Critical Thinking Cognitive Skills and Their Associated Factors in Chinese Community College Students in Hong Kong

The importance of fostering critical thinking (CT) in community college education has been recognized highly worldwide. However, limited studies have been conducted to investigate CT abilities among community college students in the Asian context. A cross-sectional correlational study was conducted with 209 Chinese community college students to assess the levels of CT cognitive skills and CT dispositions and to identify the associated factors. The California Critical Thinking Skills Test (CCTST), California Critical Thinking Disposition Inventory (CCTDI), and a questionnaire on the students’ socio-demographic and academic profiles were used. The results showed that the average level of CT cognitive skills was 17.82 ± 4.10, which was at the upper end of the moderate range. For CCTDI scores, the mean value was 278.81 ± 22.61 and positive disposition towards CT was shown in four subscales: open-mindedness, analyticity, confidence in reasoning, and inquisitiveness. From regression analysis, HKDSE total score (i.e., university entrance examination total score), CT subject grade level, CCTDI truth-seeking, and CCTDI analyticity were identified as the four significant factors associated with their CT cognitive skills. The findings provide significant implications when reviewing the program design and curriculum as well as the addition of CT elements in a separate course to promote students’ CT abilities for sustainable development.

Instruments to evaluate undergraduate healthcare student learning styles globally: A scoping review

BACKGROUND

Recognizing learning styles is important to maximizing learning outcomes and many instruments are available to investigate learning styles.

OBJECTIVE

To investigate instruments with evidence of validity and reliability most commonly used to evaluate undergraduate healthcare student learning styles globally.

METHOD

This scoping review of literature was guided by The Joanna Briggs Institute's recommendations for conducting scoping reviews and the PRISMA-ScR (extension for scoping reviews). The protocol is available for access.

DATA SOURCES

Databases searched included Cumulative Index to Nursing and Allied Health Literature, PubMed, Web of Science, and Scopus. Inclusion criteria were: fully accessible; written in English, Portuguese, or Spanish; and used reliable and/or validated instruments to describe healthcare student learning styles. Articles were excluded if the sample included healthcare professionals, there was no report of the instrument validity and reliability, or was not fully accessible. Data were extracted from each article and entered into Microsoft Office Excel documents for analysis.

RESULTS

Forty-seven articles were selected for full review, including cross-sectional, interventional, and longitudinal studies. Eleven instruments were identified with evidence of reliability and validity for assessing undergraduate healthcare student learning styles globally. The most frequently used instruments were Visual, Aural, Read-Write, and Kinesthetic; Kolb's Learning Styles Inventory; and the Honey-Alonso Questionnaire. Most instruments were developed based on a theoretical framework and/or model.

CONCLUSION

This scoping review adds to the literature an overview of available instruments which measure healthcare student learning styles with evidence of both reliability and validity. The results indicate the need for further studies to improve learning style instruments for use in intervention studies aimed at improving the teaching-learning process for healthcare students.

A scoping review of clinical reasoning research with Asian healthcare professionals

Clinical reasoning is the thought process that guides practice. Although a plethora of clinical reasoning studies in healthcare professionals exists, the majority appear to originate from Western cultures. A scoping review was undertaken to examine clinical reasoning related research across Asian cultures. PubMed, SciVerse Scopus, Web of Science and Airiti Library databases were searched. Inclusion criteria included full-text articles published in Asian countries (2007 to 2019). Search terms included clinical reasoning, thinking process, differential diagnosis, decision making, problem-based learning, critical thinking, healthcare profession, institution, medical students and nursing students. After applying exclusion criteria, n = 240 were included in the review. The number of publications increased in 2012 (from 5%, n = 13 in 2011 to 9%, n = 22) with a steady increase onwards to 12% (n = 29) in 2016. South Korea published the most articles (19%, n = 46) followed by Iran (17%, n = 41). Nurse Education Today published 11% of the articles (n = 26), followed by BMC Medical Education (5%, n = 13). Nursing and Medical students account for the largest population groups studied. Analysis of the articles resulted in seven themes: Evaluation of existing courses (30%, n = 73) being the most frequently identified theme. Only seven comparative articles showed cultural implications, but none provided direct evidence of the impact of culture on clinical reasoning. We illuminate the potential necessity of further research in clinical reasoning, specifically with a focus on how clinical reasoning is affected by national culture. A better understanding of current clinical reasoning research in Asian cultures may assist curricula developers in establishing a culturally appropriate learning environment.

