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 casebased 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.
