Using critical thinking vignettes to evaluate student learning.

Nursing skills have traditionally been evaluated using laboratory demonstration. The reality, however, is that skill performance does not occur in isolation in the practice setting. Nurses demonstrate skills while functioning within several nursing roles. Following an examination of the relationship of educational outcomes focusing on critical thinking, communication ability, and therapeutic nursing interventions, faculty at a two-year associate degree nursing program formulated Critical Thinking Vignettes as a method of assessing student outcomes. Students role-play a nurse-client interaction using a case study prompt. Student performance outcomes in skills demonstration, communication, teaching, problem solving, critical thinking, identification of resources, and response to environmental cues are evaluated. Preliminary reliability and inter-rater reliability studies suggest that this method provides a controlled method of assessing nursing outcomes reflective of actual practice.