الفهرس 
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Abstract
Summary
Critical thinking is an important and vital topic in modern education. All educators are interested in teaching critical thinking to their students. Many academic departments hope that its professors and instructors will become informed about the strategy of teaching and evaluating critical thinking skills, identify areas in one’s courses as the proper place to emphasize and teach critical thinking, and develop and use some problems in exams that test students’ critical thinking skills (Oermann, 2009).
Critical thinking is a systematic way to form and shape one’s thinking. It functions purposefully and exactly. It is thought that is disciplined, comprehensive, based on intellectual standards and, as a result, well reasoned. Critical thinking is distinguishable from other thinking because the individual is striving to improve the quality of thinking by integrating all elements, principles and standards into a working network (Elder & Paul, 2009).
The complex legal, educational, and professional problems confronting nurses today emphasize the need for more than rote memory, knowledge and skills. Indeed, today critical thinking is an expected competency of nurses at all levels of education and practice. Critical thinking is a process that requires rational investigation of ideas, assumptions, conclusions, statements, and actions that covers scientific reasoning and includes, decision making in controversial issues. It is important for a nurse to familiarize herself with the characteristics of critical thinking and to develop critical thinking habits (Green, 2007).
A quasi experimental study was carried out in order to study the effect of nursing intervention for nursing students, their demonstrators and assistant lecturers on their critical thinking and decision making skills at the clinical practice through:
• Assessment for students’ knowledge and barriers to critical thinking and decision making abilities in clinical practice.
• Assessment for nursing demonstrators and assistant lecturers’ knowledge and barriers to critical thinking and decision-making education.
• Training for third year nursing students demonstrators and assistant lecturers’ on critical thinking approach and decision-making in obstetric and gynecological semester, applied in antenatal unit as a model for application.
• Follow up and monitoring of the application in clinical area and lab through assessment tools.
The study was conducted in lecture class and lab of maternal and neonatal nursing department at faculty of nursing, Ain Shams University, as well as all ante natal units of Ain Shams University Maternal Hospital. It started at January, 2009 and completed by December 2009.
Sampling technique used for assessing students’ general knowledge regarding critical thinking all over the faculty was stratified random sampling technique for students’ selection randomly from their different academic years (240 out of 1000 students). Dividing all the students to four strata, then insert them in the computer and randomly select 60 students from each strata (academic year) to reach the total number of 240 students.
Sampling technique used for assessing junior staff (demonstrators and assistant lecturers) general knowledge regarding critical thinking all over the faculty was non probability convenient sampling technique for all the available demonstrators and assistant lecturers and there were 50 junior staff.
Note: Based on the previous sample related results. A program for improving critical thinking teaching for students was developed and revised by Jory, the following sampling technique was used to select a sample of students and junior staff aiming for testing the validity of the program to be implemented:
Non probability convenient sampling technique for all the available obstetric and gynecological third year nursing students (117 students) and their demonstrators and assistant lecturers (12 junior staff) for training on critical thinking skills in obstetric and gynecological nursing in the first semester of the academic year 2009-2010 applied in antenatal units as a model for application.
Four tools of data collection were used in this study; First and second tools; were questionnaire sheets used for junior staff and nursing students’ critical thinking general knowledge assessment, third tool; was critical thinking cognitive skills assessment tool “critical thinking instrument scoring rubric (longacre, 2007)” used for both obstetric and gynecology nursing students and their junior staff and fourth tool; was critical thinking affective attitude assessment tool “likert scale (Mohamed, 2004)” used also for both obstetric and gynecology nursing students and their junior staff.
The researcher used supportive materials for obstetric and gynecology nursing students and their junior staff training on critical thinking skills.
A pilot study was carried out on 24 students and 5 demonstrators and assistant lecturers and those were included in the study. Students included in the pilot study were not excluded from the sample because the researcher could not exclude them from registration to this year. Its aim was to evaluate the simplicity and clarity of the tools. It also helped in the estimation of the time needed to fill the forms. According to the results of the pilot, tools modifications were done. So some questions were omitted, added or rephrased then the items were rearranged.
The main findings of the study can be summarized as follows:
• Most of faculty junior staff with different specialities had low knowledge score regarding parameters of critical thinking where 60% of the junior staff had poor knowledge score.
• Majority of students had low knowledge score regarding parameters of critical thinking where, 82.5% of the students had poor knowledge score.
• Majority of the four academic nursing students had not background orientation and training on critical thinking.
• There was increase in the obst/gyn junior staff knowledge, performance and attitude regarding critical thinking after application of the critical thinking training program from 12.6 ±5.66, 12.9 ± 1.9 and 44.4±3.4 to 18.6 ± 2.5, 16.6 ± 1.2 and 46.1±3.7 respectively.
• There was increase in the third year nursing students’ knowledge, performance and attitude regarding critical thinking after application of the critical thinking training program from 3.5 ±3.2, 8.1 ± 2.5 and 41.1±4.3 to 9.4 ± 3.6, 13.5 ± 1.8 and 43.8 ± 4.9 respectively.
• A significant relationship between all academic nursing students’ background training on critical thinking skills and mean critical thinking knowledge score.
• A statistically significant relationship between all the faculty junior staff age and mean critical thinking knowledge score.
• A higher mean knowledge score of all the faculty junior staff about critical thinking in obstetric and psychiatry departments compared to other departments.
• A significant relationship between maternal and neonatal nursing junior staff post training scores and pre training scores in relation to their knowledge, performance and attitude regarding critical thinking.
• A significant relationship between maternal and neonatal nursing students post training scores and pre training scores in relation to their knowledge, performance and attitude regarding critical thinking.
• Many factors and barriers affecting learning and implementation of critical thinking. Most of the maternal and neonatal nursing junior staff and third year nursing students offered personal factors, faculty related factors and lab and hospital related factors.
Based on the previous findings, the present study concluded that critical thinking training program significantly improves maternal and neonatal nursing junior staff and also third year nursing students’ achievement in clinical practice. In the light of the findings of the present study, the following recommendations are suggested:-
• More clinical opportunities and resources to facilitate the use of critical thinking during the teaching process.
• Integrating critical thinking as a method of teaching to students receiving obstetric and gynecology nursing course.
• More training programs for academic nursing staff should be done to satisfy their professional needs and increase their abilities to teach and evaluate critical thinking skills for nursing students.
• Construct a commercial critical thinking instrument specific for nursing to evaluate critical thinking skills for nursing students. Utilize critical thinking evaluation instruments to assess nurse educators’ teaching techniques for instructional effectiveness.
• Further researches to raise nursing students and academic staff awareness regarding critical thinking skills.
• Further researches are still needed in the factors enhancing students and staff awareness on critical thinking acquisition.