critical thinking games for nurses

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Fun Critical Thinking Activities for Nursing Students

Medical courses are popular for their complexity and demanding nature. For your everyday student fighting to pay tuition, rent, food, and loans, pursuing a career in the field can be a nightmare. Those who’ve made the journey understand the importance of critical thinking for nursing students. Every facet of the course requires thorough analysis and logical engagement. Nonetheless, educators can intervene to make the journey fun and memorable by introducing exciting activities into the classroom. Below are 10 projects to consider in your classroom.

The Importance of Critical Thinking for Nursing Students

There’s no denying that critical thinking is of utmost importance for nursing students. Well, no professional field would survive without analytical skills. But nursing is about people’s well-being, which makes the practice even more sacred. Below are a few reasons why critical thinking is essential to the practice:

Patient safety

The primary role of a RN is to care for their patients. But this isn’t always the case. Some nurses, e.g., Charles Cullen, have committed atrocities against their patients. Many others have harmed their patients unintentionally or due to negligence. In the medical field, the consequences of a wrong decision can be severe. As such, we need our nurses to be on top of their game. They must possess necessary critical thinking skills to identify potential risks and avert or remedy them.

Clinical judgment

Unlike popular opinion, the role of nurses isn’t limited to administering drugs and caring for them. There are many scenarios that demand clinical judgments, e.g., evaluating symptoms and making a diagnosis, deciding on appropriate medication dosage, recognizing signs of an allergic reaction, etc. These are delicate and life-defining matters that demand critical thinking skills.

Ethical decision-making

Nothing is as demanding as making an ethical decision. The dilemma involved can make or break even the best nurses. In training, they’re often advised to make the decisions they can live with, and in the best interest of their patients. We hope you can see the catch. Whatever the situation, such cases require weighing different ethical principles, values, and perspectives, making them almost impossible to deal with. Handling critical thinking questions during training can make it a bit easier.  

Completing course assignments

All medical courses have a heavy workload of assignments, practicals, and clinical placements. If you add personal life requirements, it becomes almost impossible to handle. In some courses, students handle voluminous works that require days and weeks of reading. The vastness aside, you must be smart to understand the terminology and concepts in nursing. This is where most students fail. However, there’s no cause for alarm. You can always seek help when stranded with your essays and dissertations. There are reputable companies that specialize in nursing writing that can come through on short notice. WriteMyPaperHub , for instance, has very creative and highly trained PhD writers in nursing and medicine who can deliver complex papers within the deadline you need.

Stimulating the Mind: 10 Fun Critical Thinking Activities for Nursing Students

There are several fun critical thinking activities for nursing students to consider. However, many can be costly, time-consuming, or too demanding. For an ordinary classroom, group activities should be simple and interesting. Here, we’ve assembled 10 activities and critical thinking games for nursing students.

1. Case studies

Nursing is a very practical course. As such, any opportunity to explore real-life patient scenarios is highly welcome. This exercise provides just that. Students can organize themselves into small groups and tackle a problem, for example, examine a wound, identify its probable causes, and propose how to treat it.

There’s no better way of sharpening your critical thinking skills than through open discourses. Let your students disagree to agree, for they will gain so much more from being corrected by their peers than rote memorization. Therefore, occasionally pick a controversial or ethical topic and let them debate on it. Just ensure that the engagement is structured for maximum impact.    

3. Reflection journals

Journals can be a student’s best companion. Medical courses can be demanding, putting undue pressure on college students. However, with proper planning and focus, dedicated persons are likely to make it through. A diary can help you organize yourself, appreciate the difficulties you’ve overcome, reflect on your clinical experiences, and motivate you to keep pushing. But keeping it isn’t enough. You must read and reflect on your journey if you’re to stay on track.

4. Simulation exercises

Advances in technology have significantly impacted medical training. For instance, Virtual Reality (VR) is helping instructors to deliver realistic scenarios to their learners remotely. Imagine creating and sharing realistic images of viruses, pathogens, or sick people with your learners and asking them to explore them under pressure and deliver a verdict. It’s like being in the lab!

5. Critical thinking worksheets

Also commonly referred to as critical thinking flow sheets, this activity can be instrumental in testing students’ abilities. It’s a step-by-step process involving clinical scenarios that require extensive research. Here, learners are supposed to gather data on a specific issue, analyze it carefully, and arrive at a diagnosis. It’s a thorough process that employs logic and problem-solving skills.

6. Role-playing

Nursing schools don’t train nurses to be just subordinates. Their curriculum entails everything about patient care and simple diagnosis. In fact, in remote areas with no clinicians, they’re the doctors of the day. Their instructors can organize scenarios that expose them to such situations and let them act as the physicians in charge. They can also act as other people in the healthcare team, e.g., clerks, therapists, and pharmacists. Organizing such critical thinking activities can enhance their preparation and training.

