37
CHAPTER 2 Clinical Judgment
The following are a few examples of critical-thinking skills: ■ Objectively gathering information on a problem or issue ■ Recognizing the need for more information ■ Evaluating the credibility and usefulness of sources of information ■ Recognizing gaps in one’s own knowledge ■ Recognizing differences and similarities among things or situations ■ Listening carefully; reading thoughtfully ■ Separating relevant from irrelevant data and impor- tant from unimportant data ■ Organizing or grouping information in meaningful ways ■ Making inferences (tentative conclusions) about the meaning of the information ■ Integrating new information with prior knowledge ■ Visualizing potential solutions to a problem ■ Exploring the advantages, disadvantages, and conse- quences of each potential action What Are Critical-Thinking Attitudes? Attitudes consist of beliefs, feelings, and views toward something or someone. Your attitudes and charac- ter determine whether you will use your thinking skills fairly and with an open mind. Without a crit- ical attitude, people tend to use thinking skills to jus- tify narrow-mindedness and prejudice and to benefit themselves rather than others. The following are some critical-thinking attitudes (Paul, 1990; Paul & Elder, 2010; Papathanasiou et al., 2014): ■ Intellectual autonomy. Critical thinkers do not believe everything they are told; they listen to what others think, and they learn from new ideas. They do not accept or reject an idea before they understand it. ■ Intellectual curiosity. Critical thinkers love to learn new things. They show an attitude of curiosity and inquiry, and they frequently think or ask, “What if ...?”; “How could we do this differently?”; “How does this work?”; or “Why did that happen?” ■ Intellectual humility. Critical thinkers ask for help when they don’t know; seek the wisdom of mentors with knowledge, skill, and ability; and reevaluate their conclusions or actions in light of new information. ■ Intellectual empathy. Critical thinkers try to under- stand the feelings and perceptions of others. They try to see a situation as the other person sees it. ■ Intellectual courage. Critical thinkers consider and examine fairly their own values and beliefs, as well as the beliefs of others, even when this is uncomfort- able. They are willing to rethink, and even reject, pre- viously ill-justified beliefs. ■ Intellectual perseverance. Critical thinkers don’t jump to conclusions or settle for the quick, obvious answer. They explore effective solutions even when it takes a great deal of effort and time.
WHAT IS CRITICAL THINKING? Unlike clinical reasoning, critical thinking does not require a client situation or scenario. Yet, critical think- ing is needed for clinical reasoning, and both clinical reasoning and critical thinking are essential to the devel- opment of clinical judgment (Manetti, 2019). Any situation that requires critical thinking is likely to have more than one so-called right answer. For exam- ple, you do not need critical thinking to add 2 + 2 and come up with the answer. You simply need to know and follow the rules of addition. However, you do need critical thinking to work through important decisions and those in which the best answer is not so clear (e.g., “Should I buy a new car or a used one?”). ■ Critical thinking is a complex concept, and peo- ple think about it in different ways. As applied to nursing, it can be defined as a cognitive process that uses intellectual standards based on evidence and science to approach a subject, content, or problem (Victor-Chmil, 2013). Another closely related defini- tion is, “critical thinking is the ability to apply high- er-order cognitive skills (conceptualization, analysis, evaluation) and the disposition to be deliberate about thinking (being open-minded or intellectually hon- est) that lead to action that is logical and appropriate” (Papp et al., 2014, p. 716). Key Point: Critical think- ing is an analysis process. It is a combination of rea- soned thinking, openness to alternatives, an ability to reflect, and a desire to seek truth. There are many definitions of critical thinking because it is a complex concept and people think about it in different ways. ■ Critical thinking is linked to evidence-based prac- tice , which is a research-based method for judging and using nursing interventions. An important aspect of critical thinking is the process of identifying and checking your assumptions—and this process is also an important part of the research process. ■ Critical thinkers are flexible, nonjudgmental, inquisi- tive, honest, and interested in seeking the truth. They possess intellectual skills that allow them to use their curiosity to their advantage, and they have critical atti- tudes that motivate them to use those skills responsibly. They continually critically reflect on their assumptions to continue to develop their critical-thinking skills. What Are Critical-Thinking Skills? Skills in critical thinking refer to the cognitive (intel- lectual) processes used in complex thinking operations such as problem-solving and decision making. In this example, the skills are italicized, and the complex think- ing processes are in bold type: When planning nursing care, nurses gather information about the client and then draw tentative conclusions about the meaning of the information to identify the cli- ent’s problems. Then they think of several different actions they might take to help solve or relieve the problem .
20
Powered by FlippingBook