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PubMed1999

Catching the wave: understanding the concept of critical thinking.

As a practice-orientated profession, nursing is clearly guided by theoretical concepts. Concept clarification attempts to show speakers and readers how they can liberate themselves from the judgement limitations imposed by rigid, unexamined beliefs, by exposing differences in the interpretation of language and how that interpretation creates meaning. Critical thinking is one way nurses apply the process of inquiry. As a method of assessing, planning, implementing, evaluating and reconstructing nursing care, a critical thinking approach encourages nurses to challenge established theory and practice. Existing literature on critical thinking is confusing in its description of the process, and ambiguous in drawing relationships between critical thinking and the language currently used to illustrate the process of nursing. This paper examines elements and components of critical thinking as they relate to the language of nursing: problem solving, decision making, clinical judgement, reflection, and the nursing process. The purpose of this analysis is to illuminate the meaning and clarify the intent of critical thinking application to nursing practice. The paper begins by briefly outlining the historical aspects of critical social theory, suggesting that the foundational tenets of critical theory have influenced the development of critical thinking. The paper also critically compares the language used to describe critical thinking and that language that has traditionally defined nursing.

Decision Making↗

PubMedDate not supplied

Critical thinking skills of baccalaureate nursing students at program entry and exit.

Most nurse educators would agree that critical thinking is an essential competency for the professional nurse in today's ever-changing health care environment. In fact, critical thinking has been identified as an integral component of professional nursing practice and has been incorporated in accreditation guidelines (1-3). As a result of this imperative, professional programs of nursing must explicate a clear definition of critical thinking, identify specific learning outcomes reflective of critical thinking abilities, and select appropriate ways to measure the achievement of these outcomes in graduating students. Although much has been written about the need for critical thinking skills, the concept and measurement of critical thinking within the context of nursing education has not yet been clearly defined (4-6). As a result, nursing programs are developing their own conceptual definitions of critical thinking and using a variety of methods to measure outcomes (5). The authors caution that to ensure validity of findings, the instruments used must reflect the individual program's definition of the concept. In most cases, outcomes have been assessed using a cross-sectional design that compares students at different levels or types of programs or are measured as an end-of-program outcome. While such designs can provide educators with knowledge of students' critical thinking abilities at a particular point in the educational process, longitudinal data are needed to assess the effects of the educational program.

Accreditation↗

PubMed1996

A transactional perspective on critical thinking.

The quality of thinking has received much attention within the last decade. The scientific inquiry models introduced by Dewey, Dressel and Mayhew, and Watson-Glaser have been expanded to incorporate such aspects as reflection, development, attitude, skill, and knowledge domain. Dichotomies between critical and creative thinking have been eased. While this scholarship on thinking has been impressive, current pedagogy remains focused on scientific inquiry and on received knowledge. In nursing the learning paradigm has been similarly focused for the past 3 decades on a scientific inquiry model and received knowledge. The major cognitive approach to education and practice has been the nursing process, a linear problem-solving paradigm equivalent to the scientific method. This linear approach does not fully account for how nurses think and make judgments in clinical practice. The Transactional Model of Critical Thinking presented in this paper addresses the complexity of critical thinking in nursing. The model provides an educative and novel vision of thinking based on a transactional view of the individual, personal attributes, and the environment. Components and elements of the model are described and suggestions made for teaching-learning and for evaluation of critical thinking in nursing.

Adult↗

PubMed2003

A comparison of critical thinking in groups of third-year medical students in text, video, and virtual PBL case modalities.

