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Critical Thinking in Nursing

Critical thinking in science and in nursing is a process of inquiry in which we try to gain a better understanding of the world—from stars and meteors to the human brain and behavior to entire ecosystems. Inquiry is based on a standard set of rules known as the scientific method. The scientific method is important because it provides a regulated process for conducting research:

The scientific method is a process that other nurse researchers can then follow and repeat to reproduce and validate your results. Repetition of research studies gives the results more strength by increasing the amount of supporting evidence. For instance, you’d like to know that a medication you give a patient to fight a bacterial infection has been researched using a standard method, tested repeatedly, and has strong evidence supporting its effectiveness. Furthermore, you would want to be confident that it works on the specific bacteria your patient has and that it doesn’t have any dangerous side effects.

The main ingredient of the scientific method is the ability to think, which sounds pretty easy, perhaps like breathing. But, you can learn to improve your thinking as you progress through college course work. Even thinking about your own thinking, called reflection, can help you. Reflection helps you understand your own biases, or your particular way of looking at phenomena, so that you can find out how your previous views might be getting in the way when what you need is a fresh perspective.

Observation is a critical skill in inquiry, and you can learn to become an astute observer through practice. Another thinking skill you can learn is making connections between what you already know and what you are learning. This skill will help you put information together to make new discoveries or to come up with new solutions to old problems.

Inquiry in nursing relies on asking critical questions. Questions help direct your inquiry; they help you decide where to go for information, what tests to perform, or what experiments to design. The more you improve your thinking through practice and experience, the better you will be at coming up with questions about the world, or your area of practice, and finding methods for answering those questions.

Mind Actions and the Critical-Thinking Process

The previously discussed basic actions your mind performs when asking important questions are the basic blocks you will use to build the critical-thinking processes you will explore in the next section. You rarely use the mind actions one at a time as they are presented here. Usually you combine them and repeat them. Sometimes they overlap. When you combine them in working toward a goal (a problem to solve, a decision to make), you are performing a thinking process. Important critical-thinking processes include: solving problems, making decisions, reasoning, opening your mind to new perspectives, and planning strategically. These thinking processes are similar in that they involve the steps of gathering, evaluating, and using information. As you will see, however, the sequence or combination of mind actions may vary considerably.

How does critical thinking help you succeed in nursing?

Problem solving and decision making are probably the two most crucial and common thinking processes used in nursing. Each requires various mind actions. They overlap somewhat, because every problem that needs solving requires you to make a decision. Each process is considered separately here. You will notice similarities in the steps involved in each.

Although both of these processes have multiple steps, you will not always have to work your way through each step. As you become more comfortable with solving problems and making decisions, your mind will automatically click through the steps you need whenever you encounter a problem or decision. Also, you will become more adept at evaluating which problems and decisions need serious consideration and which can be taken care of more quickly and simply. As you become an expert nurse, learning these skills will take many years of experience and reflection—so, start now!

Problem Solving

Life constantly presents problems to be solved, ranging from common daily problems (how to manage study time) to life-altering situations (how to design a child-custody plan during a divorce). Choosing a solution without thinking critically may have negative effects. If you move through the steps of a problem-solving process, however, you have a good chance of coming up with a favorable solution.

Brainstorming

Brainstorming is a crucial element of problem solving. You are brainstorming when you approach a problem by letting your mind free-associate, coming up with as many possible ideas, examples, or solutions as you can without immediately evaluating them as good or bad. Brainstorming is also referred to as divergent thinking; you start with the issue or problem and then let your mind diverge, or go in many different directions, in search of ideas or solutions.

Following are some general guidelines for creative and successful brainstorming:

  1. Don’t evaluate or criticize an idea right away. Write down your ideas so that you remember them. Evaluate them later, after you have had a chance to think about them. Try to avoid criticizing other people’s ideas as well. Students often become stifled when their ideas are evaluated during brainstorming.
  2. Focus on quantity; don’t worry about quality until later. Generate as many ideas or examples as you can without worrying about which one is “right.” The more thoughts you generate, the better the chance that one may be useful. Brainstorming works well in groups. Group members can become inspired by, and make creative use of, one another’s ideas.
  3. Let yourself play. People often hit on their most creative ideas when they are exercising or just relaxing. Often when your mind switches into play mode, it can more freely generate new thoughts. A thought that seems crazy might be a brilliant discovery. For example, the idea for Velcro came from examining how a burr sticks to clothing. Dreams can also be a source.
  4. Use analogy. Think of similar situations and write down what you remember; what ideas or strategies have worked before? Analogy puts the similarity mind action to work recalling potentially helpful ideas and examples and stimulating your mind to come up with new ones. For example, the Velcro discovery is a product of analogy: when trying to figure out how two pieces of fabric could stick together, the inventor thought of the similar situation of a burr sticking to clothing.
  5. Don’t fear failure. Even Michael Jordan got cut from the basketball team as a high school sophomore in Wilmington, NC. If you insist on getting it right all the time, you may miss out on the creative path—often paved with failures—leading to the best possible solution.

The Problem-Solving Process

When you have a problem to solve, taking the following steps will maximize the number of possible solutions and will allow you to explore each one carefully.

Decision Making

Decisions are choices. Making a choice or decision requires thinking critically through the possible choices and evaluating which will work best for you, considering the situation.

Before you begin the process, evaluate what kind of decision you have to make. Some decisions, such as what books to bring to class, are little day-to-day considerations that you can take care of quickly. Others, such as what to major in or whether to quit your part-time job, require thoughtful evaluation, time, and perhaps the input of others you trust. The following is a list of steps for thinking critically through the more complex kind of decision:

  1. Identify a goal. Why is this decision necessary? What result do you want from this decision, and what is its value? Considering the desired effects can help you formulate your goal.
  2. Establish needs. Recall the needs of everyone involved in the decision. Consider all who will be affected.
  3. Name, investigate, and evaluate available options. Brainstorm possible choices, and then look at the facts surrounding each. Evaluate the good and bad effects of each possibility. Weigh these effects in light of the needs you have established and judge which is the best course of action.
  4. Decide on a plan and take action. Make a choice based on your evaluation, and act on it.
  5. Evaluate the result. Was it useful? Not useful? Some of both? Weigh the positive and negative effects.

Look at this example to see one way of using the decision-making plan:

Making important decisions can take time. Think through your decisions thoroughly, considering your own ideas as well as those of others you trust, but don’t hesitate to act once you have your plan. You cannot benefit from your decision until you follow through on it.

Click here for Problem Solving Exercises.

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