Critical Thinking in Associate Degree Nursing Education
Problem. This study sought to investigate the level of critical thinking (CT) of the associate degree in nursing (ADN) students and the relationship of CT and clinical judgment (CJ) with selected pre-admission and exit variables. Method. A convenience sample of 112 ADN students (79 generic, 33 non-traditional) at a small, private liberal arts college on the West Coast participated in this exploratory study. The California Critical Thinking Skills Test (CCTST) was used to measure the level of CT, and CJ was measured using the Clinical Decision Making in Nursing Scale (CDMNS). Differences between the generic and non-traditional groups were explored using t tests for independent samples. Correlational tests were used to determine the relationships between the different measures of CT, the selected variables, and CJ. Multiple linear regression was used to examine the effect of the various independent variables, separately or together, on the dependent variable of CT. Results. The graduates of the ADN program scored lower on the CCTST than the standard that was used from the Facione (1997) aggregate study. The CT scores significantfy correlated with the entrance variables of Nurse Entrance Test, Institutional Research scores, gender. Adventist high-school experience, and CNA experience, and with the exit variables of NLN Diagnostic Exam, PreRN Exam, nursing GPA and NCLEX (state board exam, pass/frdl). There was no significant correlation with the CJ scores and the entrance variables, but the exit variable of NLN had significant negative correlation. Several significant differences were found between the generic and non-traditional groups. This study failed to show a significant relationship between CT and CJ as measured by the CCTST and the CDMNS. Conclusions. This study supports the need for a clear, standard definition of both CT and CJ. A consensus of what critical thinking and clinical judgment are and how the two constructs are related is essential before they can be measured and minimum standards can be set. Continued research is needed to sort out the relationship so that nursing education curriculum can be guided to prepare graduates with the appropriate levels of critical thinking that result in good clinical judgments.
Educational Assessment, Evaluation, and Research, Nursing
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