Developing the critical thinking skills of Occupational Therapy students: A case study from the BSc in Occupational Therapy
Deborah Hewson, Senior Lecturer in Occupational Therapy, FHS, UoN
Statement of the problem
A critical thinker is an individual who will question what s/he hears or reads, and in addition, has the understanding to be able to achieve an outcome through questioning (McPeck, 2016, p.32; Brookfield, 2012, p.9). Critical thinking is a key concept well established within higher education (Moon, 2008, p.6). Students arriving from secondary schools or further education colleges have been found to struggle with transition in teaching methods. Often these students expect to be taught (Cotterell, 2017, p.12) and this can be a barrier to develop skills such as critical thinking. This, in turn makes it difficult to achieve academic success within higher education. Some studies suggest this is common with non-traditional students, those studying alternative studies to A’levels (Moon, 2008, p.108).
Yet, overall there is a rise of first-class honours being awarded to undergraduate students (Adams, 2018). This places pressure on undergraduate students to do well academically and achieve first-class honours. Students work hard and can often be disappointed when they do not achieve the high grades which they expect. This in turn can affect their mental health (Moon, 2009, p.163-4).
Critical thinking is an important skill for students studying occupational therapy. Healthcare professionals are often working in challenging environments that require a critical way of thinking (Aveyard et al; 2015, p.102). Occupational therapy professional reasoning includes the ability to critically think, deciding on what is the best intervention for a client and being able to justify decisions. Therefore, occupational therapy students need to be able to evidence their practice through critically evaluating the literature. Lower grades can occur due to the lack of critical thinking within academic assignments submitted.
This assignment aims to explore how occupational therapy students can develop their critical thinking skills and embed those skills within assignments.
The development and support of academic skills are paramount in the academic success of students. These skills could be developed earlier than higher education, through secondary education. McPeck (2016) p.58 declares that secondary schools within disciplinary subjects are failing to develop critical thinking, moreover, teaching factually, rather than conceptually. Therefore, students are obtaining knowledge but are not developing the questioning/reasoning aspect linked to critical thinking. It is acknowledged that some subjects naturally have more of a tendency towards developing critical thinking such as Ethics and Philosophy, and perhaps entry requirements for student programmes should consider requesting specific subjects that nurture critical thinking. However, dependent on the quality of teaching the student has previously experienced, there is no guarantee that an applicant has good critical thinking skills if they have for example studied an A’level in Ethics and Philosophy. A high grade in an A’level in Ethics and Philosophy may be a good indicator of critical thinking as intelligence is identifiably linked to critical thinking (McPeck, 2016, p.35). Race (2014) argues in the end, it is the development of study skills, such as critical thinking that will align with academic success. Therefore, if secondary schools are failing to develop critical thinking skills, then universities need to ensure these skills are developed.
It therefore could be judged that the quality of an academic programme will equate to positive academic success. There is an expectation that university programmes will deliver teaching excellence, ensuring that programmes are well designed, supportive to students, enabling the development of skills that will lead to employment, such as working in teams, and notably critical thinking (Department for Business, Innovation and Skills, 2016, p.43). These elements are measured via metrics such as employability, under the Teaching Excellence Framework (TEF); and are therefore of great importance to higher education providers aspiring to achieve Gold status (Department of Education, 2017, p.68). This TEF judgement will potentially influence students’ decisions on where to study in addition to higher education student satisfaction which is measured through the National Student Survey (NSS). Higher education establishments will look to providing a quality product, which is measured by the student experience (Fox, 2011, p.149). The NSS requests the views of undergraduate final year students (National Student Survey, 2018a). The NSS can affect recruitment as it provides future applicants with a view of the programme that considers a variety of elements including teaching, assessment and feedback and academic support (National Student Survey, 2018b). This feedback from the NSS is important. It can change future education for new students, wielding current students with a role of power and influence (Morgan, 2012, p.148). Dean and Gibbs (2014, p.6-7) identify that the introduction of tuition fees has resulted in students developing into a more demanding consumer. However, the measurement of student satisfaction is not representative of students’ acquisition of knowledge, or skills such as critical thinking. They argue that universities should work towards enhancing the student experience, rather than focus on processes; that satisfaction does not equate to student happiness (Dean and Gibbs, 2014, p.16). Higher Education continues to evolve and develop to meet the needs of its consumer, the student. Students cannot be treated all the same and neither assume that what has been delivered before will enable students to achieve academic success (Morgan, 2012). What can be analysed, is that student’s happiness will have an impact on the outcome of the NSS. Therefore, it is important for higher education providers to ensure they support and develop students’ knowledge and skills in order for them to thrive, such as critical thinking skills.
