STUDENTS AND NURSING FACULTY IN SOUTHWESTERN
by
Foluso O. Ojewole
CESARINA THOMPSON, PhD, Faculty Mentor and Chair
JULIA BRONNER, PhD, Committee Member
JOSEPH AINA, PhD, Committee Member
Feranda Williamson, EdD, Dean, School of Education
A Dissertation Presented in Partial Fulfillment
Of the Requirements for the Degree
Doctor of Philosophy
Capella University
August, 2013
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© Foluso Ojewole, 2013
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Abstract
The purpose of this quantitative research study was to identify the critical thinking dispositions
of undergraduate nursing students and nursing faculty in Southwestern Nigeria. Critical thinking
dispositions are required for critical thinking skills. People who have critical thinking disposition
exhibit seven traits: truth-seeking, open-mindedness, analyticity, systematicity, inquisitiveness,
cognitive maturity, and critical thinking self confidence. While critical thinking is considered as
an essential outcome for nursing education, evidence points to a deficiency of critical thinking
skills in new nurses. Critical thinking research is lacking among nursing students in Nigeria. As a
first step in addressing this problem, this study investigated the critical thinking dispositions of
undergraduate nursing students and nursing faculty in Nigeria using the California Critical
Thinking Disposition Inventory Scale (CCTDI). Using a convenience and purposive sampling,
509 undergraduate nursing students and 37 nursing faculty from 4 accredited nursing programs
completed the CCTDI. Students demonstrated a weak positive overall disposition to critical
thinking, with evidence of disposition not increasing significantly overtime. The subgroup means
of the 7 trait sub-scores revealed a very homogeneous group with truth-seeking as lowest and
inquisitiveness as highest. In contrast, nursing faculty demonstrated a strong positive overall
inclination for critical thinking with lowest mean score on the truth-seeking subscale score and
highest in inquisitiveness score. Together, the findings suggest that significant differences
occurred in scores between the two groups. Implications for nursing education included
integrating teaching and learning activities that can enhance truth-seeking, ensuring students’
function as the creators of their own knowledge, and faculty becoming eager to learn how to
train critical thinkers, exerting the mental effort needed to apply it.
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Dedication
This dissertation is dedicated first to my God, Maker, and Redeemer who is the
Source of wisdom. My husband, Tee who has travelled and labored with me through this
process and has stood by me when I almost let go. My children: David and Dorcas for
sticking with our plans and co-operating every steps of the way. I also dedicate this
dissertation to the undergraduate nursing students and nursing faculty in Southwestern
Nigeria. Their support by participating in this study has laid the foundation for exploring
and examining Nigerian nursing students’ ability to contribute to the complexity of global
healthcare challenges.
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Acknowledgments
I would like to acknowledge the following people who have supported my
scholarly efforts. Thanks to Dr. Caserina Thompson, dissertation mentor and chair for
your support and direction that steered me in the right direction. I appreciate your
concern for directing a quality project and assisting me to maintain my focus. I am
extremely grateful to Dr. Julia Bronner for accepting to act as a committee member. She
kept me focused on fully understanding the fact to look beyond critical thinking and to
admire the larger perspective. Thanks to Prof. Joseph Aina, visiting scholar for your
mentorship. Your wealth of international experience contributed to this process and has
been valuable.
I could not have accomplished this pinnacle in my life without the support of the
most prestigious school in Nigeria, Babcock University. The administration and faculty’s
unwavering support through the years was impeccable. I am extremely grateful for four
people who have been my cheering and accountability committee throughout my doctoral
program: Tee, my pastor, Prof. Ezekiel Ajao, Baba Matthew Atejioye, and Rafiat
Anokwuru. They stood by me to challenge and encourage me, praying for me
throughout. I also want to thank Wolex, Bisi, and Jojo for providing accommodation and
vehicles to use for my summer trips.
