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PubMed1996

Building bridges for future practice: an innovative approach to foster critical thinking.

Developing mechanisms to uncover and share with students the deep richness of practice through reflective, collegial, and supportive dialogue is a very timely and necessary activity. How this compliments other educational strategies and the impact of the full expression of practice dialogue continues to be created and discovered. While practice dialogue can influence experimental knowledge development, it does not negate the necessity of the student's active engagement in direct practice learning episodes with the clinical faculty. Preliminary evaluations by staff nurses and students are positive. Staff nurses have identified a "therapeutic" effect in sharing their practice dialogue. Due to the early phase of implementation, other outcome data are not available. In this project, "Critical Thinking Rounds" are being developed as a mechanism to begin to uncover critical thinking in practice. Based on the excitement of nurses and students coming together and sharing practice, similar activities need to be facilitated as essential mechanisms for expressing the essence of nursing practice in the hope of bridging the gap between education and practice.

Clinical Competence↗

PubMed1999

Concept maps: a strategy to teach and evaluate critical thinking.

The purpose of this article is to describe a study that implemented concept maps as a methodology to teach and evaluate critical thinking. Students in six senior clinical groups were taught to use concept maps. Students created three concept maps over the course of the semester. Data analysis demonstrated a group mean score of 40.38 on the first concept map and 135.55 on the final concept map, for a difference of 98.16. The paired t value comparing the first concept map to the final concept map was -5.69. The data indicated a statistically significant difference between the first and final maps. This difference is indicative of the students' increase in conceptual and critical thinking.

Achievement↗

PubMed2000

The impact of the use of inquiry-based learning as a teaching methodology on the development of critical thinking.

Problem-based learning (PBL) uses patients' problems to develop students' problem-solving and clinical skills. Inquiry-based learning (IBL) was developed as a similar methodology that was more holistic and flexible. This study sought to determine if inquiry-based learning (IBL) enhances critical-thinking ability as measured by the Watson Glaser Critical Thinking Appraisal (WGCTA). The WGCTA was administered to 228 nursing students in the first semester and 257 students in the final semester of their program. When the scores were stratified into groups, the students in the low group showed a significant increase in mean score, no change in the medium group, and a significant drop for the high group.

Curriculum↗

PubMed2005

A longitudinal study of baccalaureate nursing students' critical thinking dispositions.

A longitudinal descriptive design was used to examine nursing students' dispositions toward critical thinking as they progressed from the Sophomore II to Senior II semester in a baccalaureate nursing program in the midwestern United States. The California Critical Thinking Disposition Inventory (CCTDI) was distributed during week 10 in the Sophomore II, Junior I, Junior II, Senior I, and Senior II semesters. Significantly higher CCTDI scores were achieved in the Junior I and Junior II semesters, but no significant differences were found when comparing the Sophomore II and Senior II semesters. No relationship was found between passing the NCLEX-RN, standardized test scores, and CCTDI scores.

Analysis of Variance↗

PubMed2001

Problem-based case study to enhance critical thinking in student nurses.

The use of traditional teaching methods, for example the lecture method, does not stimulate critical thinking in student nurses. This problem can be solved by the utilisation of problem-based case study in the classroom/clinical setting. The purpose of this study is to describe guidelines for the implementation of problem-based case study in a clinical setting among first year, comprehensive course students at the Northern Province College of Nursing: Sovenga campus. The research design of this study was qualitative, explorative, descriptive and contextual and was conducted in the following phases: Phase 1: The development and implementation of a program for problem-based case study in the clinical setting; Phase II: The experiences of student nurses who were exposed to problem-based case study in the clinical setting; Phase III: The perceptions of tutors regarding the implementation of problem-based case study in the clinical setting (focus group), and; ase IV: Guidelines for the implementation of problem-based case study. The data from Phases I, II and III were used to formulate guidelines for the implementation of problem-based case study. The sample group consisted of all 69 first year student nurses at the Northern Province College of Nursing: Sovenga campus and ten tutors teaching clinical courses at the same campus. The Tesch (1990) approach is used for data analysis. Nine guidelines for the implementation of a problem-based case study approach were formulated and recommendations for development of an instrument to measure critical thinking in nursing were recommended.

