Dr. Ann Ancona on encouraging critical thinking in health professions students

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We’re celebrating Women’s History Month with interviews from women across the health sector. In today’s episode, Dr. Ann Ancona from Kent State University College of Nursing tells you how she encourages her nursing students to think critically about patient care and communication.

March is Women’s History Month. To celebrate, we’re bringing you 3 interviews with women from across the health sector who all care about health equity and patient communication. Today’s episode is about critical thinking in patient education. Dr. Ann Ancona from Kent State University College of Nursing tells you how she encourages her nursing students to think critically.
Hi everybody, I’m Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication from Health Communication Partners. If you like this show, you’ll love our courses. Equitable Patient Education promotes high quality clinical practice in patient education by helping prevent avoidable errors. Learners say there's a lot of eye -opening information I hadn't considered before, and, this course helped me look at myself as an educator and helped me to step back and analyze how I can be a better nurse. For more information, visit healthcommunicationpartners.com.

Now I get to be back on mic with friend of the show Dr. Ann Ancona who is a pediatric nurse practitioner and educator. This time Dr Ancona talks about supporting her students to be better patient educators and communicators by encouraging critical thinking. Let’s hear what Dr. Ancona has to say.

Anne Marie; I’m live via Zoom with Dr. Ann Ancona. Dr. Ancona is Professor and Coordinator of the Pediatric Nurse Practitioner Concentration at Kent State University College of Nursing. And this is Dr. Ancona’s third time on this show. So Ann, welcome back to the show.

Dr. Ann Ancona: Thank you. It’s nice to be back.

Anne Marie: It’s great to see you again. and you and I got to see each other in real life recently!

Ann: We did. That was very nice.

AM: It never happens! I was traveling and we happened to be in the same place at the same time. I’m super glad to be back on mic with you.

Ann: Thank you. It’s really nice to be back too. I hadn’t realized it was so long since I was on the show.

AM: It has been. So the first time you were on the show was five years ago in 2019. And then you came back during COVID in 2020. So I’m really glad for people to have a chance to kind of catch up with you and hear what’s going on. When you were here in 2019, you picked up the really interesting issue of patient communication when that patient is a health professional themselves, or when the patient’s parent is a health professional themselves. And then when we came back during COVID, you were working with your students and you were having them reflect about their COVID experiences during your class using reflective practice. So those have been two really very interesting topics and issues that you chose to talk about. So I can’t wait to hear what is a topic in patient communication or patient education that you’re facing right now?

Well, what I’m facing right now, and have faced for a while now, is critical thinking. I like my students to reflect and really critically think about what they’re doing as students and as future healthcare professionals.

Mmmhmm, really important and also part of the reason I like having you back on the show. So how are you facing this issue of encouraging critical thinking in your students?

Well, I’ve realized over the years that the ability to think critically varies quite a lot between students. So I try to encourage the skill in all students and I think it’s important that they are invited to think critically rather than accept something at face value and go with that. So one of the things that I do is to include a critical thinking portion in all of my assignments. So this might include something like reading an article. They thoroughly review it, they compare that article to the care of a patient. And then I tell them to ask themselves, what would they have done differently after they read that article? Would they have cared for that patient in a different way? Would they have educated the parents in a different way? And then to take a little step further, how does that apply to their practice in their student role? And then as a future advanced practice nurse?

Mmm-hmm. I love that you’re starting with the inviting because you can’t force people to reflect, right?

Right

You can just you can only invite them to think critically. So what are you learning from inviting your students to think critically about patient communication and patient care?

Well, I’m learning that they often learn better from each other. I make a lot of comments on their assignments to kind of get that critical thinking going.

Yeah.

And the assignments to me are better for the students to read those because it makes them think, rather than just using it as an evaluation tool and giving them a grade. So I encourage them to read all of my comments, respond back to me with what they think about the comments or what they think about the patient. But then I’ve also learned– back to the point about them learning from themselves–is that one of my classes has a discussion board. And they talk about their patients they’ve been seeing in practicum, and share the information about the patient but also how they took care of that patient and what they thought about while they took care of that patient.

Ah.

