The Critical Thinking Toolkit

Fostering Critical Thinking Skills in the Front Line

Topics: Nursing, Critical Thinking and Decision Making, Operations Skills, Skill Development, Workforce, Clinical Skills, Quality, Clinical Operations, Performance Management

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Today’s fast-paced environment leaves bedside nurses struggling to maintain a level of optimal care and attention. The task-oriented culture means that, too often, suboptimal care results from nurses being unable to bolster critical thinking skills and adequately care for their patients. After using this toolkit, however, members will be able to maintain a level of optimal care by:

  • Developing methods by which to alert nurses of emerging problems and train them for problem recognition
  • Training nurses in clinical decision-making, by assessing problems and determining the appropriate solutions
  • Prioritizing behavior based on urgency of care
  • Tailoring care to specific situations and patients
  • Analyzing past and present practices to determine opportunities for improvement as well as recognizing current strengths

Executive Summary

Nearly all nursing leaders report that today’s fast-paced and task-oriented care environment can prevent bedside nurses from thinking critically about their patient’s needs and nursing care—all too often resulting in suboptimal care. Expanded course offerings during new-graduate nurse orientation are no doubt an excellent starting place for bolstering critical thinking skills. But mounting evidence indicates they are not sufficient. The reach of such courses typically is too limited in timing and scope to overcome the myriad roadblocks to critical thinking that all nurses face in today’s complex care environment. Moreover, the challenge of equipping nurses to think critically is scaling. Nurses long recognized as strong critical thinkers are increasingly finding themselves challenged as the care environment becomes ever more complex due to ongoing protocolization, rising patient acuity, and decreasing length of stay.

This Toolkit contains 16 targeted exercises to enhance bedside nurse performance on five core components of critical thinking. The exercises are designed for nurses at every career stage—tenured nurses as well as new graduates. To complement didactic training and reflect adult learning theory, the exercises are highly interactive. Activities participants will be asked to conduct include role-playing, structured peer feedback, targeted patient observation, and guided self-reflection. Ideally, the managers, educators, and preceptors deploying the toolkit should first identify their frontline nurses’ most pressing improvement needs and then prioritize the most relevant exercises. To assist with this mapping, each section begins with a brief overview of the targeted critical thinking competency and supporting tools. Additionally, each tool contains a user guide, evaluation criteria, and prompts for facilitated discussion.