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Table of Contents
Acknowledgments iv
List of Tables
List of Figures
CHAPTER 1. INTRODUCTION 1
Introduction to the Problem 1
Background, Context, and Theoretical Framework 3
Statement of the Problem 6
Purpose of the Study 7
Research Questions 8
Rationale, Relevance, and Significance of the Study 10
Nature of the Study 13
Definition of Terms 14
Assumptions, Limitations, and Delimitations 15
Organization of the Remainder of the Study 17
CHAPTER 2. LITERATURE REVIEW 18
Introduction to the Literature Review 18
Theoretical Framework 18
Review of Research Literature and Methodological Literature 25
Chapter 2 Summary 51
CHAPTER 3. METHODOLOGY 53
Introduction to Chapter 3 53
Research Design 55
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Target Population, Sampling Method, and Related Procedures 56
Instrumentation 59
Data Collection 63
Data Analysis Procedures 64
Limitations of the Research Design 65
Internal Validity 66
External Validity 66
Expected Findings 67
Ethical Issues 67
Chapter 3 Summary 68
CHAPTER 4. DATA ANALYSIS AND RESULTS 69
Introduction 69
Description of the Sample 70
Summary of the Results 72
Detailed Analysis 80
Chapter 4 Summary 91
CHAPTER 5. CONCLUSIONS AND DISCUSSION 93
Introduction 93
Summary of the Results 93
Discussion of the Results 96
Discussion of the Results in Relation to the Literature 102
Limitations 108
Implication of the Results for Practice 109
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Recommendations for Further Research 111
Conclusion 112
REFERENCES 115
APPENDIX A. STATEMENT OF ORIGINAL WORK 127
APPENDIX B. DEMOGRAPHIC SHEET FOR FACULTY 129
APPENDIX C. DEMOGRAPHIC SHEET FOR STUDENT 130
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List of Tables
Table 1. Demographics of Undergraduate Nursing Students 70
Table 2. Demographics of Nursing Faculty 71
Table 3. Descriptive Statistics of Critical Thinking Dispositions 72
of Baccalaureate Nursing Students
Table 4. Descriptive Statistics of the Critical Thinking Dispositions 74
of Nursing Faculty
Table 5. Descriptive Statistics of the Critical Thinking Dispositions 75
scores of Undergraduate Nursing Students and Nursing Faculty
Table 6. Descriptive Statistics of the Critical Thinking Dispositions 76
Composite and Subscales scores of Second Year and Third Year Students
Table 7. . Descriptive Statistics of the Critical Thinking Dispositions 77
Composite and Subscales scores of Third Year and Fourth Year Students
Table 8. . Descriptive Statistics of the Critical Thinking Dispositions 78
Composite and Subscales scores of Fourth Year and Fifth Year Students
Table 9. Descriptive Statistics of the Critical Thinking Dispositions 79
of Baccalaureate nursing students and Nursing Faculty
Table 10. Independent Samples t- test for Critical Thinking Disposition 81
Scores of Baccalaureate Nursing Students and Nursing Faculty
Table 11. Independent Sample t test for Total Critical Thinking Disposition 82
scores of Second Year and Third Year Nursing students
Table 12. Independent Sample t test for the Total Critical Thinking Disposition 83
scores of Third Year and Fourth Year Students
Table 13. Independent Sample t test for Total Critical Thinking Disposition 84
scores of Fourth Year and Fifth Year Students
Table 14. Independent Sample t test for Total Critical Thinking Disposition 85
of Baccalaureate Nursing students and Nursing Faculty
Table 15. ANOVA Results for Critical Thinking Disposition scores 85
of Faculty and Students
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Table 16. ANOVA Results for Critical Thinking Disposition Scores 90
by Student level in the program
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List of Figures
Figure 1. Overall group mean CCTDI attribute sub-scores for students 73
Figure 2. Overall group mean CCTDI attribute sub-scores for nursing faculty 74
Figure 3. Overall group mean for CCTDI minimum scores, average scores, 79
and maximum scores for students and faculty
Figure 4. Box plot for Truth-seeking 86
Figure 5. Box plot for Open-mindedness 87
Figure 6. Box plot for Inquisitiveness 87
Figure 7. Box plot for Analyticity 88
Figure 8. Box plot for Systematicity 88
Figure 9. Box plot for Confidence in Reasoning 89
Figure 10. Box plot for Maturity of Judgment 89
Figure 11. Box plot for Total Critical Thinking Dispositions 90
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CHAPTER 1. INTRODUCTION
Introduction to the Problem
New graduate nurses of nowadays are increasingly exposed to complex healthcare
environments that require the skills to effectively think and reason to provide quality patient
care (Billings & Halstead, 2009; Kautz, Kuiper, Pesut, Knight-Brown & Daneker, 2005). To
adequately prepare nursing students for practice in these environments, the ability to critically
think has been included as a learning outcome in curriculum and accreditation standards
published by leading nursing education organizations, such as the American Association of
Colleges of Nursing and the National League for Nursing Accrediting Commission (Giddens,
Brady, Brown, Wright, Smith, & Harris, 2008). Guhde (2010) enumerated the importance of
nursing curriculum in preparing nursing students to display evidence of critical thinking upon
graduation.
