collaborative problem solving evidence based practice

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• Published: 11 January 2023

The effectiveness of collaborative problem solving in promoting students’ critical thinking: A meta-analysis based on empirical literature

• Enwei Xu   ORCID: orcid.org/0000-0001-6424-8169 1 ,
• Wei Wang 1 &
• Qingxia Wang 1  

Humanities and Social Sciences Communications volume  10 , Article number:  16 ( 2023 ) Cite this article

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Collaborative problem-solving has been widely embraced in the classroom instruction of critical thinking, which is regarded as the core of curriculum reform based on key competencies in the field of education as well as a key competence for learners in the 21st century. However, the effectiveness of collaborative problem-solving in promoting students’ critical thinking remains uncertain. This current research presents the major findings of a meta-analysis of 36 pieces of the literature revealed in worldwide educational periodicals during the 21st century to identify the effectiveness of collaborative problem-solving in promoting students’ critical thinking and to determine, based on evidence, whether and to what extent collaborative problem solving can result in a rise or decrease in critical thinking. The findings show that (1) collaborative problem solving is an effective teaching approach to foster students’ critical thinking, with a significant overall effect size (ES = 0.82, z  = 12.78, P  < 0.01, 95% CI [0.69, 0.95]); (2) in respect to the dimensions of critical thinking, collaborative problem solving can significantly and successfully enhance students’ attitudinal tendencies (ES = 1.17, z  = 7.62, P  < 0.01, 95% CI[0.87, 1.47]); nevertheless, it falls short in terms of improving students’ cognitive skills, having only an upper-middle impact (ES = 0.70, z  = 11.55, P  < 0.01, 95% CI[0.58, 0.82]); and (3) the teaching type (chi 2  = 7.20, P  < 0.05), intervention duration (chi 2  = 12.18, P  < 0.01), subject area (chi 2  = 13.36, P  < 0.05), group size (chi 2  = 8.77, P  < 0.05), and learning scaffold (chi 2  = 9.03, P  < 0.01) all have an impact on critical thinking, and they can be viewed as important moderating factors that affect how critical thinking develops. On the basis of these results, recommendations are made for further study and instruction to better support students’ critical thinking in the context of collaborative problem-solving.

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Introduction.

Although critical thinking has a long history in research, the concept of critical thinking, which is regarded as an essential competence for learners in the 21st century, has recently attracted more attention from researchers and teaching practitioners (National Research Council, 2012 ). Critical thinking should be the core of curriculum reform based on key competencies in the field of education (Peng and Deng, 2017 ) because students with critical thinking can not only understand the meaning of knowledge but also effectively solve practical problems in real life even after knowledge is forgotten (Kek and Huijser, 2011 ). The definition of critical thinking is not universal (Ennis, 1989 ; Castle, 2009 ; Niu et al., 2013 ). In general, the definition of critical thinking is a self-aware and self-regulated thought process (Facione, 1990 ; Niu et al., 2013 ). It refers to the cognitive skills needed to interpret, analyze, synthesize, reason, and evaluate information as well as the attitudinal tendency to apply these abilities (Halpern, 2001 ). The view that critical thinking can be taught and learned through curriculum teaching has been widely supported by many researchers (e.g., Kuncel, 2011 ; Leng and Lu, 2020 ), leading to educators’ efforts to foster it among students. In the field of teaching practice, there are three types of courses for teaching critical thinking (Ennis, 1989 ). The first is an independent curriculum in which critical thinking is taught and cultivated without involving the knowledge of specific disciplines; the second is an integrated curriculum in which critical thinking is integrated into the teaching of other disciplines as a clear teaching goal; and the third is a mixed curriculum in which critical thinking is taught in parallel to the teaching of other disciplines for mixed teaching training. Furthermore, numerous measuring tools have been developed by researchers and educators to measure critical thinking in the context of teaching practice. These include standardized measurement tools, such as WGCTA, CCTST, CCTT, and CCTDI, which have been verified by repeated experiments and are considered effective and reliable by international scholars (Facione and Facione, 1992 ). In short, descriptions of critical thinking, including its two dimensions of attitudinal tendency and cognitive skills, different types of teaching courses, and standardized measurement tools provide a complex normative framework for understanding, teaching, and evaluating critical thinking.

Cultivating critical thinking in curriculum teaching can start with a problem, and one of the most popular critical thinking instructional approaches is problem-based learning (Liu et al., 2020 ). Duch et al. ( 2001 ) noted that problem-based learning in group collaboration is progressive active learning, which can improve students’ critical thinking and problem-solving skills. Collaborative problem-solving is the organic integration of collaborative learning and problem-based learning, which takes learners as the center of the learning process and uses problems with poor structure in real-world situations as the starting point for the learning process (Liang et al., 2017 ). Students learn the knowledge needed to solve problems in a collaborative group, reach a consensus on problems in the field, and form solutions through social cooperation methods, such as dialogue, interpretation, questioning, debate, negotiation, and reflection, thus promoting the development of learners’ domain knowledge and critical thinking (Cindy, 2004 ; Liang et al., 2017 ).

Collaborative problem-solving has been widely used in the teaching practice of critical thinking, and several studies have attempted to conduct a systematic review and meta-analysis of the empirical literature on critical thinking from various perspectives. However, little attention has been paid to the impact of collaborative problem-solving on critical thinking. Therefore, the best approach for developing and enhancing critical thinking throughout collaborative problem-solving is to examine how to implement critical thinking instruction; however, this issue is still unexplored, which means that many teachers are incapable of better instructing critical thinking (Leng and Lu, 2020 ; Niu et al., 2013 ). For example, Huber ( 2016 ) provided the meta-analysis findings of 71 publications on gaining critical thinking over various time frames in college with the aim of determining whether critical thinking was truly teachable. These authors found that learners significantly improve their critical thinking while in college and that critical thinking differs with factors such as teaching strategies, intervention duration, subject area, and teaching type. The usefulness of collaborative problem-solving in fostering students’ critical thinking, however, was not determined by this study, nor did it reveal whether there existed significant variations among the different elements. A meta-analysis of 31 pieces of educational literature was conducted by Liu et al. ( 2020 ) to assess the impact of problem-solving on college students’ critical thinking. These authors found that problem-solving could promote the development of critical thinking among college students and proposed establishing a reasonable group structure for problem-solving in a follow-up study to improve students’ critical thinking. Additionally, previous empirical studies have reached inconclusive and even contradictory conclusions about whether and to what extent collaborative problem-solving increases or decreases critical thinking levels. As an illustration, Yang et al. ( 2008 ) carried out an experiment on the integrated curriculum teaching of college students based on a web bulletin board with the goal of fostering participants’ critical thinking in the context of collaborative problem-solving. These authors’ research revealed that through sharing, debating, examining, and reflecting on various experiences and ideas, collaborative problem-solving can considerably enhance students’ critical thinking in real-life problem situations. In contrast, collaborative problem-solving had a positive impact on learners’ interaction and could improve learning interest and motivation but could not significantly improve students’ critical thinking when compared to traditional classroom teaching, according to research by Naber and Wyatt ( 2014 ) and Sendag and Odabasi ( 2009 ) on undergraduate and high school students, respectively.

The above studies show that there is inconsistency regarding the effectiveness of collaborative problem-solving in promoting students’ critical thinking. Therefore, it is essential to conduct a thorough and trustworthy review to detect and decide whether and to what degree collaborative problem-solving can result in a rise or decrease in critical thinking. Meta-analysis is a quantitative analysis approach that is utilized to examine quantitative data from various separate studies that are all focused on the same research topic. This approach characterizes the effectiveness of its impact by averaging the effect sizes of numerous qualitative studies in an effort to reduce the uncertainty brought on by independent research and produce more conclusive findings (Lipsey and Wilson, 2001 ).

This paper used a meta-analytic approach and carried out a meta-analysis to examine the effectiveness of collaborative problem-solving in promoting students’ critical thinking in order to make a contribution to both research and practice. The following research questions were addressed by this meta-analysis:

What is the overall effect size of collaborative problem-solving in promoting students’ critical thinking and its impact on the two dimensions of critical thinking (i.e., attitudinal tendency and cognitive skills)?

How are the disparities between the study conclusions impacted by various moderating variables if the impacts of various experimental designs in the included studies are heterogeneous?

This research followed the strict procedures (e.g., database searching, identification, screening, eligibility, merging, duplicate removal, and analysis of included studies) of Cooper’s ( 2010 ) proposed meta-analysis approach for examining quantitative data from various separate studies that are all focused on the same research topic. The relevant empirical research that appeared in worldwide educational periodicals within the 21st century was subjected to this meta-analysis using Rev-Man 5.4. The consistency of the data extracted separately by two researchers was tested using Cohen’s kappa coefficient, and a publication bias test and a heterogeneity test were run on the sample data to ascertain the quality of this meta-analysis.

Data sources and search strategies

There were three stages to the data collection process for this meta-analysis, as shown in Fig. 1 , which shows the number of articles included and eliminated during the selection process based on the statement and study eligibility criteria.

This flowchart shows the number of records identified, included and excluded in the article.

