Critical Thinking and Reasoning

• Critical thinking involves breaking down material, identifying relationships, questioning information, and discarding the unimportant.

Divergent Thinking

• Divergent thinking analyzes diverse opinions without being limited by previous thinking.
• Divergent thinking separates relevant from irrelevant data, and draws accurate inferences using all senses.
• Divergent thinking analyzes arguments, recognizes strengths/limitations, and closely studies/evaluates data.
• Recognizing value from another's viewpoint is a good exercise and can be achieved by arguing for the opposition.

Reasoning

• Reasoning is based on logical thinking that meaningfully connects thoughts.
• Reasoning involves an ability to discriminate between observation and inference, separating fact from conjecture.

Two Types of Reasoning

• Inductive reasoning draws conclusions that probably follow but are not always certain, such as generalizations (e.g., all clients with COPD have fatigue)
• Deductive reasoning begins with a major theory and generates specific details and predictions.
• Deductive reasoning draws conclusions on individuals based on observations from a larger group.

Questions to Clarify Reasoning Skills

• Identify the data that supports your conclusion.
• Identify the process that was used to support the data.
• Reasoning errors occur when the major or minor premise is incorrect.

Reflection

• Critical thinking is multi-dimensional, not a step-by-step process.
• Past experiences integrate into the present and change future actions.
• Reflection explores alternatives and uses "if" "then" conclusions.

Creativity

• Creativity enables the thinker to produce ideas and alternatives.
• Creativity uses problem-solving strategies and considers multiple solutions.
• Intuitive inferences involve attention to intuition, gut feelings, and integrating "feelings" into thinking/decision-making.
• Creative thinkers generate ideas rapidly through brainstorming.
• They are flexible, spontaneous, use original solutions, and prefer complex thought processes.
• Moreover, they are independent, self-confident, and exhibit individualism.

Clarification

• Thorough observations should be made, noting similarities and differences.
• Classifying information allows the critical thinker to see the differences in things.
• Examples include distinguishing between acute and chronic pain.
• Identifying assumptions involves critical examination.
• It is necessary to use questions to define terms to understand their usage.

Basic Support

• Known facts and background knowledge provide evidence for judgments.
• Evaluation, determining the worth of something, must be explicit and consistently applied.
• Making and judging observations involves considering the credibility of information sources.

Attitudes of Critical Thinkers

• Intellectual humility involves knowing the limits of your knowledge.
• Recognizing when they need more information; not being afraid to say "I don't know".
• Sensitivity to prejudices or biases is important not to negatively impact client care.
• Beliefs should be examined with new evidence, and they should be willing to try new ideas.

Intellectual Courage

• Intellectual courage means a willingness to listen to and fairly evaluate diverse ideas, viewpoints, and beliefs, even in disagreement.
• New ideas can cause discomfort, whereas old ideas may provide security.

Intellectual Empathy/Interest

• Intellectual empathy involves imagining oneself in the place of another to understand them fully.
• It includes attempting to understand someone else's thinking.

Intellectual Integrity/Fair-Mindedness

• Intellectually integrity involves evaluating ideas under the same standards as others.
• Consistency in evaluating ideas is key.

Intellectual Perseverance

• Intellectual perseverance involves striving for truth and understanding despite frustrations and difficulties.
• Even though changing practice can be frustrating, improved outcomes are worth the struggle.

Faith/Confidence in Reason

• Faith in reason means believing that people can and should think logically.

Independence of Thought

• Critical thinkers think for themselves and don't passively accept others' ideas and beliefs.
• Beliefs should be examined in light of new evidence.
• Consider a wide range of ideas that challenge old ideas lacking rational support.

Intellectual Curiosity

• Intellectual curiosity involves constantly questioning assumptions and exploring alternatives.
• Why do we believe this? What causes that? Does it have to be this way? Could something else work? What would happen if we did this another way? Who says this is so?

Elements of Critical Thinking

• Key elements include information, purpose, question at issue, points of view, interpretations/inference, assumptions, and concepts.
• What do we need to know? Why are we thinking about this problem? What is the problem to be solved?
• Concepts consist of theories, models, definitions, laws, and principles.

Applying Critical Thinking to the Nursing Process

• Critical thinking and the nursing process are interrelated and interdependent.
• The process includes assessment, goal setting, nursing diagnosis, planning, implementing, and evaluation.
• The nurse uses knowledge of concepts to make more informed decision.
• What information do we need? What is the purpose of the thinking? Are these the nurse's goals or the client's goals?
• What is the question at issue? Whose point of view are we using? What do we already know?
• The nurse's knowledge provides the basis for planning, helping the patient.
• Consider what will happen if this intervention is done or not done, and how it will help the patient.
• Failure to think critically can lead to ineffective interventions.
• It's essential to evaluate if the intervention was the best choice and if it was successful.

Clinical Judgement

• Informed opinions and decisions based on empirical knowledge and experience forms clinical judgment.
• Clinical judgment develops gradually as nurses gain broader knowledge and clinical experience through patient contact.
• Clinical judgment involves recalling facts, recognizing patterns, putting facts/observations together, and acting appropriately.

Novice vs Expert Thinking

• Novice nurses organize knowledge as separate facts and rely heavily on resources
• They lack practical knowledge, focus on actions over assessment, need clear rules, and are hindered by unawareness, anxiety, and self-confidence.
• They rely on step-by-step procedures and become uncomfortable when patient needs deviate procedures.
• They have limited knowledge of suspected problems and follow standards/policies by rote, learning readily with supportive mentors.
• Expert nurses store knowledge in a highly organized manner, making recall easier.
• They have a large storehouse of knowledge and assess/think through things before acting.
• Expert nurses know when to bend rules, are aware of resources, and are self-confident/focused.
• They can focus on the parts (procedures) and the whole (patient response).
• Expert nurses are comfortable rethinking procedures as needed, questioning deeply, and analyzing standards/policies for improvements.
• They are challenged by novices' questions, clarifying their own thinking when teaching.