Effect of concept mapping on critical thinking skills in nursing students: a systematic review with meta-analysis

Clinical Snapshot

Key Findings

• P Value: CT: p=0.0004; Academic: p=0.01; Clinical: p<0.0001

• Effect Size: MD = 4.86 (CT skills); MD = 3.38 (academic achievement); MD = 5.94 (clinical performance)

• Primary Outcome: Concept mapping significantly improved critical thinking skills in nursing students compared to routine instructional methods

• Nnt Or Sensitivity: Not applicable (educational intervention); standardised mean differences would be more interpretable than raw MDs given instrument heterogeneity — SMD values not reported in abstract despite being stated as the outcome measure in the methods

• Confidence Interval: CT: 95% CI [2.16, 7.56]; Academic: 95% CI [0.76, 5.99]; Clinical: 95% CI [3.22, 8.65]

Clinical Application

Concept mapping is a low-cost, scalable pedagogical tool requiring minimal additional resources beyond faculty training. Implementation feasibility is high in both classroom and clinical simulation environments. Faculty development in CM facilitation is a prerequisite for effective deployment. Australian nursing education is governed by the Nursing and Midwifery Board of Australia (NMBA) under AHPRA, with accreditation standards set by the Australian Nursing and Midwifery Accreditation Council (ANMAC). The NMBA Registered Nurse Standards for Practice (2016) explicitly require critical thinking and clinical reasoning competencies. Concept mapping aligns with these standards and could be incorporated into Bachelor of Nursing curricula across Australian universities. The RACGP and relevant nursing peak bodies (ACN, ANMF) have not issued specific guidelines on CM, but the evidence base supports its consideration in curriculum review processes. No PBS or TGA implications apply to this educational intervention. Undergraduate and postgraduate nursing students in structured educational programmes, particularly those undertaking clinical placements where critical thinking is formally assessed

Abstract

BACKGROUND: Critical thinking (CT) among nursing students is crucial for delivering high-quality nursing care to patients. Concept mapping (CM) is one of the evidence-based pedagogies that helps to improve CT in individuals. OBJECTIVES: The objective of this review and meta-analysis was to evaluate the impact of concept mapping on CT abilities, academic achievement, and clinical skills in nursing students. METHODS: This systematic review and meta-analysis aimed to identify published articles on the effect of CM on CT in nursing students, written in English and published from 2011 to 2024. The articles were sourced from SCOPUS, Web of Science (WoS), ScienceDirect, Google Scholar, and PubMed databases. To ensure a comprehensive and relevant search, the following MeSH terms were used: "Effectiveness" OR "Impact," AND "Concept Mapping," AND "CT," AND "Nursing Student," AND "RCT" OR "Randomized Controlled Trials" OR "Quasi-Experimental." This study used the Cochrane Collaboration's Risk of Bias (RoB) tool and Standardized Mean Difference (SMD) for outcome measurement, with results analyzed using RevMan Web. RESULTS: This study analyzed 14 RCTs and quasi-experimental studies involving 1,747 participants (E=870, C=877). The meta-analysis found that concept mapping enhanced nursing students' CT skills (MD=4.86, 95 % CI [2.16 to 7.56], p=0.0004), academic achievements (MD=3.38, 95 % CI [0.76 to 5.99], p=0.01), and performance in clinical practice (MD=5.94, 95 % CI [3.22 to 8.65], p<0.0001) when compared to routine instructional methods. CONCLUSIONS: CM provides valuable insights into enhancing CT and clinical skills in nursing students, eventually preparing them to become excellent nursing professionals in the healthcare system.

References

1. 1.Devi, S., & Thapa, M. (2026). Effect of concept mapping on critical thinking skills in nursing students: a systematic review with meta-analysis. International Journal of Nursing Education Scholarship. https://doi.org/10.1016/j.cedpsych.2020.101899