Health Sciences Reasoning Test Research Articles

Critical Thinking: A Program Review of Doctor of Audiology Students.

Critical thinking is a crucial component of health care, and its importance has been recognized in training medical professionals. This study reports critical thinking skills for entering doctor of audiology (AuD) students and the trajectory of the change in critical thinking skills measured 2 times over a period of 3 years. This longitudinal, descriptive, and exploratory design was implemented for programmatic review. Critical thinking skills were measured using the Health Sciences Reasoning Test (HSRT; Insight Assessment) upon entering the program and compared to measurements during the final month of academic coursework. Descriptive statistics, exploratory analyses of the HSRT scores among cohorts, the relationship of the HSRT to the graduate record examinations (GREs), and changes in the HSRT over time using a repeated measures multivariate analysis of variance were conducted. There were no significant differences in critical thinking skills between any of the cohort years. There was a significant correlation between the GRE verbal scores and OVERALL HSRT. Improvements in critical thinking skills were found between the time the students entered the graduate program and their final academic semester. Greater gains were reported for students who initially scored below the 50th percentile on the OVERALL HSRT. This program review showed improvement in the critical thinking skills of AuD students during their academic training program. Information regarding critical thinking skills may be useful for programs to monitor students' clinical thinking skills and possibly include clinical and didactical activities to promote critical thinking skills.

Teaching Prelicensure Nursing Students Reasoning in Clinical Experiences: A Pilot Study.

Clinical experiences are foundational learning components for prelicensure nursing students. Given the complexities of modern nursing practice in an aging America, clinical educators must teach nursing students to reason when engaging in patient care. Contemporary pedagogy to enhance reasoning relies on case studies and simulation. Specific and standardized methods for clinical education are largely absent in the literature. This pilot study measured the clinical reasoning ability of nursing students using the Health Sciences Reasoning Test (HSRT). Participants completed the test before their first clinical day and again after their last clinical day. Pre- and posttest HSRT scores were analyzed by control and intervention groups as well as student levels. Posttest HSRT scores improved significantly in the intervention group at the end of the semester. The PREP framework is a novel approach to clinical education and improved the clinical reasoning of prelicensure nursing students. [J Nurs Educ. 2023;62(8):467-470.].

Scales used to evaluate critical thinking in nursing graduation

Objective: To analyze the scales used to measure critical thinking in undergraduate nursing students.Methods: Scoping review guided by Joanna Briggs Institute recommendations. Search carried out in November/2021 in five databases and two libraries. Descriptive data analysis.Results: Final sample had 57 articles. 91% (n = 53) adopted a validated scale to measure critical thinking in nursing students, and 9% (n = 4) combined two of them. California Critical Thinking Disposition Inventory, California Critical Thinking Skills Test, and Health Science Reasoning Test were the most used scales. Studies with beginners prevailed, and there were several contexts and research themes. Simulation and concept mapping were the most evaluated teaching strategies, and 59.6% (n = 34) identified an increase in critical thinking after the intervention.Conclusions: Nursing managers and educators have 17 validated scales available to measure critical thinking, a fundamental element of clinical practice.

Development, Validation, and Reliability of a P1 Objective Structured Clinical Examination Assessing the National EPAs

ObjectiveTo document the performance of first-year pharmacy students on a revised objective structured clinical examination (OSCE) based on national entrustable professional activities, identify risk factors for poor performance, and assess its validity and reliability. MethodsA working group developed the OSCE to verify students’ progress toward readiness for advanced pharmacy practice experiences at the L1 level of entrustment (ready for thoughtful observation) on the national entrustable professional activities, with stations cross-mapped to the Accreditation Council for Pharmacy Education educational outcomes. Baseline characteristics and academic performance were used to investigate risk factors for poor performance and validity, respectively, by comparing students who were successful on the first attempt with those who were not. Reliability was evaluated using re-grading by a blinded, independent grader, and analyzed using Cohen’s kappa. ResultsA total of 65 students completed the OSCE. Of these, 33 (50.8%) successfully completed all stations on first attempt, and 32 (49.2%) had to re-attempt at least 1 station. Successful students had higher Health Sciences Reasoning Test scores (mean difference 5, 95% CI 2–9). First professional year grade point average was higher for students who passed all stations on first attempt (mean difference 0.4 on a 4-point scale, 95% CI 0.1–0.7). When evaluated in a multiple logistic regression, no differences were statistically significant between groups. Most kappa values were above 0.4 (range 0.404–0.708), suggesting moderate to substantial reliability. ConclusionThough predictors of poor performance were not identified when accounting for covariates, the OSCE was found to have good validity and reliability.