7. Flipped classroom

Even though nursing is quite hands-on, its trainers can deliver their courses and instructions remotely. A flipped classroom is a dynamic approach to learning that allows students to explore their materials at home. Technological advances have made it possible for remote collaboration, making this one of the most enjoyable and fun activities.

8. Group discussions

Unlike debates that pit groups and individuals against each other, group discussions are less confrontational, making them ideal for younger learners. These setups are also suitable for discussing ethical dilemmas. While it’s often hard to find common ground for such issues, challenging assumptions are critical for nursing practice.

9. Decision-making games

The life of a nurse involves making numerous critical decisions. Some of these big resolutions require an instant response. This requires rigorous training. Trainers can use board games, for instance, to pressure students into making healthcare-related decisions fast. This can help them in making informed choices under pressure.

10. Mind mapping

You can introduce this activity as a visual instrument for arranging, generating, and investigating ideas and the links between different nursing concepts.

Critical Thinking for Critical Patient Support!

Nurses are the pillars that hold the healthcare system together. However, their services are only as good as their training and abilities. If we want the best out of our nurses, we must sharpen their critical thinking skills and make them ready for service. In this short article, we’ve explored a few activities that can help nursing trainees develop critical thinking skills essential for their future roles as healthcare professionals.

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Games and Activities to Liven up your Nursing Lectures

Between medical terminology and pharmacology, nursing students can lose motivation and get bogged down with details. so how do you, as a classroom instructor, help students stay focused and have fun we’ve found a handful of classroom games that are free or low-cost for healthcare educators to liven up their classrooms., jeopardylabs:.

This platform allows users to make their own Jeopardy style games and share them with the public. Thousands of nursing students and instructors have created games that you can access here for free.

Some of our favorites are Nursing Fundamentals for brand new students, Neurological Health Challenges and Pediatrics .

Before starting the game, you can choose how many teams will be playing and then you can divide your classroom into the appropriate number of groups. Have each team compete against each other to earn the most points during classroom Jeopardy!

Free Game and Activity Ideas for Nursing Instructors:

This blog post on the Elsevier website had to have been written by an incredible teacher. We’re thinking she probably got 100% pass rates on the NCLEX if for no other reason than her classroom was so fun.

We won’t steal her content, but definitely click on that link for free ideas like ACE Bandage Relay Races, Name that Personal Care Item, and O2 Bingo.

We adore Ponder, and it’s not just because we have an amazing partnership with them. Ponder is a simulation board game that gives you the ability to bring critical thinking and decision making into the classroom without having to do a ton of setup. Unlike some of the other free options on this list, Ponder does have a one-time fee to purchase the game. You can buy it on their website here .

Check out the game here:

We’d love to hear more about the games and activities you do at your school.

If you’d like to write a guest blog post and share your strategies with the world, send us an email at [email protected]

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10 Engaging Online Nursing Games for Enhancing Critical Thinking Skills

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Online nursing games offer an engaging way to tackle the rigors of nursing education. Meticulously designed to simulate real-world clinical scenarios, they offer a way for nursing students and professionals to develop and refine crucial skills. From mastering complex medical procedures to managing healthcare crises, these games serve as a bridge between theoretical knowledge and practical application, crucial for a successful nursing career.

The ten games listed below are not only serious games but also entertaining, providing a balance that makes the learning process more enjoyable and effective. They encompass a broad spectrum of nursing competencies, including critical thinking, clinical judgment, diagnostic proficiency, and effective communication within medical teams. These digital resources also support NCLEX exam preparation and continuous professional development, ensuring nurses are equipped to meet the challenges of modern healthcare environments.

10 Serious Online Nursing Games 

1. The Nobel Prize Blood Typing Game

In the healthcare field, registered nurses (RNs) play a crucial role in performing blood transfusions accurately and safely. To help nurses develop their skills in blood typing and transfusion procedures, an online game is available. This interactive game allows nurses to practice blood typing and learn how to perform safe blood transfusions, ultimately improving their abilities in a clinical setting.

2. SkillStat ECG Simulator

Nurses working in critical care environments need to possess strong ECG knowledge for effective monitoring and response. SkillStat's Six Second ECG Simulator is a free online game that allows nurses to explore and identify 27 common cardiac rhythms. It's a convenient and valuable tool for practicing and improving ECG interpretation skills.

3. Flow of Blood Through the Heart

It’s imperative for nurses to know the blood flow throughout the heart so that they can comprehend cardiac diseases, such as heart failure. In this game, users trace the flow of a drop of blood through the heart, starting from systemic entry to systemic outlet.

4. UbiSim Immersive Virtual Reality (VR)

Nursing games online, particularly those utilizing virtual reality (VR) technology, offer numerous benefits for nursing students. These games enhance clinical judgment, provide a realistic learning environment, and aid in NCLEX preparation. UbiSim is a leading virtual reality platform specifically designed for nursing education, offering immersive scenarios and interactive features. By embracing these innovative educational tools, nursing programs can empower their students with the knowledge and skills necessary for their future clinical practice.

