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Nursing leaders in critical care can use strategies such as questioning, clinical scenarios, conferences, and context-dependent test items to assess and improve their staff's critical thinking skills.
PURPOSE: This longitudinal study was done to investigate critical thinking dispositions and critical thinking skills of nursing students enrolled in a 4-year baccalaureate program at a university in Korea. METHOD: The study used a longitudinal design. A convenience sample of 32 nursing students who were completing their 1st, 2nd, 3rd, and 4th year in a baccalaureate program at a selected university was included. The subjects completed the California Critical Thinking Dispositions Inventory (CCTDI), the California Critical Thinking Skill Test (CCTST), and a demographic questionnaire. Data was analyzed by descriptive statistics, repeated ANOVA, adjusted p-values, and Pearson's correlation coefficient with SAS 8.12. RESULTS: There was statistically significant improvement according to academic year in the CCTDI total mean score (F=7.54, p= .0001) and subscales of Open-mindedness, Self-confidence, and Maturity. Contrarily, no statistically significant difference was found in the CCTST total mean score and subscales' score except Analysis. CONCLUSION: There is no significant correlation between critical thinking dispositions and skills, so it will be necessary to repeat a study like this, and the translated instruments should be modified by considering Korean culture.
Critical thinking is a phase that is being heard frequently in nursing education. Nurse educators are encouraged to teach students to think critically because of the higher-order thinking skills that are required in our complex health care delivery system. The challenge to educators is the selection, development, and implementation of appropriate teaching strategies. This article describes a variety of strategies for teaching critical thinking within the context of nursing.
Critical thinking is an important idea whose time seems to have come for nursing education. However, as a newly fashionable buzzword, it is in danger of being uncritically accepted, of being regarded as the panacea for all problems of nursing practice. This article goes behind the positive rhetoric of critical thinking to explore how this process manifests itself in the lives of nursing practitioners, nurse managers, administrators, and educators. Drawing on nurses' own stories of what happened as they challenged conventional professional or organizational assumptions and as they explored alternative perspectives on nursing practice, a picture of critical thinking "from the inside" emerges. Themes of impostorship, cultural suicide, lost innocence, roadrunning, and community emerge as defining features of the critical thinking process. It becomes clear that critical thinking is a strongly emotional as well as cognitive process, and that it carries considerable political dangers for its protagonists.
Critical thinking is an important component of professional practice. It is the hallmark of the competent nursing practitioner and yet there is no consensus on its definition, teaching or learning strategies of critical thinking skills in nursing students. Although critical thinking appears to be desirable at all levels of nursing practice, evidence to support its educational development in nurses appears to be limited. If educators are to prepare nurses to become leaders in their profession, the educational development of these essential skills in nurses needs to be addressed.
Evidence exists supporting relationships between bilingualism and many cognitive factors. Research, however, has not been conducted to specifically examine the relationships among bilingualism, critical thinking ability, and critical thinking disposition of baccalaureate nursing students. This cross-sectional study used a pooled, within-bilingual, correlational design to examine such relationships. Specific research questions posed were: (1) is there a statistically significant curvilinear relationship between bilingualism and critical thinking ability, (2) is there a statistically significant curvilinear relationship between bilingualism and critical thinking disposition, and (3) is there a statistically significant relationship between critical thinking disposition and critical thinking ability? A convenience sample of nursing students (N = 111) was administered a French language Cloze Test (C-Test), an English language C-Test, as well as the California Critical Thinking Skills Test, and the California Critical Thinking Disposition Inventory. Multiple regression analysis was used to test the hypotheses. Findings failed to provide sufficient evidence to support the existence of a relationship between either bilingualism and critical thinking ability, or between critical thinking disposition and critical thinking ability. However, there was sufficient evidence to support the existence of a curvilinear relationship between bilingualism and critical thinking disposition. Implications for nursing education are presented.