Curriculum↗

PubMed2002

Technical reflection for improving nursing and midwifery procedures using critical thinking in evidence based practice.

Australian nursing and midwifery education and practice have used key ideas relating to reflective practice since the 1980s. However, missing from that history has been a clear process for reflection when policies and procedures have required change, based on evidence generated from rigorous research and critical thinking processes. This article describes technical reflection as a systematic process for analysing and amending work procedures in nursing and midwifery practice, by combining key ideas in the nursing, critical thinking and reflection.

Clinical Competence↗

PubMed1996

Experiential learning and critical thinking in nursing.

This article describes a continuing ethnographic study of critical thinking, reflection and experiential learning in nursing. The author examines the related theory and explains the terms of reference which underpin the study. Date analysis so far emphasises the importance of recognising positive and negative feelings associated with experiences, when engaging in reflection. She also outlines the precursors to effective and non-effective reflection implied by the data. It is suggested that there is no correct model for critical thinking and the author highlights the need for further research into effective and non-effective outcomes of reflection.

Education, Nursing↗

PubMed1992

Critical thinking in health care supervision.

Henry Ford is reputed to have said that thinking is the hardest work there is, which is probably why so few people engage in it. Perhaps many people have felt this way sometimes, especially when they viewed the foibles of the human race displayed prominently on the evening television news. Some people do stupid things; some people seem to be mindless in what they do. This applies also to some in managerial and supervisory positions in health care organizations. The percentage of these thoughtless managers and supervisors is probably comparable to the percentage of the thoughtless people in the general population. Fortunately every normal functioning human being is capable of becoming a more critical thinker. Of course, no amount of effort is adequate to the development of critical thinking when a person lacks fundamental good sense. On the other hand, no amount of genius suffices when someone does not put forth adequate effort to become a more critical thinker.

Decision Making, Organizational↗

PubMed2001

Constructive thinking in adolescents with substance use disorders.

This study examined the concurrent validity and clinical correlates of the Constructive Thinking Inventory (CTI), a measure of experiential coping, in 551 adolescents aged 14-18 years with and without Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) substance use disorders (SUDs). The CTI was correlated with depression, anxiety, and conduct problems. After controlling for demographics and comorbid lifetime psychiatric disorders, the CTI scales of Behavioral Coping and Categorical Thinking distinguished adolescents with and without SUDs. Implications of these findings for assessment and treatment are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

[Cerebral mechanisms of mathematical thinking].

OBJECTIVE: To suggest a cerebral map of elementary mathematical thinking, and integrate the most relevant findings from neuropsychology with those from cerebral imaging techniques and cognitive behavior experiments. DEVELOPMENT: Firstly we describe investigations into our numerical sense and the way in which numerical information is represented in the human brain. Then, using a multidisciplinary approach, we present the results of different studies of Gerstmann's syndrome, regarding the relation between numerical ability and other cognitive skills; the different participation of the cerebral hemispheres and the special implication of the parietal lobe in mathematical tasks. CONCLUSIONS: Different cerebral regions are involved in doing mental arithmetic, however simple. This makes one think more in terms of cerebral circuits than in a phrenological idea which would assign the responsibility for arithmetical calculations to a specific region. The similarity between the results analysed leads us to the conclusion that one region is particularly involved in understanding numbers, namely the inferior part of the parietal lobe. Different neuronal circuits are used depending on the type of task to be performed. Finally we describe the most relevant models for the processing of numbers which have been developed during the study.

Brain↗

PubMed2001

Nursing in a time of change: a case for critical thinking.

Like all professionals, nurses live with the inevitability of change. The extent to which change is experienced as a crisis rather than as an opportunity is determined by the degree of control that nurses have over the change process. This paper outlines the determinants of change, examines the impact of change on nursing practice, explores professional ways of knowing and proposes critical thinking as a means by which nurses can interpret and manipulate change and illustrates a curriculum approach that facilitates the acquisition of the capacity to think critically.

Humans↗

PubMed2002

The identification and description of critical thinking behaviors in the practice of clinical laboratory science, Part 1: Design, implementation, evaluation, and results of a national survey.

