Abstract
The development of critical thinking is crucial in professional education to augment the capabilities of pre-professional students. One method for enhancing critical thinking is participation in role-playing simulation-based scenarios where students work together to resolve a potentially real situation. In this study, undergraduate nursing students were divided into small groups (2–3) to role-play a medical emergency (stroke) within a high fidelity simulation environment. The research team utilized a cross-case comparison design; cases were defined by the different roles played by the nursing students (e.g., primary nurse, secondary nurse, and family member). Results indicated that although students in all three roles displayed instances of reflection, contextual perspective, and logical reasoning, these were not distributed evenly across roles, with family members demonstrating fewer instances of reflection and logical reasoning and secondary nurses demonstrating fewer instances of contextual perspective. However, evidence of students’ abilities to apply clinical standards was observed fairly equally across all three roles. Implications for the use of role-plays within high-fidelity simulations are discussed.
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Alinier, G., Hunt, B., Gordon, R., & Harwood, C. (2006). Effectiveness of intermediate-fidelity simulation training technology in undergraduate nursing education. Journal of Advanced Nursing, 54, 359–369.
Astedt-Kurki, P., Paavilianen, E., Tammentie, T., & Paunonen-Ilmonen, M. (2001). Interaction between adult patients’ family members and nursing staff on a hospital ward. Nordic College of Caring Sciences, 15, 142–150.
Bambini, D., Washburn, J., & Perkins, R. (2009). Outcomes of clinical simulation for novice nursing students: Communication, confidence, clinical judgment. Nursing Education Perspectives, 30(2), 79–82.
Bradley, P. (2006). The history of simulation in medical education and possible future directions. Medical Education, 40, 254–262.
Bransford, J. D. (1993). Who ya gonna call? Thoughts about teaching problem solving. In P. Hallinger, K. Leithwood, & J. Murphy (Eds.), Cognitive perspective on educational leadership (pp. 171–191). New York: Teachers College Press.
Bremner, M. N., Aduddell, K., Bennett, D. N., & VanGeest, J. B. (2006). The use of human patient simulators: Best practices with novice nursing students. Nurse Educator, 31(4), 170–174.
Bruce, S., Bridges, E. J., & Holcomb, J. B. (2003). Preparing to respond: Joint trauma training center and USAF nursing warskills simulation laboratory. Critcial Care Nursing Clinics of North America, 15, 149–162.
Cato, M., Lacaster, K., & Peeples, A. (2009). Nursing students’ self-assessment of their simulation experiences. Nursing Education Perspectives, 30(2), 105–108.
Childs, J. C., & Sepples, S. (2006). Clinical teaching by simulation: Lessons learned from a complex patient care scenario. Nursing Education Perspectives, 27, 154–158.
Comer, S. K. (2005). Patient care simulations: Role playing to enhance clinical understanding. Nursing Education Perspectives, 26, 357–361.
Dahlgren, L. O., & Pramling, I. (1985). Conceptions of knowledge, professionalism, and contemporary problems in some professional academic subcultures. Studies in Higher Education, 10(2), 163–173.
del Bueno, D. (2005). A crisis in critical thinking. Nursing Education Perspectives, 26, 278–282.
Dreifuerst, K. T. (2009). The essentials of debriefing in simulation learning: A concept analysis. Nursing Education Perspectives, 30, 109–114.
Facione, P. A. (1990). Critical thinking: A statement for expert consensus for purpose of educational assessment and instruction. Columbus, OH: Center on Education and Training for Employment.
Fanning, R., & Gaba, D. (2008). Simulation-based learning as an educational tool. In J. Stonemetz & K. Ruskin (Eds.), Anesthesia informatics (pp. 459–479). New York: Springer.
Good, M. L. (2003). Patient simulation for training basic and advanced clinical skills. Medical Education, 37, 14–21.
Haffer, A. G., & Raingruber, B. (1998). Discovering confidence in clinical reasoning and critical thinking development in baccalaureate nursing students. Journal of Nursing Education, 37(2), 61–70.
Henneman, E. A., & Cunningham, H. (2005). Using clinical simulation to teach patient safety in an acute/critical care nursing course. Nurse Educator, 30, 172–177.
Hoke, M. M., & Robbins, L. K. (2005). The impact of active learning on nursing students’ clinical success. Journal of Holistic Nursing, 23, 348–355.
Hyslop-Marginson, E. J., & Armstrong, J. L. (2004). Critical thinking in career education: The democratic importance of foundational rationality. Journal of Career and Technical Education, 21(1), 39–49.
Issenberg, S. B., McGaghie, W. C., Petrusa, E. R., Gordon, D. L., & Scalese, R. J. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review. Medical Teacher, 27(1), 10–28.
Jeffries, P. R. (2005). A framework for designing, implementing, and evaluating simulations used as teaching strategies in nursing. Nursing Education Perspectives, 26(2), 96–103.
Jeffries, P. R. (2007). Simulation in nursing education: From conceptualization to evaluation (pp. xvi, 168 p.). New York, NY: National League for Nursing.
Jones, S. (2007). Adding value to online role plays: Virtual situated learning environment. Retrieved November 23, 2009, from http://www.ascilite.org.au/conferences/singapore07/procs/jones-s.pdf.
