Clinical nurses's critical thinking level according to sociodemographic and professional variables (Phase II): A correlational study

Critical thinking level in nursing degree students according to sociodemographic and academic variables: A correlational study

AIMS

To determine the level of critical thinking of undergraduate nursing students during their clinical practice, as well as to identify the relationship between sociodemographic and academic variables.

BACKGROUND

Nursing degree programs should prioritize the development of critical thinking skills in their curriculum and regularly assess students to ensure the acquisition of core competencies.

DESIGN

Multicenter, descriptive, cross-sectional, correlational, descriptive study. Participants included were students from the Degree in Nursing enrolled during the academic year 2020-2021. Students were selected by convenience from three universities located in Catalonia, Spain. Data were collected from 429 students, with 98 being excluded due to incomplete data.

METHODS

Data were collected by administering the Nursing Critical Thinking in Students Questionnaire and an ad hoc form of sociodemographic and academic characteristics. The STROBE guidelines checklist were followed. The study involves a secondary analysis of data from a previous study that presented psychometric analysis.

RESULTS

No significant differences were observed in total Critical Thinking scores across various parameters including academic year, current situation, work experience in healthcare, previous academic training, family situation, or recent stressful events. On average, students demonstrated moderate critical thinking scores. However, statistically significant relationships emerged between critical thinking scores and gender (p=0.046), institution attended for undergraduate studies (p=0.019) and having satisfactory social relationships despite experiencing stressful events (p=0.330).

CONCLUSIONS

The study delves into the correlation between critical thinking skills and sociodemographic and academic factors, identifying students who may benefit from specific interventions and advocating for adaptable educational methods. It emphasizes the pivotal role of trust in fostering critical thinking in nursing education and suggests a connection between critical thinking and strong social relationships. In conclusion, evaluating critical thinking is crucial for addressing healthcare challenges, validating teaching strategies and promoting continuous improvement in nursing education.

Factors associated with the critical thinking ability among nursing students: An exploratory study in Iran

BACKGROUND AND OBJECTIVE

Critical thinking is a crucial skill in nursing that nursing students should apply in their work environment. It involves analyzing, evaluating, and interpreting information. It is used in various topics such as disease diagnosis, treatment planning and implementation, monitoring, and evaluation of results, problem-solving, and decision-making in emergencies. This study in Iran aimed to evaluate factors associated with nursing students' critical thinking ability.

STUDY METHOD

Following the STROBE guidelines, an analytical cross-sectional study was conducted in Ardabil province, northwest Iran. The study collected data through convenience sampling at nursing schools in Ardabil province, with a sample of 246 nursing students participating. The data collected from a demographic information form and the Persian version of the Nursing Critical Thinking in Clinical Practice Questionnaire were analyzed using SPSS version 22.0 software.

RESULTS

The study found that the overall mean score of clinical critical thinking among nursing students was 313.87 ± 25.80 (range = 109-436). Based on this score, most students reported low (63%) or moderate (37%) clinical critical thinking levels. The highest and lowest mean scores between dimensions were related to the intellectual and cognitive (127.99 ± 13.30) and technical (17.25 ± 3.43), respectively. Multiple linear regression analysis revealed that semester and college were predictors of clinical critical thinking among nursing students. The selected predictors accounted for 19.3% of the total variance in clinical critical thinking scores (F = 9.396, p < 0.001).

CONCLUSION

The study results showed that nursing students could have performed better in critical thinking ability. The study suggests that nursing education programs should prioritize teaching critical thinking skills in clinical settings as it is an essential subject in nursing education. With significant changes in nursing clinical environments, enhancing clinical critical thinking can improve nursing student performance clinically. Therefore, one of the crucial learning objectives in a clinical nursing course is to develop clinical critical thinking skills for nursing students.

Nursing students' critical thinking and associated factors in Vietnam: A multicenter cross-sectional study

AIMS

This study aimed to evaluate the critical thinking abilities of senior nursing students in Vietnam and determine factors associated with their critical thinking disposition and skills.

BACKGROUND

Assessing critical thinking competence is crucial for determining senior nursing students' preparedness for entering the healthcare workforce and can be used to examine current nursing education's ability to cultivate nursing students' critical thinking. However, little research was found on critical thinking among Vietnamese nursing students.

DESIGN

A multicenter cross-sectional research design.

METHODS

A convenience sample of 533 senior nursing students from six universities in Vietnam participated in this study. All participants completed the online questionnaires, including basic information, a subscale of the Motivated Strategy for Learning Questionnaire (MSLQ), Critical Thinking Disposition Scale (CTDS), and Critical Thinking Self-Assessment Scale (CTSAS).

