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What is Critical Thinking?

Critical thinking is the ability to think clearly and rationally, understanding the logical connection between ideas.  Critical thinking has been the subject of much debate and thought since the time of early Greek philosophers such as Plato and Socrates and has continued to be a subject of discussion into the modern age, for example the ability to recognise fake news .

Critical thinking might be described as the ability to engage in reflective and independent thinking.

In essence, critical thinking requires you to use your ability to reason. It is about being an active learner rather than a passive recipient of information.

Critical thinkers rigorously question ideas and assumptions rather than accepting them at face value. They will always seek to determine whether the ideas, arguments and findings represent the entire picture and are open to finding that they do not.

Critical thinkers will identify, analyse and solve problems systematically rather than by intuition or instinct.

Someone with critical thinking skills can:

Understand the links between ideas.

Determine the importance and relevance of arguments and ideas.

Recognise, build and appraise arguments.

Identify inconsistencies and errors in reasoning.

Approach problems in a consistent and systematic way.

Reflect on the justification of their own assumptions, beliefs and values.

Critical thinking is thinking about things in certain ways so as to arrive at the best possible solution in the circumstances that the thinker is aware of. In more everyday language, it is a way of thinking about whatever is presently occupying your mind so that you come to the best possible conclusion.

Critical Thinking is:

A way of thinking about particular things at a particular time; it is not the accumulation of facts and knowledge or something that you can learn once and then use in that form forever, such as the nine times table you learn and use in school.

The Skills We Need for Critical Thinking

The skills that we need in order to be able to think critically are varied and include observation, analysis, interpretation, reflection, evaluation, inference, explanation, problem solving, and decision making.

Specifically we need to be able to:

Think about a topic or issue in an objective and critical way.

Identify the different arguments there are in relation to a particular issue.

Evaluate a point of view to determine how strong or valid it is.

Recognise any weaknesses or negative points that there are in the evidence or argument.

Notice what implications there might be behind a statement or argument.

Provide structured reasoning and support for an argument that we wish to make.

The Critical Thinking Process

You should be aware that none of us think critically all the time.

Sometimes we think in almost any way but critically, for example when our self-control is affected by anger, grief or joy or when we are feeling just plain ‘bloody minded’.

On the other hand, the good news is that, since our critical thinking ability varies according to our current mindset, most of the time we can learn to improve our critical thinking ability by developing certain routine activities and applying them to all problems that present themselves.

Once you understand the theory of critical thinking, improving your critical thinking skills takes persistence and practice.

Try this simple exercise to help you to start thinking critically.

Think of something that someone has recently told you. Then ask yourself the following questions:

Who said it?

Someone you know? Someone in a position of authority or power? Does it matter who told you this?

What did they say?

Did they give facts or opinions? Did they provide all the facts? Did they leave anything out?

Where did they say it?

Was it in public or in private? Did other people have a chance to respond an provide an alternative account?

When did they say it?

Was it before, during or after an important event? Is timing important?

Why did they say it?

Did they explain the reasoning behind their opinion? Were they trying to make someone look good or bad?

How did they say it?

Were they happy or sad, angry or indifferent? Did they write it or say it? Could you understand what was said?

What are you Aiming to Achieve?

One of the most important aspects of critical thinking is to decide what you are aiming to achieve and then make a decision based on a range of possibilities.

Once you have clarified that aim for yourself you should use it as the starting point in all future situations requiring thought and, possibly, further decision making. Where needed, make your workmates, family or those around you aware of your intention to pursue this goal. You must then discipline yourself to keep on track until changing circumstances mean you have to revisit the start of the decision making process.

However, there are things that get in the way of simple decision making. We all carry with us a range of likes and dislikes, learnt behaviours and personal preferences developed throughout our lives; they are the hallmarks of being human. A major contribution to ensuring we think critically is to be aware of these personal characteristics, preferences and biases and make allowance for them when considering possible next steps, whether they are at the pre-action consideration stage or as part of a rethink caused by unexpected or unforeseen impediments to continued progress.

The more clearly we are aware of ourselves, our strengths and weaknesses, the more likely our critical thinking will be productive.

The Benefit of Foresight

Perhaps the most important element of thinking critically is foresight.

Almost all decisions we make and implement don’t prove disastrous if we find reasons to abandon them. However, our decision making will be infinitely better and more likely to lead to success if, when we reach a tentative conclusion, we pause and consider the impact on the people and activities around us.

The elements needing consideration are generally numerous and varied. In many cases, consideration of one element from a different perspective will reveal potential dangers in pursuing our decision.

For instance, moving a business activity to a new location may improve potential output considerably but it may also lead to the loss of skilled workers if the distance moved is too great. Which of these is the more important consideration? Is there some way of lessening the conflict?

These are the sort of problems that may arise from incomplete critical thinking, a demonstration perhaps of the critical importance of good critical thinking.

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In Summary:

Critical thinking is aimed at achieving the best possible outcomes in any situation. In order to achieve this it must involve gathering and evaluating information from as many different sources possible.

Critical thinking requires a clear, often uncomfortable, assessment of your personal strengths, weaknesses and preferences and their possible impact on decisions you may make.

Critical thinking requires the development and use of foresight as far as this is possible. As Doris Day sang, “the future’s not ours to see”.

Implementing the decisions made arising from critical thinking must take into account an assessment of possible outcomes and ways of avoiding potentially negative outcomes, or at least lessening their impact.

• Critical thinking involves reviewing the results of the application of decisions made and implementing change where possible.

It might be thought that we are overextending our demands on critical thinking in expecting that it can help to construct focused meaning rather than examining the information given and the knowledge we have acquired to see if we can, if necessary, construct a meaning that will be acceptable and useful.

After all, almost no information we have available to us, either externally or internally, carries any guarantee of its life or appropriateness.  Neat step-by-step instructions may provide some sort of trellis on which our basic understanding of critical thinking can blossom but it doesn’t and cannot provide any assurance of certainty, utility or longevity.

Continue to: Critical Thinking and Fake News Critical Reading

See also: Analytical Skills Understanding and Addressing Conspiracy Theories Introduction to Neuro-Linguistic Programming (NLP)

Defining Critical Thinking

• A Brief History of the Idea of Critical Thinking
• Critical Thinking: Basic Questions & Answers
• Our Conception of Critical Thinking
• Sumner’s Definition of Critical Thinking
• Research in Critical Thinking
• Critical Societies: Thoughts from the Past

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1 Introduction to Critical Thinking

I. what is c ritical t hinking [1].

Critical thinking is the ability to think clearly and rationally about what to do or what to believe.  It includes the ability to engage in reflective and independent thinking. Someone with critical thinking skills is able to do the following:

• Understand the logical connections between ideas.
• Identify, construct, and evaluate arguments.
• Detect inconsistencies and common mistakes in reasoning.
• Solve problems systematically.
• Identify the relevance and importance of ideas.
• Reflect on the justification of one’s own beliefs and values.

Critical thinking is not simply a matter of accumulating information. A person with a good memory and who knows a lot of facts is not necessarily good at critical thinking. Critical thinkers are able to deduce consequences from what they know, make use of information to solve problems, and to seek relevant sources of information to inform themselves.

Critical thinking should not be confused with being argumentative or being critical of other people. Although critical thinking skills can be used in exposing fallacies and bad reasoning, critical thinking can also play an important role in cooperative reasoning and constructive tasks. Critical thinking can help us acquire knowledge, improve our theories, and strengthen arguments. We can also use critical thinking to enhance work processes and improve social institutions.

Some people believe that critical thinking hinders creativity because critical thinking requires following the rules of logic and rationality, whereas creativity might require breaking those rules. This is a misconception. Critical thinking is quite compatible with thinking “out-of-the-box,” challenging consensus views, and pursuing less popular approaches. If anything, critical thinking is an essential part of creativity because we need critical thinking to evaluate and improve our creative ideas.

II. The I mportance of C ritical T hinking

Critical thinking is a domain-general thinking skill. The ability to think clearly and rationally is important whatever we choose to do. If you work in education, research, finance, management or the legal profession, then critical thinking is obviously important. But critical thinking skills are not restricted to a particular subject area. Being able to think well and solve problems systematically is an asset for any career.

Critical thinking is very important in the new knowledge economy.  The global knowledge economy is driven by information and technology. One has to be able to deal with changes quickly and effectively. The new economy places increasing demands on flexible intellectual skills, and the ability to analyze information and integrate diverse sources of knowledge in solving problems. Good critical thinking promotes such thinking skills, and is very important in the fast-changing workplace.

Critical thinking enhances language and presentation skills. Thinking clearly and systematically can improve the way we express our ideas. In learning how to analyze the logical structure of texts, critical thinking also improves comprehension abilities.

Critical thinking promotes creativity. To come up with a creative solution to a problem involves not just having new ideas. It must also be the case that the new ideas being generated are useful and relevant to the task at hand. Critical thinking plays a crucial role in evaluating new ideas, selecting the best ones and modifying them if necessary.

