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PubMed1997

Critical thinking in nursing: classroom tactics that work.

Critical thinking ability is one of the required outcomes of nursing education and content coverage is a focus of the past (National League for Nursing, 1996). As educators, we must attend to how we define critical thinking, what educational methods support its development, and how we can assure that students have achieved some acceptable level of critical thinking skill (Tanner, 1993). This article describes the emergent development of one critical thinking format in a Community Health Nursing course. Rather than approaching critical thinking from a theoretical perspective or focusing on one type of assignment or experience as a tool to foster critical thinking development in nursing courses, this article shares with the reader a complete package. Problems, pitfalls, new insights, and changes are shared as they developed through the teaching of a semester-long Community Health Nursing course. The authors hope their experiences give faculty ideas about how to infuse critical thinking into nursing curricula.

Attitude↗

PubMed1999

Critical thinking and clinical competence: a study of their relationship in BSN seniors.

National nursing organizations and nurses in the workplace identify critical thinking skills as essential to competent nursing practice. This study sets out to test the relationship between critical thinking skills and clinical competence because it seems that competent practice depends on critical thinking abilities. This study focuses on one school of nursing's response to the challenge of defining and measuring critical thinking and clinical competence and examining their relationship. An exploratory nonexperimental design was used with a heterogeneous sample consisting of two graduating nursing classes (N = 143). While the group of participants was able to think critically and practice competently according to set standards, there were no statistically significant correlations between critical thinking and clinical competence total scores. One conclusion for these findings is that critical thinking may not emerge as an associated factor with clinical competence until some time after nursing students become practicing nurses.

Adult↗

PubMed2006

Higher order thinking skills competencies required by outcomes-based education from learners.

Outcomes-Based Education (OBE) brought about a significant paradigm shift in the education and training of learners in South Africa. OBE requires a shift from focusing on the teacher input (instruction offerings or syllabuses expressed in terms of content), to focusing on learner outcomes. OBE is moving away from 'transmission' models to constructivistic, learner-centered models that put emphasis on learning as an active process (Nieburh, 1996:30). Teachers act as facilitators and mediators of learning (Norms and Standards, Government Gazette vol 415, no 20844 of 2000). Facilitators are responsible to create the environment that is conducive for learners to construct their own knowledge, skills and values through interaction (Peters, 2000). The first critical cross-field outcome accepted by the South African Qualification Framework (SAQA) is that learners should be able to identify and solve problems by using critical and creative thinking skills. This paper seeks to explore some higher order thinking skills competencies required by OBE from learners such as critical thinking, reflective thinking, creative thinking, dialogic / dialectic thinking, decision making, problem solving and emotional intelligence and their implications in facilitating teaching and learning from the theoretical perspective. The philosophical underpinning of these higher order thinking skills is described to give direction to the study. It is recommended that a study focusing on the assessment of these intellectual concepts be made. The study may be qualitative, quantitative or mixed methods in nature (Creswell 2005).

Attitude of Health Personnel↗

PubMed1998

[Critical thinking among nurses during unit-based quality assurance projects].

The purposes of this study were to describe the objectives and levels of critical thinking among nurses during unit-based quality assurance projects and the meaning of the participation for their own development and nursing practice. The data were collected by interviewing ten nurses who had taken part in the quality assurance projects. The themes used in interviews were created on the basis of two open questions answered by 28 nurses. The data were analysed by using qualitative content analysis and applying the levels of reflective thinking developed by Mezirow (1981), Goodman (1984) and Järvinen (1990). The first level of critical thinking was defined as technical thinking, the second level as reflective thinking and the third level as critical reflection. The results showed that nurses reflected the structural factors of the quality assurance on the technical level. When reflecting their own quality assurance processes (process factors) nurses used their critical thinking on all levels. Very few nurses considered the outcome factors of the quality assurance, but when they focused their thinking on the outcomes the reflection reached all levels. The nurses reflected the meaning of the quality assurance projects on all three levels. According to the nurses, the quality assurance enhanced their professional abilities as well as motivation in work and self-esteem. The quality assurance projects also clarified the principles guiding nursing practice. Interaction between nurses, patients and colleagues became more open.

Attitude of Health Personnel↗

PubMedDate not supplied

Thinking in nursing education. Part II. A teacher's experience.

