Developing critical thinking through the application of high fidelity simulation on medical students

Desarrollo del pensamiento crítico mediante la simulación de alta fidelidad con estudiantes de medicina
Nancy de los Ángeles Segura-Azuaraa, Johanna Lizbeth Valencia Castroa, Mildred Vanessa López Cabreraa,*

a Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, NL, México.

Recibido: 9-julio-2017. Aceptado: 29-septiembre-2017.

* Autor para correspondencia: Mildred V. López Cabrera. Tel: 52/81 8888 2071.
Correo electrónico:

Palabras Clave

Simulación clínica; Pensamiento crítico; Fisiopatología.


Clinical simulation; Critical thinking; Pathophysiology.


Introduction: Critical thinking explores the causes and consequences of actions that lead to the knowledge generation, this is vital for the training of health professionals. One commonly used strategy for its development is clinical simulation. The aim of this study was to evaluate whether clinical simulation develops critical thinking in medical students.

Method: This is a quantitative, descriptive and quasi-experimental study, in which 46 students participated. As an instrument, the Individual Generic Skills Test was used to assess critical thinking in three dimensions: Interpretation and analysis of information; Judgment of a specific situation with objective and subjective data; and Inference of the consequences of the decision based on self-regulated judgment. Two cases were designed and applied: acute renal failure and glomerulonephritis. As part of the analysis we used the t-student test as well as descriptive statistics.

Results: When comparing the general average obtained in the critical thinking competence, a t-student of 0.1549 was obtained, indicating with a 95% confidence interval that the means did not have a significant difference. No significant differences were found when comparing the means by dimension.

Conclusions: The evidence from this study indicates that the simulation does not develop critical thinking skills. One explanation for the small difference between pre and post-test results was the short time elapsed between the first and second application of the questionnaire. In the future, this experience will be repeated, leaving more time between evaluations, which would allow a closer image of the students’ development.