5. Prognosis: Your Diagnosis

Nurses should be prepared to know the major diagnoses of their patients, to detect, report, and document changes in patients' condition. With Prognosis, you can improve your ability to diagnose and immediately manage key clinical presentations associated with a disease, having access to relevant facts and succinct explanations.

6. Pixel Hospital

While you play a head doctor in the game, it’s relevant to nursing professionals because a wild epidemic has hit the city, and the hospital is now teeming with patients. You have to use limited staff, resources, and equipment. Much like real clinical practice, it's your duty to nurse as many patients as possible back to health. 

7. Plague Inc.

Nurses need to be aware of infectious diseases and how they spread. Plague Inc. is a unique mix of high strategy and terrifyingly realistic simulation. A pathogen has just infected 'Patient Zero.' Now, you must bring about the end of human history by evolving a deadly, global Plague whilst adapting against everything humanity can do to defend itself.

8. Nursing Sim

Critical thinking skills are crucial for nurses. This is a mobile game to help nursing students practice the multifactor decision-making process of nurse assignment, which includes accurately recognizing nurse competency, assessing patient acuity, and determining how to equitably delegate which patients each nurse sees on a shift. 

9. Medical Abbreviations

It may seem like alphabet soup at first, but being able to memorize medical abbreviations allows for quick, accurate documentation of patient information and facilitates efficient communication between care team members. This game enables you to do flashcards or play a matching game.

10. Med Mnemonics

Mnemonics are short little rhymes or phrases that make nursing terms (or anything you're studying) easier to remember. There are so many terms to memorize as healthcare professionals, so nursing students can use this to make their memory stick. 

Final Thoughts

By incorporating these engaging and entertaining games into nursing education, students can not only improve their skills but also enjoy the learning process. Whether it's practicing blood typing, interpreting ECGs, understanding cardiac flow, or developing diagnostic abilities, these online nursing games are valuable tools for enhancing nursing practice and ensuring that nurses are well-prepared for the challenges of modern healthcare environments.

As an integral center of UbiSim's content team, Ginelle pens stories on the rapidly changing landscape of VR in nursing simulation. Ginelle is committed to elevating the voices of practicing nurses, nurse educators, and program leaders who are making a difference.

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What is Critical Thinking in Nursing? (With Examples, Importance, & How to Improve)

Successful nursing requires learning several skills used to communicate with patients, families, and healthcare teams. One of the most essential skills nurses must develop is the ability to demonstrate critical thinking. If you are a nurse, perhaps you have asked if there is a way to know how to improve critical thinking in nursing? As you read this article, you will learn what critical thinking in nursing is and why it is important. You will also find 18 simple tips to improve critical thinking in nursing and sample scenarios about how to apply critical thinking in your nursing career.

What Is Critical Thinking In Nursing?

4 reasons why critical thinking is so important in nursing, 1. critical thinking skills will help you anticipate and understand changes in your patient’s condition., 2. with strong critical thinking skills, you can make decisions about patient care that is most favorable for the patient and intended outcomes., 3. strong critical thinking skills in nursing can contribute to innovative improvements and professional development., 4. critical thinking skills in nursing contribute to rational decision-making, which improves patient outcomes., what are the 8 important attributes of excellent critical thinking in nursing, 1. the ability to interpret information:, 2. independent thought:, 3. impartiality:, 4. intuition:, 5. problem solving:, 6. flexibility:, 7. perseverance:, 8. integrity:, examples of poor critical thinking vs excellent critical thinking in nursing, 1. scenario: patient/caregiver interactions, poor critical thinking:, excellent critical thinking:, 2. scenario: improving patient care quality, 3. scenario: interdisciplinary collaboration, 4. scenario: precepting nursing students and other nurses, how to improve critical thinking in nursing, 1. demonstrate open-mindedness., 2. practice self-awareness., 3. avoid judgment., 4. eliminate personal biases., 5. do not be afraid to ask questions., 6. find an experienced mentor., 7. join professional nursing organizations., 8. establish a routine of self-reflection., 9. utilize the chain of command., 10. determine the significance of data and decide if it is sufficient for decision-making., 11. volunteer for leadership positions or opportunities., 12. use previous facts and experiences to help develop stronger critical thinking skills in nursing., 13. establish priorities., 14. trust your knowledge and be confident in your abilities., 15. be curious about everything., 16. practice fair-mindedness., 17. learn the value of intellectual humility., 18. never stop learning., 4 consequences of poor critical thinking in nursing, 1. the most significant risk associated with poor critical thinking in nursing is inadequate patient care., 2. failure to recognize changes in patient status:, 3. lack of effective critical thinking in nursing can impact the cost of healthcare., 4. lack of critical thinking skills in nursing can cause a breakdown in communication within the interdisciplinary team., useful resources to improve critical thinking in nursing, youtube videos, my final thoughts, frequently asked questions answered by our expert, 1. will lack of critical thinking impact my nursing career, 2. usually, how long does it take for a nurse to improve their critical thinking skills, 3. do all types of nurses require excellent critical thinking skills, 4. how can i assess my critical thinking skills in nursing.

