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Updated: Sep 15, 2025

Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 21, 2010
Exploring the link of educational environment and self-esteem with critical thinking in undergraduate nursing
Antonios Christodoulakis1, Izolde Bouloukaki1, Michail Zografakis-Sfakianakis2
1Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece.
Objectives:
To assess CT, SE, and perceptions of EE of nursing students in Greece, and explore the potential associations between them.
Methods:
This cross-sectional study was conducted in a Nursing department from February to May 2024. We used the Dundee Ready Education Environment Measure (DREEM), the Critical Thinking Disposition Scale (CTDS), and the Rosenberg Self-Esteem Scale (RSE) questionnaires.
Results:
A total of 185 nursing students participated. EE was generally positive, with moderate CT disposition and positive self-esteem. Robust regression showed a positive association between EE and CT disposition. Structural equation modeling indicated that SE mediates this association between EE and the Reflective Skepticism sub-scale of CTDS.
Conclusions:
Suitable interventions could be implemented to enhance the CT of nursing students through the utilization of SE and EE.
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