Critical thinking skills are essential in today’s vastly changing world. Critical thinking
is defined as a non-linear process that facilitates the development of decision-making in a
given situation (Facione & Facione, 2007; Kyung, Ja, Ju, & Kim, 2006). Critical thinking
skills in nursing are important, as they are central to providing competent quality care. The
need for the development of appropriate critical thinking skills by nursing students is also
supported by the standards of practice for nurses as determined by various state nursing
boards. As undergraduate nursing students progress through the academic program, their
critical thinking skills should continue to develop.
The importance of critical thinking skills for the professional nurse is well
documented in nursing literature (Suliman, 2006; Turner, 2005). Nurses must be able to
analyze information quickly and apply knowledge to effectively meet the needs of their
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patients, thereby improving patient outcomes. However, research indicates that new graduate
nurses are failing to meet these expectations (Del Bueno, 2005; Toofany, 2008). To address
this problem, educators need to develop teaching strategies that encourage the advancement
of critical thinking skills by their students. The American Philosophical Association (APA)
defined critical thinking (CT) as a “purposeful, self regulating judgment which results in
interpretation, analysis, evaluation and inference as well as explanation of the evidential,
conceptual methodological, or contextual consideration upon which that judgment is based”
(Facione & Facione, 2007, p. 10).
The Delphi Report sponsored by the American Philosophical Association, was the
product of the work of interdisciplinary panel of experts in the study of critical thinking. The
Delphi Committee collectively exchanged ideas on important traits of critical thinking. The
committee identified six skills (interpretation, analysis, evaluation, inference, explanation,
and self regulation), 16 sub-skills, and 19 dispositions (including inquisitiveness, openmindedness,
understanding others, and so on) that are associated with CT. These skills and
dispositions provide a complex normative framework for understanding and assessing the
qualities of human cognition. CT requires gaining mastery of a series of discrete skills or
mental operations and dispositions that can be generalized across a variety of contexts. These
skills include concepts such as interpreting, predicting, analyzing, evaluating, explanation,
and self-regulation (Facione & Facioine, 2007). Each of these core critical thinking skills has
sub-skills that help illustrate a student’s disposition toward CT.
Critical thinking dispositions are requisite for thinking critically and for developing
sound critical thinking skills. Dispositions toward thinking critically have been portrayed as
the unswerving internal inclination to problem solving and decision making achieved by
thinking (Facione & Facione, 2007; Zhang, 2008). An individual with critical thinking
dispositions display a inquiring inquisitiveness, a enthusiastic intellect, a zealous dedication
to reason, a hunger for reliable information, and are more apt to use their critical thinking
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skills than are those who do not have strong critical thinking dispositions (Facione &
Facione, 2007; Soeherman, 2010). These dispositions include the following seven traits: truth
seeking, open-mindedness, analyticity, systematicity, inquisitiveness, cognitive maturity, and
critical thinking self-confidence (American Philosophical Association, 1990). Shin, Duk,
Jung, Shin, and Kim (2006) reported a positive relationship between critical thinking skills
and critical thinking disposition. Not only do students need high level of critical thinking
skills and dispositions, but nursing faculty as facilitators of learning should also demonstrate
critical thinking as they present information to students (Alper, 2010). Thus, the facilitator of
learning must support the learner’s attempts to engage in critical thinking.