• Ask relevant questions • Justify opinions • Address and evaluate multiple points of view • Explain assumptions and reasons related to your choice of patient care options

5. Can I Be a Nurse If I Cannot Think Critically?

A Virtual Serious Game for Nursing Education

• Conference paper
• First Online: 19 October 2021
• Cite this conference paper

• Youxin Luo 9 ,
• Abel A. Reyes 9 ,
• Parashar Dhakal 10 ,
• Manisa Baker 11 ,
• Julia Rogers 11 &
• Xiaoli Yang 9  

Part of the book series: Transactions on Computational Science and Computational Intelligence ((TRACOSCI))

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Procedure skill competency is a crucial element in nursing education. However, there are several barriers to skill competency and proficiency, which include limited simulation faculty, lab time, and resources. Serious gaming has proven to be an effective approach to enhance knowledge attainment, promote problem-based active learning, and encourage critical thinking in many industries, including nursing. Therefore, we propose a virtual serious game featured with a realistic environment, considerable interaction and animation, well-designed user-friendly graphic interface, and an innovative evaluation system for nursing education. This game is designed as complementary learning material to be utilized along with traditional pedagogical methods. This game provides a supplemental learning methodology for undergraduate nursing students, enabling them to practice the skill in a safe and innovative environment. Incorporating a serious game into undergraduate nursing education can circumvent the problems of scheduling; individualized instruction; physical requirements of facilities, equipment, and supplies; and geography constraints.

• Serious game
• Nursing education
• Interaction
• Fundamental nursing skills

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Electrical and Computer Engineering, Purdue University Northwest, Hammond, IN, USA

Youxin Luo, Abel A. Reyes & Xiaoli Yang

Electrical and Computer Science Engineering, The University of Toledo, Toledo, OH, USA

Parashar Dhakal

College of Nursing, Purdue University Northwest, Hammond, IN, USA

Manisa Baker & Julia Rogers

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Luo, Y., Reyes, A.A., Dhakal, P., Baker, M., Rogers, J., Yang, X. (2021). A Virtual Serious Game for Nursing Education. In: Arabnia, H.R., et al. Advances in Parallel & Distributed Processing, and Applications. Transactions on Computational Science and Computational Intelligence. Springer, Cham. https://doi.org/10.1007/978-3-030-69984-0_68

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The effect of “typical case discussion and scenario simulation” on the critical thinking of midwifery students: Evidence from China

• Yuji Wang 1   na1 ,
• Yijuan Peng 1   na1 &
• Yan Huang 1  

BMC Medical Education volume  24 , Article number:  340 ( 2024 ) Cite this article

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Assessment ability lies at the core of midwives’ capacity to judge and treat clinical problems effectively. Influenced by the traditional teaching method of “teacher-led and content-based”, that teachers involve imparting a large amount of knowledge to students and students lack active thinking and active practice, the clinical assessment ability of midwifery students in China is mostly at a medium or low level. Improving clinical assessment ability of midwifery students, especially critical thinking, is highly important in practical midwifery education. Therefore, we implemented a new teaching program, “typical case discussion and scenario simulation”, in the Midwifery Health Assessment course. Guided by typical cases, students were organized to actively participate in typical case discussions and to promote active thinking and were encouraged to practice actively through scenario simulation. In this study, we aimed to evaluate the effect of this strategy on the critical thinking ability of midwifery students.

A total of 104 midwifery students in grades 16–19 at the West China School of Nursing, Sichuan University, were included as participants through convenience sampling. All the students completed the Midwifery Health Assessment course in the third year of university. Students in grades 16 and 17 were assigned to the control group, which received routine teaching in the Midwifery Health Assessment, while students in grades 18 and 19 were assigned to the experimental group, for which the “typical case discussion and scenario simulation” teaching mode was employed. The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) and Midwifery Health Assessment Course Satisfaction Questionnaire were administered after the intervention.

After the intervention, the critical thinking ability of the experimental group was greater than that of the control group (284.81 ± 27.98 and 300.94 ± 31.67, p  = 0.008). Furthermore, the experimental group exhibited higher scores on the four dimensions of Open-Mindedness (40.56 ± 5.60 and 43.59 ± 4.90, p  = 0.005), Analyticity (42.83 ± 5.17 and 45.42 ± 5.72, p  = 0.020), Systematicity (38.79 ± 4.70 and 41.88 ± 6.11, p  = 0.006), and Critical Thinking Self-Confidence (41.35 ± 5.92 and 43.83 ± 5.89, p  = 0.039) than did the control group. The course satisfaction exhibited by the experimental group was greater than that exhibited by the control group (84.81 ± 8.49 and 90.19 ± 8.41, p  = 0.002).

The “typical case discussion and scenario simulation” class mode can improve the critical thinking ability of midwifery students and enhance their curriculum satisfaction. This approach carries a certain degree of promotional significance in medical education.

