Critical thinking skills in midwifery practice: Development of a self-assessment tool for students

- Strategies to develop students' critical thinking may not be explicit in curricula.
- Students need guidance to develop their critical thinking in practice.
- There are few freely available standardised tools on critical thinking.
- CACTiM was found to be a valid and reliable tool for use by midwifery students.

ObjectiveDevelop and test a tool designed for use by pre-registration midwifery students to self-appraise their critical thinking in practice.DesignA descriptive cohort design was used.ParticipantsAll students (n=164) enrolled in a three-year Bachelor of Midwifery program in Queensland, Australia.MethodsThe staged model for tool development involved item generation, mapping draft items to critical thinking concepts and expert review to test content validity, pilot testing of the tool to a convenience sample of students, and psychometric testing. Students (n=126, 76.8% response rate) provided demographic details, completed the new tool, and five questions from the Motivated Strategies for Learning Questionnaire (MSLQ) via an online platform or paper version.FindingsA high content validity index score of 0.97 was achieved through expert review. Construct validity via factor analysis revealed four factors: seeks information, reflects on practice, facilitates shared decision making, and evaluates practice. The mean total score for the tool was 124.98 (SD=12.58). Total and subscale scores correlated significantly. The scale achieved good internal reliability with a Cronbach's alpha coefficient of 0.92. Concurrent validity with the MSLQ subscale was 0.35 (p<0.001).ConclusionThis study established the reliability and validity of the CACTiM - student version for use by pre-registration midwifery students to self-assess critical thinking in practice.Implications for practiceCritical thinking skills are vital for safe and effective midwifery practice. Students' assessment of their critical thinking development throughout their pre-registration programme makes these skills explicit, and could guide teaching innovation to address identified deficits. The availability of a reliable and valid tool assists research into the development of critical thinking in education and practice.