Critical thinking skills in midwifery practice: Development of a selfassessment tool for students

Objective: Develop and test a tool designed for use by pre-registration midwifery students to self-appraise their critical thinking in practice. Design: A descriptive cohort design was used. Participants: All students (n=164) enrolled in a three-year Bachelor of Midwifery program in Queensland, Australia. Methods: The staged model for tool development involved item generation, mapping draft items to critical thinking concepts and expert review to test content validity, pilot testing of the tool to a convenience sample of students, and psychometric testing. Students (n=126, 76.8% response rate) provided demographic details, completed the new tool, and five questions from the Motivated Strategies for Learning Questionnaire (MSLQ) via an online platform or paper version. Findings: A high content validity index score of 0.97 was achieved through expert review. Construct validity via factor analysis revealed four factors: seeks information, reflects on practice, facilitates shared decision making, and evaluates practice. The mean total score for the tool was 124.98 (SD=12.58). Total and subscale scores correlated significantly. The scale achieved good internal reliability with a Cronbach's alpha coefficient of 0.92. Concurrent validity with the MSLQ subscale was 0.35 (p < 0.001). Conclusion: This study established the reliability and validity of the CACTiM - student version for use by preregistration midwifery students to self-assess critical thinking in practice. Implications for practice: Critical thinking skills are vital for safe and effective midwifery practice. Students' assessment of their critical thinking development throughout their pre-registration programme makes these skills explicit, and could guide teaching innovation to address identified deficits. The availability of a reliable and valid tool assists research into the development of critical thinking in education and practice.