Abstract
Critical thinking (CT) is a vital competency for future healthcare providers, as it enables effective decision-making, problem-solving, and the delivery of patient care in increasingly complex clinical environments. This study examined perceptions, motivations, and factors associated with CT. A cross-sectional study was conducted among 330 medical and other health science students using a validated questionnaire. Spearman’s correlation coefficient was used to assess the relationship between the two domains. Multivariate analysis was performed to determine predictors of perception and motivation toward CT. The majority of participants demonstrated low to medium levels of perception of and motivation toward CT. More than 60% of students reported receiving frequent institutional support, whereas only 58% reported receiving support from their academic advisors for CT development. Female students had significantly higher perception scores (p = 0.029), and nursing students demonstrated higher perception levels than medical students (p = 0.016). Obese students exhibited lower perception (p = 0.012) and motivation scores (p = 0.008). Strategies to improve students’ perceptions of and motivation toward CT are recommended to foster the advanced clinical reasoning skills required for high-quality healthcare delivery. These strategies include enhancing opportunities for interprofessional collaboration and integrating practice-oriented CT activities.
Similar content being viewed by others
Data availability
All data supporting the findings of this study are available within the article and its Supplementary Information.
References
Diamond-Fox, S. & Bone, H. Advanced practice: Critical thinking and clinical reasoning. Br. J. Nurs. 30, 526–532. https://doi.org/10.12968/bjon.2021.30.9.526 (2021).
Halpern, D. F., Dunn, D. S. & Critical thinking a model of intelligence for solving real-world problems. J. Intell. 9. https://doi.org/10.3390/jintelligence9020022 (2021).
Berg, C., Philipp, R. & Taff, S. D. Scoping review of critical thinking literature in healthcare education. Occup. Ther. Health Care 37, 18–39. https://doi.org/10.1080/07380577.2021.1879411 (2023).
Harrison, C. V. Concept-based curriculum: Design and implementation strategies. Int. J. Nurs. Educ. Scholarsh. 17. https://doi.org/10.1515/ijnes-2019-0066 (2020).
Ramanathan, R., Shanmugam, J., Gopalakrishna, S. M., Palanisami, K. & Narayanan, S. Exploring the learners’ perspectives on competency-based medical education. J. Educ. Health Promot. 10, 109. https://doi.org/10.4103/jehp.jehp_866_20 (2021).
Falcó-Pegueroles, A., Rodríguez-Martín, D., Ramos-Pozón, S. & Zuriguel-Pérez, E. Critical thinking in nursing clinical practice, education and research: From attitudes to virtue. Nurs. Philos. 22, e12332. https://doi.org/10.1111/nup.12332 (2021).
AlOtaibi, N. G. et al. Assessing perceptions about critical thinking, motivation learning strategies in online psychiatric and mental health nursing education among Egyptian and Saudi undergraduate nursing students. BMC Nurs. 22, 112. https://doi.org/10.1186/s12912-023-01264-2 (2023).
Kaur, M. & Mahajan, R. Inculcating critical thinking skills in medical students: Ways and means. Int. J. Appl. Basic. Med. Res. 13, 57–58. https://doi.org/10.4103/ijabmr.ijabmr_214_23 (2023).
Stretton, T., Cochrane, T., Sevigny, C., Stander, J. & Merolli, M. Co-designing critical thinking in health professional education: A 360 immersive environment case study. Virtual Real. 29, 40. https://doi.org/10.1007/s10055-025-01115-2 (2025).
Vision20230. Health Sector Transformation Program. https://www.vision2030.gov.sa/en/vision-2030/vrp/health-sector-transformation-program/ (2021).
Suleiman, A. K. & Ming, L. C. Transforming healthcare: Saudi Arabia’s vision 2030 healthcare model. J. Pharm. Policy Pract. 18, 2449051. https://doi.org/10.1080/20523211.2024.2449051 (2025).
Giuliani, M. et al. Motivations for and challenges in the development of global medical curricula: A scoping review. Acad. Med. 96, 449–459. https://doi.org/10.1097/acm.0000000000003383 (2021).
Bansal, S. & Pagidas, K. Strength of motivation and academic performance of medical students: A longitudinal study. BMC Med. Educ. 25, 1154. https://doi.org/10.1186/s12909-025-07733-3 (2025).
Kasalaei, A., Amini, M., Nabeiei, P., Bazrafkan, L. & Mousavinezhad, H. Barriers of critical thinking in medical students’ curriculum from the viewpoint of medical education experts: A qualitative study. J. Adv. Med. Educ. Prof. 8, 72–82. https://doi.org/10.30476/jamp.2020.83053.1080 (2020).
Shakurnia, A., Fazelinia, T. & Khajeali, N. The trend of critical thinking disposition in medical students and its relationship with their academic performance. J. Educ. Health Promot. 10, 479. https://doi.org/10.4103/jehp.jehp_55_21 (2021).
Almansour, A. M. The level of emotional intelligence among Saudi nursing students: A cross-sectional study. Belitung Nurs. J. 9, 471–477. https://doi.org/10.33546/bnj.2794 (2023).
