Critical Thinking and Nursing
It is developed through assessing the credibility of evidence; reflection on one's own thoughts, life, and values; and teaching strategies that mobilize logical and analytical reasoning, among others. The characteristics of a desirable critical thinker are the necessary skills and disposition, namely, a willingness to learn and practice the skills. In the nursing profession, the CT process is closely related to the assertive application of various cognitive, behavioral and instrumental aspects to pursue better results from patient care.
The skills and prerequisites are the structural elements of CT, and when continuously practiced in nursing, ensure effective and safe patient care. Critical thinking in nursing is particularly essential for correctly assessing, interpreting and analyzing information with discretion and without value judgments, with the goal of determining appropriate diagnostic and decision-making needs. These skills are desirable in all areas of nursing, especially direct patient care. A past study 10 conducted on nurses showed that the major CT skills are analysis, implementation of standards, discernment, research, logical thinking, knowledge prediction and transformation.
Furthermore, the prerequisites of CT are confidence, contextual perspective, creativity, flexibility, inquisition, intellectual integrity, intuition, understanding, perseverance and reflection. It is noteworthy that, in order for CT to be a mediating tool in the improvement of care practices, effective clinical reasoning and decision making skills must be established. It is important to be able to predict diagnoses and validate obtained conclusions through constant critical review. In a past randomized clinical trial RCT , 13 the effects of a case study program were tested separately and combined with conceptual maps to evaluate CT development in registered nurses who provide direct patient care.
Critical Thinking for Nurses
Those with the greatest CT skills and open-mindedness were identified and compared to case studies separately. The study supports the application of case studies combined with concept maps as a hospital-based teaching strategy to promote development of critical thinking skills and encourage the right disposition in nurses. Studies 6,12,14 have also indicated that a good critical thinker in nursing can articulate clinical reasoning based on scientific evidence.
This promotes higher diagnostic accuracy and appropriate decision making, thus ensuring quality nursing care and significantly reducing iatrogenic events. Numerous researchers have further shown that CT skills might be developed and improved through a continuous and dynamic process that involves the application of appropriate teaching strategies.
Individuals have a number of sources and strategies, such as conceptual maps, 13 simulations, 25 problem-based learning PBL , 19,24 YouTube videos, 17 video vignettes, 18 and team-based learning TBL , 20 that can help in developing their CT skills. A meta-analysis 21,22 of 12 RCTs has been conducted, with the aim of evaluating the effectiveness of teaching strategies used for the development of CT in undergraduate nursing students.
The teaching strategies used and tested in the RCTs included: PBL, conceptual maps, simulation, reflective writing, role modeling and animated pedagogical agents. This suggests that it is essential for educators to update their teaching methods and develop novel ones. Therefore, this study will assess teaching strategies applied in courses, training and continuing education with registered nurses in health care settings.
This will clarify which strategies are most effective for CT development in nurses who provide direct patient care, with the intention of improving clinical reasoning and decision making. This is important for achieving the goal of the continuous improvement of CT in nurses who provide direct patient care.ipdwew0030atl2.public.registeredsite.com/4090-whatsapp-tracking-on.php
Critical Thinking Test
Assessment of the efficacy of the strategies will be possible through our participation as researchers in an international research network on nursing education Red Iberomericana de Investigacion en Enfermeria [RIIEE]. In addition, this study is necessary because CT research is the current focus of our multi-center research project, and no systematic reviews in this area were found. Studies that include registered nurses RN will be considered.
We will exclude studies that involve enrolled nurses, licensed practical nurses, unlicensed assistive personnel and nursing students. There are several systematic reviews 22, that address the development of critical thinking in nursing students and studies indicate that the level of critical thinking is related to age and professional experience; for this reason we will include only registered nurses in this systematic review.
This review will consider studies that evaluate the effectiveness of teaching strategies, which may include conceptual maps, 13 simulations, 25 PBL, 19,24 YouTube videos, 17 video vignettes, 18 and TBI, 20 among others, with the aim of developing or enhancing the CT prerequisites and skills of registered nurses who provide direct patient care.
The systematic review will examine studies that compare interventions based on certain teaching strategies with traditional teaching lectures or no specific intervention. This review will consider studies that include CT as an outcome measure. Regarding CT skills, the psychometric parameters established for the following skills will be considered: inference, recognition of assumptions, deduction, interpretation and evaluation, analysis, induction, deduction and critical response development. Regarding CT prerequisites, the psychometric parameters established for the following will be considered: open-mindedness, fairness, willingness to determine the cause of a problem, curiosity, desire to be well-informed, respect and ability to consider other points of view.
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The quantitative component of the review will consider both experimental and epidemiological study designs, including RCTs, non-randomized controlled trials, quasi-experimental studies, before and after studies, prospective and retrospective cohort studies, case control studies, and analytical cross-sectional studies.
The search strategy was devised to find both published and unpublished studies. A three-step search strategy will be utilized in this review. A second search using all identified keywords and index terms will then be undertaken across all included databases. The third and final step will involve examining the reference list of all identified reports and articles for additional studies. Studies published in English, Spanish, and Portuguese will be considered for inclusion in this review.
Studies published at any time will be considered for inclusion in this review.
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- Creating Tests that Measure Critical Thinking in Nursing Education?
The initial keywords to be used are as follows: registered nurses, nurse practitioners, nurses, nursing staff, clinical nurse specialist, continuing nursing education, nursing education, nursing practice, education, staff development, teaching methods, concept map, problem-based learning, patient simulation, case studies, critical thinking, and decision making. Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. Appraisal will be performed independently by two reviewers.
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The data extracted will include specific details about the interventions, populations, study methods, and outcomes of significance to the review question and specific objectives. Quantitative data will be assessed based on the overall CT score, and each skill and disposition of the various CT measurements. Heterogeneity will be assessed statistically using the standard chi-square and explored using subgroup analyses based on the different quantitative study designs included in this review.
Where statistical pooling is not possible, the findings will be presented in narrative form with tables and figures to aid in data presentation where appropriate. This study interfaces with a multi-center study being developed by members of the Red Iberomericana de Investigacion en Enfermeria. The influence of critical thinking skills on performance and progression in a pre-registration nursing program.
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Nurse EducToday ; 35 Enhancing critical thinking in clinical practice: implications for critical and acute care nurses. DimensCritCareNurs ; 33 Evolucao historica e impacto da tecnologia na area da saude e da enfermagem. Rev Eletr Enf ; 8 A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse.
Int J Nurs Stud ; 52 The impact of residency programs on new nurse graduates' clinicaldecision-making and leadership skills: A systematic review. Nurse EducToday ; 34 Evaluation of tools used to measure critical thinking development in nursing and midwifery undergraduate students: A systematic review. Instrumento de avaliacao do Pensamento Critico em estudantes e profissionais de saude.
Psicol Saude Doencas ; 15 Clinical reasoning and critical thinking.
Rev Latino-Am Enfermagem ; 18 Translation and cultural adaptation for Brazil of the Developing Nurses' Thinking model. Rev Latino-Am Enfermagem ; 22 Teaching and learning reflexive and critical thinking in nursing students in Latin America. Mexico: Cigome; A consensus statement on critical thinking in nursing. For full copies of this and many other critical thinking articles, books, videos, and more, join us at the Center for Critical Thinking Community Online - the world's leading online community dedicated to critical thinking!
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