Date of Award

Spring 2015

Document Type


Degree Name

Doctor of Philosophy (PhD)


Teaching & Learning


Curriculum and Instruction

Committee Director

Richard Overbaugh

Committee Member

Andreas Tolk

Committee Member

Jennifer Green


Critical thinking decision making is the foundation for effective, safe, nursing practice. Nurses have to assess patient issues rapidly regardless of whether it is emotional, psychological, or physical, and then sort through "rapid fire" questions resulting in invisible sorting, discerning, and drawing of conclusions. Doing this "invisible sorting" well requires practice. Nursing education provides practice through preceptors or scenarios-driven human patient simulators to practice critical thinking. This study examines Adaptive Thinking Training Methodology with simulation exercises as a possible catalyst for growth in critical thinking disposition, and help in addressing the preparation-practice gap for novice nurses.

A class of advanced nursing students entered three simulations to develop critical thinking through scenario-based learning. The first simulation had no adaptive thinking intervention. During the second simulation, only one adaptive thinking intervention occurred. The final simulation had two adaptive thinking interventions. Interventions occurred at the point in which an appropriate critical thinking decision points were appropriate for practice. The three interventions defined for simulations two and three used an Applied Cognitive Task Analysis methodology for the development of cues. The aim of this research was to accelerate growth in critical thinking disposition for professional caregivers to move further toward expertise in a shorter period. A Repeated Measures (RM) Analysis of One Way Variance (ANOVA) was used to determine effectiveness of treatment.


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