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Critical Thinking in Nursing Education
For far too long nursing has been seen as a profession that requires compassion along with obedience to the orders of doctors who were traditionally considered to be the "real" medical professionals. Nurses were until recently inside and outside of the profession seen as sort of helpmeets to the doctors, a form of junior wife to the male doctor. Of course nurses were always more than this, but it has become true only relatively recently that the medical profession as a whole has begun to acknowledge that critical thinking is as important for nurses as it is for doctors and other medical professionals.
This paper examines the ways in which the teaching of critical thinking can be incorporated more fully (and more deeply) into the teaching curricula and praxis of nursing. Focusing on the importance of critical thinking from the first day that nursing students walk into the classroom will help to create new generations of nurses that are both able to provide the highest possible degree of care to their patients and to fulfill their own ambitions to have a career that engages them on all intellectual levels.
It seems especially important to integrate courses on the importance of critical thinking within the nursing profession in programs that train vocational nurses. While critical thinking is imperative at all levels of nursing, it is more likely to be taught in programs for nurses aiming at the "higher" levels of the profession such as those enrolled in RN programs. Such skills must be inculcated at all levels of the profession because any nurse, no matter what his or her degree, may be called on to make decisions based not on rote memorization or even from past experience but rather through an analysis of the situation and synthesis of experience and education. In other words, any nurse at any time must be able to think critically.
Simpson & Courtney (n.d.) note that the importance of including critical thinking skills at all levels of nursing education is more important now than ever before in the profession, primarily as the result of relatively recent developments. These include advances in technology and pharmaceuticals that have made the practice of medicine increasingly complex as well as changes in staffing that often leave nurses as the only medical professionals to treat a patient.
As HMOs as well as other insurance bureaucracies have pushed and pushed to lower the costs of treating patients, nurses (who are paid less than doctors) are often given a degree of responsibility that in previous decades would have been assumed by physicians.
Fowler claims that practicing nurses and nurse educators concur that the increasing complexity of modern healthcare demands critical thinking. Every day, nurses sift through an abundance of data and information to assimilate and adapt knowledge for problem clarification and solution. Moreover, nurses are constantly involved in making decisions within their practice. These decisions are frequently concerned with situations where there is no single or absolutely correct response. Colucciello proclaims the use of critical thinking is vital in examining simple and complex situations in nurses' day-to-day responsibilities. It is an essential means of establishing whether the information or assessment obtained has been accurately captured in order to articulate specifically and distinctly what the information conveys. (Simpson & Courtney, n.d., p. 3)
It seems far more likely that the profession of nurses (like the medical profession as a whole) will continue to grow in complexity than the possibility that it will suddenly become far simpler. Thus the need for critical thinking skills will only become increasingly important.
Thus the question that this research proposes to investigate is: What is the best method, or methods, of introducing critical thinking into all levels of nursing curricula? Such methods must inculcate the ability to make the best decision for each patient at each moment. This proposal outlines the research methodology proposed for the project and provides a very brief overview of some of the established research in this area.
There are two basic types of research: qualitative and quantitative, as well as "mixed methodology," which is a combination of both of these. One of the very first decisions that must be made when initiating a research project is to decide between these two basic approaches. To some extent this is a choice based on whether the information that one will gather is something that is already quantified: If the researcher is concerned with discrete bits of information (for example, the number of days a patient stays in a hospital after a particular procedure), then a quantitative analysis is probably best. Quantitative research tends to use methods such as surveys and questionnaires as well as data derived from behavior that is observed and then coded.
If the point of the research, on the other hand, is to derive meaning, to understand how people understand their world, then qualitative methods are generally better. Qualitative data tend to be gathered using interviews and participant observation. However, at least as important as the type of data that the researcher is intent on gathering is the basic philosophy of the researcher. Researchers who use a quantitative method tend to believe that people can know the absolute truth, and indeed that there is an absolute truth to be known.
Researchers pursuing a qualitative methodology are more likely to see the world as a highly complex place that cannot ever be entirely understood. Qualitative research also tends to be based on the assumption that there is no single truth to be discovered but a range of subjective truths, each reflecting different realities. This distinction is summarized below:
Another major difference between qualitative and quantitative research is the underlying assumptions about the role of the researcher. In quantitative research, the researcher is ideally an objective observer that neither participates in nor influences what is being studied. In qualitative research, however, it is thought that the researcher can learn the most about a situation by participating and/or being immersed in it. These basic underlying assumptions of both methodologies guide and sequence the types of data collection methods employed. (The qualitative vs. quantitative debate, n.d.)
While, as noted above, many researchers do combine qualitative and quantitative methods, generally using the two to complement each other so that the weaknesses of one method are compensated for by the strengths of the other. However, it is also certainly arguable that the two basic ways of seeing the world and investigating it are essentially incompatible. This tension between different ways of assessing a mixed-methodology strategy is described below:
Some researchers believe that qualitative and quantitative methodologies cannot be combined because the assumptions underlying each tradition are so vastly different. Other researchers think they can be used in combination only by alternating between methods: qualitative research is appropriate to answer certain kinds of questions in certain conditions and quantitative is right for others. And some researchers think that both qualitative and quantitative methods can be used simultaneously to answer a research question. (The qualitative vs. quantitative debate, n.d.)
This research project will be based on qualitative methods since the goal is to ascertain meaning. To determine how critical thinking skills can best be conveyed through the formal educational process, nurse educators, licensed nurses, and nurses in training will be interviewed to ascertain two major points.
The first of these is whether there is a concurrence on the importance of critical thinking skills for nurses. The second is more central to this research, since the previous point has been well established in the literature: How do nurses themselves (at various points in the education and licensure process) understand the process of acquiring critical thinking skills.
Interviews are an extremely valuable way of getting detailed information about a subject. In this research, the information gained from open-ended interviews will be supplemented by observation of nursing classes. While interviews provide rich information, it is always the case that interview subjects provide their own editing on what has happened: This is simply human nature. Observing classes will supplement the information and perspective of nursing teachers and students.
The function of a literature review is to ground the current research project in the work that has been done before on roughly the same topic. There are several reasons for this. The first is that by examining the previous research on the topic, the researcher is able to avoid the job of having to reinvent the wheel (as it were) all over again. The other side of this is that by examining what other researchers have done, one can determine what gaps there are in the research. A literature review can be seen as a metaphorical jigsaw puzzle: It allows a researcher to see which part of the picture has already been filled in and where the gaps remain.
A literature review also helps to focus the research project. While the importance of critical thinking to nursing is already a relatively focused topic, it is too broad…[continue]
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