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PubMed2001

Effects of using videotaped vignettes on enhancing students' critical thinking ability in a baccalaureate nursing programme.

AIM: The aim of this study was to determine the effects of using videotaped vignettes in promoting nursing students' critical thinking abilities in managing different clinical situations. BACKGROUND: The impetus for undertaking this study came from recognition of the need to develop the level of students' critical thinking within clinical nursing practice. Eight videotaped vignettes that simulated clinical situations were developed to promote baccalaureate nursing students' critical thinking abilities in managing clinical situations. Guidelines were also developed to stimulate students' discussion. DESIGN/METHODS: A pre-test/post-test design was employed to determine the effectiveness of videotaped vignettes in promoting critical thinking skills among these students. A final sample of 83 students completed all the pre-test and post-test questionnaires on critical thinking skills and nursing knowledge test specific to a vignette. RESULTS/FINDINGS: The findings indicate that students' post-test knowledge scores were significantly higher than the pre-test knowledge scores. While the post-test critical thinking skill test scores were slightly higher than those of the pre-test for the students, the difference was not significant. One reason for such findings may be the limited exposure students had to these new types of videotaped vignettes. After the course had been completed both students and teachers were asked to reflect and to indicate their level of satisfaction with the new approach. There was overall satisfaction with the new approach to teaching clinical skills as reflected in the interview data from both teachers and students. CONCLUSIONS: While there were positive outcomes in terms of helping students to relate nursing principles to clinical situations, more time for students to learn using videotaped vignette in tutorial hours remains a challenge for teachers in planning the lectures.

Adult↗

PubMed2001

Assessing critical thinking in baccalaureate nursing students: a longitudinal study.

The purpose of this study was to evaluate the attainment of critical thinking skills of students before and after curriculum revision of a baccalaureate nursing program. The California Critical Thinking Skills Test (CCTST) was used to measure the critical thinking ability of the students at program entry, midpoint, and at exist. The sample consisted of three cohorts of students: cohort 1 (n = 55) was the baseline class before curriculum revision, whereas cohorts 2 (n = 55) and 3 (n = 73) were the first two classes to experience the revised curriculum. The results revealed that cohort 2 achieved significantly higher critical thinking scores than the baseline cohort. Cohort 2 also improved dramatically on all subscales from test 1 to test 3. However, cohort 3 failed to demonstrate improved critical thinking scores over time. Findings have implications for measuring critical thinking.

Adult↗

PubMedDate not supplied

Critical thinking. Strategies for clinical practice.

Critical thinking is an elusive concept. As a profession, nursing has yet to accept a universal definition of critical thinking. Despite the lack of consensus, nurse leaders in academia and practice settings overwhelmingly agree that critical thinking is essential. It is clear, considering the healthcare environment, nurses need to use critical thinking as a process for decision making in the clinical arena. This article clarifies critical thinking in practice by illuminating the imperative role it plays. Suggestions for fostering critical thinking, including specific strategies, provide a framework for practice.

Clinical Competence↗

PubMed1997

Negative content of thinking in panic disorder and major depression--a self-report study.

The purpose of the present study was to investigate the character and extent of negative thought content in panic disorder (PD) and the relation between thinking and bodily sensations. Content of thinking was explored in several areas, some of which are not exclusively related to anxiety. A structured diagnostic interview (SCID), a self-rating scale (SCL-90R), a sentence construction test (The Incomplete Sentences Blank (ISB)), and an inventory of childhood memories of parental rearing (the EMBU) were administered to 47 PD patients, 15 patients with major depression (MD), and 30 normal subjects. Thus, measures of implicit as well as explicit thinking, measures of thinking on present as well as past issues, and methods allowing negative as well as positive thought content to be expressed, were used. We found that PD was characterized by more negative thinking of anxiogenic, depressive, and dependent nature and less neutral or positive thinking than the normal subjects, primarily in issues related to the present. These negative thoughts were correlated with bodily symptoms. Very few significant differences were found between PD and MD, but a subgroup of PD with comorbidity of MD exceeded the other groups on measures of negative thoughts as well as bodily symptoms.

Adult↗

PubMed2004

Thinking and hallucinating: reciprocal changes in sleep.

