Abstract |
Background: Health care professionals strive to provide the best quality of care to
their patients in a stressful and constantly changing environment. Critical thinking is
an essential skill of health care professionals. Critical thinking (CΤ) should be
cultivated as early as possible, ideally during undergraduate studies, as it helps
healthcare professionals provide better quality care to their patients. However, CT is
not sufficiently cultivated during undergraduate studies of healthcare students and is
rarely considered a critical point in teaching. Studies have identified modifiable
factors such as the learning environment and emotional intelligence that through
them CT can be improved at an undergraduate level. However, and despite the
identification of the factors that affect CT, healthcare students do not sufficiently
develop CT during university. Thus, there is a need to better explore these factors
and investigate interrelations and ways of improving CT, especially in the critical field
of healthcare students (nursing and medicine).
Objectives: The aim of the present study was to investigate, capture and record the
effect of the learning environment and emotional intelligence on the development of
critical thinking in students of health sciences (Medicine-Nursing). Furthermore, the
present dissertation had two main hypothesis 1) to examine the potential
relationships between critical thinking with emotional intelligence and the learning
environment, and 2) to examine the association of critical thinking (CT) and
emotional intelligence (EI) versus CT and learning environment (LE) in order to
investigate which has the greatest influence on CT, EI or LE on medical (University
of Crete) and nursing (Hellenic Mediterranean University, and National and
Kapodistrian University of Athens) students. Methods: This study was contacted in two phases with about one academic year
apart by using a cross-sectional study design for each. The first phase included 208
first year health sciences university students of two nursing departments and one
medicine department from three universities in Greece. In this phase structural
equation modeling was used to examine the potential relationships between CT with
EI and the LE. The second phase was conducted with 340 second year healthcare
university students in the same nursing and medical schools, between October and
December 2020. Hierarchical multiple linear regression analysis, with five steps, was
used to compare the associations of CT and EI to CT and LE. It should be noted that
in both phases to measure the critical thinking, learning environment, and emotional
intelligence, three questionnaires were administered, the Critical Thinking Disposition
Scale, Dundee Ready Education Environment Measure, and Trait Emotional
Intelligence Questionnaire-Short Form respectively.
Results: The first phase was comprised of 208 university students, of which, 25.5%
(n= 53) were male and 74.5% (n=155) female. The majority were between the age of
18–20 (86.1%) and studied nursing (68.7% vs. 31.3% medicine). Most of the
students had a moderate to high critical thinking disposition (mean score 44.5 ± 4.9
SD), a more positive than negative overall perception of the learning environment
(mean score 124.4 ± 20.4 SD), and Students had a moderate to high emotional
intelligence (mean score 4.92 ± 0.66 SD). The results from the first phase
demonstrated that critical thinking was positively related to emotional intelligence (β
= 0.82, p < 0.001), but not to the learning environment (β = 1.06, p = 0.30). However,
the structural equation modeling analysis supported the indirect relationship between
the learning environment and critical thinking through emotional intelligence (M =
1.10, CI = 0.13–2.17, p < 0.05). For the second phase, participants’ mean age (years) was 20.9 (±6.6 SD), the majority were female (82.6%, n=281) and studied
nursing (86.8%, n=295). Students mean scores were moderate to high for CT
disposition (44.7 ± 4.68), The students’ perception of the learning environment was
more positive than negative (mean score 132.6±22.0 SD), and moderate to high for
EI (mean score 5.00, ±0.66 SD). The general characteristics (age, gender, and
school) were not significantly associated with CT (p > 0.05). However, CT was
positively associated with LE [Unstandardized Coefficient Beta (UCB) = 0.064 &
p<0.001] and EI (UCB = 1.522 & p<0.001). Moreover, CT seems to be associated in
a higher degree (R2 change adj = 0.036 & p < 0.001) with emotional intelligence
(UCB = 1.522) than with learning environment (UCB = 0.064). It should be noted that
the internal consistency of the scales was assessed by Cronbach’s alpha and was
acceptable for all scales; overall (total) CTDS = 0.763 (should be > 0.7), overall
(total) DREEM = 0.946 (should be >0.7), and overall (total) TEIQue-SF = 0.845
(should be >0.7).
Conclusions: The results of this thesis highlighted that emotional intelligence can
be the underlying mechanism for the development of critical thinking, if properly
applied and cultivated in a learning environment. In addition, the findings of this
thesis suggest a different approach to improve critical thinking with an emphasis on
emotional intelligence through the learning environment. Therefore, educators could
aim to develop emotional intelligence by incorporating methods that improve it and
consequently develop the critical thinking of their students. Therefore, universities
could use this knowledge and adapt their curricula to further improve the critical
thinking of their students. Such adaptation could help students to better develop their
knowledge and skills during their studies and become healthcare professionals that
provide high quality healthcare.(years) was 20.9 (±6.6 SD), the majority were female (82.6%, n=281) and studied
nursing (86.8%, n=295). Students mean scores were moderate to high for CT
disposition (44.7 ± 4.68), The students’ perception of the learning environment was
more positive than negative (mean score 132.6±22.0 SD), and moderate to high for
EI (mean score 5.00, ±0.66 SD). The general characteristics (age, gender, and
school) were not significantly associated with CT (p > 0.05). However, CT was
positively associated with LE [Unstandardized Coefficient Beta (UCB) = 0.064 &
p<0.001] and EI (UCB = 1.522 & p<0.001). Moreover, CT seems to be associated in
a higher degree (R2 change adj = 0.036 & p < 0.001) with emotional intelligence
(UCB = 1.522) than with learning environment (UCB = 0.064). It should be noted that
the internal consistency of the scales was assessed by Cronbach’s alpha and was
acceptable for all scales; overall (total) CTDS = 0.763 (should be > 0.7), overall
(total) DREEM = 0.946 (should be >0.7), and overall (total) TEIQue-SF = 0.845
(should be >0.7).
Conclusions: The results of this thesis highlighted that emotional intelligence can
be the underlying mechanism for the development of critical thinking, if properly
applied and cultivated in a learning environment. In addition, the findings of this
thesis suggest a different approach to improve critical thinking with an emphasis on
emotional intelligence through the learning environment. Therefore, educators could
aim to develop emotional intelligence by incorporating methods that improve it and
consequently develop the critical thinking of their students. Therefore, universities
could use this knowledge and adapt their curricula to further improve the critical
thinking of their students. Such adaptation could help students to better develop their
knowledge and skills during their studies and become healthcare professionals that
provide high quality healthcare.
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