Critical thinking is crucial for self-reflection. In order to live a meaningful life and to structure our lives accordingly, we need to justify and reflect on our values and decisions. Critical thinking provides the tools for this process of self-evaluation.

Good critical thinking is the foundation of science and democracy. Science requires the critical use of reason in experimentation and theory confirmation. The proper functioning of a liberal democracy requires citizens who can think critically about social issues to inform their judgments about proper governance and to overcome biases and prejudice.

Critical thinking is a   metacognitive skill . What this means is that it is a higher-level cognitive skill that involves thinking about thinking. We have to be aware of the good principles of reasoning, and be reflective about our own reasoning. In addition, we often need to make a conscious effort to improve ourselves, avoid biases, and maintain objectivity. This is notoriously hard to do. We are all able to think but to think well often requires a long period of training. The mastery of critical thinking is similar to the mastery of many other skills. There are three important components: theory, practice, and attitude.

III. Improv ing O ur T hinking S kills

If we want to think correctly, we need to follow the correct rules of reasoning. Knowledge of theory includes knowledge of these rules. These are the basic principles of critical thinking, such as the laws of logic, and the methods of scientific reasoning, etc.

Also, it would be useful to know something about what not to do if we want to reason correctly. This means we should have some basic knowledge of the mistakes that people make. First, this requires some knowledge of typical fallacies. Second, psychologists have discovered persistent biases and limitations in human reasoning. An awareness of these empirical findings will alert us to potential problems.

However, merely knowing the principles that distinguish good and bad reasoning is not enough. We might study in the classroom about how to swim, and learn about the basic theory, such as the fact that one should not breathe underwater. But unless we can apply such theoretical knowledge through constant practice, we might not actually be able to swim.

Similarly, to be good at critical thinking skills it is necessary to internalize the theoretical principles so that we can actually apply them in daily life. There are at least two ways to do this. One is to perform lots of quality exercises. These exercises don’t just include practicing in the classroom or receiving tutorials; they also include engaging in discussions and debates with other people in our daily lives, where the principles of critical thinking can be applied. The second method is to think more deeply about the principles that we have acquired. In the human mind, memory and understanding are acquired through making connections between ideas.

Good critical thinking skills require more than just knowledge and practice. Persistent practice can bring about improvements only if one has the right kind of motivation and attitude. The following attitudes are not uncommon, but they are obstacles to critical thinking:

• I prefer being given the correct answers rather than figuring them out myself.
• I don’t like to think a lot about my decisions as I rely only on gut feelings.
• I don’t usually review the mistakes I have made.
• I don’t like to be criticized.

To improve our thinking we have to recognize the importance of reflecting on the reasons for belief and action. We should also be willing to engage in debate, break old habits, and deal with linguistic complexities and abstract concepts.

The  California Critical Thinking Disposition Inventory  is a psychological test that is used to measure whether people are disposed to think critically. It measures the seven different thinking habits listed below, and it is useful to ask ourselves to what extent they describe the way we think:

• Truth-Seeking—Do you try to understand how things really are? Are you interested in finding out the truth?
• Open-Mindedness—How receptive are you to new ideas, even when you do not intuitively agree with them? Do you give new concepts a fair hearing?
• Analyticity—Do you try to understand the reasons behind things? Do you act impulsively or do you evaluate the pros and cons of your decisions?
• Systematicity—Are you systematic in your thinking? Do you break down a complex problem into parts?
• Confidence in Reasoning—Do you always defer to other people? How confident are you in your own judgment? Do you have reasons for your confidence? Do you have a way to evaluate your own thinking?
• Inquisitiveness—Are you curious about unfamiliar topics and resolving complicated problems? Will you chase down an answer until you find it?
• Maturity of Judgment—Do you jump to conclusions? Do you try to see things from different perspectives? Do you take other people’s experiences into account?

Finally, as mentioned earlier, psychologists have discovered over the years that human reasoning can be easily affected by a variety of cognitive biases. For example, people tend to be over-confident of their abilities and focus too much on evidence that supports their pre-existing opinions. We should be alert to these biases in our attitudes towards our own thinking.

IV. Defining Critical Thinking

There are many different definitions of critical thinking. Here we list some of the well-known ones. You might notice that they all emphasize the importance of clarity and rationality. Here we will look at some well-known definitions in chronological order.

1) Many people trace the importance of critical thinking in education to the early twentieth-century American philosopher John Dewey. But Dewey did not make very extensive use of the term “critical thinking.” Instead, in his book  How We Think (1910), he argued for the importance of what he called “reflective thinking”:

…[when] the ground or basis for a belief is deliberately sought and its adequacy to support the belief examined. This process is called reflective thought; it alone is truly educative in value…

Active, persistent and careful consideration of any belief or supposed form of knowledge in light of the grounds that support it, and the further conclusions to which it tends, constitutes reflective thought.

There is however one passage from How We Think where Dewey explicitly uses the term “critical thinking”:

The essence of critical thinking is suspended judgment; and the essence of this suspense is inquiry to determine the nature of the problem before proceeding to attempts at its solution. This, more than any other thing, transforms mere inference into tested inference, suggested conclusions into proof.

2) The  Watson-Glaser Critical Thinking Appraisal  (1980) is a well-known psychological test of critical thinking ability. The authors of this test define critical thinking as:

…a composite of attitudes, knowledge and skills. This composite includes: (1) attitudes of inquiry that involve an ability to recognize the existence of problems and an acceptance of the general need for evidence in support of what is asserted to be true; (2) knowledge of the nature of valid inferences, abstractions, and generalizations in which the weight or accuracy of different kinds of evidence are logically determined; and (3) skills in employing and applying the above attitudes and knowledge.

3) A very well-known and influential definition of critical thinking comes from philosopher and professor Robert Ennis in his work “A Taxonomy of Critical Thinking Dispositions and Abilities” (1987):

Critical thinking is reasonable reflective thinking that is focused on deciding what to believe or do.

4) The following definition comes from a statement written in 1987 by the philosophers Michael Scriven and Richard Paul for the  National Council for Excellence in Critical Thinking (link), an organization promoting critical thinking in the US:

Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action. In its exemplary form, it is based on universal intellectual values that transcend subject matter divisions: clarity, accuracy, precision, consistency, relevance, sound evidence, good reasons, depth, breadth, and fairness. It entails the examination of those structures or elements of thought implicit in all reasoning: purpose, problem, or question-at-issue, assumptions, concepts, empirical grounding; reasoning leading to conclusions, implications and consequences, objections from alternative viewpoints, and frame of reference.

The following excerpt from Peter A. Facione’s “Critical Thinking: A Statement of Expert Consensus for Purposes of Educational Assessment and Instruction” (1990) is quoted from a report written for the American Philosophical Association:

We understand critical thinking to be purposeful, self-regulatory judgment which results in interpretation, analysis, evaluation, and inference, as well as explanation of the evidential, conceptual, methodological, criteriological, or contextual considerations upon which that judgment is based. CT is essential as a tool of inquiry. As such, CT is a liberating force in education and a powerful resource in one’s personal and civic life. While not synonymous with good thinking, CT is a pervasive and self-rectifying human phenomenon. The ideal critical thinker is habitually inquisitive, well-informed, trustful of reason, open-minded, flexible, fairminded in evaluation, honest in facing personal biases, prudent in making judgments, willing to reconsider, clear about issues, orderly in complex matters, diligent in seeking relevant information, reasonable in the selection of criteria, focused in inquiry, and persistent in seeking results which are as precise as the subject and the circumstances of inquiry permit. Thus, educating good critical thinkers means working toward this ideal. It combines developing CT skills with nurturing those dispositions which consistently yield useful insights and which are the basis of a rational and democratic society.

V. Two F eatures of C ritical T hinking

A. how not what .

Critical thinking is concerned not with what you believe, but rather how or why you believe it. Most classes, such as those on biology or chemistry, teach you what to believe about a subject matter. In contrast, critical thinking is not particularly interested in what the world is, in fact, like. Rather, critical thinking will teach you how to form beliefs and how to think. It is interested in the type of reasoning you use when you form your beliefs, and concerns itself with whether you have good reasons to believe what you believe. Therefore, this class isn’t a class on the psychology of reasoning, which brings us to the second important feature of critical thinking.

B. Ought N ot Is ( or Normative N ot Descriptive )

There is a difference between normative and descriptive theories. Descriptive theories, such as those provided by physics, provide a picture of how the world factually behaves and operates. In contrast, normative theories, such as those provided by ethics or political philosophy, provide a picture of how the world should be. Rather than ask question such as why something is the way it is, normative theories ask how something should be. In this course, we will be interested in normative theories that govern our thinking and reasoning. Therefore, we will not be interested in how we actually reason, but rather focus on how we ought to reason.

In the introduction to this course we considered a selection task with cards that must be flipped in order to check the validity of a rule. We noted that many people fail to identify all the cards required to check the rule. This is how people do in fact reason (descriptive). We then noted that you must flip over two cards. This is how people ought to reason (normative).