Athari, Z. S., Sharif, S. M., Nasr, A. R. & Nematbakhsh, M. Assessing critical thinking in medical sciences students in two sequential semesters: Does it improve? J. Educ. Health Promot. 2, 5. https://doi.org/10.4103/2277-9531.106644 (2013).
Ossa, C. J., Rivas, S. F. & Saiz, C. Relation between metacognitive strategies, motivation to think, and critical thinking skills. Front. Psychol. 14, 1272958. https://doi.org/10.3389/fpsyg.2023.1272958 (2023).
Parejo-Jiménez, N., Expósito-López, J., Chacón-Cuberos, R. & Olmedo-Moreno, E. M. Critical thinking and motivation in vocational training and baccalaureate: A comparison study of students of Spanish nationality, unaccompanied foreign minors and young care leavers. Int. J. Environ. Res. Public. Health 19. https://doi.org/10.3390/ijerph19095272 (2022).
Karakuş, İ. University students’ cognitive flexibility and critical thinking dispositions. Front. Psychol. 15. https://doi.org/10.3389/fpsyg.2024.1420272 (2024).
Facione, P. A. The disposition toward critical thinking: Its character, measurement, and relationship to critical thinking skill. Informal logic 20 (2000).
Ryan, R. M. & Deci, E. L. Intrinsic and extrinsic motivation from a self-determination theory perspective: Definitions, theory, practices, and future directions. Contemp. Educ. Psychol. 61, 101860 (2020).
Deng, X. N. & Yi, S. Individual motivation and self-perception of excel skills learning: An empirical study of first-generation college students and their peers. J. Account. Educ. 70, 100947. https://doi.org/10.1016/j.jaccedu.2024.100947 (2025).
Galindo-Domínguez, H., Bezanilla, M. J., Campo, L., Fernández-Nogueira, D. & Poblete, M. in Frontiers Education 1127705 (Frontiers Media SA).
BF, A. L. et al. Knowledge, attitude, and practice towards evidence-based medicine among northern Saudi primary care physicians: A cross-sectional study. Healthc. (Basel). 10. https://doi.org/10.3390/healthcare10112285 (2022).
Juttla, P. K., Ndiritu, M., Milliano, F., Odongo, A. O. & Mwancha-Kwasa, M. Knowledge, attitudes and practices towards COVID-19 among healthcare workers: A cross-sectional survey from Kiambu County, Kenya. PLoS One 19, e0297335. https://doi.org/10.1371/journal.pone.0297335 (2024).
Vojdani, S. et al. Evaluation of knowledge, attitude, and practice of Iranian medical students toward complementary and alternative medicine: A cross-sectional survey. Health Sci. Rep. 8, e70539. https://doi.org/10.1002/hsr2.70539 (2025).
Hong, S., Lee, J., Jang, Y., & Lee, Y. A cross-sectional study: What contributes to nursing students’ clinical reasoning competence? Int. J. Environ. Res. Public Health. 18, 6833 (2021).
Leal, P. et al. Teaching and learning clinical reasoning in nursing education: A student training course. Healthcare 12, 1219 (2024).
Alhowaymel, F. M. et al. Empowering future nurses: Enhancing self-efficacy, satisfaction, and academic achievement through talent management educational intervention. BMC Nurs. 24, 875. https://doi.org/10.1186/s12912-025-03512-z (2025).
Yu, L. & Zin, Z. M. The critical thinking-oriented adaptations of problem-based learning models: A systematic review. Front. Educ. 8, 1139987 (2023).
Liu, Y. & Pásztor, A. Effects of problem-based learning instructional intervention on critical thinking in higher education: A meta-analysis. Think. Skills Creativity. 45, 101069. https://doi.org/10.1016/j.tsc.2022.101069 (2022).
Steinert, Y. Faculty development: From rubies to oak. Med. Teach. 42, 429–435. https://doi.org/10.1080/0142159x.2019.1688769 (2020).
Carlson, E. R. & McGowan, E. Faculty development for the twenty-first century: Teaching the teachers. Oral Maxillofac. Surg. Clin. North. Am. 34, 555–570. https://doi.org/10.1016/j.coms.2022.02.004 (2022).
Gilfillan, J., Irvine-Brown, L., Di Tommaso, A., Malfitano, A. P. S. & Farias, L. (Not) knowing what you know: Exploring educators’ perceptions of critical thinking in occupational therapy. Scand. J. Occup. Ther. 31, 2405189. https://doi.org/10.1080/11038128.2024.2405189 (2024).
Harrison, J. Student nurses’ gender role is a predictor of caring behaviours and critical thinking. Evid. Based Nurs. 22, 89. https://doi.org/10.1136/ebnurs-2018-103029 (2019).
Liu, N. Y., Hsu, W. Y., Hung, C. A., Wu, P. L. & Pai, H. C. The effect of gender role orientation on student nurses’ caring behaviour and critical thinking. Int. J. Nurs. Stud. 89, 18–23. https://doi.org/10.1016/j.ijnurstu.2018.09.005 (2019).
