5 Ways Nurses Can Improve Critical Thinking Skills
NURS 491 - Nursing Management (D)
Liberty University
Name
2022
We asked our experts for the top five strategies nurses can use to purposefully improve their critical
thinking skills.
1. Case-Based Approach
Slaughter is a fan of the case-based approach to learning critical thinking skills.
In much the same way a detective would approach a mystery, she mentors her students to ask
questions about the situation that help determine the information they have and the information they
need. "What is going on? What information am I missing? Can I get that information? What does that
information mean for the patient? How quickly do I need to act?"
Consider forming a group and working with a mentor who can guide you through case studies. This
provides you with a learner-centered environment in which you can analyze data to reach conclusions
and develop communication, analytical, and collaborative skills with your colleagues.
2. Practice Self-Reflection
Rhoads is an advocate for self-reflection. "Nurses should reflect upon what went well or did not go well
in their workday, and identify areas of improvement or situations in which they should have reached out
for help." Self-reflection is a form of personal analysis to observe and evaluate situations and how you
responded.
This gives you the opportunity to discover mistakes you may have made and establish new behavior
patterns that may help you make better decisions. You likely already do this. For example, after a
disagreement or contentious meeting, you may go over the conversation in your head and think about
ways you could have responded.
It's important to go through the decisions you made during your day and determine if you should have
gotten more information before acting or if you could have asked better questions.
During self-reflection, you may try thinking about the problem in reverse. This may not give you an
immediate answer but often will help you see the situation with fresh eyes and a new perspective. How
would the outcome of the day be different if you planned the dressing change in reverse with the
assumption you would find a wound infection? How does this information change your plan for the next
dressing change?
3. Develop a Questioning Mind
McGowan has learned that "critical thinking is a self-driven process. It isn't something that can simply be
taught. Rather, it is something that you practice and cultivate with experience. To develop critical
thinking skills, you have to be curious and inquisitive."
In other words, to get critical thinking skills, you must undergo a purposeful process of learning
strategies and using them consistently so they become a habit. One of those strategies is developing a
questioning mind. Meaningful questions lead to useful answers and are at the core of critical thinking.
However, learning to ask insightful questions is a skill you must develop. Faced with staff and nursing
shortages, declining patient conditions, and a rising number of tasks to be completed, it may be difficult
to do more than complete the task in front of you. Yet, questions drive active learning and train your
brain to see the world differently and take nothing for granted.
It is easier to practice questioning in a nonstressful, quiet environment until it becomes a habit. Then, in
the chaos of the moment when your patient's care depends on your ability to ask the right question, you
can be ready to rise to the occasion.
4. Practice Self-Awareness in the Moment
Critical thinking in nursing requires self-awareness and being present in the moment. During a hectic
shift, it is easy to lose focus as you're struggling to finish every task needed for your patients. Passing
medication, changing dressings, and hanging intravenous lines all while trying to assess your patient's
mental and emotional status can affect your focus and how you manage stress as nurse.
Staying present helps you to be proactive in your thinking and anticipate what might happen, such as
bringing extra lubricant for a catheterization or extra gloves for a dressing change.
By staying present, you are also better able to practice active listening. This raises your assessment skills
and gives you more information to base your interventions and decisions.
5. Use a Process
As you are developing critical thinking skills, it can be helpful to use a process. For example:
Ask questions
Gather information
Implement a strategy
Evaluate the results
Consider another point of view
These are the fundamental steps of the nursing process (assess, diagnose, plan, implement, evaluate).
The last step will help you overcome one of the common problems of critical thinking in nursing —
personal bias.
Common Critical Thinking Pitfalls in Nursing
Your brain uses a set of processes to make inferences about what's happening around you. In some
cases, your unreliable biases can lead you down the wrong path. McGowan places personal biases on
the top of his list of common pitfalls to critical thinking in nursing.
"We all form biases based on our own experiences. However, nurses have to learn to separate their own
biases from each patient encounter to avoid making false assumptions that may interfere with their
care," he says. Successful critical thinkers accept they have personal biases and learn to look out for
them. Awareness of your biases is the first step to understanding if your personal bias is contributing to
the wrong decision.
New nurses may be overwhelmed by the transition from academics to clinical practice, leading to a task-
oriented mindset and a common new nurse mistake; this conflicts with critical thinking skills.
"Consider a patient whose blood pressure is low but who also needs to take a blood pressure
medication at a scheduled time. A task-oriented nurse may provide the medication without regard for
the patient's blood pressure because medication administration is a task that must be completed,"
Slaughter says. "A nurse employing critical thinking skills would address the low blood pressure, review
the patient's blood pressure history and trends, and potentially call the physician to discuss whether
medication should be withheld."
Fear and pride may also stand in the way of developing critical thinking skills. Your belief system and
worldview provide comfort and guidance, but this can impede your judgement when you're faced with
an individual whose belief system or cultural practices are not the same as yours. Fear or pride may
prevent you from pursuing a line of questioning that would benefit the patient. Nurses with strong
critical thinking skills exhibit.
