Concordia University St. Paul DigitalCommons@CSP Concordia University Portland Graduate CUP Ed. Dissertations Research Fall 9-1-2019 Effect of the Scientific Method Model of Instruction in Diagnostic Medical Sonography Students Debra Crandell Concordia University - Portland, debralcrandell@outlook.com Follow this and additional works at: https://digitalcommons.edu/cup_commons_grad_edd Part of the Education Commons Recommended Citation Crandell, D. Effect of the Scientific Method Model of Instruction in Diagnostic Medical Sonography Students (Thesis, Concordia University, St.
Retrieved from https://digitalcommons.edu/cup_commons_grad_edd/391 This Dissertation is brought to you for free and open access by the Concordia University Portland Graduate Research at DigitalCommons@CSP. It has been accepted for inclusion in CUP Ed. Dissertations by an authorized administrator of DigitalCommons@CSP. For more information, please contact digitalcommons@csp.
Concordia University - Portland CU Commons Ed. Dissertations Graduate Theses & Dissertations Fall 9-2019 Effect of the Scientific Method Model of Instruction in Diagnostic Medical Sonography Students Debra Crandell Concordia University - Portland Follow this and additional works at: https://commons.edu/edudissertations Part of the Education Commons CU Commons Citation Crandell, Debra, "Effect of the Scientific Method Model of Instruction in Diagnostic Medical Sonography Students" (2019).edu/edudissertations/375 This Open Access Dissertation is brought to you for free and open access by the Graduate Theses & Dissertations at CU Commons. It has been accepted for inclusion in Ed. Dissertations by an authorized administrator of CU Commons.
For more information, please contact libraryadmin@cu-portland. Concordia University–Portland College of Education Doctorate of Education Program WE, THE UNDERSIGNED MEMBERS OF THE DISSERTATION COMMITTEE CERTIFY THAT WE HAVE READ AND APPROVE THE DISSERTATION OF Debra Crandell CANDIDATE FOR THE DEGREE OF DOCTOR OF EDUCATION Floralba Arbelo Marrero, Ed., Faculty Chair Dissertation Committee Ray W., Content Specialist Roblena E., Content Reader Effect of the Scientific Method Model of Instruction in Diagnostic Medical Sonography Students Debra Crandell Concordia University–Portland College of Education Dissertation submitted to the Faculty of the College of Education in partial fulfillment of the requirements for the degree of Doctor of Education in Higher Education Floralba Arbelo Marrero, Ed. Faculty Chair Dissertation Committee Ray W. Content Specialist Roblena E., Content Reader Concordia University–Portland 2019 Abstract Critical thinking and reasoning are fundamental skills for a diagnostic medical sonographer.
This quantitative quasi-experimental study examined whether teaching diagnostic medical sonography students the scientific method made a significant difference in the student's critical thinking and reasoning skills. Using the Health Science Reasoning Test (HSRT), two groups of students were selected to participate in the study, with a control and experimental group. The HSRT was used to determine if a significant difference in critical thinking and reasoning was discernable from pre-to-post testing between the control and experimental group of students. The data supported teaching the scientific method improved the scores on the post HSRT in the experimental group, which received instruction in the scientific method.
A student receiving instruction in the scientific method (n = 12) had a higher overall HSRT score (M = 27) than the control group (n = 12) (M = 19), with the difference being statistically significant at p = 0. Post HSRT testing shows an increase in their national percentile ranking for the posttest, the control group had an increase of 13%, and the experimental group had an increase of 32%. The HSRT can provide educators with a tool to measure the effectiveness of a student’s critical thinking and reasoning skills, facilitating their development of bridging didactic and laboratory education to the clinical setting. Keywords: critical thinking, critical reasoning, sonography, teaching, clinical education ii Dedication Many people have contributed to my successful completion of this project by providing encouragement and support.
I dedicate this work to my family: James, Brice, Rachel, Lori, Amy, and Christian. Thank you all for your love, encouragement, and understanding during this process. iii Acknowledgments I want to take this opportunity to acknowledge those outside of my family who have been there for support and guidance through this doctoral program. First, I would like to thank my three inspiring committee chairs.
