Total views : 279

Enhancing Critical Thinking through Simulation Problem based Learning in Nursing Education


  • Department of Nursing, Daegu Health College, Korea, Republic of
  • Department of Nursing, Changwon National University, Korea, Republic of


Objectives: Nursing practice and education discourse identifies a need to stimulate and simulate critical thinking. The aim of this study was to think about the pedagogical effectiveness for promoting critical thinking of nursing students. Methods/ Statistical Analysis: We review the literature regarding the simulation training, problem-based learning, clinical practice experience to enhancing the critical thinking in nursing education and discuss the future direction of nursing education to promoting critical thinking. Findings: When compared with other types of instruction and teaching strategies, simulation is associated with positive outcomes. Given continuing beliefs in the centrality of critical thinking behavior to nursing practice, learning experiences must be structured in ways that elicit and make it explicit. Clinical learning experience during undergraduate programs and uses of Problem Based Learning claim to facilitate development of skills such as critical thinking. Changing contexts of education and practice in nursing require exploration of the potential of simulation to provide alternative and complementary learning to clinical placement. Applications/Improvements: Faculty Staff development was engaged in nursing education focused on integrating and assessing elements of PBL, critical thinking and simulation through a model of Simulation PBL may address limitations of clinical placement and develop and refine clinical judgment acumen.


Critical Thinking, Nursing Education, Nursing Practice, Problem-based Learning, Simulation.

Full Text:

 |  (PDF views: 480)


