problem solving decision making and critical thinking

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How to build critical thinking skills for better decision-making

It’s simple in theory, but tougher in practice – here are five tips to get you started.

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Have you heard the riddle about two coins that equal thirty cents, but one of them is not a nickel? What about the one where a surgeon says they can’t operate on their own son?

Those brain teasers tap into your critical thinking skills. But your ability to think critically isn’t just helpful for solving those random puzzles – it plays a big role in your career. 

An impressive 81% of employers say critical thinking carries a lot of weight when they’re evaluating job candidates. It ranks as the top competency companies consider when hiring recent graduates (even ahead of communication ). Plus, once you’re hired, several studies show that critical thinking skills are highly correlated with better job performance.

So what exactly are critical thinking skills? And even more importantly, how do you build and improve them? 

What is critical thinking?

Critical thinking is the ability to evaluate facts and information, remain objective, and make a sound decision about how to move forward.

Does that sound like how you approach every decision or problem? Not so fast. Critical thinking seems simple in theory but is much tougher in practice, which helps explain why 65% of employers say their organization has a need for more critical thinking. 

In reality, critical thinking doesn’t come naturally to a lot of us. In order to do it well, you need to:

• Remain open-minded and inquisitive, rather than relying on assumptions or jumping to conclusions
• Ask questions and dig deep, rather than accepting information at face value
• Keep your own biases and perceptions in check to stay as objective as possible
• Rely on your emotional intelligence to fill in the blanks and gain a more well-rounded understanding of a situation

So, critical thinking isn’t just being intelligent or analytical. In many ways, it requires you to step outside of yourself, let go of your own preconceived notions, and approach a problem or situation with curiosity and fairness.

It’s a challenge, but it’s well worth it. Critical thinking skills will help you connect ideas, make reasonable decisions, and solve complex problems.

7 critical thinking skills to help you dig deeper

Critical thinking is often labeled as a skill itself (you’ll see it bulleted as a desired trait in a variety of job descriptions). But it’s better to think of critical thinking less as a distinct skill and more as a collection or category of skills. 

To think critically, you’ll need to tap into a bunch of your other soft skills. Here are seven of the most important. 

Open-mindedness

It’s important to kick off the critical thinking process with the idea that anything is possible. The more you’re able to set aside your own suspicions, beliefs, and agenda, the better prepared you are to approach the situation with the level of inquisitiveness you need. 

That means not closing yourself off to any possibilities and allowing yourself the space to pull on every thread – yes, even the ones that seem totally implausible.

As Christopher Dwyer, Ph.D. writes in a piece for Psychology Today , “Even if an idea appears foolish, sometimes its consideration can lead to an intelligent, critically considered conclusion.” He goes on to compare the critical thinking process to brainstorming . Sometimes the “bad” ideas are what lay the foundation for the good ones. 

Open-mindedness is challenging because it requires more effort and mental bandwidth than sticking with your own perceptions. Approaching problems or situations with true impartiality often means:

• Practicing self-regulation : Giving yourself a pause between when you feel something and when you actually react or take action.
• Challenging your own biases: Acknowledging your biases and seeking feedback are two powerful ways to get a broader understanding. 

Critical thinking example

In a team meeting, your boss mentioned that your company newsletter signups have been decreasing and she wants to figure out why.

At first, you feel offended and defensive – it feels like she’s blaming you for the dip in subscribers. You recognize and rationalize that emotion before thinking about potential causes. You have a hunch about what’s happening, but you will explore all possibilities and contributions from your team members.

Observation

Observation is, of course, your ability to notice and process the details all around you (even the subtle or seemingly inconsequential ones). Critical thinking demands that you’re flexible and willing to go beyond surface-level information, and solid observation skills help you do that.

Your observations help you pick up on clues from a variety of sources and experiences, all of which help you draw a final conclusion. After all, sometimes it’s the most minuscule realization that leads you to the strongest conclusion.

Over the next week or so, you keep a close eye on your company’s website and newsletter analytics to see if numbers are in fact declining or if your boss’s concerns were just a fluke. 

Critical thinking hinges on objectivity. And, to be objective, you need to base your judgments on the facts – which you collect through research. You’ll lean on your research skills to gather as much information as possible that’s relevant to your problem or situation. 

Keep in mind that this isn’t just about the quantity of information – quality matters too. You want to find data and details from a variety of trusted sources to drill past the surface and build a deeper understanding of what’s happening. 

You dig into your email and website analytics to identify trends in bounce rates, time on page, conversions, and more. You also review recent newsletters and email promotions to understand what customers have received, look through current customer feedback, and connect with your customer support team to learn what they’re hearing in their conversations with customers.

The critical thinking process is sort of like a treasure hunt – you’ll find some nuggets that are fundamental for your final conclusion and some that might be interesting but aren’t pertinent to the problem at hand.

That’s why you need analytical skills. They’re what help you separate the wheat from the chaff, prioritize information, identify trends or themes, and draw conclusions based on the most relevant and influential facts. 

It’s easy to confuse analytical thinking with critical thinking itself, and it’s true there is a lot of overlap between the two. But analytical thinking is just a piece of critical thinking. It focuses strictly on the facts and data, while critical thinking incorporates other factors like emotions, opinions, and experiences. 

As you analyze your research, you notice that one specific webpage has contributed to a significant decline in newsletter signups. While all of the other sources have stayed fairly steady with regard to conversions, that one has sharply decreased.

You decide to move on from your other hypotheses about newsletter quality and dig deeper into the analytics. 

One of the traps of critical thinking is that it’s easy to feel like you’re never done. There’s always more information you could collect and more rabbit holes you could fall down.

But at some point, you need to accept that you’ve done your due diligence and make a decision about how to move forward. That’s where inference comes in. It’s your ability to look at the evidence and facts available to you and draw an informed conclusion based on those. 

When you’re so focused on staying objective and pursuing all possibilities, inference can feel like the antithesis of critical thinking. But ultimately, it’s your inference skills that allow you to move out of the thinking process and onto the action steps. 

You dig deeper into the analytics for the page that hasn’t been converting and notice that the sharp drop-off happened around the same time you switched email providers.

After looking more into the backend, you realize that the signup form on that page isn’t correctly connected to your newsletter platform. It seems like anybody who has signed up on that page hasn’t been fed to your email list. 

Communication

3 ways to improve your communication skills at work

If and when you identify a solution or answer, you can’t keep it close to the vest. You’ll need to use your communication skills to share your findings with the relevant stakeholders – like your boss, team members, or anybody who needs to be involved in the next steps.

Your analysis skills will come in handy here too, as they’ll help you determine what information other people need to know so you can avoid bogging them down with unnecessary details. 

In your next team meeting, you pull up the analytics and show your team the sharp drop-off as well as the missing connection between that page and your email platform. You ask the web team to reinstall and double-check that connection and you also ask a member of the marketing team to draft an apology email to the subscribers who were missed. 

Problem-solving

Critical thinking and problem-solving are two more terms that are frequently confused. After all, when you think critically, you’re often doing so with the objective of solving a problem.

The best way to understand how problem-solving and critical thinking differ is to think of problem-solving as much more narrow. You’re focused on finding a solution.

In contrast, you can use critical thinking for a variety of use cases beyond solving a problem – like answering questions or identifying opportunities for improvement. Even so, within the critical thinking process, you’ll flex your problem-solving skills when it comes time to take action. 

Once the fix is implemented, you monitor the analytics to see if subscribers continue to increase. If not (or if they increase at a slower rate than you anticipated), you’ll roll out some other tests like changing the CTA language or the placement of the subscribe form on the page.

5 ways to improve your critical thinking skills

Beyond the buzzwords: Why interpersonal skills matter at work

Think critically about critical thinking and you’ll quickly realize that it’s not as instinctive as you’d like it to be. Fortunately, your critical thinking skills are learned competencies and not inherent gifts – and that means you can improve them. Here’s how:

• Practice active listening: Active listening helps you process and understand what other people share. That’s crucial as you aim to be open-minded and inquisitive.
• Ask open-ended questions: If your critical thinking process involves collecting feedback and opinions from others, ask open-ended questions (meaning, questions that can’t be answered with “yes” or “no”). Doing so will give you more valuable information and also prevent your own biases from influencing people’s input.
• Scrutinize your sources: Figuring out what to trust and prioritize is crucial for critical thinking. Boosting your media literacy and asking more questions will help you be more discerning about what to factor in. It’s hard to strike a balance between skepticism and open-mindedness, but approaching information with questions (rather than unquestioning trust) will help you draw better conclusions. 
• Play a game: Remember those riddles we mentioned at the beginning? As trivial as they might seem, games and exercises like those can help you boost your critical thinking skills. There are plenty of critical thinking exercises you can do individually or as a team . 
• Give yourself time: Research shows that rushed decisions are often regrettable ones. That’s likely because critical thinking takes time – you can’t do it under the wire. So, for big decisions or hairy problems, give yourself enough time and breathing room to work through the process. It’s hard enough to think critically without a countdown ticking in your brain. 

Critical thinking really is critical

The ability to think critically is important, but it doesn’t come naturally to most of us. It’s just easier to stick with biases, assumptions, and surface-level information. 

But that route often leads you to rash judgments, shaky conclusions, and disappointing decisions. So here’s a conclusion we can draw without any more noodling: Even if it is more demanding on your mental resources, critical thinking is well worth the effort.

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Critical Thinking

Developing the right mindset and skills.

By the Mind Tools Content Team

We make hundreds of decisions every day and, whether we realize it or not, we're all critical thinkers.

We use critical thinking each time we weigh up our options, prioritize our responsibilities, or think about the likely effects of our actions. It's a crucial skill that helps us to cut out misinformation and make wise decisions. The trouble is, we're not always very good at it!

In this article, we'll explore the key skills that you need to develop your critical thinking skills, and how to adopt a critical thinking mindset, so that you can make well-informed decisions.

What Is Critical Thinking?

Critical thinking is the discipline of rigorously and skillfully using information, experience, observation, and reasoning to guide your decisions, actions, and beliefs. You'll need to actively question every step of your thinking process to do it well.

Collecting, analyzing and evaluating information is an important skill in life, and a highly valued asset in the workplace. People who score highly in critical thinking assessments are also rated by their managers as having good problem-solving skills, creativity, strong decision-making skills, and good overall performance. [1]

Key Critical Thinking Skills

Critical thinkers possess a set of key characteristics which help them to question information and their own thinking. Focus on the following areas to develop your critical thinking skills:

Being willing and able to explore alternative approaches and experimental ideas is crucial. Can you think through "what if" scenarios, create plausible options, and test out your theories? If not, you'll tend to write off ideas and options too soon, so you may miss the best answer to your situation.

To nurture your curiosity, stay up to date with facts and trends. You'll overlook important information if you allow yourself to become "blinkered," so always be open to new information.

But don't stop there! Look for opposing views or evidence to challenge your information, and seek clarification when things are unclear. This will help you to reassess your beliefs and make a well-informed decision later. Read our article, Opening Closed Minds , for more ways to stay receptive.

Logical Thinking

You must be skilled at reasoning and extending logic to come up with plausible options or outcomes.

It's also important to emphasize logic over emotion. Emotion can be motivating but it can also lead you to take hasty and unwise action, so control your emotions and be cautious in your judgments. Know when a conclusion is "fact" and when it is not. "Could-be-true" conclusions are based on assumptions and must be tested further. Read our article, Logical Fallacies , for help with this.

Use creative problem solving to balance cold logic. By thinking outside of the box you can identify new possible outcomes by using pieces of information that you already have.

Self-Awareness

Many of the decisions we make in life are subtly informed by our values and beliefs. These influences are called cognitive biases and it can be difficult to identify them in ourselves because they're often subconscious.

Practicing self-awareness will allow you to reflect on the beliefs you have and the choices you make. You'll then be better equipped to challenge your own thinking and make improved, unbiased decisions.

One particularly useful tool for critical thinking is the Ladder of Inference . It allows you to test and validate your thinking process, rather than jumping to poorly supported conclusions.

Developing a Critical Thinking Mindset

Combine the above skills with the right mindset so that you can make better decisions and adopt more effective courses of action. You can develop your critical thinking mindset by following this process:

Gather Information

First, collect data, opinions and facts on the issue that you need to solve. Draw on what you already know, and turn to new sources of information to help inform your understanding. Consider what gaps there are in your knowledge and seek to fill them. And look for information that challenges your assumptions and beliefs.

Be sure to verify the authority and authenticity of your sources. Not everything you read is true! Use this checklist to ensure that your information is valid:

• Are your information sources trustworthy ? (For example, well-respected authors, trusted colleagues or peers, recognized industry publications, websites, blogs, etc.)
• Is the information you have gathered up to date ?
• Has the information received any direct criticism ?
• Does the information have any errors or inaccuracies ?
• Is there any evidence to support or corroborate the information you have gathered?
• Is the information you have gathered subjective or biased in any way? (For example, is it based on opinion, rather than fact? Is any of the information you have gathered designed to promote a particular service or organization?)

If any information appears to be irrelevant or invalid, don't include it in your decision making. But don't omit information just because you disagree with it, or your final decision will be flawed and bias.

Now observe the information you have gathered, and interpret it. What are the key findings and main takeaways? What does the evidence point to? Start to build one or two possible arguments based on what you have found.

You'll need to look for the details within the mass of information, so use your powers of observation to identify any patterns or similarities. You can then analyze and extend these trends to make sensible predictions about the future.

To help you to sift through the multiple ideas and theories, it can be useful to group and order items according to their characteristics. From here, you can compare and contrast the different items. And once you've determined how similar or different things are from one another, Paired Comparison Analysis can help you to analyze them.

The final step involves challenging the information and rationalizing its arguments.

Apply the laws of reason (induction, deduction, analogy) to judge an argument and determine its merits. To do this, it's essential that you can determine the significance and validity of an argument to put it in the correct perspective. Take a look at our article, Rational Thinking , for more information about how to do this.

