Critical thinking: toward a nursing science perspective

Learning styles and critical thinking relationship in baccalaureate nursing education: a systematic review

BACKGROUND

Critical thinking is a desirable competency for contemporary nurses although there are growing concerns supporting a disturbing paucity in its achievement. Learning styles reflect habitual behaviors which determine distinct preferences within learning situations. Evidence suggests that critical thinking could evolve through learning processes. Variances in critical thinking achievement by nursing students might therefore be influenced by individual learning preferences. The concepts "learning styles" and "critical thinking" have been independently examined in the nursing literature. No reviews were found however exploring their association in nursing education.

OBJECTIVES

To identify the potential relationships between learning styles and critical thinking in baccalaureate nursing students.

DESIGN

Systematic review.

DATA SOURCES

Eleven electronic databases were utilized without geographical and time publishing filters. Hand-searching journals and scanning references from retrieved studies were also performed.

METHODS

Databases were searched for descriptive correlational studies which considered the relationship between learning styles and critical thinking in baccalaureate nursing students. The authors independently progressed three stage screening. Retrieved articles were reviewed at title, abstract and full text levels according to predetermined criteria. All included studies were quality appraised using a rating tool for descriptive studies.

RESULTS

Six studies were finally included. Findings were grouped under four key themes: predominant learning styles, critical thinking scoring, critical thinking evolution across academic progress and learning styles-critical thinking correlations. Learning styles' diversities, weak critical thinking and inconsistent evolution through academic progress were revealed across studies. Critical thinking differed significantly between learning styles.

CONCLUSIONS

Commonly accepted models in nursing education were lacking in both learning styles and critical thinking. Within studies identical learning styles were found to be positively or negatively related to critical thinking. However comparative findings across studies revealed that all learning styles might be positive determinants toward critical thinking evolution, suggesting that there is a relationship between learning styles and critical thinking. Certain links between learning styles and critical thinking were supported in given settings and given nursing student populations. Further field exploration is required.

Curriculum design to promote the critical thinking of accelerated bachelor's degree nursing students

This project describes the curriculum design of an accelerated bachelor's degree nursing program intended to promote the critical thinking of its students. Course objectives and teaching-learning strategies are described. Rogers' unitary view of human beings supports critical thinking as a developing process that should be measured in the context of nursing practice. Pre- and post-program critical thinking test scores indicated significant growth for the 38 graduates in the first 4 consecutive classes tested.

A longitudinal study of baccalaureate nursing students' critical thinking dispositions

A longitudinal descriptive design was used to examine nursing students' dispositions toward critical thinking as they progressed from the Sophomore II to Senior II semester in a baccalaureate nursing program in the midwestern United States. The California Critical Thinking Disposition Inventory (CCTDI) was distributed during week 10 in the Sophomore II, Junior I, Junior II, Senior I, and Senior II semesters. Significantly higher CCTDI scores were achieved in the Junior I and Junior II semesters, but no significant differences were found when comparing the Sophomore II and Senior II semesters. No relationship was found between passing the NCLEX-RN, standardized test scores, and CCTDI scores.

Promoting cognitive and metacognitive reflective reasoning skills in nursing practice: self-regulated learning theory

BACKGROUND

Effective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skills. While a number of strategies have been implemented and tested to promote these skills, educators have not been able consistently to predict their development. Self-regulated learning theory suggests that this development requires concurrent attention to both the cognitive and metacognitive dimensions of reasoning in nursing care contexts.

AIMS

This paper reports on a study to explore the impact of self-regulated learning theory on reflective practice in nursing, and to advance the idea that both cognitive and metacognitive skills support the development of clinical reasoning skills.

METHODS

Integrative review of published literature in social science, educational psychology, nursing education, and professional education using the Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resource Information Center (ERIC), and American Psychological Association (PsychInfo) Databases. The search included all English language articles with the key words clinical reasoning, cognition, critical thinking, metacognition, reflection, reflective practice, self-regulation and thinking.