Brazilian undergraduate nursing students' critical thinking need to be increased: a cross-sectional study.

to map Brazilian undergraduate nursing students' critical thinking level and investigate the correlation between selected sociodemographic data and critical thinking domains. in this descriptive cross-sectional study, participants' (N=89) critical thinking was assessed using the Health Science Reasoning Test. Correlation between critical thinking domains and sociodemographic data was assessed using the Pearson correlation coefficient. the overall results showed a moderate level of participants' critical thinking (mean = 70.7; standard deviation 5.7). A poor performance was identified in 5 of the 8 critical thinking domains. A significant positive correlation was found between education period and critical thinking (p<.001). poor level in students critical thinking domains may lead to negative consequences for their learning outcomes. Further studies should be carried out to confirm our results, in addition to investigation of teaching methods that encourage and ensure the development of students' critical thinking skills during nursing education.

Investigating the clinical decision-making of nursing students using high-fidelity simulation, observation and think aloud: A mixed methods research study.

The aim of this study was to investigate nursing students' clinical decision-making by using high-fidelity simulation of a deteriorated patient scenario. A convergent parallel mixed methods research design was used consisting of quantitative and qualitative data collection. Twenty-three students completed the Health Science Reasoning Test before and after the simulation between October 2015 and June 2016. They were presented with a simulated scenario and asked to 'think aloud' during and after the simulation. The students were audio-video recorded and observations were collected by the researcher. There was a significant moderate increase in the 'deduction' and 'analysis' sub-scale scores and overall test score, suggestive of improved analytical decision-making processes through the simulation experience. Think-aloud and observation data identified that students predominantly applied 'forward' reasoning during the simulated 'patient's' deterioration, focusing mainly on cue acquisition. 'Backward' reasoning with a focus on cue interpretation was most prominent in the debriefing data, in line with the survey outcomes. Accurate cue interpretation of critical, key cues appeared more useful than the total number of cues in solving the main clinical case problem. Students learn different clinical decision-making skills during the simulation compared to what they learn from debriefing. Using observation and think-aloud methods have significant benefits for researchers seeking to optimize the evaluation of the clinical decision-making process.

Exploring the Critical Thinking Skills of Respiratory Care Students and Faculty

Background: Critical thinking is an essential skill for respiratory therapists to provide competent patient care. However, limited evidence of respiratory care students' critical thinking levels and no empirical evidence assessing that of respiratory care faculty exists. This study aims to assess the overall critical thinking levels of respiratory care students and faculty, determine whether faculty have stronger overall critical thinking skills than students, and investigate students' and faculty's perceptions regarding what critical thinking is and how it develops. Methods: An E-mail invitation was sent to all accredited US respiratory care education program directors asking for their participation and forwarding the solicitation letter to students and faculty. Participants completed a two-section online survey first requesting demographic information and presenting three open-ended questions and then providing the health sciences reasoning test (HSRT) to assess participants' critical thinking. Quantitative data were analyzed using descriptive statistics and one-tailed independent t-test (P

Applying digital storytelling in the medical oncology curriculum: Effects on students’ achievement and critical thinking

