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Critical Thinking

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The application of knowledge and experience to ID patient problems and to direct clinical judgements and actions that result in positive patient outcomes

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3 Consistent themes of critical thinking

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1. the importance of a good foundation of knowledge 2. willingness to ask questions 3. ability to recognize new answers even when not the norm

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Problem solving

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systematic, analytic approach to finding a solution to a problem

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Decision making

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choosing a solution or answer from among different options; often considered a step in the problem solving process

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Reasoning

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logical thinking that links thoughts, ideas and facts together in a meaningful way. Used in scientific inquiry & problem solving

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Clinical reasoning

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the process of using critical thinking, knowledge & experience to develop solutions to problems and make decisions in clinical settings

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Judgement

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the application of information based on observations or data leading to a decision or conclusion

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Clinical judgement

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the application of info based on clinical observations or data that leads to a patient care decision or conclusion. Demonstrates clinical thinking

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Intellectual standards of Critical Thinking

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Clarity, accuracy, precision, relevance, depth, breadth, logic, significance & fairness

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Essential to critical thinking

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Accuracy, self-reflection, clarity & fairness

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Clarity

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Being easily understood or precise in thought & style; considered a gateway standard because a statement cannot be evaluated for accuracy or precision if its ambiguous.

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Examples of clarity questions

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Can you elaborate? give an example? an illustration? Correct in meaning?

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Accuracy

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representing something in a true and correct way

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Examples of Accuracy questions

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Is that true? verifiable? determine if info is correct?

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Precision

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providing sufficient detail to understand exactly what is/was meant

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Examples of precision questions

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Can you provide additional details? Can you be more specific?

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Relevance

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focusing on facts & ideas directly related & pertinent to a topic

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Examples of relevance questions

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How is this related to the topic? related to issue? relationship to other issues/topics?

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Depth

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getting beneath the surface of the topic or problem to ID & manage related complexities

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Examples of depth questions

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How does this address complexities of issues? How to take into account problems associated with the question?

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Breadth

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considering a topic, problem or issue from every relevant viewpoint

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Examples of breadth questions

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Other options for point of view? how does issue look from a different point of view? or another approach?

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Logic

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using a mutually supportive and sensible combination of thoughts & facts to form a conclusion

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Examples of logic questions

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Does it fit together logically? makes sense? does evidence lead to this conclusion or answer?

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Significance

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concentrating on most important information when considering an issue.

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Fairness

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thinking or acting in accord with reason and without bias

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Examples of Fairness questions

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Are assumptions justified? Am I considering other points of view?

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Components of Critical Thinking

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Knowledge base, reasoning, inference, validation, intellectual traits

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Knowledge

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Baseline & information gathering. Focus on knowledge gaps

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Reasoning components

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Inductive and deductive reasoning

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Inductive reasoning

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uses specific facts or details to draw conclusions and make generalizations not based on solid proof, so more facts may need to be gathered to substantiate conclusions. Specific to general

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Deductive Reasoning

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involves generating facts or details from a major theory, generalization or premise. General to specific. Generally accepted that if the premise or fact is true than the conclusions drawn from it are also true.

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Inference components

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Assumptions, intuition, interpretation. May be logical/illogical, accurate/inaccurate, justified/unjustified.

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Assumptions

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beliefs that are taken for granted & assumed to be true

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Intuition

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feeling of knowing something without having any specific evidence to support it. Can be based on experiential knowledge

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Interpretation

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Shaped by the organizational structure and meaning assigned to the info. Based on personal conceptions & perspectives, must be differentiated from facts & evidence

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Validation

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process of gathering info to determine whether the info or data collected is factual

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Intellectual traits (attitudes) that promote Critical thinking

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confidence, thinking independently, fairness, responsibility & accountability, risk-taking, discipline, perseverance, creativity, curiosity, integrity, humility

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Confidence

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feeling certain about one's ability to accomplish a goal

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Thinking independently

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considering a wide-range of ideas before coming to a conclusion

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Fairness definition

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avoiding bias or prejudice and dealing with a situation in a just manner

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Responsibility & accountability

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acting on sound knowledge & acknowledging actions as one's own

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Risk-taking

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being willing to try new ideas

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Discipline

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following orderly thinking to do what is best

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Perseverance

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staying determined to work until the goal is achieved

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Creativity

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formulating new ideas and alternative approaches

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Curiosity

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being motivated to achieve and asking why

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Integrity

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being honest & willing to adhere to principles in the face of adversity

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Humility

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admitting one's limitations

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How are CT and clinical judgement related?

