Helping Nurses Learn How to Think Critically

Decision Making, Problem Solving and Critical Thinking Skills for Nurses

Given the critical exigencies of the profession, nurses are routinely required to strictly rely on their education, training and experience to make life-and-death decisions about their patients without investing a great deal of deep thought about the process (Cleary et al., 2023). This level of automatic regimented response, though, frequently leaves little or no time for critical thinking about what should be done -- and why. Although the concept of critical thinking is relatively new to the nursing profession, the concept has actually been used since antiquity and the days of Socrates. Indeed, it is reasonable to suggest that even Stone Age humans were forced to use critical thinking skills to help them survive a hostile world, even if the process was not so named. To determine how this concept applies to the nursing profession today, the purpose of this paper is to review the relevant literature to provide a discussion concerning the history and theoretical framework of decision-making and critical thinking in general and applied to the nursing field in particular. Following this discussion, the paper provides a summary of the research and important findings about these issues in the conclusion.

Review and Discussion

Although there is no universally accepted definition, some authorities have described critical thinking as “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” (Scriven & Paul, 2003). That is a lot to pack into one concept, but this definition does in fact highlight the essential elements that are involved in critical thinking. The operative term, though, is “intellectually disciplined” which emphasizes the essentiality of applying critical thinking skills to both familiar and novel situations. In this regard, Chen et al. (2018) emphasize that, “Critical thinking is important in nursing education and practice because it is essential in helping nurses to handle complicated health conditions and to manage patient issues effectively” (p. 197).

Similarly, Kaddoura (2021) cites the increasing complexity of healthcare systems, devices and interventions as evidence of the need for nurses at all levels and specialty areas to cultivate and continuously hone their critical thinking skills. For instance, Kaddoura notes that, “The rapidly changing nature of the health care system presents nurses with varied complex practice issues with no clear solutions. These health care problems require nursing students and nurses to have critical thinking skills” (p. 1). In sum, there is a growing body of scholarship that confirms the need for nurses to possess critical thinking skills as part of their professional repertoire of healthcare tools.

All of this is not to say, of course, that nurses should second-guess themselves when confronted with “complicated health conditions” since it is imperative that they rely on their professional and intuitive abilities in these types of situations and time is of the essence for achieving optimal clinical outcomes. It is to say, however, that there is always time for candid self-reflection and honest self-assessments where critical thinking skills can help identify potential opportunities for improvement. Likewise, honest self-reflection and assessment can also provide a useful framework in which to determine where things went wrong in those eventualities.

Fortunately, like other essential nursing skills, critical thinking can be learned (Gonzalez et al., 2022). Some ways nurses can improve their critical thinking abilities is through simulation-based and other experiential learning opportunities. In fact, simulated patient scenarios allow nurses to walk through complex clinical situations in a safe, non-threatening, cost-effective fashion, providing them with the opportunity to assess information, recognize problems, and make informed clinical judgements. In addition, reflective journaling is another technique nurses can utilize to question their own thinking and identify areas for improvement (Raterink, 2016).

It is also important to note that nursing leaders in clinical practice and educational settings also have a fundamental responsibility to help their subordinates cultivate critical thinking skills. This is an essential need since these nurses are the next generation of nursing leaders. This need can be addressed by providing the above-described experiential learning opportunities, time for self-reflection and assessment as well as through individual mentorships (Logan, 2021).

Conclusion

The research was consistent in showing that critical thinking is an essential skill for nurses to cultivate in order to provide effective care in today’s complex healthcare environments. As noted above, there is no universally accepted definition of critical thinking, but it broadly refers to the disciplined intellectual process of evaluating information to guide decisions and actions. While critical thinking has likely been used since antiquity, its formal importance to nursing is more recently acknowledged given increasingly complicated health technologies, patient needs, and care systems. The research also showed that critical thinking skills provide nurses with the ability to adeptly handle complex patient issues, identify potential problems, and make sound clinical judgements. Though urgent situations rightfully call for swift actions based on training and experience, critical thinking remains crucial for ongoing self-reflection and improvement. Some of the key techniques that were identified that can be used to enhance critical thought include simulation-based learning and reflective journaling, among others.