Prof.

ROSAMMA JOSEPH
T JOHN COLLEGE OF
NURSING
CRITICAL THINKING

• Is disciplined, self-directed, rational thinking that supports what we

know and makes clear what we don’t know. ( Wilkinson, 2001)
• It is a reasonable and reflective thinking focused on deciding what to
believe or to do- (Ennis 2000)
• Critical thinking is an active, organised cognitive process used to
carefully examine one’s thinking and thinking of others.- (Chaffie,
1994)
• It involves use of the mind in forming conclusions, making decisions,
drawing inferences and reflecting.-(Gordon, 1995)
A critical thinker
• Identifies and challenges assumptions
• Considers what is important in a situation
• Imagines and explores alternatives
• Considers ethical principles
• Applies reason and logic
• And thus makes informed decisions.
• Critical thinking not only requires
cognitive skills, but also
• A person’s habit to ask questions,
• To remain well informed,
• To be honest in facing personal biases
and
• Always to be willing to reconsider and
think clearly about issues
Think of something that someone has recently told you. Then ask yourself the
following questions:
Who said it?
Someone you know? Someone in a position of authority or power? Does it matter who
told you this?
What did they say?
Did they give facts or opinions? Did they provide all the facts? Did they leave anything
out?
Where did they say it?
Was it in public or in private? Did other people have a chance to respond an provide an
alternative account?
When did they say it?
Was it before, during or after an important event? Is timing important?
Why did they say it?
Did they explain the reasoning behind their opinion? Were they trying to make someone
look good or bad?
How did they say it?
Were they happy or sad, angry or indifferent? Did they write it or say it? Could you
• Is drinking coffee good for you?
• Search for reasons not to drink coffee
• Decreased anxiety healthier teeth weight loss and a healthier heart 
• Search for reasons to drink coffee
• Lower rates of depression , memory boost , longevity , and
a healthier heart .
Steps of Critical Thinking

• 1. Identify the problem or question.

• Be as precise as possible: the narrower the issue, the easier it is to find
solutions or answers.
•  2. Gather data, opinions, and arguments.
• Try to find several sources that present different ideas and points of view.
•  3. Analyze and evaluate the data.
• Are the sources reliable? Are their conclusions data-backed or just
argumentative? Is there enough information or data to support given
hypotheses?
• 4. Identify assumptions.
• Are you sure the sources you found are unbiased? Are you sure you weren’t
biased in your search for answers?
•  5. Establish significance.
• What piece of information is most important? Is the sample size sufficient?
Are all opinions and arguments even relevant to the problem you’re trying to
solve?
•  6. Make a decision/reach a conclusion.
• Identify various conclusions that are possible and decide which (if any) of
them are sufficiently supported. Weigh strengths and limitations of all
possible options.
• 7. Present or communicate.
• Once you’ve reached a conclusion, present it to all stakeholders.
Is drinking coffee good for you?
• This approach is way too broad.
•  First of all, what does “good” even mean?
• Is it short term benefit or long term benefit that we are referring to?
•  let’s narrow down the problem to: “is drinking coffee good for
your heart?”
• Search for research evidences
• Have enough number of evidences
• Also we need to understand coffee may be beneficial to some aspects
of heart, while bad for some others
• Also look at the nature of the evidences- done on a large population,
among people of all categories,
• is it a true experimental study or a review of literature?
• Considering all of the above, we can positively state that the
information we gathered was not significant for solving the initially
stated problem.
•  6. The only conclusion that can be reached is: according to the data
we gathered, drinking coffee might or might not be good for our
hearts, depending on many factors and variables we failed to take into
account.
•  7. Even if the conclusion is “the question cannot be answered at this
point,” it’s still worth presenting and communicating.
•  It’s good to know what the limitations of our knowledge on a given topic
are.
CRITICAL THINKING SKILLS
INTERPRETATION
• Categorization, clarifying meaning

• Be systematic in data collection.

• Look for patterns to categorize

data.

• Clarify any data that you are not

sure about.
2. ANALYSIS

• Examining ideas, analysing

arguments

• Be open-minded as you look at

information

• Do not make careless assumptions.

3. EVALUATION

• Assessing results, assessing

arguments

• Look at all situations objectively

• Use criteria to determine results of

nursing actions

• reflect on your behaviour.

4. INFERENCE

• Examining evidence

• Speculating considering alternatives

• Look at meaning and significance of things

• Are there relationship between findings?