• Section I-IV are taken from http://philosophy.hku.hk/think/ and are in use under the creative commons license. Some modifications have been made to the original content. ↵

Critical Thinking Copyright © 2019 by Brian Kim is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Article • 8 min read

Critical Thinking

Developing the right mindset and skills.

By the Mind Tools Content Team

We make hundreds of decisions every day and, whether we realize it or not, we're all critical thinkers.

We use critical thinking each time we weigh up our options, prioritize our responsibilities, or think about the likely effects of our actions. It's a crucial skill that helps us to cut out misinformation and make wise decisions. The trouble is, we're not always very good at it!

In this article, we'll explore the key skills that you need to develop your critical thinking skills, and how to adopt a critical thinking mindset, so that you can make well-informed decisions.

What Is Critical Thinking?

Critical thinking is the discipline of rigorously and skillfully using information, experience, observation, and reasoning to guide your decisions, actions, and beliefs. You'll need to actively question every step of your thinking process to do it well.

Collecting, analyzing and evaluating information is an important skill in life, and a highly valued asset in the workplace. People who score highly in critical thinking assessments are also rated by their managers as having good problem-solving skills, creativity, strong decision-making skills, and good overall performance. [1]

Key Critical Thinking Skills

Critical thinkers possess a set of key characteristics which help them to question information and their own thinking. Focus on the following areas to develop your critical thinking skills:

Being willing and able to explore alternative approaches and experimental ideas is crucial. Can you think through "what if" scenarios, create plausible options, and test out your theories? If not, you'll tend to write off ideas and options too soon, so you may miss the best answer to your situation.

To nurture your curiosity, stay up to date with facts and trends. You'll overlook important information if you allow yourself to become "blinkered," so always be open to new information.

But don't stop there! Look for opposing views or evidence to challenge your information, and seek clarification when things are unclear. This will help you to reassess your beliefs and make a well-informed decision later. Read our article, Opening Closed Minds , for more ways to stay receptive.

Logical Thinking

You must be skilled at reasoning and extending logic to come up with plausible options or outcomes.

It's also important to emphasize logic over emotion. Emotion can be motivating but it can also lead you to take hasty and unwise action, so control your emotions and be cautious in your judgments. Know when a conclusion is "fact" and when it is not. "Could-be-true" conclusions are based on assumptions and must be tested further. Read our article, Logical Fallacies , for help with this.

Use creative problem solving to balance cold logic. By thinking outside of the box you can identify new possible outcomes by using pieces of information that you already have.

Self-Awareness

Many of the decisions we make in life are subtly informed by our values and beliefs. These influences are called cognitive biases and it can be difficult to identify them in ourselves because they're often subconscious.

Practicing self-awareness will allow you to reflect on the beliefs you have and the choices you make. You'll then be better equipped to challenge your own thinking and make improved, unbiased decisions.

One particularly useful tool for critical thinking is the Ladder of Inference . It allows you to test and validate your thinking process, rather than jumping to poorly supported conclusions.

Developing a Critical Thinking Mindset

Combine the above skills with the right mindset so that you can make better decisions and adopt more effective courses of action. You can develop your critical thinking mindset by following this process:

Gather Information

First, collect data, opinions and facts on the issue that you need to solve. Draw on what you already know, and turn to new sources of information to help inform your understanding. Consider what gaps there are in your knowledge and seek to fill them. And look for information that challenges your assumptions and beliefs.

Be sure to verify the authority and authenticity of your sources. Not everything you read is true! Use this checklist to ensure that your information is valid:

• Are your information sources trustworthy ? (For example, well-respected authors, trusted colleagues or peers, recognized industry publications, websites, blogs, etc.)
• Is the information you have gathered up to date ?
• Has the information received any direct criticism ?
• Does the information have any errors or inaccuracies ?
• Is there any evidence to support or corroborate the information you have gathered?
• Is the information you have gathered subjective or biased in any way? (For example, is it based on opinion, rather than fact? Is any of the information you have gathered designed to promote a particular service or organization?)

If any information appears to be irrelevant or invalid, don't include it in your decision making. But don't omit information just because you disagree with it, or your final decision will be flawed and bias.

Now observe the information you have gathered, and interpret it. What are the key findings and main takeaways? What does the evidence point to? Start to build one or two possible arguments based on what you have found.

You'll need to look for the details within the mass of information, so use your powers of observation to identify any patterns or similarities. You can then analyze and extend these trends to make sensible predictions about the future.

To help you to sift through the multiple ideas and theories, it can be useful to group and order items according to their characteristics. From here, you can compare and contrast the different items. And once you've determined how similar or different things are from one another, Paired Comparison Analysis can help you to analyze them.

The final step involves challenging the information and rationalizing its arguments.

Apply the laws of reason (induction, deduction, analogy) to judge an argument and determine its merits. To do this, it's essential that you can determine the significance and validity of an argument to put it in the correct perspective. Take a look at our article, Rational Thinking , for more information about how to do this.

Once you have considered all of the arguments and options rationally, you can finally make an informed decision.

Afterward, take time to reflect on what you have learned and what you found challenging. Step back from the detail of your decision or problem, and look at the bigger picture. Record what you've learned from your observations and experience.

Critical thinking involves rigorously and skilfully using information, experience, observation, and reasoning to guide your decisions, actions and beliefs. It's a useful skill in the workplace and in life.

You'll need to be curious and creative to explore alternative possibilities, but rational to apply logic, and self-aware to identify when your beliefs could affect your decisions or actions.

You can demonstrate a high level of critical thinking by validating your information, analyzing its meaning, and finally evaluating the argument.

Critical Thinking Infographic

See Critical Thinking represented in our infographic: An Elementary Guide to Critical Thinking .

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• What is Critical Thinking?

The ability to think critically calls for a higher-order thinking than simply the ability to recall information.

Definitions of critical thinking, its elements, and its associated activities fill the educational literature of the past forty years. Critical thinking has been described as an ability to question; to acknowledge and test previously held assumptions; to recognize ambiguity; to examine, interpret, evaluate, reason, and reflect; to make informed judgments and decisions; and to clarify, articulate, and justify positions (Hullfish & Smith, 1961; Ennis, 1962; Ruggiero, 1975; Scriven, 1976; Hallet, 1984; Kitchener, 1986; Pascarella & Terenzini, 1991; Mines et al., 1990; Halpern, 1996; Paul & Elder, 2001; Petress, 2004; Holyoak & Morrison, 2005; among others).

After a careful review of the mountainous body of literature defining critical thinking and its elements, UofL has chosen to adopt the language of Michael Scriven and Richard Paul (2003) as a comprehensive, concise operating definition:

Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action.

Paul and Scriven go on to suggest that critical thinking is based on: "universal intellectual values that transcend subject matter divisions: clarity, accuracy, precision, consistency, relevance, sound evidence, good reasons, depth, breadth, and fairness. It entails the examination of those structures or elements of thought implicit in all reasoning: purpose, problem, or question-at-issue, assumptions, concepts, empirical grounding; reasoning leading to conclusions, implication and consequences, objections from alternative viewpoints, and frame of reference. Critical thinking - in being responsive to variable subject matter, issues, and purposes - is incorporated in a family of interwoven modes of thinking, among them: scientific thinking, mathematical thinking, historical thinking, anthropological thinking, economic thinking, moral thinking, and philosophical thinking."

This conceptualization of critical thinking has been refined and developed further by Richard Paul and Linder Elder into the Paul-Elder framework of critical thinking. Currently, this approach is one of the most widely published and cited frameworks in the critical thinking literature. According to the Paul-Elder framework, critical thinking is the:

• Analysis of thinking by focusing on the parts or structures of thinking ("the Elements of Thought")
• Evaluation of thinking by focusing on the quality ("the Universal Intellectual Standards")
• Improvement of thinking by using what you have learned ("the Intellectual Traits")

Selection of a Critical Thinking Framework

The University of Louisville chose the Paul-Elder model of Critical Thinking as the approach to guide our efforts in developing and enhancing our critical thinking curriculum. The Paul-Elder framework was selected based on criteria adapted from the characteristics of a good model of critical thinking developed at Surry Community College. The Paul-Elder critical thinking framework is comprehensive, uses discipline-neutral terminology, is applicable to all disciplines, defines specific cognitive skills including metacognition, and offers high quality resources.

Why the selection of a single critical thinking framework?

The use of a single critical thinking framework is an important aspect of institution-wide critical thinking initiatives (Paul and Nosich, 1993; Paul, 2004). According to this view, critical thinking instruction should not be relegated to one or two disciplines or departments with discipline specific language and conceptualizations. Rather, critical thinking instruction should be explicitly infused in all courses so that critical thinking skills can be developed and reinforced in student learning across the curriculum. The use of a common approach with a common language allows for a central organizer and for the development of critical thinking skill sets in all courses.

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Critical Thinking Definition, Skills, and Examples

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Critical thinking refers to the ability to analyze information objectively and make a reasoned judgment. It involves the evaluation of sources, such as data, facts, observable phenomena, and research findings.

Good critical thinkers can draw reasonable conclusions from a set of information, and discriminate between useful and less useful details to solve problems or make decisions. Employers prioritize the ability to think critically—find out why, plus see how you can demonstrate that you have this ability throughout the job application process. 