First, the databases used to systematically search for relevant articles were the journal papers of the Web of Science Core Collection and the Chinese Core source journal, as well as the Chinese Social Science Citation Index (CSSCI) source journal papers included in CNKI. These databases were selected because they are credible platforms that are sources of scholarly and peer-reviewed information with advanced search tools and contain literature relevant to the subject of our topic from reliable researchers and experts. The search string with the Boolean operator used in the Web of Science was “TS = (((“critical thinking” or “ct” and “pretest” or “posttest”) or (“critical thinking” or “ct” and “control group” or “quasi experiment” or “experiment”)) and (“collaboration” or “collaborative learning” or “CSCL”) and (“problem solving” or “problem-based learning” or “PBL”))”. The research area was “Education Educational Research”, and the search period was “January 1, 2000, to December 30, 2021”. A total of 412 papers were obtained. The search string with the Boolean operator used in the CNKI was “SU = (‘critical thinking’*‘collaboration’ + ‘critical thinking’*‘collaborative learning’ + ‘critical thinking’*‘CSCL’ + ‘critical thinking’*‘problem solving’ + ‘critical thinking’*‘problem-based learning’ + ‘critical thinking’*‘PBL’ + ‘critical thinking’*‘problem oriented’) AND FT = (‘experiment’ + ‘quasi experiment’ + ‘pretest’ + ‘posttest’ + ‘empirical study’)” (translated into Chinese when searching). A total of 56 studies were found throughout the search period of “January 2000 to December 2021”. From the databases, all duplicates and retractions were eliminated before exporting the references into Endnote, a program for managing bibliographic references. In all, 466 studies were found.

Second, the studies that matched the inclusion and exclusion criteria for the meta-analysis were chosen by two researchers after they had reviewed the abstracts and titles of the gathered articles, yielding a total of 126 studies.

Third, two researchers thoroughly reviewed each included article’s whole text in accordance with the inclusion and exclusion criteria. Meanwhile, a snowball search was performed using the references and citations of the included articles to ensure complete coverage of the articles. Ultimately, 36 articles were kept.

Two researchers worked together to carry out this entire process, and a consensus rate of almost 94.7% was reached after discussion and negotiation to clarify any emerging differences.

Eligibility criteria

Since not all the retrieved studies matched the criteria for this meta-analysis, eligibility criteria for both inclusion and exclusion were developed as follows:

The publication language of the included studies was limited to English and Chinese, and the full text could be obtained. Articles that did not meet the publication language and articles not published between 2000 and 2021 were excluded.

The research design of the included studies must be empirical and quantitative studies that can assess the effect of collaborative problem-solving on the development of critical thinking. Articles that could not identify the causal mechanisms by which collaborative problem-solving affects critical thinking, such as review articles and theoretical articles, were excluded.

The research method of the included studies must feature a randomized control experiment or a quasi-experiment, or a natural experiment, which have a higher degree of internal validity with strong experimental designs and can all plausibly provide evidence that critical thinking and collaborative problem-solving are causally related. Articles with non-experimental research methods, such as purely correlational or observational studies, were excluded.

The participants of the included studies were only students in school, including K-12 students and college students. Articles in which the participants were non-school students, such as social workers or adult learners, were excluded.

The research results of the included studies must mention definite signs that may be utilized to gauge critical thinking’s impact (e.g., sample size, mean value, or standard deviation). Articles that lacked specific measurement indicators for critical thinking and could not calculate the effect size were excluded.

Data coding design

In order to perform a meta-analysis, it is necessary to collect the most important information from the articles, codify that information’s properties, and convert descriptive data into quantitative data. Therefore, this study designed a data coding template (see Table 1 ). Ultimately, 16 coding fields were retained.

The designed data-coding template consisted of three pieces of information. Basic information about the papers was included in the descriptive information: the publishing year, author, serial number, and title of the paper.

The variable information for the experimental design had three variables: the independent variable (instruction method), the dependent variable (critical thinking), and the moderating variable (learning stage, teaching type, intervention duration, learning scaffold, group size, measuring tool, and subject area). Depending on the topic of this study, the intervention strategy, as the independent variable, was coded into collaborative and non-collaborative problem-solving. The dependent variable, critical thinking, was coded as a cognitive skill and an attitudinal tendency. And seven moderating variables were created by grouping and combining the experimental design variables discovered within the 36 studies (see Table 1 ), where learning stages were encoded as higher education, high school, middle school, and primary school or lower; teaching types were encoded as mixed courses, integrated courses, and independent courses; intervention durations were encoded as 0–1 weeks, 1–4 weeks, 4–12 weeks, and more than 12 weeks; group sizes were encoded as 2–3 persons, 4–6 persons, 7–10 persons, and more than 10 persons; learning scaffolds were encoded as teacher-supported learning scaffold, technique-supported learning scaffold, and resource-supported learning scaffold; measuring tools were encoded as standardized measurement tools (e.g., WGCTA, CCTT, CCTST, and CCTDI) and self-adapting measurement tools (e.g., modified or made by researchers); and subject areas were encoded according to the specific subjects used in the 36 included studies.

The data information contained three metrics for measuring critical thinking: sample size, average value, and standard deviation. It is vital to remember that studies with various experimental designs frequently adopt various formulas to determine the effect size. And this paper used Morris’ proposed standardized mean difference (SMD) calculation formula ( 2008 , p. 369; see Supplementary Table S3 ).

Procedure for extracting and coding data

According to the data coding template (see Table 1 ), the 36 papers’ information was retrieved by two researchers, who then entered them into Excel (see Supplementary Table S1 ). The results of each study were extracted separately in the data extraction procedure if an article contained numerous studies on critical thinking, or if a study assessed different critical thinking dimensions. For instance, Tiwari et al. ( 2010 ) used four time points, which were viewed as numerous different studies, to examine the outcomes of critical thinking, and Chen ( 2013 ) included the two outcome variables of attitudinal tendency and cognitive skills, which were regarded as two studies. After discussion and negotiation during data extraction, the two researchers’ consistency test coefficients were roughly 93.27%. Supplementary Table S2 details the key characteristics of the 36 included articles with 79 effect quantities, including descriptive information (e.g., the publishing year, author, serial number, and title of the paper), variable information (e.g., independent variables, dependent variables, and moderating variables), and data information (e.g., mean values, standard deviations, and sample size). Following that, testing for publication bias and heterogeneity was done on the sample data using the Rev-Man 5.4 software, and then the test results were used to conduct a meta-analysis.

Publication bias test

When the sample of studies included in a meta-analysis does not accurately reflect the general status of research on the relevant subject, publication bias is said to be exhibited in this research. The reliability and accuracy of the meta-analysis may be impacted by publication bias. Due to this, the meta-analysis needs to check the sample data for publication bias (Stewart et al., 2006 ). A popular method to check for publication bias is the funnel plot; and it is unlikely that there will be publishing bias when the data are equally dispersed on either side of the average effect size and targeted within the higher region. The data are equally dispersed within the higher portion of the efficient zone, consistent with the funnel plot connected with this analysis (see Fig. 2 ), indicating that publication bias is unlikely in this situation.

This funnel plot shows the result of publication bias of 79 effect quantities across 36 studies.

Heterogeneity test

To select the appropriate effect models for the meta-analysis, one might use the results of a heterogeneity test on the data effect sizes. In a meta-analysis, it is common practice to gauge the degree of data heterogeneity using the I 2 value, and I 2  ≥ 50% is typically understood to denote medium-high heterogeneity, which calls for the adoption of a random effect model; if not, a fixed effect model ought to be applied (Lipsey and Wilson, 2001 ). The findings of the heterogeneity test in this paper (see Table 2 ) revealed that I 2 was 86% and displayed significant heterogeneity ( P  < 0.01). To ensure accuracy and reliability, the overall effect size ought to be calculated utilizing the random effect model.

The analysis of the overall effect size

This meta-analysis utilized a random effect model to examine 79 effect quantities from 36 studies after eliminating heterogeneity. In accordance with Cohen’s criterion (Cohen, 1992 ), it is abundantly clear from the analysis results, which are shown in the forest plot of the overall effect (see Fig. 3 ), that the cumulative impact size of cooperative problem-solving is 0.82, which is statistically significant ( z  = 12.78, P  < 0.01, 95% CI [0.69, 0.95]), and can encourage learners to practice critical thinking.

This forest plot shows the analysis result of the overall effect size across 36 studies.

In addition, this study examined two distinct dimensions of critical thinking to better understand the precise contributions that collaborative problem-solving makes to the growth of critical thinking. The findings (see Table 3 ) indicate that collaborative problem-solving improves cognitive skills (ES = 0.70) and attitudinal tendency (ES = 1.17), with significant intergroup differences (chi 2  = 7.95, P  < 0.01). Although collaborative problem-solving improves both dimensions of critical thinking, it is essential to point out that the improvements in students’ attitudinal tendency are much more pronounced and have a significant comprehensive effect (ES = 1.17, z  = 7.62, P  < 0.01, 95% CI [0.87, 1.47]), whereas gains in learners’ cognitive skill are slightly improved and are just above average. (ES = 0.70, z  = 11.55, P  < 0.01, 95% CI [0.58, 0.82]).

