Critical Thinking Teaching Methods - A Review

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Objective To identify the perceived level of competence in teaching and assessing critical thinking skills and the difficulties facing radio-logic science program directors in implementing student-centered teaching methods.

Methods A total of 692 program directors received an invitation to complete an electronic survey soliciting information regarding the importance of critical thinking skills, their confidence in applying teaching methods and assessing student performance, and perceived obstacles. Statistical analysis included descriptive data, correlation coefficients, and ANOVA.

Results Responses were received from 317 participants indicating program directors perceive critical thinking to be an essential element in the education of the student; however, they identified several areas for improvement. A high correlation was identified between the program directors’ perceived level of skill and their confidence in critical thinking, and between their perceived level of skill and ability to assess the students’ critical thinking. Key barriers to implementing critical thinking teaching strategies were identified.

Conclusion Program directors value the importance of implementing critical thinking teaching methods and perceive a need for profes-sional development in critical thinking educational methods. Regardless of the type of educational institution in which the academic pro-gram is located, the level of education held by the propro-gram director was a significant factor regarding perceived confidence in the ability to model critical thinking skills and the ability to assess student critical thinking skills.








Perceptions of the Use of Critical

Thinking Teaching Methods

Literature Review

According to the literature found, the nursing pro-fession embraced the concept of critical thinking long before the radiologic sciences profession. However, this review demonstrates that although nursing has a well-developed concept and definition of critical thinking, nursing educators have not demonstrated significant improvement of critical thinking skills in their graduates.2,3

Research shows educators continue to focus instruction on providing practice information rather than teaching reasoning and problem solving. Therefore, graduates have limited ability to analyze problems, adapt techniques, and make decisions in clinical practice.4,5

According to Mangena and Chabeli,6

many obsta-cles impede the use of critical thinking by nursing educators and students. In the study, focus group interviews were conducted with 7 educators and 12 fourth-year nursing students to explore and describe their perceptions of critical thinking in nursing edu-cation. One obstacle identified by the group was that


dvances in technology create challenges in the radiologic science profession, mak-ing critical thinkmak-ing skills essential for quality patient care in the clinical envi-ronment.

In this study, critical thinking is defined as mean-ingful, unbiased decisions or judgments based on the use of interpretation, analysis, evaluation, inferences, and explanations of information as it relates to the evidence applied to a specific discipline.1

Critical thinking skills are developed through education, prac-tice, and experience. Therefore, the educational pro-cess must foster the development of the critical think-ing skills required for current clinical practice, which requires educators to move from a teacher-centered approach to a learner-centered approach.

This study seeks to identify the perceived level of competence in teaching and assessing critical think-ing skills and the difficulties facthink-ing radiologic science program directors in implementing student-centered teaching methods.


cause for the lack of implementation, as well as the resis-tance of faculty to change their teaching style.9

Walsh and Seldomridge10

explored the role and place of critical thinking in an undergraduate nursing program and examined whether critical thinking was being strengthened or diminished in the classroom and clinical sites. They identified several issues in rein-forcing the importance of critical thinking in nursing education. It is understood that educators realize the role they play in developing students’ critical thinking skills, yet instructors are under significant pressure to cover content material required of the profession with-in a limited time frame. As a result, lecture seems to be the strategy most often used by nursing instructors.10

However, students need not only the content material to understand their profession, but also instruction on how to critically analyze this new knowledge. Clearly a new paradigm is needed, as students can learn in many ways other than lecture.

In the radiologic sciences, a review of literature corroborates the fact that the profession lags behind other professions such as medicine and nursing in adopting critical thinking teaching methods. Much of the instruction requires memorization of information rather than synthesis and application of knowledge.11

Critical thinking is most effective when educators embed it into subjects already taught. The litera-ture indicates instructors must change from passive, instructor-centered methods to active, student-centered learning such as small group activities, reflective jour-nal writing, case studies, debates, and poster presenta-tions.6,11

Although some radiologic science educators have applied critical thinking techniques in their classroom and clinical environment, little research has been conducted in this population. Until radiologic science educators can define the skills needed and the obstacles they face to promote critical thinking skills, this concept may not be fully embraced by the radio-logic sciences.


