Introduction: Respiratory therapists evaluate the condition of their patients, make decisions about the appropriateness of the treatment plan, provide care, and evaluate the outcomes of their decisions. To practice effectively they must think critically and make appropriate decisions. As educators make curriculum changes to improve students' decision-making (DM) skills, strategies to develop critical thinking (CT) have been proposed as one method of achieving that goal. This approach is based on the hypothesis that a positive relationship exists between DM and CT. The present study examines the relationship between CT and DM in respiratory care students. If there is a positive relationship between CT and DM, respiratory care training programs might improve the DM skills of future practitioners by providing instruction that improves CT.
Methods: Using a correlational research design, DM scores from the Clinical Simulation Self-Assessment Examination (CSSAE) were compared with scores from the Watson-Glaser Critical Thinking Appraisal for 143 graduating respiratory care students from 10 programs. Program directors completed a questionnaire and were then interviewed about the methods they employ to develop CT and DM in their students.
Results: A significant correlation between CT and DM was found for 110 students completing the Secure Form of the CSSAE (r = 0.32, p < 0.01). All programs used case studies and clinical simulations, and most used role modeling, computer-assisted instruction, patient rounds, small group discussion, and study skills courses. No differences were identified in the use of the CT and DM development strategies by different programs.
Conclusions: The findings support the belief that students with strong CT proficiency make better clinical decisions. Assessment of CT proficiency could be used as one part of a process for evaluating prospective students and faculty for respiratory care programs. Program directors and faculty felt that case studies and clinical simulations are important strategies.