A Proposed Frameworkfor Teaching and Evaluating
Critical Thinking in Nursing
PHYLLISDEXTER,PHD,* MARGARETAPPLEGATE,EDD,t JANEBACKER,DSN,$
KAYECLAYTOR,MSN,~ JAN KEFFER,PHD,~J BARBARANORTON, MPH,II
ANDBEVERLYROSS,MANED#
Critical thinking is now an explicit National League for
Nursing outcome requirement for nursing education
programs, and all nursing faculty currently are ex-
pected to teach and evaluate critical thinking. How-
ever, most of the related literature is theoretical and
not on the practical level that might be directly usable
by faculty. This article presents a beginning frame-
work developed by a faculty task force at the Indiana
University School of Nursing for teaching and evaluat-
ing critical thinking. The conceptual definition of
critical thinking underlying the framework reflects the
efforts of several hundred experts from various disci-
plines, is maximally inclusive, and lends itself well to
operationalization in the nursing context. The task
force made two assumptions for this project: first, that
the principles of rational thinking are essentially the
same at every educational level, although the exper-
tise expected of students at different educational
levels certainly differs; and, second, that at this time a
focus on operational as opposed to theoretical defini-
tions for the six identified components of critical
thinking (interpretation, analysis, evaluation, infer-
ence, explanation, and self-regulation) would be par-
ticularly useful for faculty and student understanding.
(index words: Critical thinking, nursing) J Prof Nurs
13:160-167, 1997. Copyright © 1997 by W.B. Saunders
Company
*Assistant Scientist, Indiana University School of Nursing,
Indianapolis, IN.
tProfessor and Assistant Dean for Evaluation,IndianaUniver-
sitySchoolof Nursing, Indianapolis,IN,
:]:Assistant Professor, Indiana UniversitySchool of Nursing,
Indianapolis, IN.
~Associate Instructor, Indiana UniversitySchool of Nursing,
Indianapolis,IN.
~rAssistant Professor, Indiana University School of Nursing,
Indianapolis, IN.
IIAssociate Professor, Indiana UniversitySchool of Nursing,
Indianapolis, IN.
#Assistant Professor, Indiana UniversitySchool of Nursing,
Indianapolis, IN.
Address correspondenceand reprint requests to Dr Dexter:
Center for Nursing Research, Indiana University School of
Nursing, 1111 MiddleDr, Indianapolis,IN 46202-5107.
Copyright© 1997 byW.B. SanndersCompany
8755-7223/97/1303-0009503.00/0
160 JournalofProfessionalNursing, Vol 13, No 3 (May-June), 1997: pp 160-167
HE SUBJECT of how to teach and evaluate
T critical thinking is of great interest to nursing
educators because of an emerging consensus that
merely teaching the current state of knowledge in the
field is insufficient preparation for future nursing
practice. The ever-increasing rate of change in the
health care field means that nursing students must
learn how to evaluate new claims for knowledge and
monitor the rationality of their own practices in light
of new knowledge and circumstances. Nursing educa-
tors are being challenged to imbue in students lifelong
habits of rational thinking in relation to their nursing
practice. This emphasis was formalized recently when
critical thinking was implemented as one of five
outcome criteria required for National League for
Nursing (1989) accreditation of undergraduate and
master's nursing programs.
Critical thinking has always been an implicit and
important component of nursing education. How-
ever, the explicit incorporation of critical thinking
outcomes and evaluation measures into nursing cur-
ricula has proved to be a complex task. Being able to
document that graduates are inculcated with strong
habits of logical thinking in relation to their nursing
practice requires a serious commitment by faculty,
perhaps some re-education of faculty and, of particu-
lar relevance in this article, a curriculum plan that is
understandable and useful to all faculty for operation-
alizing and evaluating the various components of
critical thinking. This article describes the efforts of
one school to develop and implement such a plan.
