Last year Reebok was forced to refund $25 million to customers who purchased their EasyTone toning shoes after research published by the American Council on Exercise found that the toning shoes were no better than regular sneakers at toning muscles or burning calories (Porcari, Greany, Tepper, Edmonson, Foster, & Anders, 2011). The incredible popularity of the toning shoes (even with no evidence of their effectiveness) illustrates the need for critical thinking among consumers who face an onslaught of marketing campaigns that seek to persuade them to purchase things that are ‘good’ for them. Consumers who can think critically about sensational product claims may have saved themselves the $100-$245 expense of purchasing these faux-fitness shoes. Critical thinkers should also make better decisions about other aspects of life, for example, in the context of important financial, legal, medical, and interpersonal decisions.
Over the last several decades, educators, employers, and organizations around the world have expressed concern about student preparedness for a 21st century world (e.g., Association of American Colleges and Universities, 2010; Bureau of Labor Statistics, 2011; Galagan, 2010; Halpern, 2010b; Hunt, 1995). In response to these concerns an increased emphasis on the training of critical thinking skills has been incorporated into international education standards (European Higher Education Area, 2011; Redden, 2010; U.S. Department of Education, 2006).
Critical thinking has been defined in many differt ways (e.g., Halpern, 2003; Moseley et al. 2005; Sternberg, Roediger, & Halpern, 2007), but experts generally agree that critical thinking involves an attempt to achieve a desired outcome by thinking rationally and in a goal-oriented fashion. Recently, Stanovich argued that critical thinking is what intelligence tests fail to adequately measure (Stanovich, 2009; Stanovich & West, 2008). This idea echoes the general consensus among researchers that intelligence and critical thinking are separate constructs, but share at least one common attribute – they are difficult to adequately assess.
One relatively new test of critical thinking ability, the Halpern Critical Thinking Assessment (HCTA) moves beyond the limitations of previous multiple-choice tests by combining both open-ended and multiple-choice questions, and by assessing thinking in relation to daily, easy-to-relate-to situations (Ku, 2009). It is a standardized instrument that consists of 25 everyday scenarios that respondents analyze and critique. The scenarios involve thinking in various life domains including health, education, work, and social policy. The test is also coded for a variety of thinking skills, including (a) verbal reasoning skills, (b) argument analysis skills, (c) hypothesis testing skills, (d) likelihood and uncertainty judgment skills, and (e) decision making and problem solving skills.
A number of studies have established the reliability and validity of the HCTA (c.f. Halpern, 2010a) using a variety of methodologies (e.g., correlational, pretest-posttest experimental designs), with respondents that vary widely in education level (e.g., high school students, community college students, state university students, private liberal arts students, graduate students, community adults) and with participants from numerous countries (e.g., China, Ireland, Portugal, Spain, United States, Viet Nam, etc.). Consistent with other assessments of critical thinking, much of validity evidence for the HCTA is based on the prediction of academic achievement scores (e.g., grades, standardized test scores). However, critical thinking skills should predict more than academic outcomes. We make 100s of decisions each day that are likely to be influenced by our critical thinking ability. At the very least, we would expect critical thinkers to avoid certain negative life outcomes.
A series of recent studies have examined the relationship between critical thinking and real-world outcomes of critical thinking (Butler, in press; Butler et al., 2012) using an adapted version of an inventory of life events created by de Bruin, Parker, and Fischhoff (2007). This self-report inventory measures negative life outcomes from many domains (e.g., interpersonal, business, financial, interpersonal) that vary in severity from mildly negative (e.g., paying late fees for a movie rental) to severely negative (e.g., foreclosure on a home). The recent studies by Butler and colleagues sought to expand the validity of the Halpern Critical Thinking Assessment (HCTA) cross-nationally and to determine whether HCTA scores predicted real-world outcomes of critical thinking.
The findings were clear: In both the United States and the Republic of Ireland, those with higher critical thinking scores reported fewer negative life events than those with lower critical thinking scores. While this is bad news for people with lower critical thinking scores, the good news is that that critical thinking can be improved through instruction (see Chance, 1986; Halpern, 2003; Moseley et al., 2005; Nisbett, 1992). Future research could explore the causal link between critical thinking and real-world outcomes of critical thinking, with special emphasis on the role of education and behavioral outcomes.
In a world that is more complex and technical with each passing day, thinking critically about the information we consume is of the utmost importance. The evidence suggests that critical thinking scores can predict real-world outcomes and thus we need to appreciate that critical thinking is more than simply the new buzz word in education. Critical thinking is critical for life success. The good news is that there is a plethora of evidence that critical thinking skills can be taught and learned – critically important news coming at a critical time in history.