BackgroundDigital storytelling (DST), which combines traditional storytelling with digital tools, can provide a narrative pedagogy that promotes critical thinking (CT). However, we found no previous study in medical education. Materials and methodsThe aim of the study was to investigate if DST can promote CT and, if so, which CT skills were improved. Thirty-two students participated in a non-equivalent control group pretest-posttest research study, with 16 in each group. The participants were fifth-year medical students on a hematology rotation. We compared the routine instructional method (control group) with DST (intervention group). The measures of CT used for the pre- and post-test in both groups was the Health Science Reasoning Test (HRST) and knowledge test. We also evaluated the satisfaction of the students in DST group. We used Paired and independent t-tests for comparing the mean scores. To eliminate the confounding effect of pre-test on the results of the intervention, the ANCOVA test was used. ResultsThere was no significant difference in the overall CT pretest scores (P-value = 0.51) between the control and intervention groupsbut the difference was significant for the post-test scores (P-value = 0.03). Although post-test scores showed a significant increase (P-value = 0.002) compared to pre-test scores in the intervention group, no significant increase was observed in the control group (P-value = 0.26). Most students considered that DST improved their CT, deep learning, communication skills and team-working. ConclusionsThe study demonstrated that DST promoted CT. We recommend the use of DST to promote CT in clinical education placements.

A Comparison of Instructional Methods on Clinical Reasoning in Entry-Level Physical Therapy Students: A Pilot Study

Introduction. The primary aim of this study was to provide a comparison of the effects of 2 commonly used pedagogical approaches (paper-based case studies vs authentic patient experiences) on clinical reasoning and critical thinking of second-year entry-level physical therapy students. Current literature reveals a lack of consistency in how clinical reasoning is taught and assessed in physical therapist education. There is a need for evidence-based approaches to develop clinical reasoning in entry-level physical therapy students in the United States. Subjects. Twenty-three students in their second year of a Doctor of Physical Therapy (DPT) degree program participated in this study. Methods. Participants were randomly assigned to a control group or to receive 1 of 2 supplemental learning activities (paper-based case studies or authentic patient experiences). Outcomes measured preintervention and postintervention included the Health Science Reasoning Test with Numeracy (HSRT-N) and the Self-Assessment of Clinical Reasoning and Reflection (SACRR). Data analysis included a comparison of effect sizes of change scores between groups and correlational analysis of pretest scores and student factors. Results. Authentic patient experiences demonstrated a moderate to large effect size for improved HSRT-N scores on 5 of 8 subscales, compared with paper-based case studies. Authentic patient experiences demonstrated a moderate effect size for improved SACRR scores compared with the control group. Discussion and Conclusion. The use of authentic patient experiences may be more effective than paper-based case studies for improving critical thinking and clinical reasoning in an entry-level DPT curriculum.

Differences in learning styles, critical thinking skills, and peer evaluations between students with and without leadership engagement

IntroductionLeadership has long been suggested as an attribute essential to the pharmacy profession. Academic pharmacy has identified and addressed the need for leadership development among student pharmacists. The objective of this study is to assess differences in learning styles, critical thinking skills, and peer-perceived leadership skill evaluations between those with vs. without student leadership engagement (SLE). MethodsFour cohorts of pharmacy students were included in the analysis. Each student completed the Kolb Learning Style Inventory and Health Science Reasoning Test (HSRT) during pharmacy school orientation. Student-peer evaluation scores were derived from three courses and assessed important leadership skills such as communication, critical thinking, teamwork, and professionalism. Descriptive analysis was performed; group difference was tested using independent group t-tests on continuous variables and Fisher exact tests on categorical variables. ResultsThis study included 205 pharmacy students from the Classes of 2018 to 2021; 63 students (31%) displayed SLE. No significant differences were found in the peer evaluation scores between students with and without SLE. Students with SLE showed significantly higher scores in domains of the HSRT and the overall HSRT score. ConclusionsThe study results showed that HSRT assessment of critical thinking skills was significantly higher in students engaging in leadership, suggesting that HSRT should be explored as a possible predictor for SLE in future studies.

A preclinical hybrid curriculum and its impact on dental student learning outcomes.