Typical case discussion and scenario simulation can improve midwifery students’ critical thinking ability.

Typical case discussion and scenario simulation can enhance students’ learning interest and guide students to learn independently.

Midwifery students were satisfied with the new teaching mode.

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Maternal and neonatal health are important indicators to measure of the level of development of a country’s economy, culture and health care. The positive impact of quality midwifery education on maternal and newborn health is acknowledged in the publication framework for action strengthening quality midwifery education issued by the World Health Organization (WHO) [ 1 ]. Extensive evidence has shown that skilled midwifery care is crucial for reducing preventable maternal and neonatal mortality [ 2 , 3 , 4 ]. Clinical practice features high requirements for the clinical thinking ability of midwives, which refers to the process by which medical personnel analyze and integrate data with professional medical knowledge in the context of diagnosis and treatment as well as discover and solve problems through logical reasoning [ 5 ]. Critical thinking is a thoughtful process that is purposeful, disciplined, and self-directed and that aims to improve decisions and subsequent actions [ 6 ]. In 1986, the American Association of Colleges of Nursing formulated the “Higher Education Standards for Nursing Specialty”, which emphasize the fact that critical thinking is the primary core competence that nursing graduates should possess [ 7 ]. Many studies have shown that critical thinking can help nurses detect, analyze and solve problems creatively in clinical work and is a key factor in their ability to make correct clinical decisions [ 8 , 9 , 10 ].

However, the traditional teaching method used for midwifery students in China is “teacher-led and content-based”, and it involves efficiently and conveniently imparting a large amount of knowledge to students over a short period. Students have long failed to engage in active thinking and active practice, and the cultivation of critical thinking has long been ignored [ 5 ]. As a result, the critical thinking ability of midwifery students in China is mostly at a medium or low level [ 5 ]. Therefore, it is necessary to develop a new teaching mode to improve the critical thinking ability of midwifery students.

In 2014, Professor Xuexin Zhang of Fudan University, Shanghai, China, proposed a novel teaching method: the divided class mode. The basic idea of this approach is to divide the class time into two parts. The teachers explain the theoretical knowledge in the first lesson, and the students discuss that knowledge in the second lesson. This approach emphasizes the guiding role of teachers and encourages and empowers students to take responsibility for their studies [ 11 ]. Research has shown that the divided class mode can improve students’ enthusiasm and initiative as well as teaching effectiveness [ 12 ].

The problem-originated clinical medical curriculum mode of teaching was first established at McMaster University in Canada in 1965. This model is based on typical clinical cases and a problem-oriented heuristic teaching model [ 13 ]. The process of teaching used in this approach is guided by typical cases with the goal of helping students combine theoretical knowledge and practical skills. This approach can enhance the enthusiasm and initiative of students by establishing an active learning atmosphere. Students are encouraged to discuss and analyze typical cases to promote their ability to digest and absorb theoretical knowledge. Research has shown that the problem-originated clinical medical curriculum teaching mode can enhance students’ confidence and improve their autonomous learning and exploration ability. Scenario simulation teaching can provide students with real scenarios, allowing them to practice and apply their knowledge in a safe environment [ 14 ], which can effectively improve their knowledge and clinical skills and enhance their self-confidence [ 15 , 16 ].

Based on the teaching concept of divided classes, our research team established a new teaching model of “typical case discussion and scenario simulation”. Half of the class time is allocated for students to discuss typical cases and carry out scenario simulations to promote their active thinking and active practice. The Midwifery Health Assessment is the final professional core course that midwifery students must take in our school before clinical practice. All students must complete the course in Grade 3. Teaching this course is important for cultivating the critical thinking and clinical assessment ability of midwifery students. Therefore, our team adopted the new teaching mode of "typical case discussion and scenario simulation" in the teaching of this course. This study explored the teaching mode’s ability to improve the critical thinking ability of midwifery students.

Study design

The study employed a semiexperimental design.

Participants

A convenience sample of 104 third-year midwifery students who were enrolled in the Midwifery Health Assessment course volunteered to participate in this research at a large public university in Sichuan Province from February 2019 to June 2022 (grades 16 to 19). All the students completed the course in the third year of university. Students in grades 16 and 17 were assigned to the control group, which received the traditional teaching mode. Students in grades 18 and 19 were assigned to the experimental group, in which context the “typical case discussion and scenario simulation” class mode was used. The exclusion criteria for midwifery students were as follows: (1) dropped out of school during the study, (2) took continuous leave from school for more than two weeks, or (3) were unable to complete the questionnaire. The elimination criterion for midwifery students was that all the items were answered in the same way. No significant differences in students’ scores in their previous professional courses (Midwifery) were observed between the two groups. Textbooks, teachers, and teaching hours were the same for both groups.

Development of the “typical case discussion and scenario simulation” class mode

This study is based on the implementation of the new century higher education teaching reform project at Sichuan University. With the support of Sichuan University, we first established a “typical case discussion and scenario simulation” class mode team. The author of this paper was the head of the teaching reform project and served as a consultant, and the first author is responsible for supervising the implementation of the project. Second, the teaching team discussed and developed a standard process for the “typical case discussion and scenario simulation” class mode. Third, the entire team received intensive training in the standard process for the “typical case discussion and scenario simulation” class mode.

