The Research Of Using Think Aloud Method To Analyze Clinical Cases In Baccalaureate Nursing Education

Objective: Think aloud method was used to analyze clinical cases in baccalaureategeriatric nursing course of our school, compare that with the traditional case-analysisteaching method, to evaluate the effectiveness of think aloud in developing criticalthinking ability in baccalaureate nursing students, to assess the teaching effectiveness ofthink aloud in nursing education and students‘attitudes on it, as well as to make surewhich learning strategies the undergraduate nursing students usually use to analyze andsolve problems, also to discuss whether there is any difference among different abilitylevel students.Method: This is s quasi-experiment study, the research objects are48undergraduatenursing students in grade three of our school. They are randomly assigned to experimentalgroup (n=24) and control group (n=24). The study lasted for12weeks, nine teaching cases were provided during this period of time, including diabetes, benign prostatic hyperplasia,depression, dementia, chronic obstructive pulmonary disease, cerebral thrombosis,hypertension and coronary heart disease. The experimental group was taught to use thinkaloud method to analyze clinical cases. The process when the students used the thinkaloud method to analyze clinical cases was recorded by a video in the class, then the videodata were transcribed verbatim by the students themselves and cross-checked for accuracyof representation among the researchers and then verbalization of transcribing data wereused to make sure which learning strategies the undergraduate nursing students usually useto analyze and solve problems, also to discuss whether there is any difference amongdifferent ability level students. The control group was taught to use traditional teachingmethod to analyze clinical cases. Critical thinking ability was measured with the CriticalThinking Dispositions Inventory-Chinese Version at the beginning and the end of theresearch.Result: At the beginning of the study, there was no significant difference inCTDI-CV scales between the experimental group and the control group. A significantdifference (p＜0.05) was found in the total scores and five subscales between the twogroups at the end of the study, except―Open-mindedness‖and―Maturity‖subscales. Asignificant difference (p＜0.05) was found in the total scores and six subscales betweenthe beginning and the end of the experimental group, except―Open-mindedness‖. On thecontrary, only―Inquisitiveness‖shows a significant difference (p＜0.05) between thebeginning and the end of the control group. Both total scores and the scores of caseanalysis questions of the final exam of the geriatric nursing course show a significantdifference (p＜0.05) between the two groups. We divided the experimental group24students into higher group and lower group according to the scores of the final exam,including10students and14students respectively. The following learning strategiesincluding advance preparation, planning, self-monitoring, problem finding, repetition,guessing, logic reasoning and self-encouragement are used more frequently in the highergroup, which shows a statistical significance (p＜0.05). However, the strategy hesitationjust shows an adverse result, which is used more frequently in the lower group after a statistical test. All the experiment group students have an affirmative attitude to theteaching effect of think aloud method.Conclusion:1. The think aloud method is an effective teaching strategy, and students have anaffirmative attitude to it.2. The think aloud method is more effective in helping nursing students improvecritical thinking ability than the traditional teaching method.3. Through analyzing the verbal report data we can make sure which learningstrategies the undergraduate nursing students usually use to analyze and solve problems,and also can find out the differences among different ability level students, which can helpthe students to adjust the learning strategies according to their own needs.