Critical thinking is an important concept in educa-tion; however, educators must be willing and able to change their teaching methods to foster the develop-ment of critical thinking skills in radiologic science graduates. Therefore, the purpose of this study was to identify radiologic science program directors’ percep-tions of their current level of competence in teaching and assessing critical thinking skills and to identify the difficulties encountered when implementing student-some educators lacked adequate knowledge of critical

thinking. Additionally, educators were uncomfortable with the transition from a teacher-centered to learner-centered approach to education when outcomes-based education was emphasized in the educational pro-gram, and this inadvertently caused some resistance to the change in instruction. Instructors also had dif-ficulty incorporating critical thinking skills when stu-dent groups had a low level educational background.6

Shell conducted a survey of 262 baccalaureate program nurse educators about their perceptions of barriers that hindered the implementation of criti-cal thinking strategies.7 She concluded that faculty encounter several barriers when incorporating criti-cal thinking strategies into curriculum. The greatest barrier is students’ lack of motivation and resistance to active learning. Instructors also identified time constraints when trying to prepare and plan critical thinking activities because they could not find ample time in the classroom to incorporate the task. The amount of content or factual information required in the courses was overwhelming to both the instructor and student, leaving little time to incorporate critical thinking activities. Shell concluded that the nursing educators were only slightly confident in their knowl-edge of how to promote critical thinking in nursing students, and they felt additional education in critical thinking teaching methods was needed.7

In a study conducted by Raymond and Profetto-McGrath,8

educators identified positive and negative factors that influenced their use of critical-thinking strategies in the classroom. Positive influences included faculty development opportunities, administrative support, freedom to experiment with new ideas, and mentorship. The negative barriers to implementation included intensive workloads, strict content delivery, lack of time for new ideas, fellow faculty members who were unreceptive to critical thinking, and students who displayed negative attitudes toward critical thinking teaching methods used in class. Educators not only need assistance in developing critical thinking skills but also would benefit from strategies used to combat the negative interaction with students and peers.8

O’Sullivan et al9

conducted a survey of deans and directors of nursing programs regarding successful implementation of critical thinking strategies within the classroom. Results of the survey indicated only 20 percent of the undergraduate nursing programs imple-mented critical thinking strategies. Difficulty in develop-ing methods to teach critical thinkdevelop-ing was the common


implementation of critical thinking strategies in the nursing profession. The revised survey instrument con-sisted of 4 sections. Section 1 obtained demographic information from the participants. Section 2 included Likert-style questions using a 6-point rating-scale (1 = strongly disagree to 6 = strongly agree) designed to assess the educators’ perceptions of critical think-ing. Section 3 included 5-point frequency rating-scale questions (1 = never to 5 = always) to identify the frequency of obstacles’ occurrence in implementing critical thinking strategies. For analysis, questions in sections 2 and 3 were categorized as the following constructs: (1) confidence in the use of strategies and assessments, (2) importance of critical thinking, (3) skill in teaching critical thinking, and (4) frequency of obstacles encountered in implementing critical thinking teaching strategies. Section 4 was an open-ended question requesting program directors to fur-ther define the obstacles they have encountered when incorporating critical thinking teaching methods in the classroom and provide an explanation regarding their development, use, and assessment of students’ critical thinking skills.

The survey’s content validity was established by a panel of 4 highly regarded radiologic science educators chosen by the investigators for their expertise in criti-cal thinking. The panel critiqued the survey content to ensure the instrument measured the desired affective constructs and provided suggestions for improvement. A field test was used to establish the face validity and suitability of the instrument prior to sending the survey to the 692 study participants.