Internal deliberations (focused thoughts) and endogenous percepts (hallucinations) vary in a reciprocal manner across the states of waking and sleep, paralleling changes in regional brain activation. As subjects go from waking through sleep onset to NREM sleep and then to REM sleep, they report progressively more hallucinoid imagery and progressively less thinking. We have investigated whether this reciprocity in cognition between NREM and REM is maintained throughout the night. To do so, we analyzed 229 REM and 165 NREM reports collected with the Nightcap sleep monitoring system from 16 participants in their homes over 14 nights. The reports were scored for the presence of hallucinations and directed thinking by external judges. As predicted, hallucinations were more frequent in REM than in NREM for each segment of the night, and directed thinking was more frequent in NREM in the first 5 h of the night. Late in the night, directed thinking was equally infrequent in NREM and REM. At the same time, hallucinations increased within both NREM and REM as the night progressed, whereas directed thinking decreased in NREM and remained at a stable, low level in REM. These findings suggest that a reciprocal shift in focused thinking and hallucinating is a general property of cognitive activity across the wake-sleep cycle. Biological evidence supports the hypothesis that these cognitive changes are governed by specific state regulatory and neurocognitive processes at several levels of the brain.

Adult↗

PubMed2000

An approach to teaching for critical thinking in health education.

Teaching for critical thinking represents a vital and emerging priority in school health education. A variety of conceptions of critical thinking and approaches to teaching for critical thinking exist in the literature. This paper explores the relevance of Richard Paul's concept of critical thinking to health education. Paul's work on critical thinking has been widely disseminated and features three inter-related components called the elements of reasoning, intellectual standards, and intellectual traits. Each component appears highly relevant to health education. Paul's approach is also based on natural rather than technical language which improves its utility in learning. Unanswered questions about the approach concern the degree to which the thinking skills and traits can be transferred to health instruction and the lack of evaluation research demonstrating its efficacy. Further inquiry into the applicability and efficacy of the approach is needed.

Health Education↗

PubMed2005

Qualitative evaluation of divergent thinking in patients with schizophrenia.

Patients with schizophrenia show deficits across a broad spectrum of neurocognitive domains. In particular, deficits in verbal fluency are common. Verbal fluency tests are neuropsychological tests that assess frontal lobe function or executive function but also assess divergent thinking. However, few studies have considered the impairment of verbal fluency from the viewpoint of divergent thinking. To consider the structure of divergent thinking, not only verbal assessments but also non-verbal assessments are indispensable. We administered several fluency tests, the idea fluency test, the design fluency test, and word (letter and category) fluency tests to 26 patients with schizophrenia and 26 healthy control subjects to evaluate divergent thinking in both groups and assessed their responses qualitatively. An acceptable minimal level of intelligence was maintained in the patient group. Although attention and executive functioning were relatively preserved in the subjects with schizophrenia, they demonstrated significant deficits in divergent thinking and had particular difficulty in producing ideas and designs requiring concept flexibility, a conversion of viewpoint, originality, or novelty. Research on deficits in divergent thinking in patients with schizophrenia may contribute to the development of cognitive and behavioral rehabilitation programs.

Adult↗

PubMed1994

How to assess thinking skills in cancer patients.

This article emphasizes the importance of health care professionals assessing and working with the way cancer patients think. Health care professionals can help cancer patients think more effectively about the organic manifestations of their disease, problems that arise from the cancer experience, and problems unrelated to cancer, but which negatively influence their lives. Nine thinking skills areas are identified and described. Skills that health care professionals can use to assess patients' thinking, and to gain insight into their own thinking, are reviewed. In addition, suggestions are made for how patients can be helped to overcome thinking skills weaknesses and build their strengths so that they can optimize their chances of quality life.

Adaptation, Psychological↗

PubMed2001

Critical thinking: toward a nursing science perspective.

Critical thinking is an important phenomenon in nursing science because of its implications for education, practice, and the advancement of nursing knowledge. As a context-dependent, evolving life process, critical thinking appears to be congruent with assumptions and principles of SUHB. Thus, it may be asserted that critical thinking arises within the mutual process of human and environment and thus is a pattern manifestation of the human-environment field process. Before this assertion can be fully accepted, however, much investigation is needed. Nurse scholars are called upon to re-examine critical thinking and to consider possibilities that, until now, have been neglected or unimagined. To date, the positivistic view of critical thinking has yielded limited information. Nurse scientists, therefore, have an opportunity to extend and refine knowledge of critical thinking by embarking upon new and exciting avenues of discovery.