Background
The Indiana University School of Nursing is among
the nation's largest schools of nursing and is an
especially suitable backdrop for developing and testing
articulation models because it offers all four levels of
nursing educational programs, from associate to doc-
toral. As a part of a major curriculum revision process
A FRAMEWORK FOR CRITICAL THINKING IN NURSING
within the school, an across-program faculty task force
(comprised of the authors of this article) recently
reviewed the critical thinking outcomes for each of the
educational levels to, among other things, assure
articulation among programs. The authors believed
that it was important that faculty teaching at all levels
had a common understanding of the core elements of
critical thinking so that hypothetical nursing students
advancing sequentially through the associate, baccalau-
reate, master's, and doctoral programs could expect an
underlying consistency, even as they were being
expected to grow in the complexity of their thinking
abilities. The task force developed specific critical
thinking competency statements for each of the four
program levels and also made recommendations re-
lated to measurement of students' critical thinking
skills.
An important early assumption of the task force was
that rational thinking involves qualitatively the same
elements at every educational level, from grade school
to graduate school. There are, of course, great differ-
ences in the level of reasoning sophistication expected
at different ages and educational levels, but these
differences relate to the complexity and/or context of
problems students must address, the breadth of knowl-
edge and experience they will be expected to incorpo-
rate into their thinking, the subtlety of differentiations
they must recognize, and generally the degree of
overall skill expected of them in using the basic
reasoning processes. Just as the structure and rules for
a baseball game are essentially the same whether
played on a sandlot, in the minor leagues, or in the
major leagues--although the standards for perfor-
mance are very different--so does the underlying
structure of critical thinking remain essentially the
same for associate, baccalaureate, and graduate stu-
dents, although expected skill levels will be quite
different. Furthermore, every component of critical
thinking can be operationalized in some way at every
level. Both grade school children and doctoral stu-
dents, for example, should learn about logical errors
related to generalizing. Grade-schoolers can acquire a
beginning understanding of the idea that stereotypes
related to race or sex are unacceptable as predictors of
individual behaviors, whereas doctoral students are
expected to acquire an in-depth understanding of
exactly when data can and cannot be generalized in the
research context. This understanding proved to be
extremely helpful to the task force in its efforts to level
critical thinking competencies by program while main-
taining an underlying consistency across programs.
161
Process
Task force members were aware at the outset that
critical thinking and its components have been de-
fined and described in many ways, by nursing educa-
tors and others, and they first set about finding an
overall theoretical definition that would lend itself well
to operationalization in the nursing context. Members
reviewed the extensive literature in this area to bring
informed opinions to group discussions. (Even a
summary of this literature is beyond the scope of this
article, but see Appendix 1 for an abbreviated bibliog-
raphy.) From this reading they concluded that, al-
though there are great differences in labels, definitions,
and categorizing frameworks applied to the theoretical
components of critical thinking (eg, a process that one
theorist might label "analysis," another might label
"evaluation"), there was also fundamental agreement
in the literature about the operational nature and
range of these components.
Based on the review of literature, the task force
concluded that there would be no one "right" way to
categorize or theoretically define the dimensions of
critical thinking. They decided, therefore, to simply
choose an overall theoretical definition of critical
thinking from the general literature that was inclusive
and well supported, as well as a categorization schema
for the components of critical thinking that was
consistent with this definition. They then focused
their efforts on an area that has not been well explored,
at least not in the nursing literature, and that they
believe is currently of great practical importance to
nursing faculty: operationalizing the theoretical com-
ponents of critical thinking for use in teaching.
Finally, throughout the process task force members
kept in mind how each specified critical thinking
competency might be measured. The following sec-
tion describes the "package" of curricular components
related to critical thinking recommended to faculty by
the task force, including an across-program outcome
statement, program-leveled competency statements,
operational definitions for each specified competency,
and recommendations for student evaluation.