Data Collection

An e-mail announcement was sent to all program-matically accredited radiography and radiation therapy program directors in the United States describing the research study and providing a link to the elec-tronic survey site. Reminder e-mails were sent 1 and 2 weeks following the initial e-mailing of the survey. All data were collected through SurveyMonkey (Palo Alto, California), transferred to an Excel (Microsoft Corporation, Redmond, Washington) spreadsheet, and entered into SPSS (IBM Corporation, Armonk, New York) for statistical analysis.

Data Analysis

Descriptive statistics including means, standard devi-ations, and percentages were calculated for responses to sections 1, 2, and 3 of the survey questionnaire. centered teaching methods. This study sought to

answer the following research questions:

1. What is the perceived level of confidence in the use of teaching strategies and assessment of criti-cal thinking in the classroom and clinicriti-cal setting?

■ Is the education level of the program director related to the ability to teach and assess criti-cal thinking skills?

2. What level of importance is placed on the use of critical thinking in the classroom and clinical setting?

■ Does the importance placed on critical think-ing relate to the type of academic institution in which the program is located?

■ Is the age of the program director related to his or her perceived importance of critical thinking?

3. What is the perceived level of skill in using criti-cal thinking teaching methods in the classroom? 4. To what extent do certain factors impede the use

of strategies and assessment of critical thinking in the classroom?


This survey research study conducted in 2009 pro-vides a descriptive analysis of radiography and radia-tion therapy program directors’ percepradia-tions of critical thinking, their ability to use critical thinking teaching methods, and their ability to assess student critical thinking activities. The study was approved by The Ohio State University Institutional Review Board.


A total of 692 radiography and radiation therapy pro-gram directors from propro-grammatically accredited edu-cational programs were invited to participate in the elec-tronic survey. The institutions solicited represented both degree-granting and certificate radiologic sciences pro-grams. The program directors’ names and e-mail address-es were obtained from the Joint Review Committee on Education in Radiologic Technology (JRCERT). Frame error was controlled by assuring a current and accurate list was obtained from the JRCERT, and educator names and addresses were reviewed to assure duplicates were purged to control for selection error.


The electronic survey instrument used for this study was modeled after a nurse educators’ survey developed by Shell7


sample of 686. The initial mailing yielded 232 responses from program directors. A second e-mail was sent a week later and yielded another 85 responses for a total sample of 317, providing a 45.8% response rate.

Of the 317 respondents, 279 were radiography pro-gram directors and 38 were radiation therapy propro-gram directors. The largest numbers of program directors responding to the survey were affiliated with a 2-year community college. The second largest population rep-resented program directors from hospital certificate programs, followed by program directors employed at a 4-year college or university and by program directors affiliated with programs at a 2-year technical college. Program directors from proprietary programs represent-ed the smallest group responding to the survey. Although program directors responded from each region of the United States, the majority of the survey respondents resided in the Midwest and the Southeast. The majority of respondents’ highest level of education was a master’s degree followed by a doctorate. It is interesting to note that 29 program directors reported an education level at or below the bachelor’s degree (see Table 1).

The age of the respondents ranged from 29 to 69 years with an average age of 50.3 years. Years of expe-rience as a radiologic science educator ranged from 1 to 40 years with an average of 18.2 years, and the aver-age percentaver-age of time devoted to teaching was 53% (see Table 2).

Instrument Reliability

The internal consistency of the survey was estab-lished using Cronbach’s alpha coefficient for the sur-vey questions pertaining to each of the variables. The Pearson correlations were used to assess correlations

between the program director’s age and years of experi-ence and perceived confidexperi-ence, importance, skill level, or ability to assess critical thinking. A Spearman rho cor-relation was calculated to assess a cor-relationship between the program director’s educational level and his or her perception of the importance of critical thinking. A 1-way analysis of variance (ANOVA) was calculated to determine variances within and between groupings of respondents based on age, education level, and type of institution in which they are employed.


