title: Evaluation of tools used to measure critical thinking development in nursing and midwifery undergraduate students: a systematic review.
abstract: BACKGROUND
  Well developed critical thinking skills are essential for nursing and midwifery practices. The development of students' higher-order cognitive abilities, such as critical thinking, is also well recognised in nursing and midwifery education. Measurement of critical thinking development is important to demonstrate change over time and effectiveness of teaching strategies.
  
  
  OBJECTIVE
  To evaluate tools designed to measure critical thinking in nursing and midwifery undergraduate students.
  
  
  METHODS
  The following six databases were searched and resulted in the retrieval of 1191 papers: CINAHL, Ovid Medline, ERIC, Informit, PsycINFO and Scopus.
  
  
  METHODS
  After screening for inclusion, each paper was evaluated using the Critical Appraisal Skills Programme Tool. Thirty-four studies met the inclusion criteria and quality appraisal. Sixteen different tools that measure critical thinking were reviewed for reliability and validity and extent to which the domains of critical thinking were evident.
  
  
  RESULTS
  Sixty percent of studies utilised one of four standardised commercially available measures of critical thinking. Reliability and validity were not consistently reported and there was a variation in reliability across studies that used the same measure. Of the remaining studies using different tools, there was also limited reporting of reliability making it difficult to assess internal consistency and potential applicability of measures across settings.
  
  
  CONCLUSIONS
  Discipline specific instruments to measure critical thinking in nursing and midwifery are required, specifically tools that measure the application of critical thinking to practise. Given that critical thinking development occurs over an extended period, measurement needs to be repeated and multiple methods of measurement used over time.
authors.affiliation: School of Nursing and Midwifery, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia. Electronic address: a.carter@griffith.edu.au.
authors.forename: Amanda G
authors.initials: AG
authors.lastname: Carter
authors.affiliation: Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
authors.forename: Debra K
authors.initials: DK
authors.lastname: Creedy
authors.affiliation: School of Nursing and Midwifery, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
authors.forename: Mary
authors.initials: M
authors.lastname: Sidebotham
mesh_terms: D004508:Education, Nursing, Baccalaureate; D004521:Educational Measurement / Q000379:methods; D005260:Female; D006801:Humans; D008880:Midwifery / Q000193:education*; D015402:Nursing Education Research; D011247:Pregnancy; D015203:Reproducibility of Results; D013338:Students, Nursing / Q000523:psychology*; D013850:Thinking
keywords: Critical thinking; Evaluation; Measures; Midwifery; Nursing; Scales