Developing Nursing Student's Critical Thinking Ability Through Concept Mapping

Nursing concept mapping is a model that allows for organization of client problems and provides connections between the problems that is physically drawn to show the student’s knowledge of the connection (Gerdeman, J.L., Lux, K., & Jacko, J., 2013).  Concept mapping development was piloted in our fundamental clinical to help students develop an overall picture of their client and their situation.  Student and instructor feedback was acknowledged and utilized in development of the process and later implemented in all clinical rotations.  Fluidity in client care is captured within the development of the concept mapping process.  During the clinical experience students start prioritizing the major problem, but are able to visualize all the other problems and how they interact and influence the direction of care the student needs to take.  Students utilize critical thinking to see how all the mapping components play a role in the priority problem.  This process allowed for engagement of their critical thinking skills and in a clinical setting put it into practice to facilitate care of the client.  The five phases of the nursing process of assessment, diagnosis, planning, implementation, and evaluation are highly utilized in how the student approaches the development of the concept map (NANDA International, n.d.).   Clinical judgement, observation, specific outcome criteria, interventions, and review of current progress and potential intervention revisions are all aspects leading to the students focusing on the well-being and individualized care of the client.  During the clinical day, the initiates categorizing of the client priorities by asking the student “What is your priority problem”?, prompting the student to initiate critical thinking skills.  This allows the student to demonstrate and verbalize their thought process following the initial assessment phase to then determine the patient’s priority problem.  Instructors guide the student through prioritizing by asking related client questions.  During post conference, facilitated by the clinical instructor, students engage as a group in discussion regarding individual student client concept maps for alternative interventions, outcomes, and agreement on the priority problem. As students reflect on care provided for the client they determine alternative goals and modifications to interventions.  Through reflective activities and student, faculty, and clinical site feedback, outcome evaluation of the student’s critical thinking, through the use of concept mapping was found to be enhanced as students progressed through the nursing program.