Chinese medical students' disposition for critical thinking: a mixed methods exploration

BACKGROUND

Critical thinking (CT) is an essential competency for medical students. This study's aim was to evaluate Chinese medical students' disposition for CT and to explore the impact of current trends in medical education on students' CT development.

METHODS

We used multistage stratified cluster sampling to recruit a total of 1241 medical students among five different years of training and from three medical institutions in China. The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) and self-reported information were used to collect cross-sectional data. Based on the data from the CTDI-CV, 112 medical students in clinical course training from a single institution continued one-year follow-up. Their one-year CTDI-CV score changes were collected regarding various medical education variables.

RESULTS

The mean CTDI-CV score of the 1241 medical students was 287.04 with 729 (58.7%) students receiving a score of 280 or higher. There were statistically significant differences in schools attended(F = 3.84, P < 0.05), year of school attended(F = 10.32, P < 0.001), GPA(F = 6.32, P < 0.01), weekly time spent learning after class(F = 14.14, P < 0.001), attitude toward medicine(F = 28.93, P < 0.001), desire to be a doctor after graduation(t = - 3.35, P < 0.001), familiarity with CT(F = 20.40, P < 0.001), and perception of importance of CT(F = 22.25, P < 0.001). The participants scored the highest on the CTDI-CV subscales of "inquisitiveness" and the lowest on "truth seeking." The 112 students in the longitudinal study had significantly lower total CT scores after one academic year follow-up.

CONCLUSIONS

Chinese medical students generally exhibited positive CT dispositions. The cross-sectional survey and one-year longitudinal study indicated that students' CT disposition diminished as they progressed through traditional medical training. Our study contributes to understanding the status of Chinese medical education of and influential factors on medical students' CT disposition.

Trajectory of growth in Taiwanese nursing students' professional self-concept over two years and its association with critical thinking and class climate

BACKGROUND

Nursing is a practice-oriented profession, and the goal of education is to cultivate confidence and assertiveness for future clinical practice. Nurturing a professional self-concept at school is expecting to help students to approach their success in the nursing profession.

PURPOSE

Using a hierarchical model associated with critical thinking, academic achievement, class climate, and work experience, this longitudinal correlational study explored the growth trajectory of professional self-concept over two years in students attending 2- or 4-year baccalaureate nursing programs.

METHOD

This was a longitudinal and correlational study with five repeated measurements. Questionnaire data were collected by using the Chinese version of the Nurses Self-Concept Instrument (NSCI-C) and the California Critical Thinking Disposition Inventory (CCTDI).

RESULTS

Scores for overall professional self-concept ranged from 84.51 (standard deviation [SD] 12.34) when the students began this study to 89.28 (SD 11.23) at graduation. Hierarchical linear modeling yielded the growth trajectory of professional self-concept was significantly associated with time (β = 0.93, p < .01), CCTIDI (β = 0.13, p < .001), and class climate (β = 5.20, p < .01). An intraclass correlation coefficient was 55.48%.

CONCLUSION

This study confirmed the positive growth trajectory of the professional self-concept in the nursing students' two academic years. The continuous development of the professional self-concept of nursing students is encouraged. Development of critical thinking through their studies, feelings of belonging in their classes, and campus culture all contributed to this trend. To construct a comprehensive hierarchical model, future investigations should use large sample sizes from various classes and conduct multisite evaluations.

Comparing the effects of traditional lecture and flipped classroom on nursing students' critical thinking disposition: A quasi-experimental study

BACKGROUND

One of the most principal key aims of nursing education is to promote nursing students' and nurses' critical thinking. Therefore, nursing education needs to develop an appropriate curriculum and use effective instructional strategies for critical thinking promotion. Flipped classroom is a teaching method which substitutes individual learning for group learning in a dynamic, interactive environment where the teacher guides students to understand and use concepts.

OBJECTIVES

The present study aimed to compare the effects of traditional lecture and flipped classroom on Iranian nursing students' critical thinking disposition.

METHODS

This nonequivalent control group pretest-posttest quasi-experimental study was done in 2016 on 85 second-year bachelor's nursing students who had signed up for the Musculoskeletal Medical-Surgical Nursing theoretical training course. Because of their large number, students had been divided at the beginning of the first semester of their four-year program into two 42- and 43-student groups and attended separate theoretical training classes. These two classes were randomly allocated to either a traditional lecture or a flipped classroom group. The instructional strategies in these groups were the traditional lecture and the flipped class strategies, respectively. A demographic questionnaire and Ricketts' Critical Thinking Disposition Inventory were used for data collection.

RESULTS

After the intervention, the mean scores of critical thinking disposition and its engagement domain in the flipped class group were significantly higher than the traditional lecture group (P < 0.0001).

