The Effectiveness of Standardized Patient Experience (SPE) Model in Teaching Critical Thinking Capability of Bachelor Nursing Students Compared to Case Study

Ryan Hara Permana

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Critical thinking is a main ability for nurses. However, the learning methods that are usually used by nursing education institutions cannot facilitate the development of critical thinking of nursing students optimally. This research investigated the effectiveness of Standardized Patient Experience (SPE) model in practicing the critical thinking capability of nursing students compared to case study. This quasi-experiment study used 77 nursing students as the samples that were divided into control and experiment group. Although there are no significant different between the total critical thinking scores of the students who participated in SPE compared to case study (p= 0.146), but there are differences in analysis and problem solving aspect (p==0.019 and 0.00). the satisfaction and confidence level of the students toward the SPE are also significantly increased compared to case study (p=0.01 dan p=0.00). To conclude, both the SPE and case study method are effective in developing the critical thinking of the nursing students.

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Alfaro-LeFevre, R. (2013). What is critical thinking, clinical reasoning, and clinical judgement. What is Critical Thinking and Clinical Reasoning, 1-23.

Aprisunadi. (2011). Hubungan antara Kemampuan Berpikir Kritis Perawat dengan Kualitas Asuhan Keperawatan di Unit Perawatan Ortopedi Rumah Sakit Umum Pusat Fatmawati Jakarta. Magister Master Thesis, Universitas Indonesia, Depok. Retrieved from

Billings, D. M., & Halstead, J. A. (2005). Teaching in nursing. A guide for faculty, 2.

Brown, D., & Chronister, C. (2009). The effect of simulation learning on critical thinking and self-confidence when incorporated into an electrocardiogram nursing course. Clinical Simulation in Nursing, 5(1), e45-e52.

Cant, R. P., & Cooper, S. J. (2010). Simulation-based learning in nurse education: systematic review. Journal of advanced nursing, 66(1), 3-15.

Carter, A. G., Creedy, D. K., & Sidebotham, M. (2015). Evaluation of tools used to measure critical thinking development in nursing and midwifery undergraduate students: A systematic review. Nurse Education Today.

Choi, Y.-J. (2013). Standardized Patients for Korean Psychiatric Nursing Student Simulations. Clinical Simulation in Nursing, 9(9), e385-e392.

Churchouse, C., & McCafferty, C. (2012). Standardized Patients Versus Simulated Patients: Is There a Difference? Clinical Simulation in Nursing, 8(8), e363-e365. doi:

Del Bueno, D. (2005). A crisis in critical thinking. Nursing Education Perspectives, 26(5), 278-282.

Edgecombe, K., Seaton, P., Monahan, K., Meyer, S., LePage, S., & Erlam, G. (2013). Clinical Simulation in Nursing: A literature review and guidelines for practice.

Elaine, S. R., & Mary, C. R. (2002). Critical thinking in nursing education: Literature review. International journal of nursing practice, 8(2), 89-98.

Facione, N. C., Facione, P. A., & Sanchez, C. A. (1994). Critical thinking disposition as a measure of competent clinical judgment: the development of the California Critical Thinking Disposition Inventory. The Journal of nursing education, 33(8), 345-350.

Feng, R.-C., Chen, M.-J., Chen, M.-C., & Pai, Y.-C. (2010). Critical thinking competence and disposition of clinical nurses in a medical center. Journal of Nursing Research, 18(2), 77-87.

Gaberson, K. B., Oermann, M. H., & Shellenbarger, T. (2014). Clinical teaching strategies in nursing: Springer publishing company.

Goodstone, L., Goodstone, M. S., Cino, K., Glaser, C. A., Kupferman, K., & Dember-Neal, T. (2013). Effect of Simulation on the Development of Critical Thinking in Associate Degree Nursing Students. [Article]. Nursing Education Perspectives, 34(3), 159-162.

Jeffries, P. R. (2012). Simulation in nursing education: From conceptualization to evaluation: National League for Nursing.

Kaddoura, M. A. (2010). New graduate nurses' perceptions of the effects of clinical simulation on their critical thinking, learning, and confidence. The Journal of Continuing Education in Nursing(41), 506-516.

