The Critical Thinking Toolkit

Fostering Critical Thinking Skills in the Front Line

Sixteen tools to enhance bedside nursing performance by focusing on five core critical thinking skill areas.

Today's environment makes it difficult for nurses to think critically.

Three forces—rising patient complexity, decreasing length of stay, and increased protocolization—now challenge even tenured nurses long recognized as strong critical thinkers.

This toolkit includes 16 exercises to help bolster frontline nurses' critical thinking skills at every career stage.

The critical thinking challenge

Nationwide, hospitals are caring for more complex patients while experiencing a dramatic decrease in patient length of stay. And now, frontline nurses are implementing an expanding set of clinical protocols. These three forces combine to create a perfect storm: frontline nurses must accomplish more in less time and often default to "task-focused tunnel vision."

More critical thinking resources

To ensure safe patient care in today's fast-paced environment, nurse leaders must take action to ensure frontline staff overcome "task-focused tunnel vision" and readily see a holistic picture of their patients' conditions.

Expanded course offerings during new-graduate nurse orientation are an excellent starting place for bolstering critical thinking skills. But mounting evidence indicates they're not enough.

Orientation courses are typically limited in scope, and don't provide the level of depth needed to overcome critical thinking roadblocks 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 more complex.

How this toolkit helps

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 include role-playing, structured peer feedback, targeted patient observation, and guided self-reflection.

Ideally, the managers, educators, and preceptors using 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.

16 tools to address 5 critical thinking components

Problem recognition

    • Change in Patient Status Exercise
    • Unusual" Patient Progression Exercise
    • Unit-Level Problem Identification and Prioritization Exercise
    • Root Cause Analysis
    • In-the-Moment Safety Concern Scripting

Clinical decision making

    • Evidence-Based Nursing Practice Analysis and Application Exercise
    • Concept Mapping Exercise
    • Solution Assessment and Trade-Off Exercise


    • Delegation Decision Tree
    • Individual Patient Goal Prioritization Exercise
    • Patient Assignment Prioritization Scenarios

Clinical implementation

    • Plan of Care Customization Exercise
    • SBAR Template and Role-Play


    • Peer Feedback Request Exercise
    • Individual Self-Assessment and Development Plan
    • Clinical Narrative Exercise

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