CONCLUSIONS

This study shows the positive effects of flipped classroom on nursing students' critical thinking disposition. It is recommended that future studies assess the effects of flipped classroom on other nursing education outcomes.

Promoting emotional intelligence and resilience in undergraduate nursing students: An integrative review

OBJECTIVE

To synthesize the evidence that explored resilience and emotional intelligence in undergraduate nursing students.

BACKGROUND

Nursing is a demanding profession that offers unique challenges. Emotional intelligence and resilience are traits that can allow nursing students to effectively respond to challenges in professional placements and future practice.

DESIGN

An integrative review incorporating both quantitative and qualitative research designs.

DATA SOURCE

Studies in the English language were identified through a systematic search in electronic databases: CINAHL, PubMed, ERIC, Scopus and PsycINFO. No restriction dates were used and the search was up until November 1, 2017.

REVIEW METHODS

Methodological quality was assessed using the Critical Appraisal Skills Programme checklist for qualitative research and the Newcastle-Ottawa Quality Assessment Scale for quantitative research. Data analysis was conducted based on the integrative review method.

RESULTS

Fourteen articles were included. A positive relationship was found between resilience and performance in undergraduate studies including professional experience placements. While some studies observed an important role for emotional intelligence for nursing students, there is currently insufficient evidence to conclude that emotional intelligence improves nursing students' communication, academic success and retention.

CONCLUSION

Developing skills, such as resilience, as part of nursing programs allows students to be better prepared to deal with the unique challenges in nursing practice.

Learning styles preferences and e-learning experience of undergraduate dental students

Abstract Introduction Education in the health sciences has been undergoing profound changes due to the incorporation of information and communication technologies. Students learn through a variety of approaches, according to their learning styles. Blended learning, which combines technology-aided learning (e-learning) with traditional face-to-face teaching methods, has been found to improve learning outcomes. Objective The aims of the present study were to evaluate the learning styles of undergraduate dental students and their experience towards the use of e-learning. Material and method Two electronic questionnaires were sent to 174 students. The learning styles were determined by the Felder & Soloman Index (ILS), which evaluates the following four dimensions of learning: processing information (active-reflexive); perceiving information (sensorial-intuitive); receiving information (visual-verbal); and understanding information (sequential-global). To determine the e-learning experience we used four questions (Likert scale – five-point) which addressed the experience and the use of information and communication technologies. Result Most students presented a well-balanced style for the active-reflective (60%) and sequential-global (68%) domains. The sensing style (64%) was predominant. A lower percentage presented a global characteristic (9%). We did not find significant differences regarding the age groups (19-21 and 22-33 years) and genders (P>0.05, χ 2). However, in terms of age the difference was significant concerning websites helping in learning (P=0.0363, Mann-Whitney). Conclusion We conclude that the students do not have the same learning styles and e-learning experience. Methods such as blended learning could provide advantages when teaching undergraduate dental students.

Assessing Learning Styles of Graduate Entry Nursing Students as a Classroom Research Activity: A quantitative research study

BACKGROUND

A number of studies across different disciplines have investigated students' learning styles. Differences are known to exist between graduate and baccalaureate nursing students. However, few studies have investigated the learning styles of students in graduate entry nursing programs. .

OBJECTIVES

Study objective was to describe graduate entry nursing students' learning styles.

DESIGN/SETTING/PARTICIPANTS/METHODS

A descriptive design was used for this study. The Index of Learning Styles (ILS) was administered to 202 graduate entry nursing student volunteers at a southwestern university. Descriptive statistics, tests of association, reliability, and validity were performed. Graduate nursing students and faculty participated in data collection, analysis, and dissemination of the results.

RESULTS

Predominant learning styles were: sensing - 82.7%, visual - 78.7%, sequential - 65.8%, and active - 59.9%. Inter-item reliabilities for the postulated subscales were: sensing/intuitive (α=0.70), visual/verbal (α=0.694), sequential/global (α=0.599), and active/reflective (α=0.572). Confirmatory factor analysis for results of validity were: χ²(896)=1110.25, p<0.001, CFI=0.779, TLI=0.766, WRMR=1.14, and RMSEA =0.034.

CONCLUSIONS

Predominant learning styles described students as being concrete thinkers oriented toward facts (sensing); preferring pictures, diagrams, flow charts, demonstrations (visual); being linear thinkers (sequencing); and enjoying working in groups and trying things out (active),. The predominant learning styles suggest educators teach concepts through simulation, discussion, and application of knowledge. Multiple studies, including this one, provided similar psychometric results. Similar reliability and validity results for the ILS have been noted in previous studies and therefore provide sufficient evidence to use the ILS with graduate entry nursing students. This study provided faculty with numerous opportunities for actively engaging students in data collection, analysis, and dissemination of results.

