Informing Nursing Education through Practice: Nurses' Perceptions on the Meaning and Behaviors of Critical Thinking

Wednesday, 14 July 2010: 8:30 AM

Helene Hakim, PhD
College of Nursing, University of Texas at Tyler, Longview, TX

Learning Objective 1: define critical thinking as conceptually derived from analysis of staff nurses' critical incidents.

Learning Objective 2: describe and synthesize the nurses' perspectives on the attributes and behaviors of critical thinking in practice with consideration of applicability of information to own setting.


The purpose of this qualitative study was to explore the perceptions of practicing nurses regarding the definition and behaviors of critical thinking (CT) as occurs in practice. A better understanding of how nurses view and exhibit CT is imperative for nurse educators as they must facilitate CT in students.


A sample of 21 registered nurses, with a BSN and at least two years of nursing experience, was obtained through purposive maximum variation sampling.  Naturalistic inquiry with critical incident technique was the method used.  Data collection methods included audiotaped interviews, used to capture the perspectives of the nurses regarding critical thinking. Trustworthiness was maintained through rich descriptions of participants’ critical incidents and practice environments and through field logs and peer checks.


Analysis of the participants’ descriptions of challenging practice incidents led to the development of a conceptual definition of CT. Additional responses to questions about the participants’ CT attributes, their practice environments, and the CT behaviors of colleagues were thematically coded into six CT behaviors: (1) anticipatory, outcome-focused thinking; (2) maintaining a holistic view of the patient; (3) questioning and seeking out additional information; (4) prioritizing; (5) organizing and active planning; and (6) problem solving and step-by-step processing of information. These behaviors and attributes reflected many similarities when compared to Scheffer and Rubenfeld’s (2000) Consensus Statement on Critical Thinking in Nursing.  


Study findings provide insight on the perspectives of practicing nurses on CT and point to implications for practice, education, and research. Participants expressed need for a supportive, collaborative practice environment that included more time for CT. They identified that nursing education needed to include more hands-on experiences and higher level questioning. Finally more studies are needed to establish a foundation of the development of an instrument that can accurately measure CT in nursing.