Kataoka-Yahiro, M., & Saylor, C. (1994). A critical thinking model for nursing judgment. The Journal of nursing education, 33(8), 351-356.

Mulyaningsih. (2011). Hubungan Berpikir Kritis dengan Perilaku Caring Perawat di RSUD. Dr. Moewardi Surakarta. Magister Master Thesis, Universitas Indonesia, Depok. Retrieved from

Nuraini, T., Afifah, E., Agustini, N., Pujasari, H., Masfuri, M., & Milanti, A. (2015). Human patient simulation to improve the attitude of the nursing students. Journal of Nursing Education and Practice, 5(4), p52.

Paul, R. W. (1993). Critical Thinking. Santa Rosa: Foundation for Critical Thinking.

Permana, R. H., & Sumarwati, M. (2014). Efektivitas Metode Standardized Patients Experience (SPE) untuk Meningkatkan Kemampuan Komunikasi Terapeutik pada Mahasiswa Sarjana Keperawatan dibandingkan dengan Early Clinical Exposure (ECE). Penelitian. Keperawatan Universitas Jenderal Soedirman.

Popil, I. (2011). Promotion of critical thinking by using case studies as teaching method. Nurse Education Today, 31(2), 204-207.

Potter, P. A., Perry, A. G., & Adams, J. (2009). Fundamentals of nursing (Vol. 220): Elsevier Mosby.

Purvis, C. A. (2009). Factors that influence the development of critical thinking skills in associate degree nursing students. Doctoral Degree, University of Georgia, Athens, Georgia.

Raurell‐Torredà, M., Olivet‐Pujol, J., Romero‐Collado, À., Malagon‐Aguilera, M. C., Patiño‐Masó, J., & Baltasar‐Bagué, A. (2015). Case-Based Learning and Simulation: Useful Tools to Enhance Nurses’ Education? Nonrandomized Controlled Trial. Journal of Nursing Scholarship, 47(1), 34-42.

Rhodes, M. L., & Curran, C. (2005). Use of the human patient simulator to teach clinical judgment skills in a baccalaureate nursing program. Computers Informatics Nursing, 23(5), 256-262.

Robinson-Smith, G., Bradley, P. K., & Meakim, C. (2009). Evaluating the use of standardized patients in undergraduate psychiatric nursing experiences. Clinical Simulation in Nursing, 5(6), e203-e211.

Schneider, Z., & Whitehead, D. (2012). Nursing and midwifery research: Methods and critical appraisal for evidence-based practice: Elsevier Australia.

Sullivan-Mann, J., Perron, C. A., & Fellner, A. N. (2009). The effects of simulation on nursing students' critical thinking scores: A quantitative study. Newborn and Infant Nursing Reviews, 9(2), 111-116.

Sumarwati, M., & Permana, R. H. (2014, 12 April 2014). [Survei Pendahuluan Masalah Keterbatasan Lahan Praktik Klinik Keperawatan].

Taylor, C., Lillis, C., LeMone, & Lynn. (2010). Fundamentals of nursing: The art and science of nursing care (7th ed.). Philadelphia: Lippincott Williams & Wilkins.

The Faculty of St. Petersburg College. (2010). Assessment Rubric for Critical Thinking: Rubric Validation Process Second Workshop. St. Petersburg, US: St. Petersburg College.

Thurmond, V. A. (2001). The Holism in Critical Thinking A Concept Analysis. Journal of Holistic Nursing, 19(4), 375-389.

Wane, D., & Lotz, K. (2013). The Simulated Clinical Environment as a Platform for Refining Critical Thinking in Nursing Students: A Pilot Program. [Article]. Nursing Education Perspectives, 34(3), 163-166.

Webster, D. (2013). Using Standardized Patients to Teach Therapeutic Communication in Psychiatric Nursing. Clinical Simulation in Nursing, 10(2), e81-e86.

Wilford, A., & Doyle, T. J. (2006). Integrating simulation training into the nursing curriculum. British Journal of Nursing, 15(17), 926-931.

Yildirim, B., & Ozkahraman, S. (2011). Critical thinking in nursing process and education. International Journal of Humanities and Social Science, 1(13), 257-262.


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