Critical thinking dispositions in undergraduate nursing students: A case study approach

Background: The transition of nurse education to the higher education sector in Ireland in autumn 2002 led to the development of a new curriculum for undergraduate nursing with critical thinking as an expected outcome. Objectives: To investigate critical thinking dispositions and the difference between first and third year nursing students. Design: A single embedded case study approach incorporating a cross-sectional design. Setting: Two similar university sites providing a new four year undergraduate honours degree programme in nursing. Participants: A cohort of first (n = 237) and a cohort of third year (n = 215) undergraduate nursing students. Methods: Critical thinking provided the main case for this case study. The Delphi conceptualisation of critical thinking underpinned the study and critical thinking dispositions were measured using the California Critical Thinking Disposition Inventory. The data were analysed using descriptive statistics and an independent samples t-test was used to determine differences between the first and third year nursing students. Results: First year nursing students scored strong while third year students scored weak in overall critical thinking disposition. Both first and third year nursing students revealed a strong score for inquisitiveness, open-minded, analyticity and maturity dispositions. They revealed weak scores for self-confidence, systematicity and truth-seeking dispositions. Inquisitiveness was the strongest while truth-seeking was the weakest disposition for both cohorts. Neither cohort reached the higher positive scores indicative of consistent endorsement of higher level thinking. Conclusions: Nurse educators need to develop their knowledge of critical thinking dispositions and foster these attributes throughout the pre-registration nursing degree programme. Clinically based scenarios which challenge nursing students and invoke questioning contribute to critical thinking development. Statutory bodies responsible for nurse education and nurse educators must continue to encourage critical thinking.