BACKGROUND: Critical thinking is essential to nursing practice; therefore, knowledge and understanding of nursing students' critical thinking skills (CTS) and related dispositions are important to nurse educators. This paper presents the results of a non-experimental study conducted in spring 1998, identifies implications for nurse educators, and offers recommendations for future research. AIM: The aim of the study was to investigate the CTS and critical thinking dispositions (CTD) of students enrolled in a 4-year baccalaureate programme at a university in Western Canada. METHODS: The study used a cross-sectional design. Data collection occurred during regularly scheduled classes. A volunteer sample of 228 students from all 4 years of the baccalaureate programme completed a background/demographic questionnaire, the California Critical Thinking Skills Test, and the California Critical Thinking Disposition Inventory. The reliability of the test and inventory were established using the Kuder Richardson 20 and Cronbach Alpha respectively. Both descriptive and inferential statistical analyses were carried out. FINDINGS: Critical thinking mean scores increased from years 1 to 4 with the exception of year 3. However, there was no statistically significant difference among the four student groups. Although differences in critical thinking disposition scores were not statistically significant, students' scores differed significantly on the systematicity subscale. There was a significant relationship between students' overall CTS and CTD scores. CONCLUSIONS: Approximately 38% of the students in the current study had adequate levels of CTS and 85.5% of the students had adequate levels of CTD. Results indicate a need for students' continued development in these areas. Dispositions are crucial to critical thinking; without them critical thinking does not happen or may be substandard.
Critical thinking is a process applied to midwifery theory, research and experience. It is a positive activity, responsive to context, drawing on negative and positive triggers and emotions to suggest ways of acting in future. Practice-based and reflective midwifery assignments should reflect the midwifery goals of critical thinking. This may require adjustments in assessment criteria and a questioning of standard academic conventions.
Students who are deaf or hard of hearing must learn to think critically. Character education (CE) refers to the effort to teach basic values and moral reasoning (Doyle & Ponder, 1977). Values clarification (VC) is the process of examining one's basic values and moral reasoning (Rokeach, 1973). Character education and values clarification as subject matter foster the development of critical thinking (CT), a tool used both to develop and to modify values and moral reasoning. These three areas mutually support one another. The development of a set of values and their underlying moral reasoning is the foundation for thinking critically about values. The authors examine the components of critical thinking, character education, and values clarification, summarize the literature, and provide a template for appropriate lesson plans. They also describe strategies that promote the development of critical thinking, character education, and values clarification.
OBJECTIVE: To provide a brief introduction to the definition and disposition to think critically along with active learning strategies to promote critical thinking. DATA SOURCES: I searched MEDLINE and Educational Resources Information Center (ERIC) from 1933 to 2002 for literature related to critical thinking, the disposition to think critically, questioning, and various critical-thinking pedagogic techniques. DATA SYNTHESIS: The development of critical thinking has been the topic of many educational articles recently. Numerous instructional methods exist to promote thought and active learning in the classroom, including case studies, discussion methods, written exercises, questioning techniques, and debates. Three methods-questioning, written exercises, and discussion and debates-are highlighted. CONCLUSIONS/RECOMMENDATIONS: The definition of critical thinking, the disposition to think critically, and different teaching strategies are featured. Although not appropriate for all subject matter and classes, these learning strategies can be used and adapted to facilitate critical thinking and active participation.
OBJECTIVE: To investigate the tendency of undergraduate athletic training students to think critically, to assess their likelihood of using specific components of critical thinking, and to study the effect of selected demographic and educational variables on critical-thinking tendencies in this sample of students. DESIGN AND SETTING: Data were collected before regularly scheduled athletic training classes at the beginning of the spring semester. SUBJECTS: Ninety-one students enrolled in 3 Commission on Accreditation of Allied Health Education Programs-accredited undergraduate athletic training education programs in the southeast. The subjects ranged in age from 19 to 29 years (mean age = 22.33 +/- 1.94). Forty-six (50.5%) of the subjects were men and 45 (49.5%) were women. MEASUREMENTS: The California Critical Thinking Disposition Inventory contains 75 Likert-type items assessing 7 components of critical thinking: truth seeking, open mindedness, analyticity, systematicity, inquisitiveness, cognitive maturity, and critical-thinking self-confidence. RESULTS: The overall mean indicated a general but mild trend toward critical thinking, with weak scores on the truth-seeking subscale. One-way analysis of variance reflected significant differences among the schools for truth seeking, open mindedness, and maturity subscales and for the overall mean score for the entire inventory. Only the open-mindedness difference persisted between 2 of the schools after post hoc testing. Correlation analyses indicated no significant relationship between total score and age, sex, ethnicity, year in athletic training program, cumulative grade point average, completed semester hours, or clinical-experience hours. CONCLUSIONS: Athletic training students are inclined toward critical thinking, but this tendency is relatively weak. Classroom and clinical instructors should use teaching methods and techniques that facilitate the components of critical thinking. The promotion of critical thinking and critical-thinking skills has implications for athletic training education and the advancement of certified athletic trainers and the profession of athletic training.