5. Explanation

• Stating results

• Justifying procedures

• Support your findings and conclusions

• Use knowledge to select strategies to be

used in the care of clients.
6. SELF
REGULATION
• Self examination

• Self correction

• Reflect on your own experience

• Identify in what way one can

improve their own performance
• Integrating new information with existing knowledge.
• Visualizing potential solutions to a problem.
• Objectively evaluating the likelihood of whether each potential
solutions will work.
• Exploring the advantages , disadvantages of each potential action.
• Evaluating the credibility and usefulness of sources of information.
 CRITICAL THINKING ATTITUDES I don’t believe
every thing he
says
• Independent thinking
• They do not believe every thing they are
told.
• They listen to what others think and learn
from new ideas. I can learn
from her and
• They do not reject or accept any idea get new
before they understand ideas
Intellectual curiosity
• Love to learn new things
• They are always curious and frequently think and ask – what if……?
How could this be done differently? How does this work?
WHAT IF……?
 I don’t know everything. I
need to ask an expert to
• Intellectual humility help me in this.

• Aware that they don’t know everything.

• Not embarrassed to ask for help when
they don’t know.
• Intellectual courage
• Consider and examine fairly their own What are my
values and beliefs, other’s beliefs, even beliefs, values?
when it is uncomfortable. What are their
their beliefs
regarding this?
Intellectual empathy
• Try to understand the feeling and perception of others
• Try to see a situation as the other person sees it.

I see what she

means by that
• Intellectual perseverance
• Don’t jump into conclusions.
• Ready to give time and put effort to find solutions for
problems.
“ It ’ s not that I ’ m smart, it ’ s
• Fair-mindedness just that I stick with problems
longer. ” — Albert Einstein
• Try to make impartial judgments
• Risk taking
• Responsibility and authority
• Discipline
• integrity
Levels of critical thinking in nursing
• According to the model by Kataoka-Yahiro and Sayler (1994),
• BASIC
• COMPLEX
• COMMITMENT
 BASIC
• Thinking is concrete and based on a set of
Experts have the
rules or principles.
right answers for
every problem • The answer to complex problems are either
right or wrong.
 COMPLEX
• Begins to detach from authorities
I don’t have to completely
and analyse and examine
depend on expert’s
alternatives more independently.
opinion. There may be
conflicting solutions ! • Looks beyond expert opinion.
• Realizes that alternatives ( may be
even conflicting solutions exist!)
• Weigh the benefits and risks of
each solutions before making a
final decision.
COMMITMENT
• The individual anticipates the need to make choices without
assistance from others and then assumes accountability for
them.
• The nurse chooses an action or belief based on the alternatives
available and stands by it.
CRIITCAL THINKING COMPETENCIES
• General critical thinking- problem-solving, decision-making, scientific
method
• Specific critical thinking in clinical situations- diagnostic reasoning,
clinical inference and decision-making
• Specific critical thinking in nursing
Diagnostic reasoning
• Is a process of determining a client’s health status after the nurse
assigns meaning to the behaviours, physical signs and symptoms of
the patient.
• A process of using the data gathered to logically explain a clinical
judgment.
• Example- a bed sore in a patient is treated with an open wound
method or cleaning with normal saline
• A doctor giving a particular line of therapy for a client different form
similar clients.
Scientific method
• Is an approach to seeking truth or verifying facts.
• Is a formal way to approach a problem, plan a solution, test the
solution and come to a conclusion.
• Nurse identifies a problem and tries to solve it by a formal approach:
• Collect data
• Formulate hypothesis
• Testing hypothesis and
• Evaluating the results
Examples of critical thinking skills
• Objectively gathering information on a problem or issue
• Recognizing gaps in one’s own knowledge.
• Listening carefully, reading thoughtfully
• Separating relevant from irrelevant data, unimportant from important
data.
• Organizing or grouping information in a meaningful way.
• Making inferences about the meaning of information.
How can nurses develop critical thinking
skills?
• Suspend judgment, and demonstrate open-mindedness for other
departments and other views.
• When confronted with a problem or situation, seek out the truth by actively
investigating a problem or situation.
• Ask questions about anything you may not fully understand and never be
afraid to admit to a lack of knowledge.
• Reflect on your own thinking process and the ways in which you reach a
conclusion. Identifying a personal bias is the first step toward eliminating it,
• Look for a mentor with more experience than you have and join professional
organizations, in order to gain experiential knowledge and build a network of
colleagues whom you could turn to for advice when needed
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thinking-the-nursing-process-critical-judgement