Critical Thinking Re: to Nursing

Critical Thinking Related to Nursing

In researching the process of critical thinking, you find many definitions and

explanations. An example of the definition of critical thinking (Shriven & Paul) is the

intellectually disciplined process of actively and skillfully conceptualizing, applying,

analyzing, synthesizing, and/or generated by, observation, experience, reflection,

reasoning, or communication, as a guide to belief and action.

In her article, Learning to Think Like a Nurse, Pam DiVito-Thomas, PhD, RN

(2005) acknowledges the various definitions of critical thinking. She concedes that

"nearly all definitions of critical thinking emphasize logic and reasoning". The basis for

this article was related to a study conducted by Ms. DiVito-Thomas, involving nursing

students; in an effort to determine which teaching and learning strategies they felt would

help them develop better critical thinking skills. She mentions a theory (Knowles) that

learning occurs by putting "concepts together in meaningful ways based on former

learning experience". Utilizing this theory, Novak suggests that learning occurs by a

process called "concept mapping". Concept mapping is a visual representation of how

gathered information is interrelated and how that, in turn, leads to the acquisition of

knowledge. Below is a wonderful example of mind or concept mapping as it relates to

critical thinking in nursing (University of New Mexico [UNM], School of Nursing):

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Using this map, the student nurse draws a map listing patient problems and how these problems relate to one another. The student is then able to visualize the relationships between "medical diagnoses, nursing assessment data, diagnostic test results, nursing diagnoses and collaborative problems, and interventions and treatments" (UNM, School of Nursing). Critical Thinking 4

Another teaching/learning strategy discussed in the article is "the skill of metacognition, thinking about thinking". A method used to develop metacognition is reflective writing, where the nursing student writes, in their own words, about his/her clinical experience. This type of learning requires the learner to use cognitive or thinking skills. Finally, the last teaching/learning strategy covered is student-led clinical rounds. Based on this strategy, the student is offered the opportunity to "model critical thinking" by conducting themselves in the same professional, organized, thoughtful manner as those nurses they have seen in the clinical setting. The results of Ms. DiVito-Thomas ' study revealed that although students felt the following three strategies helpful in the development of clinical judgment:
1) utilizing concept maps of case studies
2) comprehensive, detailed discussions with instructors while performing observations in the clinical setting
3) joint decision making in patient care the most important strategy, expressed by the students, was "more clinical time and experience". In order to "think like a nurse", Ms. DiVito-Thomas feels the student nurse must be offered the opportunity to observe "nursing role models ' demonstrate their critical thinking process. In agreement with the author, I feel by increasing clinical time, student nurses will have more time to practice their skills; apply what they have learned; gain more confidence; observe various procedures and perform return demonstration. The student nurse will then have the ability to categorize and prioritize information, in a logical manner, from their own prior experiences and utilize this in making sound clinical judgments.

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References

Scriven, M. & Paul, R. The National Council for Excellence in Critical Thinking Instruction. The Critical Thinking Community. www.criticalthinking.org Retrieved 8/10/05.

DiVito-Thomas, Pam PhD, RN (May/June 2005). Nursing student stories on learning how to think like a nurse. Nurse Educator, 30(3), 133-
136. Lippincott Williams & Wilkens, Inc.

University of New Mexico, College of Nursing http://hsc.unm.edu/consg/conct/Mind%20Map.htm Retrieved 8/20/05

References: Scriven, M. & Paul, R. The National Council for Excellence in Critical Thinking Instruction. The Critical Thinking Community. www.criticalthinking.org Retrieved 8/10/05. DiVito-Thomas, Pam PhD, RN (May/June 2005). Nursing student stories on learning how to think like a nurse. Nurse Educator, 30(3), 133- 136. Lippincott Williams & Wilkens, Inc. University of New Mexico, College of Nursing http://hsc.unm.edu/consg/conct/Mind%20Map.htm Retrieved 8/20/05