JBI Database of Systematic Reviews & Implementation Reports
2015;13(2) 26 - 36
The effectiveness of teaching strategies for the development of critical thinking in nursing undergraduate students: a systematic review protocol
Larissa Bertacchini de Oliveira, BScN
1
Vilanice Alves de Araújo Püschel, BScN, PhD Leidy Johanna Rueda Díaz, BScN
1
1
Diná de Almeida Lopes Monteiro da Cruz, BScN, PhD
1
1. School of Nursing, University of Sao Paulo, Brazil
2. The Brazilian Centre for Evidence-based Healthcare: an Affiliate centre of The Joanna Briggs Institute
Corresponding author: Larissa Bertacchini de Oliveira [email protected]
Review question/objective The review objective is to synthesize the best available evidence on the effectiveness of teaching strategies for the development of critical thinking among nursing undergraduate students. The review question is: What is the effectiveness of teaching strategies in promoting the development of critical thinking in undergraduate nursing students?
Background In 1991, the National League for Nursing (NLN) identified critical thinking (CT) as a core competency 1
in the practice of nursing. Similar to the USA, CT has become a major concern of undergraduate nursing courses, particularly in regards to the way by which professors should instruct their students to think and develop CT. Based on this, the United Nations Educational, Scientific and Cultural 2
Organization (UNESCO, 1998) recommends the introduction of innovative educational approaches that enable the development of critical thinking and creativity. During the 1990s, as sponsored by the Committee on Pre-College Philosophy of the American Philosophical Association (APA), an interdisciplinary group of 46 international experts from the fields of humanities, social sciences, and education met to reach a consensus on CT, which could support
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3
future research work. These experts produced a worldwide recognized report, titled Delphi Report, in which they established that “critical thinking is the purposeful, self-regulatory judgment that leads to interpretation, analysis, evaluation and inference, as well as the explanation of the evidential, conceptual, methodological, criteriological or contextual considerations on which judgment is based”.
3(p.2) 4
According to Huang et al., CT involves higher mental abilities, it is a prerequisite for effective judgment and the expansion of knowledge and is required in a healthcare professional who can be capable of accessing and interpreting information appropriately. With the aim of addressing the challenges of teaching and assessing the CT skills of health professionals, the "North American Millennium Conference on Critical Thinking” was organized. The conference enabled the development of strategies for inclusion in the principles of CT as well as the preparation of methods for assessing CT in the curricula of professions in the health field. The product of this conference culminated in a consensus that includes critical thinking as a core competence for nurses and emphasizes the teaching of this skill by professors.
4
Two literature reviews on nursing education indicated the need to instruct nurses with CT skills has increased as a response to the rapid change in the health care environment.
5-6
According to the
authors, CT is needed not only in the clinical practice environment, but also required as a comprehensive component in Nursing education programs for the development of students’ CT skills.
5-6
7
Chang et al. claim that CT skills had a positive correlation to nurses’ competence.
7
Critical thinking is the focus of interest of professors and researchers around the world, with the need to educate critical and reflective practitioners in knowing how to act and making a difference in society becoming increasingly clear.
1-23
Thus, this systematic literature review aims to evaluate the evidence
available in the literature on the effectiveness of teaching strategies used for the development of CT among undergraduate nursing students. In a preliminary search in the Cochrane Database of Systematic Reviews, Joanna Briggs Institute Library of Systematic Reviews, PubMed, and PROSPERO, three systematic reviews were found,
24,26,27
as well as a protocol for a systematic review related to the effectiveness of strategies for
addressing CT in nursing students. Yuan, Willians and Fan
24
25
conducted a systematic review to identify and gather available evidence on
the development of CT among nursing students by using problem-based learning (PBL). English and Chinese, published within the period from 1990 to 2006, were included.
24
24
Studies in
Evidence has
shown that PBL did not promote the development of CT skills among undergraduate nursing students.
24
Further, Tang and Sung
25
prepared a protocol for systematic review in order to synthesize
the best available evidence on the effectiveness of PBL to address CT with nursing students.
