Integrating photovoice as an adjunct teaching modality in improving critical thinking disposition among Chinese nursing students in community health nursing: a mixed-methods study.

Aims: This study aimed to examine the effectiveness of using Photovoice as an adjunct teaching modality to enhance critical thinking dispositions among Chinese nursing students in a community health nursing course. It also aimed to explore students' perceptions and experiences of the Photovoice learning activity.

Methods: An explanatory sequential mixed-methods design was employed, consisting of a two-group quasi-experimental quantitative phase followed by a qualitative phase using phenomenological method. The study was conducted at Hubei Polytechnic University from February to July 2023. A convenience sample of 100 undergraduate nursing students was divided into the intervention group(n = 51) and the control group(n = 49) based on their class assignments. The intervention group engaged with a teaching modality that integrated Photovoice into the windshield survey activity, while the control group received standard teaching methods. Critical thinking disposition was assessed using the Critical Thinking Disposition Inventory for Chinese medical college students (CTDI-M) before and after the course. Qualitative data were collected through semi-structured group interviews(n = 12) and analyzed using Colaizzi's phenomenological 7-step method to identify emerging themes and the essential structure of the participants' experiences.

Results: The intervention group showed significant improvements in open-mindedness (Z=-2.406, r=-0.241, p = 0.016)and systematicity/analyticity (Z=-2.209, r=-0.221, p = 0.027), and a trend to significant improvement in critical thinking disposition (Z=-1.808, r=-0.181, p = 0.071), compared to the control group. Qualitative findings revealed four themes: holistic and effective learning, high engagement and a dynamic learning environment, in-depth community engagement and empathy, and enhancing critical thinking in community settings. Students appreciated the Photovoice activity for its ability to clarify learning purposes, connect theory with practice, and stimulate critical thinking.

Conclusion: Photovoice as an adjunct teaching modality is effective in enhancing nursing students' open-mindedness and systematicity/analyticity in critical thinking disposition. Students found Photovoice to be a valuable tool for holistic learning, fostering engagement, and promoting critical thinking. The study provides evidence supporting the integration of Photovoice into nursing education to improve learning outcomes and improving critical thinking disposition.

Clinical Trial Number: Not applicable.