Development of Critical Thinking in Nursing Students in ...

1 Running head: Development OF Critical Thinking IN Nursing Students Development of Critical Thinking in Nursing Students in the Classroom Setting A Dissertation submitted by Stacy Werner RN, MSN, (C) to College of Saint Mary in partial fulfillment of the requirements for the degree of DOCTOR OF EDUCATION This dissertation has been accepted by the faculty of College of Saint Mary by: Development OF Critical Thinking IN Nursing Students 2 We hereby certify that this Dissertation by Stacy Werner, conforms to acceptable standards and fully fulfills the Dissertation requirements for the degree of Doctor of Education from College of Saint Mary Dr.

2 Lois Linden Chair Dr. Virginia Tufano Committee member Dr. Marcie Kemnitz Committee member Development OF Critical Thinking IN Nursing Students 3 Copyright Date, 2016 Stacy Werner, RN, MSN (C) Development OF Critical Thinking IN Nursing Students 4 Dedication Page This is dedicated to Steve, my husband, for not letting me quit. You are my rock!!!! Development OF Critical Thinking IN Nursing Students 5 Acknowledgement Page I would like to first of all thank my God who was with me every step of the way throughout this process.

3 Through the good times, and the bad, but You always brought me through. Secondly, I want to thank my husband, Steve. He has always been there for me through each one of my educational endeavors. He has always been supportive and encouraging. He never let me get down. I want to thank my boys, Jacob and Will for sticking with Mom even when she was stressed because of school. Thank you to all of my supportive committee, colleagues, and friends. Thank you for keeping me going on the down days and continuing to tell me that I could do this.

4 I can do all things through Christ who strengthens me. Philippians 4:13 Development OF Critical Thinking IN Nursing Students 6 Table of Contents Abstract 12 CHAPTER I: INTRODUCTION 13 Background 13 Significance 15 Summary 17 Problem Statement 18 Purpose Statement 21 Research Questions 22 Operational Definitions 24 Assumptions, Delimitations, Limitations 28 Conclusion 29 CHAPTER II: LITERATURE REVIEW 31 History of Critical Thinking 31 Conceptual Framework 32 Facione 32 Paul & Elder 36 Concept Analysis 40 Historical Perspective 45 Teaching Critical Thinking Background 48 Definitions of Critical Thinking 52 Research Review 56 Development OF Critical Thinking IN Nursing Students 7 Understanding Meaning 56 Teaching Methods 65 Conclusion 78 CHAPTER III.

5 METHODS AND PROCEDURES 79 Research Design 79 Data Collection Methods 81 Participants/Sample and Setting 82 Online Survey Procedure 83 Interview Procedures 85 Ethical Considerations 87 Data Quality Measures 88 Data Analysis Procedure 90 Conclusion 91 CHAPTER IV: RESULTS 92 Introduction 92 Data Analysis 94 Themes 97 Summary of Analysis 114 CHAPTER V: DISCUSSION AND SUMMARY 116 Research Questions 116 Interpretation 142 Development OF Critical Thinking IN Nursing Students 8 Central Research Question 144 Overall Interpretation 147 Recommendations 148 Limitations of the Study 150 Future Research 151 Summary 153 References 154 Appendix A 165 Appendix B 168 Development OF Critical Thinking IN Nursing Students 9 LIST OF TABLES TABLE

6 PAGE Essential Intellectual Definitions of Critical Community Colleges in Nebraska .. 83 Development OF Critical Thinking IN Nursing Students 10 LIST OF FIGURES FIGURE PAGE Summary of Background 18 Research Question Model 24 Facione s Conceptual Framework 35 Teaching Critical Thinking Representation 45 Historical Perspective 48 Teaching Critical Thinking Background Summary 52 Understanding Meaning Summary 65 Teaching Methods Summary 77 The Data Analysis Spiral 93 Research Question Model

7 96 Teaching Methods Themes 98 Effectiveness of Teaching Methods Themes 101 Challenges to Integrating Themes 105 Attributes of Critical Thinkers Themes 109 Meaning of Critical Thinking Themes 111 Themes Link to Lived Experience 115 Research Question Model 116 Research Question Teaching Methods 120 Research Question Meaning 126 Development OF Critical Thinking IN Nursing Students 11 Research Question Attributes 130 Research Question Challenges 134 Research Question Effectiveness 139 Central Research Question Analysis 147 Development OF Critical Thinking IN Nursing Students 12 Abstract Changes in the healthcare industry have created a climate where Nursing no longer occurs only in the hospital, but occurs in more diverse settings.

8 These changes have revealed a need for changes to occur in how Nursing Students are taught in the classroom, and how Students develop Critical Thinking . Consequently, for these changes to occur it is important to examine the concept of Critical Thinking more closely, by viewing how Critical Thinking is developed in the classroom setting. Therefore, the purpose of this phenomenological qualitative research study was to identify the lived experiences of Nursing educators assisting Nursing Students to develop Critical Thinking skills within the classroom at community college ADN programs in Nebraska.

9 Nursing educators from six community colleges in the state of Nebraska who possessed a BSN, MSN or are making progress toward completing an MSN were emailed a link to a survey. Participants were asked survey questions that pertained to the lived experience of Critical Thinking , which included describing the meaning of Critical Thinking , teaching methods used to enhance Critical Thinking in the classroom, effectiveness of teaching methods, attributes necessary for Students to be able to critically think, and challenges of integrating Critical Thinking into the classroom setting.

10 Participant responses were analyzed which led to the Development of themes for each sub question and central research question. Themes were compared to the operational definitions that were derived from the literature, which inadvertently led to the Development of a model illustrating the lived experience of Critical Thinking in the classroom setting. Development OF Critical Thinking IN Nursing Students 13 Chapter I Introduction Background Over the past several years the healthcare system has significantly changed due to technological advances, changing patient demographics, and an economic climate that has many patients and families postponing when they seek health care (Giddens, 2007).