The effectiveness of problem-based learning on development of nursing students’ critical thinking: A systematic review and meta-analysis

The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students’ critical thinking. Searches of PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest, Cochrane Central Register...

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Published in:International journal of nursing studies Vol. 51; no. 3; pp. 458 - 469
Main Authors: Kong, Ling-Na, Qin, Bo, Zhou, Ying-qing, Mou, Shao-yu, Gao, Hui-Ming
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01.03.2014
Elsevier Limited
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ISSN:0020-7489, 1873-491X, 1873-491X
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Abstract The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students’ critical thinking. Searches of PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) were undertaken to identify randomized controlled trails from 1965 to December 2012, comparing problem-based learning with traditional lectures on the effectiveness of development of nursing students’ critical thinking, with no language limitation. The mesh-terms or key words used in the search were problem-based learning, thinking, critical thinking, nursing, nursing education, nurse education, nurse students, nursing students and pupil nurse. Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using the Cochrane Collaboration's Risk of Bias Tool. We analyzed critical thinking scores (continuous outcomes) using a standardized mean difference (SMD) or weighted mean difference (WMD) with a 95% confidence intervals (CIs). Heterogeneity was assessed using the Cochran's Q statistic and I2 statistic. Publication bias was assessed by means of funnel plot and Egger's test of asymmetry. Nine articles representing eight randomized controlled trials were included in the meta-analysis. Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students’ critical thinking (overall critical thinking scores SMD=0.33, 95%CI=0.13–0.52, P=0.0009), compared with traditional lectures. There was low heterogeneity (overall critical thinking scores I2=45%, P=0.07) in the meta-analysis. No significant publication bias was observed regarding overall critical thinking scores (P=0.536). Sensitivity analysis showed that the result of our meta-analysis was reliable. Most effect sizes for subscales of the California Critical Thinking Dispositions Inventory (CCTDI) and Bloom's Taxonomy favored problem-based learning, while effect sizes for all subscales of the California Critical Thinking Skills Test (CCTST) and most subscales of the Watson–Glaser Critical Thinking Appraisal (WCGTA) were inconclusive. The results of the current meta-analysis indicate that problem-based learning might help nursing students to improve their critical thinking. More research with larger sample size and high quality in different nursing educational contexts are required.
AbstractList The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students' critical thinking. Searches of PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) were undertaken to identify randomized controlled trails from 1965 to December 2012, comparing problem-based learning with traditional lectures on the effectiveness of development of nursing students' critical thinking, with no language limitation. The mesh-terms or key words used in the search were problem-based learning, thinking, critical thinking, nursing, nursing education, nurse education, nurse students, nursing students and pupil nurse. Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using the Cochrane Collaboration's Risk of Bias Tool. We analyzed critical thinking scores (continuous outcomes) using a standardized mean difference (SMD) or weighted mean difference (WMD) with a 95% confidence intervals (CIs). Heterogeneity was assessed using the Cochran's Q statistic and I2 statistic. Publication bias was assessed by means of funnel plot and Egger's test of asymmetry. Nine articles representing eight randomized controlled trials were included in the meta-analysis. Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students' critical thinking (overall critical thinking scores SMD = 0.33, 95%CI = 0.13-0.52, P = 0.0009), compared with traditional lectures. There was low heterogeneity (overall critical thinking scores ... = 45%, P = 0.07) in the meta-analysis. No significant publication bias was observed regarding overall critical thinking scores (P = 0.536). Sensitivity analysis showed that the result of our meta-analysis was reliable. Most effect sizes for subscales of the California Critical Thinking Dispositions Inventory (CCTDI) and Bloom's Taxonomy favored problem-based learning, while effect sizes for all subscales of the California Critical Thinking Skills Test (CCTST) and most subscales of the Watson-Glaser Critical Thinking Appraisal (WCGTA) were inconclusive. The results of the current meta-analysis indicate that problem-based learning might help nursing students to improve their critical thinking. More research with larger sample size and high quality in different nursing educational contexts are required. (ProQuest: ... denotes formulae/symbols omitted.) 55 references
The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students' critical thinking. Searches of PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) were undertaken to identify randomized controlled trails from 1965 to December 2012, comparing problem-based learning with traditional lectures on the effectiveness of development of nursing students' critical thinking, with no language limitation. The mesh-terms or key words used in the search were problem-based learning, thinking, critical thinking, nursing, nursing education, nurse education, nurse students, nursing students and pupil nurse. Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using the Cochrane Collaboration's Risk of Bias Tool. We analyzed critical thinking scores (continuous outcomes) using a standardized mean difference (SMD) or weighted mean difference (WMD) with a 95% confidence intervals (CIs). Heterogeneity was assessed using the Cochran's Q statistic and I2 statistic. Publication bias was assessed by means of funnel plot and Egger's test of asymmetry. Nine articles representing eight randomized controlled trials were included in the meta-analysis. Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students' critical thinking (overall critical thinking scores SMD = 0.33, 95%CI = 0.13-0.52, P = 0.0009), compared with traditional lectures. There was low heterogeneity (overall critical thinking scores ... = 45%, P = 0.07) in the meta-analysis. No significant publication bias was observed regarding overall critical thinking scores (P = 0.536). Sensitivity analysis showed that the result of our meta-analysis was reliable. Most effect sizes for subscales of the California Critical Thinking Dispositions Inventory (CCTDI) and Bloom's Taxonomy favored problem-based learning, while effect sizes for all subscales of the California Critical Thinking Skills Test (CCTST) and most subscales of the Watson-Glaser Critical Thinking Appraisal (WCGTA) were inconclusive. The results of the current meta-analysis indicate that problem-based learning might help nursing students to improve their critical thinking. More research with larger sample size and high quality in different nursing educational contexts are required. (ProQuest: ... denotes formulae/symbols omitted.)
