Exploring Factors Influencing Critical Thinking Skills in Undergraduate Nursing Students: A Mixed Methods Study

Health science education has been moving towards a model of Interprofessional Education in order to meet the increasing demands of Interprofessional Practice in Healthcare, which focuses on delivering high quality patient centered care. This model of Healthcare will lead to improved patient outcomes and overall efficiency of healthcare. Another integral component between effective health care practice and the education of health professional students is the development of critical thinking skills. In order for healthcare professionals to communicate effectively with their patients and their families and also with one another, as in interprofessional practice, critical thinking skills are required. Therefore, critical thinking would be necessary for interprofessional education and subsequently interprofessional practice. Critical thinking in the different health professions needs to be addressed in order for interprofessional education and practice to be effective. Critical thinking is a multi- faceted concept and is influenced by a variety of factors. However, throughout the literature on critical thinking, the influence of these factors is not consistent. The primary purpose of this study is to identify the factor(s) that influence critical thinking skills in health science professional students. A concurrent triangulation mixed methods design was used in order to collect both quantitative and qualitative data concurrently and with equal weight. The quantitative design is descriptive and cross sectional, exploratory, and experimental to gather survey data on critical thinking scores and the potential factors influencing critical thinking. The qualitative design is a one phase convergent design to obtain different but complementary data on the same topic and to validate the quantitative with the qualitative to better understand the problem. One hundred and forty students from three private Universities’ accredited BSN programs participated in this study. Study results revealed that the overall critical thinking score of undergraduate nursing students was a moderate level as measure by the Health Science Reasoning Test (HSRT). There is a significant but weak relationship between critical thinking and job shadowing experiences (p= 0.10), between critical thinking and club involvement (p=.003), and between critical thinking and athletics (p=0.035). Students involved in clubs had significantly higher overall critical thinking scores than students not involved in clubs (p= 0.002). Students involved in athletics had significantly higher critical thinking scores than students not involved in athletics (p= 0.050). Surprisingly, the stepwise regression analysis revealed only 10% of the variance in the critical thinking scores due to the involvement of clubs and healthcare experience through job shadowing. Therefore, the difference in critical thinking scores must be due to other factors not explored here, and factors not predominantly mentioned in the literature as well. The qualitative component of the study revealed that the students were involved in more teacher centered learning activities and did not have a strong understanding of what critical thinking is and its importance. This study lends support to the position that student centered learning will foster the development of critical thinking skills. The more interactive learning strategies, and opportunities for the students to form social and academic networks, the greater the development of critical thinking skills. Therefore by engaging in the active learning opportunities, the students will have the opportunity to further develop critical thinking skills by practicing and applying these skills, ultimately making them more productive, collaborative members of interprofessional education and practice