I want to express my gratitude to Dr. Mary Jones for encouraging me to explore different concepts in pursuing my research. Sally Evans, for her professionalism and kindness during the writing process. Marrero, my final committee chairperson, for her professionalism and timeliness during this process.
Completing this project was under her guidance. Next, I would like to thank other committee members who have contributed to my success in many ways—Dr. Ray Francis for help in writing APA style and providing positive suggestions for improvement. Roblena Walker and Dr.
Ray Francis for providing encouragement and sharing knowledge and expertise during the dissertation process. Lastly, I want to thank my colleague, Dr. Narayana Prasad, for our brainstorming conversations. iv Table of Contents Abstract.iv List of Tables…….ix List of Figures.……………………………………………………………………1 Introduction to the Problem…….1 Background, Context, and History…………………………………………………………….4 Statement of Problem………………….……3 Purpose of the Study………….5 Specific Objectives of the Study………………………………………………….……………………………………………………………7 Rationale, Relevance, and Significance of the Study.8 Definition of Terms.10 Assumptions, Delimitations, and Limitations……………………….16 Chapter 2: Literature Review.18 v Introduction to Literature Review.………………………………………………………………………19 Review of Research Literature and Methodological Literature.……………22 History of Critical Thinking.22 Critical Thinking in the Allied Health Professions.23 Critical Thinking in Diagnostic Medical Sonography….……………………………25 Critical Thinking Defined.26 Models of Teaching Critical Thinking Skills.26 Critical Thinking Scale.28 Review of Methodological Issues.31 Critical Thinking Instructional Practices.31 Scientific Method for Instruction.44 Synthesis of Research Findings.45 Critique of Previous Research.50 Critical thinking and Reasoning Specific to Diagnostic Medical Sonography.58 Purpose of the Study………………………………………………………………………….60 vi Research Questions.61 Target Population, Sampling Method, and Related Procedures.69 Operationalization of Variables.…71 Data Analysis Procedures.72 Limitations and Delimitations of the Research Design………………………………………72 Internal and External Validity.73 Ethical Issues in the Study.……………………………75 Chapter 4: Data Analysis and Results………………………………………………………….77 Description of the Sample.90 Chapter 5: Discussion and Conclusion.………………………………………………………………………………92 vii Summary of the Results.………95 Discussion of the Results………………….………………………………………………………………100 Discussion of the Results in Relation to the Literature.105 Implication of the Results for Practice, Policy, and Theory.…107 Recommendations for Further Research.110 Appendix A Clinical Instructors Evaluation………………………………………….……120 Appendix B Statement of Original Work…………………………………………….121 viii List of Tables Table 1 Comparison of Methodology.66 Table 2 Categorical Levels of HSRT Scores.………………68 Table 3 Descriptive Statistics Group One.84 Table 4 Descriptive Statistics Group Two…………………………………………………….84 Table 5 Comparison of Benchmark and Capstone; Clinical History and Observations.87 Table 6 Comparison of Benchmark and Capstone; Clinical Hypotheses.87 Table 7 Comparison of Benchmark and Capstone; Investigative Imaging.88 Table 8 Comparison of Benchmark and Capstone; Sonographic Findings.…………………88 Table 9 Comparison of Benchmark and Capstone; Clinical Correlation.……………………89 ix List of Figures Figure 1 Frequency chart overall posttest scores groups one and two…………….…………82 Figure 2 Histogram distribution of posttest scores.83 Figure 3 Histogram group one overall scores pre and posttest.85 Figure 4 Histogram group two overall scores pre and posttest.………………………………86 x Chapter 1: Introduction Introduction to the Problem The diagnostic medical sonographer is a professional in the allied health field, which involves technical competence, interpretive skills, and critical thinking, and reasoning skills.
The sonographic images are obtained with the use of specialized equipment, which is the technical component of being a sonographer (Ardms. Every diagnostic medical sonographer is like a detective when it comes to gathering, processing, and analyzing the patient’s clinical history and sonographic images. Like a detective, the sonographer is required to exercise critical thinking and reasoning skills in their clinical examination. This is essential as their ability has a direct impact on the interpreting physician’s diagnosis (Baun, 2006).
