The Importance of Critical Thinking to Nursing Graduates


 


            Critical thinking according to Lipe and Beasley (2003), is an essential skill in the administration of safe competent nursing care. Critical thinking may be defined as the process of purposeful, self-regulatory judgment. The process gives reasoned consideration to evidence, contexts, conceptualizations, methods and criteria. Critical thinking is important to nursing graduates like my self. Critical thinking is geared towards a goal. It involves questioning, challenging our held beliefs, perceptions and assumptions. Critical thinking is defined as an active reasoning process (data gathering, association, empathy, incubation, brainstorming, analysis, synthesis, and evaluation) that results in the production of a commonplace but socially useful idea or solution (Gendrop 1996). Critical thinking is important to nurses as it leads them to examine their assumptions, beliefs, propositions and the meaning and uses of words, statements and arguments associated with a problem (Grant 1994).


 


            Teaching critical thinking are essential higher-order cognitive skill that should be of concern for nursing instructors. This cognitive skill is invaluable to students’ futures; it prepares individuals to tackle a multitude of challenges that they are likely to face in their personal lives, careers, and duties as responsible citizens (Tsui 2002) By instilling critical thinking in students, students are groomed to become independent lifelong learners – thus fulfilling one the long-term goals of the educational enterprise (White 2004). There are several techniques that can be used in developing nursing students’ critical thinking:


1. Decision Grids – A decision grid allows one to compare alternatives from several perspectives. The individual lists alternative along one axis and various factors to be considered along the other. Each factor’s importance may be indicated by assigning a numerical value to each one (Grant 1994).


2. Concept Mapping – It has been found that concept mapping helps students gain greater understanding of the content by helping them formulate mental plans of comprehending and composing as they read and write (Holloway 2002).


3. Journaling – In the adult education classroom, this learning method becomes a tool to aid learners in terms of personal growth, synthesis, and reflection on new information that they acquire. Journaling promotes critical self-reflection where dilemmas, contradictions, and evolving worldviews are questioned or challenged (Hiemstra 2000).


4. Case Studies – Billings and Halstead (1998) defined a case study as an in-dept analysis of a real-life situation as a way to illustrate class content; applies didactic content and theory to real or simulated life or to both. Case studies stimulate thinking, retention, and recall. Students are able to apply knowledge of theories, concepts, and approaches to care to an actual scenario.


 


Critical Thinking Skills


1. Interpretation


            The skill of interpretation includes the ability to understand and explain the meaning of information or an event. It requires knowledge of theory and its subsequent application.


2. Analysis


            Nurses are practicing analysis when they investigate a course of action based on objective and subjective data. Various measures may be considered to solve a problem. The nurse should consider the advantages, disadvantages, and consequences of all possibilities. The analysis of assessment data provides direction in determining the problems the nurse can treat independently and the problems that require collaboration. It also helps to identify patient care that needs to be referred.


3. Evaluation


            The process of evaluation is the assessment of the information obtained. The nurse must consider the source of the information and determine whether it is credible and reliable. The nurse must also determine whether the information is relevant to the current problem.


4. Inference


            Critical thinkers who are skilled at inference can make correct conclusions based on available information. Their decisions are based on sound reasoning.


5. Explanation


            Another important critical thinking skill is the ability to explain one’s conclusions. The nurse should be able to provide sound rationales for answers. The ability to explain the reasoning process itself is also beneficial. This involves describing the events that lead to a particular conclusion.


6. Self-Regulation


            Self-regulation involves monitoring one’s own thinking. The individual should reflect on the process leading to his or her conclusion. While monitoring thinking, the individual should self-correct the thinking process as needed. The skill of evaluation is used to asses the accuracy and validity of information obtained. Self-regulation involves the recognition and correction of errors in one’s thought process. Self-regulation occurs in response to self-evaluation of thinking.


 


Critical Thinking and Problem Solving


            Critical thinking is the process of purposeful, self-regulatory judgment. Critical thinking enables an individual to solve problems and make decisions; therefore problem solving and decision-making are practical applications of critical thinking skills. Problem solving is a systematic process, leading to the achievement of outcomes. The ability to solve problems effectively contributes to the delivery of safe, competent nursing care.


