Design: Descriptive, quasi-experimental.
Population, Sample, Setting, Years: 36 junior level students enrolled a baccalaureate nursing program in the southeastern USA in early fall semester 2004.
Concept or Variables Studied Together: Critical thinking and composite scores from a 60-item HESI customized exam reflecting content covering myocardial infarction (20 questions), deep vein thrombosis leading to pulmonary embolism (20 questions), and shock (20 questions).
Methods: A HESI customized exam was administered as a pretest to participants and results were used to randomize the subjects into three treatment groups rotating through three learning activities illustrating nursing care of clients experiencing emergent cardiovascular or respiratory events. Upon completion of each activity, critical thinking abilities and learning outcomes were measured through administration of a 20-item customized HESI exam (posttest). One-way ANOVA calculations were conducted to determine the effect of instructional strategies on critical thinking ability and learning outcomes. Bonferroni post hoc comparisons were employed to evaluate significant (p < 0.05) differences between groups.
Findings: HESI exam scores were higher and statistically significant differences were detected between critical thinking abilities (p °Ü 0.002) and learning outcomes (p °Ü 0.001) of nursing students when simulation, or a combination of classroom and simulation, were used.
Conclusions: Results confirmed that use of the customized HESI exam was an effective means of evaluating critical thinking abilitiy and learning outcome achievement following participation in a HHPCS learning activity. Implications: Computerized testing enhanced student competency evaluation following participation in a HHPCS learning activity by providing objective assessment of students' critical thinking abilities in nursing-focused clinical practice scenarios.