Once you have considered all of the arguments and options rationally, you can finally make an informed decision.

Afterward, take time to reflect on what you have learned and what you found challenging. Step back from the detail of your decision or problem, and look at the bigger picture. Record what you've learned from your observations and experience.

Critical thinking involves rigorously and skilfully using information, experience, observation, and reasoning to guide your decisions, actions and beliefs. It's a useful skill in the workplace and in life.

You'll need to be curious and creative to explore alternative possibilities, but rational to apply logic, and self-aware to identify when your beliefs could affect your decisions or actions.

You can demonstrate a high level of critical thinking by validating your information, analyzing its meaning, and finally evaluating the argument.

Critical Thinking Infographic

See Critical Thinking represented in our infographic: An Elementary Guide to Critical Thinking .

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Critical Thinking Models: A Comprehensive Guide for Effective Decision Making

Critical thinking models are valuable frameworks that help individuals develop and enhance their critical thinking skills . These models provide a structured approach to problem-solving and decision-making by encouraging the evaluation of information and arguments in a logical, systematic manner. By understanding and applying these models, one can learn to make well-reasoned judgments and decisions.

Various critical thinking models exist, each catering to different contexts and scenarios. These models offer a step-by-step method to analyze situations, scrutinize assumptions and biases, and consider alternative perspectives. Ultimately, the goal of critical thinking models is to enhance an individual’s ability to think critically, ultimately improving their reasoning and decision-making skills in both personal and professional settings.

Key Takeaways

• Critical thinking models provide structured approaches for enhancing decision-making abilities
• These models help individuals analyze situations, scrutinize assumptions, and consider alternative perspectives
• The application of critical thinking models can significantly improve one’s reasoning and judgment skills.

Fundamentals of Critical Thinking

Definition and Importance

Critical thinking is the intellectual process of logically, objectively, and systematically evaluating information to form reasoned judgments, utilizing reasoning , logic , and evidence . It involves:

• Identifying and questioning assumptions,
• Applying consistent principles and criteria,
• Analyzing and synthesizing information,
• Drawing conclusions based on evidence.

The importance of critical thinking lies in its ability to help individuals make informed decisions, solve complex problems, and differentiate between true and false beliefs .

Core Cognitive Skills

Several core cognitive skills underpin critical thinking:

• Analysis : Breaking down complex information into smaller components to identify patterns or inconsistencies.
• Evaluation : Assessing the credibility and relevance of sources, arguments, and evidence.
• Inference : Drawing conclusions by connecting the dots between analyzed information.
• Synthesis : Incorporating analyzed information into a broader understanding and constructing one’s argument.
• Logic and reasoning : Applying principles of logic to determine the validity of arguments and weigh evidence.

These skills enable individuals to consistently apply intellectual standards in their thought process, which ultimately results in sound judgments and informed decisions.

Influence of Cognitive Biases

A key aspect of critical thinking is recognizing and mitigating the impact of cognitive biases on our thought processes. Cognitive biases are cognitive shortcuts or heuristics that can lead to flawed reasoning and distort our understanding of a situation. Examples of cognitive biases include confirmation bias, anchoring bias, and availability heuristic.

To counter the influence of cognitive biases, critical thinkers must be aware of their own assumptions and strive to apply consistent and objective evaluation criteria in their thinking process. The practice of actively recognizing and addressing cognitive biases promotes an unbiased and rational approach to problem-solving and decision-making.

The Critical Thinking Process

Stages of Critical Thinking

The critical thinking process starts with gathering and evaluating data . This stage involves identifying relevant information and ensuring it is credible and reliable. Next, an individual engages in analysis by examining the data closely to understand its context and interpret its meaning. This step can involve breaking down complex ideas into simpler components for better understanding.

The next stage focuses on determining the quality of the arguments, concepts, and theories present in the analyzed data. Critical thinkers question the credibility and logic behind the information while also considering their own biases and assumptions. They apply consistent standards when evaluating sources, which helps them identify any weaknesses in the arguments.

Values play a significant role in the critical thinking process. Critical thinkers assess the significance of moral, ethical, or cultural values shaping the issue, argument, or decision at hand. They determine whether these values align with the evidence and logic they have analyzed.

After thorough analysis and evaluation, critical thinkers draw conclusions based on the evidence and reasoning gathered. This step includes synthesizing the information and presenting a clear, concise argument or decision. It also involves explaining the reasoning behind the conclusion to ensure it is well-founded.

Application in Decision Making

In decision making, critical thinking is a vital skill that allows individuals to make informed choices. It enables them to:

• Analyze options and their potential consequences
• Evaluate the credibility of sources and the quality of information
• Identify biases, assumptions, and values that may influence the decision
• Construct a reasoned, well-justified conclusion

By using critical thinking in decision making, individuals can make more sound, objective choices. The process helps them to avoid pitfalls like jumping to conclusions, being influenced by biases, or basing decisions on unreliable data. The result is more thoughtful, carefully-considered decisions leading to higher quality outcomes.

Critical Thinking Models

Critical thinking models are frameworks that help individuals develop better problem-solving and decision-making abilities. They provide strategies for analyzing, evaluating, and synthesizing information to reach well-founded conclusions. This section will discuss four notable models: The RED Model, Bloom’s Taxonomy, Paul-Elder Model, and The Halpern Critical Thinking Assessment.

The RED Model

The RED Model stands for Recognize Assumptions, Evaluate Arguments, and Draw Conclusions. It emphasizes the importance of questioning assumptions, weighing evidence, and reaching logical conclusions.

• Recognize Assumptions: Identify and challenge assumptions that underlie statements, beliefs, or arguments.
• Evaluate Arguments: Assess the validity and reliability of evidence to support or refute claims.
• Draw Conclusions: Make well-reasoned decisions based on available information and sound reasoning.

The RED Model helps individuals become more effective problem solvers and decision-makers by guiding them through the critical thinking process ^(source) .

Bloom’s Taxonomy

Bloom’s Taxonomy is a hierarchical model that classifies cognitive skills into six levels of complexity. These levels are remembering, understanding, applying, analyzing, evaluating, and creating. By progressing through these levels, individuals can develop higher-order thinking skills.

• Remembering: Recall information or facts.
• Understanding: Comprehend the meaning of ideas, facts, or problems.
• Applying: Use knowledge in different situations.
• Analyzing: Break down complex topics or problems into sub-parts.
• Evaluating: Assess the quality, relevance, or credibility of information, ideas, or solutions.
• Creating: Combine elements to form a new whole, generate new ideas, or solve complex issues.

Paul-Elder Model

The Paul-Elder Model introduces the concept of “elements of thought,” focusing on a structured approach to critical thinking. This model promotes intellectual standards, such as clarity, accuracy, and relevance. It consists of three stages:

• Critical Thinking: Employ the intellectual standards to problem-solving and decision-making processes.
• Elements of Thought: Consider purpose, question at issue, information, interpretation and inference, concepts, assumptions, implications, and point of view.
• Intellectual Traits: Develop intellectual traits, such as intellectual humility, intellectual empathy, and intellectual perseverance.

This model fosters a deeper understanding and appreciation of critical thinking ^(source) .

The Halpern Critical Thinking Assessment

The Halpern Critical Thinking Assessment is a standardized test developed by Diane Halpern to assess critical thinking skills. The evaluation uses a variety of tasks to measure abilities in core skill areas, such as verbal reasoning, argument analysis, and decision making. Pearson, a leading publisher of educational assessments, offers this test as a means to assess individuals’ critical thinking skills ^(source) .

These four critical thinking models can be used as frameworks to improve and enhance cognitive abilities. By learning and practicing these models, individuals can become better equipped to analyze complex information, evaluate options, and make well-informed decisions.

Evaluating Information and Arguments

In this section, we will discuss the importance of evaluating information and arguments in the process of critical thinking, focusing on evidence assessment, logic and fallacies, and argument analysis.

Evidence Assessment

Evaluating the relevance, accuracy, and credibility of information is a vital aspect of critical thinking. In the process of evidence assessment, a thinker should consider the following factors:

• Source reliability : Research and understand the expertise and credibility of the source to ensure that biased or inaccurate information is not being considered.
• Currency : Check the date of the information to make sure it is still relevant and accurate in the present context.
• Objectivity : Analyze the information for potential bias and always cross-reference it with other credible sources.

When practicing critical thinking skills, it is essential to be aware of your own biases and make efforts to minimize their influence on your decision-making process.

Logic and Fallacies

Logic is crucial for deconstructing and analyzing complex arguments, while identifying and avoiding logical fallacies helps maintain accurate and valid conclusions. Some common fallacies to watch out for in critical thinking include:

• Ad Hominem : Attacking the person making the argument instead of addressing the argument itself.
• Strawman : Misrepresenting an opponent’s argument to make it easier to refute.
• False Dilemma : Presenting only two options when there may be multiple viable alternatives.
• Appeal to Authority : Assuming a claim is true simply because an authority figure supports it.

Being aware of these fallacies enables a thinker to effectively evaluate the strength of an argument and make sound judgments accordingly.

Argument Analysis

Analyzing an argument is the process of evaluating its structure, premises, and conclusion while determining its validity and soundness. To analyze an argument, follow these steps:

• Identify the premises and conclusion : Determine the main point is being argued, how it is related and substance of the argument.
• Evaluate the validity : Assess whether the conclusion logically follows from the premises and if the argument’s structure is sound.
• Test the soundness : Evaluate the truth and relevance of the premises. This may require verifying the accuracy of facts and evidence, as well as assessing the reliability of sources.
• Consider counter-arguments : Identify opposing viewpoints and counter-arguments, and evaluate their credibility to gauge the overall strength of the original argument.

By effectively evaluating information and arguments, critical thinkers develop a solid foundation for making well-informed decisions and solving problems.

Enhancing Critical Thinking

Strategies for improvement.

To enhance critical thinking, individuals can practice different strategies, including asking thought-provoking questions, analyzing ideas and observations, and being open to different perspectives. One effective technique is the Critical Thinking Roadmap , which breaks critical thinking down into four measurable phases: execute, synthesize, recommend, and communicate. It’s important to use deliberate practice in these areas to develop a strong foundation for problem-solving and decision-making. In addition, cultivating a mindset of courage , fair-mindedness , and empathy will support critical thinking development.

Critical Thinking in Education

In the field of education, critical thinking is an essential component of effective learning and pedagogy. Integrating critical thinking into the curriculum encourages student autonomy, fosters innovation, and improves student outcomes. Teachers can use various approaches to promote critical thinking, such as:

• Employing open-ended questions to stimulate ideas
• Incorporating group discussions or debates to facilitate communication and evaluation of viewpoints
• Assessing and providing feedback on student work to encourage reflection and improvement
• Utilizing real-world scenarios and case studies for practical application of concepts

Developing a Critical Thinking Mindset

To truly enhance critical thinking abilities, it’s important to adopt a mindset that values integrity , autonomy , and empathy . These qualities help to create a learning environment that encourages open-mindedness, which is key to critical thinking development. To foster a critical thinking mindset:

• Be curious : Remain open to new ideas and ask questions to gain a deeper understanding.
• Communicate effectively : Clearly convey thoughts and actively listen to others.
• Reflect and assess : Regularly evaluate personal beliefs and assumptions to promote growth.
• Embrace diversity of thought : Welcome different viewpoints and ideas to foster innovation.

Incorporating these approaches can lead to a more robust critical thinking skillset, allowing individuals to better navigate and solve complex problems.

Critical Thinking in Various Contexts

The workplace and beyond.

Critical thinking is a highly valued skill in the workplace, as it enables employees to analyze situations, make informed decisions, and solve problems effectively. It involves a careful thinking process directed towards a specific goal. Employers often seek individuals who possess strong critical thinking abilities, as they can add significant value to the organization.

In the workplace context, critical thinkers are able to recognize assumptions, evaluate arguments, and draw conclusions, following models such as the RED model . They can also adapt their thinking to suit various scenarios, allowing them to tackle complex and diverse problems.

Moreover, critical thinking transcends the workplace and applies to various aspects of life. It empowers an individual to make better decisions, analyze conflicting information, and engage in constructive debates.

Creative and Lateral Thinking

Critical thinking encompasses both creative and lateral thinking. Creative thinking involves generating novel ideas and solutions to problems, while lateral thinking entails looking at problems from different angles to find unique and innovative solutions.

Creative thinking allows thinkers to:

• Devise new concepts and ideas
• Challenge conventional wisdom
• Build on existing knowledge to generate innovative solutions

Lateral thinking, on the other hand, encourages thinkers to:

• Break free from traditional thought patterns
• Combine seemingly unrelated ideas to create unique solutions
• Utilize intuition and intelligence to approach problems from a different perspective

Both creative and lateral thinking are essential components of critical thinking, allowing individuals to view problems in a holistic manner and generate well-rounded solutions. These skills are highly valued by employers and can lead to significant personal and professional growth.

In conclusion, critical thinking is a multifaceted skill that comprises various thought processes, including creative and lateral thinking. By embracing these skills, individuals can excel in the workplace and in their personal lives, making better decisions and solving problems effectively.

Overcoming Challenges

Recognizing and addressing bias.

Cognitive biases and thinking biases can significantly affect the process of critical thinking . One of the key components of overcoming these challenges is to recognize and address them. It is essential to be aware of one’s own beliefs, as well as the beliefs of others, to ensure fairness and clarity throughout the decision-making process. To identify and tackle biases, one can follow these steps:

• Be self-aware : Understand personal beliefs and biases, acknowledging that they may influence the interpretation of information.
• Embrace diverse perspectives : Encourage open discussions and invite different viewpoints to challenge assumptions and foster cognitive diversity.
• Reevaluate evidence : Continuously reassess the relevance and validity of the information being considered.

By adopting these practices, individuals can minimize the impact of biases and enhance the overall quality of their critical thinking skills.