 


Critical Thinking and Decision-Making


            Decisions are influenced by many factors, including emotions, values, perceptions, and the current social climate. Effective decision makers tend to possess certain skills. These skills can be learned and, with practice, can be integrated into the decision process. People who approach decisions with self-confidence and a degree of assertiveness are generally more effective. A proactive approach is also beneficial. Proactive individuals have examined their values and make decisions based on them. With some decisions, flexibility is helpful. Even though every attempt is made to select the best option, sometimes perfect solutions does not exist. A knowledgeable decision maker understands that all decisions have consequences, but also understands that all decisions have consequences, but also understands that no one always makes the right decisions. Another important trait for a decision maker is the ability to focus. Priority decisions should be considered first.


 


Communication


            An essential element of the critical thinking skills is the organization and communication of thoughts. To communicate effectively, the nurse must be able to clarify and express his or her ideas and listen to the input of others. Communication is a skill that underlies many of the processes in critical thinking including problem solving and decision making in nursing. There are three levels of communication in nursing: social, therapeutic, and collegial. Social communication involves interactions for the purpose of accomplishing tasks or building social relationships, such as friendships. During therapeutic communication, the nurse listens to patient problems and focuses on the needs of the patient. Collegial communication is focused on building relationships with colleagues, improved patient care, and better documentation. Collegial communication can take place in both verbal and written forms. Communication is important in caring for patients. There is considerable evidence to show that nurses who communicate well with patients are more likely to:


1. Make an accurate, comprehensive assessment of the client’s health needs and condition. Good communication skills enable one to collect information about a patient’s problems which is comprehensive, relevant and accurate.


2. Detect emotional distress in patients.


3. Have patients who are satisfied with the care they have received and who are less anxious about their problem.


4. Have patients who agree with and follow the advice given.


            There is also evidence that good communication can have a positive effect in the patient’s physical condition – for example, blood pressure. One study showed that patients who had been allowed to express their concerns about their problem had a significantly greater reduction in their blood pressure than those who had not been given this opportunity but had been treated similarly in other respects.


 


Creativity


            Creativity is the progressing or advancing or continuous change in time. It is ongoing innovation, the production of something that is unique. In nursing, the element of creativity is seen in the dynamics of evolving uniquely more effective and efficient nursing activities for the achievement of optimal health from nay contributing parts.


 


Flexibility


            Flexibility or discretion allows one to exercise judgment, It is associated with the life cycle of a position. It is more to difficult to make new tasks routine that it is to make old tasks routine. Flexibility is associated with novelty and variety. The more routine the work and the fewer tasks assigned to a person the easier it is to establish routines, and the less powerful the position is. One can increase flexibility power by getting involved in new projects, participating in decision-making processes, initiating new ideas, reducing the percentage of routine activities in one’s job, expanding task novelty and variety, and seeking unusual jobs rather tan maintenance-oriented, repetitive jobs (Marriner-Tomey 2004).


            Graduate nurse will face daily dilemmas requiring flexibility. To keep quality of patient care at its highest level, flexibility will be necessary.


 


 


References


Billings, D M and Halstead, J A 1998, Teaching in Nursing: A Guide for Facukty, W. B. Saunders.


 


Gendrop, S C 1996, ‘Effect of an Intervention in Synectics on the Creative Thinking of Nurses’, Creativity Research Journal, vol. 9, no. 1, pp. 12+.


 


Grant, A B 1994, The Professional Nurses: Issues and Actions, Springhouse.


 


Hiemstra, R 2000, Techniques, Tools and Resources for the Self-Directed Learner.


 


Hpllpway, J H 2002, ‘Integrating Literacy with Content’, Educational Leadership, vol. 60, pp. 87-88.


 


Lipe, S K and Beasley, S 2003, Critical Thinking in Nursing: A Cognitive Skills Workbook, Lopponcott Williams and Wilkins.


 


Marrimer-Tomey, A 2004, Guide to Nursing Management and Leadership, Elsevier Health Sciences.


 


Tsui, L 2002, ‘Fostering Critical Thinking through Effective Pedagogy: Evidence From Four Institutional Case Studies’, The Journal of Higher Education, vol. 73, pp. 740-763.


 


White, H L 2004, ‘Nursing Instructors Must Also Teach Reading and Study Skills’, Reading Improvement, vol. 41, no. 1. pp. 38+.


 



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