach towards constructing criteria against which various patients' encounters were reflected. This study documented enhancement in students' independence in clinical-reasoning and clinical-judgment as they learned to take command of the elements of their clinical-reasoning. Significant improvement in students' general clinical-reasoning behavior was also documented.

CONCLUSION

The data collection tools utilized in this study can be used as clinical teaching aides, hence maximizing the impact of blended teaching strategies by providing the faculty with specific feedback regarding students' clinical reasoning and judgment abilities. Institutionalizing these processes by initiating relevant policies and guidelines is essential to help students take command of their clinical-reasoning, maturity, and responsibility in a practice area that is constantly changing and evolving.

Concept mapping to promote meaningful learning, help relate theory to practice and improve learning self-efficacy in Asian mental health nursing students: A mixed-methods pilot study

OBJECTIVES

Student nurses are provided with a great deal of knowledge within university, but they can find it difficult to relate theory to nursing practice. This study aimed to test the appropriateness and feasibility of assessing Novak's concept mapping as an educational strategy to strengthen the theory-practice link, encourage meaningful learning and enhance learning self-efficacy in nursing students.

DESIGN

This pilot study utilised a mixed-methods quasi-experimental design.

SETTING

The study was conducted in a University school of Nursing in Hong Kong.

PARTICIPANTS

A total of 40 third-year pre-registration Asian mental health nursing students completed the study; 12 in the concept mapping (CM) group and 28 in the usual teaching methods (UTM) group.

METHODS

The impact of concept mapping was evaluated thorough analysis of quantitative changes in students' learning self-efficacy, analysis of the structure and contents of the concept maps (CM group), a quantitative measure of students' opinions about their reflective learning activities and content analysis of qualitative data from reflective written accounts (CM group).

RESULTS

There were no significant differences in self-reported learning self-efficacy between the two groups (p=0.38). The concept mapping helped students identify their current level of understanding, but the increased awareness may cause an initial drop in learning self-efficacy. The results highlight that most CM students were able to demonstrate meaningful learning and perceived that concept mapping was a useful reflective learning strategy to help them to link theory and practice.

CONCLUSIONS

The results provide preliminary evidence that the concept mapping approach can be useful to help mental health nursing students visualise their learning progress and encourage the integration of theoretical knowledge with clinical knowledge. Combining concept mapping data with quantitative measures and qualitative reflective journal data appears to be a useful way of assessing and understanding the effectiveness of concept mapping. Future studies should utilise a larger sample size and consider using the approach as a targeted intervention immediately before and during clinical learning placements.

The trilayer approach of teaching physiology, pathophysiology, and pharmacology concepts in a first-year pharmacy course: the TLAT model

This paper describes the development, implementation, and students' perceptions of a new trilayer approach of teaching (TLAT). The TLAT model involved blending lecture, in-class group activities, and out-of-class assignments on selected content areas and was implemented initially in a first-year integrated pharmacy course. Course contents were either delivered by traditional lectures or by the TLAT. A survey instrument was distributed by SurveyMonkey to determine students' perceptions of the TLAT model. Descriptive statistics were used for data analysis. Students' performance in a total of 225 examination and quiz questions was analyzed to evaluate whether the TLAT model improved students' learning. Students' (n = 98) performance scores for TLAT-based and lecture-based questions were 83.3 ± 10.2 and 79.5 ± 14.0, respectively (P < 0.05). Ninety-three percent of students believed that in-class group activities enhanced conceptual understanding of course materials, helped them take responsibility of their own learning, and enhanced their overall learning experiences. More than 80% of respondents felt that solving cases and developing concept maps helped them sharpen creative and critical thinking skills. In addition, 90% of the respondents indicated that the homework throughout the semester helped them stay up to date and focused with the progress of the course. The use of the TLAT model led to an improvement in student learning of complex concepts. Moreover, the results suggest that this model improves students' self-reliance and attitudes toward learning. Our findings should serve as an impetus for inclusion of diverse active learning strategies in pharmacy education.

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.

A meta-analysis of the effects of non-traditional teaching methods on the critical thinking abilities of nursing students

BACKGROUND

Scientific framework is important in designing curricula and evaluating students in the field of education and clinical practice. The purpose of this study was to examine the effectiveness of non-traditional educational methods on critical thinking skills.

