Graduate School of Nursing; Department of Surgery; Department of Family Medicine and Community Health
Medical Education | Nursing
Objective: Nurse practitioner (NP) students at our graduate school of nursing use WISE-MDTM simulation modules in the curriculum. This prospective randomized controlled pilot study was undertaken to evaluate critical-thinking outcomes associated with adding metacognitive deliberate-reflection guidance to the learning strategy with WISE-MDTM simulation modules.
Methods: Of 33 NP students randomly assigned to intervention and control groups, 16 completed the study. The intervention group received WISE-MDTM learning modules with specific guidance or deliberate reflection. Controls used the modules with instructions for periodic free-thought reflections. Students’ tape-recorded reflections were categorized according to author-developed critical-thinking categories. Data were analyzed using NVIVOTM. Students’ feedback was collected by post-intervention anonymous survey.
Results: Critical thinking outcomes (student responses to exercises after free-thinking or deliberate-reflection guidance) did not differ between groups. However, the intervention group demonstrated a higher level of critical thought after deliberate-reflection guidance. Post-intervention quantitative and qualitative feedback from both groups endorsed the value of the WISE-MDTM modules for NP education.
Conclusions: Despite no difference in unprompted outcomes between groups, the intervention group often verbalized more thoughtful clinical decision-making. We speculate that the deliberate-reflection guidance intervention utilized with students throughout only two modules was insufficient for them to internalize the critical-thinking process. We propose using free-thought reflections with one or two WISE-MDTM modules to identify struggling students’ clinical decision-making process. These students’ remediation plan could include recording their deliberate-reflection process while viewing WISE-MDTM modules. Students would be guided to verbalize and record their critical-thinking processes for faculty review until students sufficiently integrate the process into their clinical decision-making.
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Citation: Terrien, J. M., Hale, J. F., Cahan, M., Quirk, M., Sullivan, K., Lewis, J. (2016). The impact of deliberate reflection with WISE-MDTM modules on critical thinking of nurse practitioner students: A prospective, randomized controlled pilot study. Journal of Nursing Education and Practice, 6(1), 55. DOI: 10.5430/jnep.v6n1p55. Link to article on publisher's website. Copyright the authors. This publication is open access and the publisher PDF is posted as allowed by the publisher's author rights policy at http://www.sciedu.ca/journal/index.php/jnep/about/submissions#copyrightNotice.
WISE-MD, Deliberate reflection, Self-reflection, Think aloud, Critical thinking, Nurse practitioner students, Advanced health assessment
Terrien, Jill M.; Hale, Janet Fraser; Cahan, Mitchell A.; Quirk, Mark E.; Sullivan, Kate M.; and Lewis, Joanne, "The impact of deliberate reflection with WISE-MDTM modules on critical thinking of nurse practitioner students: A prospective, randomized controlled pilot study" (2016). Graduate School of Nursing Publications and Presentations. 52.