Nursing training in Nigeria has undergone a major educational transformation.
Although this transformation is significant, critical thinking research in nursing is still
deficient compared to other countries. The complex nature of today’s healthcare environment
has made critical thinking skills acquisition by nursing student a requisite by the educational
accrediting bodies for nursing programs. Nursing and Midwifery Council of Nigeria (2011)
has mandated that educational programs are in conformity with the prevailing technological
advancement and societal needs.
Background, Context, and Theoretical Framework
The discipline of nursing education in Nigeria has developed from a non-regulated
profession in which students depend on their faculty for knowledge without demonstrating
the necessary thinking skills required to practice safely in a health profession that is closely
overseen by strict accreditation guidelines. Nursing education in Nigeria has focused more on
rote learning in which the curriculum is content saturated rather than encouraging students to
expand critical thinking skills needed to analyze and interpret patient problems. As P. A.
Facione (2000) states, “Reception of knowledge and skills simply cannot guarantee
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accomplishment in the workplace or in school. People must also be inclined to use the
knowledge gained.” (p.82). Consequently, educators and employers value CT dispositions.
The notion of critical thinking is not new in education discipline. Dewey (1993)
brought CT to the attention of educators when he encouraged teachers to develop reflective
thinking skills in children. He explained that CT arose from uncertainty situations, which
cause dilemmas and require the consideration of alternative solutions (Dewey, 1993).
Critical thinking disposition is a personal habit of mind that predisposes a person to make self
controlled decisions in response to problems and choices encountered in personal or
professional situations (Stupnisky, Renaud, Daniels, Hayes, & Perry, 2008). Thus, students
and faculty who possesses the dispositions to think have the tendency or willingness to use
critical thinking skills. These dispositions have been likened to a spirit of inquiry, being open
minded, drawing unwarranted assumptions cautiously, and weighing the credibility of
evidence (Riddell, 2007). It is thought that faculty with strong critical thinking disposition
will ensure the development and use of CT skills and students with greater critical thinking
dispositions will have the tendency to develop critical thinking.
The critical thinking dispositions as defined by the American Philosophical
Association (APA) Delphi Report (1990) and constructivism theory served as the framework
for this study. The APA defined critical thinking disposition as a personal disposition or habit
that results in the making of self controlled decisions in response to problems and choices
encountered in personal or professional situations (as cited in Shin, Lee, Ha, & Kim, 2006).
In other words, the scope of critical thinking can be said to include cognitive skills and
affective disposition. Thus, critical thinking disposition is a predisposed attitude one innately
possesses in regards to utilizing critical thinking skills.
P. A. Facione and Facione (2007) developed the California Critical Thinking
Disposition Inventory (CCTDI) to measure critical thinking disposition and the degree of
such disposition. P. A. Facione and Facione (2007) believed such disposition, attitudes, or
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habits to be elements of the rationalization process that urged individuals to think critically
with truth-seeking, open-mindedness, analyticity, systematicity, critical thinking selfconfidence,
inquisitiveness, and maturity of judgment as scales. Therefore, people who think
critically should be able to make considerations about what they should do and believe in,
and implement key critical thinking skills.