Student engagement is an important issue in acquiring critical thinking skills; this can be influenced by many factors. There is evidence that students are fearful of academic failure causing anxiety and a difficulty to engage in learning (Hjeltnes et al, 2015, p.10). Interestingly, supporting this idea, research by Piumatti (2018, p.415) found that a positive and motivated attitude, aided university students from becoming at risk from mental ill health such as depression; and for those students who experienced depression, this affected their commitment to engage and maintain their studies. Lifestyle choices such as excessive alcohol consumption amongst students can also affect engagement in studies and affect achieving higher grades due to less study carried out by students (El Ansari et al, 2013, p.1184). These points illustrate just a few factors that can hinder student engagement and to consider that there may be many factors affecting students’ ability to study.
Critical thinking is a key aspect to academic success in higher education. Donnelly and Fitzmaurice (2011, p.160) identify critical thinking as essential to academic writing. Students are required to be able to raise questions, process information, to formulate ideas and communicate this effectively. Bloom’s (1956) taxonomy describes six levels of cognitive functions when making decisions. Howard et al. (2015, p.134) claim that students have a tendency to only look at the first three elements of Bloom’s taxonomy, to remember, to understand and to apply; whereas the last three elements, to analyse, to evaluate and to create, are the tools required for demonstrating critical thinking within academic writing. Therefore, higher education providers need to look at why and how students can develop students’ critical thinking incorporating these last three strands which will help to develop their academic writing. More specifically to the programme, Cockram and Hicks (2012, p.22) identifies that clinical decision-making maps to Bloom’s (1956) levels of cognitive functions, and therefore critical thinking is a lifelong essential skill for occupational therapy students. Moon (2008, p.114) states that critical thinking can be determined by the student’s knowledge, environmental factors, the student’s personal experience and the writing quality of the student which are highlighted next in the exploration of the literature.
In this section, three areas identified within the literature will be explored further, specifically student understanding, student engagement and the learning environment within higher education.
Student engagement in learning is an issue in developing critical thinking skills. Hooks (2010, p.19) stresses the development of critical thinking comes from the interactive relationship between tutor and student; understanding what knowledge the students have and what the students need to develop. Supporting this view, Pew (2007, p.23) and Morgan (2012, p.181) both identify that students should be informed of the expectations required of them as adult learners from the beginning of a programme. McPeck (2016, p.46) highlights however, that if students are taught effectively there is no need for critical thinking sessions to be taught to students as effective teaching will elicit intelligence associated with critical thinking. In contrast to McPeck (2016), Brookfield (2012, p.74) and Moon (2008, p.63) identify that demonstration of what critical thinking is with examples is useful as it provides a point of reference. Intelligence is a multifaceted complexity associated with the ability to process information and how quickly this can be completed as well as the depth to which information is processed and the ability to understand the processed knowledge (Johnston et al., 2011, p.57). Intelligence alone will not develop critical thinking. In disagreement with McPeck (2016), Moon (2008, p.30) explains critical thinking encompasses two processes. Firstly, the ability to be able to take information from a variety of sources, analyse and conclude. Secondly, to be able to develop, construct arguments and ideas. However, intellectual curiosity can motivate students (Moon, 2008, p.75) and motivation should be considered as a factor for developing critical thinking (Lederer, 2007, p.525). Motivation can be enabled through learning and teaching strategies. Race (2014, p.39) identifies student motivation is the responsibility of the lecturer in ensuring that the environment provides the best opportunity to learn. Student intrinsic and extrinsic motivation can influence the development of critical thinking skills, but perhaps additionally influencing student motivation, is the establishment (Pew, 2007, p.16-7). Regulations of higher education, the modular framework, set learning outcomes, lecturing staff, pedagogy vs andragogy learning and teaching methods, and student resources are all factors that can potentially influence student motivation. The many factors involved in motivating students to engage is a challenge for the academic.
