The development of critical thinking in Saudi nurses : an ethnographical approach

Simpson, Elaine (2002) The development of critical thinking in Saudi nurses : an ethnographical approach. PhD thesis, Queensland University of Technology.



Saudi Arabia is the largest country in the Middle East occupying the majority of the Arabia Peninsula. In 1934 the exploration of oil propelled this country from one of the poorest to one of the highest in per capita income. Islamic law forms the basis of Saudi Arabia's constitution, its civil and penal codes and guides the Saudis in their daily and family lifestyles, governing morals, dress, eating habits and business dealings. Between 1970 and 1980, there was a sharp increase in the rate of population. Currently the population is estimated at 20.8 million with a projected increase to 44.8 million by the year 2025, with approximately 49% under the age of 20. This rise in population has implications for the health care industry, of which expatriates make up more that 85% of the country's health care system.


The purpose of the study was to examine the social and cultural experiences associated with living and working as a registered nurse in a major teaching hospital in Saudi Arabia and to identify and understand how to develop critical thinking skills in Saudi nurses during a nursing education/intervention program in Saudi Arabia.


The researcher reviewed the literature on critical thinking, which allowed the construction of a conceptual model (Appendix 1) to guide teaching and evaluation of critical thinking skills and maintained the focus on dialogue to stimulate interaction and participation in order to promote critical thinking abilities in Saudi nurses. This study adopted ethnography as a methodology and utilised Spradley's (1979)ethnographic research cyclical tasks for data collection and analysis, which are explained in the exploratory, descriptive and explanatory phases of the research. The researcher was a participant observer and collected ethnographic data in the social situation. A variety of data collection methods were employed, which included observation of students and clinical instructors, evaluation of clinical instructors teaching techniques in utilising critical thinking strategies, evaluation of students' responses in the use of critical thinking strategies, focus group interviews of students and clinical instructors and informal interviews conducted within the hospital setting with relevant informants. The use of multi-methods provided the opportunity to examine more fully the richness and complexities of the culture, by gathering data from various sources to validate the consistency of information to reflect the multiple realities of this cultural group. Cultural domains were identified after examining field notes and interviews for terms and clues repeatedly verbalised by informants, in particular students. The researcher organised the domains to formulate taxonomies, leading to cultural themes, which are answered within the research questions in Chapter 8. The research questions for this study are as follows:

Research questions

  1. What are the issues related to the implementation of critical thinking in a Professional Development Program to improve critical thinking in Saudi nurses?

  2. What major elements are involved in creating and sustaining the Saudi Arabian nursing profession?

  3. How might Saudi culture be used to support the development of professional nursing identity?

Implications for the study

This study has the potential to make a significant contribution to nursing education in Saudi Arabia in promoting critical thinking in nurses and in curriculum development for the following reasons. First, didactic instruction was replaced with an interactive approach by utilising critical thinking strategies and devices to facilitate the development of critical thinking abilities. Second, working with a conceptual framework or model made it easier to manage complex multifaceted concepts, such as critical thinking. The model maintained the focus on dialogue and experiential learning thereby assisting students and staff to integrate theory and practice. This model was effective for the program and if duplicated by other programs, could create a learning environment that would allow the effective development and evaluation of critical thinking. The model is reflected in Appendix 1.

Recommendations for the nursing profession in Saudi Arabia

  • To establish the Nursing Practice Act which subsequently leads to the formation of a National Nursing Registration Board.

  • To transfer nursing into the higher education sectors, to be on par with their Western counterparts. To foster career incentives for men to meet the cultural needs of the people, increase Saudi nurses in the workforce and to raise the image of nursing.

  • To enact Saudiisation policy.

  • To incorporate Islamic nursing history into diploma nursing and other nursing educational programs and implemented into the workplace, government policy and the media.

  • To construct separate male and female hospitals to solve the gender issues.

  • To systematically collect, collate and analyse nursing data.

  • To develop continuing education programs to meet educational needs of nurses.

Impact and interest:

Search Google Scholar™

Citation counts are sourced monthly from Scopus and Web of Science® citation databases.

These databases contain citations from different subsets of available publications and different time periods and thus the citation count from each is usually different. Some works are not in either database and no count is displayed. Scopus includes citations from articles published in 1996 onwards, and Web of Science® generally from 1980 onwards.

Citations counts from the Google Scholar™ indexing service can be viewed at the linked Google Scholar™ search.

Full-text downloads:

5,046 since deposited on 03 Dec 2008
139 in the past twelve months

Full-text downloads displays the total number of times this work’s files (e.g., a PDF) have been downloaded from QUT ePrints as well as the number of downloads in the previous 365 days. The count includes downloads for all files if a work has more than one.

ID Code: 15868
Item Type: QUT Thesis (PhD)
Supervisor: Courtney, Mary, Pillay, Hitendra, & Wilmoth, James
Keywords: Critical thinking skills, Critical thinking strategies –role-play, debate, questioning, small group activity, journaling, Saudi Arabia, Saudi nurses, Nursing education, Critical thinking model, Clinical instructors, Ethnography, Fieldwork, Participant observation
Department: Faculty of Health
Institution: Queensland University of Technology
Copyright Owner: Copyright Elaine Simpson
Deposited On: 03 Dec 2008 03:51
Last Modified: 27 Jun 2017 14:39

Export: EndNote | Dublin Core | BibTeX

Repository Staff Only: item control page