Study Sample

An electronic invitation to participate in the survey was sent to 692 individuals. Six participant e-mails were returned stating they were either on sabbatical, no longer teaching, or the e-mail was not deliverable, leaving a total

Table 1

Respondent Education Level and Educational Institution Information

Type of Educational Institution n (%) 4-year college/university 59 (18.6) 2-year community college 131 (41.3) 2-year technical college 28 (8.8) Hospital certificate program 93 (29.3) Proprietary program 6 (1.9) Region Where Educational

Program Resides n (%) Northeast 61 (19.2) Southeast 83 (26.2) Midwest 97 (30.6) South Central 32 (10.1) Northwest 17 (5.4) Southwest 27 (8.5) Highest Level of Program

Directors’ Education n (%) Doctorate 22 (6.9) Master’s Degree 266 (83.9) Bachelor’s Degree 18 (5.7) Associate Degree 8 (2.5) Other 3 (0.9) Table 2

Respondent Age and Experience

Average Age Range Standard Deviation 50.3 years 29-69 years 8.2 Average Years as Radiologic Science Educator Range Standard Deviation 18.2 years 1-40 years 9.9 Average Percentage of Time Devoted to Teaching Range Standard Deviation 53% 10-100% 25.4


closer the coefficient is to 1, the greater the internal consistency of the items.12

The Cronbach’s alpha coef-ficients demonstrated moderate to high reliability for questions related to each construct as follows: educators’ confidence in the use of critical thinking strategies and assessments, ␣ = .84; the importance of critical thinking,

␣ = .77; skill in teaching critical thinking, ␣ = .77; and the ability to assess students’ critical thinking skills,

␣ = .62.

Level of Confidence in Strategy and Assessment Use

The program directors reporting a positive level of confidence in their use of strategies to teach and assess critical thinking in the classroom and clinical setting was 3.8 on a 6-point scale (standard deviation [SD] = 0.6). Only 37% of the respondents indicated they felt confident in their abilities to teach critical thinking skills, and only 39% indicated they could model critical thinking behaviors. When the program directors were asked if they needed further professional development to incorporate critical thinking into their teaching methods, 70.9% agreed or slightly agreed.

Level of Importance Placed on Critical Thinking

The importance program directors place on criti-cal thinking in the classroom and clinicriti-cal setting was measured using 9 survey questions. The mean measure-ment of importance was a 5.1 (SD = 0.5), indicating the respondents agreed that critical thinking is an impor-tant concept in education, and it should be imple-mented in radiologic science educational programs. A large percentage of the respondents agreed or strongly agreed critical thinking was necessary for success of the student, that critical thinking is a valuable education outcome, and that critical thinking is a primary objec-tive of their teaching. Most respondents felt that using critical thinking skills in the classroom can enhance the students’ skills and that it is important to assess the students’ ability to think critically.

To determine if the program directors’ education level was associated with their perceptions of the impor-tance of critical thinking, a Spearman correlation was conducted. The Spearman rho coefficient (r = 0.009;

P = .9) indicated no relationship between the 2 factors.

Level of Skill in Using Critical Thinking Strategies in the Classroom

Program directors’ perceived skill level was evalu-ated using 16 questions relating to their ability to dem-onstrate, model, or use strategies when incorporating

critical thinking into their teaching. It also measured satisfaction with their critical thinking methods. The mean score for the questions relating to the level of skill was 4.1 on a 6-point scale (SD = 0.6).

The majority of program directors (52%) agreed their teaching strategies are designed to promote criti-cal thinking skills; however, they did not highly rate their abilities to teach, demonstrate, implement, or assess critical thinking skills or new strategies, indicat-ing the need for further professional development. In the open-ended responses, program directors indicat-ed attendance at professional seminars or continuing education sessions were the most common develop-ment strategies used to further enhance teaching skills. Other development strategies included reading or researching topics pertaining to critical thinking and completion of advanced degree course work.

