Date of Award

2015

Document Type

Dissertation

Degree Name

Doctor of Education

School

School of Education

Program

Curriculum and Instruction EdD

First Advisor

Raymond J. Ostrander

Second Advisor

Carol Allen

Third Advisor

Tevni Grajales

Abstract

Problem

Deficiencies in new nursing graduates’ ability to use critical thinking skills have been documented. Researchers have found that the continued use of traditional teaching methods and less student-centered approaches for critical thinking development has contributed to this problem. This particular issue has evoked much concern for institutions and organizations involved with the safe delivery of patient care. The purpose of this study was to examine (a) the relationship between the factors educator characteristics, attitude, subjective norm and perceived behavioral control in a hypothesized model that may influence nurse educators’ intention to use instructional methods that promote critical thinking in this study referred to as evidence-based critical thinking (EBCT) teaching strategies for critical thinking development in baccalaureate nursing students and (b) the relationship between intention to use EBCT teaching strategies and actual use.

Method

A quantitative, non-experimental correlation survey and cross-sectional design was used to analyze the data in this study. An online survey was used to collect 244 responses from nurse educators who taught in 4-year degree nursing programs in the southeast region of the United States. The Statistical Package for Social Sciences Software (SPSS) and Structural Equation Modeling (SEM) with Analysis of a Moment Structures (AMOS) were used to analyze the data, test the hypothesized model, and provide descriptive statistics, correlations, and model fit results. One main research question and null hypothesis as well as five sub-questions and null sub-hypotheses were tested in this study.

Results

Results from the analysis of the hypothesized model showed that the initial model did not fit the observed data. However, an adjusted model provided an acceptable fit to the data (X2 = 398, X2/df = 1.51, GFI = 0.88, CFI = 0.92, TLI = 0.91, RMSEA = 0.05). Educator characteristics did not contribute to the initial or adjusted model due to non- significant loadings on the items. Attitude towards use of EBCT teaching strategies had a strong significant positive direct effect on intention to use (β = .95, p ˂ .05) and accounted for 90% of the variance in intention to use; subjective norm indicated a significant weak negative effect on intention to use EBCT teaching strategies (β = ̶ .12, p = .03). No statistically significant relationship was found between perceived behavioral control and intention to use EBCT teaching strategies (β = ̶ 0.03, p =0 .54). There was a statistically significant relationship between intention to use EBCT teaching strategies and actual use (β = 0.30, p = 0.01). While this was a significant finding, the number of nurse educators who rarely or never used any of the critical thinking teaching strategies addressed in this study warrants attention. Together, all three predictors (attitude, subjective norm, and perceived behavioral control) explained 77% of the variance in intention to use EBCT teaching strategies. Correlations between the latent factors showed that attitude had a positive strong correlation with subjective norm and a weak negative correlation with perceived behavioral control. The correlation between subjective norm and perceived behavioral control was weak and negative.

Conclusions

Overall, the relationships between the factors attitude, subjective norm, and perceived behavioral control and intention to use critical thinking teaching strategies partially supported the hypothesized effects based on the theory of planned behavior. As expected, attitude towards use of EBCT teaching strategies emerged as the stronger factor to influence intention to use, meaning that nurse educators in this study strongly valued the use of critical thinking teaching strategies that are evidence-based and had a positive attitude towards use. On the other hand, although subjective norm had a significant influence on intention to use, the effect was negative. Approval from others was important; however, social pressure was not perceived as having a positive relationship with intention to use EBCT teaching strategies. Perceived behavioral control was not a significant contributor to intention because issues of controllability and ability did not seem to be a factor affecting intention to use EBCT teaching strategies.

Confirmation of some of the theoretical relationships in the hypothesized model validates the usefulness of the TPB in analyzing factors that may influence nurse educators’ intention to use and actual use of critical thinking teaching strategies. On the basis of the results, this study recommends among other actions the addition of a critical thinking instruction course to nurse educator preparation programs in order to facilitate critical thinking development in nursing students for preparation to practice. Professional learning communities should be established that will address educators’ professional needs as a response to the ongoing call to transform nursing education. Finally, the study presents suggestions for further research and implications for nursing education.

Subject Area

Nursing -- Study and teaching, Critical thinking, Nurses -- Attitudes

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