Using a cognitive approach to improving critical thinking in lpn students

Measuring the extent of critical thinking skills in Licensed Practical Nurses is overdue. The decision-making skills necessary to provide safe, quality care for the nations' seniors requires critical thinking from the LPN. Maynard (1996) provided evidence to support that critical thinking gains result from practice experience and not from educational programs. Strategies are needed in nursing education to acquire critical thinking skills that can be measured and used in practice. Strategies for improving critical thinking skills in nursing education abound but lack evidence for support while methods to identify cognitive errors in thinking are poorly utilized. Research has shown that the importance of correcting misperceptions about concepts learned is the foundation of test review practices and was suggested as an intervention to improve critical thinking in nursing school. Thirty-eight LPN students in a Midwest community college provided data to identify whether a four-hour cognitive test review improved six cognitive abilities necessary for critically thinking. The six cognitive abilities of explanation, interpretation, inference, evaluation, analysis, and self-regulation were measured using a pretest-posttest experimental design. The Critical Thinking Assessment (CTA) tool was used for measurement of the critical thinking subscale scores. There were two areas where data analysis showed significant findings. First, there were statistically significant differences between pre and posttest measures for the subscale of inference where participant scores actually declined. Secondly, males outscored females positively in the inference category. Demographic variables either did not show statistical significance or participants were too few to evaluate (n=4). Anecdotal evidence from the participants conveyed a message that while the intent to participate was genuine, an inability to focus on the study due to commitments between work, family, and school made cognitive and physical participation difficult. Study limitations included lack of student availability and minimal time from intervention to measurement of post-test scores. Opportunities exist for further study on test review interventions with different critical thinking tools and a larger sample size. Repeated test review interventions and a longer interval between measurements may provide improvements in critical thinking scores. A nursing critical thinking tool would provide a discipline specific measurement to advance nursing education.