Do Dedicated Education Units (DEU) Facilitate Critical Thinking in Nursing Students?

Friday, April 24, 2015
Thomas J. Hendrix, PhD, RN , Nursing, University of Alaska Anchorage, Anchorage, AK
Maureen O'Malley, PhD , School of Nursing, University of Alaska Anchorage, Anchorage, AK
Purposes/Aims:  The purpose of this study is to investigate whether the learning experience on a dedicated educational unit (DEU) is different than that experienced on a traditional clinical unit in an acute care facility as evidenced by the student’s ability to critically think.

Rationale/Background: In a typical undergraduate nursing educational experience, the experiences of students in the clinical setting involved some preparation and then repetitive practice of basic skills over a course of time with a clinical instructor providing oversight and guidance.  Beginning in the 1990’s and extending until today, many educational and clinical researchers have called for a change in the basic clinical model of a single clinical instructor overseeing a small cohort of clinical students.  Increasingly during this time, a nurse serving as a mentor was seen as a better approach to learning then the traditional clinical experience.  This was the beginning of the DEU model of clinical learning. In the DEU model, a University professor oversees the learning experiences of a cohort of undergraduate nursing students but it is a volunteer staff nurse that serves as a mentor for a student.  In our model, one staff nurse mentors 2 students.  The staff nurse develops a relationship with the student, is scheduled to work with the student consistently over a semester, provides guidance and expertise to the student and, in effect, serves as the “Master” to the student “apprentice”.  The University professor oversees the relationship and provides guidance and counseling as needed.  We instituted this model of clinical instruction at our University approximately 5 years ago and have had a consistently positive feedback from the teachers, the clinical staff and, most importantly, the students.

Methods:  Our University has instituted the KAPLAN learning package and as part of the package, students are tested three separate times on with a valid and reliable critical thinking test.  At the end of their junior year, the students are enrolled in a medical-surgical nursing course with a clinical component.  There are 5 clinical groups of 8 students each.  One of those groups is geographically far away from campus and students choose it for logistic reasons more than academic preference and, as such, that group will not be part of this study.  The remaining 4 groups are physically near each other and two of them utilize the DEU clinical model and the other two do not.  The faculty overseeing each of these groups are stable and consistent for many years.  This creates a natural experiment.  Each student will be tested for critical thinking before and after their clinical experiences.  The researchers will evaluate the change in critical thinking through a difference of means t-test.  The study will last through 2016.

Implications: If the null hypothesis (all clinical groups are the same) is not supported and the DEU shows a significant improvement in critical thinking when compared to the traditional clinical setting, this would lend support to the notion that the DEU model should be expanded to the other clinical settings.