Today I was thinking about critical thinking as I was preparing for a classroom activity. We know critical thinking is important to nursing, but how important is it? How does an instructor teach critical thinking, especially to those who have no concept of what it actually entails. Do our leaders critically think? Does someone in a leadership role critically think? How do we get those in leadership to learn how to critically think?
What exactly is critical thinking? The term critical thinking is often used to mean problem solving, decision making and creative thinking in nursing, and yet there is no widely accepted definition of critical thinking. (Fero, Witsberger, Wesmiller, Zull, & Hoffman, 2009). So with that as a basis for critical thinking, how then can we as educators teach the next generation of nurses to learn to "think out side the box" or "creatively think" when placed in leadership roles, if we can not teach them that skill to functiona as a nurse generalist? In critically thinking, it helps one to understand that why solutions to particular issues have failed is part of the subset of these skills necessary to think in a critical manner (Fero, et al, 2008). With the world of nursing changing almost everyday, and with patients becoming more complex, it is important for nurse eductors to to teach students to critically think and how to practice competently in a variety of situations in which there is no clear solutions to the problem presented (Kaddoura, 2011).
Nursing needs leaders that can critically think. Nursing needs leaders to improve the nursing profession and become more forthright in the provision of patient care and safety. A study by Fero and team (2009) found that approximately 25% new graduates were not meeting the expectation of having developed critical thinking skills, and these deficiencies included problem recognition, reporting of essential datat, initiating independent nursing interventions, anticipating relevant medical orders, and providing relevant rationale to support decisions. It seems frightening that we are releasing graduate nurses to the world, and they have very little skills in critical thinking. Nurse educators need to find ways of equiping the nursing skills that would promote critical thinking to solve complex problems (Kaddoura, 2011). In order to do this, educators can promote active learning and a provide prudent preparation for clinical practice by useing case-based learning (Bradshaw & Lowensteing, 2011).
Having students learn through case studies allows them to think about the big picture and to come up with all possible solutions to that particular issue. They can brainstorm together and look at the solutions and put it into role playing practice. They can also role play with the issue at hand to as to develop the critical thinking and problemsolving that wourl be a necessary skill when working with complex patients.
How do you see critical thinking? What does this term mean to you? Do you think you have the skills of critical thinking and leadership? Can one exist with out the other?
Judi
Reference
Bradshaw, M. J., & Lowenstein, A. J. (2011). Innovative teaching strategies in nursing and related health professions (5th ed.). Sudbury, MA: Jones and Bartlett.
Fero, L. J., Witsberger, C. M., Wesmiller, S. W., Zulio, T. G., & Hoffman, L. A. (2009). Critical thinking ability of new graduate and experienced nurses. Journal of Advanced Nursing, 65(1), 139-148. doi:10.1111/j.1365-2648.2008.04834.x.
Kaddoura, M.A. (2011). Critical thinking skills of nursing students in lecture-based teaching and case-based learning. International Journal for the Scholarship of Teaching and Learning, 5(2). Retrieved from http://www.georgiasouthern.edu/ijoti
Is there a difference between critical thinking and clinical reasoning? If so, which is more important to nurses?
ReplyDeleteI think that critical thinking involves not being satisfied with the status quo, but looking at the "why" things are the way they are. Clinical reasoning, to me, is the ability to receive clinical information, and prioritize patient needs based on this information. A slightly different approach to patient care. Rosalinda Alfaro-LeFevre has written extensively on this topic and has some great teaching tools.
Alfaro-LeFevre, R. (2012). Critical Thinking Indicators. Retrieved from http://www.alfaroteachsmart.com/index.html
Critical thinking is important in making sound clinical reasoning. Critical thinking involves the application of knowledge and experience to identify patient problems and to direct clinical judgments and actions that result in positive patient outcomes.(Benner, Hughes & Sutphen, n. d.). On the other hand,critical reasoning is a process whereby knowledge and experience are applied in considering multiple possibilities to achieve the desired goals, while considering the patient’s situation (Benner, Hughes, & Sutphen, n. d.). When one would think about what exactly is critical reasoning, it would be a process in which both inductive and deductive cognitive skills are used to solve the issues at hand. Sometimes clinical reasoning is presented as a form of evaluating scientific knowledge or even a form of scientific reasoning.
DeleteWhat I do know is that with the complex patient care that we are seeing not only in hospitals but in long term care facilities, clinical thinking is vital to patient care in today's world.
Benner, P., Hughes, R. G. & Sutphen, M. (n.d.). Chapter 6: Clinical reasoning, decisionmaking, and action: Thinking critically and clinically. Retrieved from http://www.ahrq.gov/qual/nurseshdbk/docs/BennerP_CRDA.pdf