The analysis of moderator effect size

The whole forest plot’s 79 effect quantities underwent a two-tailed test, which revealed significant heterogeneity ( I 2  = 86%, z  = 12.78, P  < 0.01), indicating differences between various effect sizes that may have been influenced by moderating factors other than sampling error. Therefore, exploring possible moderating factors that might produce considerable heterogeneity was done using subgroup analysis, such as the learning stage, learning scaffold, teaching type, group size, duration of the intervention, measuring tool, and the subject area included in the 36 experimental designs, in order to further explore the key factors that influence critical thinking. The findings (see Table 4 ) indicate that various moderating factors have advantageous effects on critical thinking. In this situation, the subject area (chi 2  = 13.36, P  < 0.05), group size (chi 2  = 8.77, P  < 0.05), intervention duration (chi 2  = 12.18, P  < 0.01), learning scaffold (chi 2  = 9.03, P  < 0.01), and teaching type (chi 2  = 7.20, P  < 0.05) are all significant moderators that can be applied to support the cultivation of critical thinking. However, since the learning stage and the measuring tools did not significantly differ among intergroup (chi 2  = 3.15, P  = 0.21 > 0.05, and chi 2  = 0.08, P  = 0.78 > 0.05), we are unable to explain why these two factors are crucial in supporting the cultivation of critical thinking in the context of collaborative problem-solving. These are the precise outcomes, as follows:

Various learning stages influenced critical thinking positively, without significant intergroup differences (chi 2  = 3.15, P  = 0.21 > 0.05). High school was first on the list of effect sizes (ES = 1.36, P  < 0.01), then higher education (ES = 0.78, P  < 0.01), and middle school (ES = 0.73, P  < 0.01). These results show that, despite the learning stage’s beneficial influence on cultivating learners’ critical thinking, we are unable to explain why it is essential for cultivating critical thinking in the context of collaborative problem-solving.

Different teaching types had varying degrees of positive impact on critical thinking, with significant intergroup differences (chi 2  = 7.20, P  < 0.05). The effect size was ranked as follows: mixed courses (ES = 1.34, P  < 0.01), integrated courses (ES = 0.81, P  < 0.01), and independent courses (ES = 0.27, P  < 0.01). These results indicate that the most effective approach to cultivate critical thinking utilizing collaborative problem solving is through the teaching type of mixed courses.

Various intervention durations significantly improved critical thinking, and there were significant intergroup differences (chi 2  = 12.18, P  < 0.01). The effect sizes related to this variable showed a tendency to increase with longer intervention durations. The improvement in critical thinking reached a significant level (ES = 0.85, P  < 0.01) after more than 12 weeks of training. These findings indicate that the intervention duration and critical thinking’s impact are positively correlated, with a longer intervention duration having a greater effect.

Different learning scaffolds influenced critical thinking positively, with significant intergroup differences (chi 2  = 9.03, P  < 0.01). The resource-supported learning scaffold (ES = 0.69, P  < 0.01) acquired a medium-to-higher level of impact, the technique-supported learning scaffold (ES = 0.63, P  < 0.01) also attained a medium-to-higher level of impact, and the teacher-supported learning scaffold (ES = 0.92, P  < 0.01) displayed a high level of significant impact. These results show that the learning scaffold with teacher support has the greatest impact on cultivating critical thinking.

Various group sizes influenced critical thinking positively, and the intergroup differences were statistically significant (chi 2  = 8.77, P  < 0.05). Critical thinking showed a general declining trend with increasing group size. The overall effect size of 2–3 people in this situation was the biggest (ES = 0.99, P  < 0.01), and when the group size was greater than 7 people, the improvement in critical thinking was at the lower-middle level (ES < 0.5, P  < 0.01). These results show that the impact on critical thinking is positively connected with group size, and as group size grows, so does the overall impact.

Various measuring tools influenced critical thinking positively, with significant intergroup differences (chi 2  = 0.08, P  = 0.78 > 0.05). In this situation, the self-adapting measurement tools obtained an upper-medium level of effect (ES = 0.78), whereas the complete effect size of the standardized measurement tools was the largest, achieving a significant level of effect (ES = 0.84, P  < 0.01). These results show that, despite the beneficial influence of the measuring tool on cultivating critical thinking, we are unable to explain why it is crucial in fostering the growth of critical thinking by utilizing the approach of collaborative problem-solving.

Different subject areas had a greater impact on critical thinking, and the intergroup differences were statistically significant (chi 2  = 13.36, P  < 0.05). Mathematics had the greatest overall impact, achieving a significant level of effect (ES = 1.68, P  < 0.01), followed by science (ES = 1.25, P  < 0.01) and medical science (ES = 0.87, P  < 0.01), both of which also achieved a significant level of effect. Programming technology was the least effective (ES = 0.39, P  < 0.01), only having a medium-low degree of effect compared to education (ES = 0.72, P  < 0.01) and other fields (such as language, art, and social sciences) (ES = 0.58, P  < 0.01). These results suggest that scientific fields (e.g., mathematics, science) may be the most effective subject areas for cultivating critical thinking utilizing the approach of collaborative problem-solving.

The effectiveness of collaborative problem solving with regard to teaching critical thinking

According to this meta-analysis, using collaborative problem-solving as an intervention strategy in critical thinking teaching has a considerable amount of impact on cultivating learners’ critical thinking as a whole and has a favorable promotional effect on the two dimensions of critical thinking. According to certain studies, collaborative problem solving, the most frequently used critical thinking teaching strategy in curriculum instruction can considerably enhance students’ critical thinking (e.g., Liang et al., 2017 ; Liu et al., 2020 ; Cindy, 2004 ). This meta-analysis provides convergent data support for the above research views. Thus, the findings of this meta-analysis not only effectively address the first research query regarding the overall effect of cultivating critical thinking and its impact on the two dimensions of critical thinking (i.e., attitudinal tendency and cognitive skills) utilizing the approach of collaborative problem-solving, but also enhance our confidence in cultivating critical thinking by using collaborative problem-solving intervention approach in the context of classroom teaching.

Furthermore, the associated improvements in attitudinal tendency are much stronger, but the corresponding improvements in cognitive skill are only marginally better. According to certain studies, cognitive skill differs from the attitudinal tendency in classroom instruction; the cultivation and development of the former as a key ability is a process of gradual accumulation, while the latter as an attitude is affected by the context of the teaching situation (e.g., a novel and exciting teaching approach, challenging and rewarding tasks) (Halpern, 2001 ; Wei and Hong, 2022 ). Collaborative problem-solving as a teaching approach is exciting and interesting, as well as rewarding and challenging; because it takes the learners as the focus and examines problems with poor structure in real situations, and it can inspire students to fully realize their potential for problem-solving, which will significantly improve their attitudinal tendency toward solving problems (Liu et al., 2020 ). Similar to how collaborative problem-solving influences attitudinal tendency, attitudinal tendency impacts cognitive skill when attempting to solve a problem (Liu et al., 2020 ; Zhang et al., 2022 ), and stronger attitudinal tendencies are associated with improved learning achievement and cognitive ability in students (Sison, 2008 ; Zhang et al., 2022 ). It can be seen that the two specific dimensions of critical thinking as well as critical thinking as a whole are affected by collaborative problem-solving, and this study illuminates the nuanced links between cognitive skills and attitudinal tendencies with regard to these two dimensions of critical thinking. To fully develop students’ capacity for critical thinking, future empirical research should pay closer attention to cognitive skills.

The moderating effects of collaborative problem solving with regard to teaching critical thinking

In order to further explore the key factors that influence critical thinking, exploring possible moderating effects that might produce considerable heterogeneity was done using subgroup analysis. The findings show that the moderating factors, such as the teaching type, learning stage, group size, learning scaffold, duration of the intervention, measuring tool, and the subject area included in the 36 experimental designs, could all support the cultivation of collaborative problem-solving in critical thinking. Among them, the effect size differences between the learning stage and measuring tool are not significant, which does not explain why these two factors are crucial in supporting the cultivation of critical thinking utilizing the approach of collaborative problem-solving.

In terms of the learning stage, various learning stages influenced critical thinking positively without significant intergroup differences, indicating that we are unable to explain why it is crucial in fostering the growth of critical thinking.

Although high education accounts for 70.89% of all empirical studies performed by researchers, high school may be the appropriate learning stage to foster students’ critical thinking by utilizing the approach of collaborative problem-solving since it has the largest overall effect size. This phenomenon may be related to student’s cognitive development, which needs to be further studied in follow-up research.

With regard to teaching type, mixed course teaching may be the best teaching method to cultivate students’ critical thinking. Relevant studies have shown that in the actual teaching process if students are trained in thinking methods alone, the methods they learn are isolated and divorced from subject knowledge, which is not conducive to their transfer of thinking methods; therefore, if students’ thinking is trained only in subject teaching without systematic method training, it is challenging to apply to real-world circumstances (Ruggiero, 2012 ; Hu and Liu, 2015 ). Teaching critical thinking as mixed course teaching in parallel to other subject teachings can achieve the best effect on learners’ critical thinking, and explicit critical thinking instruction is more effective than less explicit critical thinking instruction (Bensley and Spero, 2014 ).

In terms of the intervention duration, with longer intervention times, the overall effect size shows an upward tendency. Thus, the intervention duration and critical thinking’s impact are positively correlated. Critical thinking, as a key competency for students in the 21st century, is difficult to get a meaningful improvement in a brief intervention duration. Instead, it could be developed over a lengthy period of time through consistent teaching and the progressive accumulation of knowledge (Halpern, 2001 ; Hu and Liu, 2015 ). Therefore, future empirical studies ought to take these restrictions into account throughout a longer period of critical thinking instruction.

With regard to group size, a group size of 2–3 persons has the highest effect size, and the comprehensive effect size decreases with increasing group size in general. This outcome is in line with some research findings; as an example, a group composed of two to four members is most appropriate for collaborative learning (Schellens and Valcke, 2006 ). However, the meta-analysis results also indicate that once the group size exceeds 7 people, small groups cannot produce better interaction and performance than large groups. This may be because the learning scaffolds of technique support, resource support, and teacher support improve the frequency and effectiveness of interaction among group members, and a collaborative group with more members may increase the diversity of views, which is helpful to cultivate critical thinking utilizing the approach of collaborative problem-solving.

