Problem Based Learning

Students are given real-life clinical scenarios and must work together to gather information and apply knowledge to answer questions and solve problems. Problem-based learning encourages students to be independent learners. It helps students build a stronger knowledge base while giving them practice gathering and interpreting clinical information – all important parts of the critical thinking process (Carvalho et al., 2017). A good form of problem-based learning is unfolding case studies. Unlike a traditional case study that gives students all the information they need, an unfolding case study purposely leaves out information, so students must use critical thinking skills like information-seeking, logical reasoning, and analysis of data to understand the case and make decisions. Furthermore, because new information is given to students as they ask/answer questions and make decisions, the case study can evolve in a way that is unpredictable to the students with new situations arising that must be addressed, which simulates real-life and allows the teacher to assess how students make clinical decisions (Englund, 2020).

Concept Mapping

A process where students create a visual representation of the relationships between different pieces of information. The process of concept mapping helps students connect new information with what they already know, see the relationships between knowledge
and principles as well as processes and problems, and helps them reflect on their own thought processes (Yue et al., 2017). Concept maps can be used in many ways because they can be created for broad topics, like an entire clinical case, or for specific topics, like a
single disease process. For example, a student could make a concept map for a patient they cared for where they mapped out the connections between the patient’s medical condition(s), their assessment findings, laboratory findings, the medications the patient was being given, and nursing interventions performed. A student could also make a more specific concept map where they only mapped out the connections between the pathophysiology of a disease and assessment findings. Research has shown a strong correlation between concept mapping and increased critical thinking levels when used in undergraduate nursing curricula (Orique & McCarthy, 2015).

Simulation

Using simulation experiences such as clinical simulation with mannequins, real people, real equipment, role play, skits, and simulation software can help students develop their critical thinking skills by letting them practice decision-making in real-life situations. Simulation experiences are especially valuable when followed by a debriefing (Padden-Denmead et al., 2016), where students can reflect on their actions and thought processes during the simulation, as self-reflection is an important part of critical thinking. It is important to note that participating in a higher number of simulation experiences leads to greater increases in critical thinking (Shin et al., 2017), so providing students with multiple simulation opportunities is a good idea.

Reflective Writing

Reflective writing about clinical situations helps students to really consider their actions and way of thinking, which is an important part of the critical thinking process. Reflective writing also uses the power of people’s inclination to use storytelling as a way to share knowledge
and learn from experiences. In order for reflective writing to be the most effective, teachers should guide students to think about how they can approach clinical problems better in the future if their self-reflection identifies weaknesses in thought processes and/or actions (Richards et al., 2020). Examples of reflective writing activities could be having students write a reflective journal entry after each clinical or having students stop and write a brief reflection after dealing with a complicated clinical situation or a situation where something went wrong. While students are learning how to do reflective writing, it may be helpful for the teacher to give the students some questions to answer to guide their reflection. For example, in a post clinical journal entry students may be asked to answer questions like:

• During your clinical experience today, was there a time when you realized you didn’t have the knowledge needed to solve a problem? If so, what did you do next?
• Do you feel that you had any biases that affected your judgements today?
• Was there anything that happened today that reminded you of a past experience? If so, what were the similarities and what were the differences?
• Is there anything you did today that you think you could do better next clinical?

Role-Modeling

In clinical settings, nursing instructors can demonstrate critical thinking processes by “thinking out loud” to students – talking through their own thought processes and steps they plan to take to solve a problem or make a safe decision. Role-modeling critical thinking can be a powerful way to show students the importance of critical thinking and help them see how they can personally use steps in the critical thinking process in their own practice (Richards et al., 2020).