INTRODUCTION:

Empowering students to think critically is a main role of higher education. Critical thinking (CT) has been identified as a vital outcome of nursing education. Creating an environment that builds up a students critical thinking ability is one of educators, primary roles because of, Critical thinking (CT) facilitates the dynamics of academies and universities and helps them survive, develop and promotes scientific societies. Practically, to promote critical thinking skills in students, educational organization must proceed to investigate and evaluate the viability of various teaching and learning strategies [1].

One teaching and learning strategy that has recently emerged in higher education as a means to support student critical thinking is the nonlinear learning strategy of mind mapping (MM) which considered one of the most powerful tools for developing metacognition (the thinking process) for the thinking maps. One of the goals of critical thinking is the learners familiarity with their own thinking process (metacognition). One outcome, educators Lately, given more regard for, especially, in higher education is the improvement of critical thinking skills in their students [1].

Critical thinking consists of two aspects: a set of operational cognitive skills and disposition. Skills emphasize the cognitive strategies and the attitude focuses on the critical parts of thinking as well as the internal, sustainable motivations in problem solving. Dispositions toward thinking critically have been depicted as the unswerving internal inclination to problem solving and decision making achieved by thinking. Critical thinking disposition is defined 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 [2].

The dispositions of the individuals towards the critical thinking approach may vary in terms of some factors such as dealing with the quantity instead of quality in the curricula applied in educational institutions, insisting on memorization teaching styles, socioeconomic level of society, being intertwined with each field media on every field and factors such as prejudice are effective on critical thinking dispositions. Students’ academic performance has been a vital issue for higher education institutions and examination concerning the likelihood of student achievement is additionally essential from various perspectives for colleges, their educators and policy makers [2].

Academic performance can be seen as ability to study and remember facts and to be able to express such knowledge gained either verbally or in writing. It is a key criterion to judge ones total potentialities and capabilities which are frequently measured by examination results and used to pass judgement on the quality of education by academic institutions. Academic performance and academic achievement, each of these two terms was used interchangeably for the purpose of the present study. Academic performance can be measured in several ways including; performance in individual courses; grouped courses; yearly grade point average (GPA) and program GPA [3].

Students poor performances cut across different fields of education, including nursing education. The poor academic performances can lead to inadequate knowledge needed to enhance professional skills required for nursing procedures. A poorly trained nurse becomes a threat to the lives of the patients, and further compounds the already poor state of the health care in Nigeria. Students‟ poor academic performance may result from numerous factors including incongruence of the teaching strategy to the students‟ learning styles, lack of motivation, self-efficacy doubts as well as inefficient studying techniques. Furthermore, the type of assessment utilized may also have an impact on the student performance [4].

METHODS:

All major electronic sources of relevant information were systematically searched to identify peer-reviewed English and Iranian language abstracts or papers published between 1990 and 2012. To identify all relevant studies for the review, the search strategy comprised searches of the following: CINAHL database, Proquest, Pub-Med, Medline, Science Direct, OVID and Iranian Journal Full-text Databases including SID, Iran medex and Magiran; Internet source (www.google.com) using the key words: ‘critical thinking’, ‘nursing’, ‘students’ ‘nursing students’ and ‘critical thinking dispositions’ [5].

Initially 717 English articles and 78 Persian articles were found. However, several were discarded as they did not specifically address critical thinking dispositions in nursing students. The inclusion criteria were articles that were related to critical thinking dispositions in nursing student articles that used California Critical Thinking Disposition Inventory (CCTDI) [6] to measure critical thinking dispositions in nursing students. A variety of instruments have been used to study critical thinking in nursing education. Facione and Facione developed the California critical thinking disposition inventory (CCTDI) that was used to measure critical thinking dispositions [7]. California Critical Thinking Disposition Inventory contains 75 items with a Likert scale ranging from completely agree to completely disagree scoring. Maximum and minimum values of 70 and 420 are obtained from this test. Strong and stable disposition (over 350), positive (between 280 and 350), undermining (between 210 and 280) and negative (below 210) are classified [8]. The questions included seven subscales: truth-seeking (12 items), open-mindedness (12 items), analyticity (11 items), systematicity (10 items), critical thinking and self-confidence (10 items), inquisitiveness (10 items) and maturity (10 items) [9]. Total points from the seven sub-scales determine an individual’s critical thinking disposition. Therefore authors studied abstracts of 717 English articles and 78 Persian articles [10]. English and Persian language studies were separately classified and reviewed. In the final stage, critical thinking dispositions in nursing students was compared in Asian and non-Asian countries [11].