25
For
inclusion in the systematic review, the authors will at first consider experimental studies that used PBL as an intervention strategy for nursing students, and those that assessed CT skills as a result of studying through the means of the California Critical Thinking Disposition Inventory. English and Chinese will be selected. Kong et al.
26
25
Publications in
25
conducted a systematic review and meta-analysis to determine the effectiveness of PBL
to indoctrinate CT among undergraduate nursing students as compared to the strategy of traditional 2
lectures. Nine articles were included in the meta-analysis. Despite the moderate heterogeneity (I =
doi: 10.11124/jbisrir-2015-1073
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45%), the result of the meta-analysis indicated that nursing students who underwent PBL, as compared to those who attended lectures, had significantly higher CT levels (SMD = 0.33; 95%IC= 0.13-0.52; p = 0.0009).
26
The systematic review conducted by Chan
sought to assess how CT is perceived and which
strategies and obstacles are potentially involved in the teaching and learning process of CT among studies with a qualitative design, published between 2002 and 2011.
27
Seventeen studies were
selected from the databases, including The British Nursing Index, Ovid MedLine, CINAHL, PsycINFO, and Scopus.
27
The results showed that the concept of CT has undergone several changes over time,
and there remains a lack of explanation among teachers and students in the field.
27
The teaching
strategies for promoting CT frequently discussed were questioning and reflective writing.
27
The
authors identified a need to conduct a systematic review that assesses the effectiveness of new teaching strategies and interventions for improving the competence of educators to teach CT as well as for promoting CT development among nursing students. As mentioned earlier, studies included in previous systematic reviews on this topic have emphasized on teaching by PBL and have neglected other teaching strategies used in nursing education. This favors the study of only one type of teaching strategy and disfavors comparisons between any other types of existing strategies. Based on this, Chan
27
also indicated the need for a systematic review of quantitative studies to be
conducted, in order to identify the most effective teaching strategies for CT among nursing students that are currently available.
27
Hence, the present systematic review will examine research that
addresses this urgent and current need. Thus, the aim of this systematic review is to highlight the teaching strategies that promote CT in students of undergraduate courses in nursing.
Keywords Critical thinking; undergraduate student; education
Inclusion criteria Types of participants This review will consider studies on undergraduate students at any year level of a nursing program. Undergraduate nursing students from any country, and any undergraduate baccalaureate or baccalaureate equivalent course will also be considered. Types of intervention(s)/phenomena of interest The interventions which this review will examine include, but are not limited to, problem-based 11-15
learning,
16
case study,
17-18
simulation,
19-23
conceptual maps,
and other teaching methods that
specifically address the teaching and development of CT. The review will consider teaching strategies (individuals and/or groups) which were used with undergraduate students in nursing to promote the development of CT. Only studies that implemented and evaluated the effectiveness of such strategies will be included.
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Comparator/control intervention(s) This systematic review will compare studies using in the intervention group any teaching strategies and using in the control group any teaching strategies OR traditional teaching OR no specific intervention. Types of outcomes This review will consider studies that include CT as an outcome measure. It will include but not be limited to studies that assess skills in inference, recognition of assumptions, deduction, interpretation and evaluation, analysis skills, induction, deduction and, critical response development. The specific 28
instruments will include the Watson-Glaser Critical Thinking Appraisal instrument, 29
Critical Thinking Skills Test, 31
Essay,
30
The Cornell Critical Thinking Test,
the California
The Ennis Weir Critical Thinking
32
and the California Critical Thinking Disposition Inventory.
Types of studies This systematic review will consider all randomized controlled trials (RCTs) to determine the effectiveness of teaching strategies for the development of CT in nursing undergraduate students. In the absence of RCTs, other experimental study designs including non-randomized controlled trials, quasi-experimental, before and after studies and observational studies, such as comparable cohort studies, will also be included in the review.