Task Force Recommendations
CRITICAL THINKING OUTCOME
The across-program critical thinking outcome rec-
ommended by the task force for adoption by the
faculty is based on a conceptual definition of critical
thinking that was the product of a 1987 to 1989
Delphi research project sponsored by the American
162
Psychological Association and representing the collec-
tive thinking of several hundred experts from various
disciplines (Facione, 1990b). This definition is maxi-
mally inclusive and proved to be extremely useful as a
guide for developing specific critical thinking compe-
tencies. The task force recommended that the follow-
ing overall outcome, closely adapted from the Delphi
definition, be adopted by all four program levels: The
graduate is able to use a purposeful, self-regulatory
process that includes interpretation, analysis, evalua-
tion, and inference, and can explain the evidential,
conceptual, methodological, criteriological, or contex-
tual considerations on which judgments are based.
CRITICAL THINKING COMPETENCIES
The foregoing outcome statement suggests six key
components of critical thinking: interpretation, analy-
sis, evaluation, inference, explanation, and self-
regulation. Competencies related to each of these
cognitive skills were formulated for each of the
program levels (Table 1). These competencies are
• . . the task force concluded that
there would be no one "'right" way
to categorize or theoretically define
the dimensions of critical thinking•
qualitatively the same for all programs, but they are
leveled according to scope of practice context and
degree of expertise expected. As mentioned, because of
the great lack of agreement in the literature about
theoretical definitions for the components of critical
thinking, as well as their judgment that for practical
purposes such definitions are not too important to
faculty, the authors decided to define the six critical
thinking components operationally rather than concep-
tually. They believed that in this particular context
operational definitions might provide both teachers
and students with a relatively better understanding of
these components.
OPERATIONAL DEFINITIONS FOR CRITICAL THINKING
COMPONENTS
The task force developed a basic "menu" of opera-
tional definitions, or defining characteristics, for each
of the critical thinking components (Table 2). (The
items in this listing reflect a synthesis based on the
literature; however, because the same operational
"building blocks" are common to most theorists, the
DEXTER ET AL
authors have not attempted to reference individual
items. See Appendix 1 for an abbreviated list of
sources.) Although this listing is a beginning attempt,
ultimately it is intended to be as inclusive and
exhaustive as possible, even if there is some overlap
and redundancy. The authors believe that exactly
where an item is categorized is less important than
ensuring that all significant subdimensions of critical
thinking are included under at least one of the
categories. The lists are intended to be relatively free of
jargon and easy to understand.
The authors' expectation is that various combina-
tions of these critical thinking dimensions could be
chosen by faculty to teach and evaluate students in
different educational contexts. If all faculty use this
common framework, by graduation all students will
have had experience with and been evaluated on all of
these operational dimensions of critical thinking at the
level of sophistication appropriate to their particular
program. Importantly, the lists are meant to be a
starting point and to invite additions and revisions
from faculty as they further level critical thinking
competencies for each program year and course and as
they field-test different approaches to teaching and
evaluating specific critical thinking skills. The lists
need to become more extensive, detailed, and tailored
for particular programs and contexts, but this will be
an ongoing process involving faculty negotiation.
Such a common pool of mutually agreed-on opera-
tional options should ensure consistency across faculty
and programs as well as be of particular benefit to new
faculty and those who have relatively less expertise in
the teaching of critical thinking. As a further benefit,
the process of leveling these specific skills should help
focus the issues in the continuing struggle to clearly
differentiate levels of practice competencies.
CRITICAL THINKING EVALUATION
Although the task force was unable to find generic
critical thinking measurement instruments with what
was considered sufficient reliability and validity in the
nursing context, it recognized the potential usefulness
of two instruments. The California Critical Thinking
Skills Test (CCTST) (Facione, 1990a) measures the
six global reasoning skills of the Delphi model:
interpretation, analysis, evaluation, inference, explana-
tion, and self-regulation. This tool has two alternate
forms and thus is particularly suitable for pre- and
post-learning testing. The California Critical Think-
ing Disposition Inventory (CCTDI) (Facione and
Facione, 1992), which has only one form and is best
used in conjunction with the CCTST, measures
A FRAMEWORK FOR CRITICAL THINKING IN NURSING 163

TABLE 1. ProposedCriticalThinking Program Competencies

ASN
Interpretation: The ASN
graduate accurately interprets
nursing problems, as well as
objective and subjective data
from common information
sources, related to the care of
patients/clients.
