Elsevier

Nurse Education Today

Volume 45, October 2016, Pages 16-21
Nurse Education Today

Comparing the effects of problem-based learning and the traditional lecture method on critical thinking skills and metacognitive awareness in nursing students in a critical care nursing course

https://doi.org/10.1016/j.nedt.2016.06.007Get rights and content

Highlights

  • The PBL approach can help develop metacognitive awareness in nursing students.

  • The PBL approach improves the critical thinking skills of undergraduate nursing students for the theoretical course of Critical Care Nursing, thereby preparing them for clinical practice.

  • The PBL students had a significantly greater improvement on the overall California Critical Thinking Skills Test, evaluation, and deduction subscale scores compared with the lecture students.

Abstract

Background

Problem-based learning (PBL) is a method used to develop cognitive and metacognitive skills in nursing students.

Objectives

The present study was conducted to compare the effects of PBL and the traditional lecture method on critical thinking skills and metacognitive awareness in nursing students in a critical care nursing course.

Design

The present study was conducted with a quasi-experimental, single group, pretest-posttest design.

Methods

A group of third-year nursing students (n = 40) were recruited from Khorramabad School of Nursing and Midwifery in the west of Iran. The lecture method was used in one group over the first eight weeks of the first semester and PBL was adopted in the second eight weeks. Standardized self-report questionnaires including The California Critical Thinking Skills Test-B (CCTST-B) and the Metacognitive Awareness Inventory (MAI) were administered before and after the use of each of the instruction methods. Data were analyzed in SPSS using the paired t-test.

Findings

No significant changes were observed in the students' critical thinking skills and metacognitive awareness after performing the lecture method. However, a significant increase was observed in the overall critical thinking score (P < 0.01) and its sub-scales of evaluation and deduction (P < 0.05) and in the overall metacognitive awareness score (P < 0.001) after performing the PBL method.

Introduction

In the rapidly advancing healthcare environment of the contemporary society, professional nurses (Kong et al., 2014) and nursing students need to develop their critical thinking skills as a way to prepare for greater expertise in flexible, individualized, situation-specific problem-solving (Klunklin et al., 2011, Kong et al., 2014). Accrediting agencies urge nursing education to present a curriculum that trains students with high levels of cognitive and metacognitive skills, such as critical and reflective thinking skills (Josephsen, 2014).

Section snippets

Literature Review

Critical thinking is a purposeful, self-regulatory judgment that results in interpretation, analysis, evaluation and inference (Hajrezayi et al., 2015). Critical thinking is a major component of the discipline of nursing as well as nursing education (Kong et al., 2014). Walsh and Seldomridge have confirmed the positive effects of critical thinking on the quality of care provided to patients (Burrell, 2014). A study conducted by Moghadam identified the relationship between fostering critical

Study Design

The present study is quasi-experimental, single-group and pre-test-post-test in design.

Study Subjects

All the 40 third-year undergraduate nursing students who had registered for the course of Critical Care Nursing at School of Nursing and Midwifery (in Khorramabad, the administrative town of Lorestan province in the west of Iran) in the second half of the academic year 2012–2013 were invited to take part in the study. These students met the study inclusion criteria, including having registered for the

Results

Of the total of 40 students, 62.5% (n = 25) were female and 37.5% (n = 15) were male, a total of 70.3% of whom were local to Lorestan province and 29.7% were not. The mean age of the study subjects was 21.89 ± 1.26 years. Their high school GPA was 17.61 ± 1.52 and their university GPA 15.57 ± 1.1. A total of eight students had previously participated in small-group learning settings in their second year at the School of Nursing and Midwifery, but none had recent experience of participation in

Discussion

The results of the present study showed the mean critical thinking and metacognitive awareness scores obtained before and after the lecture to be poor and to not have changed significantly. However, after performing the PBL, significant improvements were observed in the overall mean score of critical thinking and its sub-scales of deduction and evaluation and also in the overall mean score of metacognitive awareness in the nursing students surveyed. Previous studies have also shown that using

Conclusion

The present study showed a statistically significant effect for the PBL method on the development of critical thinking skills and metacognitive awareness in nursing students; however, the management of the class and the details of the implementation of PBL are essential for the further development of these skills. Nursing educators can utilize strategies such as concept mapping, questioning, dynamic group sessions, reflective writing, journaling and case-based interventions in their performing

Funding

This project was funded by the School of Nursing and Midwifery, Lorestan University of Medical Sciences (1182), Khorramabad, Iran.

Financial Disclosure

The authors declare that they have no conflict of interest.

Conflict of Interest

The author reports no financial or other conflict of interest pertaining to the subjects or products discussed in this article.

Acknowledgements

The authors would like to thank all the student participants in this research study.

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