In an increasingly complex and tech-centric healthcare system, registered nurses (RNs) have to be able to make quick, effective decisions. That skill relies on critical thinking, a purposeful and logical thought process that leads to positive patient outcomes.
The task of guiding new nurses toward the ability to think critically rests on nurse educators.
Critical thinking “is not so much a method to be learned as a process or orientation of the mind, which incorporates both the affective and cognitive domains,” according to “Effectiveness of teaching strategies to improve critical thinking in nurses in clinical practice” in the research journal JBI Synthesis.
Earning an advanced degree in an online Master of Science in Nursing (MSN) program can empower nurse educators to help the next generation of RNs develop the critical-thinking skills that are fundamental to effective patient care.
What Is Critical Thinking?
Critical thinking has become an important part of the lexicon of nurse practitioner terms because, increasingly, the safety and well-being of patients depends on a nurse’s ability to grasp the concept.
“Nursing has changed from a simple caregiving job to a complex and highly responsible profession,” according to Minority Nurse. “Hence, the role of nurses has changed from being task-oriented to a team-based, patient-centered approach with an emphasis on positive outcomes. Strong critical thinking skills will have the greatest impact on patient outcomes.”
The magazine goes on to cite a detailed, foundational definition of critical thinking presented by Michael Scriven and the late Richard Paul, two philosophers and experts in the field, during an international conference on critical thinking and education reform in 1987:
Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action. In its exemplary form, it is based on universal intellectual values that transcend subject matter divisions: clarity, accuracy, precision, consistency, relevance, sound evidence, good reasons, depth, breadth, and fairness.
The Importance of Teaching Nurses Critical Thinking Skills
Nurses who provide direct patient care need to develop their critical-thinking skills early in their education and take those lessons onto the hospital floor or the physician’s office.
To teach the concept effectively, nurse educators should remember that critical thinking is not a static skill ― it’s something that is constantly in development, honed over time, and refined with experience.
“In nursing education, there is frequent reference to critical thinking and to the significance that it has in daily clinical nursing practice. Nursing clinical instructors know that students face difficulties in making decisions related to clinical practice,” according to “Critical Thinking: The Development of an Essential Skill for Nursing Students.” The article is available through PubMed Central, a medical and life sciences archive of the U.S. National Institutes of Health’s National Library of Medicine.
“The main critical thinking skills in which nursing students should be exercised during their studies are critical analysis, introductory and concluding justification, valid conclusion, distinguish of facts and opinions, evaluation the credibility of information sources, clarification of concepts, and recognition of conditions.”
Nurse educators have access to a range of resources on critical thinking skills, including conceptual maps, simulations, reflective writing, role-playing and problem-based learning (PBL), YouTube videos, and team-based learning. Those techniques have varying degrees of effectiveness, but PBL has been shown to be “significantly better in promoting critical thinking development among undergraduate nursing students” compared to lectures, according to the JBI article.
Nurse educators also must draw on what “Turning New Nurses Into Critical Thinkers,” a Lippincott Solutions article, calls “several generally recognized hallmarks of teaching for critical thinking.” They include:
- Promoting interaction among students, because learning in a group setting can help students to achieve more than they might working on their own
- Asking open-ended questions, which encourages students to think and respond creatively, without fear of giving the “wrong” answer
- Allowing sufficient time to reflect on the presented problems and questions, which helps new nurses understand that they are expected to spend time contemplating the challenge at hand and that they have no need to make a snap judgment
- Teaching for transfer, by providing opportunities for students to see how a newly acquired skill can apply to other situations and experiences.
The emphasis on critical thinking is designed to ensure that new nurses are able to adhere to and maintain certain fundamental principles. The article advises nurse educators or nursing supervisors to consider these four questions when assessing young RNs:
- Can the nurse recognize that the patient has a problem?
- Can the nurse manage the problem safely and effectively, recognizing his or her scope of practice?
- Does the nurse have a relative sense of urgency?
- Does the nurse take the right action for the right reason?
In addition to developing skills, according to the article, nurses should exhibit certain core attributes of critical thinkers, including:
- Inquisitiveness about a variety of issues
- A desire to become and remain well informed
- Flexibility when considering opinions and alternatives
- A willingness to be open-minded about differing worldviews and to understand the opinions of other people
- The ability to be honest about one’s own biases, prejudices, or stereotypes,
- Self-confidence in one’s own reasoning abilities
The ultimate goal for developing RNs’ critical thinking skills, of course, is providing superior care.
“Patient safety can be directly affected by the critical thinking ability of a nurse,” according to the Lippincott article. “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.”
Ohio University’s Online Master of Science in Nursing (MSN) Program
Ohio University’s online MSN program is designed to offer RNs the skills and experience necessary to take their careers to an advanced level. The nurse educator concentration focuses on evidence-based instructional strategies and teaching techniques that can prepare graduates to impart critical thinking skills to new nurses.
JBI Evidence Synthesis, Effectiveness of teaching strategies to improve critical thinking in nurses in clinical practice: a systematic review protocol
Minority Nurse, Critical Thinking: A vital trait for nurses
PMC, Critical Thinking: The Development of an Essential Skill for Nursing Students
Lippincott Solutions, Turning New Nurses Into Critical Thinkers