The purpose of this study is to measure how the implementation of an online, preclinical hybrid curriculum impacts dental student clinic readiness, the outcomes of grades, critical thinking skills, and student and faculty perceptions respectively. This longitudinal comparative and descriptive study used objective data and subjective (survey) data for 4 dental class cohorts. Groups A and B experienced a traditional lecture-based curriculum, while Groups C and D experienced a hybrid curriculum that was lecture-free and implemented active learning. The Health Sciences Reasoning Test (HSRT), an objective assessment, was used to measure students' critical thinking skills. Dental student outcomes have either remained steady or improved with the transition to a new hybrid curriculum. According to the student and faculty survey results, the hybrid curriculum promoted student learning, independence, critical thinking, initiative and self-motivation, and clinic practice readiness. Group C (N = 68) Total Online Platform mean scores demonstrated a significant and moderately strong correlation with the preclinical course mean grades (r = 0.68, P = 0.00). Group D HSRT (n = 63) for Attempt 1 (end of year 1) and Attempt 2 (end of Year 2) paired T test resulted in HSRT Overall (mean difference= -2.27, SD = 7.21, t = -2.5, P = 0.02) for the second preclinical year. The hybrid curricular approach afforded many benefits. Faculty took an active role in imparting knowledge when compared to the lecture hall. Having students immersed in continual assessment through an online adaptive platform and active learning promoted self-motivation, deeper learning, applied knowledge, and discouraged superficial memorization.

The impact of team-based learning on the critical thinking skills of pharmacy students

IntroductionCritical thinking is an important ability for pharmacists, but few studies have found improvements in pharmacy student critical thinking skills as a consequence of their education. Team-based learning (TBL) is an active learning strategy that encourages students to think critically to solve problems. The purpose of this study was to evaluate the impact of TBL on the critical thinking skills of pharmacy students. MethodsOne hundred ninety students from the first two cohorts at a pharmacy school were invited to participate. The Health Science Reasoning Test (HSRT) was administered prior to the first semester and after two years of the TBL-based pharmacy curriculum. Student's t-test was used for a pairwise analysis along with Welch's t-test for unequal variances when comparing HSRT score modulation. ResultsThere was an overall increase in mean HSRT score. However, some participants (29%) with initially higher mean HSRT scores did not demonstrate an increase. Nearly all (99%) participants demonstrated improvements of one of the eight domains of critical thinking evaluated in the HSRT. This corresponded with an improvement in score of the majority of participants (n = 115). ConclusionThis study provides evidence that TBL improves critical thinking skills. More research is needed to identify the specific aspects of TBL that influence critical thinking.

Learning with peers: Does that foster critical reasoning?

Background: Health science education is competency based education where one needs to critically think and analyse the problem. Critical thinking is meta-cognitive process where self-learning and meaningful learning are integral. Peer-learning helps in fostering higher order thinking and provides the environment for meaningful learning. There is a mixed evidence of effectiveness of peer learning. Very few studies have addressed changing group dynamics, group composition and its effect on critical reasoning ability. Hence present study aimed to assess effectiveness of peer-learning on critical reasoning ability, in physiotherapy undergraduate students, with changing group composition. Methodology: This quasi experimental two group crossover study was conducted in two phases. Total 37 fourth year physiotherapy students were involved in the study by convenient sampling. The students were randomly allocated in two groups. In first phase, Group One was sub-grouped based on scores of content knowledge test taken before experiment, by grouping high, medium and low scorers together. Group Two was given a freedom to choose their partners. In second phase groups crossed over. Five case-based sessions were conducted in each phase and both groups fulfilled the objectives, by peer discussion within their subgroup. Outcome measure was health science critical reasoning ability using Health Science Reasoning Test score. Results: There was no significant difference found in the test scores between both the groups. This study does not favour the effectiveness of the peer-learning in improving critical reasoning skills. There found no effect of changing group composition on critical reasoning ability. The results could be content and discipline specific.

