Bevan B.
Balbuena, RN, MN
OUTLINE:
A. Critical Thinking
B. Nursing Process
1. Assessment
2. Nursing Diagnosis
3. Planning
4. Intervention
5. Evaluation
6. Documentation
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, critical thinking
and nursing judgment; and
5. explore ways to enhance and develop critical thinking
skills as they apply to nursing.
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.”
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.”
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
have a single ‘best’ solution.
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/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.”
“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?
1. Rational and reasonable
▪ based on reasons; not on prejudice, preferences,
self-interest, fear
2. Involves conceptualization
▪ Concept – mental image of reality, ideas about
events, objects or relationship between them
3. Requires reflection
▪ Reflection – to ponder, contemplate
▪ Reflective thinking – integrates past experiences to
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
▪ standard of conduct
Personal knowledge
▪ knowing and actualizing one’s self
Practice wisdom
▪ acquired from intuition, tradition, authority, trial and
error, clinical experience
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
Independent Thinking
▪ Critical thinkers think for themselves.
▪ They consider a wide range of ideas, learn from
them and make their own judgments about them.
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
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
Intellectual Empathy
▪ the ability to imagine yourself I the place of others
in order to understand them and their actions and
beliefs.
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
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.
Intellectual Curiosity
▪ An attitude of inquiry
▪ Having a mind filled with questions
Faith in reason
▪ Implies that people can, and should learn to think
logically for themselves
▪ Not afraid of disagreement
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
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
Opinion Judgment
Inference
- a view or judgment formed - the ability to make
- a conclusion reached on
about something, not considered decisions or
the basis of evidence and
necessarily based on fact or come to sensible
reasoning
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