METHODS

A systematic review approach was applied. Studies published in peer-reviewed journals from January 2001 to December 2014 were searched using electronic databases and major education journals. A meta-analysis was performed using Review Manager 5.2. Reviewing the included studies, the California Critical Thinking Dispositions Inventory (CCTDI) and California Critical Thinking Skills Test (CCTST) were used to assess the effectiveness of critical thinking in the meta-analysis.

RESULTS

The eight CCTDI datasets showed that non- traditional teaching methods (i.e., no lectures) were more effective compared to control groups (standardized mean difference [SMD]: 0.42, 95 % confidence interval [CI]: 0.26-0.57, p < .00001). And six CCTST datasets showed the teaching and learning methods in these studies were also had significantly more effects when compared to the control groups (SMD: 0.29, 95 % CI: 0.10-0.48, p = 0.003).

CONCLUSIONS

This research showed that new teaching and learning methods designed to improve critical thinking were generally effective at enhancing critical thinking dispositions.

Aplicação do mapa conceitual: resultados com diferentes métodos de ensino-aprendizagem

Objetivo: analizar el resultado de una intervención de enseñanza aliada a un método tradicional para el desarrollo del concepto de complicaciones de la herida quirúrgica postoperatoria para uso en el pregrado en enfermería. Método: estudio de análisis cualitativocasi-experimental, aplicado por medio de una intervención de enseñanza en los estudiantes de enfermería de pregrado. La recolección de datos se dio en dos etapas, y los estudiantes fueron divididos al azar en los subgrupos I y II. Para facilitar la recopilación de datos, los estudiantes desarrollaron mapas conceptuales con la ayuda de las herramientas de software Cmap Tools®. Los datos fueron analizados mediante la técnica de análisis de contenido, identificando 12 categorías. Resultados: el subgrupo II mostró resultados positivos en relación con el subgrupo I, ya que la asociación de los dos métodos de enseñanza que utilizan la técnica de MC podría promover la capacidad de articular los conceptos desarrollados con conocimientos previos. Conclusión: se encontró que la asociación de la intervención docente con base teórica en la Teoría del Aprendizaje Significativo, más el método tradicional y el uso de la técnica de MC estimulan un buen desempeño de los estudiantes en el proceso de enseñanza-aprendizaje.

Critical Thinking and the Use of Nontraditional Instructional Methodologies

BACKGROUND

The purpose of this study was to examine the relationship between critical thinking and the use of concept mapping (CM) and problem-based learning (PBL) during care plan development.

METHOD

A quasi-experimental study with a pretest-posttest design was conducted using a convenience sample (n = 49) of first-semester undergraduate baccalaureate nursing students. Critical thinking was measured using the Holistic Critical Thinking Scoring Rubric. Data analysis consisted of a repeated measures analysis of variance with post hoc mean comparison tests using the Bonferroni method.

RESULTS

Findings indicated that mean critical thinking at phase 4 (CM and PBL) was significantly higher, compared with phase 1 (baseline), phase 2 (PBL), and phase 3 (CM [p < 0.001]).

CONCLUSION

The results support the utilization of nontraditional instructional (CM and PBL) methodologies in undergraduate nursing curricula.

Efficacy of teaching methods used to develop critical thinking in nursing and midwifery undergraduate students: A systematic review of the literature

BACKGROUND

The value and importance of incorporating strategies that promote critical thinking in nursing and midwifery undergraduate programmes are well documented. However, relatively little is known about the effectiveness of teaching strategies in promoting CT. Evaluating effectiveness is important to promote 'best practise' in teaching.

OBJECTIVE

To evaluate the efficacy of teaching methods used to develop critical thinking skills in nursing and midwifery undergraduate students.

DATA SOURCES

The following six databases; CINAHL, Ovid Medline, ERIC, Informit, PsycINFO and Scopus were searched and resulted in the retrieval of 1315 papers.

REVIEW METHODS

After screening for inclusion, each paper was evaluated using the Critical Appraisal Skills Programme tool. Twenty-eight studies met the inclusion criteria and quality appraisal.

