Critical Thinking Disposition and the achievement of critical thinking outcomes in SCPHN education

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Critical Thinking Disposition and the
achievement of critical thinking outcomes in
SCPHN education

• An assessment and exploration of Critical
  Thinking Disposition (CTD) of Specialist
  Community Public Health Nursing Students on a
  Distance Learning Programme
• Funding Source
• Higher Education Academy for Health Sciences

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Definition of Critical ThinkingAPA Delphi Study
1990

• ..purposeful, self-regulatory judgment which
  results in interpretation, analysis, evaluation,
  and inference, as well as explanation of
  evidential, conceptual, methodological,
  criteriological, or contextual considerations
  upon which that judgment is based

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The Ideal Critical ThinkerAPA Delphi Study 1990

• The Ideal Critical Thinker is habitually
  inquisitive, well-informed, and trustful of
  reason. Open-minded, flexible, fair-minded in
  evaluation, honest in facing personal biases,
  prudent in making judgments, willing to
  reconsider, clear about issues, orderly in
  complex matters, diligent in seeking relevant
  information, reasonable in the selection of
  criteria, focused in enquiry, and persistent in
  seeking results which are as precise as the
  subject and circumstances of inquiry permit.

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Critical Thinking

• CT Disposition the attitudinal basis for the
  internal motivation to think critically
• CT Skills - interpretation, analysis,
  explanation, evaluation, inference and
  metacognition
• Why focus on disposition ? (John Dewey)
• Different conceptualisations e.g. Tishman
  Andrade, Perkins, Paul Elder, Facione et al
• Important in learning
• CT skills dispositions synergistic
• Faciones conceptualisation of CTD APA basis
  tools

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Definitions of CTD Elements (Facione 2004)

• Truthseeking
• Intellectual honesty the desire for best
  knowledge, the inclination to ask challenging
  questions and to follow reason and evidenceeven
  if it fails to support or undermines existing
  knowledge/beliefs and interests
• Open-mindedness
• Tolerance for new ideas and divergent views,
  self-monitoring for biases

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Definitions of CTD Elements (Facione 2004)

• Systematicity
• Inclination towards valuing of being organised
  e.g. ability to focus and stay focused, diligence
  in approaching problems
• Critical Thinking Self-confidence
• Trust in ones own reasoning abilities and
  capacity to guide others in decision making

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Definitions of CTD Elements (Facione 2004)

• Analyticity
• Anticipation of and/or alertness to actual or
  potential problems /consequences being aware of
  when there is a need to use reason and evidence
  to solve problems demanding its application
• Inquisitiveness
• Intellectual curiosity, eagerness willingness
  to learn things even when the immediate
  application of these things is not obvious

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Definitions of CTD Elements (Facione 2004)

• Cognitive Maturity
• Capacity to make, suspend, or revise judgements
  that enable the complexity of problems to be
  appreciated and to make decisions carefully and
  cautiously. Awareness of possibility of multiple
  solutions and need to sometimes reach conclusions
  in absence of complete knowledge.

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Research Questions

• Are SCPHN students disposed towards critical
  thinking?
• What are SCPHN students views on CTD testing?
• What do students think the determinants of
  Critical Thinking Disposition are?
• How do students think their CTD can be developed?

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Approach Methods

• Mixed method 2 phase sequential explanatory
  design
• Survey California Critical Thinking Disposition
  Inventory (CCTDI) on-line
• Population sample 151 students (OHN HV) on
  a distance learning programme
• Qualitative exploration using interviews with a
  convenience sample of 4 respondents (all female).

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Quantitative Data Collection

• CCTDI - 75 item agree-disagree 6 point likert
  scale
• Total scores 0-420 sub-scales scores of 0-60
• Validity reliability (CA 0.89)
• /gt 280 is ve disposition, 210-279 ambivalence
  towards CTD, lt210 indicates a -ve disposition
• Sub-scales scores of /gt50 strongly ve /gt40
  are positive 31-39 are ambivalent /lt30 are
  weak
• Positive overall disposition requires scores of
  gt/40 in all sub-scales
• Pre-warning electronic invitation CCTDI
  (on-line) through insight assessment.com

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Quantitative Findings (N56)Limitations
response rate possible biases

