Date of Award

Fall 9-20-2022

Degree Type


Degree Name

PhD Health Sciences


Health and Medical Sciences


Genevieve Pinto Zipp, Ed.D.

Committee Member

Deborah Deluca, JD

Committee Member

Anthony D'Antoni, Ph.D.


Critical thinking, mind mapping, learning strategy, respiratory therapy, Health Science Reasoning Test (HSRT)


Background: Respiratory Therapists (RTs) work in stressful settings such as intensive care units, and emergency departments to address the cardiopulmonary needs of individuals. With the increasing demands of all healthcare professionals, including RTs, to practice safely and proficiently when entering the workforce, the academy must ensure that RT students possess the Critical Thinking Skills (CTS) needed to infuse sound evidence-based practices. Given the condensed period of academic preparation, RT students, like other healthcare professionals, must quickly acquire the knowledge and skills that will enable them to transition from students to practitioners. Among the many learning strategies employed in the academy to enhance healthcare professional student learning, understanding, and internalization of course work, the use of mind mapping stands out as a plausible strategy to facilitate critical thinking, organization, interaction, and retention of knowledge. However, the use of mind mapping in the respiratory discipline has not been specifically explored; thus, it cannot be inferred that based on the successfulness of this learning strategy in medical and other healthcare professional students that it will also be effective for RT students. Therefore, in this study, the use of mind maps as an active teaching and learning strategy to enhance CTS in RT students was explicitly investigated.

Methods: The study was conducted in two RT programs in Saudi Arabia. King Saud bin Abdulaziz University for Health Sciences in Riyadh and The Batterjie Medical College in Jeddah. An email containing the study’s letter of solicitation and a link to a prerecorded Microsoft Teams video presentation discussing the study protocol was sent to the two programs for recruitment. Participants were randomly assigned to either the MMG or SNTG. The MMG practiced MMs, and the SNTG continued their preferred learning strategy throughout the 15- week period. A pre- and post-Health Science Reasoning Test (HSRT) link was sent to be XII completed by the participants to measure their overall critical thinking scores at baseline and after 15 weeks of intervention. Mean comparisons were made between pre & post overall HSRT scores for the MMG and SNTG using a dependent t-test. Mean comparisons were also conducted on post-overall HSRT between the post-MMG and SNTG using an independent t-test.

Results: There was not a significant change between the pre & post SNTG as measured by the HSRT after 15 weeks of SNT using the HSRT. There was a significant difference between the pre- and post-MMG (p = .02) as measured by the HSRT after 15 weeks of intervention. There was also a significant change between the post-MMG and SNTG (p = .04) as measured by the HSRT after 15 weeks of intervention, where MMG had higher scores.

Conclusions: Critical thinking scores for undergraduate Saudi RTs are weak. The introduction and use of MM as a teaching and learning strategy for 15 weeks promoted CTS as compared to SNT approaches for RT students. As a result, MM is a potential robust learning strategy to promote critical thinking.

Keywords: Critical thinking, mind mapping, learning strategy, respiratory therapy.

Available for download on Thursday, September 16, 2027