The conceptual definition of constructivism is that human learning is constructed and
built upon previous knowledge (Brandon & All, 2010). Educational Broadcasting
Corporation (EBC) (2004) affirmed that the constructive theory encourages learners to be
active creators of their own knowledge. Learners are to select and transform information,
construct ideas, and make decisions, while relying on a cognitive structure (Giddens &
Brady, 2007). According to constructivism, education is developmental, and that
development is built internally, socially, and culturally (Stedman, Irani, Friedel, Rhoades, &
Ricketts, 2009). Likewise, critical thinking is internal, developmental and social. As part of
the social cognitive theory, critical thinking disposition as a behavior is constructed based on
personal experience and as information is processed and organized in school or environment
interact and influence each other. Constructivism assumes that learners construct knowledge
as part of a process of making sense of their experience and develop CT skills through
personal inquiry (Driscoll, 2005). Thus, a student who possesses disposition to think will
utilize critical thinking skills that would assist them with cognitive development and
knowledge acquisition.
As a result of the expectations established by the NLNAC and AACN, there have
been many studies conducted to measure and enhance critical thinking skills among nursing
students and nursing faculty. Studies have focused on several variables that are believed to be
associated with critical thinking disposition. These variables include age, years of experience,
success on high stakes testing for licensure examinations, and grade point average (GPA)
(Bartletts & Cox, 2002; Giddens & Gloeckner, 2005; Learer-Dunn, Harrelson, Martin, &
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Wyatt, 2002; Lederer, 2007; Stewart & Dempsey, 2005). Zygmont and Schaffer (2006)
reported that nursing faculty’s ability to think critically varied considerably. Thus, there may
be a relationship between the ability of nurse faculty to engage in CT and the ability of the
learner to develop CT skills. Therefore, students taught by faculty not skilled in CT may be at
a disadvantage in developing the CT skills required in the practice environment.
Research suggests that the development of CT skills in nursing students is related to
their level of education within the nursing program. Students’ CT skills generally increased
as students progressed through the program (Proffeto-McGarth, 2003). Thus, assessing
baseline CT skills and dispositions of nursing students prior to beginning the program is
essential to be able to then compare if skills increase as students move through the program.
Currently, there is no research to establish critical thinking baseline scores for nursing faculty
and students’ in Nigeria which makes it difficult to implement strategies to increase students’
critical thinking dispositions and evaluate their effect without first assessing baseline data.
Moreover, all the existing research on critical thinking has been conducted in other countries
and not in Nigeria.
Statement of the Problem
Critical thinking is an essential outcome for nursing education. Nurses need CT skills
in order to be safe, competent, and skillful practitioners (Rubenfeld & Schaffer, 2006). While
critical thinking has been identified as an important educational outcome of nursing education
programs (AACN, 2008; NLNAC, 2006); evidence points to a deficiency of critical thinking
skills in new nurses (Del Bueno, 2005, Fero, Witsberger, Wesmiller, Zullo, & Hoffman,
2009; Toofany, 2008). King, Smith, and Glenn (2003) observed in a survey of 117 nurse
educators, 82 nurse administrators, 23 new baccalaureate nursing graduates, and 11 deans,
that critical thinking was consistently listed as one of the most important entry level
competencies; however, it was also consistently ranked among the lowest observed
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competencies. Therefore, it is important for educational programs to assess critical thinking
abilities in their undergraduate nursing students and to select and implement strategies that
will foster the development of these skills.
In addition, it is equally important that nursing faculty demonstrate these skills so they
can effectively role model them to students. Zygmont and Schaffer (2006) noted that
faculty’s critical thinking skills test results varied considerably, suggesting students taught by
a faculty not skilled in CT may experience a drawback in developing CT. Some research
related to the development of and evaluation of CT skills has occurred in other countries,
however, no research on this important topic has been conducted in Nigeria. Although in
Nigeria, students’ scores on nursing board examinations and academic tests are above
average, feedback from clinical instructors and alumni supervisors suggest that graduates are
lacking in these skills as they begin their professional practice. Therefore, it is important to
assess students’ abilities before planning interventions for improvement. In addition, since
faculty play an integral role in preparing students for future practice, it would be important to
know about their CT abilities as well.