The ability to think critically has been identified as a pivotal attribute of health care professionals. The purpose of this study was to identify and describe critical thinking (CT) behaviors and observable events resulting from CT, important in the practice of clinical laboratory science. Medical, educational, and psychological literature related to the many behaviors characterized under the CT rubric has been focused by an operationalized definition positing CT to be a metaprocess that facilitates learning by interlinking the more basic processes associated with different learning orientations: behaviorist, cognitivist, humanist, and situated/contextual learning. A total of 65 CT behaviors were identified through a process including discovery (expert interviews, a focus group with practitioners) and refinement (literature comparisons, expert rankings/reviews, pilot survey). CT behaviors were characterized further through a national survey of practitioners (n = 1,571, > 50% of time in bench work). Using a 6-point scale, practitioners ranked the importance of the CT behaviors. Important CT behaviors were characterized as being not only cognitive in nature, but also behavioral, affective, and situated/contextual. These findings suggest a stronger relationship between CT behaviors and all aspects of practice than previously reported. Given that these behaviors span all learning domains, findings support the metaprocess view of CT. Implications are that CT behaviors cannot be learned or taught, apart from a discipline-related practice setting. This study contributes to learning theory related to transfer and how learning occurs and to literature describing survey methodology. It also provides a basis for measurement of CT in practice settings.

Data Collection↗

PubMed2000

Across the great divide: bridging the gap between understanding of toddlers' and older children's thinking.

Research on very young children's cognitive development differs greatly from research on cognitive development in older children. The differences include the questions that are asked, the methods that are used to address them, the measures that are employed to provide relevant evidence, and the level of detail at which children's knowledge is represented. The research approaches are so different that they create an impression that infants' and toddlers' thinking differs qualitatively from that of preschoolers and older children. This impression, however, may reflect differences in research approaches rather than differences in children's thinking. In the present study, we attempted to bridge this gap by applying to toddlers a type of process analysis that has proved fruitful in studies of older children. Overlapping waves theory, trial-by-trial strategy assessments, and microgenetic methods were used to analyze 1.5- and 2.5-year-olds' problem solving and learning. The results demonstrated that changes in toddlers' strategies could be assessed reliably on a trial-by-trial basis, that the changes followed the basic form predicted by the overlapping waves model, and that analyses of toddlers' strategies could tell us a great deal about both qualitative and quantitative aspects of their learning. A componential analysis of learning that previously had been applied to older children also proved useful for understanding toddlers' learning. The analysis specified that cognitive change frequently involves five components: acquisition of new strategies; strengthening of the strategies in their original context; improved mapping of strategies onto novel problems; increasingly refined choices among variants of the strategies; and increasingly skillful execution of the strategies. Independent measures of these components indicated that strategic development in toddlers involves improvements in all five components. Analyses of individual differences in learning showed that the effects of distal variables, such as age and sex, could be partially explained in terms of their influence on mastery of the components, but that the distal variables exercised additional direct effects as well. The process of learning in toddlers closely resembled that of older children in other ways as well. Like older children, toddlers use multiple strategies over the course of learning; their choices among strategies are quite adaptive from early on; their choices become progressively more adaptive as they gain experience with the task; they switch strategies not only from trial to trial but within a single trial; their transfer of learning from one problem to the next is primarily influenced by structural relations between problems but also is influenced by superficial features; they show utilization deficiencies early in learning that they gradually overcome; and they show individual differences in learning that fall into a few qualitatively distinct categories. Perhaps most striking, the 1.5- and 2.5-year-olds emerged as active learners, who continued to work out the lessons of previous instruction in the absence of further instruction. That is, they integrated the lessons of their own problem-solving efforts with the previous instruction in ways that magnified the initial effects of the instruction. Overall, the findings indicated that the gap can be bridged; that theories, methods, measures, and representations of knowledge typically used with older children can improve our understanding of toddlers' problem solving and learning as well.

Child Behavior↗

PubMed1965

DEFENSIVE THINKING IN ALCOHOL ADDICTS.

