Nursing as a Science:

CRITICAL
THINKING
Bevan B. Balbuena, RN, MN
NURSING AS A SCIENCE
OUTLINE:

A. Critical Thinking
B. Nursing Process
1. Assessment
2. Nursing Diagnosis
3. Outcome Identification & Planning
4. Intervention
5. Evaluation
6. Documentation
LEARNING OBJECTIVES
At the end of this concept, the BSN 1 students will:
1. identify the components of the nursing process;
2. discuss the requirement for effective use of the nursing process;
3. explain how critical thinking is used in nursing;
4. distinguish the relationships among knowledge, experience,
critical thinking, reflection, and nursing judgment; and
5. explore ways to enhance and develop critical thinking skills as
they apply to nursing.
 DEFINITION OF KEY TERMS
Nursing Process

“ A systematic, creative approach to thinking and doing that

nurses use to obtain, categorize and analyze patient data
and to plan actions to meet patient needs.”
Nursing Process

“A type of problem solving process requiring the use of

decision making, clinical judgment and variety of critical
thinking skills.”
Critical Thinking

“ Goal-oriented, purposeful thinking that involves many

mental attitudes and skills, such as determining which data
are relevant and making inferences. “

 Essential when a problem is ill defined and does not have a

single ‘best’ solution.
Problem solving

“ The mental activity of identifying a problem

(unsatisfactory state) and finding a reasonable solution to
it. “

 Requires decision making;

 may or may not require the use of critical thinking.
Decision Making

“ The process of choosing the best action to take - the action

most likely to produce the desired outcome. Involves
deliberation, judgment, and choice. “

Decision must be made whenever there are mutually

exclusive choices, but not necessarily problems.
Clinical Reasoning

“Logical thinking that links thoughts together in meaningful

ways. Clinical reasoning is reflective, concurrent and
creative thinking about patients and patient care.”
Reflection or Reflective Judgment

“A kind of critical thinking that considers a broad array of

possibilities and reflects on the merits of each in a given
situation.”

 Essential when a problem is complex and has no simple

“correct” solution.
Clinical Judgment

“The use of values or other criteria to evaluate or draw

conclusion about information.”

“Clinical judgments are conclusions and opinions about

patient’s health, drawn from patient data. They may or may
not be made using critical thinking.“
Analysis/Critical Analysis

Analysis:
“The process of breaking down materials into component
parts and identifying the relationship among them.”

Critical analysis:
“Is the questioning applied to a situation or idea to
determine essential information and ideas and discard
superfluous information and ideas.”
CRITICAL THINKING
“The art of thinking about your thinking while you are
thinking so as to make your thinking more clear, precise,
accurate, relevant, consistent and fair.”
(Paul , 1988)

Wilkinson, J. (2001) Nursing Process and Critical Thinking. 3rd Edition. New Jersey: Prentice Hall.
Are you a
critical
thinker?
DO YOU:
 explore the thinking and assumptions that
underlie your emotions?
 base your judgments on facts and reasoning, not
on personal feelings, self-interest or guesswork?
 suspend judgment until you have all the necessary
data?
 support your view with evidence?
 ask for clarification when you don’t understand?
 turn your mistakes into learning opportunities?
CHARACTERISTICS OF CRITICAL THINKING
1. Rational and reasonable
 based on reasons; not on prejudice, preferences, self-
interest, or fear

2. Involves conceptualization
 Concept – mental image of reality, ideas about events,
objects or relationship between them
3. Requires reflection

 Reflection – to ponder, contemplate or deliberate

something.

 Reflective thinking – integrates past experiences into the

present to explore potential alternatives
4. Involves both cognitive (thinking) and attitude (feelings)

5. Involves creative thinking

 It results in innovative ideas and products
6. Involves knowledge

Nursing knowledge
 Scientific knowledge - facts, information, principles,
theories, research findings and conceptual models
 used to describe, explain, and predict.
Ethical knowledge
 Knowledge of professional standard of conduct

Personal knowledge
 knowing and actualizing one’s self

Practice wisdom
 acquired from intuition, tradition, authority, trial and error,
clinical experience
CRITICAL THINKING ATTITUDES
1. Independent Thinking
2. Intellectual Humility
3. Intellectual Courage
4. Intellectual Empathy
5. Intellectual Integrity
6. Intellectual Perseverance
7. Intellectual Curiosity
8. Faith in reason
9. Fairmindedness
10. Interest in exploring thoughts and feelings
 CRITICAL THINKING ATTITUDES

Independent Thinking

 Critical thinkers think for themselves.

 They consider a wide range of ideas, learn from them and
make their own judgments about them.
 CRITICAL THINKING ATTITUDES

Intellectual Humility

 Means being aware of the limits of your knowledge and

realizing that the mind can be self-deceptive
 Admitting lack of knowledge or skill can will enable you
to grow professionally
 Rethinking conclusions in light of new knowledge
 CRITICAL THINKING ATTITUDES

Intellectual Courage

 Being willing to consider and examine fairly your own

beliefs and the views of others, especially those to which
you may have a strongly negative reaction
 CRITICAL THINKING ATTITUDES

Intellectual Empathy

 the ability to imagine yourself in the place of others in

order to understand them and their actions and beliefs.
 CRITICAL THINKING ATTITUDES

Intellectual Integrity

 Being consistent in the thinking standards you apply (e.g.

clarity, accuracy, completeness) – holding yourself to the
same rigorous standards of proof to which you hold others
 CRITICAL THINKING ATTITUDES

Intellectual perseverance

 A sense of the need to struggle with confusion and

unsettled questions over an extended period of time to
achieve understanding and insight.
 CRITICAL THINKING ATTITUDES

Intellectual Curiosity

 An attitude of inquiry
 Having a mind filled with questions
 CRITICAL THINKING ATTITUDES

Faith in reason

 Implies that people can, and should learn to think logically

for themselves
 Not afraid of disagreement
 CRITICAL THINKING ATTITUDES

Fairmindedness

 Making impartial judgments

 Treating all viewpoints alike, without reference to one’s
own feelings or vested interests, or those of one’s friends,
community or nation
 CRITICAL THINKING ATTITUDES

Interest in exploring thoughts and feelings

 The critical thinker knows that emotions can influence

thinking and that all thoughts create some level of feeling
CRITICAL THINKING SKILLS
1. Using language

 Precise, specific
 Avoid cliches, jargon,
euphemisms
2. Perceiving

 Avoiding selective perception

 Recognizing differences in perception
 3. Believing and knowing

Distinguishing facts from interpretation

Supporting facts, opinions, beliefs and preferences

Inference Opinion Judgment

- a conclusion reached on the - a view or judgment formed - the ability to make considered
basis of evidence and about something, not necessarily decisions or come to sensible
reasoning based on fact or knowledge. conclusions.
4. Clarifying

 Questioning to clarify meaning of words and phrases

 Questioning to clarify issues, beliefs, and points of
view
5. Comparing

 Noting similarities and differences

 Classifying
 Comparing and contrasting ideals and actual practice
 Transferring insights to new context
6. Judging / Evaluating

 Providing evidence to support judgments

 Develop evaluation criteria
7. Reasoning

Recognizing assumptions
Distinguishing between relevant and irrelevant data
Evaluating sources of information
Generating and evaluating solutions
Exploring implications, consequences,
advantages/disadvantages