Purpose of the Study
The purpose of this study is to add to the existing body of research that is concerned
with critical thinking dispositions in nursing students and faculty. Numerous research studies
on critical thinking have been carried out in the United States and other countries; however,
no research on this topic has been conducted in Nigeria. As a first step in addressing this
problem, this study will determine the critical thinking dispositions of undergraduate nursing
students at various levels of nursing education in Nigeria using the California Critical
Thinking Disposition Inventory Scale (CCTDI). In addition, the study will also describe the
critical thinking disposition of nursing faculty using the same instrument (CCTDI).
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Research Questions
One major concept will be addressed in this study: assessment of critical thinking
dispositions of nursing students and nursing faculty. This concept plays a vital role in nursing
education. For this study the main concept transformed into research questions are:
Primary Research Question
What are the Critical thinking Dispositions of baccalaureate nursing faculty and
nursing students in Southwestern Nigeria and how are these critical thinking dispositions
different and similar?
Sub-Question 1. Sub-question 1: What are the critical thinking dispositions of
baccalaureate nursing students in Southwestern Nigeria?
Sub-Question 2: What are the critical thinking dispositions of nursing faculty in
Southwestern Nigeria?
Sub-Question 3: Is there a significant difference between the critical thinking
dispositions composite and subscales scores of baccalaureate nursing students and nursing
faculty?
Sub-Question 4: Is there a significant difference between the total critical thinking
disposition composite scores and subscale scores of second year nursing students and third
year nursing students?
Sub-Question 5: Is there a significant difference between the total critical thinking
dispositions composite scores and subscale scores of third year and fourth year nursing
students?
Sub-Question 6: Is there a significant difference between the total critical thinking
dispositions composite scores and subscale scores of fourth year and fifth year nursing
students?
Sub-Question 7: Is there a significant difference between the critical thinking
dispositions of baccalaureate nursing students and nursing faculty?
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Research Hypotheses
The following hypotheses will serve as the foundation to predict the results of the
study on the critical thinking dispositions of baccalaureate nursing students and nursing
faculty.
Null Hypothesis 1(Ho): There will be no significant difference between the critical
thinking dispositions composite and subscales scores of baccalaureate nursing students and
nursing faculty
Alternative Hypothesis 1 (Hα): There will be a significant difference between the
critical thinking dispositions composite and subscales scores of baccalaureate nursing
students and nursing faculty.
Null Hypothesis 2 (Ho): There will be no significant difference between the total
critical thinking disposition composite scores and subscale scores of second year nursing
students and third year nursing students.
Alternative Hypothesis 2 (Hα): There will be a significant difference between the
total critical thinking dispositions composite scores and subscale scores of second year
nursing students and third year nursing students.
Null Hypothesis 3 (Ho): There will be no significant difference between the total
critical thinking dispositions composite scores and subscale scores of third year and fourth
year nursing students.
Alternative Hypothesis 3 (Hα): There will be a significant difference between the
total critical thinking dispositions composite scores and subscale scores of third year and
fourth year nursing students. .
Null Hypothesis 4 (Ho): There will be no significant difference between the total
critical thinking dispositions composite scores and subscale scores of fourth year and fifth
year nursing students
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Alternative Hypothesis 4 (Hα): There will be a significant difference between the
total critical thinking dispositions composite scores and subscale scores of fourth year and
fifth year nursing students.
Null Hypothesis 5 (Ho): There will be no significant difference between the critical
thinking dispositions pf baccalaureate nursing students and nursing faculty.
Alternative Hypothesis 5 (Hα): There will be a significant difference between the
critical thinking dispositions of baccalaureate nursing students and nursing faculty.
Rationale, Relevance, and Significance
This segment described the specific rationale of this study. Even though the study of
critical thinking has been in existence for a while, this study emphasized how significant the
topic of interest is to nursing, especially to nursing education in Nigeria. The importance of
the study and its possible outcome related to nursing practice was highlighted.