Search strategy The search strategy used for the review will focus on finding articles published in Portuguese, English and Spanish. The search strategy aims to find both published and unpublished studies. A three-step search strategy will be utilized in this review. An initial limited search of MEDLINE and CINAHL will be undertaken, followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. The databases to be searched include: CINAHL PubMed Embase PsycINFO Cochrane Central Register of Controlled Trials (CENTRAL) ERIC LILACS Web of Science Scopus.
doi: 10.11124/jbisrir-2015-1073
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The search for unpublished studies will include: ProQuest Dissertations and Theses Cybertesis Biblioteca Digital de Teses e Dissertações Trove Diva RCAAP- Repositório Científico de Acesso Alberto de Portugal Theses Canada Ethos DART-Europe E-Theses Portal National ETD Portal. Keywords: nursing student, student, undergraduate, baccalaureate and nursing;
problem based
learning, problem based, concept map, conceptual map, conceptual maps, concept maps, conceptual mapping, concept mapping, simulation, case study, learning, teaching, education, nursing education, traditional teaching, lectures, teaching methods and skill; thinking, critical thinking, clinical reasoning, critical judgment and clinical judgment; randomized controlled trial, trial, evaluation study, comparative study, experimental study, observational study, cohort study, pre test, pretest, post test, posttest, quasi-experimental studies.
Assessment of methodological quality Quantitative papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBIMAStARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.
Data collection Data will be extracted from papers included in the review independently by two reviewers, using standardized data extraction tools from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument JBI-MAStARI (Appendix II) Two reviewers will extract data independently for assurance of data accuracy. Discrepancies between the reviewers will be resolved by discussion or where resolution is not successful, by a third reviewer. The data extracted will include precise details about the populations and participant characteristics, inclusion and exclusion criteria, study settings and designs; descriptions of interventions, outcomes measures and results, and the number and reasons for withdrawal and dropout. If there is any data missing in the included studies, the authors will be contacted to retrieve statistical data if possible.
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Data synthesis Quantitative papers, where possible will be pooled in a statistical meta-analysis using JBI-MAStARI. All results will be subject to double data entry. Effect sizes expressed as odds ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals will be calculated for analysis. The presence of heterogeneity will, where possible be assessed statistically using the standard Chi-square and also explored using subgroup analyses based on the different study designs included in this review. Where statistical pooling is not possible the findings will be presented in narrative form including tables and figures to aid in data presentation.
Conflicts of interest The reviewers have no conflicts of interest in conducting this review.
Acknowledgements This study is part of an international partnership project between the School of Nursing of University of São Paulo (Brazil) and the University of Surrey (England) and also interfaces with a multicenter study being developed by members of the Red Iberoamericana de Investigación en Educación en Enfermería (RIIEE) with the focus on identifying teaching strategies employed by teachers to create and foster the nursing students and CT.
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References 1. National League of Nursing. Criteria and guidelines for the education of baccalaureate and higher degree programs in nursing. New York: National League of Nursing; 1991. 2. United Nations Educational, Scientific and Cultural Organization (UNESCO). World Declaration on Higher Education for the Twenty-first Century: Vision and Action. [internet]. Paris; 1998 [cited 2014 Jan. 30]. Available from: http://unesdoc.unesco.org/images/0014/001419/141952e.pdf. 3. Facione PA. Critical thinking: A Statement of Expert Consensus for purposes of Educational Assessment and Instruction – Executive Summary “The Delphi Report”.Califórnia: Santa Clara University;
1990.
[cited
2014
Apr.
01].