PURPOSE: To determine whether critical thinking in problem-based learning (PBL) group discourse differed according to case modality. METHOD: The study was conducted in 2000 in the Department of Pediatrics at the University of Colorado School of Medicine in Denver. Third-year medical students on their pediatrics clerkship were divided into three groups: face-to-face with a text case, face-to-face with a digital video case, and virtual with a digital video case. Twenty-four groups were divided among the three case modalities. Using an existing coding scheme, each distinct codable unit of discourse was placed into one of 35 indicators reflective of five critical-thinking stages. For each group's discourse, a critical-thinking ratio was calculated for each of the stages. The Kruskal-Wallis test was used to compare the critical-thinking ratios for each stage across the three modalities. Residual conversation to indicate processes occurring within the group was also coded. RESULTS: A content analysis of the transcripts of 13 of the 24 group discussions occurred. The virtual groups had the highest critical-thinking ratio. Except for the problem-identification stage, the video groups had higher ratios that the text groups did. CONCLUSIONS: This exploratory study examined how the mode of case presentation affected the critical thinking of groups using the PBL format. Students who learned in a virtual modality with a digital video case engaged in more critical thinking. The data suggest that the video enhanced critical thinking in both face-to-face and virtual PBL groups.

CD-ROM↗

PubMed2006

Appraising, researching and conceptualizing criminal thinking: a personal view.

BACKGROUND: It is argued that current interest in the concept of criminal thinking has its roots in traditional theories of criminology and criminal justice such as Sutherland's differential association model, neutralization theory, and Yochelson and Samenow's criminal personality. AIM: The purpose of this paper is to briefly review and summarize theory, research, and practice on criminal thinking as it relates to the author's work in this area. CONCLUSIONS: Three self-report inventories--the Criminal Sentiments Scale (CSS), the Psychological Inventory of Criminal Thinking Styles (PICTS), and the Measures of Criminal Attitudes and Associates (MCAA); three principal areas of research--criminal thinking as a predictor of criminal behaviour, offence as a moderator of criminal thinking, and changes in criminal thinking leading to changes in criminal behaviour; and a general theory of criminal thinking are briefly reviewed in this paper.

Attitude↗

PubMedDate not supplied

Professionalism versus general critical thinking abilities of senior nursing students in four types of nursing curricula.

This descriptive study was undertaken to investigate the relationship between professionalism and critical thinking abilities of senior nursing students in four types of nursing educational programs: generic baccalaureate, associate, and diploma--the basic registered nurse (RN) programs--along with the upper division baccalaureate, specifically RN completion, program. Fifty students from each type of program were conveniently selected during the same spring semester before graduation. Professionalism was measured by the Health Care Professional Attitude Inventory; general critical thinking abilities, by the Watson-Glaser Critical Thinking Appraisal. For individual programs, low to moderate correlations ranging from r = 0.263 (diploma) to 0.516 (upper division) were found between critical thinking and professionalism. This culminated in a significant, low positive correlation (r = 0.447) between critical thinking and professionalism across all programs. Upper division seniors showed significant low to moderate positive correlations for age with critical thinking (r = 0.487) and professionalism (r = 0.327) that were not observed in the other programs. Comparisons of professionalism scores among programs showed that upper division seniors scored highest. The measure of professionalism for seniors from 4-year generic programs was not significantly different from associate degree seniors. Diploma program seniors showed the lowest level of professionalism. When critical thinking abilities were compared, seniors from generic and upper division baccalaureate programs showed significantly higher levels than those from associate and diploma programs.

Adult↗

PubMed2004

State-dependent thinking: a comparison of waking and dreaming thought.

Thinking is known to be state dependent but a systematic study of how thinking in dreams differs from thinking while awake has not been done. The study consisted of analyzing the dream reports of 26 subjects who, in addition to providing dream reports also provided answers to questions about their thinking within the dream. Our hypothesis was that thinking in dreams is not monolithic but has two distinct components, one that is similar to wake-state cognition, and another that is fundamentally different. We found that cognition within a dream scenario was similar to that of wake-state cognition, but that thinking about the scenario itself was deficient and very different than wake-state thinking.

Adolescent↗

PubMedDate not supplied

Critical thinking during the adult years: has the developmental function changed over the last four decades?

Age, sex, and education differences in critical thinking during the adult years were investigated. The Watson-Glaser (1980) Critical Thinking Appraisal was administered to 60 men and women between the ages of 20 and 79. Regression analyses indicated that age was significantly related to overall critical thinking: Performance decreased with increasing age. Education was also significantly related to critical thinking: Performance increased with increasing education. However, an interaction between age and education in the analysis of total critical thinking scores indicated that education was significantly related to critical thinking only in the later adult years. No sex differences were found in critical thinking performance.

