Quality Enhancement Plan

Every 10 years, institutions of higher education are required to engage in a process of reaffirmation of accreditation with their geographic regional accrediting organization. The Texas A&M University Health Science Center will be reviewed by the Southern Association of Colleges and Schools (SACS) on March 5-8, 2012.

What is a QEP?

As part of this process, institutions are required to develop a Quality Enhancement Plan (QEP) which is a blueprint for a five-year course of action to enhance student learning. The QEP must be based on needs identified at the institution. SACS requires a broad base of constituencies to be included in the topic selection, development and implementation of the plan, as well as assessment of the effectiveness of the plan’s activities in improving student learning.

What is our QEP?

CARE: Critically Appraise Relevant Evidence, the HSC QEP, originated in a request for proposal topics from the Texas A&M Health Science Center community. Through an evaluation and voting process that included faculty, staff, and students, a winning proposal was selected. CARE proposes to enhance the processes through which we teach and practice our belief that all people “deserve the benefits of compassionate care, superior science and exceptional health education.”

What do we want to achieve?

The goals of CARE are to 1) develop students’ critical thinking skills, 2) develop students’ evidence-based decision making skills, and 3) develop capacity and resources to teach critical thinking and evidence-based decision making.

What is Critical Thinking?

Critical thinking is defined as “self-guided, self-disciplined thinking which attempts to reason at the highest level of quality in a fair-minded way” (Elder, 2007) and as “purposeful, reflective, judgment concerning what to believe and what should be done” (Facione & Facione, 2008).

What is Evidence-Based Decision Making?

Also called evidence-based practice, it’s the integration of the best research evidence with clinical expertise and patient values (Sackett et al., 2000).

Why this topic?

Emerging health care professionals must be taught to efficiently and effectively evaluate, synthesize, and apply vast amounts of data—scientific research, clinical results, best practices, facts, and figures. Within this deluge, the practitioner’s decisions must reflect patients’ histories, social- cultural issues, and preferences. Important criteria to be included in the making of clinical decisions are the practitioner’s own knowledge, skill, ability and experience. Health care providers taught to critically appraise relevant evidence will be better prepared to identify and deliver the best health care options.

Are we ready?

Work by HSC and academic component committees during the preparatory years (fall 2010 through spring 2012) has involved design of the project, baseline testing of students’ critical thinking skills, and provision of initial faculty development opportunities. Assessment of these activities indicates the need for building greater infrastructure related to faculty members’ expertise in the areas of critical thinking and evidence-based decision making. We will also introduce innovative methods for teaching and assessing students’ learning and application of these skills in classroom, clinical, and community environments. Starting in fall 2012, the first year of CARE will be devoted to building institutional capacity to fully implement the project through the creation, testing, and modification of online instructional modules to support instruction and the provision of extensive faculty development. Workshops for faculty will include a series of offerings led by experts from outside and within HSC on topics including: critical thinking, evidence-based decision making, use of the modules, teaching strategies/methods, and a variety of assessment means.

How will it work?

The first year’s activities will lay the groundwork for classroom implementation of CARE. Then, in fall 2013, students entering in the six academic units (Dentistry, Medicine, Nursing, Pharmacy, Graduate Studies, Rural Public Health) will be introduced to the basics of critical thinking skills and evidence-based decision making through online instructional modules embedded in selected courses. Additional courses will expand upon this basic instruction through teaching of advanced concepts and how the skills apply to specific professions. Delivery mode and content for advanced instruction and practice with these skills will differ among components to ensure alignment with standards and competencies required by each profession.

How will we know if it works?

Faculty members will demonstrate their knowledge of critical thinking skills and evidence-based decision making though design and implementation of instruction and assessment of students in their respective academic components.

Students’ scores on standardized tests of critical thinking skills will show a significant increase from pretest upon matriculation to posttest at graduation. Students will demonstrate their ability to use critical thinking skills to appraise evidence resulting in competent clinical diagnostic assessments and use of appropriate preventive or corrective interventions.

Who is involved?

The HSC-level CARE Planning Committee includes members from each of the six academic units who are advised by committees at their respective academic units. A team of library faculty members from the Texas A&M University Medical Sciences Library will assist with development of online instructional modules. Faculty and students at all academic units will participate in CARE.

When will this happen?

The timeline envisioned will include baseline/pretesting of critical thinking skills in summer or fall of 2011-2016 for incoming students and post-testing in spring before their graduation. Faculty development activities specific to CAREbegan in summer 2011 and will continue through the five years of the program. Development of the online modules began in fall 2011 and will continue through the first two years of the program. Modification of modules will be based on feedback from faculty and student participants and results of the brief quizzes following each module. In fall 2013, implementation of the online modules in courses selected by each academic unit will begin. Advanced instruction related to these topics, as determined by faculty, will follow in subsequent courses. Assessment of student learning will be conducted within the modules, through course-embedded methods and by summative measures specific to each profession, as well as identification of increases in critical thinking skills through comparison of pretest and posttest scores on standardized tests.

What are the CARE Goals and Outcomes?

Goal 1. Develop students’ skills in critical thinking.

Students will be able to apply critical thinking skills of:

  • Analysis and Interpretation
  • Inference
  • Evaluation and Explanation
  • Deductive Reasoning
  • Inductive Reasoning

Goal 2. Develop students’ skills in evidence-based decision making.

Students will be able to apply evidence-based decision making skills of:

  • Asking Focused Questions
  • Systematic Retrieval of Evidence
  • Critical Appraisal of Evidence
  • Application of Results to Practice
  • Evaluating Performance
  • Assessing or Designing Research

Goal 3. Develop capacity and resources to teach critical thinking and evidence-based decision making.

Faculty members will be trained to:

  • Assess critical thinking and evidence-based decision making skills
  • Identify appropriate teaching resources for didactic and clinical environments
  • Design instruction to enhance critical thinking and evidence-based decision making skills
  • Model the use of critical thinking and evidence-based decision making skills