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Assessment of a scenario-based approach to facilitating critical thinking among paramedic students.
Prehosp Disaster Med. 1997 Jul-Sep; 12(3):215-21.PD

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 the pre-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.

CONCLUSIONS

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.

Authors+Show Affiliations

Creighton University PreHospital Education, Omaha, Nebraska 68131, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10187017

Citation

Janing, J. "Assessment of a Scenario-based Approach to Facilitating Critical Thinking Among Paramedic Students." Prehospital and Disaster Medicine, vol. 12, no. 3, 1997, pp. 215-21.
Janing J. Assessment of a scenario-based approach to facilitating critical thinking among paramedic students. Prehosp Disaster Med. 1997;12(3):215-21.
Janing, J. (1997). Assessment of a scenario-based approach to facilitating critical thinking among paramedic students. Prehospital and Disaster Medicine, 12(3), 215-21.
Janing J. Assessment of a Scenario-based Approach to Facilitating Critical Thinking Among Paramedic Students. Prehosp Disaster Med. 1997 Jul-Sep;12(3):215-21. PubMed PMID: 10187017.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of a scenario-based approach to facilitating critical thinking among paramedic students. A1 - Janing,J, PY - 1997/6/6/pubmed PY - 1997/6/6/medline PY - 1997/6/6/entrez SP - 215 EP - 21 JF - Prehospital and disaster medicine JO - Prehosp Disaster Med VL - 12 IS - 3 N2 - 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 the pre-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. CONCLUSIONS: 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. SN - 1049-023X UR - https://www.unboundmedicine.com/medline/citation/10187017/Assessment_of_a_scenario_based_approach_to_facilitating_critical_thinking_among_paramedic_students_ DB - PRIME DP - Unbound Medicine ER -