FINDINGS

Reflective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skill acquisition. This skill acquisition is best accomplished through teaching-learning attention to self-regulation learning theory. A critical analysis of the literature in the areas of critical thinking and reflective practice are described as a background for contemporary work with self-regulated learning theory. It is apparent that single-minded attention to critical thinking, without attention to the influence of metacognition or reflection, is but one perspective on clinical reasoning development. Likewise, single-minded attention to metacognition or reflection, without attention to the influence of critical thinking, is another perspective on clinical reasoning development. While strategies to facilitate critical thinking and reflective practice have been used in isolation from each other, there is evidence to suggest that they are inextricably linked and come together with the use of self-regulated learning prompts.

CONCLUSIONS

Students and practising nurses are able to improve their cognitive and metacognitive skills in clinical contexts by using self-regulated learning strategies. The self-regulated learning model in nursing is offered to support teaching and learning of reflective clinical reasoning in nursing practice contexts.

Critical thinking and clinical decision making in critical care nursing: a pilot study

OBJECTIVE

This pilot study examined the relationship of education level, years of critical care nursing experience, and critical thinking (CT) ability (skills and dispositions) to consistency in clinical decision making among critical care nurses. Consistency was defined as the degree to which intuitive and analytical decision processes resulted in similar selection of interventions in tasks of low and high complexity.

DESIGN

The study was nonexperimental and correlational.

SAMPLE

Critical care nurses (n = 54) from adult critical care units in 3 private teaching hospitals. The majority of nurses held a BSN or MSN and had an average of 9 years of direct clinical experience in the care of the critically ill.

RESULTS

Decision-making consistency decreased significantly between low-complexity and high-complexity tasks. Both intuitive and analytical decision processes produced clear intervention selections in the low-complexity task, although the analytical process resulted in a more complete specification of interventions. In the high-complexity task, however, only the intuitive process resulted in a clear, plausible, and safe specification of interventions. Education and experience were not related to CT ability, nor was CT ability related to decision-making consistency. Only greater years of critical care nursing experience increased the likelihood of decision-making consistency.

CONCLUSIONS

Overall, intuitive decision processes resulted in more clinically consistent selection of interventions across tasks. More investigation is needed to examine the influence of decision heuristics, and the conceptualization and measurement of CT abilities among practicing nurses.

Putting the pieces together: teaching undergraduate research from a theoretical perspective

PROBLEM/PURPOSE: Baccalaureate graduates are expected to utilize research across a wide variety of practice settings. While the literature reports a variety of teaching approaches, few studies examine baccalaureate students' comprehension of research content. Teaching techniques that focus on a conceptual or theoretical approach may foster research comprehension. Therefore, the purpose of this paper is to evaluate teaching/learning outcomes of an undergraduate nursing research course designed from a conceptual or theoretical approach.

PROCEDURE/FINDINGS

Two classes of senior baccalaureate nursing students (n = 47) at a private institution, whose curriculum was based on the Roy adaptation model, were surveyed in 1990 and 1991 at the end of their undergraduate research course. The survey tool consisted of seven three-point Likert scale questions, four open-ended questions, and one unstructured comment. Findings showed that 72% strongly agreed that they would continue to read nursing articles in their practice field, 57% disagreed that they were intimidated by research language, and 55% agreed that they trusted their ability to use and utilize nursing research in practice. The most helpful learning activity was the research critique (34%) followed by group work (28%). The support of the teacher and Instructor's use of own research examples was also seen as most helpful (36%), while abstract cards (8%) were least helpful. Nonetheless, 23% requested more group activities, 13% wanted more class examples, and 11% asked for more time to comprehend definitions.

IMPLICATIONS

Students who approached research from the perspective of a nursing conceptual framework indicated that they put the pieces of the research puzzle together by working in groups, being supported by the Instructor, and learning from a variety of teaching methods.