Effects of problem-based learning on higher-order thinking in nursing education

Abstract

The notion that problem-based learning (PBL) denotes a deep process, which allows students to make sense of their learning experience by integrating newly acquired knowledge with prior knowledge and experiences, has been well acknowledged. Whereas, research indicates that problem-based learning can facilitate the development of students’ higher-order thinking skills, few studies examine the underlying theoretical foundation and effect of PBL in the field of nursing education. This study aims to empirically study the effects of problem-based learning on higher-order thinking in nursing education, in particular, to examine the educational theories of constructivism and social constructivism and their application to professional education in PBL. It was envisaged that results of the study would provide a direction in the development of teaching materials that would enhance classroom as well as clinical learning in nursing.

The study adopted a pre & post quasi-experimental design to determine the effects of problem-based learning on higher-order thinking in a group of 24 second year students enrolled in the Higher Diploma in Nursing for a period of 14 weeks. To ascertain its effects on higher-order thinking, data were obtained from pre & post epistemological belief questionnaires, study process questionnaires and motivational strategies & learning questionnaires related to both cognitive and metacognitive arenas. These, together with students’ reflective journals, focus group interviews, audio tapes of students’ PBL tutorial group interactions and results of examination papers, focused on conceptual learning and understanding.

A statistical analysis of the questionnaires revealed that students in the study group who showed some changes in high level thinking abilities in terms of adapting constructive learning styles, were more thoughtful with an improvement in cognitive abilities; but there were no significant differences between the PBL and the NPBL groups. However, the qualitative data attributed the success of PBL to provision of opportunities for students’ interactions, enabling them to view the learning pathway, at the metacognitive level, ranging from problem identification, proposing learning issues, knowledge research and sharing, and finally revisiting the scenario to solve particular problems.

This study argued that problem-based learning appeared to be an effective way to enhance development of higher-order thinking skills of Chinese nursing students in professional education. Possible factors determining the results were discussed. Theoretical significance and educational implications were presented. Finally, the study’s limitations were addressed and future studies were also suggested.