RESULTS

Twelve different teaching interventions were tested in 8 countries. Results varied, with little consistency across studies using the same type of intervention or outcome tool. Sixteen tools were used to measure the efficacy of teaching in developing critical thinking. Seventeen studies identified a significant increase in critical thinking, while nine studies found no increases, and two found unexplained decreases in CT when using a similar educational intervention.

CONCLUSIONS

Whilst this review aimed to identify effective teaching strategies that promote and develop critical thinking, flaws in methodology and outcome measures contributed to inconsistent findings. The continued use of generalised CT tools is unlikely to help identify appropriate teaching methods that will improve CT abilities of midwifery and nursing students and prepare them for practise. The review was limited to empirical studies published in English that used measures of critical thinking with midwifery and nursing students. Discipline specific strategies and tools that measure students' abilities to apply CT in practise are needed.

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.

Impact of a concept map teaching approach on nursing students' critical thinking skills

Nurses confront complex problems and decisions that require critical thinking in order to identify patient needs and implement best practices. An active strategy for teaching students the skills to think critically is the concept map. This study explores the development of critical thinking among nursing students in a required pathophysiology and pharmacology course during the first year of a Bachelor of Science in Nursing in response to concept mapping as an interventional strategy, using the Health Education Systems, Incorporated critical thinking test. A two-group experimental study with a pretest and posttest design was used. Participants were randomly divided into a control group (n = 42) taught by traditional didactic lecturing alone, and an intervention group (n = 41), taught by traditional didactic lecturing with concept mapping. Students in the concept mapping group performed much better on the Health Education Systems, Incorporated than students in the control group. It is recommended that deans, program directors, and nursing faculties evaluate their curricula to integrate concept map teaching strategies in courses in order to develop critical thinking abilities in their students.

Effect of training problem-solving skill on decision-making and critical thinking of personnel at medical emergencies

Background:

The aim of this study was to determine the effect of problem-solving training on decision-making skill and critical thinking in emergency medical personnel.

Materials and Methods:

This study is an experimental study that performed in 95 emergency medical personnel in two groups of control (48) and experimental (47). Then, a short problem-solving course based on 8 sessions of 2 h during the term, was performed for the experimental group. Of data gathering was used demographic and researcher made decision-making and California critical thinking skills questionnaires. Data were analyzed using SPSS software.

Results:

The finding revealed that decision-making and critical thinking score in emergency medical personnel are low and problem-solving course, positively affected the personnel’ decision-making skill and critical thinking after the educational program (P < 0.05).

Conclusions:

Therefore, this kind of education on problem-solving in various emergency medicine domains such as education, research, and management, is recommended.

Making large class basic histology lectures more interactive: The use of draw-along mapping techniques and associated educational activities

At Stellenbosch University, South Africa, basic histology is taught to a combination class of almost 400 first-year medical, physiotherapy, and dietetic students. Many students often find the amount of work in basic histology lectures overwhelming and consequently loose interest. The aim was to determine if a draw-along mapping activity would focus students during large class lectures. After each lecture on three basic histology tissues, a guided draw-along mapping session covering the work from the lecture was introduced in the form of a click-advance PowerPoint presentation which was used to demonstrate the unfolding of an "ideal" map. The lecturer simultaneously drew a similar map using an overhead projector allowing the students to draw their own maps on blank sheets of paper along with the lecturer. Students remained attentive during the activity and many participated in answering informal questions posed by the lecturer as the map-making session progressed. After the last session, students completed an anonymous, voluntary questionnaire (response rate of 78%). The majority of students found the draw-along maps useful (94%) and believed that its use should be continued in the future (93%). A significant increase (P < 0.001) was found in the test results of student cohorts who were given the current intervention compared to cohorts from previous years who were given mind maps as handouts only or had no intervention. The use of the draw-along mapping sessions were successful in focusing students during large class lectures while also providing them with a useful tool for their studies.

Collaborative Concept Mapping and Critical Thinking in Fourth-Year Medical Students

OBJECTIVE

To test the hypothesis that small group concept mapping of 4 core neonatal topics as part of a fourth-year allopathic medical student elective would improve critical thinking (CT) as measured by the California Critical Thinking Skills Test (CCTST). To describe any correlations between scores on the CCTST and the step 1 and step 2 Clinical Knowledge parts of the United States Medical Licensing Exam.