With regard to the learning scaffold, the three different kinds of learning scaffolds can all enhance critical thinking. Among them, the teacher-supported learning scaffold has the largest overall effect size, demonstrating the interdependence of effective learning scaffolds and collaborative problem-solving. This outcome is in line with some research findings; as an example, a successful strategy is to encourage learners to collaborate, come up with solutions, and develop critical thinking skills by using learning scaffolds (Reiser, 2004 ; Xu et al., 2022 ); learning scaffolds can lower task complexity and unpleasant feelings while also enticing students to engage in learning activities (Wood et al., 2006 ); learning scaffolds are designed to assist students in using learning approaches more successfully to adapt the collaborative problem-solving process, and the teacher-supported learning scaffolds have the greatest influence on critical thinking in this process because they are more targeted, informative, and timely (Xu et al., 2022 ).

With respect to the measuring tool, despite the fact that standardized measurement tools (such as the WGCTA, CCTT, and CCTST) have been acknowledged as trustworthy and effective by worldwide experts, only 54.43% of the research included in this meta-analysis adopted them for assessment, and the results indicated no intergroup differences. These results suggest that not all teaching circumstances are appropriate for measuring critical thinking using standardized measurement tools. “The measuring tools for measuring thinking ability have limits in assessing learners in educational situations and should be adapted appropriately to accurately assess the changes in learners’ critical thinking.”, according to Simpson and Courtney ( 2002 , p. 91). As a result, in order to more fully and precisely gauge how learners’ critical thinking has evolved, we must properly modify standardized measuring tools based on collaborative problem-solving learning contexts.

With regard to the subject area, the comprehensive effect size of science departments (e.g., mathematics, science, medical science) is larger than that of language arts and social sciences. Some recent international education reforms have noted that critical thinking is a basic part of scientific literacy. Students with scientific literacy can prove the rationality of their judgment according to accurate evidence and reasonable standards when they face challenges or poorly structured problems (Kyndt et al., 2013 ), which makes critical thinking crucial for developing scientific understanding and applying this understanding to practical problem solving for problems related to science, technology, and society (Yore et al., 2007 ).

Suggestions for critical thinking teaching

Other than those stated in the discussion above, the following suggestions are offered for critical thinking instruction utilizing the approach of collaborative problem-solving.

First, teachers should put a special emphasis on the two core elements, which are collaboration and problem-solving, to design real problems based on collaborative situations. This meta-analysis provides evidence to support the view that collaborative problem-solving has a strong synergistic effect on promoting students’ critical thinking. Asking questions about real situations and allowing learners to take part in critical discussions on real problems during class instruction are key ways to teach critical thinking rather than simply reading speculative articles without practice (Mulnix, 2012 ). Furthermore, the improvement of students’ critical thinking is realized through cognitive conflict with other learners in the problem situation (Yang et al., 2008 ). Consequently, it is essential for teachers to put a special emphasis on the two core elements, which are collaboration and problem-solving, and design real problems and encourage students to discuss, negotiate, and argue based on collaborative problem-solving situations.

Second, teachers should design and implement mixed courses to cultivate learners’ critical thinking, utilizing the approach of collaborative problem-solving. Critical thinking can be taught through curriculum instruction (Kuncel, 2011 ; Leng and Lu, 2020 ), with the goal of cultivating learners’ critical thinking for flexible transfer and application in real problem-solving situations. This meta-analysis shows that mixed course teaching has a highly substantial impact on the cultivation and promotion of learners’ critical thinking. Therefore, teachers should design and implement mixed course teaching with real collaborative problem-solving situations in combination with the knowledge content of specific disciplines in conventional teaching, teach methods and strategies of critical thinking based on poorly structured problems to help students master critical thinking, and provide practical activities in which students can interact with each other to develop knowledge construction and critical thinking utilizing the approach of collaborative problem-solving.

Third, teachers should be more trained in critical thinking, particularly preservice teachers, and they also should be conscious of the ways in which teachers’ support for learning scaffolds can promote critical thinking. The learning scaffold supported by teachers had the greatest impact on learners’ critical thinking, in addition to being more directive, targeted, and timely (Wood et al., 2006 ). Critical thinking can only be effectively taught when teachers recognize the significance of critical thinking for students’ growth and use the proper approaches while designing instructional activities (Forawi, 2016 ). Therefore, with the intention of enabling teachers to create learning scaffolds to cultivate learners’ critical thinking utilizing the approach of collaborative problem solving, it is essential to concentrate on the teacher-supported learning scaffolds and enhance the instruction for teaching critical thinking to teachers, especially preservice teachers.

Implications and limitations

There are certain limitations in this meta-analysis, but future research can correct them. First, the search languages were restricted to English and Chinese, so it is possible that pertinent studies that were written in other languages were overlooked, resulting in an inadequate number of articles for review. Second, these data provided by the included studies are partially missing, such as whether teachers were trained in the theory and practice of critical thinking, the average age and gender of learners, and the differences in critical thinking among learners of various ages and genders. Third, as is typical for review articles, more studies were released while this meta-analysis was being done; therefore, it had a time limit. With the development of relevant research, future studies focusing on these issues are highly relevant and needed.

Conclusions

The subject of the magnitude of collaborative problem-solving’s impact on fostering students’ critical thinking, which received scant attention from other studies, was successfully addressed by this study. The question of the effectiveness of collaborative problem-solving in promoting students’ critical thinking was addressed in this study, which addressed a topic that had gotten little attention in earlier research. The following conclusions can be made:

Regarding the results obtained, collaborative problem solving is an effective teaching approach to foster learners’ critical thinking, with a significant overall effect size (ES = 0.82, z  = 12.78, P  < 0.01, 95% CI [0.69, 0.95]). With respect to the dimensions of critical thinking, collaborative problem-solving can significantly and effectively improve students’ attitudinal tendency, and the comprehensive effect is significant (ES = 1.17, z  = 7.62, P  < 0.01, 95% CI [0.87, 1.47]); nevertheless, it falls short in terms of improving students’ cognitive skills, having only an upper-middle impact (ES = 0.70, z  = 11.55, P  < 0.01, 95% CI [0.58, 0.82]).

As demonstrated by both the results and the discussion, there are varying degrees of beneficial effects on students’ critical thinking from all seven moderating factors, which were found across 36 studies. In this context, the teaching type (chi 2  = 7.20, P  < 0.05), intervention duration (chi 2  = 12.18, P  < 0.01), subject area (chi 2  = 13.36, P  < 0.05), group size (chi 2  = 8.77, P  < 0.05), and learning scaffold (chi 2  = 9.03, P  < 0.01) all have a positive impact on critical thinking, and they can be viewed as important moderating factors that affect how critical thinking develops. Since the learning stage (chi 2  = 3.15, P  = 0.21 > 0.05) and measuring tools (chi 2  = 0.08, P  = 0.78 > 0.05) did not demonstrate any significant intergroup differences, we are unable to explain why these two factors are crucial in supporting the cultivation of critical thinking in the context of collaborative problem-solving.

Data availability

All data generated or analyzed during this study are included within the article and its supplementary information files, and the supplementary information files are available in the Dataverse repository: https://doi.org/10.7910/DVN/IPFJO6 .

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Acknowledgements

This research was supported by the graduate scientific research and innovation project of Xinjiang Uygur Autonomous Region named “Research on in-depth learning of high school information technology courses for the cultivation of computing thinking” (No. XJ2022G190) and the independent innovation fund project for doctoral students of the College of Educational Science of Xinjiang Normal University named “Research on project-based teaching of high school information technology courses from the perspective of discipline core literacy” (No. XJNUJKYA2003).

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Xu, E., Wang, W. & Wang, Q. The effectiveness of collaborative problem solving in promoting students’ critical thinking: A meta-analysis based on empirical literature. Humanit Soc Sci Commun 10 , 16 (2023). https://doi.org/10.1057/s41599-023-01508-1

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Collaborative Problem Solving: An Evidence-Based Approach to Implementation and Practice (Current Clinical Psychiatry) 1st ed. 2019 Edition

This book is the first to systematically describe the key components necessary to ensure successful implementation of Collaborative Problem Solving (CPS) across mental health settings and non-mental health settings that require behavioral management. This resource is designed by the leading experts in CPS and is focused on the clinical and implementation strategies that have proved most successful within various private and institutional agencies. The book begins by defining the approach before delving into the neurobiological components that are key to understanding this concept. Next, the book covers the best practices for implementation and evaluating outcomes, both in the long and short term. The book concludes with a summary of the concept and recommendations for additional resources, making it an excellent concise guide to this cutting edge approach.

Collaborative Problem Solving is an excellent resource for psychiatrists,psychologists, social workers, and all medical professionals working to manage troubling behaviors. The text is also valuable for readers interested in public health, education, improved law enforcement strategies, and all stakeholders seeking to implement this approach within their program, organization, and/or system of care.

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The Collaborative Problem Solving approach: outcomes across settings

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• 1 From Harvard Medical School (Drs. Pollastri, Epstein, and Ablon); Department of Psychiatry, Massachusetts General Hospital, Boston, MA (Drs. Pollastri, Epstein, and Ablon); St. Andrew's Healthcare, Northampton, UK (Ms. Heath).
• PMID: 24651507
• DOI: 10.1097/HRP.0b013e3182961017

In the last decade, Collaborative Problem Solving (CPS) has become a popular approach to managing the challenging behaviors of children and adolescents, and has established a growing evidence base for reducing oppositional behavior and related outcomes. In contrast with standard behavioral methods that provide incentives for meeting adult expectations, CPS focuses on identifying and treating lagging cognitive skills that interfere with children's ability to meet these expectations. Since the majority of CPS outcomes have been evaluated in clinical and educational settings as part of internal quality-improvement efforts, only a small proportion of these findings has been published in peer-reviewed academic journals. Here, we describe the CPS approach and provide a summary of all known published and unpublished findings related to its implementation in outpatient, inpatient, residential, juvenile justice, and educational settings. Finally, we provide specific recommendations for future research on the model.

