Critical care nurses need finely honed critical thinking skills in order to be safe, competent, and skillful practitioners of their profession. If clinical nurses do not learn how to reason effectively, they may make inappropriate decisions about their patients' care, ultimately resulting in increased patient mortality (Fonteyn, 1991). In addition, increasing nurses' decision-making and autonomy has been shown to improve job satisfaction and retention (Prescott, 1986).There are many authors who write about the need for developing critical thinking skills among practicing professional nurses (Creighton, 1984; Jenkins, 1985; Levenstein, 1981, 1983, 1984). However, research assessing the impact of continued education and clinical experience on the development of critical thinking skills is sparse.The purpose of this exploratory study is to determine if there is a relationship between the level of critical thinking skills (as measured by the Watson-Glaser Critical Thinking Appraisal Tool, 1980) in critical care nurses and the length of nursing experience, amount of continuing education pursued annually, and the level of formal nursing education completed. The conceptual framework that provides the basis for this study is Patricia Benner's (1984) application of the Dreyfus Model of Skill Acquisition to clinical nursing practice.Participants (N = 61) were obtained on a voluntary basis from the population of critical care nurses working in the intensive Care Unit, Coronary Care Unit, Cardiac Catheterization Laboratory, or Emergency Care Center of a 600 bed midwestern acute care facility. Each participant in the study was asked to sign an informed consent agreeing to participate after receiving a written and oral explanation of the study. Confidentiality of the participants was maintained by substituting identification numbers for the subjects' names on the data collection instruments. The investigator supervised the administration of the critical thinking instrument and demographic questionnaire.The Pearson product-moment correlation coefficient and a two-tailed t-test for independent samples were used to determine if there were any significant relationships between the WGCTA score and the length of critical care experience, attendance of continuing education programs, or completion of additional formal education. This data analysis supported hypothesis one with the results revealing a significant positive correlation (r = .46, p = <.001) between the WGCTA scores and the length of critical care experience. In addition, a statistically significant but weak positive correlation was found between the WGCTA scores and the length of experience in CCU (r = .52, p = .001). No significant correlation existed between the WGCTA scores and length of experience in ECC, ICU, or CCL. Hypothesis two was supported with a significant difference (t = 3.58, df = 59, p = .001) found between the critical thinking ability of the two groups, with those who have completed an additional formal program of nursing education scoring higher. A significant but weak positive correlation (r = .30, p =.020) was found between the number of continuing education programs attended annually and the WGCTA scores. Multiple regression was performed with the total WGCTA score being the dependent variable and total critical care experience, completion of additional formal education, and attendance of continuing education programs being the independent variables. Only total critical care experience entered the equation (E = 16.03, p = <.001) explaining 21% of the variance.The information gained from this study will provide direction for the review of existing orientation, continuing education, and staff development programs provided at different levels of nursing experience and make suggestions for change to enhance critical thinking skill development. / School of Nursing
Identifer | oai:union.ndltd.org:BSU/oai:cardinalscholar.bsu.edu:handle/185641 |
Date | January 1996 |
Creators | Fisher, Joyce Ann |
Contributors | Ball State University. School of Nursing., Brigham, Carole J. |
Source Sets | Ball State University |
Detected Language | English |
Format | viii, 105 leaves ; 28 cm. |
Source | Virtual Press |
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