DISCUSSION:

In this literature review, nursing students’ critical thinking dispositions in Asian and non-Asian countries were reviewed and compared. Limited studies showed that the critical thinking dispositions of Asian nursing students are mostly undermining. Some Asian countries such as Iran, China, Japan and Hong Kong reflect low critical thinking disposition scores of their students; while non-Asian countries tend to score highly in critical thinking dispositions in nursing students. The reasons for the low critical thinking disposition in most of studies in the Asian countries could be due to issues such as environmental, educational methods and cultural differences [12].

Brown [13] suggested that critical thinking is specific to a certain kind of culture. This may explain the observed differences in scores. Academics often affirm that Asian students do not naturally take part in critical thinking because they do not obviously contribute in classroom discussions. In a culture that does not value critical questioning and having inconsistent viewpoints, for example in the Chinese culture, students may easily lose opportunities to practice how to express conflicting views and when to delay judgment or come to a closure. Most likely the low critical thinking disposition scores of Asian nursing students are due to the application of traditional methods in nursing education, which shows the need to revise the nursing curriculum [14].

Tiwari [15] attributed higher scores of the critical thinking disposition in Australian nursing students than those of Chinese students to the active educational model used in the Australian school and to cultural differences. Critical thinking in nursing students develops through active educational programs. Pang argued that nursing is conceptualized differently by Eastern and Western nurses. For example Chinese nursing is grounded in a cultural understanding of health. It is feasible that differences in modes of thinking between nursing students in the East and West are responsible for the difference in scores [16].

Furthermore, as already mentioned, studies show that nursing students in Asian countries and non- Asian countries have differences in subscales of critical thinking disposition. Most studies have reported score of truth seeking subscale in students are low. Colucciello [17] proposed that a lower score of truth seeking could be due to traditional teaching and learning strategies where the extensive information was presented in the lectures, students are expected to learn rather than seeking information or asking questions. Huan and Vickie express Chinese students are not encouraged to ask teachers questions because teachers fear that they cannot answer questions from students and be shamed [18].

It is another reason for the low scores of truth seeking in Chinese students. The low score in open-mindness in some studies may be due to students that could not tolerate divergent views because they are not encouraged to ask questions of the instructor or other students. Low scores on the Order-taking and analysis can also show the weakness of organized reasoning and focus on problem solving. In general, review of studies shows that current nursing programs will not lead to a shift in critical thinking [19].

This has raised the need to revise these programs. Finally, the reviewed studies have applied a general tool, regardless of cultural and linguistic differences to measure critical thinking dispositions in nursing students. It could be the other reason for inconsistency in the results of studies. Many researchers have acknowledged this issue as well. There is a need to develop a discipline-specific tool designed to measure nurses’ critical thinking. California Critical Thinking Disposition Inventory may be appropriated to Western social customs and beliefs that Eastern nurses cannot fully understand it [20].

CONCLUSION:

According to present study, there are the diverse and often contradictory results about critical thinking dispositions of nursing students in Asian and non-Asian countries. In some cases, it has been expressed critical thinking disposition in Asian countries is lower than in other countries. It should be noted the most studies in critical thinking disposition of nursing students were descriptive studies without analyzing causes of low critical thinking disposition. Therefore following these few articles, we could not conclude that all nursing students in Asian countries have low disposition toward critical thinking. It is suggested to compare the trend of critical thinking of nursing students in different countries according to different cultural backgrounds. However, future studies should measure critical thinking disposition by discipline-based tools.

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Received on 10.10.2018 Modified on 03.12.2018

Int. J. Nur. Edu. and Research. 2019; 7(2):279-282.

DOI: 10.5958/2454-2660.2019.00063.2