Decision Making↗

PubMed1998

Dichotomous thinking as a sign of suicide risk on the TAT.

Previous research has supported theoretical claims that dichotomous thinking may be a risk factor for suicide. However, the concept of dichotomous thinking is vague, and thus far, no measures of it have been developed. This study developed a coding scheme useful on Thematic Aperception Test (TAT; Murray, 1943) protocols and applicable to other verbal productions to refine the concept of dichotomous thinking and to assess its utility as a predictor of suicidality. Suicidal patients had a significantly elevated rate of a narrowly defined type of dichotomous thinking involving diametric or polarized possibilities. However, suicidal and nonsuicidal patients did not differ on weaker forms of dichotomous thinking involving nonexclusive or nonbinary alternatives. Suicidal patients produced shorter TAT stories than nonsuicidal patients, supporting other findings in the literature that suicidal patients tend to be cognitively and affectively "shut down." Traditionally designated "suicide cards" also yielded shorter stories but did not elicit higher rates of dichotomous thinking.

Adult↗

PubMed2004

Personality disorder and future-directed thinking in parasuicide.

Parasuicide patients have been found to lack positive expectations for the future. The aim of the present study was to look at variations in this lack of positive future-thinking as a function of personality status. A sample (N = 442) of repeat parasuicide patients was assessed on positive and negative future-thinking and the presence of personality disorder or personality difficulty. Those with a Cluster B personality disorder (borderline or dissocial) were significantly lower in positive future-thinking than those with no Cluster B symptoms or those with Cluster B personality difficulty. Neither Cluster A nor Cluster C symptomatology was related to positive future-thinking. Negative future-thinking was not significantly related to any type of personality disorder or difficulty. The results are interpreted as evidence of the importance of personality status in influencing positive future-thinking and gives some indications of why those with Cluster B personality disorder have such high rates of recurrent self-harm.

Adult↗

PubMed2004

Contributions of thinking styles to vocational purpose beyond self-rated abilities.

The present study predicted vocational purpose from thinking styles, a construct at the interface of intelligence and personality. 233 students majoring in history and computer science from a large research-oriented university in the People's Republic of China completed the Thinking Styles Inventory and the Iowa Vocational Purpose Inventory. The participants also rated their own analytical, creative, and practical abilities. In general, results indicated that thinking styles contributed to vocational purpose beyond self-rated abilities. Specifically, the more creativity-generating and complex thinking styles tended to contribute positively to vocational purpose, whereas the more conforming and simplistic thinking styles tended to contribute negatively to vocational purpose. This article points to the need theoretically for integrating the construct of thinking style into the definition of differential psychology. Practical data argue for a collaborative working relationship between teachers and vocational counselors in institutions of higher education.

Adolescent↗

PubMed2004

Thinking styles: university students' preferred teaching styles and their conceptions of effective teachers.

In the present study, the author investigated the role of thinking styles in university students' preferences for teaching styles and their conceptions of effective teachers. Students (121 men and 134 women) from the University of Hong Kong responded to 3 self-report tests: the Thinking Styles Inventory-Revised (R. J. Sternberg, R. K. Wagner, & L-F. Zhang, 2003), the Preferred Thinking Styles in Teaching Inventory (L-F. Zhang, 2003c), and the Effective Teacher Inventory (L-F. Zhang, 2003b). Results indicated that even after age, gender, and academic discipline were controlled, particular thinking styles predisposed students to particular teaching styles. Moreover, as expected, students were open to more than just teaching styles that precisely matched their own thinking styles. Results also indicated that students' thinking styles made a difference in their conceptions of effective teachers. Discussions are focused on the study's contributions to both the style literature and the growing body of knowledge on characteristics of effective teachers.

Adolescent↗

PubMed2004

Revisiting the predictive power of thinking styles for academic performance.

