Transcript Critical Thinking - HealthcareSource

Critical Thinking
Presented by
Beth Edwards, RN, EMT-P
Clinical Education Coordinator
SMH Staff Development
Objectives
• To discuss reasons why we should use
critical thinking
• Define the meaning of critical thinking
• Discuss applications to nursing practice
• Describe traits of a critical thinker
• Discuss factors that impede or
enhance critical thinking
• Discuss how to improve critical thinking
skills
Why Should We Critically
Think?
• Widening Responsibilities as
nurses
• Patients are increasingly ill
• Patients have multi-system health
problems
• Complex working environments
• Rapid changes in healthcare
What is Critical
Thinking?
• Critical Thinking has many different
definitions
• Difficult to measure in nursing
school
• Related to competent nursing
practice
• Closely associated with nursing
process, clinical judgment &
problem solving
“Critical”
• The word critical comes from the Greek
word "kritikos," meaning "critic." To be
critical means to question; to make
sense of something; to analyze a
situation. Although for many the word
critical has become synonymous with
negativity, it really is a positive
opportunity to reach a favorable
outcome.
• Critical, as defined in Webster's
Dictionary, gives us some words to
associate. These are "crucial, decisive,
indispensable, and vital." It also is
defined as "exercising or involving
careful judgment or judicious
evaluation."
“Thinking”
• Thinking can be divided into directed
and non-directed thinking.
– Non-directed thinking
• when we engage our brains in habitual activities like
grooming or driving to and from work.
– Directed thinking
• goal-oriented and purposeful
• searching for answers & meaning, requires a
conscious mental effort
• involves observation, memory, inquiry, interpretation,
analysis, & evaluation skills.
• Webster's Dictionary: thinking is
synchronous with "to have as an opinion,"
"to have as an expectation," "to mediate,"
"to form a mental picture of," and "to
subject to the processes of logical thought."
Putting them together
• Putting the two terms together
would indicate a mental process
of putting together crucial,
decisive, indispensable and vital
information to provide careful
judgment and judicious
evaluation in formulating an
opinion, mental picture,
expectation and/or decision.
Definition
• From the Delphi Study of American
Philosophical Association:
– Critical thinking is a “purposeful, selfregulatory judgment which results in
interpretation, analysis, evaluation,
and inference as well as the
explanation of the rationale upon
which the judgment is based. Critical
thinking is reasonable, rational,
reflective, autonomous thinking that
inspires attitude of inquiry.”
What else?
• Reasonable, reflective thinking focused
on what to believe or do
• The tendency to engage in an activity
with reflective skepticism
• Purposeful, goal-directed thinking
• Purposeful, self-regulatory judgment
• The art of thinking about thinking while
thinking to make thinking better
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
How does this translate
into 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 that
impede or enhance critical
thinking?
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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?
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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 of a
critical thinker?
• 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
• Analyst – alert to potentially problematic
situations
• Systematic – organized, orderly, focused, diligent
inquiry
• Self-confidence – trust in own reasoning
• Inquisitiveness – intellectual curiosity, values
being well informed
• Mature – disposed to make reflective judgments
• Reflection, Perseverance, Appropriate
perspective, Creativity, Flexibility, Intuition
APA Delphi Study
What are some cognitive
skills of critical thinkers?
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Interpret – categorization, decoding
significance, clarifying meaning
Analyze – examining ideas, detecting and
analyzing arguments
Evaluate – assessing claims and arguments
Infer – question evidence, imagine
alternatives, drawing conclusions
Explain – stating results, justifying
procedures, presenting arguments
Self-monitor - self-examination and
correction
Information seeking, Discriminating,
Predicting, Applying Standards, Logical
reasoning
APA Delphi Study
Who can critically think?
• Anyone can and everyone should!
• There is no research to support that a
professional program of study
increases critical thinking ability.
• We can all critically think within our
roles.
We must think about our
thinking!
• Critical thinking requires you to
challenge your assumptions and think
about consequences.
• Think about it!
• Pull from past experiences and
knowledge base to expect and
anticipate.
• Consciously THINK about a situation
and act on it.
Think about it!
• How do you think about what
you think you think about???
How do we improve on our
critical thinking skills?
• Communication!
• Reflection!
• After any incident or shift, meet with your
co-workers and ask these questions:
– What went well?
– If you could do it over again, what would you
do differently?
– What are your plans for improvement that will
help you be more successful in the future?
– What help do you need to meet your goals?
Related Concepts
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Mind Map
Logic and reasoning
Creativity
Intuition
Emotional intelligence
Problem solving
Nursing process
Decision making
Clinical or diagnostic reasoning
Reflective practice
Clinical judgment
Putting the pieces together
(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
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 feedback loop
References
• Cise, J., Wilson, C., Thie, M. (2004). A qualitative tool for
critical thinking skill development. Nurse Educator, 29(4).
Retrieved May 8, 2005 from Ovid database.
• University of New Mexico Health Sciences Center
College of Nursing (2005). What is critical thinking?
Retrieved May 23, 2005 from
http://hsc.unm.edu/consg/conct/whatis.shtml#translate.
• Nichols, M. (2003). Critical thinking process. Retrieved
May 23, 2005 from
http://www.netce.com/course.asp?course=3119.