The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students' critical thinking.OBJECTIVESThe objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students' critical thinking.Searches of PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) were undertaken to identify randomized controlled trails from 1965 to December 2012, comparing problem-based learning with traditional lectures on the effectiveness of development of nursing students' critical thinking, with no language limitation. The mesh-terms or key words used in the search were problem-based learning, thinking, critical thinking, nursing, nursing education, nurse education, nurse students, nursing students and pupil nurse.DATA SOURCESSearches of PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) were undertaken to identify randomized controlled trails from 1965 to December 2012, comparing problem-based learning with traditional lectures on the effectiveness of development of nursing students' critical thinking, with no language limitation. The mesh-terms or key words used in the search were problem-based learning, thinking, critical thinking, nursing, nursing education, nurse education, nurse students, nursing students and pupil nurse.Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using the Cochrane Collaboration's Risk of Bias Tool. We analyzed critical thinking scores (continuous outcomes) using a standardized mean difference (SMD) or weighted mean difference (WMD) with a 95% confidence intervals (CIs). Heterogeneity was assessed using the Cochran's Q statistic and I(2) statistic. Publication bias was assessed by means of funnel plot and Egger's test of asymmetry.REVIEW METHODSTwo reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using the Cochrane Collaboration's Risk of Bias Tool. We analyzed critical thinking scores (continuous outcomes) using a standardized mean difference (SMD) or weighted mean difference (WMD) with a 95% confidence intervals (CIs). Heterogeneity was assessed using the Cochran's Q statistic and I(2) statistic. Publication bias was assessed by means of funnel plot and Egger's test of asymmetry.Nine articles representing eight randomized controlled trials were included in the meta-analysis. Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students' critical thinking (overall critical thinking scores SMD=0.33, 95%CI=0.13-0.52, P=0.0009), compared with traditional lectures. There was low heterogeneity (overall critical thinking scores I(2)=45%, P=0.07) in the meta-analysis. No significant publication bias was observed regarding overall critical thinking scores (P=0.536). Sensitivity analysis showed that the result of our meta-analysis was reliable. Most effect sizes for subscales of the California Critical Thinking Dispositions Inventory (CCTDI) and Bloom's Taxonomy favored problem-based learning, while effect sizes for all subscales of the California Critical Thinking Skills Test (CCTST) and most subscales of the Watson-Glaser Critical Thinking Appraisal (WCGTA) were inconclusive.RESULTSNine articles representing eight randomized controlled trials were included in the meta-analysis. Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students' critical thinking (overall critical thinking scores SMD=0.33, 95%CI=0.13-0.52, P=0.0009), compared with traditional lectures. There was low heterogeneity (overall critical thinking scores I(2)=45%, P=0.07) in the meta-analysis. No significant publication bias was observed regarding overall critical thinking scores (P=0.536). Sensitivity analysis showed that the result of our meta-analysis was reliable. Most effect sizes for subscales of the California Critical Thinking Dispositions Inventory (CCTDI) and Bloom's Taxonomy favored problem-based learning, while effect sizes for all subscales of the California Critical Thinking Skills Test (CCTST) and most subscales of the Watson-Glaser Critical Thinking Appraisal (WCGTA) were inconclusive.The results of the current meta-analysis indicate that problem-based learning might help nursing students to improve their critical thinking. More research with larger sample size and high quality in different nursing educational contexts are required.CONCLUSIONSThe results of the current meta-analysis indicate that problem-based learning might help nursing students to improve their critical thinking. More research with larger sample size and high quality in different nursing educational contexts are required.