Implementation of the “typical case discussion and scenario simulation” class mode

Phase i (before class).

Before class, in accordance with the requirements for evaluating different periods of pregnancy, the teacher conceptualized typical cases and then discussed those cases with the teaching team and made any necessary modifications. After the completion of the discussion, the modified cases were released to the students through the class group. To ensure students’ interest, they were guided through the task of discovering and solving relevant problems using an autonomous learning approach.

Phase II (the first week)

Typical case discussion period. The Midwifery Health Assessment course was taught by 5 teachers and covered 5 health assessment periods, namely, the pregnancy preparation, pregnancy, delivery, puerperium and neonatal periods. The health assessment course focused on each period over 2 consecutive teaching weeks, and 2 lessons were taught per week. The first week focused on the discussion of typical cases. In the first lesson, teachers introduced typical cases, taught key knowledge or difficult evaluation content pertaining to the different periods, and explored the relevant knowledge framework. In the second lesson, teachers organized group discussions, case analyses and intergroup communications for the typical cases. They were also responsible for coordinating and encouraging students to participate actively in the discussion. After the discussion, teachers and students reviewed the definitions, treatments and evaluation points associated with the typical cases. The teachers also encouraged students to internalize knowledge by engaging in a process of summary and reflection to achieve the purpose of combining theory with practice.

Phase III (the second week)

Scenario simulation practice period. The second week focused on the scenario simulation practice period. In the first lesson, teachers reviewed the focus of assessment during the different periods and answered students’ questions. In the second lesson, students performed typical case assessment simulations in subgroups. After the simulation, the teachers commented on and summarized the students’ simulation evaluation and reviewed the evaluation points of typical cases to improve the students’ evaluation ability.

The organizational structure and implementation of the “typical case discussion and scenario simulation” class mode showed in Fig.  1 .

“Typical case discussion and scenario simulation” teaching mode diagram

A demographic questionnaire designed for this purpose was used to collect relevant information from participants, including age, gender, single-child status, family location, experience with typical case discussion or scenario simulation and scores in previous professional courses (Midwifery).

The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) was developed by Peng et al. to evaluate the critical thinking ability of midwifery students [ 17 ]. The scale contains 70 items across a total of seven dimensions, namely, open-mindedness, truth-seeking, analytical ability, systematic ability, self-confidence in critical thinking, thirst for knowledge, and cognitive maturity. Each dimension is associated with 10 items, and each item is scored on a 6-point Likert scale, with 1 indicating “extremely agree” and 6 representing “extremely disagree”. The scale includes 30 positive items, which receive scores ranging from “extremely agree” to “extremely disagree” on a scale of 6 to 1, and 40 negative items, which receive scores ranging from “extremely agree” to “extremely disagree” on a scale of 1 to 6. A total score less than 210 indicates negative critical thinking ability, scores between 211 and 279 indicate an unclear meaning, scores of 280 or higher indicate positive critical thinking ability, and scores of 350 or higher indicate strong performance. The score range of each trait is 10–60 points; a score of 30 points or fewer indicates negative trait performance, scores between 31 and 39 points indicate that the trait meaning is incorrect, scores of 40 points or higher indicate positive trait performance, and scores of 50 points or higher indicate extremely positive trait performance. The Cronbach’s α coefficient of the scale was 0.90, thus indicating good content validity and structure. The higher an individual’s score on this measure is, the better that individual’s critical thinking ability.

The evaluation of teaching results was based on a questionnaire used to assess undergraduate course satisfaction, and the researchers deleted and modified items in the questionnaire to suit the context of the “typical case discussion and scenario simulation” teaching mode. Two rounds of discussion were held within the study group to form the final version of the Midwifery Health Assessment satisfaction questionnaire. The questionnaire evaluates the effect of teaching in terms of three dimensions, namely, curriculum content, curriculum teaching and curriculum evaluation. The questionnaire contains 21 items, each of which is scored on a 5-point Likert scale, with 1 indicating “extremely disagree” and 5 representing “extremely agree”. The higher the score is, the better the teaching effect.

Data collection and statistical analysis

We input the survey data into the “Wenjuanxing” platform ( https://www.wjx.cn/ ), which specializes in questionnaire services. At the beginning of the study, an electronic questionnaire was distributed to the students in the control group via student WeChat and QQ groups for data collection. After the intervention, an electronic questionnaire was distributed to the students in the experimental group for data collection in the final class of the Midwifery Health Assessment course. All the data were collected by the first author (Yuji Wang). When students had questions about the survey items, the first author (Yuji Wang) immediately explained the items in detail. To ensure the integrity of the questionnaire, the platform required all the items to be answered before submission.