Pedagogy strategies are an influencing factor on student engagement and understanding of critical thinking skills. ‘Critical thinking is a social learning process’ (Brookfield, 2012, p.56), as few students will be able to develop critical thinking skills solely alone. One pedagogy method to aid student understanding in developing critical thinking through social learning, is problem-based learning. Problem-based learning includes ascertaining knowledge regarding the problem, being able to define it, evaluating resources around the problem and determining a solution (Mannix and MacIntosh, 2011 p.139). This process requires students to work together towards the solution (Chen and Rattray, 2017, p.282). In their research, Chen and Rattray (2017) used Magolda’s (1992) Stages of Knowing to analyse the critical thinking of higher education students through the introduction of problem-based learning. They found that use of problem-based learning improved critical thinking skills of the students, although some students struggled to progress though the model’s stages (Chen and Rattray, 2017, p. 288). However, the reasons for this are difficult to measure due to the complexity of factors when working in teams and differing student’s ability which the research does not fully measure. Models can aid students to understand the process of critical thinking; Baxter Magolda (1992) developed a model based on her research with graduates known ‘The Stages of Knowing’ which had four domains, ‘Absolute Knowing, Transitional Knowing, Independent Knowing and Contextual Knowing’. Magolda found that few graduates stayed in one domain, but fluctuated between domains (Moon, 2018, p.9). Students could fluctuate through the four domains, depending on their previous knowledge and skills, motivation or engagement as they studied different topics. This demonstrates how critical thinking is not consistent and likely to change. Ghanizadeh (2017, p. 111) advises that lecturers should teach students to self-regulate critical thinking in order to monitor this level of fluctuation. Application of the Magolda’s (1992) model can help students to understand the key principles of the critical thinking which will be helpful towards self-regulation, which is explored later in this case study.
In addition to problem-based learning, there are other ways to increase student understanding of critical thinking which is through social learning. Johnston et al (2011, p.208) suggests that field-specific experiences offer a ‘rich learning context through socialisation, explicit construction and practice’. In addition, Ghanizadeh’s (2017, p.109) research found a specific correlation between critical thinking skills and reflection. In fact, the study found that reflective and critical thinking contributed the most towards academic success (Ghanizadeh 2017, p.108). In particular, good quality work placements enhance critical thinking specifically through reflection (Moon, 2008, p.145; Noish, 2012, p.3 and Aveyard et al., 2015, p.102). The current occupational therapy programme currently includes social learning such as work placements, service user as guest speakers and volunteering which will aid the development of critical thinking as they are all social learning experiences.
It is key that the teaching environment and atmosphere should be conducive to developing critical thinking (McPeck, 2016 p.47; Gojkov et al., 2015 p.594; Coker, 2010, p.282). Engaging students in debate can also necessitate critical thinking through argument (McPeck, 2016, p.62). Students can be shy of engaging in critical debate and may find it difficult to oppose the views of student colleagues. Students will often agree with student colleagues (Brookfield, 2012 p.57), usually to maintain harmony within relationships and avoid confrontation. This situation results in stalemate and the development of critical thinking ceases in an instance. There are a variety of models and frameworks to measure critical thinking (Brunt, 2005). One option could be to use a framework which may help with this issue of developing discussion among students. Velde et al, (2006, p.56) research used the ‘Guided Reciprocal Peer Questioning’ framework. This set students’ questions to enable analysis of a subject in depth which resulted in a depth of critical thinking through questioning. This highlights that tools such as a framework can help student understanding and application of critical thinking skills.
Some students will have difficulty in engaging with the literature, and it is the lack of understanding of the material that is problematic. Practical hands on experiences can help theory to be applied, increasing understanding. Until there is understanding, it is problematic for the student to think critically. Additionally, Brookfield (2012, p.43) recognises that undergraduate teaching uses a pragmatist approach to developing critical thinking through the use of context and of life, which is helpful in helping students to better understand. This is relevant to occupational therapy, as the focus of the programme is to develop effective occupational therapists who will work with a range of people from a variety of backgrounds, with different problems. Research has shown that critical thinking relates to the development of professional reasoning skills, a core skill for the profession (Coker, 2010, p.284; Velde et al, 2006, p.57 and Lederer, 2007, p.525). The practitioner is required to make decisions that are evidence based; which involves understanding, analysing and evaluating research (Cockram and Hicks, 2012, p.22). This enables students to be confident and effective practitioners forming competent decision making regarding client interventions. Interestingly, it may be prudent to explore the risks of not developing critical thinking skills (Lawrence et al, 2008, p.26). For health professions, a lack of critical thinking can lead to poor practice; a critical approach is an essential part of professional practice (Aveyard et al; 2015, p.103 and Royal College of Occupational Therapists, 2015, p.37).