A 1-way ANOVA was calculated to determine if the program director’s level of skill, confidence in his or her critical thinking skills, and ability to assess critical think-ing, as well as the level of importance they place on criti-cal thinking in the classroom, were significantly different by education level and by the type of radiologic science program in which the program director was employed. As indicated in Table 3, there was no significance between the education level and the level of importance. There also was no significance between the education level and the program director’s ability to assess criti-cal thinking. Level of confidence and level of skill were significantly different based on the program director’s highest level of education. The level of education within the institution was not significant for the 4 variables. A post hoc analysis using the Scheffé method was used to

Table 3

Influence of Program Director Education Level and Type of Academic Institution on Teaching Critical Thinking

Variable Program Director Education Level Type of Academic Institution F Sig. F Sig. Level of confidence 2.68 0.05 0.38 0.82 Level of importance 1.44 0.23 1.26 0.29 Level of skill 3.08 0.03 0.31 0.88 Ability to assess 1.62 0.19 1.34 0.25 F = Frequency, Sig. = Significance


for instructors to learn new teaching methods; and (4) lack of student motivation to become critical thinkers.

The fourth section allowed an open-ended response regarding other obstacles encoun-tered in incorporating critical thinking skills. Of the 127 responses to the open question regarding obstacles, very few new obstacles were identi-fied. The lack of faculty acceptance and reinforcement, as well as the need for a clear definition of “critical thinking” specific to our profession, was listed by 4 respondents. One respondent identified the need for facilities for authentic assessment, and 1 respondent identified that retaining a behaviorist curriculum emphasizing behavioral objective outcomes leads to rote memorization skills. Forty-eight respondents reit-erated a lack of time because of constraints related to administrative duties and the need to cover a large amount of coursework in a limited time frame.

It is interesting to note that although lack of appro-priate teaching materials was ranked eighth of the 17 obstacles listed, this item was the second most frequent-ly mentioned obstacle in the open-ended responses (see Table 6). Additionally, although obstacles related to educators’ knowledge of and expertise in implement-ing and assessimplement-ing critical thinkimplement-ing teachimplement-ing methods ranked in the lower third of the responses, this area comprised the third most frequently mentioned obsta-cle in the open-ended section of the survey.

Current Use of Critical Thinking Teaching Strategies

Of the 317 individuals responding to this survey, 81% provided information in the open-ended por-tion of the survey describing how they believe they incorporate critical thinking in their classroom. This high percentage appears encouraging; however, few of the teaching methods listed by program directors have been successfully used by nursing and other allied health professions to promote critical thinking skills. This finding emphasizes the need for a clear definition of critical thinking in the radiologic sciences and a need to develop critical thinking educational resources for radiologic science educators. Although actively further analyze the differences in the program directors’

education level compared with their level of confidence and level of skill. The test reported the greatest signifi-cance for both perceived confidence (mean difference = 0.6; P = .05) and skill level (mean difference = 0.4;

P = .03) between program directors holding a doctoral degree and a master’s degree. Those program directors holding a doctorate were more confident and perceived a higher level of skill in using critical thinking strategies in the classroom.

A Pearson correlation was used to determine if the program director’s age or years of experience related to perceived confidence, importance, skill level, or abil-ity to assess (see Table 4). A significant correlation was not demonstrated between age or experience and the 4 variables. However, a high correlation was identified between the program directors’ perceived level of skill and their confidence in critical thinking (r = 0.8;

P≤ .001) and their perceived level of skill and their per-ceived ability to assess the students’ critical thinking (r = 0.8; P≤ .001). Although program directors perceive critical thinking skill assessment as imperative to the development of student skills, the results of this survey demonstrated a large variation in the program direc-tors’ perception of their ability to assess critical think-ing assignments.

Obstacles to the Use of Critical Thinking Teaching Methods

The third section of the survey elicited responses from the program directors regarding the frequency in which they face specific obstacles when implement-ing critical thinkimplement-ing teachimplement-ing methods (see Table 5). The most frequently reported obstacles were: (1) the need to deliver a large amount of information to cover content; (2) student concerns of getting a good grade vs actually learning the content; (3) insufficient time

Table 4

Correlation Between Variables and Program Director Age and Experience Variable Age Experience in education

Pearson Corr. Sig. (2-tailed) Pearson Corr. Sig. (2-tailed) Level of confidence 0.01 0.83 0.05 0.37 Level of importance 0.04 0.51 -0.09 0.11 Level of skill 0.05 0.36 0.01 0.83 Ability to assess -0.02 0.80 0.03 0.63 Correlation is significant at the 0.01 level (2-tailed).



