Promoting Students’ Critical Thinking: The Use of Videotaped Vignettes in a Baccalaureate Nursing Programme

Nurses need to think critically and respond to a wide variety of clinical situations. Simulations can provide realistic examples of typical clinical situations to undertake learning of complex skills in a less threatening environment. The teacher is thus provided with more control over the learning environment, resulting in a situation which is beneficial in knowledge and skill acquisition. In the current study, simulated vignettes of clinical situations were videotaped, and used to promote nursing students’ critical thinking abilities in managing situations arising in different clinical contexts. The findings from pre-study interviews of students and teachers guided the type of clinical situation to be simulated and the content of the critical thinking discussion guidelines. A pre-test/post-test design was used to collect data from 83 baccalaureate first and second year nursing students. The California Critical Thinking Skills Test and the Nursing Knowledge Test were used to determine how effective the videotaped vignettes and discussion guidelines were in promoting critical thinking and nursing knowledge. The findings showed that students made significant improvement in their level of nursing knowledge, while no significant differences were found for the posttest scores in critical thinking skills. Interview data indicated that students found the vignettes and discussion guidelines beneficial in developing their critical thinking skills. The absence of posttest improvement in critical thinking may be related to the limited exposure of students to the new approach of videotaped vignettes and the lack of sensitivity of the California Critical Thinking Skills Test in being unable to detect changes. However the use of simulated vignettes and discussion guidelines did improve the students’ knowledge and provided a way of learning that was found beneficial by the students.