As nurses know, seconds can often mean the difference between life and death. With increasing responsibility and higher patient acuity, it’s imperative for nurses and bedside clinicians to be able to make quick, accurate decisions in response to unforeseen circumstances.
The term ‘critical thinking’ is often used interchangeably with problem-solving and clinical decision-making in nursing literature. Problem-solving focuses on identification and resolution, whereas critical thinking goes beyond this and incorporates asking questions and critiquing solutions. The concept of clinical decision-making focuses attention on the clinical nature of a problem, but falls short of facilitating understanding of the broader spectrum of the issue.
Creative thinking, a combination of imagination and knowledge, can also be helpful in understanding solutions that have failed and coming up with new ideas.
There are many skills necessary to be an effective critical thinker. Decision-making and critical thinking need to happen together in order to produce reasoning, clarification, and potential solutions. To advance nursing practice, it is necessary to develop and evaluate strategies to help new nurses develop these essential critical thinking skills.
In assessing new graduate nurses’ critical-thinking capabilities, it’s helpful to consider the fundamental principles of critical thinking. Ask the following 4 questions:
Just as there are similarities among the definitions of critical thinking across subject areas and levels, there are several generally recognized hallmarks of teaching for critical thinking. These include:
After evaluating where new nurses are at in terms of critical-thinking skills, look at the attributes of a critical thinker. Strong critical thinkers demonstrate the following characteristics: (Based on the APA Expert Consensus Delphi Report description of strong critical thinkers.)
Patient safety can be directly affected by the critical thinking ability of a nurse. Nurses must have the ability to recognize changes in patient condition, perform independent nursing interventions, anticipate orders, and prioritize. These actions require critical thinking ability, advanced problem-solving skills and the ability to communicate clearly.
Patient safety may be compromised if a nurse cannot provide clinically competent care. Assessments such as a performance-based development system (PBDS) can provide information about learning needs and facilitate individualized orientation targeted to increase performance level. PBDS evaluates a nurse’s ability to think critically in clinical situations, assessing ability to use clinical knowledge in real-world situations.
Research has shown that these instruments predict strength in critical thinking in problem situations and success on professional licensure examinations.What type of training and resources do you think is most helpful for younger nurses and clinicians to fully develop their critical-thinking skills? Leave us a comment below.