Dealing with Information Overload

In today’s world, information is abundant, and it can become increasingly difficult to demystify and make sense of the available data. Dealing with information overload is a crucial aspect of critical thinking. Here are some strategies to address this challenge:

• Prioritize information : Focus on the most relevant and reliable data, filtering out unnecessary details.
• Organize data : Use tables, charts, and lists to categorize information and identify patterns more efficiently.
• Break down complex information : Divide complex data into smaller, manageable segments to simplify interpretation and inferences.

By implementing these techniques, individuals can effectively manage information overload, enabling them to process and analyze data more effectively, leading to better decision-making.

In conclusion, overcoming challenges such as biases and information overload is essential in the pursuit of effective critical thinking. By recognizing and addressing these obstacles, individuals can develop clarity and fairness in their thought processes, leading to well-informed decisions and improved problem-solving capabilities.

Measuring Critical Thinking

Assessment tools and criteria.

There are several assessment tools designed to measure critical thinking, each focusing on different aspects such as quality, depth, breadth, and significance of thinking. One example of a widely used standardized test is the Watson-Glaser Critical Thinking Appraisal , which evaluates an individual’s ability to interpret information, draw conclusions, and make assumptions. Another test is the Cornell Critical Thinking Tests Level X and Level Z , which assess an individual’s critical thinking skills through multiple-choice questions.

Furthermore, criteria for assessing critical thinking often include precision, relevance, and the ability to gather and analyze relevant information. Some assessors utilize the Halpern Critical Thinking Assessment , which measures the application of cognitive skills such as deduction, observation, and induction in real-world scenarios.

The Role of IQ and Tests

It’s important to note that intelligence quotient (IQ) tests and critical thinking assessments are not the same. While IQ tests aim to measure an individual’s cognitive abilities and general intelligence, critical thinking tests focus specifically on one’s ability to analyze, evaluate, and form well-founded opinions. Therefore, having a high IQ does not necessarily guarantee strong critical thinking skills, as critical thinking requires additional mental processes beyond basic logical reasoning.

To build and enhance critical thinking skills, individuals should practice and develop higher-order thinking, such as critical alertness, critical reflection, and critical analysis. Using a Critical Thinking Roadmap , such as the four-phase framework that includes execution, synthesis, recommendation, and the ability to apply, individuals can continuously work to improve their critical thinking abilities.

Frequently Asked Questions

What are the main steps involved in the paul-elder critical thinking model.

The Paul-Elder Critical Thinking Model is a comprehensive framework for developing critical thinking skills. The main steps include: identifying the purpose, formulating questions, gathering information, identifying assumptions, interpreting information, and evaluating arguments. The model emphasizes clarity, accuracy, precision, relevance, depth, breadth, logic, and fairness throughout the critical thinking process. By following these steps, individuals can efficiently analyze and evaluate complex ideas and issues.

Can you list five techniques to enhance critical thinking skills?

Here are five techniques to help enhance critical thinking skills:

• Ask open-ended questions : Encourages exploration and challenges assumptions.
• Engage in active listening: Focus on understanding others’ viewpoints before responding.
• Reflect on personal biases: Identify and question any preconceived notions or judgments.
• Practice mindfulness: Develop self-awareness and stay present in the moment.
• Collaborate with others: Exchange ideas and learn from diverse perspectives.

What is the RED Model of critical thinking and how is it applied?

The RED Model of critical thinking consists of three key components: Recognize Assumptions, Evaluate Arguments, and Draw Conclusions. To apply the RED Model, begin by recognizing and questioning underlying assumptions, being aware of personal biases and stereotypes. Next, evaluate the strengths and weaknesses of different arguments, considering evidence, logical consistency, and alternative explanations. Lastly, draw well-reasoned conclusions that are based on the analysis and evaluation of the information gathered.

How do the ‘3 C’s’ of critical thinking contribute to effective problem-solving?

The ‘3 C’s’ of critical thinking – Curiosity, Creativity, and Criticism – collectively contribute to effective problem-solving. Curiosity allows individuals to explore various perspectives and ask thought-provoking questions, while Creativity helps develop innovative solutions and unique approaches to challenges. Criticism, or the ability to evaluate and analyze ideas objectively, ensures that the problem-solving process remains grounded in logic and relevance.

What characteristics distinguish critical thinking from creative thinking?

Critical thinking and creative thinking are two complementary cognitive skills. Critical thinking primarily focuses on analyzing, evaluating, and reasoning, using objectivity and logical thinking. It involves identifying problems, assessing evidence, and drawing sound conclusions. Creative thinking, on the other hand, is characterized by the generation of new ideas, concepts, and approaches to solve problems, often involving imagination, originality, and out-of-the-box thinking.

What are some recommended books to help improve problem-solving and critical thinking skills?

There are several books that can help enhance problem-solving and critical thinking skills, including:

• “Thinking, Fast and Slow” by Daniel Kahneman: This book explores the dual process theory of decision-making and reasoning.
• “The 5 Elements of Effective Thinking” by Edward B. Burger and Michael Starbird: Offers practical tips and strategies for improving critical thinking skills.
• “Critique of Pure Reason” by Immanuel Kant: A classic philosophical work that delves into the principles of reason and cognition.
• “Mindware: Tools for Smart Thinking” by Richard E. Nisbett: Presents a range of cognitive tools to enhance critical thinking and decision-making abilities.
• “The Art of Thinking Clearly” by Rolf Dobelli: Explores common cognitive biases and errors in judgment that can affect critical thinking.

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Critical Thinking Is About Asking Better Questions

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Six practices to sharpen your inquiry.

Critical thinking is the ability to analyze and effectively break down an issue in order to make a decision or find a solution. At the heart of critical thinking is the ability to formulate deep, different, and effective questions. For effective questioning, start by holding your hypotheses loosely. Be willing to fundamentally reconsider your initial conclusions — and do so without defensiveness. Second, listen more than you talk through active listening. Third, leave your queries open-ended, and avoid yes-or-no questions. Fourth, consider the counterintuitive to avoid falling into groupthink. Fifth, take the time to stew in a problem, rather than making decisions unnecessarily quickly. Last, ask thoughtful, even difficult, follow-ups.

Are you tackling a new and difficult problem at work? Recently promoted and trying to both understand your new role and bring a fresh perspective? Or are you new to the workforce and seeking ways to meaningfully contribute alongside your more experienced colleagues? If so, critical thinking — the ability to analyze and effectively break down an issue in order to make a decision or find a solution — will be core to your success. And at the heart of critical thinking is the ability to formulate deep, different, and effective questions.

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Critical Thinking and Decision-Making  - Decision-Making Strategies

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Critical Thinking and Decision-Making: Decision-Making Strategies

Lesson 3: decision-making strategies.

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How do you usually make decisions?

There are lots of ways to make a decision . For example, you could flip a coin. You could trust your gut and do what you think is right. Or you could avoid thinking about it at all, and just make a choice at random—for better or for worse.

That's probably OK for small decisions, but what about more important ones? It's better to think carefully about your options and consider the many paths you could take.

With the right tools, you can learn to do this objectively , so you can make decisions you feel good about. We're going to cover several strategies that can help.

Watch the video below to learn more about decision-making strategies.

Making decisions objectively

The first step to making any decision is simple: Identify the problem . As an example, say you're trying to choose between two apartments. One is cheaper but farther away from work. The other is closer—and nicer!—but much more expensive.

Which one would you choose? Depending on what you value, you probably have some idea. This initial response, the one tied to your instincts and emotions , is perfectly valid; however, you should also try to look at your options rationally .

Comparing your options

Start by comparing them. There are several ways to do this. For example, you could list all the factors that you're considering—things like price, location, and other amenities—then choose the one thing that's most important to you. With that in mind, which option comes out on top?

Creating a points system

You could go one step further and create a points system . Take that same list and turn it into a scorecard for each option.

In this example, it means the first apartment would score high on affordable rent (let's say a 10), but much lower on location . The other apartment would score about the opposite in the same categories.

Keep going down the list until you've scored every item, being as objective as you can. Then add up the totals, and see if you have a winner.

Identifying pros and cons

Looking at it another way, you could evaluate one option at a time using a list of pros and cons. It sounds simple, but sometimes it helps to write these things down.

This time, it's OK to be subjective —certain factors can and should carry more weight than others. It's how you feel about them that counts, so be honest about what these things mean to you.

Thinking about the consequences

Imagining possible outcomes might give you some perspective on the decision. Say you're thinking about adopting a dog. What do you think the consequences might be in a month? In a year? How about several years from now?

Making decisions can be a roller coaster ride, especially when there are long-term consequences to think about. We can't see into the future, but we can try to be prepared.

Other mental tricks

At this point, it's normal to feel overwhelmed, even stuck. With so much to consider, how do you know you're making the right choice? There are a couple more techniques that can help you fire up your brain and trick it into thinking differently . Try these the next time you need a mental reset.

The two-minute diversion

Distract yourself with a two-minute activity that you find moderately difficult . Maybe you like playing mobile games, or solving math problems for fun—whatever works for you (we won't judge).

Believe it or not, you'll continue to process the decision unconsciously , according to brain imaging research by Carnegie Mellon University. This brief window of time helps you internalize important details, so you can make better, more insightful decisions.

Thinking in third person

Sometimes it helps to step outside yourself and pretend you're helping someone else . Studies show we're able to think more objectively in third person —that's why it's easier to give advice than it is to receive it.

If a friend or family member were struggling with the same decision, what questions would you ask them? What compromises would you suggest?

Really think about it. Adopting a different point of view might help you see the situation in an entirely new way.

Making decisions with confidence

Making decisions isn't like taking a test. There are no right or wrong answers, per se—it just depends on the situation.

Focus on taking the time to think about your options and what you hope to achieve so you can feel confident about the choices you make. It's not as easy as flipping a coin, but it's worth the extra effort.

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5.3: Using Critical Thinking Skills- Decision Making and Problem Solving

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Introduction

In previous lessons, you learned about characteristics of critical thinkers and information literacy. In this module, you will learn how to put those skills into action through the important processes of decision making and problem solving.

As with the process of developing information literacy, asking questions is an important part of decision making and problem solving. Thinking is born of questions. Questions wake us up. Questions alert us to hidden assumptions. Questions promote curiosity and create new distinctions. Questions open up options that otherwise go unexplored. Besides, teachers love questions.

We make decisions all the time, whether we realize it or not. Even avoiding decisions is a form of decision making. The student who puts off studying for a test until the last minute, for example, might really be saying, “I’ve decided this course is not important” or “I’ve decided not to give this course much time.”

Decisions are specific and lead to focused action. When we decide, we narrow down. We give up actions that are inconsistent with our decision.

In addition to decision making, critical thinking skills are important to solving problems. We encounter problems every single day, and having a solid process in place is important to solving them.

At the end of the lesson, you will learn how to put your critical thinking skills to use by reviewing an example of how critical thinking skills can help with making those everyday decisions.

Using Critical Thinking Skills: Asking Questions

Questions have practical power. Asking for directions can shave hours off a trip. Asking a librarian for help can save hours of research time. Asking how to address an instructor—by first name or formal title—can change your relationship with that person. Asking your academic advisor a question can alter your entire education. Asking people about their career plans can alter your career plans.

You can use the following strategies to develop questions for problem solving and decision making:

Ask questions that create possibilities. At any moment, you can ask a question that opens up a new possibility for someone.

• Suppose a friend walks up to you and says, “People just never listen to me.” You listen carefully. Then you say, “Let me make sure I understand. Who, specifically, doesn’t listen to you? And how do you know they’re not listening?”
• Another friend tells you, “I just lost my job to someone who has less experience. That should never happen.” You respond, “Wow, that’s hard. I’m sorry you lost your job. Who can help you find another job?”
• A relative seeks your advice. “My mother-in-law makes me mad,” she says. “You’re having a hard time with this person,” you say. “What does she say and do when you feel mad at her? And are there times when you don’t get mad at her?”

These kinds of questions—asked with compassion and a sense of timing—can help people move from complaining about problems to solving them.

Discover new questions. Students sometimes say, “I don’t know what questions to ask.” Consider the following ways to create questions about any subject you want to study or about any

area of your life that you want to change:

• Let your pen start moving. Sometimes you can access a deeper level of knowledge by taking out your pen, putting it on a piece of paper, and writing down questions—even before you know what to write. Don’t think. Just watch the pen move across the paper. Notice what appears. The results might be surprising.
• Ask about what’s missing . Another way to invent useful questions is to notice what’s missing from your life and then ask how to supply it. For example, if you want to take better notes, you can write, “What’s missing is skill in note taking. How can I gain more skill in taking notes?” If you always feel rushed, you can write, “What’s missing is time. How do I create enough time in my day to actually do the things that I say I want to do?”
• Pretend to be someone else. Another way to invent questions is first to think of someone you greatly respect. Then pretend you’re that person. Ask the questions you think she would ask.
• What can I do when ... an instructor calls on me in class and I have no idea what to say? When a teacher doesn’t show up for class on time? When I feel overwhelmed with assignments?
• How can I ... take the kind of courses that I want? Expand my career options? Become much more effective as a student, starting today?
• When do I ... decide on a major? Transfer to another school? Meet with an instructor to discuss an upcoming term paper?
• What else do I want to know about ... my academic plan? My career plan? My options for job hunting? My friends? My relatives? My spouse?
• Who can I ask about ... my career options? My major? My love life? My values and purpose in life?

Many times you can quickly generate questions by simply asking yourself, “What else do I want to know?” Ask this question immediately after you read a paragraph in a book or listen to someone speak.

Start from the assumption that you are brilliant. Then ask questions to unlock your brilliance.

Using Critical Thinking Skills in Decision Making

As you develop your critical thinking skills, you can apply them as you make decisions. The following suggestions can help in your decision-making process:

Recognize decisions. Decisions are more than wishes or desires. There’s a world of difference between “I wish I could be a better student” and “I will take more powerful notes, read with greater retention, and review my class notes daily.” Deciding to eat fruit for dessert instead of ice cream rules out the next trip to the ice cream store.