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Collaborative Problem Solving® (CPS)

About this program.

Target Population: Children and adolescents (ages 3-21) with a variety of behavioral challenges, including both externalizing (e.g., aggression, defiance, tantrums) and internalizing (e.g., implosions, shutdowns, withdrawal) who may carry a variety of related psychiatric diagnoses, and their parents/caregivers, unless not age appropriate (e.g. young adult or transition age youth)

For children/adolescents ages: 3 – 21

For parents/caregivers of children ages: 3 – 21

Program Overview

Collaborative Problem Solving® (CPS) is an approach to understanding and helping children with behavioral challenges who may carry a variety of psychiatric diagnoses, including oppositional defiant disorder, conduct disorder, attention-deficit/hyperactivity disorder, mood disorders, bipolar disorder, autism spectrum disorders, posttraumatic stress disorder, etc. CPS uses a structured problem solving process to help adults pursue their expectations while reducing challenging behavior and building helping relationships and thinking skills. Specifically, the CPS approach focuses on teaching the neurocognitive skills that challenging kids lack related to problem solving, flexibility, and frustration tolerance. Unlike traditional models of discipline, this approach avoids the use of power, control, and motivational procedures and instead focuses on teaching at-risk kids the skills they need to succeed. CPS provides a common philosophy, language and process with clear guideposts that can be used across settings. In addition, CPS operationalizes principles of trauma-informed care.

Program Goals

The goals of Collaborative Problem Solving® (CPS) are:

• Reduction in externalizing and internalizing behaviors
• Reduction in use of restrictive interventions (restraint, seclusion)
• Reduction in caregiver/teacher stress
• Increase in neurocognitive skills in youth and caregivers
• Increase in family involvement
• Increase in parent-child relationships
• Increase in program cost savings

Logic Model

View the Logic Model for Collaborative Problem Solving® (CPS) .

Essential Components

The essential components of Collaborative Problem Solving® (CPS) include:

• Three different types of intervention delivery to parents and/or children/adolescents depending on the personal situation:
• Family therapy sessions (conducted both with and without the youth) which typically take place weekly for approximately 10-12 weeks
• 4- and 8-week parent training curricula that teach the basics of the model to parents in a group format (maximum group size = 12 participants)
• Direct delivery to youth in treatment or educational settings in planned sessions or in a milieu
• In the family sessions or parent training sessions, parents receive:
• An overarching philosophy to guide the practice of the approach ("kids do well if they can")
• A specific assessment process and measures to identify challenging behaviors, predictable precipitants, and specific thinking skill deficits. Lagging thinking skills are identified in five primary domains:
• Language and Communication Skills
• Attention and Working Memory Skills
• Emotion and Self-Regulation Skills
• Cognitive Flexibility Skills
• Social Thinking Skills
• A specific planning process that helps adults prioritize behavioral goals and decide how to respond to predictable difficulties using 3 simple options based upon the goals they are trying to pursue:
• Plan A – Imposition of adult will
• Plan B – Solve the problem collaboratively
• Plan C – Drop the expectation (for now, at least)
• A specific problem solving process (operationalizing "Plan B") with three core ingredients that is used to collaborate with the youth to solve problems durably, pursue adult expectations, reduce challenging behaviors, teach skills, and create or restore a helping relationship.
• When directly working with the youth in treatment or education settings, providers engage youth with:

Program Delivery

Child/adolescent services.

Collaborative Problem Solving® (CPS) directly provides services to children/adolescents and addresses the following:

• A range of internalizing and externalizing behaviors, including (but not limited to) physical and verbal aggression, destruction of property, self-harm, substance abuse, tantrums, meltdowns, explosions, implosive behaviors (shutting down), crying, pouting, whining, withdrawal, defiance, and oppositionality

Parent/Caregiver Services

Collaborative Problem Solving® (CPS) directly provides services to parents/caregivers and addresses the following:

• Child with internalizing and/or externalizing behaviors, difficulty effectively problem solving with their child

Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Any caregivers, educators, and other supports are essential to the success of the approach. Caregivers, teachers and other adult supporters are taught to use the approach with the child outside the context of the clinical setting. School and clinical staff typically learn the model via single or multi-day workshops and through follow-up training and coaching.

Recommended Intensity:

Typically family therapy (in which the youth is the identified patient, but the parents are heavily involved in the sessions so that they can get better at using the approach with their child on their own) occurs once per week for approximately 1 hour. The approach can also be delivered in the home with greater frequency/intensity, such as twice a week for 90 minutes. Parent training group sessions occur once a week for 90 minutes over the course of 4 or 8 weeks. The approach can also be delivered by direct care staff in a treatment setting and/or educators in a school system, in which case delivery is not limited to scheduled sessions, but occurs in the context of regular contact in a residence or classroom.

Recommended Duration:

Family therapy: 8-12 weeks; In-home therapy: 8-12 weeks; Parent training groups: 4-8 weeks

Delivery Settings

This program is typically conducted in a(n):

• Adoptive Home
• Birth Family Home
• Foster / Kinship Care
• Outpatient Clinic
• Community-based Agency / Organization / Provider
• Group or Residential Care
• Justice Setting (Juvenile Detention, Jail, Prison, Courtroom, etc.)
• School Setting (Including: Day Care, Day Treatment Programs, etc.)

Collaborative Problem Solving® (CPS) includes a homework component:

Identifying specific precipitants, prioritizing behavioral goals, and practicing the problem solving process are expected to be completed by the caregiver and youth between sessions.

Collaborative Problem Solving® (CPS) has materials available in languages other than English :

Chinese, French, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative ( contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Trained personnel. If being delivered as parent group training, it requires a room big enough to hold the number of families (anywhere from a couple of parents up to 12 participants), as well as A/V equipment or printed materials for delivery of material in training curriculum.

Manuals and Training

Prerequisite/minimum provider qualifications.

Service providers and supervisors must be certified in CPS . There is no minimum educational level required before certification process can begin.

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Treatment Manual: Greene, R. W., & Ablon, J. S. (2005). Treating explosive kids: The Collaborative Problem Solving approach . Guilford Press.

Training Information

There is training available for this program.

Training Contact:

• Think: Kids at Massachusetts General Hospital [email protected] phone: (617) 643-6030

Training Type/Location:

Training can be obtained onsite, at Massachusetts General Hospital in Boston, at trainings hosted in other locations, online (introductory training only), or via video/phone training and coaching.

Number of days/hours:

Ranges from a 2-hour exposure training to more intensive (2.5 day) advanced sessions as well as hourly coaching:

• Exposure/Introductory training: These in-person and online trainings typically last from 2–6 hours and provide a general overview exposure of the model including the overarching philosophy, the assessment , planning and intervention process. Training can accommodate an unlimited number of participants.
• Two-and-a-half day intensive trainings that provide participants in-depth exposure to all aspects of the model using didactic training, video demonstration, role play and breakout group practice. Tier 1 training is limited to 150 participants. Tier 2 training is limited to 75 participants.
• Coaching sessions for up to 12 participants that provide ongoing support and troubleshooting in the model

Additional Resources:

There currently are additional qualified resources for training:

There are many certified trainers throughout North America who teach the model as well as well as systems that use the approach. The list is available at https://thinkkids.org/our-communities

Implementation Information

Pre-implementation materials.

There are pre-implementation materials to measure organizational or provider readiness for Collaborative Problem Solving® (CPS) as listed below:

A CPS Organizational Readiness Assessment measure has been developed that is available for systems interested in implementing the model. It can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at [email protected].

Formal Support for Implementation

There is formal support available for implementation of Collaborative Problem Solving® (CPS) as listed below:

For organization-wide implementation , Think:Kids offers formal implementation support, including ongoing coaching of staff to maximize practice fidelity , implementation consultation to the organization’s leader(s) or implementation team, and implementation /outcome monitoring and reporting. Organizations that opt for implementation support are matched with a Think:Kids Project Manager who helps coordinate the various training and implementation activities. There is a Manager of Implementation at Think:Kids who oversees these implementation supports.

Fidelity Measures

There are fidelity measures for Collaborative Problem Solving® (CPS) as listed below:

Self-Study of CPS Sustainability, Updated 06/2019 : A guide for systems to assess the degree to which they have put the structures in place to implement CPS with fidelity .

CPS Manualized Expert-Rated Integrity Coding System (CPS-MEtRICS) and Practice Integrity Form (CPS-PIF) : Fidelity tools to help measure the degree to which CPS is being practiced with fidelity in a specific encounter.

Both of the above can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at [email protected]

Established Psychometrics:

Pollastri, A. R., Wang, L., Raftery-Helmer, J. N., Hurley, S., Eddy, C. J., Sisson, J., Thompson, N., & Ablon, J. S. (2022). Development and evaluation of an audio coding system for assessing providers’ integrity to Collaborative Problem Solving in youth-service settings. Professional Psychology: Research and Practice, 53 (6), 640–650. https://doi.org/10.1037/pro0000476

Wang, L., Stoll, S. J., Eddy, C. J., Hurley, S., Sisson, J., Thompson, N., Raftery-Helmer, J., Ablon, J. S., & Pollastri, A. R. (2023). Pragmatic fidelity measurement in youth service settings. Implementation Research and Practice . Advanced online publication. https://doi.org/10.1177/26334895231185380

Implementation Guides or Manuals

There are implementation guides or manuals for Collaborative Problem Solving® (CPS) as listed below:

Clinician Session Guide : Guides the clinician in all aspects of the treatment, from initial assessment to ongoing work. Can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri, at [email protected].