Available
from:
http://assessment.aas.duke.edu/documents/Delphi_Report.pdf. 4. Huang GC, Newman LR, Schwartzstein RM. Critical thinking in Health Professions Education: Summary and Consensus Statments of the Millennium Conference 2011. Teach Learn Med. 2014;26(1):95-102. 5. Simpson E, Courtney M. Critical thinking in nursing education: literature review. Int J Nurs Pract. 2002;8(2):89-98. 6. Brunt BA. Critical thinking in nursing: an integrated review. J Contin Educ Nurs. 2005;36(2):60-7. 7. Chang MJ, Chang YJ, Kuo SH, Yang YH, Chou FH. Relationships between critical thinking ability and nursing competence in clinical nurses clinical nurses. J Clin Nurs. 2011;20(21-22):3224-32. 8. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health system in an interdependent world. Lancet. 2010; 376(9756):1923-58. 9. Morrall P, Goodman B. Critical thinking, nurse education and universities: Some thoughts on current issues and implications for nursing practice. Nurse Educ Today. 2013;33(9):935–7. 10. Chan ZCY. A systematic review of critical thinking in nursing education. Nurse Educ Today. 2013;33(3):236-40. 11. Applin H, Willians B, Day R, Buro K. A comparison of competencies between problem-based learning an non-problem-based graduate nurses. Nurse Educ Today. 2011;31(2):129-34. 12. Yuan D, Kunaviktikul W, Klunklin A, Williams BA. Improvement of nursing students' critical thinking skills through problem-based learning in the People's Republic of China: a quasiexperimental study. Nurs Health Sci. 2008;10(1):70-6. 13. Choi E, Lindquist R, Song Y. Effects of problem-based learning vs. traditional lecture on Korean nursing students' critical thinking, problem-solving, and self-directed learning. Nurse Educ Today. 2014;34(1):52-6. 14. Kong LN, Qin B, Zhou YQ, Mou SY, Gao HM. The effectiveness of problem-based learning on development of nursing students' critical thinking: a systematic review and meta-analysis. Int J Nurs Stud. 2014;51(3):458-69. 15. Chan ZCY. Role-playing in the problem-based learning class. Nurse Educ Pract. 2012;12(1):21-7.
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16. Popil I. Promotion of critical thinking by using case studies as teaching method. Nurse Educ Today. 2011;31(2):204-7. 17. Gantt LT. Using the Clark Simulation Evaluation Rubric with associate degree and baccalaureate nursing students. Nurs Educ Perspec. 2010;31(2):101-5. 18. Cant RP, Cooper SJ. Simulation-based learning in nurse education: systematic review. J Adv Nurs. 2010;66(1):3-15. 19. Chen S, Liang T, Lee M, Liao. Effects of Concept Map Teaching on Students’ Critical Thinking and Approach to Learning and Studying. J Nurs Educ. 2011;50(8):466-9. 20. Atay S, Karabacak U. Care plans using concept maps and their effects on the critical thinking dispositions of nursing students. Int J Nurs Pract. 2012;18(3):233-9. 21. Lee W, Chiang CH, Liao IC, Lee ML, Chen SL, Liang T. The longitudinal effect of concept map teaching on critical thinking of nursing students. Nurse Educ Today. 2013;33(10):1219-23. 22. Wheeler LA, Collins SK. The influence of concept mapping on critical thinking in baccalaureate nursing students. J Prof Nurs. 2003;19(6):339-46. 23. Gerdeman JL, Lux K, Jacko J. Using concept mapping to build clinical judgment skills. Nurse Educ in Practice. 2013;13(1):11-17. 24. Yuan H, Willians BA, Fan L. A systematic review of selected evidence on developing nursing students? critical thinking through problem-based learning. Nurse EducToday. 2008;28(6):657-63. 25. Tang L, Sung H. The Effectiveness of problem-based learning on nursing students' critical thinking: a systematic review. JBI Library of Systematic Reviews. 2012;10(57):3907-3916. 26. Kong LN, Qin B, Zhou YQ, Mou SY, Gao HM. The effectiveness of problem-based learning on development of nursing students' critical thinking: a systematic review and meta-analysis. Int J Nurs Stud. 2014;51(3):458-69. 27. Chan ZCY. A systematic review of critical thinking in nursing education. Nurse Educ Today. 2013;33(3):236-40. 28. Watson G, Glaser EM. Watson-Glaser critical thinking appraisal manual. Cleveland: Psychological Corp;1980. 29. Facione PA. The California critical thinking skills test manual. California Academic Press;1992. 30. Ennis RH, Millman J, Tomko TN. Cornell critical thinking tests level X and level Z manual. Pacific Grove: Midwest Publications;1985. 31. Ennis RH, Weir E. The Ennis-Weir critical thinking essay test. Pacific Grove: Midwest Publications;1985. 32. Facione NC, Facione PA. The California critical thinking dispositions inventory test manual. Millbrae: California Academic Press;1992.