Analysis: Using a defined data
base, the ASN graduate ana-
lyzes nursing problems,
objective & subjective data,
ideas/arguments, & possible
courses of action related to
the care of patients/clients in
institutional or home settings.
Evaluation: The ASN graduate
evaluates information to deter-
mine its probable trustworthi-
ness as well as its relevance
to particular patient care situa-
tions.
Inference: The ASN graduate
makes correct inferences, rec-
ognizes faulty reasoning, &
reaches conclusions appro-
priate to the nursing care of
patients/clients.
Explanation: The ASN graduate Explanation: The BSN graduate Explanation: The MSN graduate Explanation: The PhD graduate
can clearly explain and
defend the reasoning by
which he or she has arrived at
specific conclusions or deci-
sions in the context of the
health care of patients/clients.
Self-regulation: The ASN
graduate will have acquired
the habit of monitoring her or
his own thinking using uni-
versal intellectual criteria
(Table 3) and of self-correcting
as appropriate in the context
of caring for patients/clients.
Abbreviations: ASN, associate; BSN, baccalaureate; MSN, master's; PhD, doctorate.
BSN
Interpretation: The BSN
graduate accurately interprets
nursing problems, as welt as
objective & subjective data
from theoretical & empirical
information sources, related to
the care of patients/clients,
groups, & communities.
Analysis: Using a broad general Analysis: Using an in-depth
knowledge base, the BSN
graduate analyzes nursing
problems, objective & subjec-
tive data, ideas/arguments, &
possible courses of action
related to the health of
patients/clients, groups, and
communities.
Evaluation: The BSN graduate
evaluates information to deter-
mine its probable validity &
reliability as well as its rel-
evance to particular health
problems of patients/clients,
groups, or communities.
Inference: The BSN graduate
makes correct inferences,
avoids faulty reasoning, &
reaches conclusions appro-
priate to the nursing care of
patients/clients, groups, or
communities.
can clearly explain and
defend the reasoning by
which he or she has arrived at
specific conclusions or deci-
sions in the context of the
health care of patients/clients,
groups, or communities.
Self-regulation: The BSN Self-regulation: The MSN
graduate will have acquired
the habit of monitoring her or
his own thinking using uni-
versal intellectual criteria
(Table 3) and of self-correcting
as appropriate in the context
of caring for patients/clients,
groups, or communities.
MSN
Interpretation: The MSN
graduate accurately interprets
nursing problems and issues,
as well as objective & subjec-
tive data from theoretical &
empirical information sources,
related to a specialized area
of practice.
knowledge base, the MSN
graduate analyzes nursing
problems, data, ideas/argu-
ments, standards of nursing
practice, & health policy
issues within a specialized
area of practice.
Evaluation: The MSN graduate
evaluates information to deter-
mine its validity & reliability as
well as its relevance to par-
ticular health problems, cur-
rent nursing practice stan-
dards, or health care policy
issues within a specialized
area of practice.
Inference: The MSN graduate
makes correct inferences,
avoids faulty reasoning, &
reaches conclusions appro-
priate to health problems,
nursing practice standards, or empirical health literature,
health care policy issues
within a specialized area of
practice,
can clearly explain and
defend the reasoning by
which he or she has arrived at
specific conclusions or deci-
sions in the context of health
problems, practice standards,
or health care policy issues
related to a specialized area
of practice.
Self-regulation: The PhD
graduate will have acquired
the habit of monitoring her or
his own thinking using uni-
versal intellectual criteria
(Table 3) and of self-correcting
as appropriate in the context
of health problems, practice
standards, or health care
policy issues related to a spe-
cialized area of practice.
PHD
Interpretation: The PhD graduate
accurately interprets knowl-
edge needs, as well as objec-
tive & subjective data from
theoretical & empirical infor-
mation sources, related to
research & theory develop-
ment.