• Mean Age 39.5 25 with first degree 48 lt3
  modules 98gt 5 years post-reg.
• Mean Total CTD Score 289.9
• Total scores negatively skewed wide range
  (207-350)
• Sub-scales Mean sub-scale scores for truth
  seeking systematicity ambivalent (lt40 but gt30)
  widest score ranges in systematicity, CT
  self-confidence, cognitive maturity, truth
  seeking
• TS mean gt than Faciones for all years but not
  returning licensed nurses (RLN)
• All others (total sub-scales scores) lt
  Faciones for all years RLN (312.8 n333)

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Qualitative Findings

• Students found testing interesting valuable for
  CT orientation
• Life experiences, home environment, cultural
  background, gender, professional socialization,
  work culture, personality and confidence were
  identified as CTD determinants
• Higher education experience was seen to promote
  CTD by supporting questioning and developing
  confidence to question
• CTD depends on learning environments and
  relationships that support dialogue and
  questioning
• Organisation disposition (systematicity) was
  linked to organisation skills learning autonomy

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Qualitative Findings

• Research appraisal skills were seen to be a
  positive determinant of CTD
• Participants related organisation disposition
  (systematicity) to organisation skills and
  learning autonomy - they saw the need for a
  balance between course structure flexibility
• Distance learning students value opportunities
  for face to face dialogue

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Conclusions

• Some SCPHN students are ambivalent or negatively
  disposed towards CT
• Not all students live and/or work in cultures
  and/or have relationships that support CTD
• Higher education can develop CTD by providing
  questioning opportunities developing confidence
  to question theory practice
• Learning environments and relationships must be
  supportive of dialogue and questioning

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Conclusions

• Research appraisal skills may enhance CTD
• CTD testing with follow on dialogue may support
  development
• Distance learning may be challenging for students
  with deficits in systematicity
• Promoting systematicity requires a balance
  between course structure flexibility
• Having to develop organisation skills promotes
  systematicity
• CTD development depends on internal motivation
  based on a belief that development is possible

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Recommendations

• CTD testing with follow on dialogue may support
  CTD development
• Sociological psychological determinants of CTD
  should be explored with students and educators
• Dispositional strengths could be used to address
  deficits - truth-seeking systematicity may be
  deficits in SCPHN students
• Research appraisal skills may help address
  deficits in truth-seeking systematicity

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Recommendations

• Learning autonomy may develop systematicity
  organization skills
• Blended (face to face on-line delivery) may
  develop CTD better than fully on-line delivery
• Feedback development should address both skills
  dispositions in tandem
• Differentiated support in academic and practice
  learning may be required to support CTD
  development
• Students with negative CTD scores may need
  development before SCPHN education

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Data Collection

• Quantitative
• CCTDI - Established face, content, construct
  validity reliability, some issues re
  reliability of some sub-scales
• Correlates with ego-resilience (r0.58)
  openness to experience (r0.37) p 0.001 N198
  (Facione et al 1997)
• Used extensively in nurse education other HE
  studies
• Qualitative
• Semi-structured interviews on test experience
  factors perceived to affect CTD and its
  development

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Critical Thinking in NursingEmphasis on
Disposition Application in Practice

• An essential component of professional
  accountability and quality nursing care. Critical
  thinkers in nursing exhibit these habits of mind
  confidence, contextual perspective, creativity,
  flexibility, inquisitiveness, intellectual
  integrity, intuition, open-mindedness,
  perseverance, and reflection.
• Scheffer and Rubenfeld (2000)

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Summary of Literature Review

• CT essential in clinical judgements critical
  reflection
• Reflective critical thinking important in
  education for public health (nursing)
  assessment of need, design of interventions
  evaluation
• For CT both dispositions and skills matter -
  synergistic - lack of CTD limits CT skills
  development
• CTD variation within student practising nurse
  populations
• Limitations in truth seeking common
• Evidence of linkage between CTD and research
  utilisation

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Summary of Literature Review

• Socio-cultural and political factors as
  determinants of CT
• Limitation in knowledge of CT skills CTD in
  nursing populations due to
• definition and measurement debates (applied CT or
  theoretical CT)
• validity reliability of measurement tools
• small studies with convenience samples
• lack of longitudinal studies

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Summary of Literature Review

• Evidence largely derived from pre-registration
  nursing students in the North America e.g.
  Facione et als (1997) meta-study (CCTDI
  CCTST)
• Ambivalent truth seeking scores in nursing
  students
• Pre-post group (n171) significant (0.05) gains
  in total CTD, truth-seeking, analyticity
  critical thinking self-confidence
• Impact of education on licensed nurses returning
  to study - CTD diminished (312.8 309.3)
• Lack of CTD evidence to inform UK
  post-registration nurse education, including DL
  SCPH nurse education