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Appendix I: Appraisal instruments MAStARI appraisal instrument
Insert page break
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Appendix II: Data extraction instruments MAStARI data extraction instrument
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The effectiveness of teaching strategies for the development of critical thinking in nursing undergraduate students: a systematic review protocol
Larissa Bertacchini de Oliveira, BScN
1
Vilanice Alves de Araújo Püschel, BScN, PhD Leidy Johanna Rueda Díaz, BScN
1
1
Diná de Almeida Lopes Monteiro da Cruz, BScN, PhD
1
1. School of Nursing, University of Sao Paulo, Brazil
2. The Brazilian Centre for Evidence-based Healthcare: an Affiliate centre of The Joanna Briggs Institute
Corresponding author: Larissa Bertacchini de Oliveira [email protected]
Review question/objective The review objective is to synthesize the best available evidence on the effectiveness of teaching strategies for the development of critical thinking among nursing undergraduate students. The review question is: What is the effectiveness of teaching strategies in promoting the development of critical thinking in undergraduate nursing students?
Background In 1991, the National League for Nursing (NLN) identified critical thinking (CT) as a core competency 1
in the practice of nursing. Similar to the USA, CT has become a major concern of undergraduate nursing courses, particularly in regards to the way by which professors should instruct their students to think and develop CT. Based on this, the United Nations Educational, Scientific and Cultural 2
Organization (UNESCO, 1998) recommends the introduction of innovative educational approaches that enable the development of critical thinking and creativity. During the 1990s, as sponsored by the Committee on Pre-College Philosophy of the American Philosophical Association (APA), an interdisciplinary group of 46 international experts from the fields of humanities, social sciences, and education met to reach a consensus on CT, which could support
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3
future research work. These experts produced a worldwide recognized report, titled Delphi Report, in which they established that “critical thinking is the purposeful, self-regulatory judgment that leads to interpretation, analysis, evaluation and inference, as well as the explanation of the evidential, conceptual, methodological, criteriological or contextual considerations on which judgment is based”.
3(p.2) 4
According to Huang et al., CT involves higher mental abilities, it is a prerequisite for effective judgment and the expansion of knowledge and is required in a healthcare professional who can be capable of accessing and interpreting information appropriately. With the aim of addressing the challenges of teaching and assessing the CT skills of health professionals, the "North American Millennium Conference on Critical Thinking” was organized. The conference enabled the development of strategies for inclusion in the principles of CT as well as the preparation of methods for assessing CT in the curricula of professions in the health field. The product of this conference culminated in a consensus that includes critical thinking as a core competence for nurses and emphasizes the teaching of this skill by professors.
4
Two literature reviews on nursing education indicated the need to instruct nurses with CT skills has increased as a response to the rapid change in the health care environment.
5-6
According to the
authors, CT is needed not only in the clinical practice environment, but also required as a comprehensive component in Nursing education programs for the development of students’ CT skills.
5-6
7
Chang et al. claim that CT skills had a positive correlation to nurses’ competence.
7
Critical thinking is the focus of interest of professors and researchers around the world, with the need to educate critical and reflective practitioners in knowing how to act and making a difference in society becoming increasingly clear.
1-23
Thus, this systematic literature review aims to evaluate the evidence
available in the literature on the effectiveness of teaching strategies used for the development of CT among undergraduate nursing students. In a preliminary search in the Cochrane Database of Systematic Reviews, Joanna Briggs Institute Library of Systematic Reviews, PubMed, and PROSPERO, three systematic reviews were found,
24,26,27
as well as a protocol for a systematic review related to the effectiveness of strategies for
addressing CT in nursing students. Yuan, Willians and Fan
24
25
conducted a systematic review to identify and gather available evidence on
the development of CT among nursing students by using problem-based learning (PBL). English and Chinese, published within the period from 1990 to 2006, were included.
