# Self-perceived design thinking competence among Taiwanese nursing students: a longitudinal study

## TL;DR

This study tracks how nursing students' self-perceived design thinking skills change over time after training, finding that higher-scoring students retain skills better than lower-scoring ones.

## Contribution

The study reveals longitudinal patterns of self-perceived design thinking competence and suggests spiral teaching models to sustain skills.

## Key findings

- Both higher- and lower-scoring students showed significant declines in design thinking skills over time.
- Higher-scoring students experienced smaller declines in most skills compared to lower-scoring students.
- The findings suggest that longitudinal, spiral teaching models could help sustain design thinking competence.

## Abstract

Design thinking (DT) is increasingly valued in nursing education for cultivating innovation and problem-solving skills. Although individual differences in DT competence are recognized, the pattern of change in these competencies over time remains unclear.

Ninety-six nursing students enrolled in a DT training course completed the Creative Synthesis Inventory–Taiwan (CSI–Taiwan) at four time points: before training, immediately after training, and one- and three-months post-training. Students were classified into higher- and lower-scoring groups using K-means clustering. Generalized Estimating Equations (GEE) were used to analyze changes in CSI–Taiwan scores over time.

GEE analysis showed no significant differences in visualization, discovery, prototyping, and evaluation skills immediately after training. Both higher- and lower-scoring students demonstrated significant declines in all DT skills over time. The magnitude of decline was significantly smaller among higher-scoring students, except for the discovery skill between immediately after training and one-month post-training.

These findings align with Bandura’s self-efficacy theory, suggesting that efficacious self-beliefs in DT competence are reflected in differing patterns of change over time. Nursing curricula incorporating longitudinal, spiral models of DT instruction—such as project-based applications in clinical settings—may help consolidate and sustain DT skills, particularly among lower-scoring students.

Less is known whether and how changes would occur in the self-assessment of design thinking (DT) competence across time among nursing students.

DT competence as self-perceived by students was characterized by significant individual differences in the change pattern over a 3-month period after a DT training,

Both higher- and lower-scoring students demonstrated a significant decline over time in DT competence

The magnitude of decline was significantly smaller for the higher-scoring students than the lower-scoring students

It is suggested nursing curricula incorporating longitudinal, spiral models of DT instruction to enhance lower-scoring students’ DT competence.