Analysis: Using an extensive
theoretical & empirical knowl-
edge base, the PhD graduate
analyzes data and ideas/argu-
ments related to health care
issues at every level from the
individual to the societal.
Evaluation: The PhD graduate
evaluates the validity & reli-
ability of research data as well
as the relevance of these data
to particular empirical or theo-
retical issues.
Inference: The PhD graduate
makes correct inferences,
avoids faulty reasoning, &
reaches conclusions in the
context of the theoretical and
especially in his or her area of
expertise, and in the context
of his or her independent
research.
can clearly explain and
defend the theoretical rea-
soning and empirical evi-
dence supporting conclusions
in her or his area of expertise
and independent research,
graduate will have acquired
the habit of monitoring her or
his own thinking using uni-
versal intellectual criteria
(Table 3) and of self-correcting
as appropriate in the context
of research and theory devel-
opment.

affective and attitudinal dimensions relevant to critical these two instruments to students at appropriate
thinking: truth-seeking, open-mindedness, "analyt- points in their educational programs to ascertain (1) if
icity, .... systematicity," self-confidence, inquisitiveness, there would be significant change over time in these
and maturity. The task force suggested administering scores and (2) how well the scores correlated with
164 DEXTERET AL

TABLE 2. Operational Definitions/Defining Characteristics of the Critical Thinking Competencies: A Synthesis

From the Literature (See Appendix 1 for Abbreviated Bibliography)
Interpretation
To understand, comprehend, or decipher written materials, verbal or nonverbal communications, empirical data, theoretical for-
mulations, graphics, questions, etc
To explain the meaning of or to make understandable
To identify nursing problems in a clinical situation
To place in the context of a situation or one's own experience
To paraphrase, summarize, clarify meaning of written material or verbal communications
To define terms in written material
To identify purpose, theme, or point of view
To recognize one's own interpretations and distinguish them from evidence/raw data
To avoid reading into data a meaning that confirms one's own convictions (or to recognize that one may be doing this)
To recognize and consider alternative explanations
Analysis
To examine, organize, classify, categorize, or prioritize variables leg, signs and symptoms, evidence, facts, research findings,
concepts, ideas, beliefs, views, elements)
To identify elements of an argument: assumptions, premises, theories, principles, steps, conclusions
To identify implications, possible consequences, cost versus benefit of alternative decisions
To differentiate among empirical, conceptual, and evaluative questions
To differentiate fact from opinion
To examine ideas/arguments/situations/data to identify essential elements/factors and their possible relationships
Evaluation
To assess the credibility of sources of information
To assess the strength of evidence/inferencesto support conclusions
To assess claims/arguments in relation to the evidential, conceptual, methodological, or contextual considerations on which the
claims/arguments were based
To assess the relevance, significance, value or applicability of information/arguments in relation to a specific situation
To assess information for bias, stereotypes, cliches, or loaded language
To apply criteria appropriate to particular situations leg, statistical, ethical/moral, semantic)
Inference
To conjecture alternatives, formulate hypotheses, or draw conclusions based on premises/evidence
To differentiate between conclusions/hypotheses that are logically or evidentially necessary and those that are merely possible or,
to whatever degree, probable
To demonstrate knowledge of syllogistic reasoning, principles of logic, logical fallacies, and rules for induction and deduction
To identify knowledge gaps or needs
Explanation
To explicate, in writing or orally, the assumptions and reasoning processes followed in reaching conclusions
To justify one's reasoning/conclusions in terms of evidential, conceptual, methodological, or contextual considerations
To construct graphic representations of the relationships among variables leg, tables, graphs)
Self-regulation
To continually monitor, reflect on, and question one's own thinking in relation to all of the foregoing steps in the reasoning process
To reconsider interpretations or judgments as appropriate based on further analysis of facts or added information
To examine one's own views with sensitivity to the possible influence of personal biases or self-interest
To review and confirm or reformulate one's previous understandings/explanations/inferences in relation to a particular situation
To demonstrate the "dispositional skills" (Facione and Facione, 1992) of truth-seeking, open-mindedness, "analyticity," "systema-
ticity," self-confidence, inquisitiveness, and maturity

measures considered valid in nursing education, such
as clinical performance measures, individual course
grades, grade point average, and National Council
Licensure Examination-Registered Nurse scores. If the
CCTST and the CCTDI are found to be sufficiently
valid and reliable in the nursing context, they could be
adopted for evaluation purposes.
