The effect of learning styles, critical thinking disposition, and critical thinking on clinical judgment in senior baccalaureate nursing students during human patient simulation

Simulated learning experiences using high-fidelity human patient simulators (HPS) are increasingly being integrated into baccalaureate nursing programs. Thus, the purpose of this study was to examine relationships among learning style, critical thinking disposition, critical thinking, and clinical judgment during high-fidelity human patient simulation (HPS) in pre-licensure senior baccalaureate nursing students. Participant characteristics such as age, gender, cumulative grade-point average (GPA), and prior simulation experience were examined. The study also sought to determine predictors that may influence clinical judgment during the HPS simulation experience. A predictive correlational research design was employed to examine relationships among variables conceptualized from the NLN/Jeffries Simulation Framework and Kolb's Experiential Learning Theory (ELT). Independent/predictor variables included in this study were critical thinking, critical thinking disposition, and learning style. The dependent variable was clinical judgment in the high-fidelity HPS experiential learning approach. A sample of 63 level III baccalaureate nursing students who were in their senior level of the four-year undergraduate nursing program was recruited for this study. Learning styles were measured using Kolb's Learning Style Inventory (LSI) Version 3.1. Critical thinking disposition and critical thinking were evaluated using the California Critical Thinking Disposition Inventory (CCTDI) and the Health Sciences Reasoning Test (HSRT), while clinical judgment was assessed with Lasater's Clinical Judgment Rubric (LCJR). Data collection methods included a demographic questionnaire and inventories administered prior to the start of the simulation. During the simulated learning experience, participants were evaluated utilizing the LCJR and data were analyzed using the Statistical Package for the Social Sciences (SPSS). Based on bivariate correlation, a weak positive correlation, indicating a significant linear relationship, was found between age and clinical judgment. However, gender and GPA were not related to clinical judgment in the high-fidelity human patient simulation experiential learning approach. Additionally, participants with higher overall critical thinking disposition had higher overall critical thinking skills. Bivariate correlation also revealed that critical thinking disposition and critical thinking were not related to clinical judgment. Analysis of variance indicated that no statistically significant difference was found between clinical judgment and learning styles. Furthermore, based on multiple regression analysis, neither overall critical thinking disposition nor overall critical thinking was a significant predictor of clinical judgment. Thus, a small effect size was represented between the variables.