Rationale for the Study
Benner, Sutphen, Leonard, and Day (2010) stated that employers are criticizing
nursing programs for producing unqualified graduates who are unable to manage the realities
of nursing. Based on the current changes in health care, effective thinking skills are essential
for nurses to plan, implement, and evaluate nursing interventions and other treatment
modalities.
Baccalaureate nursing students in Nigeria enter the nursing program with a goal to
complete the program and enter the profession of nursing. The core curriculum of this
program is based on competencies and objectives that must be completed. However, currently
no educational strategies are used to identify students who may need more support to develop
the thinking skills needed to be successful. Identifying and reinforcing CT dispositions can
lead to the identification of students that are experiencing difficulties progressing through the
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program, serve to potentially increase student retention, and facilitate the development of
teaching-learning strategies to enhance the CT skills of future nurses.
Currently, many students do not succeed in baccalaureate nursing programs in Nigeria
(BU Academic Report, 2010). These students may be empowered to succeed by identifying
their critical thinking dispositions, along with their strengths and weaknesses in these areas,
early in their academic endeavors. In addition, to enhance students’ CT skills, students need
to be taught by nurse educators who can serve as role models with respect to thinking skills.
Thus, it is just as important to assess faculty’s CT dispositions prior to planning and
implementing new teaching strategies.
Relevance of the Study
This study is needed to advance educators’ and researchers’ knowledge related to the
critical thinking dispositions of baccalaureate nursing students and nursing faculty in Africa.
The study will be relevant to nurse educators interested in identifying factors that may be
contributing to academic issues that confront nursing students. This study will serve as a first
step in addressing issues related to the concept of critical thinking and nursing curricula in
Nigeria. Finally, this study examined the differences between critical thinking dispositions of
nursing students and faculty, adding to the existing body of knowledge that pertains to critical
thinking development.
This study informed the research about critical thinking disposition of both nursing
students and nursing faculty and adds an international perspective to existing knowledge
related to critical thinking and nursing education. This study should expand nurse educators’
understanding of and how the conceptual framework or the concept of critical thinking may
apply in international populations of nursing students.
Significance of the Study
Numerous scholars have attempted to define the essential attributes of critical
thinking (CT). The American Philosophical Association concluded that interpretation,
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analysis, evaluation, inference, explanation, and self regulation were components (Facione,
2007). The definition of CT varies because of its abstract characteristics. Brookfield (1987)
defined critical thinking as consisting of four elements: identifying and challenging the
assumptions that serve as the basis of ideas, values, and actions; challenging the importance
of context; assuming and exploring the alternatives; and reflective skepticism. Critical
thinking in nursing includes the goal-oriented and meaningful thinking which allows a nurse
to make decision based on evidence not assumptions (Alfaro-LeFevre, 2007). Preparing
students to think critically is a goal of many higher education professionals. CT is a core
competency in nursing and has been widely discussed in nursing education. Lauder and
James (2002) asserted that CT is one of the most important attributes for success in the 21st
century and bas been defined as the process of reasonably deciding what to believe and do.
The development of critical thinking disposition and decision-making ability through clinical
practices has become an important issue in nursing education in Nigeria.
Nursing educators have been asked to develop the most effective teaching methods to
enhance the critical thinking disposition of students. Critical thinking dispositions are
attitudes that developed over time and are influenced by the environment, social norms, peers
and significant adults, and are difficult to change in the short term (Irani, Rudd, Gallo,
Ricketts, Friedel, & Rhoades, 2007). Simply, if there is no disposition toward critical
thinking, then critical thinking will not take place, regardless of the presence or absence of
the necessary skills. Encouragement, enhancement, and emphasis on the need for a
disposition toward problem solving is essential. Educators with strong critical thinking
dispositions will encourage students to critically reflect on the quality of their thinking as
they engage them in teaching and learning and will continually monitor their own thought
processes for imperfections (Elder & Paul, 2008).
Many studies on critical thinking have been conducted in the United States and other
countries (Giddens & Gloeckner, 2005; Kaddoura, 2010; Lederer, 2007; Stewart & Dempsey,
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