The present study is a further examination of the contributions of thinking styles to academic achievement (see L-F. Zhang, 2001a, 2001b, 2002f; L-F. Zhang & R. J. Sternberg, 1998). Secondary school students in Hong Kong (N = 250; 131 from a Catholic boys' school and 119 from a Protestant girls' school) participated in the study. Students' scores on the Thinking Styles Inventory (R. J. Sternberg & R. K. Wagner, 1992) were used to predict their academic achievement in 16 subjects after age, gender, school class level, and performance on the Sternberg Triarchic Abilities Test (R. J. Sternberg, 1993) were controlled. Results indicated that the use of the hierarchical thinking style significantly contributed to better achievement in the social sciences and humanities and that the use of the judicial style uniquely contributed to better achievement in the natural sciences. The use of the monarchic thinking style significantly predicted students' achievement in design and technology. The results of this study suggest that thinking styles should be taken into account in school settings and that thinking styles that generate creativity should be cultivated in students.

Achievement↗

PubMedDate not supplied

Antidote Dilemma--an activity to promote critical thinking.

BACKGROUND: In a health care environment of increased patient acuity and greater demands on nursing practitioners, the ability to think critically is requisite to functioning safely and proficiently. METHOD: Definitions and tenets of critical thinking promulgated by Brookfield (1987) and Paul (1992) provided the theoretical foundation for Antidote Dilemma, an activity designed to promote critical thinking. RESULTS: Nurses who participated in the activity identified plausible solutions to a nursing dilemma, considered context in identifying alternatives, and thought about their thinking. CONCLUSION: Critical thinking is most likely to occur and continue when it is supported by others and repeatedly practiced. Continuing/staff-development educators play a vital role in promoting critical thinking among nursing practitioners.

Decision Making↗

PubMedDate not supplied

Critical thinking in nursing: an integrated review.

Critical thinking skills are essential to function in today's complex health care environment and to ensure continuing competence for the future. This article provides a review of various definitions and research studies related to critical thinking. Educators and researchers need to clearly define critical thinking, because there has been wide variation in definitions and descriptions of critical thinking. Research studies have shown inconsistent findings, and many have used a one-group pretest-posttest design over a single course or during the length of a nursing program. Studies have not shown an association between critical thinking and competence; rigorous research studies are needed to understand the process of critical thinking.

Attitude of Health Personnel↗

PubMed1990

The relationship between clinical decision-making skills in nursing and general critical thinking abilities of senior nursing students in four types of nursing programs.

This descriptive study was undertaken to investigate the relationship between clinical decision-making skills in nursing and critical thinking abilities of senior nursing students in four types of nursing education programs: generic baccalaureate, associate, and diploma--the basic RN programs, along with the upper division baccalaureate (specifically RN completion) program. Fifty senior students from each type of program were conveniently selected. Clinical decision-making in nursing was measured by the Nursing Performance Simulation Instrument. General critical thinking abilities were determined by the Watson-Glaser Critical Thinking Appraisal. Among the basic RN programs, the higher level of general critical thinking ability was attained by generic baccalaureate seniors (mean score, 61.3) compared with the associate (50.0) and diploma (51.3) seniors. The clinical decision-making scores in nursing skills were virtually identical for the three basic programs--generic (32.2), associate (32.2), and diploma (32.3). That is, mean performance scores of the 2-year associate degree, 3-year diploma, and 4-year generic baccalaureate degree students on the Nursing Performance Simulation Instrument showed no statistically significant difference. The mean critical thinking score for the upper division baccalaureate seniors (61.1) was comparable to that of the generic baccalaureate seniors. Clinical decision-making mean score for the upper division seniors was significantly higher (38.0) than those of the other three groups. A weak though significant positive correlation (r = 0.249) between clinical decision-making and critical thinking across all four types of programs was found.

Clinical Competence↗

PubMed1994

A critical thinking model for nursing judgment.

Increasingly, the characteristic that distinguishes a professional nurse is cognitive rather than psychomotor ability. Critical thinking is an essential component of nursing. Yet, no clear definition or conceptualization of critical thinking for nursing judgment has existed. Lack of consensus and overlapping definitions may well diminish the profession's ability to articulate this concept and facilitate its development. This article proposes the Critical Thinking Model for Nursing Judgment, which specifies five components: specific knowledge base, experience, competencies, attitudes, and standards. The model has three levels of critical thinking: basic, complex, and commitment. It provides a definition and conceptualization of critical thinking based on a review of the literature and input from nurses and nurse educators. The model provides a first step for development of further research and educational strategies to promote critical thinking as an essential part of autonomous, excellent nursing practice.

Attitude of Health Personnel↗