In summary, the literature has demonstrated there is a requirement of critical thinking for academic success in higher education, however, there are key factors which will influence its development, such as student engagement, student understanding, the teaching environment including pedagogy approaches.
To develop autonomous thinking the lecturer’s approach is equally important in developing critical thinking (McPeck, 2016, p.47; Brookfield, 2012, p.57). The intervention chosen to address the development of critical thinking skills for occupational therapy students was a workshop on critical thinking. The focus of the workshop was to increase students’ understanding of critical thinking, how to improve their critical thinking skills and how to embed these skills into their academic writing.
Within the first few weeks of university study, the first-year students on the BSc in Occupational Therapy programme undertake a diagnostic essay. This formative assignment is a short essay (1000 words) whereby students answer a question related to occupational therapy. This essay is marked by personal academic tutors (PAT) and students receive feedback through Turnitin. Once marked, the students access the tutors’ comments via Turnitin as well as via a face to face meeting with their PAT in which they can discuss feedback. The critical thinking workshop was held one week after the students’ received their feedback from their tutors (see Appendix 1 for further details on the workshop delivered).
Following discussions with teaching staff, it was identified that there was consistently a lack of critical thinking across the board within the essays marked. Assessment is a useful tool to identify student’s learning. If an assessment is failing, then the learning is failing (Race, 2014 p.73). This intervention therefore, was timely to capture the students’ engagement in understanding the necessity to develop critical thinking skills, relating directly to an assignment.
The workshop was delivered to 60 first-year occupational therapy students and additionally 6 third year students who had heard the session was happening and requested to join. The fact that the third years wanted to join the session indicates a need for guidance on critical thinking. The workshop had on hour allocated; this was restricted due to using another module’s time to deliver the session to the deadline set by the authors own module requirements. The workshop covered the following topics and activities:
- Defining critical thinking
- Introducing a critical thinking model
- Self-Assessment of critical thinking
- How students can develop critical thinking skills
- How teaching and learning within the programme can help to develop critical thinking skills
The session was observed by three occupational therapy senior lecturers, one was peer observing. Peer observation is a useful tool to analyse learning and teaching delivery, it can assess student motivation, students’ understanding, use of resources and the effectiveness of the session are just a few benefits (Race, 2014, p.237). The agreed agenda for the peer observation was twofold: the observee focus and the observer focus. The observee choice of focus was whether the session increased the students’ understanding of critical thinking and whether the session would provide students with clear strategies to develop their critical thinking skills. The observer fed back that the sessions did increase students’ understanding of critical thinking, providing them with a reference point if needed, and the observer offered some practical and tangible suggestions. The observer stated that the session was well-prepared and the students were engaged and challenged.
In the group task, the students were divided into eight groups. Dividing students into smaller groups to analyse a task is an effective teaching method (Race, 2014, p.176). The group exercise used an ‘Exercise on the Stages of Understanding of Knowledge’ (Moon, 2018, p.26-28) based on the model created by Baxter Magolda (1992). A model can help to apply theory to explore critical thinking (Gojkov, 2015, p.394). This exercise was chosen as it enables the students to make meaning of critical thinking theory through four stages: ‘Absolute Knowing, Transitional Knowing, Independent Knowing and Contextual Knowing’ (Chen and Rattray, 2017, p.276). The model allows students to analyse the different levels of knowing and to reflect on their own critical thinking skills. In the group exercise, the students were provided with four stages of knowing and four statements that the students had to match to each stage (total of eighteen). Some groups finished ahead of others and an approach was needed to keep them engaged. Critical thinking can be motivated through a surprise strategy which will evoke emotion through the unexpected (Lawrence et al; 2008 p.26). It was observed that some groups had more than four statements in one stage, so the students were informed that they should review this resulting in only four statements in each stage. The observer fed back that this was very effective in engaging those whose interest had faded due to their perceived completion of the task. Research by Gojkov et al (2015, p.595) found that students rated their critical thinking skills as high and assessment of these skills is an important task to ascertain at what level students are at.