A student’s ability to apply critical think-ing skills is not only developed by the indi-vidual but also is fos-tered in the classroom setting. Educators play a vital role in the over-all process, yet little is known about edu-cators’ perceptions and abilities to apply critical thinking skills in the classroom.13,14

It is assumed educa-tors are experienced critical thinkers and are therefore able to use teaching strate-gies effectively to help students develop their own skills. Yet evidence shows gaps exist between what the educators may believe to be critical thinking and their abilities to promote it within the class-room.15,16

Mangena and Chabeli found the facilitation of critical thinking was impeded by nurse educators’ lack of critical thinking knowledge.6

Educators need to keep abreast of changes in their field of education and the need for critical think-ing in developthink-ing lifelong learners in the students. To do so, educators must continually reflect on their teaching skills, update critical thinking methods, and increase their knowledge of critical thinking.

Results of this survey showed program directors are fairly confident in their ability to teach or demonstrate critical thinking, although they also expressed a need for further professional development. These findings sup-port previous research that emphasizes the imsup-portance of modeling.5,6,15,16

When educators lack strong critical think-ing skills, they cannot model this behavior to students. Within the radiologic sciences, almost all instructors were first educated and employed as practitioners, and many engaging students in the classroom supports adult

learning theories such as experiential learning and situated cognition, active engagement in the classroom does not necessarily lead to the development of criti-cal thinking skills. The classroom activities included in the responses that are supported by research studies regarding critical thinking educational strategies in nursing and medicine include:

■ Team-based learning. ■ Collaborative projects. ■ Simulation modules.

■ Scenarios with alternate methods/solutions. ■ Concept mapping.

■ Problem-based learning modules.

■ Reflective journaling and portfolio development. ■ Research reports/critical analysis papers.

Table 5

Obstacles Encountered When Implementing Critical Thinking Strategies

Obstacle Frequencya

Need to deliver a large amount of information to cover content. 3.48 Student concerns of getting a good grade vs learning. 3.44 Insufficient time to learn new teaching methods. 3.16 Lack of student motivation to become critical thinkers. 3.11 Lack of time for preparing and planning critical thinking

teaching strategies.

3.00 Student expectation of lecture format instruction. 3.00 Student resistance to active learning. 2.91 Lack of appropriate instructional materials. 2.88 Insufficient class time. 2.87 Lack of time in assessing student critical thinking skills. 2.87 Lack of knowledge of how to promote students’ critical

thinking skills.

2.6 Difficulty in assessing student work that reflects critical


2.55 Feelings of unpreparedness to teach critical thinking skills. 2.49 Lack of knowledge of what constitutes critical thinking. 2.38 Large number of students per class. 2.11 Lack of administrative support in developing new teaching


1.98 Fear of negative student evaluations. 1.75



Confidence in using critical thinking teaching strategies may take years to develop, and advanced education helps to formulate adult learning methods and ideas. This survey demonstrated a significant dif-ference in the program directors’ confidence based on highest level of education; program directors holding radiologic science educators have not pursued additional

coursework in educational methodology and adult learn-ing.17

This hinders the ability of radiologic science educa-tors to serve as good critical thinking models, limits their ability to implement critical thinking teaching methods, and limits their ability to assess student progress.

Table 6

Perceived Barriers to Implementing Critical Thinking Teaching Strategies

Topic Comments

Lack of appropriate teaching materials Lack of continuing education information regarding improvement of critical thinking skills.

Lack of facilities for authentic assessment.

Critical thinking materials/texts/exercises relevant to radiation therapy seem to be completely lacking.

Lack of textbooks to supplement. Lack of good educational presentations. Lack of good educational materials/scenarios. Lack of instructional resources/materials/models.

Examples of critical thinking activities used by other radiologic science edu-cators would be valuable.