So it used to be an assignment that they turned into me. but then I thought, well, this is great that they turned into me but it could be so much better if I let them kind of turn it in, so to speak, to each other and learn from that. which has been really great.

That’s what I was thinking. It’s got to be great because all of these people aren’t necessarily in the same specialty, right?

Correct. Yes, that’s correct. They are in different pediatric subspecialties. So the class I have now is rather small, but still makes for great conversation, and they can all talk about different patients depending where they are, Neurology or orthopedics or endocrinology, a variety of sub -specialties really which has been really great for them.

And a chance for them to learn from each other and hear what another specialty is doing and maybe someone from another specialty would have a certain perspective on their problem that they might not have thought of before.

Yes, exactly. and I love that part. It’s usually a very chatty discussion board, in a good way.

Love it! Love it!

They really do love, “oh this is so great, I learned this” or “this is what we did,” or “I came across something similar,” or “this is how my preceptor approached this but i would have done something different or extra.” It’s really and it’s actually is kinda fun to sorta hear them talk on the discussion board!

I mean, that’s what it’s about too, pushing in that kind of learning, or setting up the context where they can do that kind of learning. Now, we’re talking about this and when it’s working well, but have you learned anything about inviting students into this kind of critical reflection about, you know, what makes it a little bit difficult? Is there anything complicated, you know, how do you deal with that?

Yes, there are some complicated areas, mainly with students who don’t quite understand what it means to think critically. So their reflection might be just below the surface, but they’re not really getting into it. But I’ve noticed once I push a little bit or encourage them to think more outside just that patient, in all of the factors we need to think about, that they do better. So I want them to see that patient as a child first, and then they’re a patient. But that also encompasses their parents or siblings. Their household, if it’s smooth, if it’s chaotic. And then, older kids, I want them to think about how school affects whatever’s going on. Or their neighborhood, Is it safe or unsafe? And just more of that global approach to that patient. So once I start asking them more questions like that, then they’re better at, “Oh, yes, I didn’t think about this, but now I do, and here’s what I think about that.”

I love it, Ann. So you’re helping them, you’re scaffolding them to think critically by the way that you’re responding to them, the kinds of questions that you’re asking them, and the kinds of assignments that you’re designing so that they have a chance to learn from each other.

Yes.

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I’ll go the advice route.

Ok sounds good!

Just from what I’ve learned is that starting with critical thinking at the beginning of, for me, for my nurse practitioner program, I start with my first class that I have students. And for me it’s a fall semester. So I start right then with critical thinking. So they might not be great at it that’s okay. But I start there and keep building on that into different semesters and then I sort of rearrange it a little bit, like the student to student learning, as they get, as they become more familiar with each other in the classroom, and as they are more confident in their role as a student PNP. So I think that’s important not too much right at the beginning

Yeah sure you’re starting from the beginning but you’re not expecting too much.

Right

I think that’s a really important way to go about it too. You’re not kind of saving the critical thinking as something that we can kind of sprinkle on later.

Right

Like, no, it’s core to what we’re doing.

Yes, and one more piece of advice too is I have my beginning students write their philosophy of what it means for them to be a Pediatric Nurse Practitioner. Then they go through the program. And then at the end, I tell them to save that. And then at the end, they have to go back and reread their first philosophy, reflect on that, and tell me what they learned about themselves as a student and themselves as a soon to be graduated advanced practice nurse. And I love that, too. That’s it’s very eye opening for them.

I bet! I bet it. is. Oh, wow, how great for them to read. And also, gosh, interesting for you to read. Well, Dr. Ancona, this is another, I mean, you’re knocking them out of the park. Thank you so much for coming back on the show and giving us a chance to learn from you about this topic of encouraging critical thinking in the nurse force. And I really appreciate your coming back on the show today.

Thank you, thank you for having me back again. It’s always fun to talk to you.

Yay! Thanks again to Dr. Ann Ancona from Kent State University College of Nursing. I’ll link to Dr. Ancona’s bio and program in the show notes. Transcripts for this and all episodes available at healthcommunicationpartners.com with links to relevant research and resources. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional Music by Alexis Rounds. Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners LLC.

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