Julian, M., Kinzie, M. B., & Larsen, V. A. (2000). Compelling case experiences: Performance, practice, and application for emerging instructional designers. Performance Improvement Quarterly, 13(3), 164–201.
Kulper, R. A., & Pesut, D. J. (2004). Promoting cognitive and metacognitive reflection reasoning skills in nursing practice: Self-regulated learning theory. Journal of Advanced Nursing, 45, 381–391.
Lan, C. H., Tseng, C. C., & Lai, K. R. (2008, July). Developing a negotiation-based intelligent tutoring system to support problem solving: A case study in role-play learning. Paper presented at the Eighth IEEE International Conference on Advanced Learning Technologies. Cantabria, France.
Leininger, M. (1994). Teaching and learning in transcultural nursing. In T. G. Mashaba & H. I. Brink (Eds.), Nursing education: An international perspective (pp. 207–226). Kenwyn, South Africa: Juta.
Lincoln, Y., & Guba, E. (1985). Naturalistic inquiry. New York: Sage.
McNaughton, N., Ravitz, P., Wadell, A., & Hodges, B. D. (2008). Psychiatric education and simulation: A review of the literature. The Canadian Journal of Psychiatry, 53(2), 85–93.
Medley, C. F., & Horne, C. (2004). Using simulation technology for undergraduate nursing education. Journal of Nursing Education, 44(1), 31–34.
Mooradian, J. (2008). Using simulated sessions to enhance clincial social work education. Journal of Social Work Education, 44(3), 21–35.
Nelson, D. L., & Blenkin, C. (2007). The power of online role-play simulations: Technology in nursing education. International Journal of Nursing Education Scholarship, 4(1). Retreived November 23, 2009, from http://www.bepress.com/ijnes/vol4/iss1/art1/.
Nikendei, C., Zeuch, A., Dieckmann, P., Roth, C., Schäfer, S., Völkl, M., et al. (2005). Role-playing for more realistic technical skills training. Medical Teacher, 27(2), 122–126.
Patton, M. Q. (2002). Qualitative research and evaluation research methods. London: Sage.
Platt, J. (2007). Case study. In W. Outhwaite & S. P. Turner (Eds.), The Sage handbook of social science methodology (pp. 100–118). Thousand Oaks, CA: Sage.
Rubenfeld, M. G., & Scheffer, B. K. (2006). Critical thinking tactics for nurses. Boston: Jones & Bartlett.
Ruggenberg, S. (2008). The effect of simulated clinical experience on knowledge, near transfer, and far transfer in nursing education. Unpublished Dissertation, University of San Francisco.
Rush, K. L., Dyches, C. E., Waldrop, S., & Davis, A. (2008). Critical thinking among RN-to-BSN distance students participating in human patient simulation. Journal of Nursing Education, 47, 501–507.
Scheffer, B. K., & Rubenfeld, M. G. (2000). A consensus statement on critical thinking in nursing. Journal of Nursing Education, 39, 352–359.
Schon, D. A. (1983). The reflective practitioner. New York: Basic Books.
Schon, D. A. (1987). Educating the reflective practicioner. San Francisco: Jossey Bass.
Simpson, E., & Courtney, M. D. (2002) Critical thinking in nursing education: A literature review. International Journal of Nursing Practice, 8(April), 89–98.
Soderstrom, I.-M., Benzein, E., & Saveman, B.-I. (2003). Nurses’ experiences of interactions with family members in intensive care units. Nordic College of Caring Sciences, 17, 185–192.
Sogunro, O. A. (2004). Efficacy of role-playing pedagogy in training leaders: Some reflections. The Journal of Management Development, 23, 355–371.
Stepich, D. A., Ertmer, P. A., & Lane, M. M. (2001). Problem-solving in a case-based course: Strategies for facilitating coached expertise. Educational Technology Research and Development, 49(3), 53–70.
Switky, R. (2006). Simulating the free trade area of the Americas. Paper presented at the annual meeting of the International Studies Association, San Diego, California. Retrieved November 23, 2009, from http://www.allacademic.com/meta/p98758_index.html.
Tanner, C. (2006). Thinking like a nurse: A research-based model of clinical judgement in nursing. Journal of Nursing Education, 45, 204–211.
Thompson, G. N., Estabrooks, C. A., & Degner, L. F. (2006). Clarifying the concepts in knowledge transfer: A literature review. Journal of Advanced Nursing, 53, 691–701.
Tsui, L. (2002). Fostering critical thinking through effective pedagogy. Journal of Higher Education, 73, 740–763.
Whitehead, A. N. (1929). The aims of education: And other essays. New York: Macmillan.
Acknowledgment
The researchers express their sincere gratitude to Dr. Maria Young and Ms. Lyn Nuti for their guidance in designing and implementing the study, and to the 17 nursing students who willingly participated. We dedicate this work to our dear friend, Xi. We continue to be inspired by memories of her great dedication and passion.
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Ertmer, P.A., Strobel, J., Cheng, X. et al. Expressions of critical thinking in role-playing simulations: comparisons across roles. J Comput High Educ 22, 73–94 (2010). https://doi.org/10.1007/s12528-010-9030-7
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DOI: https://doi.org/10.1007/s12528-010-9030-7