Why Do Employers Value Critical Thinking Skills?

Employers want job candidates who can evaluate a situation using logical thought and offer the best solution.

 Someone with critical thinking skills can be trusted to make decisions independently, and will not need constant handholding.

Hiring a critical thinker means that micromanaging won't be required. Critical thinking abilities are among the most sought-after skills in almost every industry and workplace. You can demonstrate critical thinking by using related keywords in your resume and cover letter, and during your interview.

Examples of Critical Thinking

The circumstances that demand critical thinking vary from industry to industry. Some examples include:

• A triage nurse analyzes the cases at hand and decides the order by which the patients should be treated.
• A plumber evaluates the materials that would best suit a particular job.
• An attorney reviews evidence and devises a strategy to win a case or to decide whether to settle out of court.
• A manager analyzes customer feedback forms and uses this information to develop a customer service training session for employees.

Promote Your Skills in Your Job Search

If critical thinking is a key phrase in the job listings you are applying for, be sure to emphasize your critical thinking skills throughout your job search.

Add Keywords to Your Resume

You can use critical thinking keywords (analytical, problem solving, creativity, etc.) in your resume. When describing your  work history , include top critical thinking skills that accurately describe you. You can also include them in your  resume summary , if you have one.

For example, your summary might read, “Marketing Associate with five years of experience in project management. Skilled in conducting thorough market research and competitor analysis to assess market trends and client needs, and to develop appropriate acquisition tactics.”

Mention Skills in Your Cover Letter

Include these critical thinking skills in your cover letter. In the body of your letter, mention one or two of these skills, and give specific examples of times when you have demonstrated them at work. Think about times when you had to analyze or evaluate materials to solve a problem.

Show the Interviewer Your Skills

You can use these skill words in an interview. Discuss a time when you were faced with a particular problem or challenge at work and explain how you applied critical thinking to solve it.

Some interviewers will give you a hypothetical scenario or problem, and ask you to use critical thinking skills to solve it. In this case, explain your thought process thoroughly to the interviewer. He or she is typically more focused on how you arrive at your solution rather than the solution itself. The interviewer wants to see you analyze and evaluate (key parts of critical thinking) the given scenario or problem.

Of course, each job will require different skills and experiences, so make sure you read the job description carefully and focus on the skills listed by the employer.

Top Critical Thinking Skills

Keep these in-demand critical thinking skills in mind as you update your resume and write your cover letter. As you've seen, you can also emphasize them at other points throughout the application process, such as your interview. 

Part of critical thinking is the ability to carefully examine something, whether it is a problem, a set of data, or a text. People with  analytical skills  can examine information, understand what it means, and properly explain to others the implications of that information.

• Asking Thoughtful Questions
• Data Analysis
• Interpretation
• Questioning Evidence
• Recognizing Patterns

Communication

Often, you will need to share your conclusions with your employers or with a group of colleagues. You need to be able to  communicate with others  to share your ideas effectively. You might also need to engage in critical thinking in a group. In this case, you will need to work with others and communicate effectively to figure out solutions to complex problems.

• Active Listening
• Collaboration
• Explanation
• Interpersonal
• Presentation
• Verbal Communication
• Written Communication

Critical thinking often involves creativity and innovation. You might need to spot patterns in the information you are looking at or come up with a solution that no one else has thought of before. All of this involves a creative eye that can take a different approach from all other approaches.

• Flexibility
• Conceptualization
• Imagination
• Drawing Connections
• Synthesizing

Open-Mindedness

To think critically, you need to be able to put aside any assumptions or judgments and merely analyze the information you receive. You need to be objective, evaluating ideas without bias.

• Objectivity
• Observation

Problem Solving

Problem-solving is another critical thinking skill that involves analyzing a problem, generating and implementing a solution, and assessing the success of the plan. Employers don’t simply want employees who can think about information critically. They also need to be able to come up with practical solutions.

• Attention to Detail
• Clarification
• Decision Making
• Groundedness
• Identifying Patterns

More Critical Thinking Skills

• Inductive Reasoning
• Deductive Reasoning
• Noticing Outliers
• Adaptability
• Emotional Intelligence
• Brainstorming
• Optimization
• Restructuring
• Integration
• Strategic Planning
• Project Management
• Ongoing Improvement
• Causal Relationships
• Case Analysis
• Diagnostics
• SWOT Analysis
• Business Intelligence
• Quantitative Data Management
• Qualitative Data Management
• Risk Management
• Scientific Method
• Consumer Behavior

Key Takeaways

• Demonstrate that you have critical thinking skills by adding relevant keywords to your resume.
• Mention pertinent critical thinking skills in your cover letter, too, and include an example of a time when you demonstrated them at work.
• Finally, highlight critical thinking skills during your interview. For instance, you might discuss a time when you were faced with a challenge at work and explain how you applied critical thinking skills to solve it.

University of Louisville. " What is Critical Thinking ."

American Management Association. " AMA Critical Skills Survey: Workers Need Higher Level Skills to Succeed in the 21st Century ."

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How to Learn Critical Thinking

Learning how to think critically makes you smart..

Posted October 29, 2017 | Reviewed by Ekua Hagan

Some readers may think you have to be smart to think critically. But a corollary is that learning how to think critically makes you smart. The assumption is that one can learn to think critically (that is, be smart). The assumption is correct. Here, I hope to show you how you can become smarter by learning critical thinking skills.

Require Yourself to Think Critically

When you read or listening to others talk, force yourself to become more attentive and engaged with the information. Asking questions assures engagement.

Learn and Look for Common Thinking Errors

Unfortunately, most adults are not taught formal logic, even in college. College logic courses are electives and are made confusing by obtuse premises, propositions, and equations. But common-sense logic can suffice. I have posted a list of common thinking errors elsewhere.[1] Here are some of the more serious thinking errors:

Appeal to authority or consensus : attempting to justify the conclusion by quoting an authority in its support or on the basis of how many people hold the same view.

Argument selectivity : glossing over alternative perspectives (often called “cherry-picking.)” It is not only fair but usually helpful to include opposing positions when making arguments to support a position. Commonly, opposing arguments, even when wrong overall, usually have some grain of truth that needs to be accommodated.

Circular reasoning : reasoning where the premise of an argument or a conclusion is used as support for the argument. Usually, this happens when evidence is missing or glossed over.

Cognitive shortcut bias : doggedly sticking with a favored view or argument for a position, when other more fruitful possibilities exist. Even chess masters, for example, may use an established gambit when a better tactic is available.

Confusing correlation with causation : asserting that when two things happen together, and especially when one occurs just before the other, that one thing causes the other. Without other more direct evidence of causation, this assumption is not justified. Both events could be caused by something else. Example: rain and lightning go together, but neither causes the other.

Exclusivity confusion : failure to recognize elements of compatibility in multiple apparently conflicting ideas or facts. It is important to know whether they are independent, compatible, or mutually exclusive. Example: concepts of evolution and creationism, as they are typically used, are mutually exclusive. However, stated in other ways, they have shared elements of agreement.

False analogy : explaining an idea with an analogy that is not parallel, as in comparing apples and oranges. While analogies and metaphors are powerful rhetorical tools, they are not equivalent to what they reference.

Jumping to conclusions : using only a few facts for a definitive conclusion. The most common situation is failure to consider alternatives. An associated cause is failure to question and test assumptions used to arrive at a conclusion.

Overgeneralization : assuming that what is true for one is true for something else. Example: Some scientists studying free will claim that the decision-making process for making a button press is the same for more complex decisions.

Learn Specific Strategies

Be aware of your thinking . Explain to students the need to think about how they think. This is the art of introspection, focused on being aware of such things as one's own degree of alertness, attentiveness, bias, emotional state, exploration of interpretation options, self-assurance .

Train the ability to focus . In today's multi-tasking world, students commonly lack the ability to concentrate. They are easily distracted. They don't listen well and are not very effective at extracting meaning from what they read.

Use evidence-based reasoning . Don't confuse opinion with fact. When others make a claim, don't accept it without supporting evidence. Even then, look for contrary evidence that is omitted.

Identify what is missing . In conversation or reading, the most important points may be what is not stated. This is especially true when someone is trying to persuade you of their viewpoint.

Ask questions and provide your own answer . I had a professor, C. S. Bachofer at Notre Dame who built a whole course based on this principle. For every reading assignment, he required the students to ask a provocative question about the reading and then write how it might be answered. Fellow students debated each other's questions and answers. Developing this as a thinking habit will ensure you will become a more critical thinker, learn more, and provide some degree of enlightenment to others with whom you interact.

[1] Klemm, W. R. (2014). Analytical thinking—logic errors 101. http://thankyoubrain.blogspot.com/2014/10/analytical-thinking-logic-err…

William Klemm , Ph.D ., is a senior professor of Neuroscience at Texas A&M University.

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Critical thinking is the one skillset you can't afford not to master

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What is critical thinking?

5 characteristics of critical thinking, what are critical thinking skills, and why are they important, 6 key critical thinking skills, critical thinking example in real-life, 13 ways to start thinking critically.