Zhuang, H. et al. Depression, anxiety, stress symptoms among overweight and obesity in medical students, with mediating effects of academic burnout and internet addiction. Sci. Rep. 15, 16566. https://doi.org/10.1038/s41598-025-01793-7 (2025).
Dakanalis, A. et al. Overweight and obesity is associated with higher risk of perceived stress and poor sleep quality in young adults. Med. (Kaunas). 60. https://doi.org/10.3390/medicina60060983 (2024).
Cheng, M. M. W. & Leung, J. S. C. in Education in the 21st Century: STEM, Creativity and Critical Thinking. 119–135 (eds Berry, A.) (Springer International Publishing, 2021).
Skurvydas, A. et al. Do physical activity, BMI, and wellbeing affect logical thinking? Int. J. Environ. Res. Public. Health 19. https://doi.org/10.3390/ijerph19116631 (2022).
Anderson, A. S. & Good, D. J. Self-perceptions of critical thinking skills in university students are associated with BMI and exercise. J. Am. Coll. Health 70, 1444–1450. https://doi.org/10.1080/07448481.2020.1803879 (2022).
El-Demerdash, D., Elsayed, S. H. & Ata, A. A. Relation between critical thinking and motivation to learn among nursing students at Zagazig University. Zagazig Nurs. J. 15, 158–167 (2019).
Aldekhyyel, R. N., Alhumaid, N. & Alismail, D. S. Saudi women’s views on healthcare leadership in the era of Saudi 2030 health transformation. J. Multidiscip. Healthc. 17, 237–249. https://doi.org/10.2147/jmdh.S439146 (2024).
Liu, Y. & Pásztor, A. Moderated mediating effects of gender among the components of critical thinking disposition in undergraduate students. Heliyon 9, e14664. https://doi.org/10.1016/j.heliyon.2023.e14664 (2023).
Albarracín-Vivo, D., Encabo-Fernández, E. & Jerez-Martínez, I. & Hernández-Delgado, L. Gender differences and critical thinking: A study on the written compositions of primary education students. Societies 14 (2024).
Shubina, I., Kwiatek, P. & Kulakli, A. The relationships between critical thinking and creativity among university students in contemporary education: Empirical analysis of gender differences. New. Educ. Rev. 65, 87–98 (2021).
Berger, K. et al. Motivation for critical thinking in nursing students in Chile. Hispanic Health Care Int. 19, 131–137. https://doi.org/10.1177/1540415320970110 (2020).
Dwyer, C. P. An Evaluative review of barriers to critical thinking in educational and real-world settings. J. Intell. 11. https://doi.org/10.3390/jintelligence11060105 (2023).
Swart, R. Critical thinking instruction and technology enhanced learning from the student perspective: A mixed methods research study. Nurse Educ. Pract. 23, 30–39. https://doi.org/10.1016/j.nepr.2017.02.003 (2017).
Algouzi, S., Alzubi, A. A. F., Nazim, M. & Enhancing EFL students’ critical thinking skills using a technology-mediated self-study approach: EFL graduates and labor market in perspective. PLoS One 18, e0293273. https://doi.org/10.1371/journal.pone.0293273 (2023).
Jaramillo Gómez, D. L. et al. Determining factors for the development of critical thinking in higher education. J. Intell. 13 (2025).
Bayram, A. et al. Nursing students’ perceptions of nursing diagnoses, critical thinking motivations, and problem-solving skills during distance learning: A multicentral study. Int. J. Nurs. Knowl. 33, 304–311. https://doi.org/10.1111/2047-3095.12362 (2022).
Acknowledgements
We thank Dr. Bashayer Farhan ALruwali for her immense contribution to this manuscript preparation. Furthermore, we would like to thank Editage (www.editage.com) for English language editing.
Funding
“This work was funded by the Deanship of Graduate Studies and Scientific Research at Jouf University under grant No. (DGSSR-2023-01-02529).”
Author information
Authors and Affiliations
Contributions
Concepts, M.U.S., A.A.A., M.A. and M.S.A.; methods, M.U.S., A.N.A, M.A.A., M.F.A. and A.S.A.; software, A.S.A. and M.A.; validation, M.U.S., A.N.A., M.F.A. and A.S.A.; data analysis, M.U.S., A.A.A., M.A. and M.S.A; investigation, M.A., M.A.A. and A.S.A.; data curation, M.S.A., A.N.A, M.A.A., M.F.A. and A.S.A.; writing—original draft preparation, M.U.S., A.A.A., M.A. and M.S.A.; writing—review and edit-ing, A.N.A., M.A.A., M.F.A. and A.S.A.; visualization, M.F.A. and A.S.A.; supervision, M.U.S.; project administration, M.U.S., A.A.A. and M.A. All authors have read and agreed to the published version of the manuscript.”
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Sayeed, M.U., Alsaidan, A.A., Thirunavukkarasu, A. et al. Perceptions and motivations toward critical thinking among health science students in northern Saudi Arabia: a cross-sectional study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-49924-y
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-49924-y