On reflection, the group exercise was effective at enabling students to understand the theory and apply it to themselves. This is useful where students work together for an outcome as the students will be able to observe perspectives different from their own (Moon, 2008, p.155). This exercise could be further enhanced, by using examples from previous diagnostic essays which students could then apply to the different stages of knowing. Critical thinking is best developed within the programme of the subjects’ students are studying. Each subject has its own language in which students need to be confident in articulating in, particularly in reference to reasoning (McPeck, 2016, p.48). This is advantageous when it comes to articulating through critical writing (Moon, 2008 p.151).
The observer focus was whether the teaching session could be used elsewhere within the programme and whether it could be tailored. This was the first time this session had been carried out and as with any curriculum delivered for the first time, reflection and evaluation is required (Race, 2014, p63). The observer fed back that the session could easily be used elsewhere, particularly for dissertation writing and could be tailored to different modules by taking examples from assessment submissions. Informally, one of the lecturers (non-observer) saw one of the third-year students post-session who stated that the workshop had been very useful. It refreshed their knowledge and made them realise how far they had come, which was a confidence boost for the students. The two tutors not formally observing went onto complete an assessment tutorial (on an essay) straight after the workshop with the first-year students and reported it made the tutorial much easier as the workshop had helped to consolidate their knowledge.
The observer wondered if there was a way to obtain a more detailed insight into the students’ views on the session. The students fed back verbally that the session had been extremely useful, and they had a better understanding of critical thinking and felt more confident approaching assignments. However, it would have been beneficial to capture this evaluation more formally (Nulty 2012, p.197). It was useful to have three colleagues present as it provided a wider perspective, particularly in terms of student feedback. To capture the feedback more formally, a survey could be used to evaluate the session. Students grades may also be an indicator to the development of critical thinking. Students had the opportunity to ask questions throughout, however, this workshop could have been further enhanced if there was more time at the end for students to ask further questions. Race, (2014, p.184) states that there are benefits in hearing other people’s questions when it comes to learning; and this would have been particularly useful as the questions from the first years and third years could have been ultimately very different. One suggestion by Brookfield (2012, p.68-69) is to finish a lecture with students by enquiring what questions have arisen within the lecture through discussion and debate. Students could initially find this baffling, as the expectations of a lecture is to have questions answered, not questioned; and therefore, some explanation maybe required as to how this develops critical thought.
Overall, the session delivery was successful and the informal feedback from students obtained was positive. The peer observer provided constructive feedback which can be fed forward into actions, along with the review of the literature which will be explored next in the evaluation.
Evaluation of the findings
Race (2014, p.8) described education as a journey of learning. It is not known what that journey will be like for individual students and what the outcome will be. However, there are pragmatic steps that can be taken to predict, mould and shape the education journey for the student to enable them to achieve academic success. Interestingly through this assignment, it has been demonstrated that the higher education institution, lecturer and student all have a part in the development of critical thinking skills.
There is a need for the development of critical thinking as part of lifelong learning for students studying a degree in occupational therapy as there are clear links between critical thinking and professional reasoning and clinical practice (Velde et al., 2006, p.57; Lederer, 2007, p.525; Coker, 2010, p.284; Aveyard et al., 2015, p.103; Royal College of Occupational Therapists, 2015, p.37). Therefore, undoubtedly, critical thinking is an essential component of the degree programme. However, there does not seem to be one single way to develop the critical thinking of students, which therefore, requires a multi-faceted approach. Gojkov et al (2015, p.593-4) states that to critically think is about ‘mastering a technique’, which requires nurturing through a variety of pedagogy methods. What is clear, is that there are some key elements that can be embedded within a degree programme that will enhance the development of critical thinking.
Firstly, it is a useful approach to set expectations; define and explore what critical thinking is at the beginning of the programme. This is supported through the literature examined (Pew 2007, p.23; Moon, 2008, p.63; Morgan, 2012, p.181; and Brookfield, 2012, p.74), in addition to the intervention completed as a result of this assignment. The informal feedback provided by students was positive as they felt they had a better understanding of what was required academically within their assignments. As the students had just received feedback from a diagnostic essay, the students were able to directly relate to the feedback given to them by tutors. The next submission for an assignment will provide a level of measurement as to whether they have been able to develop their critical thinking skills through understanding. McPeck (2016, p.32) stated ‘An effective thinker in one area is not necessarily an effective thinker in all other areas’, and therefore critically thinking needs to be translated to each module, each assignment. The literature demonstrated that students’ ability in critical thinking will fluctuate and therefore, students should be taught to self-assess their critical thinking skills. The intervention combined with the diagnostic essay proved an effective way of linking critical thinking and written academic assignments. This direct link to the programme is effective as it is more advantageous to critically think in the language of the subject (McPeck, 2016, p.48); therefore, making the content more relevant. It is not just the skill of critically thinking that needs to be acquired; students’ application through academic writing skills is required for university study and writing critically requires time to develop (Donnelly and Fitzmaurice, 2011 p.168).
