From exams to engagement: A writing-intensive redesign to strengthen critical thinking in undergraduate nursing

Abstract

Objective Undergraduate nursing research and data analysis courses are foundational to evidence-based practice yet are frequently perceived as abstract and disconnected from clinical care. This study describes an instructional redesign that transitioned from an exam-centered model to a writing-intensive, guided learning approach to improve engagement, critical thinking, and clinical relevance.

Methods A structured pedagogical redesign incorporated writing-intensive assessment, guided skeletal notes, unfolding case studies, and interactive learning tools within a concept-based undergraduate nursing curriculum. A pre-post descriptive design was used to compare course-based assessment scores (analysis, application, and critical thinking) across multiple semesters. Qualitative data from student course evaluations were analyzed to assess perceived engagement, clarity, and relevance to nursing practice.

Results Following implementation, analysis and application scores increased by approximately 7%, while course-based measures of critical thinking improved by 6%. Continued refinement of the instructional approach was associated with sustained improvements, with analysis and application averages reaching 95%-98% in subsequent semesters. Student evaluations further indicated increased engagement, improved clarity of content, enhanced relevance to nursing practice, and greater confidence in applying evidence-based concepts.

Conclusions Writing-intensive, scaffolded instructional strategies grounded in learning science and concept-based education was associated with improvements in course-based measures of critical thinking and professional identity formation in undergraduate nursing education.

Keywords

Active learning / Clinical judgment / Concept-based curriculum / Evidence-based practice / Nursing education / Writing-intensive instruction

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