Using Think Aloud in Health Assessment: A Mixed-Methods Study

Background: Health assessment courses are foundational to prepare students in nursing baccalaureate programs for clinical practice. Nurse educators are interested in testing strategies to improve students' ability to perform physical assessment techniques. Method: A mixed-methods design was used to examine nursing students' experiences with the Think Aloud (TA) approach and its affect on their ability and perceived self-efficacy when performing physical assessment skills. Results: The participants in the TA intervention group made significant pre-post self-efficacy score gains and had higher focused physical examination marks. There was no significant difference in pre-post self-efficacy scores with the control group. A focus group yielded the following themes: benefits of TA, student challenges, and transferring physical assessment skills to practice. Conclusion: The TA approach encourages students to focus on the critical steps in physical assessment skills aiding memory, knowledge gains and preparation for practical testing, and transition to clinical practice.