Every day in Canada and the United States thousands of patients seek medical help for diseases and injuries acquired as a result of excessive alcohol consumption. Unfortunately much of the medical effort expended in this way is wasted. Failure to bridge the gap between initial treatment and a rehabilitation program is the main reason for this waste.Since the power of the abnormal desire in addiction compels the victim to continue to indulge in spite of his awareness of his addiction, he becomes more and more defensive. His thinking is marked by alibis, lying, projection, resentment and suspicion. Resistance to treatment becomes an integral part of the disability.The addict usually cannot stop defending his dependence simply because he is advised to do so. However, a physician can often find ways to interrupt defensive thinking long enough to initiate a treatment and rehabilitation program if he will consider the primary and secondary factors concerned.

Alcoholism↗

PubMed2002

'Atamai, fakakaukau and vale: 'mind', 'thinking' and 'mental illness' in Tonga.

This paper explores the concepts of "mind", "thinking" and "mental illness" from a Tongan perspective. Their old Tongan equivalents are 'atamai, fakakaukau and vale. Of specific interest is mental illness. A specific state of mind, mental illness is investigated, firstly, in the conflicting relationships of mind and thinking and, secondly, in the context of the dialectical relationships between traditional forms of disease and illness and medicinal and healing concepts and practices. Their inherently clear spatio-temporal basis gives them a sense of realism. This realistic sense is much more revealing when they are positioned in the context of ta and va, Tongan for "time" and "space". Ontologically, time and space are the common medium of existence of all things, in a single level of reality. On the epistemological level, time and space are social constructs, deriving from their relative arrangement across cultures. Conflicts inevitably arising from the time-space, form-content transformation of types of human activity, create symmetries and asymmetries in the natural, mental and social realms. By integrating time and space, a general tă-vă theory could be developed, so that we can better understand the complexity surrounding nature, mind and society.

Attitude to Health↗

PubMed2004

Goldratt's thinking process applied to the budget constraints of a Texas MHMR facility.

Managers for years have known that the best way to run a business is to constantly be looking for ways to improve the way to do business. The barrier has been the ability to identify and solve the right problems. Eliyahu Goldratt (1992c), in his book The Goal, uses a love story format to illustrate his "Theory of Constraints." In Goldratt's (1994) next book, It's Not Luck, he further illustrates this powerful technique called "The Thinking Process" which is based on the Socratic method, using the "if ... then" reasoning process, The first step is to identify UDEs or undesirable effects within the organization and then use these UDEs to create a Current Reality Tree (CRT) which helps to identify the core problem. Next, use an Evaporating Cloud to come up with ideas and a way to break the constraint. Finally, use the injections in the Evaporating Cloud to create a Future Reality Tree, further validating the idea and making sure it does not create any negative effects. In this article, the "Thinking Process" will be used to identify and solve problems related to the General Medical Department of an MHMR State Hospital.

Budgets↗

PubMedDate not supplied

Tracing the development of critical thinking in baccalaureate nursing students.

A repeated measures design was used to trace 83 baccalaureate students' critical thinking (CT) ability as they progressed in a nursing program. CT was assessed with the Watson-Glaser Critical Thinking Appraisal at four strategic junctures in the curriculum; program entry, mid junior year, beginning of senior year, and program exit. Sixty students (Group One) had been in the program when the study began and were not pretested. Group Two (N = 23) was tested at all four junctures. The sample was racially and culturally diverse, predominantly female, and a majority had prior college. Over time, scores tended not to improve, and they were below published norms. Findings are discussed from the perspectives of what constitutes CT in nursing and its measurement, the cultural context of its assessment, and the nature of nursing education and its influence on CT.

Adult↗

PubMed1992

[Critical thinking during the clinical teaching at the beginning of nursing students' clinical education].

This article examines how critical thinking is seen in learning decision making during the clinical lessons in the beginning of nursing students' clinical education. The data has been collected by taping all the clinical lessons (11) of the students (32). The data was analyzed by using content analysis both quantitatively and qualitatively. The phases of the nursing process, in other words the phases of decision making appeared clearly in the discussions. A lot of assessment of the nursing needs of the patient appeared clearly. Physical needs were focused among the nursing problems. The objects of the nursing were defined nurse-centrically and generally. The discussion about the implementation and the evaluation of the nursing received insufficient attention. There were presented neither alternative solutions of the care nor any reasons for proposed solutions. Learning of the students represented mainly superficial, mechanical learning, lacking critical thinking.

Decision Making↗