The complexity and changing nature of nursing today requires proficiency in thinking skills to ensure knowledgeable, confident, creative, and sensitive decisions regarding client care. Nurse educators are faced with the task of promoting educational strategies to develop the abilities of nursing students to think critically in all health care settings (1). However, a lack of consensus on what characterizes critical thinking leads to difficulty in the development of instruments for adequate measurement. It is important to decide on a definition of critical thinking that faculty support and are willing to use in practice. The term is diversely defined in the literature. For example, Alfaro-LeFevre states that critical thinking in nursing "entails purposeful, goal directed thinking; aims to make judgments based on evidence (fact) rather than conjecture (guesswork); is based on principles of science and scientific method; requires strategies that maximize human potential and compensate for problems caused by human nature" (2). The authors of this study use a definition by Paul: "thinking about your thinking while you are thinking in order to make your thinking better, more clear, more accurate, more defensible" (3). The authors believe that the development and/or enhancement of critical thinking ability must be the result of conscious, deliberate activity throughout the nursing program. As the student matures, the ability to think critically will be manifested in decision making that reflects accurate assessment and resolution of problems. The nursing faculty selected an instrument to evaluate the critical thinking abilities of baccalaureate nursing students that had strong reliability and validity documented in the nursing literature: the total and subtest scores of the Watson-Glaser Critical Thinking Appraisal (WGCTA), Form A (4). The instrument was deemed to be congruent with the definition of critical thinking supported by the faculty.
The ability to think critically is considered an essential skill of nursing graduates and competent nursing practice. Yet, the literature reports that teachers are having difficulty teaching for critical thinking and that critical thinking is lacking in new nursing graduates. This research study sought to identify barriers to the implementation of critical thinking teaching strategies by nursing faculty currently teaching in generic baccalaureate programs in Tennessee. Surveys were mailed to 262 nursing faculty; 194 were returned, and 175 were usable. Students' attitudes and expectations represented the single greatest barrier to the implementation of critical thinking teaching strategies, followed by time constraints and the perceived need to teach for content coverage. Recommendations to support and encourage faculty to teach for critical thinking are outlined.
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.
BACKGROUND: In a health care environment of increased patient acuity and greater demands on nursing practitioners, the ability to think critically is requisite to functioning safely and proficiently. METHOD: Definitions and tenets of critical thinking promulgated by Brookfield (1987) and Paul (1992) provided the theoretical foundation for Antidote Dilemma, an activity designed to promote critical thinking. RESULTS: Nurses who participated in the activity identified plausible solutions to a nursing dilemma, considered context in identifying alternatives, and thought about their thinking. CONCLUSION: Critical thinking is most likely to occur and continue when it is supported by others and repeatedly practiced. Continuing/staff-development educators play a vital role in promoting critical thinking among nursing practitioners.
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).
Developing the ability to think critically is an important element of undergraduate physiology education and is influenced by many factors, including the learning environment, the social context of the learning environment, and the instructor's approach to teaching. In this work, we describe online learning modules (OLM) that were designed to promote higher-order critical thinking skills in students enrolled in an upper-division Exercise Testing and Prescription course. The OLM provided students with an online learning environment in which to review clinical physiological details from authentic patient case data and develop exercise prescriptions (ExRx), by requiring students to critically analyze authentic patient case histories and collaborate on computer-based learning activities. On the basis of assessment data, we conclude that the OLM helped exercise science students develop the critical thinking skills necessary for development of effective exercise prescriptions by requiring them to think critically while concurrently reinforcing lecture-presented exercise science content.
Catheter-related sepsis (CRS) is a clinical problem gaining increasing attention in the literature. Before strategies for reducing the incidence of CRS can be identified, a consistent definition of the problem must be developed. Critical thinking is an intellectual process used to reflect upon a topic of interest. The critical thinking process provides a framework for comprehensive analysis of patient care problems. The article describes the critical thinking process and proposes a model of critical thinking for practicing nurses. This model is applied to the development of comprehensive definitions for CRS that may be used by neonatal nurses for clinical and research purposes.