Examining the Predictive Validity of the Health Sciences Reasoning Test (HSRT) in a Nontraditional Graduate OT Program

Abstract Date Presented 03/28/20 The purpose of this study was to determine whether the HSRT predicts student success. The data was analyzed using an ordinal logistic regression and a Spearman’s rho correlation coefficient. Statistical analyses revealed that the HSRT is not a valid predictor of student success, and there is also a weak relationship between the HSRT and student success. The HSRT can be further studied with other admission tools to determine what most accurately measures student success in a graduate OT program. Primary Author and Speaker: Kathryn Kendrick Additional Authors and Speakers: Joanna Such, Aileen Burke Contributing Authors: Catherine Cavaliere, Pamela Story

Effects of high-fidelity simulation on the critical thinking skills of baccalaureate nursing students: A causal-comparative research study

BackgroundCritical thinking has been identified as one of the standards for nursing school accreditation and a long-standing outcome of nursing education and nursing practice. High-fidelity simulation is one method currently used by nursing programs to increase critical thinking in nursing students. Despite these expectations, there is limited empirical evidence which compares the effects of simulation to other teaching strategies. ObjectivesThe purpose of this study was to examine whether statistically significant differences existed in mean critical thinking skill scores within groups (pretest to posttest) and between groups (simulation versus written case studies). DesignA quantitative causal-comparative methodology with a pretest/posttest design. SettingA private university in the midwestern United States which offers a four-year Bachelor of Science Nursing program. ParticipantsBaccalaureate junior nursing students (N = 69) were recruited from a convenience sample and divided into two groups which consisted of a simulation group (n = 36) and a written case studies comparison group (n = 33). MethodsThis research study consisted of a pretest, three weeks of being in either the simulation group or the written case studies group, and a posttest. The Health Science Reasoning Test (HSRT) was the instrument used for the pretest and posttest to measure critical thinking skills of all participants. ResultsA repeated measures mixed analysis of variance (ANOVA) indicated there was no statistically significant difference in participants' mean critical thinking scores within groups (pretest to posttest) or between groups (simulation versus written case studies). ConclusionsThe use of high-fidelity simulation as a teaching strategy versus written case studies to increase critical thinking skills of nursing students was not supported.

Critical Thinking in Health Sciences and How It Pertains to Sonography Education: A Review of the Literature

Objective: Critical thinking is an important skill that sonographers must develop beginning in educational programs and into professional practice. Critical thinking requires students to reflect on information, use judgment skills, and engage in higher levels of thinking, including analysis, interpretation, inference, evaluation, and explanation, to formulate reliable decisions. Methods: Current research related to critical thinking has focused on medicine, nursing, physical therapy, pharmacy, and dental programs, but there has been no description of assessing sonography students. The Dreyfus model has been used as a framework to describe acquired skills that reflects students’ progress from novice to expert clinicians. This model illustrates specific cognitive abilities that students develop as they advance in education. Results: This review of the literature describes critical thinking skills coupled with a framework to understand different levels of cognitive thinking, as well as how it can be assessed. Conclusion: To understand differences between undergraduate sonography students and experts, the Dreyfus model is an excellent model to recognize progression. It can be used with the Health Sciences Reasoning Test, which is a nationally recognized critical thinking examination that can ascertain different levels of health sciences students’ critical thinking skills.

Critical Thinking Skills of RNs: Exploring Demographic Determinants

Previous studies of nurses' critical thinking skills that included demographic characteristics as determinants have been inconclusive. This study explored demographic determinants of critical thinking skills among nurses from public hospitals in Peninsular Malaysia. This cross-sectional study included 549 nurses recruited via multistage cluster sampling. Nurses completed the demographic questionnaire and Health Sciences Reasoning Test (HSRT). The majority of respondents failed to demonstrate critical thinking skills with a mean overall HSRT score of 13.8 (SD = 3.4). Educational qualifications (p = .003) and clinical specialties (p = .022) were significantly related to nurses' critical thinking skills. Years of clinical experience, age, and job ranking were not significant CONCLUSION: The findings indicate a need to address the present curriculum in nursing education and to reinforce critical thinking skills in the nursing workforce. Future research on how nurses in Malaysia acquire critical thinking skills is needed. [J Contin Educ Nurs. 2020;51(3):109-117.].