Learning Styles: Impact on Knowledge and Confidence in Nursing Students in Simulation and Classroom

Nurse Educators must develop nursing curriculum with engaging learning strategies that promote the knowledge and confidence needed for safe, effective nursing practice. Faculty should explore new methods of teaching that consider how students learn. Studies have shown mixed results regarding student learning styles, academic achievement, and development of confidence in nursing practice. An experimental study using Felder and Soloman’s (2004). Index of learning styles instrument was conducted to examine nursing student learning styles and their impact on confidence and knowledge in traditional and high fidelity simulation settings. Findings revealed students were more likely to have active, visual, sensing, and sequential learning styles. Student confidence or knowledge did not significantly differ among the learning styles in either simulation or traditional classroom methods. Awareness of learning styles may aid faculty in adapting engaging teaching strategies. Further research is needed with larger samples to identify best approaches to enhance student learning within the context of learning styles.

Exploring the association between parental rearing styles and medical students' critical thinking disposition in China

BACKGROUND

Critical thinking is an essential ability for medical students. However, the relationship between parental rearing styles and medical students' critical thinking disposition has rarely been considered. The aim of this study was to investigate whether parental rearing styles were significant predictors of critical thinking disposition among Chinese medical students.

METHODS

1,075 medical students from the first year to the fifth year attending one of three medical schools in China were recruited via multistage stratified cluster sampling. The Chinese Critical Thinking Disposition Inventory(CTDI-CV) and The Egna Minnen av Barndoms Uppfostran (EMBU) questionnaire were applied to collect data and to conduct descriptive analysis. Stepwise multiple linear regression was used to analyze the data.

RESULTS

The critical thinking disposition average mean score was 287.44 with 632 participants (58.79%) demonstrating positive critical thinking disposition. Stepwise multiple linear regression analysis revealed that the rearing styles of fathers, including "overprotection", "emotional warmth and understanding", "rejection" and "over-interference" were significant predictors of medical students' critical thinking disposition that explained 79.0% of the variance in critical thinking ability. Rearing styles of mothers including "emotional warmth and understanding", "punishing" and "rejection" were also found to be significant predictors, and explained 77.0% of the variance.

CONCLUSIONS

Meaningful association has been evidenced between parental rearing styles and Chinese medical students' critical thinking disposition. Parental rearing styles should be considered as one of the many potential determinant factors that contribute to the cultivation of medical students' critical thinking capability. Positive parental rearing styles should be encouraged in the cultivation of children's critical thinking skills.

Critical thinking skills in nursing students: a comparison between freshmen and senior students

Background:

Critical thinking is one of the most important concepts in the field of education. Despite studies published on nursing students’ critical thinking skills (CTS), some suggest that there is not enough evidence supporting the relationship between content of nursing education programs and nursing students’ CTS.

Objectives:

Given the existing discrepancies, this study aimed to compare the critical thinking skills of freshmen and senior nursing students.

Patients and Methods:

This comparative study was conducted on 150 undergraduate freshmen and senior nursing students in Kashan University of Medical Sciences, during 2012. The students in the first and the last semesters of their study in nursing were entered in the study using the census method. Data were collected using a questionnaire including questions on demographic data and the California Critical Thinking Skills Test, form B. Data analysis was performed using the SPSS v.13 software. Descriptive statistics were calculated. Moreover, independent sample t-test and Spearman and Pearson’s correlation coefficients were used in the data analysis.

Results:

Both the freshmen and senior nursing students had low CTS. The mean critical thinking scores were 11.79 ± 4.80 and 11.21 ± 3.17 for the freshmen and the senior students, respectively (P = 0.511). Moreover, no significant correlation was found between the students’ score in CTS and their age, gender, high school grade point average (GPA), rank in university entrance examination (RUEE) and interest in the nursing profession.

Conclusions:

The students were low skilled in critical thinking and their CTS did not significantly change during their nursing degree. Thus it may be concluded that the nursing education program did not affect the CTS of its students. Longitudinal studies are suggested for assessing nursing students’ critical thinking over time. Moreover, revising the curriculum and preparing nursing educators for implementing innovative and active teaching strategies are suggested.

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.

