Dissertation Abstract

The Effect of a Peer to Peer Strategy Within Radiation Therapy and Nursing Clinical Settings on the Development of Critical Thinking Skills

Today's health care delivery system is changing at a rapid rate. Present and future health care trends indicate that roles and responsibilities of entry level practitioners are expanding. It is important to have students develop the cognitive flexibility to adequately prepare for changes in a dynamic health care system. The cultivation of critical thinking skills is seen as one way to assist health care workers in making informed decisions.

The development of critical thinking skills through a Guided Reciprocal Peer Questioning (GRPQ) technique (King, 1990) is the focus of this investigation. The literature indicates that the use of GRPQ as a teaching strategy may promote high elaborative questioning which in turn induces high elaborative responses characteristic of improved critical thinking skills (Webb, 1989).

The research question addressed in this study is: What is the effect of using a guided reciprocal peer-questioning technique on the development of critical thinking skills of nursing and radiation therapy students? The study was conducted in 3 higher educational institutions offering associate degree programs. The cohort for this research was nursing and radiation therapy technology students enrolled in a clinical course and accompanying post clinical conferences (N = 38). The experimental group (n = 23) consisted of 21 nursing students and 2 radiation therapy students. The control group (n = 15) consisted of 13 nursing students and 2 radiation therapy students. An initial demographic survey and a pre Watson-Glaser Critical Thinking Appraisal was administered to all subjects. A post Watson-Glaser Critical Thinking Appraisal was given after the last post clinical conference had been conducted. GRPQ was incorporated into the experimental group's weekly one hour post-clinical session, in which students were required to generate 2–3 questions based on their actual clinical experience for that particular week. Working in dyads, one student asked her/his partner a question that s/he had generated, to which the partner responded. The procedure was reversed so that each member of the pair asked and responded to questions.

The post-clinical conferences were conducted for approximately one hour once a week facilitated by a clinical faculty member. These conferences were audiotaped and coded. The control group participated in conferences, which were conducted in the traditional manner of discussions between students and clinical faculty with no specific questioning technique employed. These conferences were audiotaped and coded in a similar manner. The study occurred over 6 weeks.

An ANOVA was performed on the pretest and post-test Watson-Glaser Critical Thinking Appraisal scores of the experimental group and the control group. Critical thinking scores decreased significantly. A Chi-square test was performed to see if there was any association between the GRPQ intervention and the level of questions asked and responses given. The findings showed there was a strong association. The experimental group provided significantly more high level responses and fewer low level responses when the GRPQ technique was used than would be expected when this technique was not employed.

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