Whether you’re aiming to improve your performance at work or simply trying to live a more fulfilling life , you’ll need a variety of hard and soft skills to move the needle. Some skills come naturally to some people, while others need to develop them actively.

One of these skills is critical thinking. But critical thinking itself is made up of several types of skills that contribute to solving problems more effectively.

Let’s explore the different types of critical thinking skills and how you can start improving them to level up your career.

Critical thinking is the ability to analyze facts objectively and form a judgment. It is a form of emotional intelligence .

Someone with critical thinking skills can think clearly and rationally when the situation demands it. It allows them to perform problem-solving and decision-making more effectively. 

As a result, you can look further than what you see at face value. You’re able to analyze what you see from a situation and gain some insight that goes further than what’s obvious to anyone from the outside.

Critical thinking also requires being able to understand the logical connection between two or more ideas or concepts. For example, a team working on a company’s pricing strategy needs to think critically about several concepts. 

Both the marketing and sales teams must work together. They need to analyze how to maximize sales. But they need to do so while also meeting profit goals. It’s important to understand the logical connection between sales strategy and marketing logistics. It’s the only way to get a good outcome.

Critical thinking is different from creative thinking . Creative thinking is the ability to generate brand new, innovative ideas. On the other hand, critical thinking requires you to carefully and logically analyze what information is given to you. Both are important to maximize results in any given situation.

What defines critical thinking? How does it affect the decision-making process? Here are five characteristics that make up the ability to think critically.

1. Dispositions

Critical thinkers have specific traits that allow them to think the way they do. Some people are predisposed to these traits, while others need to develop them actively.

Some of these dispositions include:

• Open-mindedness
• Respecting evidence and reasoning
• Being able to consider different perspectives and points of view: in other words, having cognitive flexibility
• Not being stuck in one position
• Clarity and precision

2. Argument

Good critical thinkers need to make solid arguments. 

An argument is making a statement aided by supporting evidence. It’s important to use well thought-out arguments when you’re in a constructive conflict . When analyzing a situation critically, you’ll need to make several arguments in your own mind to come to a judgment. 

3. Reasoning

In addition to arguments, critical thinking also requires inferring conclusions. From the facts and arguments presented to you, you need to use reasoning skills to come to a logical conclusion. 

This conclusion will determine the best course of action to take.

4. Criteria

Critical thinking is sometimes a matter of discerning truth from fiction. Not all facts presented to you may have the same level of truth. Certain conditions need to be met for something to be considered believable, and a critical thinker needs to be able to understand that.

5. Metacognition

Metacognition is the ability to think about your own thinking. Critical thinkers should be able to analyze their thoughts so that they can judge whether or not they’ve thought everything through. This helps them come up with better hypotheses.

The critical thinking skills definition is: soft skills that help you in the critical thinking process. Developing these skills can improve your ability to think critically.

Critical thinking skills are considered one of many durable skills in the workplace . Many of these are soft skills that are also useful in other situations.

According to research by America Succeeds, critical thinking is in the top five most requested durable skills in job postings. Those top five durable skills get requested 2.6x more often than the top five hard skills. This goes to show that soft skills like critical thinking skills are in demand in the workplace.

Critical thinking skills are important for several reasons. These include helping you work independently and solve problems . Not all positions require ongoing critical thinking. But, those skills definitely matter to anyone who wants to uplevel their career. And even the most easygoing positions require at least some level of critical thinking skills.

For example, working as an accountant can be straightforward in most cases. But it may require critical thinking skills. For instance, what if certain expenses aren’t easily distributed in simple categories? Without critical thinking skills, an accountant will struggle to work independently and solve problems on their own.

Critical thinking abilities also matter in everyday life. Having a foundation for critical thinking can help you analyze several possible solutions for problems that pop up in the home. It can also help you:

• Analyze different viewpoints
• Come up with the best solution for complex problems
• Become a better learner

The key critical thinking skills are identifying biases, inference, research, identification, curiosity, and judging relevance.

Let’s explore these six critical thinking skills you should learn and why they’re so important to the critical thinking process.

1. Identifying biases

This critical thinking skill is necessary for metacognition, which is the fifth characteristic of critical thinking. It involves knowing when others have a cognitive bias and when you have one yourself.

Biases can influence how someone understands the facts presented to them. But when you’re aware of those biases, you can question yourself on those biases and consider other points of view.

Identifying biases is especially important for people who make hiring decisions. That’s because biases against groups of minorities can lead to inequalities in the workplace when not identified. 

For example, imagine a hiring manager comparing two resumes. Their gut feeling could guide them to discount one of the resumes due to a bias against the opposite gender. But let’s say this hiring manager realizes they have this bias. They can then question themselves on whether or not this bias is influencing their judgment. 

2. Inference

Inference is the ability to draw conclusions based on the information you have. Without inference, it can be difficult to take action once you’ve analyzed the facts presented to you. Processing information is key to coming up with a reasoned judgment.

For example, let’s go back to the accountant struggling to assign the correct category to a business expense. They can analyze other similar situations and infer the most logical category based on that information.

3. Research

Before you analyze facts and infer a conclusion, you need to find out what those facts are. Researching skills allow you to discover facts and figures to make an argument.

Not all situations will have the required information available to you. Researching skills are necessary to dig into a situation and gather the information you need to think critically.

Some situations don’t require further research. For example, a first responder who arrives on the scene of an automobile accident won’t perform further research. They’ll have to analyze what they see in front of them and decide which injuries are the most urgent to care for. 

On the other hand, someone performing a market analysis will need to research competitors and gather information before coming up with an opinion. 

4. Identification

Identification is different from inference and research. It involves being able to identify a problem but also what’s influencing that problem.

In short, identification is necessary for someone to realize that they need to think critically about something. Without proper identification skills, it will be difficult for someone to know when it’s time to analyze a situation. 

For example, let’s say you’re entering numbers in a spreadsheet. The numbers aren’t coming out as they usually do. Without identification skills, you could easily keep going without realizing there’s an issue. But when you identify what’s going on, you can see that something is broken in the spreadsheet’s formula.

Only once you identify the fact that the formula is broken can you start analyzing what’s going on to solve the issue.

5. Curiosity

Don’t be afraid to question everything and explore what you’re curious about. That’s because intellectual curiosity is a valuable skill, especially when it comes to critical thinking.

One way to practice curiosity is to adopt a beginner’s mindset . When you come into every situation with the mindset of a beginner, you’re able to keep an open mind. You’ll be able to perceive things you may not have noticed when keeping your mind closed.

6. Judging relevance

Not all information is equally pertinent. In order to make a critical judgment, it’s important to be able to judge the relevance of the information you have.

Take, for instance, basic online researching skills. You have access to a plethora of information on virtually every topic imaginable. But performing online research requires you to constantly judge the relevance of what you see. 

Without judging relevance, you’d spend too much time on details that don’t matter as much for the final desired outcome. But when you’re able to discern what’s most pertinent, you can give that information more weight as you’re thinking critically.

So what would critical thinking skills look like in a real-life situation?

Let’s imagine you’re working in software quality assurance (QA) as a team lead. But every time your team needs to enter bug regression, everyone gets bottlenecked because you must manually populate the spreadsheet used for the regression. While you do this task, your team cannot be productive without you.

This process happens once a week and easily wastes half an hour for each team member.

First, you must identify what’s going on. The team gets bottlenecked because only you, as the team lead, can access the information required to fill in the regression spreadsheet.

Next, you can research information. You can inquire to higher-ups about the reason why only you have access to this information. You can also speak to other teams about what potential solutions they’ve come up with to solve this problem.

Once you’ve done your research, it’s time to analyze the information and judge relevance. Some teams have solutions that don’t apply to you, so that information isn’t relevant anymore. 

Figure out if there are any personal biases before you analyze your information. 

For example, it’s possible that you don’t get along with one of the other team leads. As a result, you could discount the information they’ve given you. But by identifying this bias, you can look past your personal opinion of this person and see how valuable their solution is.

Based on what you’ve analyzed, it’s time to brainstorm and come up with a solution. You realize that creating a simple, automated script will save your team’s time. And it will do so without consuming too many resources from the engineering department.

Next, present your solution to your manager. Explain how you came to this conclusion. 

Now, let’s say your spreadsheet automation solution is approved. It’s important to go back and analyze what happens after implementing the solution. But only do this once the spreadsheet has been in place for long enough to gather plenty of information. 

Here’s an example. You could realize that the solution did solve the bottleneck. But, the script also slows down the spreadsheet and makes it difficult to work with. This would require you to go back to the drawing board and start the process all over again.

