CRITICAL THINKING

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CRITICAL THINKING

• AN ACQUIRED PROCESS

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Critical Thinking Defined

• . . . an active, organized, cognitive process
  used to carefully examine ones thinking and the
  thinking of others

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Goals of Critical Thinking

• Best nursing care for clients
• Professionalism
• Best solutions for clients needs
• Assist client to maintain, regain or improve
  health

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I Wonder Why

• ?
• ?
• ?

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Critical Thinking
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Attributes of Critical Thinkers

• Identifies and challenges assumptions
• Considers what is important in a situation
• Imagines and explores alternatives
• Considers ethical principles
• Applies reason and logic

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Questions to Ask

• What do I really know about this nursing
  situation?
• How do I know it?
• What options are available to me?

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Important Aspects of Critical Thinking

• Reflection
• Language
• Intuition

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Reflection

• . . . process of purposefully thinking back or
  recalling a situation to discover its purpose or
  meaning
• . . . process that helps make sense out of an
  experience so that the next time a similar
  experience arises, a nurse can use approaches
  that were successful or revise a previous
  approach to achieve better client outcomes

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Benefits of Reflection

• Provides insights about meaning of situation
• Assists with self-evaluation
• Enables understanding of relationships between
  concepts learned in class and real-life clinical
  situations
• Allows consideration of all possibilities

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Language

• Language use is closely associated with ability
  to think meaningfully.
• Must be able to use language precisely and
  clearly

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Intuition

• . . . Direct understanding of particulars in a
  situation without conscious deliberation.
• Inner sense
• Develops as clinical experience increases
• Trigger or Red-Flag
• CAN NOT be used alone
• Critical to be aware of what you Dont Know

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Thinking and Learning

• Learning
• Lifelong process
• Requires flexibility

• Thinking
• Must not become routine or standardized

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Knowledge

• With knowledge a nurse is able to think
  critically and positively influence nursing
  practice.

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Levels of Critical Thinking

• Basic
• Complex
• Commitment

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Basic Level of Critical Thinking

• Learner trusts experts
• Accepts opinions and values
• Thinking is concrete based on set of rules or
  principles
• Answers to questions are either right or wrong
• One answer usually exists
• Does not deviate from standard protocols or
  policies

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Complex Level of Critical Thinking

• Detaches from authorities
• Analyzes and examines alternatives independently
• Look beyond experts opinions
• Realizes alternative solutions do exist
• Weighs benefits and risks
• Creative and innovative thinking emerges
• Willing to consider deviations from standard
  protocols and policies

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Commitment Level of Critical Thinking

• Anticipates needs to make choices without
  assistance from others
• Assumes accountability for choices
• Considers complex alternatives, chooses action or
  belief based on alternatives available, and
  stands by choice

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Critical Thinking Competencies

• General Critical Thinking
• Specific Critical Thinking in Clinical Situations
• Specific Critical Thinking in Nursing

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General Critical Thinking

• Scientific method
• Problem solving
• Decision making

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Specific Critical Thinking in Clinical Situations

• Diagnostic reasoning
• Clinical inferences
• Clinical decision making

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Scientific Method

• Identify the problem
• Collect data
• Formulate hypothesis or question
• Test hypothesis or question
• Evaluate results

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Problem Solving

• Obtaining and using information and knowledge to
  find a solution
• Also involves evaluation solution over time to
  determine effectiveness

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Decision Making

• . . . End point of critical thinking that
  hopefully leads to problem resolution.
• Depends on appropriate recognition and definition
  of the problem as well as thorough data
  collection
• Requires consideration of all options and
  consequences
• Requires examination of all criteria

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Diagnostic Reasoning and Inference

• Diagnostic reasoning occurs when clinical data is
  analyzed.
• Inferences are conclusions drawn from related
  pieces of evidence.

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Clinical Decision Making

• Collaborative nurse-client process
• . . . requires careful reasoning so that the
  options for the best client outcomes are chosen
  on the basis of the clients condition and the
  priority of the problem.

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Decision Making Criteria

• What needs to be achieved?
• What needs to be preserved?
• What needs to be avoided?

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Nursing Process
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Critical Thinking Model
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Components of Critical Thinking in Nursing

• Specific knowledge base in nursing
• Experience in nursing
• Critical thinking competencies
• Attitudes for critical thinking
• Standards for critical thinking

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Specific Knowledge Base

• Varies by educational experience
• Includes self-initiative
• Includes information and theory from the basic
  sciences, humanities, behavioral sciences, and
  nursing
• Broad knowledge base gives a more holistic view
  of clients and their health care needs

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Experience

• Practice is necessary for critical thinking
  skills to develop
• Nurses learn from observing, sensing, talking
  with clients and families and active reflection
  on all experiences

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Attitudes for Critical Thinking

• Confidence
• Thinking independently
• Fairness
• Responsibility and Accountability
• Risk taking
• Discipline
• Perseverance
• Creativity
• Curiosity
• Integrity
• Humility

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Standards for Critical Thinking

• Intellectual standards
• Professional standards