METHODS

Twenty-seven students participated in this pilot study during a 1-month elective. A pretest CCTST, California Critical Thinking Disposition Inventory (CCTDI), and multiple choice knowledge test (MCKT) were completed immediately before the elective began. Four weekly group sessions were held with assigned reading on each of the 4 neonatal topics. Concept mapping was performed in small groups of 4 to 6 students with a group concept map collected at the end of the exercise. A posttest CCTST and MCKT was completed after the 4 group sessions.

RESULTS

Pre-CCTST overall score was 83.9 ± 6, and post-CCTST overall score was 85.6 ± 6.9 (P = .57). Pearson correlation of USMLE step 1 and pre-CCTST showed r(25) = .276, P = .164. Pearson correlation of USMLE step 2 CK and pre-CCTST revealed r(25) = .214, P = .482. The precourse MCKT average was 35%, and the postcourse average 50% (P ≤ .001).

CONCLUSIONS

A recent meta-analysis confirms this is the first report of a comparison between the increasingly common CCTST and the USMLE. We confirmed that concept mapping is a valid mechanism to teach content knowledge. Although the difference in the CCTST scores was not significant, this study could serve as an important start toward development of a curriculum devoted to teaching content and improving CT. The small number of students may have prevented us from defining a significant impact.

Evaluation of tools used to measure critical thinking development in nursing and midwifery undergraduate students: a systematic review

BACKGROUND

Well developed critical thinking skills are essential for nursing and midwifery practices. The development of students' higher-order cognitive abilities, such as critical thinking, is also well recognised in nursing and midwifery education. Measurement of critical thinking development is important to demonstrate change over time and effectiveness of teaching strategies.

OBJECTIVE

To evaluate tools designed to measure critical thinking in nursing and midwifery undergraduate students.

DATA SOURCES

The following six databases were searched and resulted in the retrieval of 1191 papers: CINAHL, Ovid Medline, ERIC, Informit, PsycINFO and Scopus.

REVIEW METHODS

After screening for inclusion, each paper was evaluated using the Critical Appraisal Skills Programme Tool. Thirty-four studies met the inclusion criteria and quality appraisal. Sixteen different tools that measure critical thinking were reviewed for reliability and validity and extent to which the domains of critical thinking were evident.

RESULTS

Sixty percent of studies utilised one of four standardised commercially available measures of critical thinking. Reliability and validity were not consistently reported and there was a variation in reliability across studies that used the same measure. Of the remaining studies using different tools, there was also limited reporting of reliability making it difficult to assess internal consistency and potential applicability of measures across settings.

CONCLUSIONS

Discipline specific instruments to measure critical thinking in nursing and midwifery are required, specifically tools that measure the application of critical thinking to practise. Given that critical thinking development occurs over an extended period, measurement needs to be repeated and multiple methods of measurement used over time.

The influence of critical thinking skills on performance and progression in a pre-registration nursing program

BACKGROUND

The importance of developing critical thinking skills in preregistration nursing students is recognized worldwide. Yet, there has been limited exploration of how students' critical thinking skill scores on entry to pre-registration nursing education influence their academic and clinical performance and progression.

AIM

The aim of this study was to: i) describe entry and exit critical thinking scores of nursing students enrolled in a three year bachelor of nursing program in Australia in comparison to norm scores; ii) explore entry critical thinking scores in relation to demographic characteristics, students' performance and progression.

METHOD

This longitudinal correlational study used the Health Sciences Reasoning Test (HSRT) to measure critical thinking skills in a sample (n=134) of students, at entry and exit (three years later). A one sample t-test was used to determine if differences existed between matched student critical thinking scores between entry and exit points. Academic performance, clinical performance and progression data were collected and correlations with entry critical thinking scores were examined.

RESULTS

There was a significant relationship between critical thinking scores, academic performance and students' risk of failing, especially in the first semester of study. Critical thinking scores were predictive of program completion within three years. The increase in critical thinking scores from entry to exit was significant for the 28 students measured. In comparison to norm scores, entry level critical thinking scores were significantly lower, but exit scores were comparable. Critical thinking scores had no significant relationship to clinical performance.