The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students’ critical thinking. Searches of PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) were undertaken to identify randomized controlled trails from 1965 to December 2012, comparing problem-based learning with traditional lectures on the effectiveness of development of nursing students’ critical thinking, with no language limitation. The mesh-terms or key words used in the search were problem-based learning, thinking, critical thinking, nursing, nursing education, nurse education, nurse students, nursing students and pupil nurse. Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using the Cochrane Collaboration's Risk of Bias Tool. We analyzed critical thinking scores (continuous outcomes) using a standardized mean difference (SMD) or weighted mean difference (WMD) with a 95% confidence intervals (CIs). Heterogeneity was assessed using the Cochran's Q statistic and I2 statistic. Publication bias was assessed by means of funnel plot and Egger's test of asymmetry. Nine articles representing eight randomized controlled trials were included in the meta-analysis. Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students’ critical thinking (overall critical thinking scores SMD=0.33, 95%CI=0.13–0.52, P=0.0009), compared with traditional lectures. There was low heterogeneity (overall critical thinking scores I2=45%, P=0.07) in the meta-analysis. No significant publication bias was observed regarding overall critical thinking scores (P=0.536). Sensitivity analysis showed that the result of our meta-analysis was reliable. Most effect sizes for subscales of the California Critical Thinking Dispositions Inventory (CCTDI) and Bloom's Taxonomy favored problem-based learning, while effect sizes for all subscales of the California Critical Thinking Skills Test (CCTST) and most subscales of the Watson–Glaser Critical Thinking Appraisal (WCGTA) were inconclusive. The results of the current meta-analysis indicate that problem-based learning might help nursing students to improve their critical thinking. More research with larger sample size and high quality in different nursing educational contexts are required.
The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students' critical thinking. Searches of PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) were undertaken to identify randomized controlled trails from 1965 to December 2012, comparing problem-based learning with traditional lectures on the effectiveness of development of nursing students' critical thinking, with no language limitation. The mesh-terms or key words used in the search were problem-based learning, thinking, critical thinking, nursing, nursing education, nurse education, nurse students, nursing students and pupil nurse. Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using the Cochrane Collaboration's Risk of Bias Tool. We analyzed critical thinking scores (continuous outcomes) using a standardized mean difference (SMD) or weighted mean difference (WMD) with a 95% confidence intervals (CIs). Heterogeneity was assessed using the Cochran's Q statistic and I(2) statistic. Publication bias was assessed by means of funnel plot and Egger's test of asymmetry. Nine articles representing eight randomized controlled trials were included in the meta-analysis. Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students' critical thinking (overall critical thinking scores SMD=0.33, 95%CI=0.13-0.52, P=0.0009), compared with traditional lectures. There was low heterogeneity (overall critical thinking scores I(2)=45%, P=0.07) in the meta-analysis. No significant publication bias was observed regarding overall critical thinking scores (P=0.536). Sensitivity analysis showed that the result of our meta-analysis was reliable. Most effect sizes for subscales of the California Critical Thinking Dispositions Inventory (CCTDI) and Bloom's Taxonomy favored problem-based learning, while effect sizes for all subscales of the California Critical Thinking Skills Test (CCTST) and most subscales of the Watson-Glaser Critical Thinking Appraisal (WCGTA) were inconclusive. The results of the current meta-analysis indicate that problem-based learning might help nursing students to improve their critical thinking. More research with larger sample size and high quality in different nursing educational contexts are required.
Author Gao, Hui-Ming
Zhou, Ying-qing
Kong, Ling-Na
Mou, Shao-yu
Qin, Bo
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– sequence: 2
  givenname: Bo
  surname: Qin
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  organization: Nursing College of Chongqing Medical University, Chongqing 400016, PR China
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  givenname: Shao-yu
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  fullname: Mou, Shao-yu
  organization: Nursing College of Chongqing Medical University, Chongqing 400016, PR China
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  givenname: Hui-Ming
  surname: Gao
  fullname: Gao, Hui-Ming
  organization: Nursing College of Chongqing Medical University, Chongqing 400016, PR China
BackLink https://www.ncbi.nlm.nih.gov/pubmed/23850065$$D View this record in MEDLINE/PubMed
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Keywords Nursing education
Systematic review
Problem-based learning (PBL)
Critical thinking
Meta-analysis
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Snippet The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students’ critical...
The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students' critical...
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StartPage 458
SubjectTerms Analysis
Bias
Classification
Clinical training
Clinical trials
College students
Critical thinking
Data quality
Education
Effectiveness
Effectiveness studies
Humans
Infrastructure
Learning
Learning environment
Lectures
Measures
Medical education
Medical personnel
Medical research
Meta-analysis
Nurses
Nursing
Nursing education
Problem based learning
Problem-based learning (PBL)
Quality assessment
Risk assessment
Scores
Sensitivity analysis
Students
Students, Nursing - psychology
Systematic review
Test bias
Thinking
Thinking skills
Weapons of mass destruction
Title The effectiveness of problem-based learning on development of nursing students’ critical thinking: A systematic review and meta-analysis
URI https://dx.doi.org/10.1016/j.ijnurstu.2013.06.009
https://www.ncbi.nlm.nih.gov/pubmed/23850065
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https://www.proquest.com/docview/1501835008
https://www.proquest.com/docview/1514420724
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