title: The revised critical thinking skills scale for a life-and-death course: preliminary scale refinement.
abstract: BACKGROUND
  Death education involves acquiring knowledge, changing behavior, and developing proper views of life in both the affective and the value domains. Critical thinking that is honed through reflecting on life-and-death issues represents a way to reach these goals. Designing assessments able to measure college student content and critical thinking skills related to life-and-death issues is thus important. The Test of Critical Thinking Skills for Life-And-Death content (TCTS-LD) instrument requires the administration of additional tests to assess reliability and validity for future use in the assessment of perceptions on life and death.
  
  
  OBJECTIVE
  The purpose of this study was to refine the TCTS-LD.
  
  
  METHODS
  A cross-sectional, descriptive design was used to recruit 715 college students in southern Taiwan. Three structured scales were administered in class to the participants. Data were collected in 2004 and 2006. Confirmatory factor analysis was applied to validate the structure of scales.
  
  
  RESULTS
  Examination of the reliability of the three-factor and 15-item scale revealed a Kuder-Richardson coefficient of internal consistency of .54. The split-half reliability coefficients were .47 in the Spearman-Brown correlation and .40 in the intraclass correlation coefficient (ICC). The test-retest reliability coefficients (n = 22) were .58 in Pearson correlation and .56 in ICC. In addition to content validity verification by experts and face validity by students, the validity of this test was assessed using three methods, including (a) a comparable validity rating between this test and the TCTS-A (r = .34, p < .001; (b) a contrast-group technique with different responses to the instrument between those in education and nursing majors (t = 2.71, p < .01), with scores of 10.98 (SD = 2.42) and 9.82 (SD = 2.25), respectively; and (c) a confirmatory factor analysis confirming that TCTS-LD is related to the three dimensions of assumption, evaluation, and induction (χ = 81.800, p = .158, normed chi-square χ/df = 1.169, comparative fit index [CFI] = .976, Tucker-Lewis index = .984, root mean square error of approximation [RMSEA] = 0.015). Three factors explained 31.19% of total variance for the revised TCTS-LD.
  
  
  CONCLUSIONS
  The revised TCTS-LD scale improved performance and effectiveness to a certain degree. However, reliability and construct validity must be further tested to permit its use as an evaluation tool.
authors.affiliation: Department of Nursing, National Tainan Institution of Nursing, College of Nursing, Kaohsiung Medical University. hhwang@kmu.edu.tw
authors.forename: Huei-Lih
authors.initials: HL
authors.lastname: Hwang
authors.forename: Huey-Shyan
authors.initials: HS
authors.lastname: Lin
authors.forename: Hsiu-Hung
authors.initials: HH
authors.lastname: Wang
mesh_terms: D000328:Adult; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D004506:Education, Nursing; D004521:Educational Measurement / Q000379:methods*; D005163:Factor Analysis, Statistical; D006801:Humans; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D013624:Taiwan; D013850:Thinking