CONCLUSION

Entry critical thinking scores significantly correlate to academic performance and predict students risk of course failure and ability to complete a nursing degree in three years. Students' critical thinking scores are an important determinant of their success and as such can inform curriculum development and selection strategies.

The teaching-learning approach and critical thinking development: a qualitative exploration of Taiwanese nursing students

Health care professionals are challenged by the complexities of the health care environment. This study uses a qualitative approach to explore how teaching strategy affects the development of critical thinking (CT) among Taiwanese baccalaureate-level nursing students. Data collected from 109 students' reflection reports were analyzed using content analysis. Three categories generated by the analysis were the teaching-learning strategy, enhancing CT, and transiting into a different learning style. The teaching-learning strategy consisted of concept mapping, question and answer, and real-life case studies. CT was enhanced alternately by self-directed learning, the realization of the gap between known and unknown, and connecting the gap between theoretical nursing knowledge and clinical practice. The study results emphasize participants' perceptions of becoming a critical thinker, turning into an active learner, and eventually achieving self-confidence. These learning effects invest the wisdom of teaching-learning with a far-reaching significance.

Promoting English oral communication and higher-order thinking in Taiwanese ESL students through the use of knowledge visualization techniques

The study examined whether the students using concept mapping in a Freshman English course would improve English oral communication proficiency, higher-order thinking, and perception of abilities. A quasi-experimental design, lasting for 12 weeks, was administered to an experimental group (21 students) and a control group (20 students). The experimental group had significantly better performance on all measures. Concept mapping was effective in improving college students' English oral communication, higher-order thinking, and perception of abilities development.

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.

Critical thinking skills of undergraduate nursing students: description and demographic predictors

AIM

This study investigated the critical thinking skills among undergraduate nursing students in Australia to obtain a profile and determine demographic predictors of critical thinking.

BACKGROUND

There is universal agreement that being a critical thinker is an outcome requirement for many accreditation and registering nursing bodies. Most studies provide descriptive statistical information about critical thinking skills while some have studied the changes in critical thinking after an intervention. Limited research about factors that predict critical thinking skills is available.

METHODS

A cross-sectional descriptive study was conducted using convenience sampling. Two hundred and sixty-nine students were recruited across three years of an undergraduate programme in 2009. Most students' age ranged from under 20 to 34 years (58%), 87% were female, 91% were Australian and 23% of first and second year students had nursing associated experience external to the university. Data about critical thinking skills were collected via the Health Science Reasoning Test (HSRT). Linear regression analysis investigated the predictors of nursing students' critical thinking skills.

RESULTS

The students in third year had a profile of critical thinking skills comparable with HSRT norms. Year of study predicted higher critical thinking scores for all domains (p<0.001) except the subscale, analysis. Nationality predicted higher scores for total CT skill scores (p<0.001) and subscales, inductive (p=0.001) and deductive reasoning (p=0.001). Nursing associated experience predicted higher scores for the subscale, analysis (p<0.001). Age and gender were not predictive. However, these demographic predictors only accounted for a small variance obtained for the domains of CT skills.

CONCLUSION

An understanding of factors that predict nursing students' CT skills is required. Despite this study finding a number of significant predictors of nursing students' CT skills, there are others yet to be understood. Future research is recommended exploring explicit CT instructional approaches and nursing students' CT skills.

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.

Mapping as a learning strategy in health professions education: a critical analysis

CONTEXT

Mapping is a means of representing knowledge in a visual network and is becoming more commonly used as a learning strategy in medical education. The assumption driving the development and use of concept mapping is that it supports and furthers meaningful learning.

OBJECTIVES

The goal of this paper was to examine the effectiveness of concept mapping as a learning strategy in health professions education.

METHODS

The authors conducted a critical analysis of recent literature on the use of concept mapping as a learning strategy in the area of health professions education.

RESULTS

Among the 65 studies identified, 63% were classified as empirical work, the majority (76%) of which used pre-experimental designs. Only 24% of empirical studies assessed the impact of mapping on meaningful learning. Results of the analysis do not support the hypothesis that mapping per se furthers and supports meaningful learning, memorisation or factual recall. When documented improvements in learning were found, they often occurred when mapping was used in concert with other strategies, such as collaborative learning or instructor modelling, scaffolding and feedback.

