Critical Thinking Cards: Transforming Classroom Knowledge and Clinical Judgment

Monday, 9 November 2015

Cindra S. Holland, DNP, RNC-OB, ACNS-BC
Deborah Ulrich, PhD, RN
College of Nursing and Health, Wright State University, Dayton, OH, USA


            Critical thinking is an essential component for nursing students to become successful practitioners. It is vital for educators to help students learn to apply classroom content to the clinical setting (Benner, Sutphen, Leonard, & Day, 2010). This is a challenge for nurse educators. The purpose of this descriptive study was to develop an intervention that required students to use knowledge to solve clinical issues. Outcome measures included the intervention’s effectiveness in helping students apply class content, as well as improve clinical judgment and critical thinking skills.


            Faculty teaching in a junior level obstetrics course at a Midwestern university were presented with a deck of 116 Critical Thinking Cards to utilize as an intervention with students in the clinical setting. The cards were divided into four categories: Antepartum, Labor and Delivery, Postpartum, and Newborn and included questions that required students to use critical thinking to apply course content to various common scenarios. Two researcher created surveys were used to gather data from students (n=66) and faculty (n=4) regarding the effectiveness of the intervention.


            The vast majority of students stated that the activity helped them apply content from class and claimed the activity also helped them improve clinical judgment. Positive feedback was received from faculty who utilized Critical Thinking Cards as a teaching strategy during clinical. Faculty liked the variety of questions included in the deck and felt that the cards reinforced content from class.


            Critical thinking cards are a valuable tool that promotes multiple active learning skills. Faculty used the cards as springboards for individual and group discussion related to the content of the question on the card. Some faculty used the cards during “down time” in clinical, and others used them as post conference activities. Students seemed to enjoy the activity and felt it helped them improve clinical judgment.


            Critical thinking cards incorporate active learning skills designed to enhance knowledge of course content and increase critical thinking skills. This creative teaching strategy resulted in positive outcomes for both students and faculty. More research is needed to determine how to best use the cards, what faculty characteristics tend to be associated with better learning outcomes, and how the cards work with students of different levels and in different clinical settings.