Adult↗

PubMedDate not supplied

Critical thinking and accuracy of nurses' diagnoses.

Interpretations of patient data are complex and diverse, contributing to a risk of low accuracy nursing diagnoses. This risk is confirmed in research findings that accuracy of nurses' diagnoses varied widely from high to low. Highly accurate diagnoses are essential, however, to guide nursing interventions for the achievement of positive health outcomes. Development of critical thinking abilities is likely to improve accuracy of nurses' diagnoses. New views of critical thinking serve as a basis for critical thinking in nursing. Seven cognitive skills and ten habits of mind are identified as dimensions of critical thinking for use in the diagnostic process. Application of the cognitive skills of critical thinking illustrates the importance of using critical thinking for accuracy of nurses' diagnoses. Ten strategies are proposed for self-development of critical thinking abilities.

Adolescent↗

PubMed2003

A study of critical thinking and research utilization among nurses.

Previous studies have suggested that critical thinking influences research utilization; however, empirical support for the link between critical thinking dispositions and research utilization is nonexistent. In this article, critical thinking dispositions and research utilization habits are detailed, and the relationship of critical thinking dispositions to research utilization in a sample of 141 nurses working on two acute surgical units and five pediatric units in four tertiary care hospitals are examined. Results indicate a significant positive correlation between the total critical thinking disposition score and overall research utilization. Overall critical thinking disposition correlates significantly with all forms of research utilization, with the exception of symbolic research utilization. These findings indicate a need to foster critical thinking in both nursing education and the work environment.

Analysis of Variance↗

PubMed2001

The holism in critical thinking. A concept analysis.

In nursing, critical thinking is particularly important because of its potential impact on patient care. With the rapid changes in health care and the influx of new technology, nurses must be able to use critical thinking to make decisions that provide optimal patient care. The rapid, dynamic changes occurring in the health care setting have dictated a stronger, more comprehensive, holistic way of arriving at decisions than the traditional nursing process. This more comprehensive, holistic approach is called critical thinking. Nurses must be able to engage in critical thinking to handle the onslaught of continuous procedural and technological changes. Critical thinking has become such a key component in learning that the National League for Nursing requires that graduates be able to demonstrate critical thinking. This article is a concept analysis of critical thinking using the Walker and Avant model.

Adult↗

PubMed1991

Critical thinking for environmental health risk education.

This article proposes an approach for helping school-age children to think critically about environmental health risks. It discusses three key elements of a school curriculum--defining a decision perspective, making choices under uncertainty, and thinking about consequences--and recommends procedures to aid in classroom implementation of the proposed ideas. Critical thinking skills are shown to enhance childrens' ability to anticipate the health or safety consequences of a decision by distinguishing automatic from decision thinking, by detecting inconsistent objectives or neglected consequences, and by making explicit value-based tradeoffs. Training in critical thinking also should empower children because it acknowledges the power of personal initiatives in decreasing health risks and, in general, because it focuses the classroom experience on learning about how to think rather than merely learning about what to think.

Adolescent↗

PubMed2004

Exploring the attributes of critical thinking: a conceptual basis.

Many teaching methods used in nursing education to enhance critical thinking focus on teaching students how to directly apply knowledge; a technically rational approach. While seemingly effective at enhancing students' critical thinking abilities in structured learning situations, these methods don't prepare students to operationalize critical thinking to manage the complexities that actually exist in practice. The work of contemporary educational theorists Paulo Freire, Donald Schon, Chris Argyris, Jack Mezirow, Stephen Brookfield, and Robert Tennyson all share similar perspectives on thinking in practice and the use of reflection to achieve a coherence of understanding. Their perspectives provide insight on how educators can shift from a means-end approach to operationalizing thinking in practice. The author identifies four attributes of critical thinking in practice evidenced in these views, followed by a discussion of specific educational strategies that reflect these attributes, and operationalize a critical thinking process in nursing practice to achieve a coherence of understanding.

