The Science Journal of the American Association for Respiratory Care
BACKGROUND: Respiratory care practitioners (RCP) evaluate the condition of their patients, make decisions about the appropriateness of the treatment plan, provide care, and evaluate the outcomes of their decisions. In order to practice effectively, they must think critically and make appropriate decisions. As educators make curricular changes to improve the decision making skills of their students, strategies to develop critical thinking have been proposed as one method of achieving this goal. This approach is based upon the hypothesis that a positive relationship exists between decision making (DM) and critical thinking (CT). This study examined the relationship between CT and DM in prospective RCP and evaluated differences between educational programs. If a positive relationship could be demonstrated between these constructs, programs may improve the DM skills of future practitioners by providing instruction which improves CT. METHOD: Using a correlational research design, DM scores from a clinical simulation examination (CSE) were compared with scores from the Watson-Glaser Critical Thinking Appraisal for 154 graduating respiratory care students from 11 programs. Program directors completed a questionnaire and were then interviewed about the methods they employ to develop CT and DM in their students.
Results: A significant correlation between CT and DM was found for 110 students completing the Secure Form of the CSE (r = 0.32) and 10 students completing Form 4 of the exam (r = 0.64). No significant difference was found between programs. When examined individually, only 2 programs demonstrated statistically significant correlations between CT and DM. Case studies and clinical simulations were used by all programs, and most utilized role modeling, computer assisted instruction, patient rounds, small group discussion, and study skills courses. No apparent differences were identified in the use of these strategies by different programs.
Conclusions: The findings support the prediction that students and practitioners with strong CT proficiency should make better clinical decisions. Assessment of CT proficiency could be used as one part of a process for evaluating prospective students and faculty for respiratory care programs. Program directors and faculty felt that case studies and clinical simulations are important strategies to utilize with their students.