Date of Award


Document Type

Doctoral Dissertation

Degree Name

Education, Ed.D.



First Advisor

Sally Hood

Second Advisor

Ellyn Arwood

Third Advisor

Eric Anctil

LC Subjects

Medical students--Training of; Medicine--Study and teaching--Simulation methods; Critical thinking--Study and teaching


The purpose of this study was to examine the effects of a simulation-based training on the critical thinking skills of 10 graduate medical education trainees to understand the potential of simulation-based training as an innovative tool to improve medical competencies among trainees in a graduate medical training program. The theoretical framework incorporated in this study focused on the Five-Stage Model of Adult Skill Acquisition by Dreyfus and Dreyfus and the Theory of Andragogy by Malcolm Knowles to examine how adults learn in a medical simulation-based training setting. This study utilized a pre-and posttest, the AAC&U VALUE Critical Thinking Rubric, and individual interviews with trainees after the simulation. In analyzing pre/posttest scores, a paired samples t-test revealed that all 10 trainees showed a small growth in critical thinking regarding the management of a patient with cardiogenic shock based on hemodynamics by 0.30. A summary of the rubric study findings reported that third-year trainees received the highest critical thinking scores, while first-year trainees received the lowest critical thinking scores. Participant mean scores on the rubric also showed a correlation in the progression of training year to increased critical thinking in their use of hemodynamics to manage patient with cardiogenic shock. Post-simulation interviews with study participants reflected four major themes that included: (a) discrepancies in frequency and classification of simulation training, (b) the simulation learning environment, (c) from theory to practice, and (d) the impact of simulation training on clinical practice. The results of this study indicated the amount of prior exposure a trainee has to the medical competency that is being addressed in the simulation may have an influence on how the trainee perceives the value of the training. This study also found the amount of interaction that a rater has with the trainee may cultivate a bias in how they evaluate the trainee’s procedural and theoretical knowledge. The researcher recommends the implementation of a cohesive simulation curriculum for graduate medical education training programs. The researcher also recommends providing trainees with adequate exposure to simulation that is meaningful, practical, and relevant to their training to elevate the trainees overall learning experience


Copyright for this work is retained by the author.