Chapter seven

Critical thinking
NSA 05/27/2023 1
Critical thinking

 Critical thinking does entail an orderly investigation of ideas, assumptions, principles, and
conclusions.

 Critical thinking is the process that guides

 scientific reasoning, the nursing process, problem solving, and decision making.

 The cognitive skills attributed to the critical thinking process include

 divergent thinking,
 reasoning,
 reflection,
 creativity,
 clarification, and
 basic support

NSA 05/27/2023 2
Critical thinking …Con’t
 Divergent thinking is the ability of an individual to analyze a variety of opinions
and judgments.

 Reasoning involves the use of logic and the ability to discriminate between
 observation and inference,
 fact and guessing

 Reflection allows one to deliberate about something, whereas creativity enables

one to produce ideas and alternatives and consider multiple solutions.

 Clarification includes identifying similarities, differences, and assumptions and

defining terms.

 Basic support involves the use of known facts and background knowledge

NSA 05/27/2023 3
Critical Thinking Process

 Identifying Assumptions

 Considering the Context

 Data Collection

NSA 05/27/2023 4
Critical Thinking Process…Con’t
 Identifying assumptions underlying the issue
 Begins by exploring the assumptions underlying a situation
 These assumptions may be beliefs that influence how an individual will
reason or understand a situation and may reflect a person’s point of view or
perspective.
 These assumptions may not necessarily be grounded in reality

NSA 05/27/2023 5
  For example –
 Administering of medication is a common activity of nurses and finding strategies
to avoid medication errors has become an important concern and problem-
solving initiative in many organizations.

 If a patient assumes the nurse will always administer the correct medication, it
is unlikely that the patient will question any medications the nurse offers.

 This assumption will have an impact on any efforts to include the patient in a
program to decrease medication administration errors.

NSA 05/27/2023 6
Critical Thinking Process …Con’t
Considering the context
Considering the context and
meaning of the issues to all of the
individuals
Involves considering the context of the
present problem or situation.
Analysis and interpretation of the
meanings of the present issue or
NSA
situation are essential to developing a
05/27/2023 7

conclusion.
 A context could be when the patient is not
responsive or not physically or mentally
capable of being involved in taking the
medications and cannot be safely included
in the process.
Another context is the patient taking
medications at home without direct
nursing supervision.

All these situations might involve different

strategies to try to avoid medication errors.
NSA 05/27/2023 8
Critical Thinking Process …Con’t
Gathering enough data to allow for
consideration of alternatives and
prediction of multiple outcomes
All too frequently, snap decisions are
made based on first impressions.
Leaders who use critical thinking skills do
consider first impressions, but they are
always careful to continue to gather data
and carefully evaluate all the
NSA alternatives and possible outcomes.
05/27/2023 9
Decision Making

 Is a choice made between two or more alternatives.

 It is choosing the best alternative to reach the predetermined objective.
 Thus decision-making is a process of identifying and selecting a course of action to
solve specific problem.

 Classifications of decision making

 Ends -Means
 Administrative-Operational
 Programmed-Non-programmed

NSA 05/27/2023 10
Decision Making … Con’t

 Ends-Means
 Ends: deals with the determination of desired results to be achieved
 Means: decisions deal with strategic or operational programmes, activities that will
accomplish desired results. These usually occur during managerial planning
processes, strategy and objective formulation processes

NSA 05/27/2023 11
Decision Making … Con’t

 Administrative-Operational
 Administrative: made by senior management, which have significant impact
throughout the organization.
 Usually this type of decision is concerned with policy, resource allocation and utilization.
 Operational: are generally made by mid level and first line managers and address
day to day operational activities of a particular organizational

NSA 05/27/2023 12
Decision Making … Con’t

 Programmed – Non-programmed
 Programmed-these are repetitive and routine in nature. Since they can be
programmed, procedures, rules and often manuals are formulated to cover those
situations
 None programmed: unique and non- routine

NSA 05/27/2023 13
Decision Making … Con’t

 Conditions that initiate decision making

 Opportunity/threat
 Crisis
 Deviation
 Improvement

NSA 05/27/2023 14
Decision Making … Con’t

 Ways of Decision Making

 Relying on tradition: taking the same decisions that had been undertaken when
similar problem arouse in the past

 May appeal to authority and make decisions based on suggestions from an expert/a
higher level management

 Priori reasoning: based on assumption

 Logical decision making: is a rational, intelligent and systematic approach to

decision making

NSA 05/27/2023 15
Decision Making … Con’t

 Steps of logical Decision Making

1. Investigating the situation

 Define the problem
 Identify the problem objective
 Diagnose the cause

2. Develop alternatives
3. Evaluate alternatives
4. Implement and follow up

NSA 05/27/2023 16
Factors Influencing Decision Making

 Decision makers attribute

 Knowledge, experience, and judgment
 Perception and personality
 Values and philosophy

 The Situation
 Urgency of solution and time pressures
 Magnitude and importance
 Structure and uncertainty and risk
 Cost benefit

 Environmental Constraints
 External
 Internal

NSA 05/27/2023 17
Problem solving

 Decision making may or may not involve a problem but always involves
selecting one action from several alternatives.

 Problem solving involves diagnosing or identifying a problem and solving it and

includes making decisions along the way

 Problem solving is often the result of critical thinking; it occurs when a problem
is diagnosed and resolved using one or more strategies.
 critical thinking is broader and more abstract.
 Problem solving may lead to a single solution, while critical thinking may lead to a
host of alternatives that each bear value and meaning with regard to the problem or
issue at hand.
NSA 05/27/2023 18
Problem solving … Con’t

 The process of problem solving is similar to the nursing process in that it

consists of the following steps
 Define the problem
 Gather data
 Analyze the data
 Develop options
 Select an option
 Implement the option
 Evaluate the outcome

NSA 05/27/2023 19