Critical thinking occurs through social learning (Brookfield, 2012, p.56; Johnston et al, 2001, p.208). As identified within the intervention, the group exercise provided students with an opportunity to hear the views and opinions of others. Small group work where students are required to make a judgement within a task, within larger lectures is an effective pedagogy strategy in developing critical thinking. This is well supported by Race (2014, p.177) who identifies that lectures are not about merely providing information, they are about helping students to understand and analyse. The exercise task provided students with the opportunity to conceptualise what critical thinking looked like, providing a rich social learning experience. This is further supported by using a problem-solving approach; through collaboration students develop critical thinking skills (Mannix and MacIntosh, 2011, p.139). Problem-based learning is very relevant to health care professions as it simulates decision making carried out in clinical practice (Woodhouse, 2011, p.211).
Another rich social learning experience discussed within the literature is the extended time spent on developing critical thinking through hands on experience or situations that require decisions to be made independently; these experiences will have an impact on academic achievement (Moon, 2008, p103). During the occupational therapy degree programme, students will embark on three block placements. These placements will provide them with a variety of experiences, in which reflection is a key element. The literature identified reflection to be a key concept linked to critical thinking. This is assessed during occupational therapy student placements and is often required in assignments where students are requested to reflect on service user narratives. Reflection was used during the intervention where the students were encouraged to reflect on the feedback provided on the diagnostic essay, to self-assess at which ‘stage of knowing’ (Baxter, 1992), they were currently at. Students would have found this difficult if they were unable to reflect on the feedback given. The session could have been enhanced by using statements related specifically to the diagnostic essay in the group exercise which would have developed critical thinking skills directly to the assessment, this would have further aided the students to reflect on their own academic writing in more depth. A range of study skills are required within higher education for academic success. Partnerships should be strengthened with central services that provide students with academic skills support (Ody, 2012, p.146). Study skills should be embedded within programmes, not as a stand along entity.
In summary, the critical thinking session encompassed pedagogy strategies to understand and increase critical thinking such as small group work, problem-based learning, reflection; and directly linking the content to the programme and more specifically, an assessment. The findings outline clear benefits to exploring what critical thinking is at the beginning of a programme, and especially if it can be directly linked to an assessment.
The following recommendations are suggested based on the intervention:
- Each programme to provide support to develop critical thinking in the first few weeks of university. The support could be a session that helps define and explore what critical thinking is, explore and apply theory with explicit examples to help students understand the concept and how this relates to and is embedded into assignments.
- Early on in the programme, students should be empowered to self-assess their critical thinking skills, a skill that they can constantly review throughout their courses during undergraduate and postgraduate study. This process of self-assessment will help students to determine the critical thinking skills required for different modules and levels.
- As students’ abilities for critical thinking vary and fluctuate between topics studied, lecturers need to be explicit during teaching and assessments, by demonstrating examples of critical thinking directly linked to assignments and academic success.
- The use of critical thinking models or frameworks can aid students in assessing and measuring their own critical thinking skills and should be used as strategies to increase understanding, application and debate amongst students.
- Reflective thinking should be explored and embedded within the curriculum as it has direct links to higher levels of critical thinking.
- Teaching strategies should enable social learning through, for example, small group work, work placements, real life experiences through guest speakers such as service users or professionals sharing their practice, and volunteering.
- Programmes should consider working closely with central academic support, such as Learning Development, to embed study skills into the curriculum, within each module of a programme. This will develop not just critical thinking, but other study skills.