Laboratory resources. Instructional models. Easy access to ideas.

My area of expertise is radiation physics. I would love some suggestions for how to incorporate critical thinking into that class that wouldn’t take up too much of my 3-hour lecture once a week. Critical thinking is fun, but I com-pletely fill my 3 hours of time with lecture. I would need more time if I did more of the fun learning.

Educators’ knowledge of and expertise in implementing and assessing critical thinking teaching methods

Better understanding of how to teach critical thinking.

Need more education, support, and tools on how to teach critical thinking. Difficulty in persuading clinical instructors to view critical thinking as a teach-able skill.

I sometimes am spread a bit too thin to be as creative as I might be otherwise. It would be nice to have examples from other instructors on critical thinking methods they use.

Just lack of knowledge on how to do it.

Lack of continuing education info regarding improvement of critical thinking skills. Need fundamental knowledge to begin the process of critical thinking. Unsure how to apply to all areas of radiographic imaging.

Critical thinking activities I have seen are “high schoolish” and are like a game, and we do not have the luxury of the time to play games.


review the content material and, more importantly, manipulate it to focus on critical thinking strategies in the context of professional practice.6,14

This allows stu-dents to think about content from a different perspec-tive and reflect on application in clinical practice.

The results of this study demonstrated the program directors’ ages and years of teaching experience were not related to their skills in teaching critical reason-ing. This contradicts the findings of Zygmont and Schaefer,5

who suggest educators advanced in age are less likely to engage in critical evaluation, lack the abil-ity to transfer information from 1 situation to another, and tend to apply an inflexible approach to education-al situations.

This survey identified limited support from admin-istration (ie, workload demands on the educator were high) and that funding for tools to implement critical thinking strategies were not provided. Factors often expressed in the open-ended responses included concerns regarding a lack of materials, instructional resources, exercises, or tools needed to teach critical thinking. Raymond and Profetto-McGrath presented similar barriers to implementing new teaching meth-ods, including intensive workloads, strict content delivery, not allowing time for new ideas, fellow faculty members who were unreceptive to critical thinking, and students who displayed negative attitudes toward critical thinking ideas used in class.8

Nonetheless, they suggested positive influences such as faculty develop-ment opportunities, administrative support, freedom to experiment with new ideas, and mentorship could help overcome these perceived barriers.


The study has several limitations. Of the 817 radio-logic science programs existing at the time of this study, only 86.5% maintain JRCERT program accredi-tation. Because the survey only targeted program directors associated with JRCERT-accredited programs, the results can only be generalized to this population. Additionally, this study only solicited information from program directors; therefore, not all levels of educa-tors within the radiologic sciences programs are repre-sented. The questionnaire used in this study captured self-reported perceptions of the program directors and therefore is not a direct measurement of their actual critical thinking abilities or teaching and assessment skills. The response rate also limits the generalizability of this study, as nonrespondents may hold different per-ceptions than those responding to the survey.

a doctoral degree reported the highest confidence level within the study. This also is supported through the open-ended responses in which program directors stated they have developed their critical thinking skills and teaching methods through advanced-level educa-tion courses. However, only 0.15% of technologists credentialed by the American Registry of Radiologic Technologists hold a doctorate, and these individuals are not all employed in education.18 In fact, the major-ity of academic institutions with a radiologic science program do not traditionally offer tenure positions or promote doctoral degree attainment. This great dispar-ity between radiologic science educators compared with other disciplines in 2-year and 4-year institutions in terms of tenure status negatively affects professionalism in the discipline.19

Thus, we inadvertently may be creat-ing an additional barrier specific to our profession that inhibits the implementation of critical thinking educa-tional methods.