24
24
Studies in
Evidence has
shown that PBL did not promote the development of CT skills among undergraduate nursing students.
24
Further, Tang and Sung
25
prepared a protocol for systematic review in order to synthesize
the best available evidence on the effectiveness of PBL to address CT with nursing students.
25
For
inclusion in the systematic review, the authors will at first consider experimental studies that used PBL as an intervention strategy for nursing students, and those that assessed CT skills as a result of studying through the means of the California Critical Thinking Disposition Inventory. English and Chinese will be selected. Kong et al.
26
25
Publications in
25
conducted a systematic review and meta-analysis to determine the effectiveness of PBL
to indoctrinate CT among undergraduate nursing students as compared to the strategy of traditional 2
lectures. Nine articles were included in the meta-analysis. Despite the moderate heterogeneity (I =
doi: 10.11124/jbisrir-2015-1073
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2015;13(2) 26 - 36
45%), the result of the meta-analysis indicated that nursing students who underwent PBL, as compared to those who attended lectures, had significantly higher CT levels (SMD = 0.33; 95%IC= 0.13-0.52; p = 0.0009).
26
The systematic review conducted by Chan
sought to assess how CT is perceived and which
strategies and obstacles are potentially involved in the teaching and learning process of CT among studies with a qualitative design, published between 2002 and 2011.
27
Seventeen studies were
selected from the databases, including The British Nursing Index, Ovid MedLine, CINAHL, PsycINFO, and Scopus.
27
The results showed that the concept of CT has undergone several changes over time,
and there remains a lack of explanation among teachers and students in the field.
27
The teaching
strategies for promoting CT frequently discussed were questioning and reflective writing.
27
The
authors identified a need to conduct a systematic review that assesses the effectiveness of new teaching strategies and interventions for improving the competence of educators to teach CT as well as for promoting CT development among nursing students. As mentioned earlier, studies included in previous systematic reviews on this topic have emphasized on teaching by PBL and have neglected other teaching strategies used in nursing education. This favors the study of only one type of teaching strategy and disfavors comparisons between any other types of existing strategies. Based on this, Chan
27
also indicated the need for a systematic review of quantitative studies to be
conducted, in order to identify the most effective teaching strategies for CT among nursing students that are currently available.
27
Hence, the present systematic review will examine research that
addresses this urgent and current need. Thus, the aim of this systematic review is to highlight the teaching strategies that promote CT in students of undergraduate courses in nursing.
Keywords Critical thinking; undergraduate student; education
Inclusion criteria Types of participants This review will consider studies on undergraduate students at any year level of a nursing program. Undergraduate nursing students from any country, and any undergraduate baccalaureate or baccalaureate equivalent course will also be considered. Types of intervention(s)/phenomena of interest The interventions which this review will examine include, but are not limited to, problem-based 11-15
learning,
16
case study,
17-18
simulation,
19-23
conceptual maps,
and other teaching methods that
specifically address the teaching and development of CT. The review will consider teaching strategies (individuals and/or groups) which were used with undergraduate students in nursing to promote the development of CT. Only studies that implemented and evaluated the effectiveness of such strategies will be included.
doi: 10.11124/jbisrir-2015-1073
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Comparator/control intervention(s) This systematic review will compare studies using in the intervention group any teaching strategies and using in the control group any teaching strategies OR traditional teaching OR no specific intervention. Types of outcomes This review will consider studies that include CT as an outcome measure. It will include but not be limited to studies that assess skills in inference, recognition of assumptions, deduction, interpretation and evaluation, analysis skills, induction, deduction and, critical response development. The specific 28
instruments will include the Watson-Glaser Critical Thinking Appraisal instrument, 29
Critical Thinking Skills Test, 31
Essay,
30
The Cornell Critical Thinking Test,
the California
The Ennis Weir Critical Thinking
32
and the California Critical Thinking Disposition Inventory.
