The Effects of Case-Based Learning on Critical Thinking Skills among Nursing Students

Main Article Content

Chutima Jirathikrengkrai
Jiraporn Kesornsuwan


This quasi-experimental research aimed to compare the critical thinking skills of nursing students before and after using case-based learning, and to study the level of satisfaction of the nursing students. The participants were 105 third-year nursing students who enrolled in the mental health and psychiatric nursing course at Metharath University. The research instruments consisted of five processes of case-based learning lesson plans, handouts, the critical thinking skill test, and the satisfaction questionnaires. Data were analyzed using descriptive statistics; means, standard deviations, and a paired t-test. The results indicate that after receiving case-based learning, the mean score of critical thinking skills in nursing students was significantly higher than before that case-based learning (p-value .05). The level of satisfaction of nursing students with case-based learning in all aspects was the highest (mean=4.72, S.D.=0.24). Case-based learning can improve the critical thinking skills of nursing students. Therefore, this teaching approach should be utilized also in other courses to improve the critical thinking skills of nursing students continuously.

Article Details

How to Cite
Jirathikrengkrai, C., & Kesornsuwan, J. (2024). The Effects of Case-Based Learning on Critical Thinking Skills among Nursing Students. Journal of Education and Innovative Learning, 4(1), 51–64. Retrieved from
Research Articles


Ar-yuwat, S., Sangkamkul, C., & Kitreerawutiwong, K. (2019). The effects of problem-based learning on critical thinking among baccalaureate nursing students. Journal of Research in Nursing-Midwifery and Health Sciences, 39(2), 87-97. [in Thai]

Azizi-Fini, I., Hajibagheri, A., & Adib-Hajbaghery, M. (2015). Critical thinking skills in nursing students: a comparison between freshmen and senior students. Nursing and Midwifery Studies, 4(1), e25721. doi:10.17795/nmsjournal25721

Bormann, S. von., Khumkom, S., Khaobunmasiri, S., Wajanatinapart, P., & Jai-ai, R. (2022). Effects of team-based learning on critical thinking, problem solving skills, and attitudes towards learning in second-year nursing students. Nursing Journal of The Ministry of Public Health, 32(2), 22-35. [in Thai]

Burucu, R., & Arslan, S. (2021). Nursing students’ views and suggestions about case-based learning integrated into the nursing process: A qualitative study. Florence Nightingale Journal of Nursing, 29(3), 371-378. doi:10.5152/FNJN.2021.20180

Chang, M. J., Chang, Y. J., Kuo, S. H., Yang, Y. H., & Chou, F. H. (2011). Relationships between critical thinking ability and nursing competence in clinical nurses. Journal of Clinical Nursing, 20(21-22), 3224-3232. doi:10.1111/j.1365-2702.2010.03593.x

Fesler-Birch, D. M. (2005). Critical thinking and patient outcomes: a review. Nursing Outlook, 53(2), 59-65. doi:10.1016/j.outlook.2004.11.005

Holland, C., & Ulrich, D. (2016). Critical thinking cards: An innovative teaching strategy to bridge classroom knowledge with clinical decision making. Teaching and Learning in Nursing, 11(3), 108-112. doi:10.1016/j.teln.2016.01.005

Hong, S., & Yu, P. (2017). Comparison of the effectiveness of two styles of case-based learning implemented in lectures for developing nursing students' critical thinking ability: A randomized controlled trial. International Journal of Nursing Studies, 68, 16-24. doi:10.1016/j.ijnurstu.2016.12.008

Khorphon, S., Pankeaw, J., Sarobol, T., Choopun, K., Chomchan, S., & Boonlue, N. (2019). Promoting of critical thinking skills in nursing students through reflective thinking. Nursing Journal CMU, 46(1), 87-101. [in Thai]

Kim, N. H., Park, J. Y., & Jun, S. E. (2015). The effects of case-based learning (CBL) on learning motivation and learning satisfaction of nursing students in a human physiology course. Journal of Korean Biological Nursing Science, 17(1), 78-87. doi:10.7586/jkbns.2015.17.1.78

Kuluski, K., Ho, J. W., Hans, P. K., & Nelson, M. (2017). Community care for people with complex care needs: bridging the gap between health and social care. International Journal Of Integrated Care, 17(4), 2. doi:10.5334/ijic.2944

Kusoom, W., & Hengyotmakt, A. (2019). The effects of case-based learning on nursing students’ knowledge retention. Academic Journal Bangkokthonburi University, 8(1), 187-196. [in Thai]

Li, S. S., Ye, X. C., & Chen, W. T. (2019). Practice and effectiveness of "nursing case-based learning" course on nursing student's critical thinking ability: A comparative study. Nurse Education in Practice, 36, 91-96. doi:10.1016/j.nepr.2019.03.007

McLean, S. F. (2016). Case-based learning and its application in medical and health-care fields: a review of worldwide literature. Journal of Medical Education and Curricular Development, 3, JMECD.S20377. doi:10.4137/JMECD.S20377

Sannathimmappa, M., Nambiar, V., & Arvindakshan, R. (2019). Implementation and evaluation of case-based learning approach in microbiology and immunology. International Journal of Medical Research & Health Sciences, 8(1), 1-5.

Sapeni, M. A. A. R., & Said, S. (2020). The effectiveness of case-based learning in increasing critical thinking of nursing students: A literature review. Enfermería Clínica, 30(2), 182-185. doi:10.1016/j.enfcli.2019.07.073

Shohani, M., Bastami, M., Gheshlaghi, L. A., & Nasrollahi, A. (2023). Nursing student's satisfaction with two methods of CBL and lecture-based learning. BMC medical education, 23(1), 48. doi:10.1186/s12909-023-04028-3

Srisawad, K., & Chaleoykitti, S. (2017). Critical thinking of nursing students. Royal Thai Army Medical Journal, 70(3), 169-174. [in Thai]

Tsekhmister, Y. (2023). Effectiveness of case-based learning in medical and pharmacy education: A meta-analysis. Electronic Journal of General Medicine, 20(5), em515. doi:10.29333/ejgm/13315

Watson, G., & Glaser, E. M. (1964). Watson-glaser critical thinking appraisal. New York: Harcourt, Brace, and World.

Williams, B. (2005). Case based learning-a review of the literature: is there scope for this educational paradigm in prehospital education?. Emergency Medicine Journal, 22(8), 577-581. doi:10.1136/emj.2004.022707

Yurdanur, D. (2016). Critical thinking competence and dispositions among critical care nurses: a descriptive study. International Journal of Caring Sciences, 9(2), 489-495.

Zuriguel Pérez, E., Lluch Canut, M. T., Falcó Pegueroles, A., Puig Llobet, M., Moreno Arroyo, C., & Roldan Merino, J. (2015). Critical thinking in nursing: scoping review of the literature. International Journal of Nursing Practice, 21(6), 820-830. doi:10.1111/ijn.12347