Across academia, educators are investigating teaching strategies that facilitate students' abilities to think critically. Because may these strategies require low teacher-student ratios or sustained involvement over time, efforts to implement them are often constrained by diminishing resources for education, faculty reductions, and increasing number of part-time teachers and students. In nursing, the challenges of teaching and learning critical thinking are compounded by the demands of providing care to patients with increasingly acute and complex problems in a wide variety of settings. To meet these challenges, nurse teachers have commonly used a variety of strategies to teach critical thinking (1). For instance, they often provide students with case studies or simulated clinical situations in classroom and laboratory settings (2). At other times, students are taught a process of critical thinking and given structured clinical assignments, such as care plans or care maps, where they apply this process in anticipating the care a particular patient will require. Accompanying students onto clinical units, teachers typically evaluate critical thinking ability by reviewing a student's preparation prior to the experience and discussing it with the student during the course of the experience. The rationales students provide for particular nursing interventions are taken as evidence of their critical thinking ability. While this approach is commonly thought to be effective, the evolving health care system has placed increased emphasis on community nursing (3,4), where it is often difficult to prespecify learning experiences or to anticipate patient care needs. In addition, teachers are often not able to accompany each student to the clinical site. Thus, the traditional strategies for teaching and learning critical thinking common to hospital-based clinical courses are being challenged, transformed, and extended (5). Part II of this article describes findings that suggest how many teachers and students are challenging the conventional approaches to schooling and creating pedagogies that are more responsive to the contemporary context of health care.

Attitude of Health Personnel↗

PubMed2003

Critical thinking in respiratory care practice: a qualitative research study.

INTRODUCTION: Recent publications indicate that critical thinking should be an integral part of respiratory care education. However, we know very little about critical thinking in the context of respiratory care. The critical thinking abilities and decision-making characteristics of practicing respiratory therapists have not been studied. PURPOSE: Identify and describe the critical thinking skills and traits of respiratory therapists, using a qualitative, descriptive research methodology. METHODS: Critical thinking was defined as the combination of logical reasoning, problem-solving, and reflection. The sample was selected through nominations of experts, using reputational-case selection. The research involved observations of 18 registered respiratory therapists, followed by in-depth interviews. Data were collected over a 1-year period and there were 125 hours of observation and 36 hours of interview. The observations were the basis for identifying and describing context-bound situations that require critical thinking, as well as the essential skills and related traits. RESULTS: The data set consists of over 600 single-spaced pages of interview transcripts and participant-observation field notes, in addition to 36 audio tapes. Field notes and interview transcripts were continuously analyzed throughout the study, using the constant-comparative method described by Glaser and Strauss. CONCLUSIONS: The findings suggest that critical thinking in respiratory care practice involves the abilities to prioritize, anticipate, troubleshoot, communicate, negotiate, reflect, and make decisions.

Adult↗

PubMedDate not supplied

Enhancing critical thinking in paramedic continuing education.

Critical thinking has become a buzzword, especially in medical education. The challenge is first to determine what skills compose critical thinking and what teaching techniques promote critical-thinking skills, and then to determine how to apply these techniques effectively and efficiently to a given population in the classroom. This article begins with a working definition of critical thinking and explores the parameters and skills implied or stated in the definition. Then a teaching environment constructed around a model of critical thinking and characteristics of the audience is described. A specific teaching method, suggested by research and designed to exercise critical-thinking skills, is then applied to a specific patient problem in a continuing education class. Preliminary outcomes are presented. The purpose of this article is to propose a productive and efficient educational method for promoting and enhancing critical-thinking skills appropriate for paramedic-level continuing education.

Clinical Competence↗

PubMedDate not supplied

Creating innovative research designs: the 10-year Methodological Think Tank case study.

PURPOSE: Addressing important but complex research questions often necessitates the creation of innovative mixed methods designs. This report describes an approach to developing research designs for studying important but methodologically challenging research questions. METHODS: The Methodological Think Tank has been held annually in conjunction with the Primary Care Research Methods and Statistics Conference in San Antonio since 1994. A group of 3 to 4 methodologists with expertise balanced between quantitative and qualitative backgrounds is invited by the think tank coordinators to serve on a 2-day think tank to discuss a research question selected from those submitted in response to a call for proposals. During the first half-day, these experts explore the content area with the investigator, often challenging beliefs and assumptions. During the second half-day, the think tank participants systematically prune potential approaches until a desirable research method is identified. RESULTS: To date, the most recent 7 think tanks have produced fundable research designs, with 1 being funded by a K award and 4 by R01 grants. All participating investigators attributed much of their success to think tank participation. Lessons learned include (1) the importance of careful selection of participating methodologists, (2) all think tank communities of inquiry must go through 4 stages of development from pseudocommunity to community, and (3) the critical importance of listening by the investigator. CONCLUSION: Researchers and academic departments could use this process locally to develop innovative research designs.

Cooperative Behavior↗

PubMedDate not supplied

Walking around the elephant: a critical-thinking strategy for decision making.

