NURS3802 Module 6: Critical Thinking and Decision-Making

What is critical thinking?

- applying knowledge, experience, and data to make decisions

- a process not a value or a belief

- data driven, meets criteria, reflective

- uses good judgement and standards

- reasonable and self-correcting

- not negative, looking for flaws, judgmental, biased, directive

- not trying to get everyone to think alike

- not to take the place of feelings or emotions

What is clinical judgement?

informed opinions and decisions based on knowledge, evidence, and experience

Compare inductive and deductive reasoning.

Inductive:

- from specific to general

- ex. poor skin turgor, dark and concentrated urine, dry mucous membranes -> probably dehydrated

Deductive:

- from general to specific

- ex. giving a child peanut butter because "all kids like peanut butter"

What are some factors that affect critical thinking?

- assumptions

- lack of data

- personal bias

- age

- experience

- gender

- ethnicity

- religious beliefs

- mental state

- creativity

- perseverance

- motivation

- curiosity

- open-mindedness

What are clinical judgement key questions?

- What major outcomes do we expect the see in this particular person, family, or group when the plan of care is terminated?

- What problems or issues must be addressed to achieve the major outcomes?

- What are the circumstances?

- What knowledge is required?

- How much room is there for error?

- How much time do I have?

- What resources can help me?

- Whose perspectives must be considered?

- What is influencing my thinking?

What is Benner's theory?

Stages of Nursing Proficiency/ Novice to Expert

What are critical thinking standards?

- clarity

- accuracy

- precision

- relevance

- depth

- breadth

- logic

- significance

- fairness

What are characteristics of critical thinking?

- inquisitive

- well-informed

- self-confident

- open-minded

- flexible

- respecting others' opinions

- fair-minded

- honesty

- prudent

- willing to reconsider or revise

What are the steps of critical thinking?

1. define the problem

- ask the right questions

- consider deadlines

2. select necessary data or information to problem-solve or answer the question

- should be reliable and valid

3. recognize stated and unstated assumptions

- look at all options

4. formulate and select relevant and/or promising hypotheses

- consider pros and cons of each

5. draw valid conclusions

- based on facts

6. consider the soundness of your decisions

What are characteristics of a novice in Benner's theory?

- have little background

- have limited skills

- relies on rules to know what to do

- needs a lot of direction

What are characteristics of an advanced beginner in Benner's theory?

- marginally competent

- starts to incorporate theory

- has difficulty with prioritization

What are characteristics of a competent practitioner in Benner's theory?

- organized

- establishes goals

- thinks abstractly

- analytical

- can multitask

What are characteristics of a proficient practitioner in Benner's theory?

- holistic approach to care

- recognizes subtle changes

- able to prioritize

- considers long-term goals

What are characteristics of an expert practitioner in Benner's theory?

- autonomous

- integrated responses

- expertise comes naturally

- the "go to" person

What are the 6 critical questions to think about when someone has something to say?

- who

- what

- where

- when

- why

- how

What is the best way to obtain clinical judgement?

seek out evidence