It was the conclusion of the task force that, even if
satisfactory generic tests become available, critical
thinking in nursing will always need to be evaluated in
nursing contexts and by multiple measures, including
(1) course-specific written tests that require thinking
skills beyond simple recall and, of special importance,
(2) direct observation and individualized feedback on
students' reasoning in all nursing education settings.
As an aid to the nurse educator in providing this
individualized feedback, Table 3 lists a set of broadly
accepted criteria for critical thinking described by Paul
(1990) and referred to in the self-regulation category
of the competcncies grid (Table 1). The task force
recommended that these simple, universal criteria be
used consistently and explicitly by all faculty through-
out all programs for evaluating the critical thinking of
individual students, whether in the context of tests,
written assignments, class or clinical presentations,
class discussions, patient care, theses, or dissertations.
Obviously, the depth, precision, completeness, and so
forth expected of an associate-degree student would
A FRAMEWORKFOR CRITICALTHINKING IN NURSING
TABLE3. Proposed Universal Criteria for Evaluation
of Critical Thinking
Clarity
Precision
Specificity
Accuracy
Relevance
Consistency
Logicalness
Depth
Completeness
Significance
Fairness
Adequacy (for purpose)
Realism
Data from Paul (1990).
not be the same as for a doctoral student. Further-
more, certain of the criteria are relatively more
appropriate in particular educational and clinical
contexts and should be applied accordingly. The
expectation is that if all faculty consistently give
feedback to students throughout their educational
programs using these universal criteria, graduates will
internalize them and gain lifelong habits of monitor-
ing their own thinking and professional practice using
these same criteria.
Finally, the task force prepared a summary of
common logical fallacies as described by Engel (1990)
and suggested that these be reviewed by faculty
(Appendix 2). "Logicalness" is one of the universal
criteria (Table 3) and, to recognize and give students
feedback on their mistakes of logic and, very impor-
tantly, to role-model logical thinking, faculty must
themselves be familiar with at least the common
logical fallacies. The particular fallacies that belong on
such a list can be negotiated, but the authors believe
that an understanding by faculty of the need for this
type of knowledge is essential for any serious effort to
teach critical thinking.
Discussion
This article has described the work of an Indiana
University School of Nursing task force charged with
making recommendations to the faculty in relation to
the teaching and evaluation of critical thinking. The
group proposed an across-program outcome state-
ment based on a well-supported theoretical definition
of critical thinking, program-leveled competency state-
ments compatible with this definition, and a basic
array of operational options for each of these compe-
tencies that can be expanded and tailored for various
educational settings and program levels. In addition,
165
the task force made recommendations regarding the
evaluation of critical thinking skills.
The model for teaching and evaluating critical
thinking presented here is not meant to be definitive
but rather to serve as an example of the type of fairly
concrete framework that might be helpful to the
average nursing educator. The authors recognize that
the psychological development of critical thinking
abilities is a much more individualized, complex,
dynamic, and, at times, chaotic process than is
reflected by this relatively simplistic framework. How-
ever, they believe that this limitation is outweighed by
the potential benefits of an operational framework
that could be used relatively easily and directly by
faculty and students.