  • Rezmer J, Begaz T, Treat R, Tews M. Impact of group size on the effectiveness of a resuscitation simulation curriculum for medical students. Teaching and Learning in Medicine. 2011 Jul–Sep; 23(3):251–5.
  • Baillie L, Curzio J. Students’ and facilitators’ perceptions of simulation in practice learning. Nurse Education in Practice. 2009 Sep; 9(5):297–306.
  • Leigh GT. High-fidelity patient simulation and nursing students’ self-efficacy: A review of the literature. International Journal of Nursing Education Scholarship. 2008 Sep; 5(1):1–17.
  • Kiat TK, Mei TY, Nagammal S, Jonnie A. A review of learners experience with simulation based training in nursing. Singapore Nursing Journal. 2007; 34(4):37–43.
  • LaFond CM, Vincent HV. A critique of the National League for Nursing/Jeffries Simulation Framework. Journal of Advanced Nursing. 2013 Feb; 69(2):465–80.
  • Smithburger P, Kane-Gill S, Ruby C, Seybert M. Comparing effectiveness of 3 learning strategies: Simulation-based learning. problem-based learning, and standardized patients. Simulation in Healthcare. 2012 Jun; 7(3):141–6.
  • Partin JL, Payne TA, Slemmons MF. Students’ perceptions of their learning experiences using high-fidelity simulation to teach concepts relative to obsterics. Nursing Education Perspectives. 2011 May–Jun; 32(3):186–8.
  • Lundberg KM. Promoting self confidence in clinical nursing students. Nurse Educator. 2008 Mar–Apr; 33(2):86–9.
  • Tanner CA. Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education. 2006 Jun; 45(6):204–11.
  • Miller MG, Berry DC. An assessment of athletic training students' clinical-placement hours. Journal of Athletic Training. 2002 Oct –Dec; 37(S4):S-229–35.
  • Pietro DA, Shyavitz LJ, Smith RA, Auerbach S. Detecting and reporting medical errors: Why the dilemma? British Medical Journal. 2000 Mar; 320(7237):794–6.
  • Duffield C, Roche M, O’Brien-Pallas L, Diers D, Aisbett C, King M, Aisbett K, Hall J. Glueing it together: Nurses their work environment and patient safety. Centre for Health Management University of Technology Sydney, Final Report to NSW Health; 2007. p. 1–14.
  • Bandali K, Parker K, Mummery M, Preece M. Skills integration in a simulated and inter-professional environment: An innovative undergraduate applied health curriculum. Journal of Interprofessional Care. 2008 Mar; 22(2):179–89.
  • Australian Nursing and Midwifery Council Inc. National competency standards for the midwife, Canberra [Internet]. [cited 2014 Nov 10]. Available from:
  • Benner P. From novice to expert: Excellence and power in clinical nursing practice. California: Addison-Wesley Publishing; 1984.
  • Benner P, Tanner C, Chesla C. Expertise in nursing practice: Caring, clinical judgment and ethics, 2nd Edition, Springer Publishing Company; 2009 Mar.
  • Briscoe, Mary H. Preparing Scientific Illustrations. New York: Springer Publishing; 1996.
  • Conway J, McMillan M. Maximising learning opportunities and preparing for professional practice. Daly J, Speedy S, Jackson D, editors, Contexts of nursing, Sydney: MacLennan and Petty. 2006; 8(1):95–7.
  • Lunney M. Current knowledge related to intelligence and thinking with implications for the development and use of case studies. International Journal of Nursing Terminologies and Classifications. 2008 Oct –Dec; 19(4):158–62.
  • Facione N, Facione P, Sanchez C. Critical thinking disposition as a measure of competent clinical judgment: The development of the California critical thinking disposition inventory. Journal of Nursing Education. 1994 Oct; 33(8):345–50.
  • Rush KL, Dyches CE, Waldrop S, Davis A. Critical thinking among RN-to-BSN distance students participating in Human Patient Simulation. Journal of Nursing Education. 2008 Nov; 47(11):501–17.
  • Harden R, Michael S. International meeting on simulation in healthcare. Gordon Lectureship address; 2008.
  • Scheffer BK, Rubenfeld MG. A consensus statement on critical thinking in nursing. Journal of Nursing Education. 2000; 39(8):352–9.
  • Macdonald R, Barrett T, Labbrainn IM, Fallon H . Assessment strategies for enquiry and problem-based learning. Handbook of Enquiry and Problem-based Learning Galway; 2006. p. 85–93.
  • Yuan H, Williams BA, Fan L. A systematic review of selected evidence on developing nursing students’ critical thinking through problem-based learning. Nurse Education Today. 2008 Aug; 28(6):657–63.
  • Brown T, Williams B. Should DVD simulations replace hospital-based clinical placements? Medical Education. 2007; 41(11):1089–90.
  • Lasater K. Clinical judgment development: Using simulation to create an assessment rubric. Journal of Nursing Education. 2007; 46(11):496–503.
  • Rothgeb M. Creating a nursing simulation laboratory: A literature review. Journal of Nursing Education. 2008 Nov; 47(11):489–94.
  • Brannan JD, White A, Bezanson JL. Simulator effects on cognitive skills and confidence levels. Journal of Nursing Education. 2008 Nov; 47(11):495–500.
  • Gaba DM. The future vision of simulation in health care. Nursing Education Perspectives. 2004; 26(6):357–61.
  • Levett-Jones T, Hoffman K, Dempsey J, Jeong S, Noble D, Norton C, Roche J, Hickey N. The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients. Nurse Education Today. 2010; 30(6):515–20.
  • Sittnr BJ, Aebersold ML, Paige JB, Grahan LLM, Schram AP, Decker SI, Lioce L. INACSL standards of best practice for simulation: Past, present, and future. Nursing Education Perspectives. 2015; 36(5):294–8.
  • Beebe RI. Relationship between fidelity and dose of human patient simulation, critical thinking skills, and knowledge in an associate degree nursing program. West Virginia University, Doctoral dissertation; 2012.
  • Kennedy CC, Maldonado F, Cook DA. Simulation-based bronchoscopy training: Systematic review and meta-analysis.Chest. 2013 Jul; 144(1):183–92.
  • McGaghie WC, Issenberg SB, Barsuk JH, Wayne DB. A critical review of simulation-based mastery learning with translational outcomes. Medical Education. 2014 Apr; 48(4):375–85.
  • Halla C. Newcastle PBL center reports, Cheju Halla University, Republic of Korea; 2007/2008.
  • Park MY, McMillan M, Little P, Park CS, Park HO. Simulation-PBL(Problem Based Learning): An evaluation of the implementation of learning modules in the Korean nursing context. International Meeting on Simulation in Healthcare, Lake Buena Vista, FL: Society for Simulation in Healthcare; 2009. p. 41–51.
  • Rogers G, Mentowski M. Abilities that distinguish the effectiveness of five year alumna performance across work, family and civic roles: A higher education validation. Higher Education Research and Development. 2004 Aug; 23(3): 347–74.
  • Curtin MM, Dupuis MD. Development of human patient simulation programs: Achieving big results with a small budget. Journal of Nursing Education. 2008 Nov; 47(11):522–3.
  • PROBLARC. Criteria for learning events, Unpublished workshop material University of Newcastle; 2000.
  • Jeffries P. Simulation in nursing education: Valuing and adopting an experiential clinical model, New York: National League for Nursing; 2007.
  • Epstein RM, Hundert EM. Defining and assessing professional competence. Journal of the American Medical Association. 2002 Ja;, 287(2):226–35.


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.