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Butler, H. A., Dwyer, C. P., Hogan, M. J., Franco, A., Rivas, S. F., Saiz, C., & Almeida, L. F. (2012). Halpern Critical Thinking Assessment and real-world outcomes: Cross-national applications. Thinking Skills and Creativity, 7, 112-121. doi: 10.1016/j.tsc.2012.04.001
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The nursing profession tends to attract those who have natural nurturing abilities, a desire to help others and a knack for science or anatomy. But there is another important skill that successful nurses share and it’s often over-looked: the ability to think critically.
Identifying a problem, determining the best solution and choosing the most effective method are all parts of the critical thinking process. After executing the plan, critical thinkers reflect on the situation to figure out if it was effective and if it could have been done better. As you can see, critical thinking is a transferable skill that can be leveraged in several facets of your life.
But why is it so important for nurses to use? We spoke with several experts to learn why critical thinking skills in nursing are so crucial to the field, the patients and the success of a nurse. Keep reading to learn why and to see how you can improve this skill.
Why are critical thinking skills in nursing important?
You learn all sorts of practical skills in nursing school, like flawlessly dressing a wound, taking vitals like a pro or giving an IV without flinching. But without the ability to think clearly and make rational decisions, those skills alone won’t get you very far—you need to think critically as well.
“Nurses are faced with decision-making situations in patient care, and each decision they make impacts patient outcomes. Nursing critical thinking skills drive the decision-making process and impact the quality of care provided,” says Georgia Vest, DNP, RN and senior dean of nursing at Rasmussen College School of Nursing.
Critical thinking is embedded in a nurse’s everyday routine. They flex this mental muscle each day they enter the floor. When you’re faced with decisions that could ultimately mean life or death, the ability to analyze a situation and come to a solution separates the good nurses from the great ones.
How are critical-thinking skills acquired in nursing school?
Nursing school offers a multitude of material to master and high expectations for your performance. But in order to learn in a way that will actually equip you to become an excellent nurse, you have to go beyond just memorizing terms. You need to apply an analytical mindset to understanding course material.
One way for students to begin implementing critical thinking is by applying the nursing process to their line of thought, according to Vest. The process includes five steps: assessment, diagnosis, outcomes/planning, implementation and evaluation.
“One of the fundamental principles for developing critical thinking is the nursing process,” Vest says. “It needs to be a lived experience in the learning environment.”
Nursing students often find that there are multiple correct solutions to a problem. The key to nursing is to select the “the most correct” solution—one that will be the most efficient and best fit for that particular situation. You will often find yourself in situations where there are few “correct” forms of care, but one that is most appropriate. Using the nursing process, students can narrow down their options to select the best one.
When answering questions in class or on exams, challenge yourself to go beyond simply selecting an answer. Start to think about why that answer is correct and what the possible consequences might be. Simply memorizing the material won’t translate well into a real-life nursing setting.
How can you develop your critical thinking skills?
As you know, learning doesn’t stop with graduation from nursing school. Good nurses continue to soak up knowledge and continually improve throughout their careers. Likewise, they can continue to build their critical thinking skills in the workplace with each shift.
“To improve your critical thinking, pick the brains of the experienced nurses around you to help you get the mindset,” suggests Eileen Sollars, RN ADN, AAS. Understanding how a seasoned nurse came to a conclusion will provide you with insights you may not have considered and help you develop your own approach.
The chain of command can also help nurses develop critical thinking skills in the workplace.
“Another aid in the development of critical thinking I cannot stress enough is the utilization of the chain of command,” Vest says. “In the chain of command, the nurse always reports up to the nurse manager and down to the patient care aide. Peers and fellow healthcare professionals are not in the chain of command. Clear understanding and proper utilization of the chain of command is essential in the workplace.”
How are critical thinking skills applied in nursing?
“Nurses use critical thinking in every single shift,” Sollars says. “Critical thinking in nursing is a paramount skill necessary in the care of your patients. Nowadays there is more emphasis on machines and technical aspects of nursing, but critical thinking plays an important role. You need it to understand and anticipate changes in your patient's condition.”
As a nurse, you will inevitably encounter a situation in which there are multiple solutions or treatments and you’ll be tasked with determining the solution that will provide the best possible outcome for your patient. You must be able to quickly and confidently assess situations and make the best care decision in each unique scenario. It is in situations like these that your critical thinking skills will direct your decision making.
You’re now well aware of the importance of critical thinking skills in nursing. Even if you wouldn’t consider yourself a high-caliber critical thinker today, you can work toward strengthening that skill. The more you practice it, the better you will become and the more naturally it will come to you.
Critical thinking isn’t the only component that makes an effective nurse. Learn about how else you can position yourself to climb the ranks in your nursing career in our article, "Nursing Career Advancement: 7 Ways to Stand Out in Your Scrubs."
*This article was originally published in July 2012. It has since been updated to include information relevant to 2017.