RESULTS

The mean score for the CTDS was 42.81 (standard deviation (SD) = 5.29), while the mean score for the CTSAS was 168.29 (SD = 44.43). Results of the multiple linear-regression analysis showed that an increase in self-study hours per day (B = 0.41, p = 0.007), higher self-efficacy in learning and performance (B = 0.26, p < 0.001), and a more-supportive environment (B = 0.97, p < 0.001) were predictors of critical thinking disposition. Moreover, an increase in self-study hours per day (B = 4.09, p = 0.001), higher self-efficacy in learning and performance (B = 2.65, p < 0.001), a more-supportive environment (B = 7.74, p < 0.001), and more experience with research (B = 7.03, p = 0.03) were predictors of critical thinking skills.

CONCLUSIONS

This study revealed that senior nursing students in Vietnam possess a moderate level of critical thinking abilities. Those students who dedicate more hours to self-study, demonstrate higher self-efficacy in learning and performance, experience a supportive environment, and engage in more research activities exhibit better critical thinking disposition and skills. The findings highlight the ongoing need to enhance critical thinking disposition and skills of nursing students in Vietnam. It is suggested that nursing faculty members should develop the appropriate strategies to improve nursing students' critical thinking disposition and skills.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Capturing New Nurses' Experiences and Supporting Critical Thinking: Text Network Analysis of Critical Reflective Journals

This study analyzed the contents of critical reflective journals written by new nurses during their orientations using a text network. This study aimed to find ways to reduce turnover and improve clinical field adaptability among new nurses. The authors analyzed the content of reflective journals written by 143 new nurses from March 2020 to January 2021. Text network analysis was performed using the NetMiner 4.4.3 program. After data preprocessing, frequency of occurrence, degree centrality, closeness centrality, betweenness centrality, and eigenvector community were analyzed. In total, 453 words were extracted and refined, and words with high simple frequency and centrality were "incompetence," "preparation," "explanation," "injection," "time," "examination," and "first try." "Medication" had the highest frequency of occurrence, and "incompetence" was the most important keyword in the centrality analysis. In addition, component analysis and eigenvector community analysis revealed three sub-theme groups: (1) basic nursing skills required for new nurses, (2) insufficient competency, and (3) explanation of nursing work. Significantly, this study is the first to use the text network method to analyze the subjective experiences of the critical reflective journals of new nurses. In conclusion, changes are needed to improve the education system for new nurses and promote efficient sharing of nursing tasks.

Multilevel Modeling of Individual and Group Level Influences on Critical Thinking and Clinical Decision-Making Skills among Registered Nurses: A Study Protocol

Critical thinking and clinical decision-making are two essential components of nursing services. The practice of nursing requires both components at every level of nurses' daily tasks. This paper describes the protocol for an ongoing project, which aims to examine the prevalence of critical thinking and clinical decision-making among registered nurses and determine the factors that influence the skills at individual and group levels using a multilevel modeling approach. Survey data will be collected from approximately nine states, with nine general hospitals, nine district hospitals, one private hospital, and one educational hospital in Malaysia included. We aim to recruit 800 registered nurses working shifts in hospital settings. We will use questionnaires to measure the perceived nurses' knowledge, critical thinking skills, and clinical decision-making skills. The study will have three levels as the nurses are nested within the unit and further nested within the hospitals. This study will give an insight into the nursing profession today where critical thinking and clinical decision-making skills can play a significant role in patient safety and the quality of care in nursing practice.

How to choose a preceptor: aspects to consider based on a grounded theory study

BACKGROUND

Nurses in clinical practice settings share responsibility with academy teachers in the education of nursing students in clinical teaching. This dynamic is essential for the students' learning and their skill development. During preceptorship, the nurse has to mobilize the available resources to act competently and effectively. The purpose of this article is to identify the aspects that should be considered when selecting a nurse preceptor.

METHODS

A qualitative study was carried out based on Grounded Theory using Strauss and Corbin's version. The study took place in a medicine ward and a surgery ward of a hospital in the Lisbon metropolitan area. The authors conducted fourteen semi-structured interviews with nurses who were at different stages of Benner's Professional Development Model and with different outlooks on nursing preceptorship. The initial script was reorganized after the pilot test. It was also adjusted after the first exploratory interviews and after the in-depth interviews in order to reflect the interviewees' work experience and outlooks on preceptorship. The interviews had an average duration of 45 min and were audio recorded. Theoretical sampling was conducted considering the needs identified in data coding until we reached theoretical saturation. Data analysis began after the first interview, first by open coding, followed by axial and selective coding, always in a logic of constant comparison with theory. Ethical principles, scientific integrity and methodological rigour were ensured throughout the study.

