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Reasonable, reflective thinking focused on what to believe or do (Ennis & Milman, 1985)
The propensity to engage in an activity with reflective skepticism (McPeck, 1990)
Purposeful goal directed thinking (Halpern, 1989)
The art of thinking about thinking while thinking to make thinking better (Paul & Heaslip, 1995)
Purposeful, self-regulatory judgment (Facione, 1990)
What it is NOT
Common sense
Spontaneous responses
Regular or “normal” thinking
Being critical or judgmental
Disorganized
Task-oriented
Working in isolation
Being competitive
Inability to communicate with others
Lack of concern with motives, facts, underlying reasons
Emotion-driven
What are some related concepts?
Mind Map
Logic and reasoning
Creativity
Intuition
Emotional intelligence
Problem solving
Nursing process
Decision making
Clinical or diagnostic reasoning
Reflective practice
Clinical judgment
Convergent or divergent thinking
How does this translate to nursing?
Reflective, reasonable thinking about nursing problems without a single solution
Clinical decision making or diagnostic reasoning or Professional judgment
Reflective practice
Why is it essential to be a Critical Thinker in nursing?
To manage complex dilemmas
For empowerment and liberation
To exchange views and information
To broaden or change our thinking and learning
For self-actualization
What are some factors which impede or enhance critical thinking?
Moral development (fair mindedness)
Age, self confidence
Dislikes, prejudices, biases
Interpersonal skills
Reading and writing skills
Anxiety, stress, fatigue
Time factors
Environmental distractions or comforts
Lack of motivation or positive reinforcement
Past experiences
Support systems—mentors, coaches, colleagues, family, friends
What are some key assumptions for critical thinking?
It is rational
It involves conceptualization
It requires reflection
It is a nonlinear process that expands problem solving and nursing process
It involves both cognitive and affective skills
The skills can be taught, learned, and measured
The skills need to be practiced and reinforced
It involves creative thinking
It requires basic and advanced nursing knowledge
It is both a process and an outcome
It is embedded in our practice
Are you a Critical Thinker? Do you…
Explore underlying thinking and assumptions
Base judgments on facts and reasoning
Suspend judgment until you have all the data
Support views with evidence
Evaluate the credibility of sources
Turn mistakes into learning opportunities
Ask “Why?” and “Why not?”
Be open to possibilities
Seek themes, patterns, trends
Follow hunches
What are some traits or dispositions of Critical Thinkers?
APA Delphi Study (Facione, 1990)
Truth-seeking – courageous about asking questions, honest and objective in pursuing inquiry
Open-mindedness – sensitive to own bias, respect rights of others to hold differing opinions
Analyticity – alert to potentially problematic situations
Systematicity – organized, orderly, focused, diligent inquiry
Self-confidence – trust in own reasoning
Inquisitiveness – intellectual curiousity, values being well informed
Maturity – disposed to make reflective judgments
Reflection, Perseverance, Contextual perspective, Creativity, Flexibility, Intuition (Nursing Delphi Study, Scheffer & Rubenfeld, 2000)
What are some cognitive skills of Critical Thinkers?
APA Delphi Study (Facione, 1990)
Interpretation – categorization, decoding significance, clarifying meaning
Analysis – examining ideas, detecting and analyzing arguments
Evaluation – assessing claims and arguments
Inference – quering evidence, conjecturing alternatives, drawing conclusions
Explanation –stating results, justifying procedures, presenting arguments
Self-monitoring -- self-examination and correction
Information seeking, Discriminating, Predicting, Applying Standards, Logical reasoning (Nursing Delphi Study, Scheffer & Rubenfeld, 2000)
What are some Nursing Models or conceptual frameworks related to critical thinking?
Novice vs. Expert or Struggling vs. Exemplary nurses (Benner, 1984; Beeken, 1997)
T.H.I.N.K. Model (Rubenfeld & Scheffer, 1995)
Critical Thinking Interaction Model (Miller & Babcock, 1996)
Nursing judgment model (Kataoka-Yahiro & Saylor, 1994)
Curricular model for evaluation (Videbeck, 1997)
Conceptual framework based on consensus statement for evaluation of specific outcomes and competencies (Facione, 1990; Dexter et al., 1997; Colucciello, 1997)
Four Steps for Problem Analysis and Positive Problem Solving (Jackson, 2004)
How do we put the pieces together to see the Big Picture and relate the concepts for nursing? (see Mind Map)
Begin with Triggers or a particular event or dilemma or complex problem
Go to Starting Points or types of thinking that help us begin the process, i.e. brainstorming, intuition, thinking aloud, reflective thinking
Build on the Scaffolds or knowledge, skills and expertise that supports our ability to think critically
Lead into the Processes which involve different types of thinking that contribute to critical thinking, i.e. convergent and divergent thinking, reflection, nursing process, problem solving, creative thinking, diagnostic reasoning
Follow with Outcomes which may include problem resolution, alternative solutions, clinical judgments, reflective practice
Evaluate Triggers
Continuous and iterative loop—A Mind Map for Critical Thinking in Nursing
What is a Holistic Approach to Critical Thinking?
Critical Listening = monitoring how we listen
Critical Thinking = disciplined, self-directed, thinking about thinking
Critical Writing = requires disciplined thinking, expression of disciplined thinking
Critical Reading = inner dialogue with writer, enter point of view of writer
Critical Speaking = others gain in-depth understanding of speaker’s perspective
What are some final reflections?
Critical thinking is both a process and an outcome
Critical thinking involves reflection in knowing and in action and self monitoring
Critical thinking is composed of specific traits or dispositions and cognitive skills.
Nursing utilizes critical thinking as diagnostic reasoning and professional or clinical judgment.
Nursing supports critical thinking in Reflective Practice
Critical thinking in nursing is based on a triggering event or situation, a starting point, scaffolds, processes, and outcomes that make up a continuous or iterative feedback loop