CPS Coaching Guide : A guide specifically geared towards trainer individuals who are helping caregivers to implement the model over time. Available to certified trainers.

CPS Implementation Manual : Provides detailed implementation guideposts and instructions for those implementing CPS system-wide. Available to organizations opting for CPS implementation support from Think:Kids. More information available from the Manager of Implementation , Hallie Carpenter, at [email protected]

Implementation Cost

There are no studies of the costs of Collaborative Problem Solving® (CPS) .

Research on How to Implement the Program

Research has been conducted on how to implement Collaborative Problem Solving® (CPS) as listed below:

Ercole-Fricke, E., Fritz, P., Hill, L. E., & Snelders, J. (2016). Effects of a Collaborative Problem Solving approach on an inpatient adolescent psychiatric unit. Journal of Child and Adolescent Psychiatric Nursing, 29 (3), 127–134. https://doi.org/10.1111/jcap.12149

Pollastri, A. R., Boldt, S., Lieberman, R., & Ablon, J. S. (2016). Minimizing seclusion and restraint in youth residential and day treatment through site-wide implementation of Collaborative Problem Solving. Residential Treatment for Children & Youth, 33 (3-4), 186–205. https://doi.org/10.1080/0886571X.2016.1188340

Pollastri, A. R., Ablon, J. S., & Hone, M. J. (Eds.). (2019). Collaborative Problem Solving: An evidence-based approach to implementation and practice. Springer.

Pollastri, A. R., Wang, L., Youn, S. J., Ablon, J. S., & Marques, L. (2020). The value of implementation frameworks: Using the active implementation frameworks to guide system-wide implementation of Collaborative Problem Solving. Journal of Community Psychology , 48 (4), 1114–1131. https://doi.org/10.1002/jcop.22325

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Greene, R. W., Ablon J. S., Goring, J. C., Raezer-Blakely, L., Markey, J., Monuteaux, M. C., Henin, A, Edwards, G., & Rabbitt, S. (2004). Effectiveness of Collaborative Problem Solving in affectively dysregulated children with oppositional defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72 (6), 1157–1164. https://doi.org/10.1037/0022-006X.72.6.1157

Type of Study: Randomized controlled trial Number of Participants: 47

Population:

• Age — 4–12 years
• Race/Ethnicity — Not specified
• Gender — 32 Male and 15 Female
• Status — Participants were parents and their children with oppositional defiant disorder (ODD).

Location/Institution: Massachusetts

Summary: (To include basic study design, measures, results, and notable limitations) The purpose of the study was to examine the efficacy of Collaborative Problem Solving (CPS) in affectively dysregulated children with oppositional defiant disorder (ODD). Participants were randomized to either the parent training version of CPS or parent training (PT). Measures utilized include the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Epidemiologic version (K-SADS–E), the Wechsler Intelligence Scale for Children—Revised, the Parent–Child Relationship Inventory (PCRI), the Parenting Stress Index (PSI), the Oppositional Defiant Disorder Rating Scale (ODDRS), and the Clinical Global Impression–Improvement (CGI-I) . Results indicate that CPS produced significant improvements across multiple domains of functioning at posttreatment and at 4-month follow-up. Limitations include small sample size and length of follow-up.

Length of controlled postintervention follow-up: 4 months.

Pollastri, A. R., Boldt, S., Lieberman, R., & Ablon, J. S. (2016). Pollastri, A. R., Boldt, S., Lieberman, R., & Ablon, J. S. (2016). Minimizing seclusion and restraint in youth residential and day treatment through site-wide implementation of Collaborative Problem Solving. Residential Treatment for Children & Youth. 33 (3–4), 186–205. https://doi.org/10.1080/0886571X.2016.1188340

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental) Number of Participants: Not specified

• Age — Not specified
• Gender — Not specified
• Status — Participants were in residential and day treatment and included youth in foster care and child welfare.

Location/Institution: Oregon

Summary: (To include basic study design, measures, results, and notable limitations) The purpose of the study was to describe the results of one agency’s experience implementing the Collaborative Problem Solving (CPS) approach organization-wide and its effect on reducing seclusion and restraint (S/R) rates. Participants were grouped into the CPS intervention at a residential or day treatment facility. Measures utilized include the Child and Adolescent Functional Assessment Scale (CAFAS) and the Child and Adolescent Needs Assessment (CANS) . Results indicate that during the time studied, frequency of restrictive events in the residential facility decreased from an average of 25.5 per week to 2.5 per week, and restrictive events in the day treatment facility decreased from an average of 2.8 per week to 7 per year. Limitations include lack of randomization of participants, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Additional References

Greene, R. W., & Ablon, J. S. (2005). Treating explosive kids: The Collaborative Problem Solving approach . Guilford Press.

Greene, R. W., Ablon, J. S., Goring, J. C., Fazio, V., & Morse, L. R. (2003). Treatment of oppositional defiant disorder in children and adolescents. In P. Barrett & T. H. Ollendick (Eds.), Handbook of Interventions that work with children and adolescents: Prevention and treatment. John Wiley & Sons.

Pollastri, A. R., Epstein, L. D., Heath, G. H., & Ablon, J. S. (2013). The Collaborative Problem Solving approach: Outcomes across settings. Harvard Review of Psychiatry, 21 (4), 188–199. https://pubmed.ncbi.nlm.nih.gov/24651507/

Contact Information

Date Research Evidence Last Reviewed by CEBC: July 2023

Date Program Content Last Reviewed by Program Staff: December 2023

Date Program Originally Loaded onto CEBC: May 2017

Glossary | Sitemap | Limitations & Disclosures

The CEBC is funded by the California Department of Social Services’ (CDSS’) Office of Child Abuse Prevention and is one of their targeted efforts to improve the lives of children and families served within child welfare system.

© copyright 2006-2024 The California Evidence-Based Clearinghouse for Child Welfare www.cebc4cw.org

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Drawing on knowledge from process improvement, organisation theory, human resource management, change management, occupational health and safety, and other fields, the book is a practical, easy-to-read guide to problem solving.

Illustrated with a series of short case studies, this book provides an integrated approach to problem solving in the workplace. Collaborative Problem Solving walks through the steps in the problem solving process, introducing dozens of tools, techniques, and concepts to use throughout. Chris J. Shannon describes the behaviours to practice which are most conducive to creating a positive problem solving culture based on curiosity, collaboration, and evidence-based thinking. This book explains why successful problem solving is a collaborative process and provides tools and techniques for responding to other people’s behaviour when designing and implementing solutions.

Offering practical advice on problem solving in an easy-to-understand way, this book is aimed at people working in office environments, service industries, and knowledge organisations, enabling them to feel confident in applying the knowledge from the book in their own workplace.

TABLE OF CONTENTS

Chapter chapter 1 | 14  pages, the problem solving model, chapter chapter 2 | 17  pages, problem solving behaviour, chapter chapter 3 | 10  pages, perceiving the problem, chapter chapter 4 | 26  pages, defining the problem, chapter chapter 5 | 33  pages, investigating the problem, chapter chapter 6 | 10  pages, selecting the solution, chapter chapter 7 | 12  pages, implementing the solution, chapter chapter 8 | 8  pages, reviewing the results, chapter chapter 9 | 14  pages, responding to other people’s behaviour, chapter | 2  pages.

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Collaborative & Proactive Solutions (CPS): A Review of Research Findings in Families, Schools, and Treatment Facilities

• Published: 25 June 2019
• Volume 22 , pages 549–561, ( 2019 )

Cite this article

• Ross Greene   ORCID: orcid.org/0000-0002-2047-572X 1 , 2 &
• Jennifer Winkler 3  

Collaborative & Proactive Solutions (CPS) is a psychosocial treatment model for behaviorally challenging youth, which has been applied in a diverse array of settings, including families, schools, and therapeutic facilities. Numerous studies have documented its effectiveness and examined factors that mediate and moderate the effectiveness of the model. Data have thus far shown that, with regard to behavioral improvements, CPS is at least the equivalent of the standard of care for externalizing youth, Parent Management Training, and that CPS may hold additional benefits as regards parent–child interactions and children’s skill enhancement.

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Greene, R., Winkler, J. Collaborative & Proactive Solutions (CPS): A Review of Research Findings in Families, Schools, and Treatment Facilities. Clin Child Fam Psychol Rev 22 , 549–561 (2019). https://doi.org/10.1007/s10567-019-00295-z

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Collaborative Problem Solving for Parents

Our evidence-based approach, developed at Massachusetts General Hospital, is a big mind-shift when it comes to understanding your child’s behavior and what to do about it. Collaborative Problem Solving ® (CPS) is an evidence-based, trauma-informed practice that helps kids meet expectations, reduces concerning behavior, builds children’s skills, and improves family relationships.

You’ll learn how to partner with the children in your life to identify the triggers for their challenging behavior, and work together to produce a game plan for how to handle problems before they happen. Collaborative Problem Solving avoids using power, control, and motivational procedures. Instead, it focuses on collaborating with children to solve the problems leading to them not meeting expectations and displaying problematic behavior.

Collaborative Problem Solving is designed to meet the needs of all children at all ages, including those with social, emotional, and behavioral challenges. It promotes the understanding that kids who have trouble meeting expectations or managing their behavior lack the skill—not the will—to do so . These children struggle with skills related to problem-solving, flexibility, and frustration tolerance and Collaborative Problem Solving builds these skills.

