Critical thinking and clinical reasoning

Critical thinking in nursing education and practice has greatly been emphasized as an important skill over a long period. Its definitions have changed over these periods and can be defined as a purposeful and self-regulated judgment of an individual based on the basic application of cognitive tools to base a judgment. Some of these tools may include evaluations, making inferences and explaining evidential, criteria or methodological considerations (Hood, 2014). Others may define it as a self-directed and thought oriented plus corrections based on self that result in excellence and commands taken mindfully for personal use. A common center of paradox in its definitions is that it entails effective problem solving and communication abilities through a commitment to overcome ones sociocentrism and egocentrism.

In the nursing practice, critical thinking forms a key component of achieving professional accountability and the provision of quality nursing care. A critical thinker can easily exhibit most mindful habits such as confidence, creativity, intuition, and reflection. The NLNAC defined critical thinking as a process that is nonlinear but deliberate for collecting, analyzing, interpreting and drawing conclusions in the presentation of information that is either belief-based or evidence-based shown by clinical judgments of diagnostic, research, ethical and therapeutic dimensions.

Baccalaureate prepared nurses apply their knowledge and skills to use nursing and other relevant theories and models in establishing a suitable ethical framework and can further be attested by the application of research-based knowledge from nursing and other disciplines as a foundation for their practice (Hood, 2014). Furthermore, they can evaluate the outcomes of nursing care by acquiring data and correct inconsistencies thus revising actions. On the other hand, clinical reasoning stands out a practice-based reasoning and requires scientific and research that is based on technology as a background for some cases. They can assess the general clinical trajectory of the patient including concerns to come up with conclusions.

According to Patricia Benner’s theory of Novice to expert nursing, it is proved that expertise is acquired through professional experience, and a nurse who has moved beyond proficiency levels can be a better decision maker compared to a novice. When the actions of an advanced beginner are questioned over a complex patient situation, they may feel that there was no safety in their practices due to deficits in knowledge confusions in applying their knowledge (Victor-Chmil, 2013). They can later advance to better decision-making skills as a result of knowledge gained from past mistakes or those of their colleagues.

On the other hand, a nurse with great experience in the practice continuously questions what they see and hear and feel that urge to know more about clinical situations. They can advance from following orders of physicians and using care plans to interpreting and analyzing situations of patients. They can further acknowledge the change in the relevance of clinical situations that requires actions that are beyond their plans or anticipation by could organize for interventions in the event of a change in patient’s needs in care situations.

Evidence-based practice is dependent upon the synthesis of evidence from various sources and later applying them appropriately to the care needs of individuals or populations. It is a clear indication of expertise put into practice by applying evidence in the unique needs of patients. It serves to support independent clinical decisions for the best interest in the needs of a patient (DiCenso et al., 2014). An example is the prevention of pressure ulcer where analysis is done on the drug sensitiveness and allergies including a study of comorbidities to come up with a specific measure in reducing the impact.

References

DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-based nursing: A guide to clinical practice. Elsevier Health Sciences.

Victor-Chmil, J. (2013). Critical thinking versus clinical reasoning versus clinical judgment: Differential diagnosis. Nurse educator38(1), 34-36.

Hood, L. J. (2014). Conceptual bases of professional nursing (8th ed.).

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