Critical Thinking Skills During a Physical Therapist Professional Education Program

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Background and Purpose. The purpose of this study was to determine if critical-thinking skills changed as a result of completing a 27-month, traditional physical therapist (PT) education curriculum at the postbaccalaureate level. Subjects. Forty-two students in graduating classes between 1998 and 2001 who completed the 27-month, master's degree PT professional education program agreed to participate. Subjects were 69% women and 31% men, with a mean age at admission to the program of 26.52 years and a range of 22-38 years. Methods. The California Critical Thinking Skills Test (CCTST), a standardized examination consisting of 34 items in a multiple-choice format that is content neutral and designed for adults, was administered during the first week in the PT education program and again during the last week of the program. The number of correct responses formed the composite score on the test and on each of the three subscales. Each item on the test was categorized into one of three subscales defined as analysis, inference, and evaluation. A paired t test investigated the differences between pretest and posttest scores on the CCTST composite score and three subscale scores. Results. The mean score for the pretest CCTST cumulative of 19-32 was compared to the mean posttest of 20.61. T test results of the pretest and posttest GCTST showed no significant differences at the 0.05 level between the cumulative or subscale scores. Discussion and Conclusion. Critical-thinking abilities of PT professional students as measured by the CCTST did not change as a result of participation in a master's degree PT education program. Use of a different instrument or larger sample may provide further information about the critical-thinking skills of PT students. Development of critical-thinking skills appears to be an important goal of professional physical therapist education programs; however, meaningful measurement of changes in critical-thinking skills during the educational process remains difficult. Key Words: Critical thinking, Physical therapist education, Analysis, Inference, Evaluation. BACKGROUND AND PURPOSE The term critical is used in many disciplines to describe the inductive and deductive reasoning processes that form the basis of decision making. Critical thinking (CT) has been related to clinical decision making and clinical judgment in health professions education1 and as a component of clinical reasoning.2 Professional education in physical therapy focuses on the development of clinical decision-making skills.3 Critical thinking has been identified as one of seven factors in a model of professional behavior recently developed for physical therapy.4 It is also included in a list of 10 generic abilities developed by physical therapist educators at the University of Wisconsin-Madison. The list includes CT as a separate item and several additional items that are often considered to be components of CT, such as problem solving, commitment to learning, use of constructive feedback, and responsibility.5 Researchers in physical therapist education have had mixed results when measuring changes in CT among PT students. Significant relationships have been found between measures of CT and admission data6 and first-year performance measures.7 One study found significant changes in CT during the middle year of an undergraduate PT education program.8 However, correlations between CT and clinical performance have not been significant? nor have changes in CT over two semesters in a graduate program.10 A study by Gross6 analyzed admission and outcome measures of three undergraduate PT education programs. One of the three programs used the Watson-Glaser Critical Thinking Appraisal (WGCTA) as an admission criterion. Gross found statistically significant correlational relationships (n=53; r=0.29; p=.037) between scores on the WGCTA and students' grade point averages in the PT education program. …