Impact and Reasoning: Applying Community Service Learning in a Non-Traditional Field

Background: Health care today is presented with a complex set of circumstances requiring exploration of new and varied teaching methodologies to produce requisite student reasoning and prepare them for professional practice. Health care practitioners require high-level clinical reasoning skills to practice, skills traditionally achieved through clinical experiences. Purpose: The purpose of this study was to explore the impact of a community service learning clinical experience on the clinical reasoning skills of pre-licensure nursing students. Methodology/Approach: A sample of junior-level nursing students was recruited and given the Health Science Reasoning Test pre-test. Participants then completed a community service learning clinical experience, after which they took a post-test and completed a reflective journal entry. Findings/Conclusions: Quantitative data analysis was inconclusive due to limitations. Qualitative data analysis suggested that clinical reasoning skills were affected and identified major themes (communication, holistic care, and knowledge and skills). Implications: Community service learning clinical experiences have the potential to enhance clinical reasoning skills and should be further evaluated for inclusion in today’s nursing programs.

Examination of Clinical Internship Impact on Critical Thinking Utilizing the Health Science Reasoning Test

Abstract Introduction The Health Science Reasoning Test (HSRT) is a validated instrument to assess critical thinking skills and is specifically calibrated for trainees in undergraduate and graduate health science educational programs. The objective of this study was to examine the association of scores on the HSRT with clinical internship education in laboratory science students. Methods In March 2019, assessment of clinical reasoning skills by the HSRT was administered to 29 laboratory science students in the following programs: medical laboratory science and cytotechnology. As this was a pretest/posttest design, the HSRT was also administered after the completion of a 5-week clinical internship. Results Significant positive correlations were found between clinical internship education and HSRT scores. Changes in the HSRT scores occurred in overall scores and in the subdomains of deduction, evaluation, and inference after the students completed the 5-week clinical internship. Conclusion Clinical internships are an opportunity for students to develop critical thinking by participating in higher levels of learning objectives, including application, analysis, synthesis, and evaluation. However, the impact of clinical internships on critical thinking is unknown, and this study has shown a significant improvement in HSRT scores following student participation in a 5-week clinical internship. The HSRT was useful in measuring the association and impact of clinical internship education and critical thinking. Therefore, it is reasonable to conclude clinical internships are valuable educational experiences fostering critical thinking in laboratory science students.

Impact of Students’ Strengths, Critical Thinking Skills and Disposition on Academic Success in the First Year of a PharmD Program

Objective. To determine the critical thinking skills, critical thinking disposition, and personal strengths that contribute to student success and excellence in the first year of a doctor of pharmacy (PharmD) program. Methods. Student pharmacists from three cohorts completed the Health Sciences Reasoning Test (HSRT) to assess their critical thinking skills, the California Critical Thinking Disposition Inventory (CCTDI) to assess their critical thinking disposition, and the StrengthsFinder 2.0 assessment to determine their top five Signature Themes. HSRT overall categories, CCTDI subcategories, and top five Signature Themes were analyzed to determine both independent predictors and a logistic regression model of success and excellence. Results. HSRT and the Signature Theme of Consistency were independently associated with both success and excellence. CCTDI Open-mindedness and the Signature Themes of Achiever and Learner were also independent predictors of excellence. Age and several Signature Themes were negative independent predictors of success. In a multiple logistic regression model, HSRT overall category and the absence of Signature Themes Command and Woo predicted success and HSRT overall category predicted excellence. Conclusion. This is the first model to determine performance in the first year of PharmD program using Signature Themes. Critical thinking skills, the critical thinking disposition of Open-mindedness and the Signature Themes of Achiever, Consistency, and Learner are associated with the highest student performance.