Establish priorities. Some decisions are trivial. No matter what the outcome, your life is not affected much. Other decisions can shape your circumstances for years. Devote more time and energy to the decisions with big outcomes.

Base decisions on a life plan. The benefit of having long-term goals for our lives is that they provide a basis for many of our daily decisions. Being certain about what we want to accomplish this year and this month makes today’s choices more clear.

Balance learning styles in decision making. To make decisions more effectively, use all four modes of learning explained in a previous lesson. The key is to balance reflection with action, and thinking with experience. First, take the time to think creatively, and generate many options. Then think critically about the possible consequences of each option before choosing one. Remember, however, that thinking is no substitute for experience. Act on your chosen option, and notice what happens. If you’re not getting the results you want, then quickly return to creative thinking to invent new options.

Choose an overall strategy. Every time you make a decision, you choose a strategy—even when you’re not aware of it. Effective decision makers can articulate and choose from among several strategies. For example:

• Find all of the available options, and choose one deliberately. Save this strategy for times when you have a relatively small number of options, each of which leads to noticeably different results.
• Find all of the available options, and choose one randomly. This strategy can be risky. Save it for times when your options are basically similar and fairness is the main issue.
• Limit the options, and then choose. When deciding which search engine to use, visit many search sites and then narrow the list down to two or three from which to choose.

Use time as an ally. Sometimes we face dilemmas—situations in which any course of action leads to undesirable consequences. In such cases, consider putting a decision on hold. Wait it out. Do nothing until the circumstances change, making one alternative clearly preferable to another.

Use intuition. Some decisions seem to make themselves. A solution pops into your mind, and you gain newfound clarity. Using intuition is not the same as forgetting about the decision or refusing to make it. Intuitive decisions usually arrive after we’ve gathered the relevant facts and faced a problem for some time.

Evaluate your decision. Hindsight is a source of insight. After you act on a decision, observe the consequences over time. Reflect on how well your decision worked and what you might have done differently.

Think of choices. This final suggestion involves some creative thinking. Consider that the word decide derives from the same roots as suicide and homicide . In the spirit of those words, a decision forever “kills” all other options. That’s kind of heavy. Instead, use the word choice , and see whether it frees up your thinking. When you choose , you express a preference for one option over others. However, those options remain live possibilities for the future. Choose for today, knowing that as you gain more wisdom and experience, you can choose again.

Using Critical Thinking Skills in Problem Solving

Think of problem solving as a process with four Ps : Define the problem , generate possibilities ,

create a plan , and perform your plan.

Step 1: Define the problem. To define a problem effectively, understand what a problem is—a mismatch between what you want and what you have. Problem solving is all about reducing the gap between these two factors.

Tell the truth about what’s present in your life right now, without shame or blame. For example: “I often get sleepy while reading my physics assignments, and after closing the book I cannot remember what I just read.”

Next, describe in detail what you want. Go for specifics: “I want to remain alert as I read about physics. I also want to accurately summarize each chapter I read.”

Remember that when we define a problem in limiting ways, our solutions merely generate new problems. As Albert Einstein said, “The world we have made is a result of the level of thinking we have done thus far. We cannot solve problems at the same level at which we created them” (Calaprice 2000).

This idea has many applications for success in school. An example is the student who struggles with note taking. The problem, she thinks, is that her notes are too sketchy. The logical solution, she decides, is to take more notes; her new goal is to write down almost everything her instructors say. No matter how fast and furiously she writes, she cannot capture all of the instructors’ comments.

Consider what happens when this student defines the problem in a new way. After more thought, she decides that her dilemma is not the quantity of her notes but their quality . She adopts a new format for taking notes, dividing her notepaper into two columns. In the right-hand column, she writes down only the main points of each lecture. In the left-hand column, she notes two or three supporting details for each point.

Over time, this student makes the joyous discovery that there are usually just three or four core ideas to remember from each lecture. She originally thought the solution was to take more notes. What really worked was taking notes in a new way.

Step 2: Generate possibilities. Now put on your creative thinking hat. Open up. Brainstorm as many possible solutions to the problem as you can. At this stage, quantity counts. As you generate possibilities, gather relevant facts. For example, when you’re faced with a dilemma about what courses to take next semester, get information on class times, locations, and instructors. If you haven’t decided which summer job offer to accept, gather information on salary, benefits, and working conditions.

Step 3: Create a plan. After rereading your problem definition and list of possible solutions, choose the solution that seems most workable. Think about specific actions that will reduce the gap between what you have and what you want. Visualize the steps you will take to make this solution a reality, and arrange them in chronological order. To make your plan even more powerful, put it in writing.

Step 4: Perform your plan. This step gets you off your chair and out into the world. Now you actually do what you have planned.

Ultimately, your skill in solving problems lies in how well you perform your plan. Through the quality of your actions, you become the architect of your own success.

When facing problems, experiment with these four Ps, and remember that the order of steps is not absolute. Also remember that any solution has the potential to create new problems. If that happens, cycle through the four Ps of problem solving again.

Critical Thinking Skills in Action: Thinking About Your Major, Part 1

One decision that troubles many students in higher education is the choice of a major. Weighing the benefits, costs, and outcomes of a possible major is an intellectual challenge. This choice is an opportunity to apply your critical thinking, decision-making, and problem-solving skills. The following suggestions will guide you through this seemingly overwhelming process.

The first step is to discover options. You can use the following suggestions to discover options for choosing your major:

Follow the fun. Perhaps you look forward to attending one of your classes and even like completing the assignments. This is a clue to your choice of major.

See whether you can find lasting patterns in the subjects and extracurricular activities that you’ve enjoyed over the years. Look for a major that allows you to continue and expand on these experiences.

Also, sit down with a stack of 3 × 5 cards and brainstorm answers to the following questions:

• What do you enjoy doing most with your unscheduled time?
• Imagine that you’re at a party and having a fascinating conversation. What is this conversation about?
• What kind of problems do you enjoy solving—those that involve people? Products? Ideas?
• What interests are revealed by your choices of reading material, television shows, and other entertainment?
• What would an ideal day look like for you? Describe where you would live, who would be with you, and what you would do throughout the day. Do any of these visions suggest a possible major?

Questions like these can uncover a “fun factor” that energizes you to finish the work of completing a major.

Consider your abilities. In choosing a major, ability counts as much as interest. In addition to considering what you enjoy, think about times and places when you excelled. List the courses that you aced, the work assignments that you mastered, and the hobbies that led to rewards or recognition. Let your choice of a major reflect a discovery of your passions and potentials.

Use formal techniques for self-discovery. Explore questionnaires and inventories that are designed to correlate your interests with specific majors. Examples include the Strong Interest Inventory and the Self-Directed Search. Your academic advisor or someone in your school’s career planning office can give you more details about these and related assessments. For some fun, take several of them and meet with an advisor to interpret the results. Remember inventories can help you gain self-knowledge, and other people can offer valuable perspectives. However, what you do with all this input is entirely up to you.

Critical Thinking Skills in Action: Thinking About Your Major, Part 2

As you review the following additional suggestions of discovering options, think about what strategies you already use in your own decision-making process. Also think about what new strategies you might try in the future.

Link to long-term goals. Your choice of a major can fall into place once you determine what you want in life. Before you choose a major, back up to a bigger picture. List your core values, such as contributing to society, achieving financial security and professional recognition, enjoying good health, or making time for fun. Also write down specific goals that you want to accomplish 5 years, 10 years, or even 50 years from today.

Many students find that the prospect of getting what they want in life justifies all of the time, money, and day-to-day effort invested in going to school. Having a major gives you a powerful incentive for attending classes, taking part in discussions, reading textbooks, writing papers, and completing other assignments. When you see a clear connection between finishing school and creating the life of your dreams, the daily tasks of higher education become charged with meaning.

Ask other people. Key people in your life might have valuable suggestions about your choice of major. Ask for their ideas, and listen with an open mind. At the same time, distance yourself from any pressure to choose a major or career that fails to interest you. If you make a choice solely on the basis of the expectations of other people, you could end up with a major or even a career you don’t enjoy.

Gather information. Check your school’s catalog or website for a list of available majors. Here is a gold mine of information. Take a quick glance, and highlight all the majors that interest you. Then talk to students who have declared these majors. Also read the descriptions of courses required for these majors. Do you get excited about the chance to enroll in them? Pay attention to your gut feelings.

Also chat with instructors who teach courses in a specific major. Ask for copies of their class syllabi. Go to the bookstore and browse the required texts. Based on all of this information, write a list of prospective majors. Discuss them with an academic advisor and someone at your school’s career-planning center.

Invent a major. When choosing a major, you might not need to limit yourself to those listed in your school catalog. Many schools now have flexible programs that allow for independent study. Through such programs, you might be able to combine two existing majors or invent an entirely new one of your own.

Consider a complementary minor. You can add flexibility to your academic program by choosing a minor to complement or contrast with your major. The student who wants to be a minister could opt for a minor in English; all of those courses in composition can help in writing sermons. Or the student with a major in psychology might choose a minor in business administration, with the idea of managing a counseling service some day. An effective choice of a minor can expand your skills and career options.

Think critically about the link between your major and your career. Your career goals might have a significant impact on your choice of major.

You could pursue a rewarding career by choosing among several different majors. Even students planning to apply for law school or medical school have flexibility in their choice of majors. In addition, after graduation, many people tend to be employed in jobs that have little relationship to their major. And you might choose a career in the future that is unrelated to any currently available major.

Critical Thinking Skills in Action: Thinking About Your Major, Part 3

Once you have discovered all of your options, you can move on to the next step in the process— making a trial choice.

Make a Trial Choice

Pretend that you have to choose a major today. Based on the options for a major that you’ve already discovered, write down the first three ideas that come to mind. Review the list for a few minutes, and then choose one.

Evaluate Your Trial Choice

When you’ve made a trial choice of major, take on the role of a scientist. Treat your choice as a hypothesis, and then design a series of experiments to evaluate and test it. For example:

• Schedule office meetings with instructors who teach courses in the major. Ask about required course work and career options in the field.
• Discuss your trial choice with an academic advisor or career counselor.
• Enroll in a course related to your possible major. Remember that introductory courses might not give you a realistic picture of the workload involved in advanced courses. Also, you might not be able to register for certain courses until you’ve actually declared a related major.
• Find a volunteer experience, internship, part-time job, or service-learning experience related to the major.
• Interview students who have declared the same major. Ask them in detail about their experiences and suggestions for success.
• Interview people who work in a field related to the major and “shadow” them—that is, spend time with those people during their workday.
• Think about whether you can complete your major given the amount of time and money that you plan to invest in higher education.
• Consider whether declaring this major would require a transfer to another program or even another school.

If your “experiments” confirm your choice of major, celebrate that fact. If they result in choosing a new major, celebrate that outcome as well.

Also remember that higher education represents a safe place to test your choice of major—and to change your mind. As you sort through your options, help is always available from administrators, instructors, advisors, and peers.

Choose Again

Keep your choice of a major in perspective. There is probably no single “correct” choice. Your unique collection of skills is likely to provide the basis for majoring in several fields.

Odds are that you’ll change your major at least once—and that you’ll change careers several times during your life. One benefit of higher education is mobility. You gain the general skills and knowledge that can help you move into a new major or career field at any time.

Viewing a major as a one-time choice that determines your entire future can raise your stress levels. Instead, look at choosing a major as the start of a continuing path that involves discovery, choice, and passionate action.

As you review this example of how you can use critical thinking to make a decision about choosing your major, think about how you will use your critical thinking to make decisions and solve problems in the future.

Critical Thinking, Decision Making, and Problem Solving

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The Joint Matriculation Board published each year reports of how the candidates performed in each of the questions. One comment on a question in engineering science was published by Carter, Heywood and Kelly (i). It illustrates just how difficult it is to design such questions. The report reads: “The figure (not shown here) represents some of the more important parts of a single bar, 1 kw radiant electric fire. Discuss the purpose of these components and suggest a suitable material for each. (Base your discussion on the function each part has to fulfil and requisite physical properties). Discuss the other factors that a manufacturer would consider in producing the components from particular materials. Describe and suggest materials for other parts which you believe will be necessary for satisfactory use of the fire, but which has not been indicated in the sketch.” 77 The examiners published comment on the answers was: “This was the most popular question and the most badly done. Only one of the two candidates calculated the resistance required for the element. Candidates tended not to answer the questions asked. E.g., they did not state the function of each of the parts of the fire and materials were often suggested without reasons. Candidates stated factors the manufacturer should consider, without discussion. The question was answered on the whole in too facile a number.” In (i) they expanded on this type of question as follows, “Although this type of question suffered from superficiality of response it was retained in similar form as a component of the examination for six years. However, significant attempts were made to direct candidates’ answers into more detailed engineering analyses of the problems set, by the requiring statements relevant, for example, to improved safety and efficiency, broadening the range of use or versatility of the device, and by specifying more closely, the parameters which were of most importance, e.g., electrical, mechanical, thermal or optical properties. Although this further guidance was given, the Examiners’ reports continued to indicate that a significant proportion of the candidates’ answers were superficial, and that the necessary skills for attempting such questions were not being fully developed by the curriculum study as hoped. In the seventh year, therefore, this type ofquestion was modified to consider not engineering devices, but engineering situations, and the methods of achieving solutions under a variety of constraints. Thus, in the next examination a question was set about the design of a technician’s preparation room and the modifications to the design which would be necessary by imposition of a 50% reduction in available finance after the first design stage. The topic was deliberately chosen to lie within the familiarity and experience of the candidates; logical argument and judgement about possible alternative solutions were required from the candidate. The realities of life were introduced into the question through economic constraints and the skills of evaluation and judgement were tested. This type of question is generally, most difficult to assess but with experience the examiners are readily able to evaluate the cogent and relevant arguments and detect the simplistic and facile. Since the introduction ofthis type ofquestion, there have been many excellent answers and there have been some signs ofa general improvement in the candidates’ engineering reasoning, synthesis and evaluative ability.” (i) Carter, G., Heywood, J., and D. T. Kelly (1986). Case Study in Curriculum Assessment. GCE Engineering Science (Advanced). Manchester. Roundthorn Press.