Want to start improving your own critical thinking skill sets? Here’s how you can improve critical thinking skills using 13 techniques:

• Play games that require critical thinking skills
• Ask more questions, even basic ones
• Question your assumptions
• Develop your technical skills so that you can identify problems more easily
• Find ways to solve more problems (at work and at home)
• Become aware of your mental processes, like the availability heuristic
• Think for yourself: don’t adopt other people’s opinions without questioning them first
• Seek out diversity of thought
• Start developing foresight
• Try active listening
• Weigh the consequences of different actions before you act
• Seek a mentor who can help you develop these skills
• Get professional coaching

How to improve your critical thinking skills 

Critical thinking skills aren’t always easy to develop. But it’s much easier to start thinking critically when you have someone to work with. Try a custom BetterUp demo to see how a coach can help you develop your critical thinking skills today.

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Maggie Wooll, MBA

Maggie Wooll is a researcher, author, and speaker focused on the evolving future of work. Formerly the lead researcher at the Deloitte Center for the Edge, she holds a Bachelor of Science in Education from Princeton University and an MBA from the University of Virginia Darden School of Business. Maggie is passionate about creating better work and greater opportunities for all.

How to develop critical thinking skills

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A Short Guide to Building Your Team’s Critical Thinking Skills

• Matt Plummer

Critical thinking isn’t an innate skill. It can be learned.

Most employers lack an effective way to objectively assess critical thinking skills and most managers don’t know how to provide specific instruction to team members in need of becoming better thinkers. Instead, most managers employ a sink-or-swim approach, ultimately creating work-arounds to keep those who can’t figure out how to “swim” from making important decisions. But it doesn’t have to be this way. To demystify what critical thinking is and how it is developed, the author’s team turned to three research-backed models: The Halpern Critical Thinking Assessment, Pearson’s RED Critical Thinking Model, and Bloom’s Taxonomy. Using these models, they developed the Critical Thinking Roadmap, a framework that breaks critical thinking down into four measurable phases: the ability to execute, synthesize, recommend, and generate.

With critical thinking ranking among the most in-demand skills for job candidates , you would think that educational institutions would prepare candidates well to be exceptional thinkers, and employers would be adept at developing such skills in existing employees. Unfortunately, both are largely untrue.

• Matt Plummer (@mtplummer) is the founder of Zarvana, which offers online programs and coaching services to help working professionals become more productive by developing time-saving habits. Before starting Zarvana, Matt spent six years at Bain & Company spin-out, The Bridgespan Group, a strategy and management consulting firm for nonprofits, foundations, and philanthropists.  

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13 Easy Steps To Improve Your Critical Thinking Skills

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With the sheer volume of information that we’re bombarded with on a daily basis – and with the pervasiveness of fake news and social media bubbles – the ability to look at evidence, evaluate the trustworthiness of a source, and think critically is becoming more important than ever. This is why, for me, critical thinking is one of the most vital skills to cultivate for future success.

Critical thinking isn’t about being constantly negative or critical of everything. It’s about objectivity and having an open, inquisitive mind. To think critically is to analyze issues based on hard evidence (as opposed to personal opinions, biases, etc.) in order to build a thorough understanding of what’s really going on. And from this place of thorough understanding, you can make better decisions and solve problems more effectively.

To put it another way, critical thinking means arriving at your own carefully considered conclusions instead of taking information at face value. Here are 13 ways you can cultivate this precious skill:

1. Always vet new information with a cautious eye. Whether it’s an article someone has shared online or data that’s related to your job, always vet the information you're presented with. Good questions to ask here include, "Is this information complete and up to date?” “What evidence is being presented to support the argument?” and “Whose voice is missing here?”

2. Look at where the information has come from. Is the source trustworthy? What is their motivation for presenting this information? For example, are they trying to sell you something or get you to take a certain action (like vote for them)?

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3. Consider more than one point of view. Everyone has their own opinions and motivations – even highly intelligent people making reasonable-sounding arguments have personal opinions and biases that shape their thinking. So, when someone presents you with information, consider whether there are other sides to the story.

4. Practice active listening. Listen carefully to what others are telling you, and try to build a clear picture of their perspective. Empathy is a really useful skill here since putting yourself in another person's shoes can help you understand where they're coming from and what they might want. Try to listen without judgment – remember, critical thinking is about keeping an open mind.

5. Gather additional information where needed. Whenever you identify gaps in the information or data, do your own research to fill those gaps. The next few steps will help you do this objectively…

6. Ask lots of open-ended questions. Curiosity is a key trait of critical thinkers, so channel your inner child and ask lots of "who," "what," and "why" questions.

7. Find your own reputable sources of information, such as established news sites, nonprofit organizations, and education institutes. Try to avoid anonymous sources or sources with an ax to grind or a product to sell. Also, be sure to check when the information was published. An older source may be unintentionally offering up wrong information just because events have moved on since it was published; corroborate the info with a more recent source.

8. Try not to get your news from social media. And if you do see something on social media that grabs your interest, check the accuracy of the story (via reputable sources of information, as above) before you share it.

9. Learn to spot fake news. It's not always easy to spot false or misleading content, but a good rule of thumb is to look at the language, emotion, and tone of the piece. Is it using emotionally charged language, for instance, and trying to get you to feel a certain way? Also, look at the sources of facts, figures, images, and quotes. A legit news story will clearly state its sources.

10. Learn to spot biased information. Like fake news, biased information may seek to appeal more to your emotions than logic and/or present a limited view of the topic. So ask yourself, “Is there more to this topic than what’s being presented here?” Do your own reading around the topic to establish the full picture.

11. Question your own biases, too. Everyone has biases, and there’s no point pretending otherwise. The trick is to think objectively about your likes and dislikes, preferences, and beliefs, and consider how these might affect your thinking.

12. Form your own opinions. Remember, critical thinking is about thinking independently. So once you’ve assessed all the information, form your own conclusions about it.

13. Continue to work on your critical thinking skills. I recommend looking at online learning platforms such as Udemy and Coursera for courses on general critical thinking skills, as well as courses on specific subjects like cognitive biases.

Read more about critical thinking and other essential skills in my new book, Future Skills: The 20 Skills & Competencies Everyone Needs To Succeed In A Digital World . Written for anyone who wants to surf the wave of digital transformation – rather than be drowned by it – the book explores why these vital future skills matter and how to develop them.

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NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr.

Patient Safety and Quality: An Evidence-Based Handbook for Nurses.

Chapter 6 clinical reasoning, decisionmaking, and action: thinking critically and clinically.

Patricia Benner ; Ronda G. Hughes ; Molly Sutphen .

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This chapter examines multiple thinking strategies that are needed for high-quality clinical practice. Clinical reasoning and judgment are examined in relation to other modes of thinking used by clinical nurses in providing quality health care to patients that avoids adverse events and patient harm. The clinician’s ability to provide safe, high-quality care can be dependent upon their ability to reason, think, and judge, which can be limited by lack of experience. The expert performance of nurses is dependent upon continual learning and evaluation of performance.

• Critical Thinking

Nursing education has emphasized critical thinking as an essential nursing skill for more than 50 years. 1 The definitions of critical thinking have evolved over the years. There are several key definitions for critical thinking to consider. The American Philosophical Association (APA) defined critical thinking as purposeful, self-regulatory judgment that uses cognitive tools such as interpretation, analysis, evaluation, inference, and explanation of the evidential, conceptual, methodological, criteriological, or contextual considerations on which judgment is based. 2 A more expansive general definition of critical thinking is

. . . in short, self-directed, self-disciplined, self-monitored, and self-corrective thinking. It presupposes assent to rigorous standards of excellence and mindful command of their use. It entails effective communication and problem solving abilities and a commitment to overcome our native egocentrism and sociocentrism. Every clinician must develop rigorous habits of critical thinking, but they cannot escape completely the situatedness and structures of the clinical traditions and practices in which they must make decisions and act quickly in specific clinical situations. 3

There are three key definitions for nursing, which differ slightly. Bittner and Tobin defined critical thinking as being “influenced by knowledge and experience, using strategies such as reflective thinking as a part of learning to identify the issues and opportunities, and holistically synthesize the information in nursing practice” 4 (p. 268). Scheffer and Rubenfeld 5 expanded on the APA definition for nurses through a consensus process, resulting in the following definition:

Critical thinking in nursing is an essential component of professional accountability and quality nursing care. Critical thinkers in nursing exhibit these habits of the mind: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, openmindedness, perseverance, and reflection. Critical thinkers in nursing practice the cognitive skills of analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting, and transforming knowledge 6 (Scheffer & Rubenfeld, p. 357).

The National League for Nursing Accreditation Commission (NLNAC) defined critical thinking as:

the deliberate nonlinear process of collecting, interpreting, analyzing, drawing conclusions about, presenting, and evaluating information that is both factually and belief based. This is demonstrated in nursing by clinical judgment, which includes ethical, diagnostic, and therapeutic dimensions and research 7 (p. 8).

These concepts are furthered by the American Association of Colleges of Nurses’ definition of critical thinking in their Essentials of Baccalaureate Nursing :

Critical thinking underlies independent and interdependent decision making. Critical thinking includes questioning, analysis, synthesis, interpretation, inference, inductive and deductive reasoning, intuition, application, and creativity 8 (p. 9).