Transform Discipline at Home

Are you tired of the meltdowns, nagging, yelling, and constant power struggles between you and your child? If behavior charts, rewards, and punishments aren't working, we know why!  Research shows kids with challenging behavior lack the skill, not the will, to behave.

Traditional discipline is broken, it doesn’t result in improved behavior or improved relationships between adults and children. The Collaborative Problem Solving approach is an effective form of relational discipline that reduces concerning behavior and parent stress while building skills and relationships between adults and children.

A Mother’s Story

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The Results

Our research has shown that the Collaborative Problem Solving approach helps kids and adults build crucial social-emotional skills and leads to dramatic decreases in behavior problems across various settings including schools, residential, in and outpatient treatment, and homes. Results reported by parents, pediatricians, and outpatient therapists include improved behavior and reductions in caregiver stress.

Collaborative Problem Solving in Action

Watch these examples of Collaborative Problem Solving conversations to get an idea of what it is all about.

What Our Families Say

Parent & caregiver insights, how to talk to your kids about social media, kids lack skill, not will, behaviors charts: helpful or harmful, seeing red 4 steps to try before responding, changing behavior takes time, a mother’s collaborative problem solving story, the power of brief relational interactions in changing our brains and behavior, is social media ruining kids’ mental health let’s ask them, thinking skills assessment, attention and working memory thinking skills, language and communication thinking skills, rethinking our approach to youth mental health care, child having trouble transitioning between activities here’s how to help, how lagging social thinking skills can influence behavior, managing challenging behavior in youth sports, privacy overview.

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

Nursing professional development evidence-based practice.

Barbara A. Brunt ; Melanie M. Morris .

Affiliations

Last Update: March 4, 2023 .

• Introduction

Evidence-based practice is “integrating the best available evidence with the healthcare educator’s expertise and the client’s needs while considering the practice environment. [1] One of the roles of the NPD practitioner in the 2022 edition of the Nursing Scope and Standards of Practice is a champion for scientific inquiry. In this role, the NPD practitioner promotes a spirit of inquiry, the generation and dissemination of new knowledge, and the use of evidence to advance NPD practice, guide clinical practice, and improve the quality of care for the healthcare consumer/partner. Scholarly inquiry is a standard of practice within that role. It is defined as “The nursing professional development (NPD) practitioner integrates scholarship, evidence, and research findings into practice” (p. 104).

There is often confusion between quality improvement, evidence-based practice, and research. A seminal article by Shirey and colleagues. [2]  differentiated these three topics. Evidence-based practice is a systematic problem-solving approach that is evidence-driven and translates new knowledge into clinical, administrative, and educational practice. Institutional Review Board (IRB) approval is usually not required unless outcomes are intended for publication, or the project could potentially expose individuals to harm.

The EBP process, as defined by Melnyk and Fineout-Overholt, includes seven steps:         

• Encouraging and supporting a spirit of inquiry
• Asking questions
• Searching for evidence
• Appraising the evidence
• Integrating evidence into practice
• Evaluating outcomes
• Sharing results

Implementing EBP in practice has been shown to lead to a higher quality of care and better patient outcomes, but nurses encounter many barriers when implementing EBP. NPD practitioners can facilitate the implementation of EBP by ensuring a supportive environment for EBP, providing educational sessions to nurses about the EBP process, being role models, and mentoring nurses.

• Issues of Concern

PICOT Question

The foundation of EBP is developing a PICOT question, which identifies the terms to be used to search for the best evidence to answer a burning clinical question. [3] This framework breaks down the question into keywords. P stands for patient/population; I refers to Intervention; C stands for comparison/control; O stands for the outcome; and T refers to the time frame. When looking at the population, it is important to consider the relevant patients, including age, sex, geographic location, or specific characteristics that would be important to the question.

The intervention examines the management strategy, diagnostic test, or exposure of interest. There may not always be a comparison in the PICOT analysis. If there is, this would be a control or alternative management strategy compared to the intervention. Outcomes should be measurable, as the best evidence comes from rigorous studies with statistically significant findings. The time factor looks at what period should be considered. There are a variety of clinical domains that PICOT questions can evaluate, such as intervention, diagnosis, etiology, prevention, prognosis/prediction, quality of life, or therapy. Writing a good PICOT question for an effective search and making robust, evidence-based recommendations to improve care and outcomes is critical.

The Evidence

While there are multiple ways to evaluate and rank evidence in the literature, one of the most widely used in nursing in the United States uses seven levels. These seven accepted levels of evidence are assigned to studies based on the methodological quality of the design, validity, and application to patient care. In addition, these levels provide the “grade” or strength of the recommendation.

• Level I –  Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs) or evidence-based clinical practice guidelines based on a systematic review of RCTs or three or more RCTs of decent quality with comparable results.
• Level II -  Evidence obtained from at least one well-designed RCT
• Level III – Evidence obtained from well-designed controlled trials without randomization
• Level IV -  Evidence from well-designed case-control or cohort studies        
• Level V - Evidence from a systematic review of descriptive and qualitative studies (meta-syntheses)
• Level VI – Evidence from a single or descriptive or qualitative study              
• Level VII - Evidence from the opinion of authorities and/or reports of expert committees.

Roe-Prior discussed the strength of evidence by comparing it to a murder trial. A suspect’s conviction should require more than the testimony of one witness. If a crowd of people all agree that the suspect was the perpetrator or there was DNA evidence, that evidence is much stronger. Studies without a comparative group, methodologically weak studies, or poorly controlled studies could be likened to one witness. Roe Prior encouraged individuals to also look at non-nursing research findings since research centered on other disciplines, like psychology or education, could be appropriate.

Other frameworks for identifying levels of evidence include The Oxford Centre for Evidence-Based Medicine Levels of Evidence and Burns framework. [4] The Oxford Centre describes five levels with various subparts as listed here:

• 1a           Systematic review of RCTs
• 1b           Individual RCT
• 2a           Systematic review of cohort studies
• 2b           Individual cohort study
• 2c           Outcomes research
• 3a           Systematic review of case-control studies
• 3b           Individual case-control study
• 4             Case series
• 5             Expert opinion

Burns uses three levels to differentiate the strength of the evidence presented:

• I             At least 1 RCT with proper randomization
• II.1         Well-designed cohort or case-control study
• II.2         Time series comparisons or dramatic results from uncontrolled studies
• III           Expert opinions

Roe Prior outlined guidelines for the literature review. [5] Use keywords from the PICOT question to perform simple, then more complex searches in reliable databases, preferably limited to the past five years, although landmark studies can be included. Limit the review to peer-reviewed and research articles and use caution when including only full-text articles, as some key papers may be missed. Check the validity of any online sources and use original research where possible. Remember that textbooks are often obsolete by their publication date, and books are considered secondary sources.

The Cochran Library is comprised of multiple databases where systematic reviews on healthcare topics can be found. Using the Preferred Reporting Items for Systemic Review and Meta-Analysis (PRISMA) Guidelines to evaluate a systemic review or meta-analysis can help the individual ensure the findings are valid and reliable. Findings from the literature review are put into an evidence-based table. There are various formats for these tables, but they all include information about the source, design, sample, summary of findings, and level of evidence for each of the articles included.

The most frequently used EBP models are the Iowa Model, the Advancing Research and Clinical Practice through Close Collaboration (ARCC) Model, the Star Model of Knowledge Transformation, and the John Hopkins Nursing Evidence-based Practice (JHNEBP) Model. The IOWA Model focuses on implementing evidence-based practice changes, and the ARCC model on advancing EBP in systems by using EBP mentors and control and cognitive behavioral therapies. The Star Model provides a framework for approaching EBP, and the John Hopkins Model is a problem-based approach to clinical decision-making accompanied by tools to guide its use.

The Iowa model was revised and updated in 2017 by the Iowa Model Collaborative. [6]  Changes in the healthcare environment, such as a focus on implementation science and emphasis on patient engagement, prompted a reevaluation, revision, and validation of the model. This model differs from other frameworks by linking practice changes within the system. Model changes included an expansion of piloting, implementation, patient engagement, and sustaining change.

Support for the ARCC Model was outlined in an article by Melnyk and colleagues in a study exploring how an evidence-based culture and mentorship predicted EBP implementation, nurse job satisfaction, and intent to stay. [7] This model involves assessing organizational culture and readiness for EBP using EBP mentors who work with clinicians to facilitate the implementation of evidence-based practice.

A concept analysis of feelings of entrapment during the COVID-19 pandemic, using the ACE Star Model, was completed by Lee and Park. The ACE Star model is used to understand the cycle, nature, and characteristics of knowledge used in various aspects of EBP. The model consists of five steps: discovery research, evidence summary, translation to guidelines, practice integration, and process and outcome evaluation.

The JHNEBP Model is a problem-solving approach to clinical decision-making with user-friendly tools to guide individual or group use. It is explicitly designed to meet the needs of the practicing nurse and uses a three-step process called PET: practice question, evidence, and translation. In a study conducted by Speroni and colleagues on using EBP models across the United States, this was the second most frequently used model by the 127 nurse leaders who responded to the questionnaire. [8]

EBP Competence and Implementation

NPD practitioners are instrumental in implementing EBP. Harper and colleagues conducted a national study to examine NPD practitioners’ beliefs and competencies, frequency of implementing EBP, and perceptions of organizational culture and readiness for EBP. [9] The Association for Nursing Professional Development (ANPD) collaborated with the Center for Transdisciplinary Evidence-Based Practice at The Ohio State University to explore the NPD practitioners’ beliefs and experiences with EBP, as well as to explore relationships among NPD practitioner characteristics and healthcare organizational outcomes such as nursing sensitive quality indicator scores and core measures. A total of 253 NPD practitioners from 43 states and the District of Columbia participated in this study. Findings indicated that NPD practitioners need to develop personal competence in EBP, become involved in shared governance, collaborate with others to facilitate the implementation of EBP, and become comfortable with using quality metrics to demonstrate the effectiveness of NPD activities.

The Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare of the Ohio State University developed an Evidence-Based Practice Certificate, which was approved by the Accreditation Board for Specialty Nursing Certification in 2018. There are 24 EBP competencies; 13 for practicing registered nurses and an additional 11 competencies for practicing advanced practice nurses and EBP experts. These competencies are outlined in an article by Melnyk et al. [10]

Although these competencies were initially written for nurses, they apply to other interprofessional team members who have received advanced EBP education. In addition to demonstrating completion of the EBP coursework, applicants must demonstrate current EBP knowledge through content review and successful testing and submit a portfolio to review that shows an EBP practice change project before receiving a certificate.

In 2020, ANPD worked with the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare to develop a curriculum for the Nursing Professional Development EBP Academy. [11] The program consists of live webinars, 26 asynchronous modules, and the completion of an EBP change initiative/project. This Academy curriculum aligns with the EBP Certificate educational requirements.

There are numerous resources available for NPD practitioners on evidence-based practice. There is a peer-reviewed journal published by Sigma Theta Tau International, Worldviews on Evidence-based Nursing, which includes original research with recommendations applicable to use as best practices to improve patient care. ANPD has a year-long evidence-based fellowship consisting of theory and completion of an evidence-based project. The Nursing Professional Development Evidence-Based Practice (EBP) Academy is a 12-month mentored program designed to guide the NPD practitioner through creating PICOT questions, gathering and critically appraising literature, and EBP implementation, evaluation, dissemination, and sustainment. Participation in the EBP Academy enhances the evidence-based competencies of nursing professional development practitioners to enable them to fulfill their role as champions of scientific inquiry and mentor other healthcare professionals in implementing EBP practices.

EBP in Action

One organization evaluated the use of evidence-based practice in clinical practice after nurses attended a formal evidence-based practice course. [12]  Nurses who attended the organization’s EBP course were invited to participate in focus groups to provide additional qualitative data. Data from two focus groups highlighted the impact of the EBP course, areas for further development, and potential barriers to the use of EBP. The nurses indicated that the course changed their way of thinking and enhanced their patient care. They stated there was a need for mentoring and that time was a significant barrier to EBP. That information was used by organizational leadership to help identify areas needing consideration for educational offerings and support mechanisms.

Another large academic medical center evaluated the implementation of an EBP program. [13]  They noted that although their approach to educating professional staff on EBP provided initial benefits, holding the gains over a one-year period was difficult. The “train-the-trainer” model envisioned by the team was not realistic, as the participants did not feel well-versed enough to teach others. They concluded future efforts require attention to participant feedback and the implementation of measures to decrease the barriers to implementing EBP.

There are numerous examples in the literature of individuals/organizations using evidence-based principles to develop programs in a variety of settings. McGarity and colleagues examined frontline nurse leaders oriented with only on-the-job training questioning whether their level of competence is improved with a professional development program. [14] This project used a pre-and post-survey design to evaluate a leadership development curriculum. The intervention was an evidence-based leadership curriculum that consisted of twelve four-hour classes. The fact that all 38 frontline nurse leaders who participated in this project improved their competencies reinforced the need for formal professional development. The outcome of this training program showed that all 38 frontline nurse leaders who attended it were more confident in their skills and improved their competence in leading effective teams, reinforcing the need for education.

Ydrogo and colleagues discussed a multifaceted approach to strengthening nurses’ EBP capabilities in a comprehensive cancer center. [15] They created a program designed to promote a spirit of inquiry, strengthen EBP facilitators, overcome barriers to EBP, and expand nurses’ knowledge of EBP. The program consisted of a blended interactive seminar with leader-directed discussion on promoting a spirit of inquiry, a seven-week course on retrieving, reading, analyzing, and evaluating research papers, and a monthly challenge emailed to staff, posted to the hospital intranet, and included in a weekly nursing newsletter. Both leadership and staff gained increased confidence and a foundation to initiate two research projects and one EBP project shortly after completing the course.

Integrating EBP into an emergency department nurse residency program was the subject of an article by Asselta. [16] In addition to extensive training in the core competencies of emergency nursing, this 6-month program included exemplars in EBP and its positive impact on patient care and/or ED workflow. One of the requirements for this program was for the nurses to participate in developing an EBP project specific to emergency nursing practice. An example of a project comparing intravenous (IV) push medications versus IV piggyback medications was shared. This project demonstrated the advantages of the IV push route of administration, which yielded significant cost savings for the organization.

Pediatric nurses were the focus of a project described by Cline et al. [17] They evaluated nurses’ perceptions of barriers, facilitators, confidence, and attitudes toward research and evidence-based practice. There were 369 nurses who completed the survey during the baseline data collection period, 288 nurses completed the 6-month survey, and 284 nurses completed the 12-month survey. The results indicated that implementation of a curriculum focused on research and EBP may be most successful when implemented with the availability of mentors, in a research-supported environment, with grant funding support for novice researchers, and with an ample amount of time allotted to complete a research study.

Many nurses work in long-term care. Higuchi and colleagues described a study that examined the impact of EBP practice change in ten long-term care (LTC) settings in Canada. [18] Introducing and sustaining practice changes that enhance the quality of care is a significant challenge in LTC facilities. A full-day workshop that included identifying success stories, describing current practice challenges, building a case for change, seizing the moment, and identifying an action plan was presented at each site. Participants completed a questionnaire at the end of the workshop, and all participants were invited to participate in semi-structured interviews five months after the program. The benefits identified in the follow-up interviews were initiating the change process and enhancing team collaboration. This study demonstrated that an interactive workshop had important positive effects on LTC staff.

Clinical nurse educators were the focus of a study conducted by Dagg and colleagues. [19]  Centralization of a new clinical nurse educator (CNE) role created role confusion and poor role outcomes. An evidence-based quality improvement project was completed to integrate the ANPD practice model and transition to the practice fellowship program. An ANPD competency assessment survey tool was selected because it included information specific to the CNE role expectations. The nurse-sensitive indicators selected were fall rates and indwelling urinary catheter rates. Self-assessed competencies and nurse-sensitive quality outcomes of the CNEs were measured before and after the ANPD practice model was integrated into their daily practice. There were only 5 CNEs who completed both the pre-and post-assessment, but results supported that CNEs influenced patient quality outcomes and improved their self-assessed competency.

Phan and Hampton described an evidence-based project focused on promoting civility in the workplace by addressing bullying in new graduate nurses using simulation and cognitive rehearsal. [20]  Nurse bullying (NB) has been a problem for many years, and this can threaten the safety of patients, nurses, and organizations. This study used a mixed-methods, quasi-experimental design.

The NPD Scope and Standards were used to assess, plan, implement, and evaluate the project. In addition to the demographic data collected at baseline, participants completed the Clark Workplace Civility Index (CWCI) at baseline and three times after the intervention (immediately, 2.5 months, and five months). The sample included 36 new graduate nurses (NGNs). The intervention consisted of 2.75 hours of didactic, polling, reflection, simulation role-play, and debriefing. The training was developed virtually on the Zoom platform, and breakout rooms facilitated small group discussions and role-playing. Although there was no statistically significant increase in civility scores, the qualitative data indicated the participants could apply knowledge and skills from the intervention to improve communication, peer relationships, teamwork, patient safety, and care.

• Clinical Significance

Evidence-based practice falls under the champion for scientific inquiry role of the NPD practitioner. According to the NPD scope and standards of practice, the NPD practitioner promotes a spirit of inquiry and assists with generating and disseminating new knowledge. The NPD practitioner also uses evidence to advance the specialty of NPD and guide practice.

The ultimate goal is to promote the quality of care for the healthcare consumer. Competencies for scholarly inquiry include acting as a champion for inquiry, generating new knowledge, and integrating the best available evidence into practice. In addition, the standards include disseminating inquiry findings, including evidence-based practice and quality improvement activities, through educational and professional development activities.

• Enhancing Healthcare Team Outcomes

The healthcare consumer is the ultimate recipient of NPD practice. Therefore, NPD practitioners collaborate with the interprofessional team to ensure quality care, leading to optimal care outcomes and population health. Interprofessional partnerships are critical factors in achieving safe, effective, high-quality care.

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Disclosure: Barbara Brunt declares no relevant financial relationships with ineligible companies.

Disclosure: Melanie Morris declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Brunt BA, Morris MM. Nursing Professional Development Evidence-Based Practice. [Updated 2023 Mar 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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• Beliefs and implementation of evidence-based practice among nurses in the nursing homes of a Swiss canton: An observational cross-sectional study. [J Clin Nurs. 2021] Beliefs and implementation of evidence-based practice among nurses in the nursing homes of a Swiss canton: An observational cross-sectional study. Perruchoud E, Fernandes S, Verloo H, Pereira F. J Clin Nurs. 2021 Nov; 30(21-22):3218-3229. Epub 2021 May 7.
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• Strategies for advancing evidence-based practice in clinical settings. [J N Y State Nurses Assoc. 2004] Strategies for advancing evidence-based practice in clinical settings. Fineout-Overholt E, Levin RF, Melnyk BM. J N Y State Nurses Assoc. 2004 Fall-2005 Winter; 35(2):28-32.
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