The existing nursing literature on critical thinking,
although often excellent, tends to be theoretical and
somewhat abstruse to all except those academics who
specialize in the area. The average, nonspecialist
educator may well come away with a feeling that
critical thinking is sort of a mystical phenomenon that
is almost impossible to understand. However, the
present situation is that all nursing educators, even
beginners and those who do not have the time or
inclination to master the theoretical literature, are
being asked to explicitly teach and evaluate their
students' critical thinking abilities right now. Further-
more, it cannot even be assumed that all nursing
faculty have expert global critical thinking skills
themselves; one of the two studies that the authors
were able to find on this topic (Saarmann, Freitas,
Rapps, & Riegel, 1992) found, controlling for age,
that faculty performance on the Watson and Glaser
Critical Thinking Ability scale (Watson & Glaser,
1964) was not significantly higher than that of their
sophomore baccalaureate students. The second study
(Hartley & Aukamp, 1994) did find better perfor-
mance by faculty, but it did not control for age, which
is thought to have independent effects on critical
thinking (Watson & Glaser, 1980).
The framework presented here undoubtedly has
elements of "cookbook" critical thinking, which raises
interesting philosophical issues. The current national
emphasis on practice guidelines for medical care,
which arose mainly because of the indefensible varia-
tion in practice in different regions of the country, is
analogous, has evoked the same criticism, and must be
answered with the same defense. Yes, such concrete
guidelines do detract from the "art" of nursing
education or, as the case may be, medical practice, and
they may well be set at too basic a level for experts.
However, the important goal is to raise the average
166
level of student instruction or patient care. At present
there is no assurance that every nursing graduate is
receiving even this "cookbook" level of reaching in
critical thinking, and basic models like the one
presented in this artide are a first and necessary step.
There is a common core of minimal standards for
rational thinking accepted by the broad scientific
community that nursing students must be taught in a
way adapted to their program level. Educators will
always be free to, indeed should be encouraged to, go
beyond this minimal level.
Curriculum development at the Indiana University
School of Nursing is, as elsewhere, a decentralized
process, and currently a number of faculty groups are
reviewing the task force recommendations to decide if
or how they can be tailored for their respective
programs and courses. Components of the proposal
package have been incorporated into all of the pro-
Appendix 1.
Abbreviated Critical Thinking Bibliography
Alfaro-LeFevre, R. (1995). Critical thinking in nursing.
Philadelphia: Saunders.
Brookfield, S. (1987). Developing critical thinkers: Chal-
lenging adults to explore alternative ways of thinking and
acting. San Francisco: Jossey-Bass.
Ennis, R. (1985). A logical basis for measuring critical
thinking skills. EducationalLeadership, 43, 44-48.
Facione, E A. (1992). Critical thinking: What it is and
why it counts. Millbrae, CA: California Academic.
Mezirow, J. (1990). Fostering critical reflection in adult-
hood." A guide to transformative and emancipatory learning.
San Francisco: Jossey-Bass.
Appendix 2.
Common Logical Fallacies (Summarized From Engel [1990])
Fallacies of ambiguity are arguments that are unsound
because they contain words that can be understood in more
than one sense. They can result from
1. poor sentence structure;
2. confusion about where the spoken emphasis in a
written sentence would be (as in something meant
sarcastically);
3. using an abstract word in a concrete way (eg, the
"system" destroys people); and
4. allowing a key word to shift its meaning through
the course of a discussion (eg, using "man" first to
mean mankind and later to mean man as opposed
tO woman).
DEXTER ET AL
grams. Informal faculty comments have been that the
recommendations appear to be understandable, practi-
cal, adaptable to different educational settings, and
theoretically sound.
The faculty believe strongly in the importance of
critical thinking in nursing education and practice,
and an increasingly scholarly environment in the
future is envisioned in which nursing students will be
expected to continually monitor not only their own
reasoning but also that of their colleagues and profes-
sors using universally accepted standards of rational
thinking. If nurses aspire to interdisciplinary credibil-
ity, and if nurse educators are serious about producing
graduates with lifelong habits of critical thinking in
relation to their professional practice, the profession
must support a culture in which intellectual rigor is
the norm and intellectual challenge and debate are
actively encouraged.
Paul, R. W. (1990). Criticalthinking. Rohnert Park, CA:
Sonoma State University.
