Promotion of Critical Thinking Dispositions Amongst Intensive Care Registered Nurses Through Utilization of High-Fidelity Simulation

Background: Critical thinking is considered an essential component to sound nursing practice. Whereby critical thinking dispositions, or habits of the mind, are considered to be the foundation for effective critical thinking, the literature suggests that this concept has lacked in development and assessment, particularly within critical care nurses. High-fidelity simulation (HFS) has the demonstrated potential to meet this need.
Purpose: The purpose of this study was to evaluate the use of high-fidelity simulation for the promotion of critical thinking dispositions of intensive care unit registered nurses.
Methods: A quasi-experimental study took place over two weeks in a tertiary academic medical center where a convenience sample of adult critical care registered nurses was taken. Participants completed the California Critical Thinking Disposition Inventory (CCTDI) prior to the high-fidelity simulation and again upon completion to evaluate overall change in critical thinking and individual dispositions.
Results: 22 nurses participated in this study. Overall CCTDI scores significantly increased after participation in the HFS, with four of the seven subscales displaying statistically significant increases as well. There were found to be no significant relationships between measured demographics and overall CCTDI. Within the subscales, significant relationships were found between truth-seeking and years as a critical care nurse, open-mindedness, age, and years as a registered nurse, as well as, systematicity and certification status.
Discussion: Participation in a single high-fidelity simulation showed a positive impact on overall critical thinking dispositions of practicing critical care nurses, as well as, the majority of the dispositional components. This is the first identified study to demonstrate such an effect. The significance of this could foster development of transition-to-practice and continuing education programs to improve critical thinking, clinical judgment, and ultimately improve patient outcomes.