Clinical Judgments: Critical Thinking in Practice

Question 1

What is critical thinking?

Answer 1

• Purposeful thinking - considering all information before arriving at tentative conclusion
• Exploring with an open mind, engaged reasoning
• Deliberative process of generating, analyzing and evaluating alternatives

Question 2

Describe the meta-concept of critical thinking:

Answer 2

• Critical analysis
• Clinical reasoning
• Clinical judgment
• Critical reflection

Question 3

What are characteristics of critical thinkers?

Answer 3

• Open-minded
• Pro-active versus reactive
• Consequences
• Global thinkers
• Thinking out the box
• Flexible
• Avoids over-simplification
• Being aware of limits and personal biases
• Reflective thinker, independent
• Diligent, focused in inquiry
• Persistent in seeking results

Question 4

What is non-critical thinking characterized by?

Answer 4

• Task orientated
• Taking everything at face value
• No questioning
• Relying on thoughts of others
• Emotion in place of reason
• Blinded by one dominant idea or POV

Question 5

Describe novice thinking:

Answer 5

• Context-free rules
• Textbook principles
• Practice guided by theory

Question 6

Describe advanced beginner:

Answer 6

• Clinical situations are seen as a set of tasks

- Use standards of care, procedures, rules based, etc.

Question 7

Describe competent:

Answer 7

• 2-3 years
• Ability to anticipate the likely course of events
• Focus switches to clinical situation from task orientation
• Holistic orientation
• Priority setting is deliberate

Question 8

Describe proficient:

Answer 8

• Able to read and response to situations appropriately
• Moves from use of quantitative measures to patient particulars to guide judgments
• Flexible and responsive to changing situations.

Question 9

Describe expert:

Answer 9

• Increased intuitive links for each situation
• Attends to context and environment
• Organization and priority setting do not show up as focal points

Question 10

What are the four components of critical thinking?

Answer 10

1. Identifying / challenging assumptions
2. Understanding the importance of context
3. Exploring and imagining alternatives
4. Reflecting with an open mind

Question 11

What is clinical judgment?

Answer 11

• Refers to reasoning process
• Choosing what to observe, interpreting observations, taking appropriate actions
• Requires an ability to critically think
• Includes ‘thinking –in-action” skills of noticing, interpreting, responding and ‘reflection-in-action’
• Requires weighing evidence against expectation, norm or standard

Question 12

What are factors influencing clinical judgment?

Answer 12

• Nurses background
• Context
• Relationship with patient
• Initial grasp of situation
• Reasoning ability
• Practical knowledge