Critical Thinking in the Healthcare Environment

1
Critical Thinking in the Healthcare Environment

• Final MIL Project Report
• N. Johnson
• MIL Fellow 2004-05

2
Focus of Investigation

• Develop and Expand
• Students ability to transfer knowledge acquired
  in medical imaging courses to real life situations

3
Research Questions

• Do students who experience an increase in
  higher-level-thinking activities in laboratory
  classes
• Expand their critical thinking processes?
• Have improved exam scores?
• Respond using content relationships on image
  evaluation assessments?
• Will the student transfer knowledge gained
  through laboratory activities to the clinical
  setting?

4
Approach

• Classroom
• Increase application of knowledge by
  incorporating clinical situations
• Discussion of clinical situations (Socratic
  Questioning)
• (2 lecture periods for each content area)
• Chest
• Upper Extremity
• Lower Extremity
• On-line reviews for each content area

5
Approach

• Lab setting
• Developed activities that required students to
  apply knowledge in a clinical situation
• Model in lab
• Interactive Chest Imaging PowerPoint
• Interactive Elbow Imaging PowerPoint
• Content/Mind Mapping activities

6
Evidence/Conclusions

• Classroom
• Classroom Test of Scientific Reasoning (form A)
  Administered in September and December
• Results
• The control group and the treatment group
  demonstrated a significant increase in their
  reasoning abilities
• Two-tailed t-tests
• Control p lt .05
• Treatment p lt .05

7
Evidence/Conclusions

• Classroom
• 4 exams throughout the semester
• Results
• No difference in class test grades or GPAs
• Treatment group experience
• 46 less retakes on exams (116)
• 60 less attrition (52)
• 84 retention in control group
• 91 retention in treatment group

8
Evidence/Conclusions

• Lab setting
• 3 Image Evaluation Assessments
• Chest evaluation in September
• Upper Extremity in October
• Lower Extremity in December
• Results
• The treatment group demonstrated a significant
  (plt.05 to plt.001) higher level of understanding
  when scores on each image evaluation were
  analyzed using a Mann-Whitney U.

9
Evidence/Conclusions

• Clinical Setting
• Survey-Students and Clinical Instructors
• Questions
• Knowledge of basic positions
• Critical Thinking performance of basic and
  special projections in given situations
• Problem Solving identify image problems and
  formulate solutions

10
Evidence/Conclusions

• Results
• Student self evaluations reported very similar
  results no significant differences between
  groups
• CIs ratings statistically demonstrated no
  significant differences between groups, however
• Students who struggled in class were rated lower
  in all areas
• Treatment group
• 50 of the group was rated at exceeds or
  exceptional in critical thinking (26 in control
  group)
• - 14 were rated marginal in problem solving
• (21 in control group)

11
Moving Forward Next Steps

• Incorporate more Socratic questioning in lecture
• Incorporate critical thinking activities for all
  lab classes
• Workshops for all faculty instructing lab
• Develop instructors manual for lab
• Monitor Image Evaluation using developed rubric
• Administer Classroom Test of Scientific Reasoning
• After 1st year of clinical experience (fall 05)
• At the end of the program (spring 06)
• Complete written report publish
• Contact ASRT (national professional organization)
  for possible video presentation