Course work or ethical experiences should provide the graduate with the knowledge and skills to:

• Use nursing and other appropriate theories and models, and an appropriate ethical framework;
• Apply research-based knowledge from nursing and the sciences as the basis for practice;
• Use clinical judgment and decision-making skills;
• Engage in self-reflective and collegial dialogue about professional practice;
• Evaluate nursing care outcomes through the acquisition of data and the questioning of inconsistencies, allowing for the revision of actions and goals;
• Engage in creative problem solving 8 (p. 10).

Taken together, these definitions of critical thinking set forth the scope and key elements of thought processes involved in providing clinical care. Exactly how critical thinking is defined will influence how it is taught and to what standard of care nurses will be held accountable.

Professional and regulatory bodies in nursing education have required that critical thinking be central to all nursing curricula, but they have not adequately distinguished critical reflection from ethical, clinical, or even creative thinking for decisionmaking or actions required by the clinician. Other essential modes of thought such as clinical reasoning, evaluation of evidence, creative thinking, or the application of well-established standards of practice—all distinct from critical reflection—have been subsumed under the rubric of critical thinking. In the nursing education literature, clinical reasoning and judgment are often conflated with critical thinking. The accrediting bodies and nursing scholars have included decisionmaking and action-oriented, practical, ethical, and clinical reasoning in the rubric of critical reflection and thinking. One might say that this harmless semantic confusion is corrected by actual practices, except that students need to understand the distinctions between critical reflection and clinical reasoning, and they need to learn to discern when each is better suited, just as students need to also engage in applying standards, evidence-based practices, and creative thinking.

The growing body of research, patient acuity, and complexity of care demand higher-order thinking skills. Critical thinking involves the application of knowledge and experience to identify patient problems and to direct clinical judgments and actions that result in positive patient outcomes. These skills can be cultivated by educators who display the virtues of critical thinking, including independence of thought, intellectual curiosity, courage, humility, empathy, integrity, perseverance, and fair-mindedness. 9

The process of critical thinking is stimulated by integrating the essential knowledge, experiences, and clinical reasoning that support professional practice. The emerging paradigm for clinical thinking and cognition is that it is social and dialogical rather than monological and individual. 10–12 Clinicians pool their wisdom and multiple perspectives, yet some clinical knowledge can be demonstrated only in the situation (e.g., how to suction an extremely fragile patient whose oxygen saturations sink too low). Early warnings of problematic situations are made possible by clinicians comparing their observations to that of other providers. Clinicians form practice communities that create styles of practice, including ways of doing things, communication styles and mechanisms, and shared expectations about performance and expertise of team members.

By holding up critical thinking as a large umbrella for different modes of thinking, students can easily misconstrue the logic and purposes of different modes of thinking. Clinicians and scientists alike need multiple thinking strategies, such as critical thinking, clinical judgment, diagnostic reasoning, deliberative rationality, scientific reasoning, dialogue, argument, creative thinking, and so on. In particular, clinicians need forethought and an ongoing grasp of a patient’s health status and care needs trajectory, which requires an assessment of their own clarity and understanding of the situation at hand, critical reflection, critical reasoning, and clinical judgment.

Critical Reflection, Critical Reasoning, and Judgment

Critical reflection requires that the thinker examine the underlying assumptions and radically question or doubt the validity of arguments, assertions, and even facts of the case. Critical reflective skills are essential for clinicians; however, these skills are not sufficient for the clinician who must decide how to act in particular situations and avoid patient injury. For example, in everyday practice, clinicians cannot afford to critically reflect on the well-established tenets of “normal” or “typical” human circulatory systems when trying to figure out a particular patient’s alterations from that typical, well-grounded understanding that has existed since Harvey’s work in 1628. 13 Yet critical reflection can generate new scientifically based ideas. For example, there is a lack of adequate research on the differences between women’s and men’s circulatory systems and the typical pathophysiology related to heart attacks. Available research is based upon multiple, taken-for-granted starting points about the general nature of the circulatory system. As such, critical reflection may not provide what is needed for a clinician to act in a situation. This idea can be considered reasonable since critical reflective thinking is not sufficient for good clinical reasoning and judgment. The clinician’s development of skillful critical reflection depends upon being taught what to pay attention to, and thus gaining a sense of salience that informs the powers of perceptual grasp. The powers of noticing or perceptual grasp depend upon noticing what is salient and the capacity to respond to the situation.

Critical reflection is a crucial professional skill, but it is not the only reasoning skill or logic clinicians require. The ability to think critically uses reflection, induction, deduction, analysis, challenging assumptions, and evaluation of data and information to guide decisionmaking. 9 , 14 , 15 Critical reasoning is a process whereby knowledge and experience are applied in considering multiple possibilities to achieve the desired goals, 16 while considering the patient’s situation. 14 It is a process where both inductive and deductive cognitive skills are used. 17 Sometimes clinical reasoning is presented as a form of evaluating scientific knowledge, sometimes even as a form of scientific reasoning. Critical thinking is inherent in making sound clinical reasoning. 18

An essential point of tension and confusion exists in practice traditions such as nursing and medicine when clinical reasoning and critical reflection become entangled, because the clinician must have some established bases that are not questioned when engaging in clinical decisions and actions, such as standing orders. The clinician must act in the particular situation and time with the best clinical and scientific knowledge available. The clinician cannot afford to indulge in either ritualistic unexamined knowledge or diagnostic or therapeutic nihilism caused by radical doubt, as in critical reflection, because they must find an intelligent and effective way to think and act in particular clinical situations. Critical reflection skills are essential to assist practitioners to rethink outmoded or even wrong-headed approaches to health care, health promotion, and prevention of illness and complications, especially when new evidence is available. Breakdowns in practice, high failure rates in particular therapies, new diseases, new scientific discoveries, and societal changes call for critical reflection about past assumptions and no-longer-tenable beliefs.

Clinical reasoning stands out as a situated, practice-based form of reasoning that requires a background of scientific and technological research-based knowledge about general cases, more so than any particular instance. It also requires practical ability to discern the relevance of the evidence behind general scientific and technical knowledge and how it applies to a particular patient. In dong so, the clinician considers the patient’s particular clinical trajectory, their concerns and preferences, and their particular vulnerabilities (e.g., having multiple comorbidities) and sensitivities to care interventions (e.g., known drug allergies, other conflicting comorbid conditions, incompatible therapies, and past responses to therapies) when forming clinical decisions or conclusions.

Situated in a practice setting, clinical reasoning occurs within social relationships or situations involving patient, family, community, and a team of health care providers. The expert clinician situates themselves within a nexus of relationships, with concerns that are bounded by the situation. Expert clinical reasoning is socially engaged with the relationships and concerns of those who are affected by the caregiving situation, and when certain circumstances are present, the adverse event. Halpern 19 has called excellent clinical ethical reasoning “emotional reasoning” in that the clinicians have emotional access to the patient/family concerns and their understanding of the particular care needs. Expert clinicians also seek an optimal perceptual grasp, one based on understanding and as undistorted as possible, based on an attuned emotional engagement and expert clinical knowledge. 19 , 20

Clergy educators 21 and nursing and medical educators have begun to recognize the wisdom of broadening their narrow vision of rationality beyond simple rational calculation (exemplified by cost-benefit analysis) to reconsider the need for character development—including emotional engagement, perception, habits of thought, and skill acquisition—as essential to the development of expert clinical reasoning, judgment, and action. 10 , 22–24 Practitioners of engineering, law, medicine, and nursing, like the clergy, have to develop a place to stand in their discipline’s tradition of knowledge and science in order to recognize and evaluate salient evidence in the moment. Diagnostic confusion and disciplinary nihilism are both threats to the clinician’s ability to act in particular situations. However, the practice and practitioners will not be self-improving and vital if they cannot engage in critical reflection on what is not of value, what is outmoded, and what does not work. As evidence evolves and expands, so too must clinical thought.

Clinical judgment requires clinical reasoning across time about the particular, and because of the relevance of this immediate historical unfolding, clinical reasoning can be very different from the scientific reasoning used to formulate, conduct, and assess clinical experiments. While scientific reasoning is also socially embedded in a nexus of social relationships and concerns, the goal of detached, critical objectivity used to conduct scientific experiments minimizes the interactive influence of the research on the experiment once it has begun. Scientific research in the natural and clinical sciences typically uses formal criteria to develop “yes” and “no” judgments at prespecified times. The scientist is always situated in past and immediate scientific history, preferring to evaluate static and predetermined points in time (e.g., snapshot reasoning), in contrast to a clinician who must always reason about transitions over time. 25 , 26

Techne and Phronesis

Distinctions between the mere scientific making of things and practice was first explored by Aristotle as distinctions between techne and phronesis. 27 Learning to be a good practitioner requires developing the requisite moral imagination for good practice. If, for example, patients exercise their rights and refuse treatments, practitioners are required to have the moral imagination to understand the probable basis for the patient’s refusal. For example, was the refusal based upon catastrophic thinking, unrealistic fears, misunderstanding, or even clinical depression?

