ABSTRACT The increasingly complex role of a nurse requires a much higher level of critical thinking and clinical judgment skills than in the past. Opportunities to provide critical thinking experiences in clinical settings are challenged by various factors, including limited clinical facilities and a shortage of nurse faculty. Alternative methods to provide critical thinking experiences in undergraduate nursing education are required. Kolb's theory of experiential learning theory is discussed as the foundation for the development of an alternative strategy that uses moderate-fidelity manikins. The strategy involved scenario-based performance of selected nursing skills in order to evaluate critical thinking and theory-clinical correlation.
Key Words Critical Thinking--Experiential Learning--Learning Styles--Nursing Education--Nursing Students--Simulation
MANY OF TODAY'S NURSING STUDENTS HAVE VARIED LEARNING STYLES, PRESENTING A CHALLENGE TO FACULTY AS THEY SEEK OUT WAYS TO TEACH STUDENTS TO THINK CRITICALLY. The achievement of critical thinking skills has been identified as a necessary outcome of undergraduate nursing education (National League for Nursing Accrediting Commission, 2004). Various other factors, including limited clinical facilities, the nurse faculty shortage, high patient acuity, decreased acute care admissions, shorter lengths of stay, and the shortage of nurses in clinical facilities add to the challenge. Alternative methods to provide critical thinking experiences must be developed and incorporated into undergraduate nursing education. * Traditional approaches to nursing education, including didactic lectures, memorization, and return laboratory demonstrations, may indicate technical mastery, but do not facilitate the outcome of critical thinking. Rather, nursing students learn best through experiential learning. Kolb's experiential learning theory and model are discussed here as the foundation for a practice integration method designed to provide critical thinking experiences in a baccalaureate nursing curriculum. Scenarios with moderate-fidelity manikins constituted one part of the integration method.
The Transformation of Experience Kolb (1984) viewed learning as the process whereby knowledge is created through transformation of experience. Although not specifically identified as a nursing theory, Kolb's theory was selected as a framework for implementation of the proposed intervention based on a review of criteria presented by Kenney (2006). Kenney identified that "theory based nursing practice is the creative application of models, theories, and principles from nursing, medical, behavioral, and humanistic sciences" (p. 300).
Developed by David A. Kolb, PhD, a professor of organizational behavior, Kolb's theory was determined to be the best choice for practice integration of critical thinking experiences through the application of questions developed by Fawcett (2000). Fawcett developed criteria for analysis and evaluation of nursing theories that included questions regarding significance, internal consistency, parsimony, testability, and empirical and pragmatic adequacy. Kolb's theory addresses the provision of learning experiences and offers different interventions to meet the needs of all types of learners. According to Kolb, learning is a continuous process, and knowledge is created by transforming experience into existing cognitive frameworks, thus changing the way a person thinks and behaves.
The theory identifies and defines key concepts for the learner. According to Kolb, experiences are grasped through apprehension or comprehension. Apprehension is viewed as participation in the actual experience, whereas comprehension occurs outside the actual experience through abstract conceptualization.
For learning to occur, experiences must be transformed. Transformation happens through either extension or intention. Extension is a process achieved by active external experimentation; intention is achieved through internal reflection of the experience. …