Paul, R. W. (1993). Critical thinking." How to prepare
students for a rapidly changing world. Santa Rosa, CA:
Foundation for Critical Thinking.
Rubenfeld, M. G., & Scheffer, B. K. (1995). Critical
thinking in nursing." An interactive approach. Philadelphia:
Lippincott.
Rudinow, J., & Barry, V. E. (1994). Invitation to critical
thinking. Fort Worth, TX: Harcourt Brace College.
Scriven, M. (1976). Reasoning. New York: McGraw-Hill.
White, N. E., Beardslee, N. Q., Peters, D., & Supples, J.
M. (1990). Promoting critical thinking skills. Nurse Educa-
tor, 15, 16-19.
Fallacies of presumption are arguments that are unsound
because of unfounded or unproven assumptions embedded
in them. They may involve overlooking, evading, or
intentionally distorting the facts. Examples include
1. sweeping generalization (applying usually true
generalizations to exceptional cases);
2. hasty generalizations (using insufficient evidence
or an isolated example as the basis for generaliz-
ing);
3. assuming a classification must be either/or when
other alternatives exist;
4. "begging the question," eg, when a conclusion
simply restates the premise in different words,
A FRAMEWORK FOR CRITICAL THINKING IN NURSING
when a circular argument is used, when strongly
emotional language is used tO force home an
otherwise unsupported conclusion, or when a
"loaded" or leading question is asked;
5. applying a double standard--one for ourselves and
another for others;
6. false analogy (reaching a conclusion by likening
two incomparable cases);
7. "slippery slope" (assuming, unjustifiably, that a
proposed step will set off an undesirable and
uncontrollable chain of events); and
8. irrelevant thesis (seeking to prove a conclusion not
at issue, eg, injecting a "red herring" into an
argument or setting up a "straw man" and then
attacking it.
Fallacies of relevance are arguments in which the
References
Engel, S. M. (1990). With good reason:An introduction to
informal fallacies. New York: St. Martin's.
Facione, E A. (1990a). California Critical Thinking Skills
Test: college level. Millbrae, CA: California Academic.
Facione, E A. (1990b). Critical thinking: A statement of
expert consensus for purposes of educational assessment and
instruction. Millbrae, CA: California Academic.
Facione, E A., & Facione, N. C. (1992). The California
Critical Thinking Dispositions Inventory (CCTDI) and the
CCTDI TestManuaL Millbrae, CA: California Academic.
Hartley, D., & Aukamp, V. (1994). Critical thinking
ability of nurse educators and nursing students. Journal of
Nursing Education, 33, 34-35.
167
premises, despite appearances, are not relevant to the
conclusions. They always involve an attempt to obscure the
real issue by stirring up emotions. Examples include
1. ad hominem (avoiding a discussion of the issues by
focusing on the character, credibility, background,
consistency, or vested interests of opponents rather
than on their ideas);
2. appeal to pity (seeking to persuade by arousing
pity rather than by presenting evidence);
3. appeal to authority (seeking to persuade not by
giving evidence but by citing authorities, public
opinion, or tradition);
4. appeal to ignorance (trying to prove a claim not
with evidence but by focusing on the lack of
evidence against it); and
5. appeal to fear (seeking to persuade through fear).
National League for Nursing (1989). Criteria for the
evaluation of baccalaureate and higher degree programs in
nursing (6th ed.). New York: Author.
Paul, R. W (1990). Critical thinking. Rohnert Park, CA:
Sonoma State University.
Saarmann, L., Freitas, L., Rapps, J., & Riegel, B. (1992).
The relationship of education to critical thinking ability
and values among nurses: Socialization into professional
nursing. Journal of Professional Nursing, 8, 26-34.
Watson, G., & Glaser, E. (1964). Critical thinking
appraisal Orlando, FL: Harcourt, Brace, Jovanovich.
Watson, G., & Glaser, E. (1980). Watson-Glaser critical
thinking appraisal manual. New York: Harcourt, Brace &
World.