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Heywood, J. (2018). Critical Thinking, Decision Making, and Problem Solving. In: Empowering Professional Teaching in Engineering. Synthesis Lectures on Engineering. Springer, Cham. https://doi.org/10.1007/978-3-031-79382-0_6

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Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr.

Patient Safety and Quality: An Evidence-Based Handbook for Nurses.

Chapter 6 clinical reasoning, decisionmaking, and action: thinking critically and clinically.

Patricia Benner ; Ronda G. Hughes ; Molly Sutphen .

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This chapter examines multiple thinking strategies that are needed for high-quality clinical practice. Clinical reasoning and judgment are examined in relation to other modes of thinking used by clinical nurses in providing quality health care to patients that avoids adverse events and patient harm. The clinician’s ability to provide safe, high-quality care can be dependent upon their ability to reason, think, and judge, which can be limited by lack of experience. The expert performance of nurses is dependent upon continual learning and evaluation of performance.

• Critical Thinking

Nursing education has emphasized critical thinking as an essential nursing skill for more than 50 years. 1 The definitions of critical thinking have evolved over the years. There are several key definitions for critical thinking to consider. The American Philosophical Association (APA) defined critical thinking as purposeful, self-regulatory judgment that uses cognitive tools such as interpretation, analysis, evaluation, inference, and explanation of the evidential, conceptual, methodological, criteriological, or contextual considerations on which judgment is based. 2 A more expansive general definition of critical thinking is

. . . in short, self-directed, self-disciplined, self-monitored, and self-corrective thinking. It presupposes assent to rigorous standards of excellence and mindful command of their use. It entails effective communication and problem solving abilities and a commitment to overcome our native egocentrism and sociocentrism. Every clinician must develop rigorous habits of critical thinking, but they cannot escape completely the situatedness and structures of the clinical traditions and practices in which they must make decisions and act quickly in specific clinical situations. 3

There are three key definitions for nursing, which differ slightly. Bittner and Tobin defined critical thinking as being “influenced by knowledge and experience, using strategies such as reflective thinking as a part of learning to identify the issues and opportunities, and holistically synthesize the information in nursing practice” 4 (p. 268). Scheffer and Rubenfeld 5 expanded on the APA definition for nurses through a consensus process, resulting in the following definition:

Critical thinking in nursing is an essential component of professional accountability and quality nursing care. Critical thinkers in nursing exhibit these habits of the mind: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, openmindedness, perseverance, and reflection. Critical thinkers in nursing practice the cognitive skills of analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting, and transforming knowledge 6 (Scheffer & Rubenfeld, p. 357).

The National League for Nursing Accreditation Commission (NLNAC) defined critical thinking as:

the deliberate nonlinear process of collecting, interpreting, analyzing, drawing conclusions about, presenting, and evaluating information that is both factually and belief based. This is demonstrated in nursing by clinical judgment, which includes ethical, diagnostic, and therapeutic dimensions and research 7 (p. 8).

These concepts are furthered by the American Association of Colleges of Nurses’ definition of critical thinking in their Essentials of Baccalaureate Nursing :

Critical thinking underlies independent and interdependent decision making. Critical thinking includes questioning, analysis, synthesis, interpretation, inference, inductive and deductive reasoning, intuition, application, and creativity 8 (p. 9).

Course work or ethical experiences should provide the graduate with the knowledge and skills to:

• Use nursing and other appropriate theories and models, and an appropriate ethical framework;
• Apply research-based knowledge from nursing and the sciences as the basis for practice;
• Use clinical judgment and decision-making skills;
• Engage in self-reflective and collegial dialogue about professional practice;
• Evaluate nursing care outcomes through the acquisition of data and the questioning of inconsistencies, allowing for the revision of actions and goals;
• Engage in creative problem solving 8 (p. 10).

Taken together, these definitions of critical thinking set forth the scope and key elements of thought processes involved in providing clinical care. Exactly how critical thinking is defined will influence how it is taught and to what standard of care nurses will be held accountable.

Professional and regulatory bodies in nursing education have required that critical thinking be central to all nursing curricula, but they have not adequately distinguished critical reflection from ethical, clinical, or even creative thinking for decisionmaking or actions required by the clinician. Other essential modes of thought such as clinical reasoning, evaluation of evidence, creative thinking, or the application of well-established standards of practice—all distinct from critical reflection—have been subsumed under the rubric of critical thinking. In the nursing education literature, clinical reasoning and judgment are often conflated with critical thinking. The accrediting bodies and nursing scholars have included decisionmaking and action-oriented, practical, ethical, and clinical reasoning in the rubric of critical reflection and thinking. One might say that this harmless semantic confusion is corrected by actual practices, except that students need to understand the distinctions between critical reflection and clinical reasoning, and they need to learn to discern when each is better suited, just as students need to also engage in applying standards, evidence-based practices, and creative thinking.

The growing body of research, patient acuity, and complexity of care demand higher-order thinking skills. Critical thinking involves the application of knowledge and experience to identify patient problems and to direct clinical judgments and actions that result in positive patient outcomes. These skills can be cultivated by educators who display the virtues of critical thinking, including independence of thought, intellectual curiosity, courage, humility, empathy, integrity, perseverance, and fair-mindedness. 9

The process of critical thinking is stimulated by integrating the essential knowledge, experiences, and clinical reasoning that support professional practice. The emerging paradigm for clinical thinking and cognition is that it is social and dialogical rather than monological and individual. 10–12 Clinicians pool their wisdom and multiple perspectives, yet some clinical knowledge can be demonstrated only in the situation (e.g., how to suction an extremely fragile patient whose oxygen saturations sink too low). Early warnings of problematic situations are made possible by clinicians comparing their observations to that of other providers. Clinicians form practice communities that create styles of practice, including ways of doing things, communication styles and mechanisms, and shared expectations about performance and expertise of team members.

By holding up critical thinking as a large umbrella for different modes of thinking, students can easily misconstrue the logic and purposes of different modes of thinking. Clinicians and scientists alike need multiple thinking strategies, such as critical thinking, clinical judgment, diagnostic reasoning, deliberative rationality, scientific reasoning, dialogue, argument, creative thinking, and so on. In particular, clinicians need forethought and an ongoing grasp of a patient’s health status and care needs trajectory, which requires an assessment of their own clarity and understanding of the situation at hand, critical reflection, critical reasoning, and clinical judgment.

Critical Reflection, Critical Reasoning, and Judgment

Critical reflection requires that the thinker examine the underlying assumptions and radically question or doubt the validity of arguments, assertions, and even facts of the case. Critical reflective skills are essential for clinicians; however, these skills are not sufficient for the clinician who must decide how to act in particular situations and avoid patient injury. For example, in everyday practice, clinicians cannot afford to critically reflect on the well-established tenets of “normal” or “typical” human circulatory systems when trying to figure out a particular patient’s alterations from that typical, well-grounded understanding that has existed since Harvey’s work in 1628. 13 Yet critical reflection can generate new scientifically based ideas. For example, there is a lack of adequate research on the differences between women’s and men’s circulatory systems and the typical pathophysiology related to heart attacks. Available research is based upon multiple, taken-for-granted starting points about the general nature of the circulatory system. As such, critical reflection may not provide what is needed for a clinician to act in a situation. This idea can be considered reasonable since critical reflective thinking is not sufficient for good clinical reasoning and judgment. The clinician’s development of skillful critical reflection depends upon being taught what to pay attention to, and thus gaining a sense of salience that informs the powers of perceptual grasp. The powers of noticing or perceptual grasp depend upon noticing what is salient and the capacity to respond to the situation.

Critical reflection is a crucial professional skill, but it is not the only reasoning skill or logic clinicians require. The ability to think critically uses reflection, induction, deduction, analysis, challenging assumptions, and evaluation of data and information to guide decisionmaking. 9 , 14 , 15 Critical reasoning is a process whereby knowledge and experience are applied in considering multiple possibilities to achieve the desired goals, 16 while considering the patient’s situation. 14 It is a process where both inductive and deductive cognitive skills are used. 17 Sometimes clinical reasoning is presented as a form of evaluating scientific knowledge, sometimes even as a form of scientific reasoning. Critical thinking is inherent in making sound clinical reasoning. 18

An essential point of tension and confusion exists in practice traditions such as nursing and medicine when clinical reasoning and critical reflection become entangled, because the clinician must have some established bases that are not questioned when engaging in clinical decisions and actions, such as standing orders. The clinician must act in the particular situation and time with the best clinical and scientific knowledge available. The clinician cannot afford to indulge in either ritualistic unexamined knowledge or diagnostic or therapeutic nihilism caused by radical doubt, as in critical reflection, because they must find an intelligent and effective way to think and act in particular clinical situations. Critical reflection skills are essential to assist practitioners to rethink outmoded or even wrong-headed approaches to health care, health promotion, and prevention of illness and complications, especially when new evidence is available. Breakdowns in practice, high failure rates in particular therapies, new diseases, new scientific discoveries, and societal changes call for critical reflection about past assumptions and no-longer-tenable beliefs.

Clinical reasoning stands out as a situated, practice-based form of reasoning that requires a background of scientific and technological research-based knowledge about general cases, more so than any particular instance. It also requires practical ability to discern the relevance of the evidence behind general scientific and technical knowledge and how it applies to a particular patient. In dong so, the clinician considers the patient’s particular clinical trajectory, their concerns and preferences, and their particular vulnerabilities (e.g., having multiple comorbidities) and sensitivities to care interventions (e.g., known drug allergies, other conflicting comorbid conditions, incompatible therapies, and past responses to therapies) when forming clinical decisions or conclusions.

Situated in a practice setting, clinical reasoning occurs within social relationships or situations involving patient, family, community, and a team of health care providers. The expert clinician situates themselves within a nexus of relationships, with concerns that are bounded by the situation. Expert clinical reasoning is socially engaged with the relationships and concerns of those who are affected by the caregiving situation, and when certain circumstances are present, the adverse event. Halpern 19 has called excellent clinical ethical reasoning “emotional reasoning” in that the clinicians have emotional access to the patient/family concerns and their understanding of the particular care needs. Expert clinicians also seek an optimal perceptual grasp, one based on understanding and as undistorted as possible, based on an attuned emotional engagement and expert clinical knowledge. 19 , 20

Clergy educators 21 and nursing and medical educators have begun to recognize the wisdom of broadening their narrow vision of rationality beyond simple rational calculation (exemplified by cost-benefit analysis) to reconsider the need for character development—including emotional engagement, perception, habits of thought, and skill acquisition—as essential to the development of expert clinical reasoning, judgment, and action. 10 , 22–24 Practitioners of engineering, law, medicine, and nursing, like the clergy, have to develop a place to stand in their discipline’s tradition of knowledge and science in order to recognize and evaluate salient evidence in the moment. Diagnostic confusion and disciplinary nihilism are both threats to the clinician’s ability to act in particular situations. However, the practice and practitioners will not be self-improving and vital if they cannot engage in critical reflection on what is not of value, what is outmoded, and what does not work. As evidence evolves and expands, so too must clinical thought.

Clinical judgment requires clinical reasoning across time about the particular, and because of the relevance of this immediate historical unfolding, clinical reasoning can be very different from the scientific reasoning used to formulate, conduct, and assess clinical experiments. While scientific reasoning is also socially embedded in a nexus of social relationships and concerns, the goal of detached, critical objectivity used to conduct scientific experiments minimizes the interactive influence of the research on the experiment once it has begun. Scientific research in the natural and clinical sciences typically uses formal criteria to develop “yes” and “no” judgments at prespecified times. The scientist is always situated in past and immediate scientific history, preferring to evaluate static and predetermined points in time (e.g., snapshot reasoning), in contrast to a clinician who must always reason about transitions over time. 25 , 26

Techne and Phronesis

Distinctions between the mere scientific making of things and practice was first explored by Aristotle as distinctions between techne and phronesis. 27 Learning to be a good practitioner requires developing the requisite moral imagination for good practice. If, for example, patients exercise their rights and refuse treatments, practitioners are required to have the moral imagination to understand the probable basis for the patient’s refusal. For example, was the refusal based upon catastrophic thinking, unrealistic fears, misunderstanding, or even clinical depression?

Techne, as defined by Aristotle, encompasses the notion of formation of character and habitus 28 as embodied beings. In Aristotle’s terms, techne refers to the making of things or producing outcomes. 11 Joseph Dunne defines techne as “the activity of producing outcomes,” and it “is governed by a means-ends rationality where the maker or producer governs the thing or outcomes produced or made through gaining mastery over the means of producing the outcomes, to the point of being able to separate means and ends” 11 (p. 54). While some aspects of medical and nursing practice fall into the category of techne, much of nursing and medical practice falls outside means-ends rationality and must be governed by concern for doing good or what is best for the patient in particular circumstances, where being in a relationship and discerning particular human concerns at stake guide action.

Phronesis, in contrast to techne, includes reasoning about the particular, across time, through changes or transitions in the patient’s and/or the clinician’s understanding. As noted by Dunne, phronesis is “characterized at least as much by a perceptiveness with regard to concrete particulars as by a knowledge of universal principles” 11 (p. 273). This type of practical reasoning often takes the form of puzzle solving or the evaluation of immediate past “hot” history of the patient’s situation. Such a particular clinical situation is necessarily particular, even though many commonalities and similarities with other disease syndromes can be recognized through signs and symptoms and laboratory tests. 11 , 29 , 30 Pointing to knowledge embedded in a practice makes no claim for infallibility or “correctness.” Individual practitioners can be mistaken in their judgments because practices such as medicine and nursing are inherently underdetermined. 31

While phronetic knowledge must remain open to correction and improvement, real events, and consequences, it cannot consistently transcend the institutional setting’s capacities and supports for good practice. Phronesis is also dependent on ongoing experiential learning of the practitioner, where knowledge is refined, corrected, or refuted. The Western tradition, with the notable exception of Aristotle, valued knowledge that could be made universal and devalued practical know-how and experiential learning. Descartes codified this preference for formal logic and rational calculation.

