Title: CRITICAL THINKING
1CRITICAL THINKING
SOAR-RN
- Jenny Hopkins, RN
- ICU Teamleader/Educator
2Objectives
- Differentiate between critical thinking and
reflective practice and how they enhance clinical
practice.
3What does critical thinking look like?
- Name someone you know who is a great critical
thinker - What are their characteristics?
- A good critical thinker is.
4Why use critical thinking in clinical practice???
- Safe and effective nursing interventions
- Complex, rapidly changing healthcare environment
- Patients that are not textbook
- Evidence Based Practice
- Not always clear-cut protocols
- What we know and what we do are two different
things
5What is critical thinking?
- Critical thinking is a process and cognitive
skill that we apply to identify and define
problems and opportunities for improvement to
generate, examine and evaluate alternatives to
reach conclusions and decisions, and to create
and use criteria for evaluating our decisions - Purposeful and goal-directed thinking that
focuses on what to believe or do - Thinking about your thinking, while you are
thinking
6Components of Critical Thinking
- Characteristics
- Intellectual Skills
- Technical Skills
- Interpersonal Skills
- (Alfaro-LeFevre, 2001)
7Emotional Intelligence (EQ)
- 5 components
- Self-awareness
- Self-regulation
- Motivation
- Empathy
- Social skill
8Key intellectual traits
- Intellectual humility willingness to admit you
dont know - Intellectual integrity continual evaluation of
your own thinking and willingness to admit when
it may be flawed - Intellectual courage awarenss of the need to
face and fairly address ideas, beliefs, or
viewpoints about which you have negative feelings
and havent given serious hearing - Intellectual empathy a conscious effort to
understand others by putting your own feelings
aside and imaging yourself in their place. - Paul, R. and Elder, L. Center for Critical
Thinking in California
9Critical thinking skills sets
- Ability to recognize
- Ability to manage
- Ability to differentiate priority
- Ability to justify actions
- Del bueno
10Strategies to engage in critical thinking
- Anticipate questions others may ask
- Ask Why?, What else? and What if?
- Ask an expert to think out-loud
- Restate something in your own words
- Think out loud or write things down, draw
pictures or concept maps
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12More Strategies
- Organize and reorganize information
- Substitute I dont know and Im not sure with
Ill find out - Look for flaws in your thinking, open your
thinking to others for them to see the flaws - Reframe Turn errors into learning opportunities
- Share your mistakes with others
13Clinical Judgement
- Way in which nurses come to understand the
problems, issues, or concerns of patients - Nursing decisions made about things related to
the patient - Nursing opinions made about a patients health at
a point in time
14Components of Critical Thinking Clinical
Judgment
- Problem Identification
- Problem Clarification
- Problem Exploration
- Evaluate Integrate
- Noticing
- Interpreting
- Action
- Reflection in Action
- Reflection on Action
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17New graduates level of development
- Unconsciously incompetent
- Consciously incompetent
- Consciously competent
- Unconsciously competent
18Socrates learned more from questioning others
that he did from reading books.--
19Learning from Stories
- Ask people to tell you about their most
significant learning and they will tell you a
story - All deep learning takes the form of a story
- We are designed by nature to learn most
effectively from stories both those we hear and
those we experience - WNRP nurse residents felt that sharing stories
was one of the most important elements of the
program
20Strategies for Developing Clinical Judgment
- Develop your knowledge base and keep pocket
guides or notes normal and abnormal assessment
findings, physiology, pathophysiology - Finely tune your assessment skills
- Use the nursing process, protocols, procedures,
standards of care, best practice and understand
the reasoning behind them
21More Strategies
- Know why your interventions are indicated, why
they work, how they apply within the context of
this patient situation - Learn from your experts
- Learn from others on the multidisciplinary team
- Use your resources
22The Action-Reflection Cycle
Results
- Action
- Learning
- Reflection
Knowledge
There is no learning without action.
Shibley, 2000
23Reflection is what allows us to learn from our
experiences
Reflection is an assessment of where we have been
and where we want to go next
24Reflective exercise
- As a result of this situation
-
- I have learned how to..
- This situation gave me insights into
collaborating with others because of.. - This situation shows I have more to learn
about..
25Critical thinking exercise
- Scenario
- Common causes for this issue.
- List what additional information may be needed.
- List what the options are.
- Verbalize rationale for each of the options
- Identify what corse of action the RN should take.
- Identify what assumptions or biases could affect
the critical thinking process.
26Barriers to Critical Thinking
- Situational Factors anxiety, stress, fatigue,
environment - Habits self-focusing, mine-is-better, tunnel
vision, face-saving, resistance to change,
conformity, stereotyping or self-deception