Clinical Competence↗

PubMed2004

Psychometric analysis of the Minnesota Test of Critical Thinking.

With the increase over the past two decades in interest in critical thinking instruction, reliable and valid means for measuring critical thinking are necessary. The Minnesota Test of Critical Thinking was developed to measure critical thinking as defined by the American Philosophical Association in 1990. The present purpose was to explore the structure and reliability of the intervention and its instantiation of the critical thinking framework. Analyses of responses from 151 adult participants gave estimates of reliability varying from .29 to .78. A factor analysis of the test scores supported critical thinking conceptualized as a single, latent trait. With further refinement, the invention should become a valuable measure of general critical thinking skills of upper-division secondary and postsecondary students.

Adult↗

PubMedDate not supplied

Factors associated with critical thinking among nurses.

The ability to think critically is increasingly hypothesized to play an important role in a nurse's ability to function competently in complex health care settings. This cross-sectional exploratory survey used secondary data (Gendrop, 1989) to assess the critical thinking ability of a convenience sample of 160 nurses from two urban hospitals. Four variables hypothesized to be associated with critical thinking ability were explored: age, level of education, years of nursing experience, and area of expertise in nursing. Critical thinking was assessed using the Watson Glaser Critical Thinking Appraisal Tool (WGCTA). Study findings suggest that age and years of experience were negatively correlated with critical thinking ability. However, the level of education was positively related to critical thinking. Future needs for research were identified and implications for nursing education and practice were provided.

Adult↗

PubMedDate not supplied

Models, measurement, and strategies in developing critical-thinking skills.

Health care professionals must use critical-thinking skills to solve increasingly complex problems. Educators need to help nurses develop their critical-thinking skills to maintain and enhance their competence. This article reviews various models of critical thinking, as well as methods used to evaluate critical thinking. Specific educational strategies to develop nurses' critical-thinking skills are discussed. Additional research studies are needed to determine how the process of nursing practice can nurture and develop critical-thinking skills, and which strategies are most effective in developing and evaluating critical thinking.

Attitude of Health Personnel↗

PubMed1993

Clarifying the concept of critical thinking in nursing.

Nursing must chart a course between the pedagogical extremes of process versus content-focused courses. No one would deny the fact that nurses must have a solid knowledge base in addition to demonstrating an ability to think critically. Reason favors a "both-and" rather than an "either-or" approach to this issue. Justifiably, nurses have jumped on the bandwagon of critical thinking. Once on the bandwagon, however, the elusive butterfly of critical thinking has been difficult to net. It is time to inform the driver that a new course for nursing must be charted. So far, the reported nursing research has focused on critical thinking conceptualized as a score on a broad, objective test. The important first step of establishing a clear concept that defines critical thinking in nursing has not been accomplished. Finding out what the expert nurse does with knowledge will help us to articulate a conception of critical thinking that can then be used as a springboard for various teaching strategies. If educators are persuaded that "students can and should think their way through the content of their courses, can and should gain some grasp of the logic of what they study, can and should develop explicit intellectual standards, then they can find many ways to move instruction in this direction" (Barnes, 1992, p. 22).

Clinical Competence↗

PubMed1996

Relationship of critical thinking ability to professional nursing competence.

The relationship of critical thinking ability to professional nursing competence was investigated. Professional nursing competence, defined by Benner (1984) as stages of skill acquisition (novice, advanced beginner, competent, proficient, and expert), provided the conceptual framework. A randomly selected, cross-sectional sample of nursing graduates (N = 121) was utilized. Two cohorts (N = 30) of the sample group were measured longitudinally for critical thinking ability. Relationships were investigated between measures of critical thinking and professional competencies of leadership, critical care, teaching/collaboration, planning/evaluation, interpersonal communication and professional development. Critical thinking was measured over time from beginning nursing student to practicing nurse. Critical thinking ability did not change significantly during the educational experience (sophomore to senior), however, a significant increase was found in scores as practicing nurses. No relationship was demonstrated between critical thinking ability and professional competence. The experiential component of practice emerged as the key influencing factor on the development of competence and critical thinking.

Analysis of Variance↗