Aristotle recognized that when knowledge is underdetermined, changeable, and particular, it cannot be turned into the universal or standardized. It must be perceived, discerned, and judged, all of which require experiential learning. In nursing and medicine, perceptual acuity in physical assessment and clinical judgment (i.e., reasoning across time about changes in the particular patient or the clinician’s understanding of the patient’s condition) fall into the Greek Aristotelian category of phronesis. Dewey 32 sought to rescue knowledge gained by practical activity in the world. He identified three flaws in the understanding of experience in Greek philosophy: (1) empirical knowing is the opposite of experience with science; (2) practice is reduced to techne or the application of rational thought or technique; and (3) action and skilled know-how are considered temporary and capricious as compared to reason, which the Greeks considered as ultimate reality.

In practice, nursing and medicine require both techne and phronesis. The clinician standardizes and routinizes what can be standardized and routinized, as exemplified by standardized blood pressure measurements, diagnoses, and even charting about the patient’s condition and treatment. 27 Procedural and scientific knowledge can often be formalized and standardized (e.g., practice guidelines), or at least made explicit and certain in practice, except for the necessary timing and adjustments made for particular patients. 11 , 22

Rational calculations available to techne—population trends and statistics, algorithms—are created as decision support structures and can improve accuracy when used as a stance of inquiry in making clinical judgments about particular patients. Aggregated evidence from clinical trials and ongoing working knowledge of pathophysiology, biochemistry, and genomics are essential. In addition, the skills of phronesis (clinical judgment that reasons across time, taking into account the transitions of the particular patient/family/community and transitions in the clinician’s understanding of the clinical situation) will be required for nursing, medicine, or any helping profession.

Thinking Critically

Being able to think critically enables nurses to meet the needs of patients within their context and considering their preferences; meet the needs of patients within the context of uncertainty; consider alternatives, resulting in higher-quality care; 33 and think reflectively, rather than simply accepting statements and performing tasks without significant understanding and evaluation. 34 Skillful practitioners can think critically because they have the following cognitive skills: information seeking, discriminating, analyzing, transforming knowledge, predicating, applying standards, and logical reasoning. 5 One’s ability to think critically can be affected by age, length of education (e.g., an associate vs. a baccalaureate decree in nursing), and completion of philosophy or logic subjects. 35–37 The skillful practitioner can think critically because of having the following characteristics: motivation, perseverance, fair-mindedness, and deliberate and careful attention to thinking. 5 , 9

Thinking critically implies that one has a knowledge base from which to reason and the ability to analyze and evaluate evidence. 38 Knowledge can be manifest by the logic and rational implications of decisionmaking. Clinical decisionmaking is particularly influenced by interpersonal relationships with colleagues, 39 patient conditions, availability of resources, 40 knowledge, and experience. 41 Of these, experience has been shown to enhance nurses’ abilities to make quick decisions 42 and fewer decision errors, 43 support the identification of salient cues, and foster the recognition and action on patterns of information. 44 , 45

Clinicians must develop the character and relational skills that enable them to perceive and understand their patient’s needs and concerns. This requires accurate interpretation of patient data that is relevant to the specific patient and situation. In nursing, this formation of moral agency focuses on learning to be responsible in particular ways demanded by the practice, and to pay attention and intelligently discern changes in patients’ concerns and/or clinical condition that require action on the part of the nurse or other health care workers to avert potential compromises to quality care.

Formation of the clinician’s character, skills, and habits are developed in schools and particular practice communities within a larger practice tradition. As Dunne notes,

A practice is not just a surface on which one can display instant virtuosity. It grounds one in a tradition that has been formed through an elaborate development and that exists at any juncture only in the dispositions (slowly and perhaps painfully acquired) of its recognized practitioners. The question may of course be asked whether there are any such practices in the contemporary world, whether the wholesale encroachment of Technique has not obliterated them—and whether this is not the whole point of MacIntyre’s recipe of withdrawal, as well as of the post-modern story of dispossession 11 (p. 378).

Clearly Dunne is engaging in critical reflection about the conditions for developing character, skills, and habits for skillful and ethical comportment of practitioners, as well as to act as moral agents for patients so that they and their families receive safe, effective, and compassionate care.

Professional socialization or professional values, while necessary, do not adequately address character and skill formation that transform the way the practitioner exists in his or her world, what the practitioner is capable of noticing and responding to, based upon well-established patterns of emotional responses, skills, dispositions to act, and the skills to respond, decide, and act. 46 The need for character and skill formation of the clinician is what makes a practice stand out from a mere technical, repetitious manufacturing process. 11 , 30 , 47

In nursing and medicine, many have questioned whether current health care institutions are designed to promote or hinder enlightened, compassionate practice, or whether they have deteriorated into commercial institutional models that focus primarily on efficiency and profit. MacIntyre points out the links between the ongoing development and improvement of practice traditions and the institutions that house them:

Lack of justice, lack of truthfulness, lack of courage, lack of the relevant intellectual virtues—these corrupt traditions, just as they do those institutions and practices which derive their life from the traditions of which they are the contemporary embodiments. To recognize this is of course also to recognize the existence of an additional virtue, one whose importance is perhaps most obvious when it is least present, the virtue of having an adequate sense of the traditions to which one belongs or which confront one. This virtue is not to be confused with any form of conservative antiquarianism; I am not praising those who choose the conventional conservative role of laudator temporis acti. It is rather the case that an adequate sense of tradition manifests itself in a grasp of those future possibilities which the past has made available to the present. Living traditions, just because they continue a not-yet-completed narrative, confront a future whose determinate and determinable character, so far as it possesses any, derives from the past 30 (p. 207).

It would be impossible to capture all the situated and distributed knowledge outside of actual practice situations and particular patients. Simulations are powerful as teaching tools to enable nurses’ ability to think critically because they give students the opportunity to practice in a simplified environment. However, students can be limited in their inability to convey underdetermined situations where much of the information is based on perceptions of many aspects of the patient and changes that have occurred over time. Simulations cannot have the sub-cultures formed in practice settings that set the social mood of trust, distrust, competency, limited resources, or other forms of situated possibilities.

One of the hallmark studies in nursing providing keen insight into understanding the influence of experience was a qualitative study of adult, pediatric, and neonatal intensive care unit (ICU) nurses, where the nurses were clustered into advanced beginner, intermediate, and expert level of practice categories. The advanced beginner (having up to 6 months of work experience) used procedures and protocols to determine which clinical actions were needed. When confronted with a complex patient situation, the advanced beginner felt their practice was unsafe because of a knowledge deficit or because of a knowledge application confusion. The transition from advanced beginners to competent practitioners began when they first had experience with actual clinical situations and could benefit from the knowledge gained from the mistakes of their colleagues. Competent nurses continuously questioned what they saw and heard, feeling an obligation to know more about clinical situations. In doing do, they moved from only using care plans and following the physicians’ orders to analyzing and interpreting patient situations. Beyond that, the proficient nurse acknowledged the changing relevance of clinical situations requiring action beyond what was planned or anticipated. The proficient nurse learned to acknowledge the changing needs of patient care and situation, and could organize interventions “by the situation as it unfolds rather than by preset goals 48 (p. 24). Both competent and proficient nurses (that is, intermediate level of practice) had at least two years of ICU experience. 48 Finally, the expert nurse had a more fully developed grasp of a clinical situation, a sense of confidence in what is known about the situation, and could differentiate the precise clinical problem in little time. 48

Expertise is acquired through professional experience and is indicative of a nurse who has moved beyond mere proficiency. As Gadamer 29 points out, experience involves a turning around of preconceived notions, preunderstandings, and extends or adds nuances to understanding. Dewey 49 notes that experience requires a prepared “creature” and an enriched environment. The opportunity to reflect and narrate one’s experiential learning can clarify, extend, or even refute experiential learning.

Experiential learning requires time and nurturing, but time alone does not ensure experiential learning. Aristotle linked experiential learning to the development of character and moral sensitivities of a person learning a practice. 50 New nurses/new graduates have limited work experience and must experience continuing learning until they have reached an acceptable level of performance. 51 After that, further improvements are not predictable, and years of experience are an inadequate predictor of expertise. 52

The most effective knower and developer of practical knowledge creates an ongoing dialogue and connection between lessons of the day and experiential learning over time. Gadamer, in a late life interview, highlighted the open-endedness and ongoing nature of experiential learning in the following interview response:

Being experienced does not mean that one now knows something once and for all and becomes rigid in this knowledge; rather, one becomes more open to new experiences. A person who is experienced is undogmatic. Experience has the effect of freeing one to be open to new experience … In our experience we bring nothing to a close; we are constantly learning new things from our experience … this I call the interminability of all experience 32 (p. 403).

Practical endeavor, supported by scientific knowledge, requires experiential learning, the development of skilled know-how, and perceptual acuity in order to make the scientific knowledge relevant to the situation. Clinical perceptual and skilled know-how helps the practitioner discern when particular scientific findings might be relevant. 53

Often experience and knowledge, confirmed by experimentation, are treated as oppositions, an either-or choice. However, in practice it is readily acknowledged that experiential knowledge fuels scientific investigation, and scientific investigation fuels further experiential learning. Experiential learning from particular clinical cases can help the clinician recognize future similar cases and fuel new scientific questions and study. For example, less experienced nurses—and it could be argued experienced as well—can use nursing diagnoses practice guidelines as part of their professional advancement. Guidelines are used to reflect their interpretation of patients’ needs, responses, and situation, 54 a process that requires critical thinking and decisionmaking. 55 , 56 Using guidelines also reflects one’s problem identification and problem-solving abilities. 56 Conversely, the ability to proficiently conduct a series of tasks without nursing diagnoses is the hallmark of expertise. 39 , 57

Experience precedes expertise. As expertise develops from experience and gaining knowledge and transitions to the proficiency stage, the nurses’ thinking moves from steps and procedures (i.e., task-oriented care) toward “chunks” or patterns 39 (i.e., patient-specific care). In doing so, the nurse thinks reflectively, rather than merely accepting statements and performing procedures without significant understanding and evaluation. 34 Expert nurses do not rely on rules and logical thought processes in problem-solving and decisionmaking. 39 Instead, they use abstract principles, can see the situation as a complex whole, perceive situations comprehensively, and can be fully involved in the situation. 48 Expert nurses can perform high-level care without conscious awareness of the knowledge they are using, 39 , 58 and they are able to provide that care with flexibility and speed. Through a combination of knowledge and skills gained from a range of theoretical and experiential sources, expert nurses also provide holistic care. 39 Thus, the best care comes from the combination of theoretical, tacit, and experiential knowledge. 59 , 60

Experts are thought to eventually develop the ability to intuitively know what to do and to quickly recognize critical aspects of the situation. 22 Some have proposed that expert nurses provide high-quality patient care, 61 , 62 but that is not consistently documented—particularly in consideration of patient outcomes—and a full understanding between the differential impact of care rendered by an “expert” nurse is not fully understood. In fact, several studies have found that length of professional experience is often unrelated and even negatively related to performance measures and outcomes. 63 , 64

In a review of the literature on expertise in nursing, Ericsson and colleagues 65 found that focusing on challenging, less-frequent situations would reveal individual performance differences on tasks that require speed and flexibility, such as that experienced during a code or an adverse event. Superior performance was associated with extensive training and immediate feedback about outcomes, which can be obtained through continual training, simulation, and processes such as root-cause analysis following an adverse event. Therefore, efforts to improve performance benefited from continual monitoring, planning, and retrospective evaluation. Even then, the nurse’s ability to perform as an expert is dependent upon their ability to use intuition or insights gained through interactions with patients. 39

Intuition and Perception

Intuition is the instant understanding of knowledge without evidence of sensible thought. 66 According to Young, 67 intuition in clinical practice is a process whereby the nurse recognizes something about a patient that is difficult to verbalize. Intuition is characterized by factual knowledge, “immediate possession of knowledge, and knowledge independent of the linear reasoning process” 68 (p. 23). When intuition is used, one filters information initially triggered by the imagination, leading to the integration of all knowledge and information to problem solve. 69 Clinicians use their interactions with patients and intuition, drawing on tacit or experiential knowledge, 70 , 71 to apply the correct knowledge to make the correct decisions to address patient needs. Yet there is a “conflated belief in the nurses’ ability to know what is best for the patient” 72 (p. 251) because the nurses’ and patients’ identification of the patients’ needs can vary. 73

A review of research and rhetoric involving intuition by King and Appleton 62 found that all nurses, including students, used intuition (i.e., gut feelings). They found evidence, predominately in critical care units, that intuition was triggered in response to knowledge and as a trigger for action and/or reflection with a direct bearing on the analytical process involved in patient care. The challenge for nurses was that rigid adherence to checklists, guidelines, and standardized documentation, 62 ignored the benefits of intuition. This view was furthered by Rew and Barrow 68 , 74 in their reviews of the literature, where they found that intuition was imperative to complex decisionmaking, 68 difficult to measure and assess in a quantitative manner, and was not linked to physiologic measures. 74

Intuition is a way of explaining professional expertise. 75 Expert nurses rely on their intuitive judgment that has been developed over time. 39 , 76 Intuition is an informal, nonanalytically based, unstructured, deliberate calculation that facilitates problem solving, 77 a process of arriving at salient conclusions based on relatively small amounts of knowledge and/or information. 78 Experts can have rapid insight into a situation by using intuition to recognize patterns and similarities, achieve commonsense understanding, and sense the salient information combined with deliberative rationality. 10 Intuitive recognition of similarities and commonalities between patients are often the first diagnostic clue or early warning, which must then be followed up with critical evaluation of evidence among the competing conditions. This situation calls for intuitive judgment that can distinguish “expert human judgment from the decisions” made by a novice 79 (p. 23).