The parable of the blind men and the elephant provides a metaphor for emphasizing important characteristics of critical thinking and strategies for decision making. The article describes critical thinking as a process and cognitive skill that functions in identifying and defining problems and opportunities for improvement; generating, examining and evaluating options; reaching conclusions and decisions, and creating and using criteria to evaluate decisions. Critical thinking improves the quality of professional and personal decisions. Critical thinking also contributes to the effectiveness of group decision making by creating synergy and collaboration. The article presents evidence of the crucial nature of critical thinking in nursing practice, management, and executive roles, and in the practice of continuing education and staff development. The article identifies and develops the major defining characteristics of critical thinking. Illustrating the characteristics in practical examples, the article suggests ways to foster critical thinking for ourselves, with our learners, with managers, and with our colleagues.

Decision Making↗

PubMed2026

Does Inquiry-Based Learning Improve Students' Critical Thinking? A Meta-Analysis Accounting for Control Group Variations.

BACKGROUND: Inquiry learning is widely recognized, through empirical studies, as an appropriate instruction in enhancing students' critical thinking, yet the results were varied across context. The previous meta-analysis did not include the control group variations as a potential moderator and the studies subject domain was limited only to science subjects. Consequently, it is difficult to generalize the effectiveness of IBL in enhancing critical thinking. This meta-analysis aims to investigate whether inquiry learning is effective in improving the students' critical thinking skills and examine the moderating roles of each study characteristic. Methods The literature search applying the PRISMA protocol 2020 was conducted by utilizing SCOPUS, ERIC, and DOAJ databases. A total of 57 studies from 51 articles, published from 2015 to 2025, were synthesized using a random-effects model with standardized mean difference (SMD). RESULTS: The analysis revealed that IBL has a large and significant effect on enhancing students' critical thinking (g = 1.336; 95% CI [1.061, 1.611]). However, substantial heterogeneity was observed (I 2 = 92.09%), suggesting variability across contexts. Moderator analyses revealed that the main moderator, control group variations, was statistically significant in moderating the effectiveness of IBL (Qm = 5.21; p = .022). in contrast, subject domain (Qm = 1.43; p = .698), education level (Qm = 1.11; p = .774), and country ( Q m  = 3.33; p = .650), were insignificantly moderating the effectiveness of inquiry learning. CONCLUSIONS: The present meta-analysis highlighted that IBL is effective in improving students' critical thinking. However, the effectiveness of IBL was relative to the type of control group variations. Its effect on critical thinking was greater when compared with teacher-centered learning but smaller when compared with other student-centered learning.

Thinking↗

PubMed2006

Temporal cognition in children with autistic spectrum disorders: tests of diachronic thinking.

Impaired diachronic thinking-(the propensity and capacity to think about events spreading across time)-was demonstrated in a 2-Phase study in which children with autism were compared with age and ability matched controls. Identical tests of diachronic thinking were administered in both phases of the study, but to different participant groups, with the same results. The marked impairments shown are therefore robust. Various non-temporal explanations of the findings were eliminated by the results of control tasks in Phase 2. Diachronic thinking did not correlate with verbal or non-verbal ability, age, or mentalising ability, consistent with other evidence of the specificity of diachronic thinking ability. Possible causes of impaired diachronic thinking in autism are discussed.

Adolescent↗

PubMed2005

Strategies to overcome obstacles in the facilitation of critical thinking in nursing education.

UNLABELLED: This paper seeks to describe strategies that can be used to overcome obstacles in the facilitation of critical thinking in nursing education. A qualitative, explorative, descriptive and contextual design was used to conduct the research in which fourth year basic comprehensive students and nurse educators volunteered to take part in the study by signing an informed consent. The participants were purposively selected. Focus group interviews were used to collect data from both groups. Tesch's descriptive method of open coding described in (Creswell, J. 1994. RESEARCH DESIGN: Qualitative and quantitative approach. Sage, London.) was used to analyse data. (Democratic Nursing Organisation of South Africa, 1998. Ethical standards for nurse researchers. Denosa, Pretoria) ethical standards for research were observed to maintain the standard and quality of the research. (Lincoln, Y.S., Guba, E.G. 1985. Naturalistic inquiry. Sage, London.) framework was used to ensure trustworthiness of the study. The following obstacles were identified and recontextualised within the existing literature to be able to describe the strategies to overcome the identified obstacles to the facilitation of critical thinking of students: the educators' lack of knowledge; use of teaching and assessment methods that do not facilitate critical thinking of learners; the negative attitudes of educators and their resistance to change; inappropriate selection process and poor educational background that did not facilitate critical thinking of students; inadequate socialisation, cultural and instructional language incompetence. Findings indicated that there is a need for nurse educators to model critical thinking in all aspects of nursing education. It is recommended that there be a whole paradigm shift in nursing education from the traditional teacher-centred methods to a more learner-centred approach that will facilitate critical thinking of student nurses.

Attitude of Health Personnel↗

PubMedDate not supplied

Critical thinking and patient outcomes: a review.

