Critical Thinking and Critical reasoning

• Dr. Christine Tanner, 2006: “Thinking like a nurse”
• Critical thinking is a process of intentional higher-level thinking to define a client problem, examine the evidence based practice in caring for the client, and make choices in the delivery of care.
• Critical thinking requires the nurse to think creatively, use reflection, and engage in analytical thinking.
• Clinical reasoning is a cognitive process that uses thinking strategies to gather and analyze clinical data, evaluate the relevance, and decide on possible nursing actions to improve the client psychological and psychosocial outcomes.
• Clinical reasoning involves the ability to focus and filter clinical data to recognize what is most important, so the nurse can identify if an actual problem is present.
• Clinical judgment is a conclusion about the patient’s needs, or health problems, and the decision to take or avoid action.
• Trial and Error is a problem-solving approach that involves trying multiple approaches until a solution is found, often used in the home setting.
• Intuition, also known as the sixth sense, hunch, instinct, feeling, or suspicion, is a problem-solving approach that relies on the nurse's inner sense, often inappropriate for nursing decisions but viewed as an essential and legitimate aspect of clinical judgment acquired through knowledge and experience.
• Nursing Process is a systemic, rational method of planning and providing individualized nursing care.
• Research Process is a formal, logical, systematic approach to problem-solving.
• Problem Solving is a mental activity in which a problem is identified that represents an unsteady state, requiring nurses to obtain information that clarifies the nature of the problem and suggest the possible solution.
• Inductive reasoning forms generalizations from a set of factor observations, moves from specific examples to a generalized conclusion, and involves cues, generalization, and hypothesis.
• Deductive reasoning is reasoning from a general premise to a specific conclusion.
• Critical thinking and clinical reasoning involve differentiating knowledge from belief, using the Socratic Process which includes clarification, probing assumptions, probing rationale, questioning viewpoints, probing consequences, and questions on the questions.
• Clinical judgment separates the registered nurse from unlicensed workers in tasks such as collecting data, observing for condition changes, identifying problems, planning care, and taking action, if condition deteriorates.
• Nurses need to make accurate and appropriate clinical decisions.
• Nurses need to solve problems and find solutions.
• Nurses need to be able to creatively when planning care for clients.
• Socratic questioning involves looking beneath the surface, recognizing and examining assumptions, searching for inconsistencies, examining multiple points of view.
• Critical analysis is the application of a set of questions to a particular situation, or idea to determine essential information and ideas and discard unimportant information, and ideas.
• The use of creativity provides nurses with the ability to generate many ideas rapidly, be generally flexible and natural, create original solutions to problems, be independent and self-confident, even when under pressure, and demonstrate individuality.
• Socratic questioning is a technique designed to encourage critical thinking, increase engagement in discussions, and reach the core of an issue.
• Creativity is thinking that results in the development of new ideas and products.
• Socratic questioning is a technique one can use to look beneath the surface, recognize and examine assumptions, search for inconsistencies, examine multiple points of view and differentiate what one knows from what one merely believes.
• Nurses need to plan care for each client and client problem.
• In problem-solving and decision-making, creativity is the ability to develop and implement new and better solutions for healthcare outcomes.
• Higher mental process, such as perception, memory language, are also part of the cognitive process.
• In every case, the nurse must be able to provide the rationale for any action taken.
• Intellectual Courage to Challenge the Status Quo and Rituals involves the strength to go against the tide, but rational belief should be supported by solid reasons in data.
• Perseverance enables nurses to clarify concepts and sort out related issues, in spite of difficulties and frustrations.
• Being readily able to admit, and evaluate inconsistencies with their own beliefs, in between their own beliefs, and those of another, is a component of integrity.
• Confidence is a state of feelings, certain about the truth of something.
• Clinical Reasoning is the analysis of a clinical situation as it unfolds or develops, requiring the nurse to use cognitive and metacognitive processes.
• Curiosity is a strong desire to learn something.
• Fair-Mindedness helps one consider opposing points of view, and understand new ideas before rejecting or accepting them.
• Insight to Egocentricity involves being open to the possibility that personal biases or social pressures and customs could unduly affect thinking.
• Integrity requires that individuals apply the same rigorous standards of proof to their own knowledge and beliefs as they apply to the knowledge and beliefs of others.
• Critical thinkers are willing to admit what they do not know; they are willing to seek new information and to rethink their conclusions in light of new knowledge.
• Intellectual Humility means having an awareness of the limits of one’s own knowledge.
• Cognitive Process are the thinking processes based on the knowledge of aspects of client care, learned through reading and applying health-related literature.