Shaw 80 equates intuition with direct perception. Direct perception is dependent upon being able to detect complex patterns and relationships that one has learned through experience are important. Recognizing these patterns and relationships generally occurs rapidly and is complex, making it difficult to articulate or describe. Perceptual skills, like those of the expert nurse, are essential to recognizing current and changing clinical conditions. Perception requires attentiveness and the development of a sense of what is salient. Often in nursing and medicine, means and ends are fused, as is the case for a “good enough” birth experience and a peaceful death.

• Applying Practice Evidence

Research continues to find that using evidence-based guidelines in practice, informed through research evidence, improves patients’ outcomes. 81–83 Research-based guidelines are intended to provide guidance for specific areas of health care delivery. 84 The clinician—both the novice and expert—is expected to use the best available evidence for the most efficacious therapies and interventions in particular instances, to ensure the highest-quality care, especially when deviations from the evidence-based norm may heighten risks to patient safety. Otherwise, if nursing and medicine were exact sciences, or consisted only of techne, then a 1:1 relationship could be established between results of aggregated evidence-based research and the best path for all patients.

Evaluating Evidence

Before research should be used in practice, it must be evaluated. There are many complexities and nuances in evaluating the research evidence for clinical practice. Evaluation of research behind evidence-based medicine requires critical thinking and good clinical judgment. Sometimes the research findings are mixed or even conflicting. As such, the validity, reliability, and generalizability of available research are fundamental to evaluating whether evidence can be applied in practice. To do so, clinicians must select the best scientific evidence relevant to particular patients—a complex process that involves intuition to apply the evidence. Critical thinking is required for evaluating the best available scientific evidence for the treatment and care of a particular patient.

Good clinical judgment is required to select the most relevant research evidence. The best clinical judgment, that is, reasoning across time about the particular patient through changes in the patient’s concerns and condition and/or the clinician’s understanding, are also required. This type of judgment requires clinicians to make careful observations and evaluations of the patient over time, as well as know the patient’s concerns and social circumstances. To evolve to this level of judgment, additional education beyond clinical preparation if often required.

Sources of Evidence

Evidence that can be used in clinical practice has different sources and can be derived from research, patient’s preferences, and work-related experience. 85 , 86 Nurses have been found to obtain evidence from experienced colleagues believed to have clinical expertise and research-based knowledge 87 as well as other sources.

For many years now, randomized controlled trials (RCTs) have often been considered the best standard for evaluating clinical practice. Yet, unless the common threats to the validity (e.g., representativeness of the study population) and reliability (e.g., consistency in interventions and responses of study participants) of RCTs are addressed, the meaningfulness and generalizability of the study outcomes are very limited. Relevant patient populations may be excluded, such as women, children, minorities, the elderly, and patients with multiple chronic illnesses. The dropout rate of the trial may confound the results. And it is easier to get positive results published than it is to get negative results published. Thus, RCTs are generalizable (i.e., applicable) only to the population studied—which may not reflect the needs of the patient under the clinicians care. In instances such as these, clinicians need to also consider applied research using prospective or retrospective populations with case control to guide decisionmaking, yet this too requires critical thinking and good clinical judgment.

Another source of available evidence may come from the gold standard of aggregated systematic evaluation of clinical trial outcomes for the therapy and clinical condition in question, be generated by basic and clinical science relevant to the patient’s particular pathophysiology or care need situation, or stem from personal clinical experience. The clinician then takes all of the available evidence and considers the particular patient’s known clinical responses to past therapies, their clinical condition and history, the progression or stages of the patient’s illness and recovery, and available resources.

In clinical practice, the particular is examined in relation to the established generalizations of science. With readily available summaries of scientific evidence (e.g., systematic reviews and practice guidelines) available to nurses and physicians, one might wonder whether deep background understanding is still advantageous. Might it not be expendable, since it is likely to be out of date given the current scientific evidence? But this assumption is a false opposition and false choice because without a deep background understanding, the clinician does not know how to best find and evaluate scientific evidence for the particular case in hand. The clinician’s sense of salience in any given situation depends on past clinical experience and current scientific evidence.

Evidence-Based Practice

The concept of evidence-based practice is dependent upon synthesizing evidence from the variety of sources and applying it appropriately to the care needs of populations and individuals. This implies that evidence-based practice, indicative of expertise in practice, appropriately applies evidence to the specific situations and unique needs of patients. 88 , 89 Unfortunately, even though providing evidence-based care is an essential component of health care quality, it is well known that evidence-based practices are not used consistently.

Conceptually, evidence used in practice advances clinical knowledge, and that knowledge supports independent clinical decisions in the best interest of the patient. 90 , 91 Decisions must prudently consider the factors not necessarily addressed in the guideline, such as the patient’s lifestyle, drug sensitivities and allergies, and comorbidities. Nurses who want to improve the quality and safety of care can do so though improving the consistency of data and information interpretation inherent in evidence-based practice.

Initially, before evidence-based practice can begin, there needs to be an accurate clinical judgment of patient responses and needs. In the course of providing care, with careful consideration of patient safety and quality care, clinicians must give attention to the patient’s condition, their responses to health care interventions, and potential adverse reactions or events that could harm the patient. Nonetheless, there is wide variation in the ability of nurses to accurately interpret patient responses 92 and their risks. 93 Even though variance in interpretation is expected, nurses are obligated to continually improve their skills to ensure that patients receive quality care safely. 94 Patients are vulnerable to the actions and experience of their clinicians, which are inextricably linked to the quality of care patients have access to and subsequently receive.

The judgment of the patient’s condition determines subsequent interventions and patient outcomes. Attaining accurate and consistent interpretations of patient data and information is difficult because each piece can have different meanings, and interpretations are influenced by previous experiences. 95 Nurses use knowledge from clinical experience 96 , 97 and—although infrequently—research. 98–100

Once a problem has been identified, using a process that utilizes critical thinking to recognize the problem, the clinician then searches for and evaluates the research evidence 101 and evaluates potential discrepancies. The process of using evidence in practice involves “a problem-solving approach that incorporates the best available scientific evidence, clinicians’ expertise, and patient’s preferences and values” 102 (p. 28). Yet many nurses do not perceive that they have the education, tools, or resources to use evidence appropriately in practice. 103

Reported barriers to using research in practice have included difficulty in understanding the applicability and the complexity of research findings, failure of researchers to put findings into the clinical context, lack of skills in how to use research in practice, 104 , 105 amount of time required to access information and determine practice implications, 105–107 lack of organizational support to make changes and/or use in practice, 104 , 97 , 105 , 107 and lack of confidence in one’s ability to critically evaluate clinical evidence. 108

When Evidence Is Missing

In many clinical situations, there may be no clear guidelines and few or even no relevant clinical trials to guide decisionmaking. In these cases, the latest basic science about cellular and genomic functioning may be the most relevant science, or by default, guestimation. Consequently, good patient care requires more than a straightforward, unequivocal application of scientific evidence. The clinician must be able to draw on a good understanding of basic sciences, as well as guidelines derived from aggregated data and information from research investigations.

Practical knowledge is shaped by one’s practice discipline and the science and technology relevant to the situation at hand. But scientific, formal, discipline-specific knowledge are not sufficient for good clinical practice, whether the discipline be law, medicine, nursing, teaching, or social work. Practitioners still have to learn how to discern generalizable scientific knowledge, know how to use scientific knowledge in practical situations, discern what scientific evidence/knowledge is relevant, assess how the particular patient’s situation differs from the general scientific understanding, and recognize the complexity of care delivery—a process that is complex, ongoing, and changing, as new evidence can overturn old.

Practice communities like individual practitioners may also be mistaken, as is illustrated by variability in practice styles and practice outcomes across hospitals and regions in the United States. This variability in practice is why practitioners must learn to critically evaluate their practice and continually improve their practice over time. The goal is to create a living self-improving tradition.

Within health care, students, scientists, and practitioners are challenged to learn and use different modes of thinking when they are conflated under one term or rubric, using the best-suited thinking strategies for taking into consideration the purposes and the ends of the reasoning. Learning to be an effective, safe nurse or physician requires not only technical expertise, but also the ability to form helping relationships and engage in practical ethical and clinical reasoning. 50 Good ethical comportment requires that both the clinician and the scientist take into account the notions of good inherent in clinical and scientific practices. The notions of good clinical practice must include the relevant significance and the human concerns involved in decisionmaking in particular situations, centered on clinical grasp and clinical forethought.

The Three Apprenticeships of Professional Education

We have much to learn in comparing the pedagogies of formation across the professions, such as is being done currently by the Carnegie Foundation for the Advancement of Teaching. The Carnegie Foundation’s broad research program on the educational preparation of the profession focuses on three essential apprenticeships:

To capture the full range of crucial dimensions in professional education, we developed the idea of a three-fold apprenticeship: (1) intellectual training to learn the academic knowledge base and the capacity to think in ways important to the profession; (2) a skill-based apprenticeship of practice; and (3) an apprenticeship to the ethical standards, social roles, and responsibilities of the profession, through which the novice is introduced to the meaning of an integrated practice of all dimensions of the profession, grounded in the profession’s fundamental purposes. 109

This framework has allowed the investigators to describe tensions and shortfalls as well as strengths of widespread teaching practices, especially at articulation points among these dimensions of professional training.

Research has demonstrated that these three apprenticeships are taught best when they are integrated so that the intellectual training includes skilled know-how, clinical judgment, and ethical comportment. In the study of nursing, exemplary classroom and clinical teachers were found who do integrate the three apprenticeships in all of their teaching, as exemplified by the following anonymous student’s comments:

With that as well, I enjoyed the class just because I do have clinical experience in my background and I enjoyed it because it took those practical applications and the knowledge from pathophysiology and pharmacology, and all the other classes, and it tied it into the actual aspects of like what is going to happen at work. For example, I work in the emergency room and question: Why am I doing this procedure for this particular patient? Beforehand, when I was just a tech and I wasn’t going to school, I’d be doing it because I was told to be doing it—or I’d be doing CPR because, you know, the doc said, start CPR. I really enjoy the Care and Illness because now I know the process, the pathophysiological process of why I’m doing it and the clinical reasons of why they’re making the decisions, and the prioritization that goes on behind it. I think that’s the biggest point. Clinical experience is good, but not everybody has it. Yet when these students transition from school and clinicals to their job as a nurse, they will understand what’s going on and why.

The three apprenticeships are equally relevant and intertwined. In the Carnegie National Study of Nursing Education and the companion study on medical education as well as in cross-professional comparisons, teaching that gives an integrated access to professional practice is being examined. Once the three apprenticeships are separated, it is difficult to reintegrate them. The investigators are encouraged by teaching strategies that integrate the latest scientific knowledge and relevant clinical evidence with clinical reasoning about particular patients in unfolding rather than static cases, while keeping the patient and family experience and concerns relevant to clinical concerns and reasoning.

Clinical judgment or phronesis is required to evaluate and integrate techne and scientific evidence.

Within nursing, professional practice is wise and effective usually to the extent that the professional creates relational and communication contexts where clients/patients can be open and trusting. Effectiveness depends upon mutual influence between patient and practitioner, student and learner. This is another way in which clinical knowledge is dialogical and socially distributed. The following articulation of practical reasoning in nursing illustrates the social, dialogical nature of clinical reasoning and addresses the centrality of perception and understanding to good clinical reasoning, judgment and intervention.

Clinical Grasp *

Clinical grasp describes clinical inquiry in action. Clinical grasp begins with perception and includes problem identification and clinical judgment across time about the particular transitions of particular patients. Garrett Chan 20 described the clinician’s attempt at finding an “optimal grasp” or vantage point of understanding. Four aspects of clinical grasp, which are described in the following paragraphs, include (1) making qualitative distinctions, (2) engaging in detective work, (3) recognizing changing relevance, and (4) developing clinical knowledge in specific patient populations.

Making Qualitative Distinctions

Qualitative distinctions refer to those distinctions that can be made only in a particular contextual or historical situation. The context and sequence of events are essential for making qualitative distinctions; therefore, the clinician must pay attention to transitions in the situation and judgment. Many qualitative distinctions can be made only by observing differences through touch, sound, or sight, such as the qualities of a wound, skin turgor, color, capillary refill, or the engagement and energy level of the patient. Another example is assessing whether the patient was more fatigued after ambulating to the bathroom or from lack of sleep. Likewise the quality of the clinician’s touch is distinct as in offering reassurance, putting pressure on a bleeding wound, and so on. 110

Engaging in Detective Work, Modus Operandi Thinking, and Clinical Puzzle Solving

Clinical situations are open ended and underdetermined. Modus operandi thinking keeps track of the particular patient, the way the illness unfolds, the meanings of the patient’s responses as they have occurred in the particular time sequence. Modus operandi thinking requires keeping track of what has been tried and what has or has not worked with the patient. In this kind of reasoning-in-transition, gains and losses of understanding are noticed and adjustments in the problem approach are made.

We found that teachers in a medical surgical unit at the University of Washington deliberately teach their students to engage in “detective work.” Students are given the daily clinical assignment of “sleuthing” for undetected drug incompatibilities, questionable drug dosages, and unnoticed signs and symptoms. For example, one student noted that an unusual dosage of a heart medication was being given to a patient who did not have heart disease. The student first asked her teacher about the unusually high dosage. The teacher, in turn, asked the student whether she had asked the nurse or the patient about the dosage. Upon the student’s questioning, the nurse did not know why the patient was receiving the high dosage and assumed the drug was for heart disease. The patient’s staff nurse had not questioned the order. When the student asked the patient, the student found that the medication was being given for tremors and that the patient and the doctor had titrated the dosage for control of the tremors. This deliberate approach to teaching detective work, or modus operandi thinking, has characteristics of “critical reflection,” but stays situated and engaged, ferreting out the immediate history and unfolding of events.

