The Effect of Case-Based Learning on Nursing Students’ Critical Thinking Skills Acquisition at Higher Educational Institutions in Northern Region of Malaysia

Background: Critical thinking skills (CTS) are fundamental to effective decision-making in emergency nursing. However, many nursing students continue to demonstrate inadequate levels of critical thinking skills competence.
Objective: This study aimed to examine the effectiveness of case-based learning (CBL) in enhancing nursing students’ CTS acquisition in emergency nursing subject.
Methods: A quasi-experimental design with non-equivalent groups was conducted at two higher educational institutions located in Northern region of Malaysia. A total of 101 participants recruited with 50 in control group received didactic lectures (DL), while another 51 in experimental group took part in CBL. Critical thinking skills were assessed using a standardized multiple-choice CTS assessment tool.
Results: Results at baseline found most students demonstrated low to moderate levels of CTS in emergency nursing. Analysis of demographic factors on academic grade, prerequisite qualification, and nursing as a first-choice career found non-significant association with CTS acquisition. Following the intervention, students in the CBL group demonstrated significantly greater improvements in CTS compared to those in the DL group (p < .001) with a significant effect size (d = 1.25).
Conclusions: Overall, the findings suggest that CBL is a more effective and engaging pedagogical approach than traditional lecture method for enhancing critical thinking skills in emergency nursing education, regardless of students’ academic background or career preference.

Case-based learning; Critical thinking skills; Emergency nursing education; Didactic lecture; Nursing students; Quasi-experimental study

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