Nursing Education and Critical Thinking

Critical Thinking and Nursing Education

Whats is Critical Thinking and Its Component,Impact of Critical Thinking on Nursing Education,Outcomes of Critical Thinking in Nursing Education,How Critical Thinking Helpful In Nursing Education.

Whats is Critical Thinking and Its Components

    Critical thinking is defined as having 11. effective components (such as confidence, inquisitiveness, and intellectual integrity) and 7 cognitive skills (such as analyzing, logical reasoning, and predicting and transforming knowledge). This definition was created from a study of 55 nurse experts to develop a consensus statement on critical thinking in nursing (Scheffer & Rubenfeld, 2000).

Impact of Critical Thinking on Nursing Education

    Critical thinking is an important skill for competence and performance at a high level. Nurse educators must have a clear understanding of critical thinking and possess the ability to think critically themselves in order to teach it to others (Robert & Petersen, 2013). The importance of teaching critical thinking and introducing nursing students to the concept should be started early in nursing education and developed through experience and practice (Chan, 2013). 

    Nurse educators and preceptors of students and new graduates need to make clear application of the critical reasoning process in complex patient care environments. They must also be aware that students and new graduate nurses need and desire clear guidance in application of critical thinking to clinical situations (Lasater, 2010).

    One recommendation for educators and preceptors in clinical practice is to think out loud when making clinical decisions to help students gain insight into their thought process and decisions (Forneris & Peden-McAlpine, 2009, Lasater, 2010). Other strategies recommended to facilitate critical thinking include reflective writing and journaling, concept maps, and case studies (Walsh & Seldomridge, 2006). Approaches such as narrative understanding, situational learning, and interpretation of clinical situations help students develop clinical imagination, which assists in understanding changes in the patient situation over time (Benner, Sutphin, Leonard, & Day, 2010).

    A model to teach critical thinking is the Lasater Clinical Judgment Rubric (LCIR) (Lasater, 2010). It is a model for educators and preceptors to use in helping to develop the clinical judgment of students. The rubric has four aspects: noticing, interpreting, responding, and reflecting. For each aspect, there are multiple levels that assist the educator and preceptor in rating the student's development of critical thinking skills. In addition, the use of high-level questions promotes thinking at deeper levels. 

    An example of a high-level question to stimulate deep thinking and learning is "What did you first notice about the patient?" (Lasater, 2010, p. 89). Another approach to develop critical thinking is the use of case studies. Case studies can provide a low-risk opportunity for nurse educators to help students and nurses achieve skill development. Case studies help to stimulate the critical thinking process and provide challenges for students to advance in skill acquisition (Lunney, 2009),

Outcomes of Critical Thinking in Nursing Education

    Nursing literature on critical thinking sup ports the view that educational preparation of registered nurses must include development of strong critical thinking skills to provide safe, quality care (Benner et al., 2010; Fater & Ready, 2011; Lasater, 2010; Newton & Moore , 2013). In a comprehensive literature review of critical thinking, Chan (2013) identified four categories that influenced critical thinking in nursing education: students, educator, education system, and environment. 

    For example, students may be hindered to think critically by their cultural background or a language barrier. The educator can influence critical thinking by being supportive and approachable. Teachers of nursing should value critical thinking and teach it as a subject with active learning opportunities. Lastly, positive learning environments, such as feeling accepted in the clinical arena, can facilitate critical thinking.

    Most importantly, nurse educators may not have mastered the teaching of critical thinking therefore, support for faculty development is a requisite. Faculty development for teaching critical thinking to students should be started early since it promotes a higher level of student performance (Chan, 2013; Fater & Ready, 2011)

How Critical Thinking Helpful In Nursing Education

    The overarching goal of nursing is to provide safe, quality patient care. Critical thinking is recognized as an important nursing skill that can improve nursing practice at all levels of the professional practice environment. Nurse educators in both academia and clinical settings must be competent to teach critical thinking and measure outcomes tied directly to critical thinking Students learn how to critically think and reason by situational experiences involving patients, such as case studies, as well as patients in clinical settings or simulation (Benner et al. 2010; Robert & Petersen, 2013).

    Rather than focusing on conventional strategies of recalling content, future research in nursing education should focus on the process of thinking. This process demonstrates thinking critically about the content and asking questions related to how the content applies to the clinical situation (Forneris & Peden McAlpine, 2009). More research is needed on how nursing students' critical thinking skills progress from an evolutionary perspective during their learning experiences (Newton & Moore, 2013). Understanding how critical thinking skills are developed and practiced at a level to produce the best patient outcomes is a fertile area for current research. Benner, P. Sutphin, M. Leonard, V., & Day, L (2010) Educating nurses. San Francisco, CA: Jossey-Bass.