Presenting the information and images with optimization and accuracy is essential for the patient’s health care and health improvement. The sonographer deals with complex situations that require critical thinking and clinical reasoning skills. Critical thinking and reasoning skills are primarily developed through education and learning (Elder & Paul, 2013). Background, Context, and History The use of ultrasound as a diagnostic imaging tool became widespread with commercial applications beginning in 1963.
Entry-level sonography positions require an associate degree (U. Bureau of Labor, 2019). Diagnostic medical sonographers are a member of the healthcare team providing images of the human body through the use of sound waves. The sonographer evaluates the organs, such as the heart, liver, and kidneys, as well as blood vessels, muscles, tendons, and the fetus.
The images are used by a physician to aid in the diagnosis of the patient. Sonography education is at the associates and bachelor degree level. Diagnostic medical sonographers have a national credentialing examination through the American Registry of 1 Diagnostic Medical Sonographer (ARDMS). The ARDMS credentialing examination and continuing education requirements ensure the sonographer has met requirements to hold the credential (ARDMS.
Educational programs include clinical experience under the supervision of a credentialed sonographer along with the didactic education for the sonographer’s specialty area. Sonographers perform ultrasound examinations and tests that aid physicians in diagnosing the patients' medical problems (U. Bureau of Labor, 2019). Every educational institution must have a well-proven method to develop and accurately gauge the students’ ability to transfer knowledge from the classroom to the clinical setting (Penny & Zachariason, 2015).
Developing a working measurement and teaching methodology is a challenge and yet very essential for the student, health care professional team, and the patient (Penny & Zachariason, 2015). The focus of the research study is on sonography students in a baccalaureate program of study. The program leads to credentials for Registered Diagnostic Medical Sonographer, through the American Registry of Diagnostic Medical Sonographers (ARDMS). A sonography student must have theoretical and clinical knowledge in order to pass these examinations.
Programs in sonography are focused on clinical education hours and the theoretical knowledge as per program accreditation standards (Commission on Accreditation of Allied Health Education Programs [CAAHEP], n. American Philosophical Association Delphi Report, Facione, (1990) and Facione and Facione (2008) defined critical thinking for health care professionals as a process used in making a judgment regarding what to believe and what to do about the symptoms that a patient is presenting for diagnosis and treatment. Most educators hold the assumption that clinical reasoning and critical thinking skills will be learned through experience in the clinical setting. Modeling the behavior of the clinical instructor does not provide the skill set necessary for the student to develop critical thinking and 3 reasoning skills in a different vignette (McInerney & Baird, 2016).
Students need instruction through learning activities to bridge the didactic or knowledge-based instruction into the clinical setting by analyzing and applying their knowledge as applied to a patient’s examination (McInerney & Baird, 2016). Fitzpatrick (2015) asserted that educators realize the need for critical thinking skills but question the best methods for teaching these skills to the student. This is a disadvantage to the student’s development of critical thinking and reasoning skills and has an effect on the provision of quality health care to patients in the student’s clinical environment and practice (Penny & Zachariason, 2015). Having a method for integrating patient history and sonographic findings from the examination through critical thinking and reasoning is a crucial part of the cognitive functions of the sonographer (Baun, 2004).
Critical thinking is the process that the sonographer uses to make a judgment about the patient’s history and information obtained from the sonographic images that facilitate the diagnosis and treatment of the patient (Penny & Zachariason, 2015). Therefore, critical thinking and reasoning skills are essential for the sonographer to present the sonographic images with accuracy in facilitating the diagnosis rendered from these images by the interpreting physician. Critical thinking and reasoning skills for the diagnostic medical sonographer are highly essential to the patient’s health care and outcome. Conceptual Framework The conceptual framework used to ground this study was Paul and Elder’s (2019) model of critical thinking.
Paul and Elder (2019) developed an eight-step process for students learning to identify, analyze, and evaluate a problem. Paul and Elder’s (2019) eight-step method correlates to the five-step scientific method advocated for diagnostic medical sonographers by Baun (2004), and Penny and Zachariason (2015). The Delphi Report defines critical thinking 4 based on the practitioner's scope of practice, and Facione (1990) equates critical thinking with the scientific process as the method of inquiry.