The Difference Between Critical Thinking And Clinical Reasoning

Critical thinking is a term you will often here in regards to nursing education and the ability to be a successful nurse. Critical thinking is one of the most important skills of a nurse. Nurses must be able to constantly asses and analyze situations in order to prioritize what is the most important task to accomplish next. This is an ever changing situation in health care and especially in the Intensive Care Units.

Castledine, G (2010) in Critical thinking is crucial in British Journal of Nursing 19 (4) pp271

Alfaro-LeFevre, R. (2013). Critical thinking, clinical reasoning, and clinical judgment : A practical approach (Fifth ed.).

As the nurses who participated in a study (Jones & Cheek, 2003) overwhelmingly advised, there is no such thing as a typical day for a nurse. Nurses face new situations everyday and it is important that they can adjust their knowledge and skills accordingly. Critical thinking and reflection are essential skills because they can enhance nurses’ ability to solve problems and make sound decisions. Critical thinking skills enable nurses to identify multiple possibilities in clinical situations and alternatives to interventions; weigh the consequences of alternate actions; and make sound judgement and decisions (Brunt, 2005). Through reflection, nurses can examine their practice, explore feelings and reactions and connect new meanings to past experience (Brunt). Reflection can enhance self-awareness, foster professional satisfaction and growth and increase the possibility for change and improvement in nursing practice and therapeutic relationships (Thorne & Hayes, 1997).

In addition to these characteristics, nursing also involves critical thinking. "Critical thinking is the active, organized, cognitive process used to carefully examine one's thinking and the thinking of others. It involves the use of the mind in forming conclusions, making decisions, drawing inferences, and reflecting" (Perry,

Critical thinking is a nursing process that includes reflective practice, problem solving and decision making which are connected to one another. The definition of critical thinking is transferring and applying knowledge and skills in a new situation. The critical thinking is needed in a lot of aspects of the nurses’ job such as when the nurses need to provide the precise identification in the specific problems had by the patients. They need to be in detail and also critical to themselves in every time in order to be able to provide identification precisely. When you have the profession in nursing, it is important to be critical thinker. The nurses have the high responsibilities and their responsibilities are increasing from time to time.

After reading the Nurse of he Future Nursing Core Competencies (NOF), I believed it was created to help nurses used critical thinking when delivering care. Being a nurse had empowered me to know the important of critical thinking when caring for patients. “Nurses use critical thinking to integrate objective data with knowledge gained from an assessment of the subjective experiences of patients and groups, and to apply the best available evidence and research data to the processes of diagnosis and treatment”.

Underlying both the clinical decision-making process and the nursing process is the skill of critical thinking. Critical thinking has been described as the ability to gather and process data in such a way as to arrive at the best conclusion using the filters of prior knowledge, experience and external resources to overcome personal emotions, biases, and assumptions. (This description was developed during NUR/300 class, University of Phoenix, S. Colorado, March 16, 2006) Note that critical thinking is described as a

The national league for nurses defines critical thinking in the nursing process as “a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns” (Kozier, 2008). This definition is imperative to help a nursing student learn how to think in terms of nursing care. Nursing students must achieve a comprehensive understanding of critical thinking in order to understand the nursing process. The purpose for this paper is for nursing students to learn how to use the nursing process, how to properly document their findings and assessments, and correctly implement APA formatting in a formal paper.

In other words, critical thought is a skill acquired through experience; in this instance, it is gained from clinical practice. I envision myself using critical thinking when assessing my clients, administering medication, enacting physician orders, and reviewing nursing recommendations.

The major study variables in this investigation were critical thinking and clinical judgment skill of nursing students. Critical thinking was operationally defined with the ATI Critical Thinking Test and clinical judgment was operationally defined with the Lasater’s Clinical Judgment Rubric (Mann, 2012). The independent variable was identified as the Level II baccalaureate nursing students. The dependent variable was identified as the critical thinking and clinical judgment skills of the nursing students. The demographic variables included the gender and age of the

Clinical reasoning can be defined as, ‘the process by which nurses (and other clinicians) collect cues, process the information, come to an understanding of a patient’s problem or situation, plan and implement interventions, evaluate outcomes and reflect on and learn from the process’ (Levett-Jones & Hoffman 2013, p.4). It requires health professionals to be able to think critically and ensures better engagement and results for the patient (Tanner 2006, p.209). The Quality in Australian Healthcare Study (Wilson 1995, p.460) discovered that ‘cognitive failure’ resulted in approximately 57% of unfavourable clinical events involving the failure to produce and act correctly on clinical information. It also recognises that often nurse’s preconceptions and assumptions can greatly affect patient care and by going through such a process, one can take into account the holistic nature of the patient and provide the best, most appropriate care.

Critical thinking and clinical reasoning are terms often used interchangeably throughout the history of nursing. However, they are not the same, and distinguishing the difference amongst them is important. The purpose of this paper is to define critical thinking and clinical reasoning, discuss each concepts similarities and differences, as well as share this author’s perspective on how critical thinking and clinical reasoning have developed and evolved throughout my own career, guiding my clinical practice decisions.

The nursing process and Watson’s theory both provide a framework to promote critical thinking by the nurse so conclusions can be made and they can have a caring moment. This is completed by “assessment, plan, intervention, evaluation.” (Nursing Theories, 2012, p.4) The theory is well organized, not complex and “can be used to guide and improve practice.”(Nursing Theories, 2012, p.4)

In this essay, I will share my experience when I was still a novice in the nursing profession and how my understanding of critical thinking has radically transformed, the importance of critical thinking skills in this profession and useful ways on how to develop this specific skill.