Statistical Package for Social Sciences Version 26.0 (SPSS 26.0) software was used for data analysis. The Shapiro‒Wilk test was used to test the normality of the data. The measurement data are expressed as the mean ± standard deviation (X ± S), and an independent sample t test was used for comparisons among groups with a normal distribution. The data presented as the number of cases (%), and the chi-square test was performed. A P value < 0.05 indicated that a difference was statistically significant.

Ethical considerations

The study was funded by the New Century Teaching Reform Project of Sichuan University and passed the relevant ethical review. Oral informed consent was obtained from all individual participants in the study.

Characteristics of the participants

A total of 104 third-year midwifery students were enrolled from February 2019 to June 2022, and 98.1% (102/144) of these students completed the survey. Two invalid questionnaires that featured the same answers for each item were eliminated. A total of 100 participants were ultimately included in the analysis. Among the participants, 48 students were assigned to the control group, and 52 students were assigned to the experimental group. The age of the students ranged from 19 to 22 years, and the mean age of the control group was 20.50 years (SD = 0.61). The mean age of the experimental group was 20.63 years (SD = 0.65). Of the 100 students who participated in the study, the majority (96.0%) were women. No significant differences were observed between the intervention and control groups in terms of students’ demographic information (i.e., age, gender, status as an only child, or family location), experience with scenario simulation or typical case discussion and scores in previous Midwifery courses (Table  1 ).

Examining the differences in critical thinking ability between the two groups

The aim of this study was to evaluate the effect of the new teaching mode of “typical case discussion and scenario simulation” on improving the critical thinking ability of midwifery students. Independent sample t tests were used to examine the differences in critical thinking ability between the two groups (Table  2 ). The results showed that the total critical thinking scores obtained by the experimental group were greater than those obtained by the control group (284.81 ± 27.98 and 300.94 ± 31.67, p  = 0.008). The differences in four dimensions (Open-Mindedness (40.56 ± 5.60 and 43.59 ± 4.90, p  = 0.005), Analyticity (42.83 ± 5.17 and 45.42 ± 5.72, p  = 0.020), Systematicity (38.79 ± 4.70 and 41.88 ± 6.11, p  = 0.006), and Critical Thinking Self-Confidence (41.35 ± 5.92 and 43.83 ± 5.89, p  = 0.039)) were statistically significant.

Examining the differences in curriculum satisfaction between the two groups

To evaluate the effect of the new teaching mode of “the typical case discussion and scenario simulation” on the course satisfaction of midwifery students. Independent sample t tests were used to examine the differences in course satisfaction between the two groups (Table  3 ). The results showed that the curriculum satisfaction of the experimental group was greater than that of the control group (84.81 ± 8.49 and 90.19 ± 8.41, p  = 0.002). Independent sample t tests were used to examine the differences in the three dimensions of curriculum satisfaction between the two groups (Table  3 ). The results showed that the average scores of the intervention group on the three dimensions were significantly greater than those of the control group (curricular content: 20.83 ± 1.96 and 22.17 ± 2.23, p  = 0.002; curriculum teaching: 34.16 ± 3.89 and 36.59 ± 3.66, p  = 0.002; curriculum evaluation: 29.81 ± 3.27 and 31.42 ± 3.19, p  = 0.015).

Midwifery is practical and intensive work. To ensure maternal and child safety, midwives must make decisions and take action quickly. Therefore, midwives should have both critical thinking ability and clinical decision-making ability [ 18 ]. In addition, the Australian Nursing and Midwifery Accreditation Council (ANMAC) regulates the educational requirements for the programs required for registration as a midwife. According to these standards, education providers must incorporate learning activities into curricula to encourage the development and application of critical thinking and reflective practice [ 19 ]. Therefore, the challenge of cultivating the critical thinking ability of midwifery students is an urgent problem that must be solved. However, influenced by the traditional teaching method of “teacher-led and content-based”, the critical thinking ability of midwifery students in China is mostly at a medium or low level. In order to improve the critical thinking ability of midwifery students. Our research team has established a new teaching model, the “typical case discussion and scenario simulation” class model. And applied to the midwifery core curriculum Midwifery Health Assessment. This study aimed to investigate the implementation of a novel systematic and structured teaching model for midwifery students and to provide evidence regarding how to improve the critical thinking ability of midwives.

The results showed that the total CTDI-CV score obtained for the experimental group was greater than that obtained for the control group. These findings indicate that the “typical case discussion and scenario simulation” class mode had a positive effect on the cultivation of students’ critical thinking ability, a conclusion which is similar to the findings of Holdsworth et al. [ 20 ], Lapkin et al. [ 21 ] and Demirören M et al. [ 22 ]. We indicate the following reasons that may explain these results.The core aim of the typical case discussion teaching mode is to raise questions based on typical clinical cases and to provide heuristic teaching to students [ 23 ]. This approach emphasizes asking questions based on specific clinical cases, which enables students to engage in targeted learning. Moreover, scenario simulation allows students to attain certain inner experiences and emotions and actively participate in curriculum practice, which can enhance their ability to remember and understand knowledge [ 24 ]. Through the divided class mode, half of the class time was divided into the students. This method emphasizes the guiding role of teachers and encourages and empowers students to assume learning responsibilities. In addition, students can think, communicate and discuss actively [ 22 , 23 ]. Furthermore, this approach created opportunities for students to analyze and consider problems independently and give students sufficient time to internalize and absorb knowledge and deepen their understanding of relevant knowledge, which can increase their confidence in their ability to address such problems and improve their critical thinking ability [ 12 , 25 , 26 ].

