摘要：Critical thinking is a necessary component of clinical reasoning that should be addressed as part of the graduate curriculum for occupational therapists. For students to apply critical thinking in practice they must also have confidence and minimal anxiety about their abilities. Case-based learning was chosen to address critical thinking skill development, increase confidence, and decrease anxiety. The purpose of this mixed methods pilot study was to evaluate progressively independent engagement with case-based learning on student performance, confidence, and anxiety in applying critical thinking skills in the clinical setting. Critical thinking was measured using a rubric to assess students’ performance in analyzing the case studies with decreasing levels of instructor guidance over the semester. Confidence and anxiety levels were measured using a Likert confidence and anxiety scale at the start and end of the semester. Qualitative data was collected through telephone interviews to determine ways in which classroom activities translated to a clinical setting and to elicit student feedback about the lesson design and what they felt they learned in class after the first Level II fieldwork. All three areas of critical thinking, confidence, and anxiety improved, demonstrating a significance of p<0.001. Overall, results of this pilot study suggest that case studies using the format of progressively independent engagement may help improve critical thinking and confidence and reduce anxiety. Also, although limited by the small number of participants, the qualitative content analysis indicated that students found the case studies helpful to develop and apply critical thinking to their fieldwork experiences.
