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This is a quasi-experimental study with one group pretest and posttest design. The objective was to study the effectiveness of teaching and learning using the process of developing a nursing practice guideline: from an evidence-based and reflective thinking on twenty first century learning skills. The sample included 156 second year nursing students. The instrument used in the experiment was a teaching and learning model using the process of developing a nursing practice guideline from an evidence based and reflective thinking. The conceptual framework was a model of developing a nursing practice guideline from an evidence-base (based on Soukup) and reflective thinking (based on Gibbs.) The research instrument was a questionnaire on twenty-first century learning skills developed by Turner, et al. Data were analyzed by using mean, standard deviation and paired t-test. The results showed that the twenty-first century learning skills of nursing students after learning using the process of developing a nursing practice guideline from an evidence-based and reflective thinking were higher than before learning at a statistically significant at level (p < 05). The results of this research clearly reflect the effectiveness of teaching and learning using the process of developing a nursing practice guideline from an evidence-based with reflective thinking. Nursing educations should provide a teaching and learning design that emphasizes the use of an evidence-based with concrete reflective thinking in every subject they should cultivate good attitudes towards the use of an evidence base throughout the period of being a student, to enable them to apply empirical an evidence-based in nursing practice and to improve nursing service quality in the future.
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