There has been a multidisciplinary plethora of critical thinking definitions stemming from educators in 1912 1 through and inclusive of today. As nurses' roles change in response to the dynamics of managed care and an increase in use of biotechnology in health care, more is expected of them both in terms of psychomotor and cognitive skills. The American Association for Colleges of Nursing requires that critical thinking be reflected within academic nursing programs as a core competency for program accreditation. 2 Although critical thinking has been associated with and evaluated in regard to learning outcomes, little information exists which links critical thinking to patient outcomes. The purpose of this article is to provide a literature review of critical thinking and to explore a possible link between nurses' critical thinking and patient outcomes.

Accreditation↗

PubMedDate not supplied

A proposed framework for teaching and evaluating critical thinking in nursing.

Critical thinking is now an explicit National League for Nursing outcome requirement for nursing education programs, and all nursing faculty currently are expected to teach and evaluate critical thinking. However, most of the related literature is theoretical and not on the practical level that might be directly usable by faculty. This article presents a beginning framework developed by a faculty task force at the Indiana University School of Nursing for teaching and evaluating critical thinking. The conceptual definition of critical thinking underlying the framework reflects the efforts of several hundred experts from various disciplines, is maximally inclusive, and lends itself well to operationalization in the nursing context. The task force made two assumptions for this project: first, that the principles of rational thinking are essentially the same at every educational level, although the expertise expected of students at different educational levels certainly differs; and, second, that at this time a focus on operational as opposed to theoretical definitions for the six identified components of critical thinking (interpretation, analysis, evaluation, inference, explanation, and self-regulation) would be particularly useful for faculty and student understanding.

Curriculum↗

PubMed2006

[Clinical decision making and critical thinking in the nursing diagnostic process].

The daily routine requires complex thinking processes of nurses, but clinical decision making and critical thinking are underestimated in nursing. A great demand for educational measures in clinical judgement related with the diagnostic process was found in nurses. The German literature hardly describes nursing diagnoses as clinical judgements about human reactions on health problems / life processes. Critical thinking is described as an intellectual, disciplined process of active conceptualisation, application and synthesis of information. It is gained through observation, experience, reflection and communication and leads thinking and action. Critical thinking influences the aspects of clinical decision making a) diagnostic judgement, b) therapeutic reasoning and c) ethical decision making. Human reactions are complex processes and in their course, human behavior is interpreted in the focus of health. Therefore, more attention should be given to the nursing diagnostic process. This article presents the theoretical framework of the paper "Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies".

Decision Making↗

PubMed1998

Teaching critical thinking for transfer across domains. Dispositions, skills, structure training, and metacognitive monitoring.

Advances in technology and changes in necessary workplace skills have made the ability to think critically more important than ever before, yet there is ample evidence that many adults consistently engage in flawed thinking. Numerous studies have shown that critical thinking, defined as the deliberate use of skills and strategies that increase the probability of a desirable outcome, can be learned in ways that promote transfer to novel contexts. A 4-part empirically based model is proposed to guide teaching and learning for critical thinking: (a) a dispositional component to prepare learners for effortful cognitive work, (b) instruction in the skills of critical thinking, (c) training in the structural aspects of problems and arguments to promote transcontextual transfer of critical-thinking skills, and (d) a metacognitive component that includes checking for accuracy and monitoring progress toward the goal.

Adult↗

PubMed1996

Defensive pessimism, optimism, and simulating alternatives: some ups and downs of prefactual and counterfactual thinking.

Four studies investigated the prefactual (alternative preoutcome predictions) and counterfactual (alternative postoutcome "what might have beens") mental simulations of defensive pessimists and optimists. In Study 1, defensive pessimists engaged in upward (better than expected) prefactual thinking, whereas optimists engaged in downward (worse than actuality) counterfactual thinking in reaction to a course exam. In Study 2, defensive pessimists preferred upward prefactual thinking and optimists preferred no prefactual thinking when prefactual thoughts were directly manipulated. In Studies 3 and 4, defensive pessimists and optimists differed in reactions to manipulated success and failure, and these reactions were further moderated by the opportunity to engage in prefactual thinking and the possibility of a second try. Individual differences in strategies of prefactual and counterfactual thinking are discussed.

Adolescent↗

PubMed1998

Critical thinking as an outcome of nursing education. What is it? Why is it important to nursing practice?

Critical thinking is currently a highly valued educational outcome throughout the educational spectrum, but particularly so in relation to higher and professional education. International concerns have focused upon citizen's thinking abilities and thus the nations' abilities to function and compete in complex societies and economies. Educationalists are questioning the wisdom of teaching content as opposed to teaching how to think as a means of dealing with relentless information development and change. Nursing education is also embracing the construct critical thinking as a desirable educational outcome. Some commentators refer to the importance of critical thinking in nursing practice as a central component or in some cases a given. This paper intends to examine the background to the construct and address in detail some of the important questions surrounding critical thinking, and its association with competent nursing practice.

Clinical Competence↗