RESULTS

Two categories emerged that were supported by all nurses: skills and individual characteristics. The former includes communication skills, relational skills, reflective skills, technical-scientific skills, and emotional skills, while the latter includes perceptiveness, responsibility, motivation, and professional initiative.

CONCLUSION

Nurses value both the individual characteristics they possess and the skills they have developed throughout their career. The recognition of the aspects found in this study for the selection of nurse preceptors allows for an informed and reasoned decision making, with a view to the success of the preceptorship and to the improvement of the quality of nursing education.

Effects of Blended Simulation on Nursing Students' Critical Thinking Skills: A Quantitative Study

Introduction

Critical thinking is regarded as imperative to healthcare quality and patient outcomes; therefore, effective strategies in nursing education are required to promote students' critical thinking abilities, leading to their success in clinical work. Accordingly, simulation-based education has been suggested as a measure for achieving this goal.

Objective

The aim of this study was to explore whether a nursing education course with blended simulation activities (hands-on simulations with high-fidelity manikins and a web-based interactive simulation program) could increase nursing students' critical thinking skills.

Method

A quasiexperimental, one-group pretest and post-test design was utilized. Data were collected through premeasurement and postmeasurement using a critical thinking questionnaire and were analyzed using paired sample t-tests, independent sample t-tests, and the nonparametric Wilcoxon signed-rank test. The effect size was calculated using Cohen's d formula.

Results

Sixty-one nursing students (57 women and four men, mean age 30 years) participated in the study. Findings of the paired sample t-test showed a significantly higher mean score for posteducation than pre-education, indicating a significant change in nurses' critical thinking capabilities (p < .001). The results for Cohen's d formula ( - 0.87) of the mean scores between pre-education and posteducation indicated a large effect size. The Wilcoxon signed-rank test also showed a statistically significant increase in the students' critical thinking abilities between pre-education and posteducation measures (p < .001). No statistically significant differences were found in the mean score according to age or sex.

Conclusion

This study concluded that blended simulation-based education can increase nursing students' critical thinking capabilities. As a result, this study builds on the use of simulation as a measure for developing and promoting critical thinking abilities during nursing education.

Differences in Critical Thinking and Decision Making among Critical Care and Non-Critical Care Nurses

Critical thinking and decision-making are essential for nurses to identify and analyze judgments for nursing care. Hence, this study aims to determine critical thinking and clinical decision-making among critical and non-critical care nurses. A cross-sectional study was conducted among 237 nurses using a self-administered questionnaire. This study discovered that critical and non-critical care nurses had a modest level of critical thinking and clinical decision-making. The findings of this study can serve as a guide for nursing administration employees in implementing effective techniques to enhance the critical thinking skills of nurses in on-the-job training and orientation programs for nursing staff.

Factors Predicting Post-Traumatic Positive and Negative Psychological Changes Experienced by Nurses during a Pandemic COVID-19: A Cross-Sectional Study

It is common knowledge that COVID-19 affects physiopathological changes in all systems of the human body. On the other hand, events related to the COVID-19 pandemic also have a significant impact on the social and mental sphere of human functioning. The aim of this study is to determine the relationship between selected sociodemographic variables and selected subjective cognitive resources, and the positive and negative perception of the consequences of the COVID-19 pandemic in a group of nurses working in Poland. The computer-assisted web interviewing method was conducted between 1 and 15 May 2020. Participants were requested to complete the following questionnaires: The Changes in Outlook Questionnaire (CIOQ), The Impact Event Scale-Revised (IES-R), The Multidimensional Scale of Perceived Social Support (MSPSS), The Safety Experience Questionnaire (SEQ), and The Meaning in Life Questionnaire (MLQ). Three-hundred and twenty fivenurses working all over Poland participated in the study. Their mean age was 39.18 ± 11.16 years. A higher average level was noted among the surveyed nurses in the Positive Change subscale (18.56 ± 4.04). In a multivariate model, taking into account both sociodemographic and cognitive variables, the level of perceived traumatic stress, the level of social support, a sense of security, reflection on safety and a sense of meaning and meaning in life were independent predictors of a positive perception of the consequences of the COVID-19 pandemic. Those variables explained as much as 37% of the dependent variable, and the nature of the relationship was positive. While we are still a long way from understanding the full range of the long-term impact of the COVID-19 pandemic on mental health and psychosocial well-being, it is possible that in this challenging context there are many individual resources available to perceive the effects of the current pandemic positively. Therefore, they should be strengthened through the development and implementation of intervention programs to improve the mental state of nurses.