Types of studies This systematic review will consider all randomized controlled trials (RCTs) to determine the effectiveness of teaching strategies for the development of CT in nursing undergraduate students. In the absence of RCTs, other experimental study designs including non-randomized controlled trials, quasi-experimental, before and after studies and observational studies, such as comparable cohort studies, will also be included in the review.
Search strategy The search strategy used for the review will focus on finding articles published in Portuguese, English and Spanish. The search strategy aims to find both published and unpublished studies. A three-step search strategy will be utilized in this review. An initial limited search of MEDLINE and CINAHL will be undertaken, followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. The databases to be searched include: CINAHL PubMed Embase PsycINFO Cochrane Central Register of Controlled Trials (CENTRAL) ERIC LILACS Web of Science Scopus.
doi: 10.11124/jbisrir-2015-1073
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The search for unpublished studies will include: ProQuest Dissertations and Theses Cybertesis Biblioteca Digital de Teses e Dissertações Trove Diva RCAAP- Repositório Científico de Acesso Alberto de Portugal Theses Canada Ethos DART-Europe E-Theses Portal National ETD Portal. Keywords: nursing student, student, undergraduate, baccalaureate and nursing;
problem based
learning, problem based, concept map, conceptual map, conceptual maps, concept maps, conceptual mapping, concept mapping, simulation, case study, learning, teaching, education, nursing education, traditional teaching, lectures, teaching methods and skill; thinking, critical thinking, clinical reasoning, critical judgment and clinical judgment; randomized controlled trial, trial, evaluation study, comparative study, experimental study, observational study, cohort study, pre test, pretest, post test, posttest, quasi-experimental studies.
Assessment of methodological quality Quantitative papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBIMAStARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.
Data collection Data will be extracted from papers included in the review independently by two reviewers, using standardized data extraction tools from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument JBI-MAStARI (Appendix II) Two reviewers will extract data independently for assurance of data accuracy. Discrepancies between the reviewers will be resolved by discussion or where resolution is not successful, by a third reviewer. The data extracted will include precise details about the populations and participant characteristics, inclusion and exclusion criteria, study settings and designs; descriptions of interventions, outcomes measures and results, and the number and reasons for withdrawal and dropout. If there is any data missing in the included studies, the authors will be contacted to retrieve statistical data if possible.
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Data synthesis Quantitative papers, where possible will be pooled in a statistical meta-analysis using JBI-MAStARI. All results will be subject to double data entry. Effect sizes expressed as odds ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals will be calculated for analysis. The presence of heterogeneity will, where possible be assessed statistically using the standard Chi-square and also explored using subgroup analyses based on the different study designs included in this review. Where statistical pooling is not possible the findings will be presented in narrative form including tables and figures to aid in data presentation.
Conflicts of interest The reviewers have no conflicts of interest in conducting this review.
Acknowledgements This study is part of an international partnership project between the School of Nursing of University of São Paulo (Brazil) and the University of Surrey (England) and also interfaces with a multicenter study being developed by members of the Red Iberoamericana de Investigación en Educación en Enfermería (RIIEE) with the focus on identifying teaching strategies employed by teachers to create and foster the nursing students and CT.
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References 1. National League of Nursing. Criteria and guidelines for the education of baccalaureate and higher degree programs in nursing. New York: National League of Nursing; 1991. 2. United Nations Educational, Scientific and Cultural Organization (UNESCO). World Declaration on Higher Education for the Twenty-first Century: Vision and Action. [internet]. Paris; 1998 [cited 2014 Jan. 30]. Available from: http://unesdoc.unesco.org/images/0014/001419/141952e.pdf. 3. Facione PA. Critical thinking: A Statement of Expert Consensus for purposes of Educational Assessment and Instruction – Executive Summary “The Delphi Report”.Califórnia: Santa Clara University;
1990.
[cited
2014
Apr.
01].
Available
from:
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Appendix I: Appraisal instruments MAStARI appraisal instrument
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Appendix II: Data extraction instruments MAStARI data extraction instrument
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