Systematic Review of Assessments That Evaluate Clinical Decision Making, Clinical Reasoning, and Critical Thinking Changes After Simulation Participation

Abstract

Background and Purpose. Increasingly, simulation experiences are augmenting and replacing portions of classroom and clinical education time. The purposes of this systematic review were to (1) systematically review the literature to determine whether simulated experiences impact the development of clinical decision making (CDM), clinical reasoning (CR), or critical thinking (CT) in students in health professional educational programs, (2) assess the quality of evidence for the effectiveness of simulation in developing CDM, CR, or CT in health professions students, (3) compare the effectiveness of simulated experiences to usual teaching methods in developing CDM, CR, and CT in health profession education students, and (4) identify and characterize assessment tools used to measure CDM, CR, and CT in the selected studies. Methods. The study design was a systematic review. PubMed, Ovid, Cochrane Database of Systematic Reviews, Google Scholar, EdITLib, and ERIC were searched for articles published in English from January 2000 until March 2017. Thirty-one articles met the inclusion criteria: 1 mixed methods study, 3 qualitative studies, and 27 quantitative studies. Articles were assessed using the Mixed Methods Appraisal Tool for the mixed methods study, the McMaster University Critical Review Form—Qualitative Studies for qualitative studies, and the Evaluation Guidelines for Rating the Quality of an Intervention Study. Results. The results demonstrate that simulation improves CDM, CT, or CR. The outcomes from the studies revealed that more repetitions in a simulated environment produced greater changes. Six outcome measures were identified, which assessed the desired constructs. Discussion and Conclusion. Future research investigating each tool across health care disciplines is needed. The optimal number of simulated encounters needed for improvement in decision making, thinking, and reasoning in physical therapy will be beneficial.

Evaluating the Clinical Reasoning of Student Health Professionals in Placement and Simulation Settings: A Systematic Review

“…They identified tools by examining papers that applied an experimental design and measured critical thinking on multiple occasions in undergraduate nursing and midwifery education [ 9 ]. Similarly, Macauley et al [ 10 ] systematically reviewed evaluations of clinical reasoning that were used as outcome measures, this time in examining simulation programs in any health profession. They also included broad outcome measures that did not necessarily focus on clinical reasoning (e.g., the physical therapy entry-level competency assessment, the Assessment of Physiotherapy Practice [ 10 ]).…”

“…Similarly, Macauley et al [ 10 ] systematically reviewed evaluations of clinical reasoning that were used as outcome measures, this time in examining simulation programs in any health profession. They also included broad outcome measures that did not necessarily focus on clinical reasoning (e.g., the physical therapy entry-level competency assessment, the Assessment of Physiotherapy Practice [ 10 ]). In a recent scoping review, Daniel et al [ 5 ] expanded the scope to investigate approaches to clinical reasoning evaluation used in a range of settings (workplace-based, simulation-based, and non-workplace-based settings), rather than only outcomes-based research, but restricted their review to the evaluation of the clinical reasoning of medical students, residents, and physicians.…”

Structured simulations improves students’ knowledge acquisition and perceptions of teaching effectiveness: A quasi‐experimental study

“…In an umbrella review covering 25 systematic reviews and over 700 primary studies, Cant and Cooper (2017) found evidence that simulation supported psychomotor development and improved self-efficacy among pre-licensure nursing students and was equivalent or superior to other teaching strategies. Similarly, authors of a systematic review of 31 studies found moderate to strong evidence that simulation improves clinical decision-making, critical thinking, and clinical reasoning for healthcare students (Macauley et al, 2017). In seven of the quantitative studies in the previous review, simulation was found to be at least as effective as traditional learning.…”

“…Although simulation decreases the gap between theory and clinical application (Tinnon & Newton, 2017), few researchers have investigated the effect of embedding simulation with traditional lectures to augment learning and enhance students' knowledge acquisition. Overall, when simulation was used to augment lecture, improvements in clinical decision-making, clinical reasoning, and critical thinking were observed (Macauley et al, 2017). Other reviews have also shown that integration of simulation into lecture improved knowledge, skills and confidence of healthcare students (Alanazi et al, 2017).…”

Design of English Intelligent Simulated Paper Marking System

“…e objective questions are marked using the string matching method, while the essay questions are marked using the intelligent marking technology proposed in this paper. e administrator, as the system administrator, is responsible for the management of teachers, students, and classes [21][22][23][24]. e administrator in this system is equivalent to the position of the head of the teaching and research team and reviews the group papers completed by the teachers and approves them before submitting the papers to the system.…”