CONCLUSIONS

Current empirical research on mapping as a learning strategy presents methodological shortcomings that limit its internal and external validity. The results of our analysis indicate that mapping strategies that make use of feedback and scaffolding have beneficial effects on learning. Accordingly, we see a need to expand the process of reflection on the characteristics of representational guidance as it is provided by mapping techniques and tools based on field of knowledge, instructional objectives, and the characteristics of learners in health professions education.

Concept mapping. Does it improve critical thinking ability in practical nursing students?

Critical thinking is an essential skill taught at all levels of nursing education. This article reports on a study designed to determine if concept mapping is superior to traditional care planning as a teaching method for practical nursing students. Specifically, the study evaluated the effects of concept mapping as a teaching methodology on the development of critical thinking skills. A control group consisting of students taught through the traditional methodology was compared to two groups of students taught with concept mapping. Data were collected using the National League for Nursing Critical Thinking in Clinical Nursing Practice/PN Examination. Results indicated that students who were taught the nursing process using the traditional care planning method scored statistically significantly better on the examination than students taught with the concept mapping method.

Concept mapping: a distinctive educational approach to foster critical thinking

Advanced practice nurses must be able to link interventions to address pathophysiological processes with underlying alterations in normal physiological function to promote safe, effective patient care. Development of creative methods to assist students to make their own connections among healthcare concepts is imperative to create a positive learning environment. The authors discuss the use of concept mapping in conjunction with case-study clinical rounds to maximize critical thinking and greater learning retention among advanced practice nurses in a graduate physiology/pathophysiology course.

Effects of concept map teaching on students' critical thinking and approach to learning and studying

The purpose of this study was to explore the effects of concept mapping in developing critical thinking ability and approach to learning and studying. A quasi-experimental study design with a purposive sample was drawn from a group of nursing students enrolled in a medical-surgical nursing course in central Taiwan. Students in the experimental group were taught to use concept mapping in their learning. Students in the control group were taught by means of traditional lectures. After the intervention, the experimental group had better overall critical thinking scores than did the control group, although the difference was not statistically significant. After controlling for the effects of age and the pretest score on critical thinking using analysis of covariance, the experimental group had significantly higher adjusted mean scores on inference and overall critical thinking compared with the control group. Concept mapping is an effective tool for improving students' ability to think critically.

Education strategies to foster health professional students' clinical reasoning skills

Clinical reasoning is an important skill for health professionals that should be developed to achieve high levels of expertise. Several education strategies have been suggested for implementation by health professional educators to foster their students' clinical reasoning skills. The strategies have included the following: problem-based learning, the integrative curriculum, reflection, and concept mapping. This review assesses which is the most effective education strategy for developing the clinical reasoning skills of health professional students. Four publications, from a total of 692 identified records, were included. Overall, this review was not able to make a final conclusion to answer the question. Therefore, there is a need to conduct more studies with larger samples and to undertake research that evaluates the following aspects: more alternate education interventions, variations in the delivery of education interventions, and the cost-effectiveness of implementing education strategies.

Critical thinking competence and disposition of clinical nurses in a medical center

BACKGROUND

Critical thinking is essential in nursing practice. Promoting critical thinking competence in clinical nurses is an important way to improve problem solving and decision-making competence to further improve the quality of patient care. However, using an adequate tool to test nurses' critical thinking competence and disposition may provide the reference criteria for clinical nurse characterization, training planning, and resource allocation for human resource management.

PURPOSE

The purpose of this study was to measure the critical thinking competence and critical thinking disposition of clinical nurses as well as to explore the related factors of critical thinking competence.

METHODS

Clinical nurses from four different clinical ladders selected from one medical center were stratified randomly. All qualified subjects who submitted valid questionnaires were included in the study. A Taiwan version of the modified Watson-Glaser Critical Thinking Appraisal and Critical Thinking Disposition Inventory was developed to measure the critical thinking competence and critical thinking disposition of clinical nurses. Validity was evaluated using the professional content test (content validity index = .93). Reliability was assessed with a Cronbach's alpha coefficient of .85. Data were analyzed using the SPSS for Windows (Version 12.0; SPSS Inc., Chicago, IL).

