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Richard Paul Critical Thinking Articles For Nurses

Dr. Richard Paul was Director of Research and Professional Development at the Center for Critical Thinking, and was Chair of the National Council for Excellence in Critical Thinking. His body of work, including eight books and over 200 articles, established him as an internationally-recognized authority on critical thinking. In addition to writing books for every grade level, he experimented extensively with teaching tactics and strategies, and with devising (among other things) novel ways to engage students in rigorous self-assessment. 

 

Dr. Paul received four degrees and gave lectures on critical thinking at many universities in both the United States and abroad, including Harvard, the University of Chicago, the University of Illinois, and the universities of Puerto Rico, Costa Rica, British Columbia, Toronto, and Amsterdam. He taught beginning and advanced courses in critical thinking at the university level for over 20 years.

Paul received numerous honors and awards in his lifeitme, including Distinguished Philosopher (Council for Philosophical Studies, 1987), O.C. Tanner Lecturer in Humanities (Utah State University, 1986), Lansdown Visiting Scholar (University of Victoria, 1987), and the Alfred Korsybski Memorial Lecturer (Institute for General Semantics, 1987).  His views on critical thinking have been canvassed in the New York Times, Education Week, The Chronicle of Higher Education, American Teacher, Reader’s Digest, Educational Leadership, Newsweek, and U.S. News and World Report. Dr. Paul’s wide-ranging knowledge, practical strategies, and enthusiasm made him highly sought-after as a presenter and keynote speaker.

See our Memorial Page for Dr. Richard Paul.

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Video Biography: Introduction by Dr. Gerald Nosich at the 2008 International Conference

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One of the most commonly heard phrases right from day one of nursing school is “critical thinking.” The common consensus is that everyone has to develop sound critical thinking in order to be a safe and effective, registered nurse (RN). This necessity is magnified when it comes to critical care areas where one decision by the RN can change the patient’s outcome. Nursing has changed from a simple caregiving job to a complex and highly responsible profession. Hence, the role of nurses has changed from being task-oriented to a team-based, patient-centered approach with an emphasis on positive outcomes. Strong critical thinking skills will have the greatest impact on patient outcomes.

So, what is critical thinking and how do we develop this? A precise definition was proposed in a statement by Michael Scriven and Richard Paul at the Eighth Annual International Conference on Critical Thinking and Education Reform during the summer of 1987. “Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action. In its exemplary form, it is based on universal intellectual values that transcend subject matter divisions: clarity, accuracy, precision, consistency, relevance, sound evidence, good reasons, depth, breadth, and fairness,” reads the document.

Simply put, critical thinking in nursing is a purposeful, logical process which results in powerful patient outcomes. “Critical thinking involves interpretation and analysis of the problem, reasoning to find a solution, applying, and finally evaluation of the outcomes,” according to a 2010 study published in the Journal of Nursing Education. This definition essentially covers the nursing process and reiterates that critical thinking builds upon a solid foundation of sound clinical knowledge. Critical thinking is the result of a combination of innate curiosity; a strong foundation of theoretical knowledge of human anatomy and physiology, disease processes, and normal and abnormal lab values; and an orientation for thinking on your feet. Combining this with a strong passion for patient care will produce positive patient outcomes. The critical thinking nurse has an open mind and draws heavily upon evidence-based research and past clinical experiences to solve patient problems.

How does one develop critical thinking skills? A good start is to develop an inquisitive mind, which leads to questioning, and a quest for knowledge and understanding of the complex nature of the human body and its functioning. A vital step in developing critical thinking for new nurses is to learn from those with a strong base of practical experience in the form of preceptors/colleagues. An open-minded nurse can learn valuable lessons from others’ critical thinking ability and will be able to practice for the good of their patients.

Critical thinking is self-guided and self-disciplined. Nursing interventions can be reasonably explained through evidence-based research studies and work experience. A strong sense of focus and discipline is also important for critical thinking to work. If thinking is unchecked, nurses can be easily misguided and deliver flawed patient care. A constant comparison of practice with best practices in the industry will help guide a nurse to think critically and improve care. This makes it easier to form habits which continue to have a positive impact on patients and colleagues. Every decision a critical thinking nurse makes affects not only the patient but also his or her families, coworkers, and self.

In summary, the take-home message for nurses is that critical thinking alone can’t ensure great patient care. A combination of open-mindedness, a solid foundational knowledge of disease processes, and continuous learning, coupled with a compassionate heart and great clinical preceptors, can ensure that every new nurse will be a critical thinker positively affecting outcomes at the bedside.

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Srinidhi Lakhanigam, BSN, RN, CCRN, CMSRN

Srinidhi Lakhanigam, BSN, RN, CCRN, CMSRN, is a member of the critical care team at Good Samaritan Hospital in San Jose, California.

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