Aveyard, H; Sharp, P; and Williams, M. (2015) A Beginner’s Guide to Critical Thinking and Writing in Health and Social Care. 2nd edition. Open University Press: Berkshire
Adam, R. (2018) UK University figures show up to fivefold rise in first-class degrees [ONLINE] Available from: https://www.theguardian.com/education/2018/jun/13/uk-university-figures-show-up-to-fivefold-rise-in-first-class-degrees [Accessed 06.01.2019]
Bloom, B; (1956) Taxonomy of Educational Objectives. Allyn and Bacon: Boston
Brookfield, S. (2012) Teaching for Critical Thinking; Tools and Techniques to help students question their assumptions. Jossey-Bass: USA
Brunt, B. (2005) Models, Measurement and Strategies in Developing Critical-Thinking Skills. The Journal of Continuing Education in Nursing 36(6): 255-262
Cleaver, E; Lintern, M; and McLinden, M. (2018) Teaching and Learning in Higher Education: Disciplinary Approaches to Educational Enquiry. 2nd edition. Sage: London
Cockram, E. and Hicks, S. (2012) Chapter 1 Clinical Decision Making p.21-37 In Cox, C; Hill, M. and Lack, V. Advanced Practice in Healthcare: Skills for Nurses and Allied Health Professionals. Routledge: Oxon
Coker, P. (2010) Effects of an Experiential Learning Program on the Clinical Reasoning and Critical Thinking Skills of Occupational Therapy Students. Journal of Allied Health 39(4):280-286
Cottrell, S. (2017) Critical Thinking Skills: Effective Analysis, Argument and Reflection. 3rd edition Palgrave: London
Chen, D. and Rattray, J. (2017) Transforming Thinking Through Problem-Based Learning in the News Media Literacy Class: Critical Thinking as a threshold concept towards threshold capabilities. Practice and Evidence of Scholarship of Teaching and Learning in Higher Education 12(2): 272-293
Dean, A. and Gibbs, P. (2014) Student satisfaction or happiness? A preliminary rethink of what is important in the student experience. Quality Assurance in Education; 23(1):5-19
Department for Business, Innovation and Skills (2016) Success as a Knowledge Economy: Teaching Excellence, Social Mobility & Student Choice [ONLINE] Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/523546/bis-16-265-success-as-a-knowledge-economy-web.pdf. [Accessed 06.01.2019]
Department of Education (20117) Teaching Excellence and Student Outcomes Framework Specification [ONLINE] Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/658490/Teaching_Excellence_and_Student_Outcomes_Framework_Specification.pdf. [Accessed 06.01.2019]
Donnelly, R. and Fitzmaurice, M. (2011) Chapter 7 Crucial Connections: An Exploration of Critical thinking and Scholarly Writing, p.159-174); In Horvath, C. and Forte, J. Critical Thinking and systems thinking: towards a critical literacy for systems thinking in practice. Nova Science Publishers: USA
Fox, J. (2011) Chapter 28 Quality assurance and enhancement p.149-155 In McIntosh, A; Gidma, J; and Mason-Whitehead, E. Key Concepts in Healthcare Education SAGE: London
Ghanizedah, A. (2017) The interplay between reflective thinking, critical thinking, self-monitoring, and academic achievement in higher education. Higher Education 74: 101-114
Gojkov, G; Stojanovic, A; and Rajic, A. (2015) Critical Thinking of Students-Indicator of Quality in Higher Education. Social and Behavioural Sciences 191: 591-596
Hjeltnes, A; Binder, P; Moltu, C, and Dundas, I. (2015) Facing the fear of failure; An explorative qualitative study of client experiences in a mindfulness-based stress reduction program for university students with academic evaluation anxiety. International Journal of Qualitative Studies on Health and Well-Being 10: 1-14
Hooks, B. (2010) Teaching Critical Thinking: Practical Wisdom. Routledge: New York
Howard, L; Li-Ping Tang, T, and Jill Austin, M. (2015) Teaching Critical Thinking Skills: Ability, Motivation, Intervention, and the Pygmalion Effect. Journal of Business Ethics 128:133-147
Lawrence, N; Serdikoff, S; Zinn, T. and Baker, S. (2008) Chapter 3: Have We Demystified Critical Thinking p23-33, In Dunn, D; Halonen, J; and Smith, R. (eds) Teaching Critical Thinking in Psychology: A Handbook of Best Practices. John Wiley & Sons: Oxford
Lederer, J. (2007) Disposition Toward Critical Thinking Among Occupational Therapy Students. American Journal of Occupational Therapy, 61(5):519-526.