RESULTS

Results showed that competence of interpretation was the highest critical thinking competence factor. Inference was the lowest, and reflective thinking as a critical thinking disposition was more positive. In addition, age, years of nursing experience, and experiences in other hospitals significantly influenced critical thinking competence (p < .05). Factors of age, years of experience, and nurses clinical ladder were shown to affect critical thinking disposition scores. Clinical ladder N4 nurses had the highest scores in both competence and disposition. A significant relationship was found between critical thinking competence and disposition scores, with 29.3% of the variance in critical thinking competence potentially explained by total years of nurse hospital experience. Clinical ladder and age were predictive factors for critical thinking disposition. Commonality was 27.9%.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Nursing experience and clinical ladders positively affect critical thinking competence and disposition. Issues of critical thinking competence increasingly need to be measured. Therefore, appropriate tools for nursing professions should be further developed and explored for specific areas of practice.

Concept mapping: a road to critical thinking

Graduate nurses entering the workforce today are, at times, lacking in the area of critical thinking. Giving graduate nurses a concept map would provide a tool to guide their critical thinking until it becomes inherent or second nature. The concept map, a graphic illustration of key points, guides the focus of patient problems using a body system approach. This article details the use of a concept map in the application of knowledge to practice.

Avaliação de mapas conceituais elaborados por estudantes de enfermagem com o apoio de software

Este estudo objetiva avaliar a estratégia de utilização de mapas conceituais elaborados com o software CmapTools®, no curso na modalidade a distância denominado Introdução a Anamnese e ao Exame Físico de Enfermagem. Trata-se de um estudo de caso qualitativo, que contou com a participação de 20 estudantes de graduação em enfermagem. Os dados foram obtidos por meio da avaliação dos 11 mapas conceituais elaborados no curso, da avaliação escrita da atividade realizada e das informações obtidas pela técnica de grupo focal. A partir da análise temática, identificou-se que os estudantes demonstraram apropriação dos principais conceitos necessários na elaboração dos mapas conceituais, devendo ainda aperfeiçoar a expressão de reflexões críticas. Os mesmos avaliaram a atividade como positiva por possibilitar a síntese dos temas em estudo e ter aplicações futuras. Constatou-se a importância de desenvolver, com os estudantes de enfermagem, mapas conceituais com o apoio de software.

The impact of active/cooperative instruction on beginning nursing student learning strategy preference

Rapid changes in the nursing field and high demand for practicing nurses put pressure on nursing faculty to educate increasing numbers of nursing students, often without corresponding increases in resources. Although the use of active and cooperative instruction methods in the classroom has been associated with improved student learning, these practices require increased effort on the part of both faculty and students. In addition, little is known about whether these methods influence student nurses' use of these more elaborative processing strategies in their independent study. The purpose of this quasi-experimental investigation was to identify the impact of incorporating active and cooperative classroom instructional activities on student preference for teaching methods and use of learning strategies in independent study. A convenience sample of beginning baccalaureate nursing students at a large Mid-Atlantic University was randomly assigned by the registrar to two class sections. Students in one section received primarily active/cooperative instruction, while the other received primarily traditional lecture-based instruction. Results indicated that student nurses exposed to active/cooperative instructional methods had an increased preference for these methods after a semester of instruction, while those exposed to traditional instruction had a higher preference for traditional methods. In addition, students participating in active class instruction reported increased preference for more elaborative independent study strategies, although overall preference for both groups indicated a reliance on surface study strategies of memorization and recall. Implications for use of instruction and student testing methodologies are presented.

Concept mapping: a nursing model for care planning

Concept mapping has many applications and has been used as an effective teaching strategy in nursing and other disciplines to evaluate both content knowledge and student thinking patterns. Previous applications related to nursing care planning usually organize client information around a medical diagnosis. The approach described is focused around the reason for nursing care and a holistic nursing view of the client, rather than a disease model. Students use a software program to cluster and sort assessment data to identify client problems and describe relationships between the problems. This results in a nonlinear "picture" of the client that can be used for nursing care planning. The process is dynamic and flexible, prompting students to identify gaps in information, consider salience, and understand the complexity of the particular client situation. It teaches critical thinking skills and nursing theory, develops competence with technology, and fosters effective interchange between faculty and students.