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CRITICAL THINKING & NURSING PROCESSDR. JAMES Malce ALO

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The principal goal of education is to create men and women . . .who have minds which can be critical, can verify, and not accept everything they are offered.

-Jean Piaget

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nbWHAT IS CRITICAL THINKING? is the process that allows nurses to see the big

picture (envision the overall perspective) instead of focusing only on details.

Ennis’(1987) classic description, “reasonable reflective thinking that is focused on deciding what to believe or do.”

Every day, nurses make decisions that are derived through critical thinking.

Making clinical judgments relies on critical thinking.

Critical thinking is identified as an essential nursing competency by the National League for Nurses (1997).

ongoing activity for professional nurses.

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COMPONENTS OF CRITICAL THINKING1. Mental operations,2. Knowledge, and 3. Attitudes

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MENTAL OPERATIONS- Activities such as decision-making

and reasoning that are used to find or create meaning.result of these mental operations is

creative, appropriate problem solving.

Other cognitive operations involved in critical thinking are; strategizing (planning) and evaluating one’s thinking

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KNOWLEDGE knowledge base that includes

1. declarative knowledge, (specific facts or information)

2. operative knowledge (an understanding of the nature of that knowledge).

Nursing curricula assist the student in learning specific facts about nursing and the delivery of quality care.

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In order to think critically, to solve problems, and to make decisions, nurses must develop a broad base of knowledge. It includes; from other disciplines such as science

(anatomy, physiology,biology), psychology, and philosophy (logic).

Nurses apply this knowledge to specific client situations through critical thinking.

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ATTITUDES ATTITUDES OF CRITICAL THINKERS

• Tolerance, open-mindedness, nonjudgmental mind-set

• Curiosity, proactive, flexible, organized• Persistence, intellectual courage• Respect for others’ perspectives• Comfort dealing with ambiguity,

uncertainty• Intellectual humility (knowing that one

does not have all the answers)• Self-confidence (belief in own ability to

think things through and make appropriate decisions)

(Data from: Beyer [1987]; Ennis [1987]; Krathwohl, Bloom, & Masia [1964]; Paul, [1993]; and Rubenfeld & Scheffer [1999].)

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PHASES OF CRITICAL THINKING 1. Trigger event: A problem that is

reframed as an opportunity for improvement

2. Appraisal of the situation: Self-examination of one’s underlying assumptions

3. Exploration: Searching for new ideas, solutions, and/or approaches

4. Integration: Incorporating new information and new ways of thinking

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DEVELOPMENT OFCRITICAL THINKING SKILLS1. Identify goals.2. Determine what knowledge is

required.3. Assess the margin for error.4. Determine the amount of time

available for decision making.5. Identify available resources.6. Recognize factors (i.e., biases,

fatigue) that may influence decision making (Alfaro-LeFevre, 1998).

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CRITICAL THINKING SKILLS

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CRITICAL THINKING AND CREATIVITY Critical thinkers are also creative

thinkers. Both types of thinking require assessment and result in new discoveries (Paul & Ballin, 1988).

creative problem solving is goal-directed thinking that leads to

achievement by using new ideas or methods.

Creativity is “the basic building block of invention and thus innovation"

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Creative thinking is the foundation for individualizing client care, in that the nurse identifies unique needs of each client and develops interventions specific to those needs. Without creative thinking, nursing care would become routine, that is, the same for every client.

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COMPARISON OF CRITICAL AND CREATIVE THINKINGCritical Thinkers Creative Thinkers

• Defines the parameters of a problem

• Defines the existing problem

• Sets reasonable criteria for assessing the

• Delays judgment or suspends criticism of alternativesappropriateness of an action

• Adapts one’s behavior as needs

• Exercises judgment in selecting the best alternativeand/or norms change

• Transfers learning from one situation to another

• Learns from mistakes

• Pays attention to the problem at hand

• Breaks away from usual problem-solving methods to developcreative responses

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CRITICAL THINKERS• Detects ambiguity or false inferences

• Analyzes interrelationships of ideas fromseveral perspectives

• Tests out inferences by consideringopposing viewpoints

• Creates innovative solutions to complex problemsRef:(Data from Gilmartin [1999] and Paul [1993].)

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CRITICAL THINKING ANDDECISION MAKING When making a clinical decision, the

nurse determines action that will help move the client toward achievement of the expected outcomes.

Thus, decision making is defined as considering and selecting interventions from a repertoire of actions that facilitate the achievement of a desired outcome (Pesut, 1999).

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NURSING PROCESS

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THANK YOU. - DR. ALO