Critical Thinking In Nursing Education Introduction

Critical thinking is a crucial skill in nursing, as it helps nurses make well-informed decisions, prioritize patient care, and solve complex health issues. In nursing education, critical thinking exercises (CTEs) play a vital role in cultivating these abilities, helping students bridge the gap between theoretical knowledge and practical application. This article discusses the importance of critical thinking exercises in nursing education, the THINK model, and how to implement CTEs effectively.

Critical Thinking Exercises in Nursing Education

General Description

Critical Thinking Exercises (CTEs) are designed to encourage nursing students to engage with course material actively. By introducing these exercises early in the class or including them in preparatory readings, educators can foster an environment where students begin to internalize critical thinking habits. These exercises emphasize the importance of learning to prioritize tasks and think like a nurse, helping students gain insight into what matters most in clinical decision-making.

For novice nurses, setting priorities can be overwhelming. CTEs help by focusing on key issues and guiding students through the process of problem-solving and decision-making.

Example of Critical Thinking Exercise

A typical CTE might involve a clinical scenario where students are asked:

• “What is the nurse’s role in caring for this client?”
• “What is the highest priority for the nurse and the client?”
• “How should the nurse handle this situation?”

Such exercises encourage students to analyze situations critically, apply theoretical knowledge, and practice decision-making in a safe learning environment.

Use of the THINK Model in Critical Thinking Exercises

The THINK model, developed by Scheffer and Rubenfeld, provides a structured approach to critical thinking. This model highlights five key elements:

• T: Total recall and memory – Students must recall information accurately.
• H: Habits of learning and thinking – Encouraging habitual critical thinking behavior.
• I: Inquiry and in-depth thinking – Stimulating curiosity and exploration of complex concepts.
• N: New ideas and creativity – Promoting innovative thinking and problem-solving.
• K: Knowing how one thinks and reflecting – Encouraging self-awareness and reflection on thought processes.

By using this model, educators can design exercises that promote deep thinking and allow students to assess their learning before formal evaluations.

Implementation of Critical Thinking Exercises in Nursing Education

1. Use at the Beginning and End of Class

Instructors can introduce CTEs at both the start and end of a class. This strategy helps students engage with the material from the outset and offers an opportunity for reflection and closure at the end of the session. For example, students can be presented with a critical thinking question at the beginning and asked to revisit it at the end, allowing them to evaluate their understanding and growth.

2. Customize for Different Settings

CTEs can be tailored to specific nursing specialties or topics, such as medical-surgical nursing or pediatric care, to keep students interested and invested in learning. Educators can develop unique names for these exercises to increase student engagement.

3. Use in Email and Online Formats

CTEs can be adapted for use in e-learning environments. Educators might send out “E-mail Exercises” before class, asking students to reflect on a question and submit responses prior to the next session. This can help keep students engaged outside the classroom and encourage deeper preparation.

4. Align with Examinations and Class Objectives

CTEs should be aligned with class objectives and evaluation materials. This not only helps students prepare for exams but also reinforces key learning outcomes. For instance, educators can design exam questions based on CTEs, allowing students to practice critical thinking in ways that mirror their assessments.

5. Adapt for Continuing Education

In continuing education programs, CTEs can be included in class brochures, registration letters, or promotional materials. Well-designed exercises help students focus on the essential topics and may encourage more active participation.

Representative Examples of Critical Thinking Exercises

Here are some sample CTEs that can be used both as classroom exercises and as examination questions:

• Clinical Prioritization: “How do hospitals make up for the costs on an extended admission when diagnosis-related groups (DRGs) are in effect?”
• Accountability in Nursing: “You make a medication error as a nursing student. Who is accountable?”
• Patient Care Application: “Why does helping a client sit up ease respirations?”
• Shock Differentiation: “How do the signs of impaired perfusion differ in hypovolemic shock and in septic shock?”
• Mental Status Assessment: “How can you assess mental status changes in a client with hepatic encephalopathy?”
• Glucose Monitoring: “What are the classic signs of hypoglycemia? Compare them with the signs of hyperglycemia.”
• Pharmacological Management: “A client is in congestive heart failure. What medications or classes of medications would you anticipate being part of their care?”
• Pain Assessment: “How do you assess pain in a nonverbal client?”

Conclusion

Critical thinking is essential for nursing students as they prepare to navigate the complex clinical environments they will encounter. The use of Critical Thinking Exercises (CTEs) provides students with opportunities to internalize the THINK model, enhance their problem-solving skills, and practice making informed decisions in a structured learning environment. By implementing CTEs effectively in both academic and continuing education settings, nursing educators can help students develop the critical thinking abilities necessary for successful nursing practice.