Following a curriculum revision, which emphasized critical thinking, a school of nursing selected the California Critical Thinking Skills Test (CCTST) as a standardized outcomes measure for its bachelor's of science in nursing (BSN) program. Students in three tracks of the program were administered the CCTST on entry into the nursing curriculum and again on exit. Paired t tests for dependent samples were used to analyze pretest-posttest differences of all students (N = 136) in the program. Results for students in each of the three tracks demonstrated significantly improved (P < or = .05) CCTST scores on all subscales and total scores, with one exception. RN to BSN students' scores on the Analysis subscale approached but did not reach significance (P = .058). Implications for evaluation are discussed.

Several cross-sectional, qualitative studies suggest that physical alterations in appearance or functioning have the potential to influence self-esteem. There have been no studies describing the process of adapting to body image disruption. A grounded theory of reimaging is proposed, based on the experiences of 28 participants who had experienced significant weight change, loss or paralysis of body parts, ostomies, scarring from burns or trauma, or surgical reconstruction. Participants were interviewed at 3, 6, 12, and 18 months following the physical alteration. Three phases, action processes, influencing factors, and outcomes, of reimaging are described.