Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T23:23:24.758Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of a Scenario-Based Approach to Facilitating Critical Thinking Among Paramedic Students

Published online by Cambridge University Press:  28 June 2012

Judy Janing
Judy Janing*
Affiliation:
Creighton UniversityPreHospital Education Omaha, Nebraska 68131, USA
*
EMT-P Program DirectorCreighton UniversityPreHospital Education 2514 Cuming Street Omaha, NE 68131 USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Paramedic practice is shifting from [direct] on-line medical control to protocol-driven care initiated on the paramedic's judgment of the patient's problem(s). Teaching in most paramedic training programs remains grounded in technical rationality. This does not adequately prepare practitioners for current day practice. Medical conditions often present as ill-defined problems. To deal with these situations, practitioners need problem solving and reflective-thinking skills. Methodologies incorporating the use of these skills in a contextual situation similar to actual practice may help paramedics develop these skills.

Hypothesis:

This study sought to determine the impact of written scenario exercises in the context of clinical problems as a means of learning in order to foster higher level thinking skills and self-directed tendencies. It involved three hypotheses: 1) Post-test scores would correlate with scores attained on the traditional, multiple choice, final examination; 2) Post-test scores would correlate with scores on the critical thinking sub-test of the final examination; and 3) Scores would be better on the post-test compared to thepre-test.

Methods:

This two year, longitudinal, prospective study was conducted with 55 paramedic students using a pre- and post-test. Post-test scores were compared with final examination scores and scores of the subset of higher level thinking questions within that examination using the Pearson r-test. The relationship between the pre- and post-test scores was analyzed using a one-tailed dependent t-test. Post-hoc analysis of the variables of age, experience, and education was conducted using one-way analysis of variance.

Results:

The correlation between post-test scores with final examination scores was positive and modestly significant. There was no correlation of post-test scores with sub-test scores. Comparison of pre- and post-test scores was significant. Effects for age, experience, and education were not significant statistically.

Conclusion:

Using written scenarios increases ability to utilize reflective thinking and self-directed tendencies. However, this ability may not be demonstrated consistently on traditional written examinations. A multi-site study using large numbers and a control group or alternative methods appears to be indicated to demonstrate more accurate effects of the methodology.

Keywords

critical thinkingeducationjudgmentlearningmedical controlparamedicproblem-based learningprotocolproblem-solvingreflective thinking
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 12 , Issue 3 , September 1997 , pp. 42 - 48
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Borg, W, Gall, M: Educational Research 2d ed. New York: Longman, 1979.Google Scholar
2. Bloom, BS (ed): Taxonomy of Educational Objectives: Cognitive Domain. New York: David McKay Co., Inc., 1956.Google Scholar
3. Marchais, J: A student-centered, problem-based curriculum: 5 years’ experience. Canadian Medical Association Journal 1993;148:1567–1572.Google Scholar
4. Benner, P: From novice to expert. American Journal of Nursing 1982;82:402–407.Google ScholarPubMed
5. Norman, G, Schmidt, G: The psychological basis of problem-based learning: A review of the evidence. Academic Medicine 1992;67:557–565.CrossRefGoogle ScholarPubMed
6. King, P, Kitchener, K: Developing Reflective Judgment. San Francisco: Jossey-Bass, 1994.Google Scholar
7. Schon, D: Educating the Reflective Practitioner. San Francisco: Jossey-Bass, 1987.Google Scholar
8. Jones, S, Brown, L: Critical thinking: Impact on nursing education. Journal of Advanced Nursing 1990;16:529–533.CrossRefGoogle Scholar
9. Glover, J, Ronning, R, Bruning, R: Cognitive Psychology for Teachers. New York: Macmillan, 1990.Google Scholar
10. Patel, V, Groen, G, Norman, G: Effects of conventional and problem-based medical curricula on problem solving. Academic Medicine 1991;66:380–389.CrossRefGoogle ScholarPubMed
11. Joyce, B, Weil, M, Showers, B: Models of Teaching. Boston: Allyn and Bacon, 1992.Google Scholar
12. Janing, J: Critical thinking: Incorporation into the paramedic curriculum. Prehospital and Disaster Medicine 1994;9:238–242.CrossRefGoogle ScholarPubMed
13. Norman, G: Problem-solving skills, solving problems and problem-based learning. Medical Education 1988;22:279–286.CrossRefGoogle ScholarPubMed
14. Farmer, J Jr, Buckmaster, A, LeGrand, B: Cognitive apprenticeship: Implications for continuing professional education. In: Baskett, H, Marsick, V (eds), New Directions for Adult and Continuing Education. San Francisco: Jossey-Bass, 1992, pp 41–50.Google Scholar
15. Polglase, R, Parish, D, Buckley, R, Smith, R, Joiner, T: Problem-based ACLS instruction: A model approach for undergraduate emergency medical education. Annals of Emergency Medicine 1989;18:997–1000.CrossRefGoogle Scholar
16. Schwartz, R, Donnelly, M, Nash, P, et al: Problem-based learning: An effective educational method for a surgery clerkship. Journal of Surgical Research 1992;53:326–330.CrossRefGoogle ScholarPubMed
17. Schwarz, R, Donnelly, M, Nash, P, Young, B: Developing students‘ cognitive skills in a problem-based surgery clerkship. Academic Medicine 1992;67:694–696.CrossRefGoogle Scholar
18. Quattlebaum, T, Darden, P, Sperry, J: In-training examinations as predictors of resident clinical performance. Pediatrics 1989;84:165–172.CrossRefGoogle ScholarPubMed
19. Albanese, M, Mitchell, S: Problem-based learning: A review of literature on its outcomes and implementation issues. Academic Medicine 1993;68:52–81.CrossRefGoogle ScholarPubMed