Johnston, B; Mitchell, R; Myles, F. and Ford, P. (2011) Developing student criticality in higher education: undergraduate learning in arts and social sciences. Continuum International Publishing: London
Mannix, J. and McIntosh, A. Chapter 26: Problem-based Learning p.138-148 In McIntosh, A; Gidma, J; and Mason-Whitehead, E. Key Concepts in Healthcare Education SAGE: London
McPeck, J. (2016) Teaching Critical Thinking. Taylor and Francis: London
Moon, J. (2008) Critical Thinking: An exploration of theory and practice. Routledge: Oxon
Moon, J. (2009) Achieving Success through Academic Assertiveness: Real Life Strategies for Today’s Higher Education Students. Routledge: New York
Moon, J. (2018) We seek it here- a new perspective on the elusive activity of critical thinking: A theoretical and practical approach. [ONLINE] Available from: http://escalate.ac.uk/downloads/2041.pdf. [Accessed 15.11.18]
Morgan, M. (ed) (2012) Improving the Student Experience: A Practical Guide for Universities and Colleges. Routledge: New York
National Student Survey (2018a) About the NSS [ONLINE] Available from: https://www.thestudentsurvey.com/about.php. [Accessed 06.01.2019]
National Student Survey (2018b) National Student Survey 2017-Core Questionnaire [ONLINE] Available from: https://www.thestudentsurvey.com/content/NSS2017_Core_Questionnaire.pdf. [Accessed 06.01.2019]
Noish, G. (2012) Learning to Critically think things through: A Guide to Critical Thinking across the curriculum. 4th edition. Pearson: Boston
Nulty, D. (2012) Chapter 12 Student Evaluation and feedback p.196-200 In Improving the Student Experience: A Practical Guide for Universities and Colleges. Routledge: New York
Ody, M. (2012) Chapter 9 Academic Student Support and Development In Morgan, M. (ed) Improving the Student Experience: A Practical Guide for Universities and Colleges. Routledge: New York
Pew (2007) Andragogy and Pedagogy as Foundational Theory for Student Motivation in Higher Education. InSight : A Journal of Scholarly Teaching. 2(1):14-25
Piumatti, G. (2018) Motivation, health-related lifestyles and depression among university students: A longitudinal analysis. Psychiatry Research 260: 412-417
Race, P. (2014) Making Learning Happen: A guide for Post-Compulsory Education. Sage: London
Royal College of Occupational Therapists (2015) Codes of Ethics and Professional Conduct. Royal College of Occupational Therapists: London
Velde, B; Wittman, P; and Vos, P. (2006) Development of Critical Thinking in Occupational Therapy Students. Occupational Therapy International 13(1): 49-60
Woodhouse, J. (2011) Chapter 38 Teaching Strategies p.208-213 In McIntosh, A; Gidma, J; and Mason-Whitehead, E. Key Concepts in Healthcare Education SAGE: London
Appendix 1: Teaching Plan for Critical Thinking session for L4 Occupational Therapy Students
The following demonstrates the content of the session and how it was delivered:
|Workshop content||How the content was delivered?|
|Defining critical thinking||Exploration of what the students’ thought critical thinking was through questioning and discussion, followed by definitions provided and explanation given.|
|Introducing a critical thinking model||Introduction to the Stages of Knowing by Baxter Magolda, with an explanation of each stage including an example given for each stage. This was then followed up with a group exercise where by students had statements from different students and they had to identify which stage the student was at. The third-year students were asked to disperse themselves amongst the first-year students which were in eight groups. The actual results were then shared with the students, so each group could identify how many they got correct.|
|Self-assessment of critical thinking||
Students were then asked to discuss with a student colleague where they felt they were in the stage of knowing. Students were asked to reflect on their diagnostic essay and the feedback received to help them identify where they were.
Students were provided with information on Bloom’s Taxonomy in relation to the stages of knowing, considering where/how they needed to develop.
|How students’ can develop critical thinking skills||All students identified they needed to develop their critical thinking skills. Students were then guided through a variety of ways in which they can help themselves to develop their critical thinking skills. Students were guided to the student intranet study skills site where resources could be accessed to develop these skills. Examples were provided as to how critical thinking can be translated into writing critically.|
|How teaching and learning within the programme help to develop critical thinking skills||
Examples and discussion took place as to how the programme and lecturers also helped to develop the critical thinking skills of students.
Students were provided with the opportunity to ask questions throughout.