Critical thinking dispositions of nursing students in Asian and non-Asian countries: a literature review

Critical thinking disposition represents an inclination of a person to use possessed skills in relation to critical thinking. The trend of critical thinking has been described as inner motivation to solve problems and make decisions by thinking. In nursing as a practical profession, the concept of critical thinking dispositions is important component in helping to manage complex health situations and to deal with patient issues effectively. Willingness to think critically is a prerequisite for safe and subtly performance. The results of studies show critical thinking dispositions of nursing students in Asian countries are different from non-Asian countries. Aim of this literature review was to compare critical thinking dispositions of nursing students in Asian and non-Asian countries. Literature review was done in English and Persian databases. The results showed of the 795 articles published in English and Persian language that studied critical thinking, 73 ones studied critical thinking skills and dispositions in nursing education, and relationship between teaching methods and critical thinking skills and dispositions in nursing education of different countries. Fifteen of seventy three articles assessed critical thinking dispositions in nursing students. Limited studies showed that the Asian nursing students had mostly undermining score of the critical thinking dispositions, while non-Asian countries tend to positive scores. The reasons for these differences could be due to issues such as environmental, educational methods and cultural differences. However, future studies should measure critical thinking disposition by discipline-based tools.

A prospective cohort study examining the preferred learning styles of acute care registered nurses

OBJECTIVES

This paper reports on the preferred learning styles of Registered Nurses practicing in acute care environments and relationships between gender, age, post-graduate experience and the identified preferred learning styles.

METHODS

A prospective cohort study design was used. Participants completed a demographic questionnaire and the Felder-Silverman Index of Learning Styles (ILS) questionnaire to determine preferred learning styles.

RESULTS

Most of the Registered Nurse participants were balanced across the Active-Reflective (n = 77, 54%), and Sequential-Global (n = 96, 68%) scales. Across the other scales, sensing (n = 97, 68%) and visual (n = 76, 53%) were the most common preferred learning style. There were only a small proportion who had a preferred learning style of reflective (n = 21, 15%), intuitive (n = 5, 4%), verbal (n = 11, 8%) or global learning (n = 15, 11%). Results indicated that gender, age and years since undergraduate education were not related to the identified preferred learning styles.

CONCLUSIONS

The identification of Registered Nurses' learning style provides information that nurse educators and others can use to make informed choices about modification, development and strengthening of professional hospital-based educational programs. The use of the Index of Learning Styles questionnaire and its ability to identify 'balanced' learning style preferences may potentially yield additional preferred learning style information for other health-related disciplines.

An exploratory study of the relationship between age and learning styles among students in different nursing programs in Taiwan

The purpose of this study was to identify the relationship between learning styles and age among nursing students in a two-year, a five-year associate degree of nursing (ADN) program, and a two-year bachelor of science in nursing (BSN) program in Taiwan. The Chinese version of the Myers-Briggs Type Indicator (MBTI) Form M was used to measure individual preferences in four dichotomous dimensions of Jungian theory: extraversion/introversion, sensing/intuition, thinking/feeling, and judging/perceiving. The study sample included 331 nursing students. The analysis of the data revealed that the most common learning styles were introversion, sensing, thinking, and judging (ISTJ) and introversion, sensing, feeling, and judging (ISFJ). The findings indicated that the SJs comprised 43.0% of the participating nursing students. SJs are highly preferred in the field of nursing. However, the ages of nursing students were not significantly related to their learning styles. The findings suggested that the participating nursing students were homogeneous. We recommend the use of a large sample for further studies. The awareness and understanding of individual differences is of great importance in tailoring each learning style to benefit educators and learners, thereby enhancing nursing education.

Dundee Ready Education Environment Measure: psychometric testing with Chinese nursing students

AIM

This paper is a report of the psychometric testing of the Dundee Ready Education Environment Measure with Chinese nursing students.

BACKGROUND

Although the Dundee Ready Education Environment Measure has been widely used to measure educational environments in the healthcare professions, no psychometric evaluation of the measure with Chinese nursing students has been reported.

METHOD

Data from 214 nursing students were collected during a 2-month period between December, 2004 and January, 2005. Exploratory factor analysis, internal consistency reliability and Cronbach's alpha were examined.

RESULTS

Five factors were found by principal components analysis with Oblimin with Kaiser Normalization rotation. The original factor names were maintained, but items in each factor changed. These five factors all achieved eigenvalues >1, and in total accounted for 52.186% of the variance. Cronbach's alpha ranged from 0.623 to 0.9 across factors, with an overall alpha of 0.949.

CONCLUSION

The Chinese version of the Dundee Ready Education Environment Measure could be a valuable measurement for nursing educators in professional development programmes and nursing curriculum design. Further studies need in different Chinese nursing schools and larger sample sizes to be conducted to validate its stability and factor structure.