Critical thinking among clinical nurses and related factors: A survey study in public hospitals

AIMS AND OBJECTIVES

The study investigated clinical nurses' critical thinking levels in public hospitals and related factors.

BACKGROUND

Since health care environments have become more complex, the critical thinking skills of clinical nurses are more important in daily problem-solving and decision-making processes. However, little research was conducted on this topic among clinical nurses.

METHODS

It was a cross-sectional study at five public hospitals between December 2018 and January 2019. The study followed the STROBE guideline. Data were collected from 559 nurses by a survey consisted of a data form and the Turkish version of the Nursing Critical Thinking in Clinical Practice Questionnaire.

RESULTS

Nurses' mean critical thinking scores were moderate level. Total critical thinking scores of the clinical nurses significantly differed according to education, hospital type, shift work, professional category and role. There was a significant effect on the total critical thinking scores of the clinical nurses according to variables.

CONCLUSION

This study found that critical thinking levels of nurses' working in clinical settings in public hospitals were moderate level. Hospital type, shift work, professional and educational level and role were significantly associated with clinical nurses' critical thinking levels.

RELEVANCE TO CLINICAL PRACTICE

This study provides evidence related to the levels of critical thinking of clinical nurses working in public hospitals. Since the critical thinking scores of the manager nurses, daytime working nurses' and nurses with bachelor's and master's degree education are higher, hospital managers may benefit from the study to implement effective strategies to improve the competence of critical thinking levels of nurses.

Development, reliability and validity of infectious disease specialist Nurse's Core competence scale

Aim

This study aims to develop an instrument to measure infectious disease specialist nurses’ core competence and examining the scale’s validity and reliability.

Background

With the increase of infectious diseases, more and more attention has been paid to infectious disease nursing care. The core competence of the infectious disease specialist nurses is directly related to the quality of nursing work. In previous researches, infectious disease specialist nurses’ core competence was measured by the tools developed for general nurses instead of specialized tools, which made it difficult to clarify the core competence of nurses in infectious diseases department.

Methods

Preliminary items were developed through literature review, theoretical research, qualitative interview and Delphi method. The confirmed 47 items were applied in the two rounds of data collection. Evaluation data on 516 infectious disease specialist nurses’ core competence in the first round were utilized to preliminarily evaluate and explore the scale’s constrution, while evaluation data on 497 infectious disease specialist nurses’ core competence in the second round were utilized to do reliability analysis and validity analysis. In this study, factor analysis, Cronbach’s α, Pearson correlation coefficients were all adopted.

Results

The final scale is composed of 34 items and 5 factors, and adopted the 5-point scoring method. The factors are Professional Development Abilities, Infection Prevention and Control Abilities, Nursing Abilities for Infectious Diseases, Professionalism and Humanistic Accomplishment, and Responsiveness to Emergency Infectious Diseases. The explanatory variance of the five factors was 75.569%. The reliability and validity of the scale is well validated. The internal consistency, split-half reliability and test-retest reliability were 0.806, 0.966 and 0.831 respectively. The scale has good structural validity and content validity. The content validity was 0.869. Discrimination analysis showed that there were significant differences in the scores of core competence and its five dimensions among infectious disease specialist nurses of different ages, working years in infectious diseases, titles, educational background, marital status and wages (all P < 0.05).

Conclusions

The proposed scale takes on high reliability and validity, and is suitable for assessing the infectious disease specialist nurses’ core competence.

Relevance to clinical practice

This scale provides a reference for clinical assessment of infectious disease nursing.

Development of critical thinking skills of undergraduate students throughout the 4 years of nursing degree at a public university in Spain: a descriptive study

OBJECTIVE

To analyse the critical thinking skills of students enrolled in the four academic years of the nursing degree at a public university belonging to the European Higher Education Area.

DESIGN

Cross-sectional, quantitative, descriptive study. Using the Critical Thinking Questionnaire to analyse the critical thinking skills in their substantive and dialogic dimension.

SETTING

Faculty of Nursing, Valladolid Public University in Spain, belonging to the European Higher Education Area.

PARTICIPANTS

The sample consisted of 215 first-year, second-year, third-year and fourth-year undergraduate nursing students.