Recognizing Changing Clinical Relevance

The meanings of signs and symptoms are changed by sequencing and history. The patient’s mental status, color, or pain level may continue to deteriorate or get better. The direction, implication, and consequences for the changes alter the relevance of the particular facts in the situation. The changing relevance entailed in a patient transitioning from primarily curative care to primarily palliative care is a dramatic example, where symptoms literally take on new meanings and require new treatments.

Developing Clinical Knowledge in Specific Patient Populations

Extensive experience with a specific patient population or patients with particular injuries or diseases allows the clinician to develop comparisons, distinctions, and nuanced differences within the population. The comparisons between many specific patients create a matrix of comparisons for clinicians, as well as a tacit, background set of expectations that create population- and patient-specific detective work if a patient does not meet the usual, predictable transitions in recovery. What is in the background and foreground of the clinician’s attention shifts as predictable changes in the patient’s condition occurs, such as is seen in recovering from heart surgery or progressing through the predictable stages of labor and delivery. Over time, the clinician develops a deep background understanding that allows for expert diagnostic and interventions skills.

Clinical Forethought

Clinical forethought is intertwined with clinical grasp, but it is much more deliberate and even routinized than clinical grasp. Clinical forethought is a pervasive habit of thought and action in nursing practice, and also in medicine, as clinicians think about disease and recovery trajectories and the implications of these changes for treatment. Clinical forethought plays a role in clinical grasp because it structures the practical logic of clinicians. At least four habits of thought and action are evident in what we are calling clinical forethought: (1) future think, (2) clinical forethought about specific patient populations, (3) anticipation of risks for particular patients, and (4) seeing the unexpected.

Future think

Future think is the broadest category of this logic of practice. Anticipating likely immediate futures helps the clinician make good plans and decisions about preparing the environment so that responding rapidly to changes in the patient is possible. Without a sense of salience about anticipated signs and symptoms and preparing the environment, essential clinical judgments and timely interventions would be impossible in the typically fast pace of acute and intensive patient care. Future think governs the style and content of the nurse’s attentiveness to the patient. Whether in a fast-paced care environment or a slower-paced rehabilitation setting, thinking and acting with anticipated futures guide clinical thinking and judgment. Future think captures the way judgment is suspended in a predictive net of anticipation and preparing oneself and the environment for a range of potential events.

Clinical forethought about specific diagnoses and injuries

This habit of thought and action is so second nature to the experienced nurse that the new or inexperienced nurse may have difficulty finding out about what seems to other colleagues as “obvious” preparation for particular patients and situations. Clinical forethought involves much local specific knowledge about who is a good resource and how to marshal support services and equipment for particular patients.

Examples of preparing for specific patient populations are pervasive, such as anticipating the need for a pacemaker during surgery and having the equipment assembled ready for use to save essential time. Another example includes forecasting an accident victim’s potential injuries, and recognizing that intubation might be needed.

Anticipation of crises, risks, and vulnerabilities for particular patients

This aspect of clinical forethought is central to knowing the particular patient, family, or community. Nurses situate the patient’s problems almost like a topography of possibilities. This vital clinical knowledge needs to be communicated to other caregivers and across care borders. Clinical teaching could be improved by enriching curricula with narrative examples from actual practice, and by helping students recognize commonly occurring clinical situations in the simulation and clinical setting. For example, if a patient is hemodynamically unstable, then managing life-sustaining physiologic functions will be a main orienting goal. If the patient is agitated and uncomfortable, then attending to comfort needs in relation to hemodynamics will be a priority. Providing comfort measures turns out to be a central background practice for making clinical judgments and contains within it much judgment and experiential learning.

When clinical teaching is too removed from typical contingencies and strong clinical situations in practice, students will lack practice in active thinking-in-action in ambiguous clinical situations. In the following example, an anonymous student recounted her experiences of meeting a patient:

I was used to different equipment and didn’t know how things went, didn’t know their routine, really. You can explain all you want in class, this is how it’s going to be, but when you get there … . Kim was my first instructor and my patient that she assigned me to—I walked into the room and he had every tube imaginable. And so I was a little overwhelmed. It’s not necessarily even that he was that critical … . She asked what tubes here have you seen? Well, I know peripheral lines. You taught me PICC [peripherally inserted central catheter] lines, and we just had that, but I don’t really feel comfortable doing it by myself, without you watching to make sure that I’m flushing it right and how to assess it. He had a chest tube and I had seen chest tubes, but never really knew the depth of what you had to assess and how you make sure that it’s all kosher and whatever. So she went through the chest tube and explained, it’s just bubbling a little bit and that’s okay. The site, check the site. The site looked okay and that she’d say if it wasn’t okay, this is what it might look like … . He had a feeding tube. I had done feeding tubes but that was like a long time ago in my LPN experiences schooling. So I hadn’t really done too much with the feeding stuff either … . He had a [nasogastric] tube, and knew pretty much about that and I think at the time it was clamped. So there were no issues with the suction or whatever. He had a Foley catheter. He had a feeding tube, a chest tube. I can’t even remember but there were a lot.

As noted earlier, a central characteristic of a practice discipline is that a self-improving practice requires ongoing experiential learning. One way nurse educators can enhance clinical inquiry is by increasing pedagogies of experiential learning. Current pedagogies for experiential learning in nursing include extensive preclinical study, care planning, and shared postclinical debriefings where students share their experiential learning with their classmates. Experiential learning requires open learning climates where students can discuss and examine transitions in understanding, including their false starts, or their misconceptions in actual clinical situations. Nursing educators typically develop open and interactive clinical learning communities, so that students seem committed to helping their classmates learn from their experiences that may have been difficult or even unsafe. One anonymous nurse educator described how students extend their experiential learning to their classmates during a postclinical conference:

So for example, the patient had difficulty breathing and the student wanted to give the meds instead of addressing the difficulty of breathing. Well, while we were sharing information about their patients, what they did that day, I didn’t tell the student to say this, but she said, ‘I just want to tell you what I did today in clinical so you don’t do the same thing, and here’s what happened.’ Everybody’s listening very attentively and they were asking her some questions. But she shared that. She didn’t have to. I didn’t tell her, you must share that in postconference or anything like that, but she just went ahead and shared that, I guess, to reinforce what she had learned that day but also to benefit her fellow students in case that thing comes up with them.

The teacher’s response to this student’s honesty and generosity exemplifies her own approach to developing an open community of learning. Focusing only on performance and on “being correct” prevents learning from breakdown or error and can dampen students’ curiosity and courage to learn experientially.

Seeing the unexpected

One of the keys to becoming an expert practitioner lies in how the person holds past experiential learning and background habitual skills and practices. This is a skill of foregrounding attention accurately and effectively in response to the nature of situational demands. Bourdieu 29 calls the recognition of the situation central to practical reasoning. If nothing is routinized as a habitual response pattern, then practitioners will not function effectively in emergencies. Unexpected occurrences may be overlooked. However, if expectations are held rigidly, then subtle changes from the usual will be missed, and habitual, rote responses will inappropriately rule. The clinician must be flexible in shifting between what is in background and foreground. This is accomplished by staying curious and open. The clinical “certainty” associated with perceptual grasp is distinct from the kind of “certainty” achievable in scientific experiments and through measurements. Recognition of similar or paradigmatic clinical situations is similar to “face recognition” or recognition of “family resemblances.” This concept is subject to faulty memory, false associative memories, and mistaken identities; therefore, such perceptual grasp is the beginning of curiosity and inquiry and not the end. Assessment and validation are required. In rapidly moving clinical situations, perceptual grasp is the starting point for clarification, confirmation, and action. Having the clinician say out loud how he or she is understanding the situation gives an opportunity for confirmation and disconfirmation from other clinicians present. 111 The relationship between foreground and background of attention needs to be fluid, so that missed expectations allow the nurse to see the unexpected. For example, when the background rhythm of a cardiac monitor changes, the nurse notices, and what had been background tacit awareness becomes the foreground of attention. A hallmark of expertise is the ability to notice the unexpected. 20 Background expectations of usual patient trajectories form with experience. Tacit expectations for patient trajectories form that enable the nurse to notice subtle failed expectations and pay attention to early signs of unexpected changes in the patient's condition. Clinical expectations gained from caring for similar patient populations form a tacit clinical forethought that enable the experienced clinician to notice missed expectations. Alterations from implicit or explicit expectations set the stage for experiential learning, depending on the openness of the learner.

Learning to provide safe and quality health care requires technical expertise, the ability to think critically, experience, and clinical judgment. The high-performance expectation of nurses is dependent upon the nurses’ continual learning, professional accountability, independent and interdependent decisionmaking, and creative problem-solving abilities.

This section of the paper was condensed and paraphrased from Benner, Hooper-Kyriakidis, and Stannard. 23 Patricia Hooper-Kyriakidis wrote the section on clinical grasp, and Patricia Benner wrote the section on clinical forethought.

• Cite this Page Benner P, Hughes RG, Sutphen M. Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 6.
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Problem-solving, decision-making, and critical thinking: how do they mix and why bother?

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Critical Problem Solving and Decision Making

Often misjudged as criticism, critical thinking focuses on the ability to follow logical steps, enabling you to arrive at a decisive and appropriate conclusion. From solving problems at work to facing challenging personal situations, critical thinking is a valuable skill for everyone to master.

Improving critical thinking skills will shape you into a more rational and disciplined thinker, reducing your own prejudice and bias, while helping you understand other viewpoints. This workshop provides you with the skills to analyze the way you think as well as evaluate, identify and distinguish between relevant and irrelevant information, leading to a more productive career.

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Title: towards reasoning in large language models: a survey.

Abstract: Reasoning is a fundamental aspect of human intelligence that plays a crucial role in activities such as problem solving, decision making, and critical thinking. In recent years, large language models (LLMs) have made significant progress in natural language processing, and there is observation that these models may exhibit reasoning abilities when they are sufficiently large. However, it is not yet clear to what extent LLMs are capable of reasoning. This paper provides a comprehensive overview of the current state of knowledge on reasoning in LLMs, including techniques for improving and eliciting reasoning in these models, methods and benchmarks for evaluating reasoning abilities, findings and implications of previous research in this field, and suggestions on future directions. Our aim is to provide a detailed and up-to-date review of this topic and stimulate meaningful discussion and future work.

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Harnessing the Power of Critical Thinking in Daily Life

This essay about critical thinking outlines its importance and practical applications in everyday life. It defines critical thinking as the art of analyzing and evaluating information to form reasoned conclusions, emphasizing the importance of questioning information, structuring thoughts, and self-reflection. The essay discusses how critical thinking encourages creativity and systematic problem-solving, which are valuable in both professional and personal settings. Challenges such as information overload and the necessity for constant skepticism are also addressed. Furthermore, the essay explores the role of critical thinking in education, advocating for a learning environment that promotes independent thought and exploration. Overall, it presents critical thinking as a vital skill that enhances decision-making and fosters a more informed, discerning society.

How it works

Critical thinking isn’t merely a buzzword or a skill reserved for the confines of academia; it’s a robust, everyday tool that can dramatically enhance our decision-making and problem-solving capabilities. So, what exactly is critical thinking? Simply put, it’s the art of analyzing and evaluating information to reach well-reasoned conclusions. It’s about being actively engaged in your thought processes, challenging conventional wisdom, and not taking things at face value.

Critical thinking starts with questioning. Whenever you encounter new information, whether through a conversation, reading, or media, it involves pausing and asking yourself: What is the evidence? Who benefits from this information? Could there be a bias? Consider a scenario where you read a headline that feels emotionally charged; a critical thinker would step back and assess the source, check for other evidence, and not let initial emotions drive immediate reactions.

Structuring your thoughts is another cornerstone of critical thinking. It’s not just about what you think but how you organize those thoughts. This could mean prioritizing what’s most important or structuring your day to optimize for peak mental performance. For example, in planning a project, critical thinking helps lay out clear, manageable steps, ensuring that each phase builds on the previous one for coherent results.

Self-reflection is a significant, albeit challenging, aspect of critical thinking. It requires us to examine our own beliefs and motivations critically, asking ourselves why we hold certain views and being open to adjusting those views in light of new evidence. This self-examination extends to recognizing personal biases—everyone has them, and they can color our perceptions and decisions in subtle, sometimes profound ways.

Critical thinking also dovetails with creativity. It pushes us to question existing approaches and brainstorm innovative solutions. This creative problem-solving becomes invaluable in workplaces that value adaptability and forward-thinking, where the usual solutions don’t always resolve new or complex problems.

However, developing and maintaining strong critical thinking skills is not without its challenges. It demands a consistent, deliberate effort and the mental flexibility to consider multiple viewpoints and outcomes. In today’s fast-paced world, where information overload is common, it can be particularly daunting to sift through vast amounts of data to find what’s relevant and true.

Moreover, instilling critical thinking in educational environments can be tricky. It requires creating a space where questioning is encouraged, and students aren’t penalized for thinking outside the box or challenging the status quo. Educators must strike a balance between guiding students and giving them the freedom to explore ideas independently.

In the real world, critical thinking is more than an academic exercise; it’s a practical skill that affects every decision we make. From discerning which job offer to accept to navigating personal relationships, the ability to analyze facts dispassionately, understand logical connections, and make informed judgments is invaluable. It helps us avoid manipulation and make decisions that align with our values and goals.

In essence, critical thinking is about cultivating a mindset that questions, analyzes, and innovates. It empowers us to tackle complex challenges, reduces our susceptibility to misinformation, and enhances our ability to communicate effectively. By fostering this skill, we can improve not only our own lives but also contribute to a more rational, informed society.

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Harnessing the Power of Critical Thinking in Daily Life. (2024, May 12). Retrieved from https://papersowl.com/examples/harnessing-the-power-of-critical-thinking-in-daily-life/

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PapersOwl.com. (2024). Harnessing the Power of Critical Thinking in Daily Life . [Online]. Available at: https://papersowl.com/examples/harnessing-the-power-of-critical-thinking-in-daily-life/ [Accessed: 13-May-2024]

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