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Learning Objective 1: 1. The learner will be able to differentiate clinical reasoning, critical thinking and self-regulated learning strategies from students in different clincial learning environments.
Learning Objective 2: 2. The learner will be able to describe the longitudinal effect of guided self-regulated reflection on clinical reasoning and critical thinking during clinical learning experiences.
Purpose To provide further definition and clarification of critical thinking and clinical reasoning during student experiences, guided reflective journaling with self-regulation learning strategies was implemented over a semester long clinical course. Verification of self-regulated learning strategy use was evaluated by using the Motivated Strategies for Learning Questionnaire (MSLQ). The aims were to determine differences between clinical groups, grade point averages, previous work experience, and time.
Methods The quasi-experimental design compared a purposive sample of baccalaureate students, 20 in community health and 22 in acute care. After approval by the institutional IRB, the 81 item MSLQ questionnaire was completed as a pre-test and post-test at the end of the course, after 6 reflective journals. Protocol analysis was applied to journal narratives and MSLQ scores were analyzed with the independent chi-square test to compare groups, cognitive abilities and demographic characteristics.
FindingsFourteen items on the MSLQ revealed statistical significant higher scores in the subscales of metacognition, rehearsal, help seeking, peer learning and elaboration. Scores decreased for study time and effort regulation. There were higher post-test scores in the acute care group and for students with higher GPA’s with elaboration (p = .02). Students with lower GPA’s had higher scores for motivation (p=.05) and metacognitive control (p = .02). Protocol analysis revealed a focus on reactions, knowledge work, and time/situation/environment concerns. Inference, analysis and interpretation were the critical thinking skills that predominated.
Conclusions The results show trends in self-regulation learning strategy use, however, research is needed for evaluating larger sample sizes in a variety of clinical areas, with interventions that improve cognitive abilities, and with measures that accurately reflect changes in cognitive abilities.
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