MAIN OUTCOMES

The students of the four academic years were positively disposed towards critical thinking. The students of the final courses obtained higher average scores.

RESULTS

The study sample was 215 students, 19.1% men/80.9% women. The average score in the substantive dimension (3.81±0.53 points) was higher than that in the dialogic dimension (3.48±0.51 points) (p<0.001). They had a greater ability in listening and speaking (3.77±0.61 points) with respect to writing (3.65±0.61 points) and reading (3.52±0.43 points) (p<0.001). There are significant differences in the critical thinking average scores across academic years.

CONCLUSIONS

Nursing students displayed a greater critical thinking ability in its substantive dimension compared with the dialogic one. This reflects a greater ability in actions related to provide reasons and evidence that support their point of view. Identifying critical thinking skills in nursing students will help establish specific teaching methodologies focused on improving these skills.

Cultural adaptation and validation of an instrument about nursing critical thinking skills

OBJECTIVES

to validate the Nursing Critical Thinking in Clinical Practice Questionnaire regarding cultural aspects and metric properties.

METHODS

a methodological research carried out through cross-cultural adaptation, face and content validity, dimensional construct and known groups validity, test-retest reliability and internal consistency. 511 nurses from four hospitals participated in the study, of which 54 participated in retest.

RESULTS

the instrument validation for Brazilian Portuguese maintained equivalences, according to the original version. The dimensional validity demonstrated adjustment to the tetrafactorial structure of the original version (GFI=0.69). There were statistically significant differences in critical thinking skills between nurses with graduate degrees and who undertook training, reading articles, developing research and working in an institution with a longer time implementation of the Nursing Process. The instrument showed temporal stability (ICC 073-0.84; p<0.001) and adequate internal consistency (α=0.97).

CONCLUSIONS

the instrument proved to be valid and reliable for the studied population.

Post-traumatic growth and influencing factors among frontline nurses fighting against COVID-19

OBJECTIVE

To explore the level and influencing factors of frontline nurses' post-traumatic growth (PTG) during COVID-19 epidemic.

METHODS

A cross-sectional survey was conducted in February 2020 in three hospitals in China. The Post-traumatic Growth Inventory (PTGI) was used to investigate the PTG of frontline nurses. Data on related factors, including demographic characteristics and subjective variables, were collected. The Event-Related Rumination Inventory was used to assess rumination. Pearson's or Spearman's correlation was calculated for bivariate analysis. Independent sample t-tests or one-way analysis of variance and multiple linear regression analysis were used to examine the related factors.

RESULTS

A total of 179 frontline nurses were recruited, and 167 were included in the analyses. The mean PTG score was 70.53±17.26. The bivariate analyses showed that deliberate rumination was modestly positively correlated with PTG (r=0.557, p<0.01), while intrusive rumination had a modest negative correlation with PTG (r=-0.413, p<0.01). Multiple linear regression demonstrated that working years, self-confidence in frontline work, awareness of risk, psychological intervention or training during the epidemic and deliberate rumination were the main influencing factors of PTG among frontline nurses and accounted for 42.5% of the variance (F=31.626, p<0.001).

CONCLUSIONS

The PTG of frontline nurses was at a medium to high level and was influenced by working years, self-confidence in frontline work, awareness of risk, psychological intervention or training and deliberate rumination. It is necessary to strengthen psychological guidance and training for frontline nurses and promote their deliberate rumination on epidemic events to improve their PTG.

Critical thinking in nursing clinical practice, education and research: From attitudes to virtue

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science.

Levels, antecedents, and consequences of critical thinking among clinical nurses: a quantitative literature review

The purpose of this study was to obtain a more comprehensive understanding of critical thinking within the clinical nursing context. In this review, we addressed the following specific research questions: what are the levels of critical thinking among clinical nurses?; what are the antecedents of critical thinking?; and what are the consequences of critical thinking? A narrative literature review was applied in this study. Thirteen articles published from July 2013 to December 2019 were appraised since the most recent scoping review on critical thinking among nurses was conducted from January 1999 to June 2013. The levels of critical thinking among clinical nurses were moderate or high. Regarding the antecedents of critical thinking, the influence of sociodemographic variables on critical thinking was inconsistent, with the exception that levels of critical thinking differed according to years of work experience. Finally, little research has been conducted on the consequences of critical thinking and related factors. The above findings highlight the levels, antecedents, and consequences of critical thinking among clinical nurses in various settings. Considering the significant association between years of work experience and critical thinking capability, it may be effective for organizations to deliver tailored education programs on critical thinking for nurses according to their years of work experience.