Respondents to this survey agreed with the necessity of applying critical thinking skills in the classroom, and they valued its development as an educational outcome for the student. Devoting classroom time to critical thinking activities continues to be a barrier because instructors seem to prefer lecturing to convey content. These findings suggest that helping students develop critical thinking is not yet a high priority for most edu-cators. Additionally, more than 30% of respondents expressed concern regarding their ability to assess the students’ skills in critical thinking. This implies educa-tors may be unsure of how to combine content cover-age with the development of critical thinking skills, and these findings support previous research.7,10

Students not only need the content material to understand their profession, but they also need instruction on apply-ing the knowledge usapply-ing critical thinkapply-ing. Educators should acknowledge that total coverage of content is the purpose of textbooks, and they should avoid lectur-ing facts that can be obtained from other resources; instead, they should provide students with guidelines to help develop problem-solving or decision-making skills.

In the radiologic sciences, the profession drives course content. However, curriculum guides only pro-vide the content, and it is the educator’s responsibility to define the mechanisms that will enable the students to grasp the knowledge.11,20

Students must be able to create a relationship between content and professional practice because true learning only occurs through application of the new knowledge. Researchers have demonstrated that a better method may be to merely


professional courses. Perhaps these academic faculty and programs could serve as role models for radiologic science educators.

Results also indicate the highest level of education held by program directors is a significant factor in their perceived confidence, ability to model critical think-ing skills, and ability to assess student critical thinkthink-ing skills regardless of the institutional level of education (ie, baccalaureate, associate, or certificate) of the aca-demic program. Many of the educators expressed a need for professional development in critical thinking educational methods. Research demonstrates a low number of radiologic science educators prepared at the doctoral level and tenure levels lagging behind other disciplines.18

These important educational issues must be addressed by our profession to move forward in a positive direction.


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Implications and Need for Further Research

The number of faculty in the radiologic sciences prepared at the doctoral level lags behind nursing and many other health disciplines, which also may serve as a barrier in implementing critical thinking teaching methods in the radiologic science educational arena. Because many radiologic science programs are housed in community colleges, the lack of appointment, pro-motion, and tenure terminal-degree requirements for faculty also may limit the number of faculty obtaining doctorates. Additionally, radiologic science faculty generally carry high teaching loads compared with other allied health disciplines, regardless of the type of academic institution in which they are employed, thus limiting time availability for continued professional development and curricular revisions.

Limited research is available specific to the radio-logic sciences in terms of measureable educational out-comes; therefore, rigorous research is needed in refer-ence to critical thinking teaching methods that provide measureable positive outcomes in student performance. In addition, an evaluation of educational research con-ducted in other health disciplines is warranted and may provide important information to radiologic science educators regarding exemplary teaching strategies and curricular integration.


The results of this survey suggested radiologic sci-ence program directors value the importance of imple-menting critical thinking teaching methods. Students must be encouraged to develop alternative methods of thinking through interpretation, analysis, evaluation, inferences, and explanations of information as it relates to the evidence applied to the radiologic sciences. Barriers in applying critical thinking teaching strate-gies identified in this study include:

■ Balancing limited classroom time with the need to deliver a significant amount of content information. ■ Student resistance to critical thinking teaching


■ Lack of student motivation.

■ High instructional workloads resulting in insuf-ficient time for program directors to learn and implement new teaching methods.

■ The lack of appropriate teaching materials. A review of the literature demonstrates similar obstacles in nursing and other allied health disciplines. However, many programs have overcome the barriers and integrate critical thinking teaching strategies into


Nina Kowalczyk, PhD, R.T.(R)(CT)(QM), FASRT, is an assistant professor in the radiologic sciences and therapy department in the School of Allied Medical Professions at The Ohio State University in Columbus. She is also chairman of the Radiologic Technology Editorial Review Board.

Ruth Hackworth, MS, R.T.(R)(T), is the radiation therapy program director in the radiologic sciences and therapy depart-ment in the School of Allied Medical Professions at The Ohio State University.

Jane Case-Smith, EdD, OTR/L, FAOTA, is a profes-sor and chairperson of the occupational therapy division in the School of Allied Medical Professions at The Ohio State University.

scales. Course presented at: Midwest Research to Practice Conference in Adult, Continuing, and Community Education; October 8-10, 2003; Columbus, OH.

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