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Clinical judgement demonstrates critical thinking

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Which themes are common definitions of critical thinking?

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openness to new answers, willingness to ask questions & need for foundational knowledge

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Which statement describes the relationship between critical thinking & clinical reasoning?

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critical thinking is the base of clinical reasoning

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Which process uses clinical observations or data to arrive at a patient care decision or conclusion?

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Clinical judgement

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Which critical thinking intellectual standard is addressed when the nurse asks, "How did the evidence lead me to this answer?"

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Logic

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Which critical thinking intellectual standard is addressed when the nurse asks, "Is this information correct?"

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Accuracy

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Which critical thinking intellectual standard is addressed when the nurse asks, "Does this new piece of data have any relationship to to this issues?"

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Relevance

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Which intellectual standard is compromised when bias is allowed to influence decision making?

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Breadth & fairness

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Which critical thinking intellectual standard is upheld when a student cites the sources of info used in a term paper?

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Accuracy

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Which descriptors characterize critical thinking

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Accurate, clear, self-reflective & sound

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Which statement describes a characteristic of inductive reasoning?

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Conclusions may need to be substantiated; they are not based on solid proof

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Which statement is true about inferences?

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Inferences can be accurate, inaccurate, justified or unjustified. The accuracy of an inference is directly related to the accuracy of its underlying assumption

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Which process, based on its definition, describes the nursing process?

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Problem-solving: a systematic, analytic approach to finding a solution to a problem. The nursing process, with its 5-steps ADPIE, is used to solve patient care problems systematically & analytically.

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Which info about deductive reasoning is correct?

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Generated facts from a major theory & proceeds from general to specific

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Which dimensions are included in the NLNAC's definition of clinical judgement?

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Diagnostic dimension, ethical dimension, therapeutic dimension

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Which term is used by the NLNAC to describe the manifestations of critical thinking in nursing?

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Clinical judgement

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What is the definition of problem-solving?

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A systematic, analytical approach to finding a solution to a problem

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What statement describes clinical reasoning?

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Using critical thinking to develop a solution to a problem. Also using knowledge and experience to develop solutions.

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Which critical thinking intellectual standard would the nurse illustrate by asking the patient to be more specific when complaining about "just not feeling right?"

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Precision: requires sufficient detail be provided to explain exactly what is meant.

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Which critical thinking intellectual standard is demonstrated by a nurse who says to a patient, "This is what I heard you say. Am I correct about your meaning?"

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Clarity: being easily understandable in thought and style.

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Asking the question "is there another approach to this problem?" aligns with which intellectual standard?

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Breadth: considering a topic, problem or issue from every relevant viewpoint

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Which data obtained during a health assessment would require validation?

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complaint of a red pin point underarm rash. Because report is patient's subjective report, examiner needs to inspect area to validate info.

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Upon what do expert nurses base their intuition?

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Experiential knowledge

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What does the American Philosophical Associate (APA) define critical thinking as?

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Purposeful, self-regulatory judgement, uses cognitive tools such as interpretation, analysis, evaluation, inference and explanation of the evidential, methodological, criteriological or contextual considerations on which judgement is based.

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How does the Center for Critical Thinking define critical thinking?

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Complex process that is "the art of thinking about your thinking while you are thinking, in order to improve your thinking" (Paul, 1998)

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How does the National League for Nursing Accreditation Commission (NLNAC) define critical thinking?

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Deliberate nonlinear process of collecting, interpreting, analyzing, drawing conclusions about, presenting and evaluating info; both factually and belief-based. Demonstrated in nursing by clinical judgement, which includes ethical, diagnostic, and therapeutic dimensions & research.

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Clarity questions

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How can you elaborate on that point? How can you express that point differently? What is an illustration of what you mean? What is an example? This is what I heard you say; am I correct about your meaning?

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