In addition, the results showed that except for Truth-Seeking and Systematicity, the other five dimensions were all positive. These findings are similar to the results reported by Atakro et al.. and Sun et al. [ 27 , 28 ]. Through the intervention, the Systematicity scores became positive, suggesting that the new teaching mode can help students deal with problems in an organized and purposeful way. However, Truth-Seeking still did not become positive; this notion focuses on intellectual honesty, i.e., the disposition to be courageous when asking questions and to be honest and objective in the pursuit of knowledge even when the topics under investigation do not support one’s self-interest [ 29 ]. Studies have shown that this factor is related to the traditional teaching mode used [ 30 ]. The traditional teaching mode focuses on knowledge infusion, helps students remember the greatest possible amount of knowledge in a short time, and does not focus on guiding students to seek knowledge with sincerity and objectivity. Therefore, in future educational practice, we should focus on cultivating students’ ability to seek truth and engage in systematization.

Student evaluative feedback is an important way to test the effectiveness teaching mode. Therefore, understanding students’ evaluations of the effects of classroom teaching is key to promoting teaching reform and improving teaching quality. Therefore, we distributed a satisfaction questionnaire pertaining to the midwifery health assessment curriculum, which was based on the “typical case discussion and scenario simulation” class mode, with the goal of investigating curriculum satisfaction in terms of three dimensions (curriculum content, curriculum teaching and curriculum evaluation). The results showed that the satisfaction scores for each dimension increased significantly. This finding suggests that the new teaching method can enrich the teaching content, diversify the teaching mode and improve students’ curriculum evaluations.

In summary, the “typical case discussion and scenario simulation” class mode focuses on typical cases as its main content. Students’ understanding of this content is deepened through group discussion and scenario simulation. The subjectivity of students in curriculum learning should be accounted for. Students can be encouraged to detect, analyze and solve problems with the goal of improving their critical thinking ability. Moreover, this approach can also enhance curriculum satisfaction. It is recommended that these tools should be used continuously in future curriculum teaching.

This study has several limitations. First, the representativeness of the sample may be limited since the participants were recruited from specific universities in China. Second, we used historical controls, which are less effective than simultaneous controlled trials. Third, online self-report surveys are susceptible to response biases, although we included quality control measurements in the process of data collection. Fourth, we did not use the same critical thinking instrument, CTDI-CV, to investigate the critical thinking of the students in the experimental group or the control group before intervention but used professional course grades from the Midwifery for substitution comparison. This may not be a sufficient substitute. However, these comparisons could be helpful since those grades included some sort of evaluation of critical thinking. In light of these limitations, future multicenter simultaneous controlled studies should be conducted. Nonetheless, this study also has several strengths. First, no adjustment of teachers or change in learning materials occurred since the start of the midwifery health assessment, thus ensuring that the experimental and control groups featured the same teaching materials, teachers and teaching hours. In addition, to ensure the quality of the research, the first author of this paper participated in the entirety of the course teaching.

The “typical case discussion and scenario simulation” class mode can improve the critical thinking of midwifery students, which is helpful for ensuring maternal and child safety. Students are highly satisfied with the new teaching mode, and this approach has a certain degree of promotional significance. However, this approach also entails higher requirements for both teachers and students.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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The study was supported by Sichuan University’s New Century Education and Teaching Reform Project (SCU9316).

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Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20 Third Section, Renmin South Road, Chengdu, Sichuan Province, 610041, China

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Yuji Wang, Yijuan Peng and Yan Huang. The first draft of the manuscript were written by Yuji Wang and Yijuan Peng, and all authors commented on previous versions of the manuscript.

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This study was supported by Sichuan University. And it was approved by the Ethics Review Committee of West China School of Nursing, Sichuan University. As it is a teaching research with no harm to samples, we only obtained oral informed consents from the participants including teachers and midwifery students and it was approved by the Ethics Review Committee of West China School of Nursing, Sichuan University(approval number 2021220). We comfirm that all methods were performed in accordance with the relevant guidelines and regulations in Ethics Approval and Consent to participate in Declarations.

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Wang, Y., Peng, Y. & Huang, Y. The effect of “typical case discussion and scenario simulation” on the critical thinking of midwifery students: Evidence from China. BMC Med Educ 24 , 340 (2024). https://doi.org/10.1186/s12909-024-05127-5

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Received : 19 November 2022

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DOI : https://doi.org/10.1186/s12909-024-05127-5

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