Techne, as defined by Aristotle, encompasses the notion of formation of character and habitus 28 as embodied beings. In Aristotle’s terms, techne refers to the making of things or producing outcomes. 11 Joseph Dunne defines techne as “the activity of producing outcomes,” and it “is governed by a means-ends rationality where the maker or producer governs the thing or outcomes produced or made through gaining mastery over the means of producing the outcomes, to the point of being able to separate means and ends” 11 (p. 54). While some aspects of medical and nursing practice fall into the category of techne, much of nursing and medical practice falls outside means-ends rationality and must be governed by concern for doing good or what is best for the patient in particular circumstances, where being in a relationship and discerning particular human concerns at stake guide action.

Phronesis, in contrast to techne, includes reasoning about the particular, across time, through changes or transitions in the patient’s and/or the clinician’s understanding. As noted by Dunne, phronesis is “characterized at least as much by a perceptiveness with regard to concrete particulars as by a knowledge of universal principles” 11 (p. 273). This type of practical reasoning often takes the form of puzzle solving or the evaluation of immediate past “hot” history of the patient’s situation. Such a particular clinical situation is necessarily particular, even though many commonalities and similarities with other disease syndromes can be recognized through signs and symptoms and laboratory tests. 11 , 29 , 30 Pointing to knowledge embedded in a practice makes no claim for infallibility or “correctness.” Individual practitioners can be mistaken in their judgments because practices such as medicine and nursing are inherently underdetermined. 31

While phronetic knowledge must remain open to correction and improvement, real events, and consequences, it cannot consistently transcend the institutional setting’s capacities and supports for good practice. Phronesis is also dependent on ongoing experiential learning of the practitioner, where knowledge is refined, corrected, or refuted. The Western tradition, with the notable exception of Aristotle, valued knowledge that could be made universal and devalued practical know-how and experiential learning. Descartes codified this preference for formal logic and rational calculation.

Aristotle recognized that when knowledge is underdetermined, changeable, and particular, it cannot be turned into the universal or standardized. It must be perceived, discerned, and judged, all of which require experiential learning. In nursing and medicine, perceptual acuity in physical assessment and clinical judgment (i.e., reasoning across time about changes in the particular patient or the clinician’s understanding of the patient’s condition) fall into the Greek Aristotelian category of phronesis. Dewey 32 sought to rescue knowledge gained by practical activity in the world. He identified three flaws in the understanding of experience in Greek philosophy: (1) empirical knowing is the opposite of experience with science; (2) practice is reduced to techne or the application of rational thought or technique; and (3) action and skilled know-how are considered temporary and capricious as compared to reason, which the Greeks considered as ultimate reality.

In practice, nursing and medicine require both techne and phronesis. The clinician standardizes and routinizes what can be standardized and routinized, as exemplified by standardized blood pressure measurements, diagnoses, and even charting about the patient’s condition and treatment. 27 Procedural and scientific knowledge can often be formalized and standardized (e.g., practice guidelines), or at least made explicit and certain in practice, except for the necessary timing and adjustments made for particular patients. 11 , 22

Rational calculations available to techne—population trends and statistics, algorithms—are created as decision support structures and can improve accuracy when used as a stance of inquiry in making clinical judgments about particular patients. Aggregated evidence from clinical trials and ongoing working knowledge of pathophysiology, biochemistry, and genomics are essential. In addition, the skills of phronesis (clinical judgment that reasons across time, taking into account the transitions of the particular patient/family/community and transitions in the clinician’s understanding of the clinical situation) will be required for nursing, medicine, or any helping profession.

Thinking Critically

Being able to think critically enables nurses to meet the needs of patients within their context and considering their preferences; meet the needs of patients within the context of uncertainty; consider alternatives, resulting in higher-quality care; 33 and think reflectively, rather than simply accepting statements and performing tasks without significant understanding and evaluation. 34 Skillful practitioners can think critically because they have the following cognitive skills: information seeking, discriminating, analyzing, transforming knowledge, predicating, applying standards, and logical reasoning. 5 One’s ability to think critically can be affected by age, length of education (e.g., an associate vs. a baccalaureate decree in nursing), and completion of philosophy or logic subjects. 35–37 The skillful practitioner can think critically because of having the following characteristics: motivation, perseverance, fair-mindedness, and deliberate and careful attention to thinking. 5 , 9

Thinking critically implies that one has a knowledge base from which to reason and the ability to analyze and evaluate evidence. 38 Knowledge can be manifest by the logic and rational implications of decisionmaking. Clinical decisionmaking is particularly influenced by interpersonal relationships with colleagues, 39 patient conditions, availability of resources, 40 knowledge, and experience. 41 Of these, experience has been shown to enhance nurses’ abilities to make quick decisions 42 and fewer decision errors, 43 support the identification of salient cues, and foster the recognition and action on patterns of information. 44 , 45

Clinicians must develop the character and relational skills that enable them to perceive and understand their patient’s needs and concerns. This requires accurate interpretation of patient data that is relevant to the specific patient and situation. In nursing, this formation of moral agency focuses on learning to be responsible in particular ways demanded by the practice, and to pay attention and intelligently discern changes in patients’ concerns and/or clinical condition that require action on the part of the nurse or other health care workers to avert potential compromises to quality care.

Formation of the clinician’s character, skills, and habits are developed in schools and particular practice communities within a larger practice tradition. As Dunne notes,

A practice is not just a surface on which one can display instant virtuosity. It grounds one in a tradition that has been formed through an elaborate development and that exists at any juncture only in the dispositions (slowly and perhaps painfully acquired) of its recognized practitioners. The question may of course be asked whether there are any such practices in the contemporary world, whether the wholesale encroachment of Technique has not obliterated them—and whether this is not the whole point of MacIntyre’s recipe of withdrawal, as well as of the post-modern story of dispossession 11 (p. 378).

Clearly Dunne is engaging in critical reflection about the conditions for developing character, skills, and habits for skillful and ethical comportment of practitioners, as well as to act as moral agents for patients so that they and their families receive safe, effective, and compassionate care.

Professional socialization or professional values, while necessary, do not adequately address character and skill formation that transform the way the practitioner exists in his or her world, what the practitioner is capable of noticing and responding to, based upon well-established patterns of emotional responses, skills, dispositions to act, and the skills to respond, decide, and act. 46 The need for character and skill formation of the clinician is what makes a practice stand out from a mere technical, repetitious manufacturing process. 11 , 30 , 47

In nursing and medicine, many have questioned whether current health care institutions are designed to promote or hinder enlightened, compassionate practice, or whether they have deteriorated into commercial institutional models that focus primarily on efficiency and profit. MacIntyre points out the links between the ongoing development and improvement of practice traditions and the institutions that house them:

Lack of justice, lack of truthfulness, lack of courage, lack of the relevant intellectual virtues—these corrupt traditions, just as they do those institutions and practices which derive their life from the traditions of which they are the contemporary embodiments. To recognize this is of course also to recognize the existence of an additional virtue, one whose importance is perhaps most obvious when it is least present, the virtue of having an adequate sense of the traditions to which one belongs or which confront one. This virtue is not to be confused with any form of conservative antiquarianism; I am not praising those who choose the conventional conservative role of laudator temporis acti. It is rather the case that an adequate sense of tradition manifests itself in a grasp of those future possibilities which the past has made available to the present. Living traditions, just because they continue a not-yet-completed narrative, confront a future whose determinate and determinable character, so far as it possesses any, derives from the past 30 (p. 207).

It would be impossible to capture all the situated and distributed knowledge outside of actual practice situations and particular patients. Simulations are powerful as teaching tools to enable nurses’ ability to think critically because they give students the opportunity to practice in a simplified environment. However, students can be limited in their inability to convey underdetermined situations where much of the information is based on perceptions of many aspects of the patient and changes that have occurred over time. Simulations cannot have the sub-cultures formed in practice settings that set the social mood of trust, distrust, competency, limited resources, or other forms of situated possibilities.

One of the hallmark studies in nursing providing keen insight into understanding the influence of experience was a qualitative study of adult, pediatric, and neonatal intensive care unit (ICU) nurses, where the nurses were clustered into advanced beginner, intermediate, and expert level of practice categories. The advanced beginner (having up to 6 months of work experience) used procedures and protocols to determine which clinical actions were needed. When confronted with a complex patient situation, the advanced beginner felt their practice was unsafe because of a knowledge deficit or because of a knowledge application confusion. The transition from advanced beginners to competent practitioners began when they first had experience with actual clinical situations and could benefit from the knowledge gained from the mistakes of their colleagues. Competent nurses continuously questioned what they saw and heard, feeling an obligation to know more about clinical situations. In doing do, they moved from only using care plans and following the physicians’ orders to analyzing and interpreting patient situations. Beyond that, the proficient nurse acknowledged the changing relevance of clinical situations requiring action beyond what was planned or anticipated. The proficient nurse learned to acknowledge the changing needs of patient care and situation, and could organize interventions “by the situation as it unfolds rather than by preset goals 48 (p. 24). Both competent and proficient nurses (that is, intermediate level of practice) had at least two years of ICU experience. 48 Finally, the expert nurse had a more fully developed grasp of a clinical situation, a sense of confidence in what is known about the situation, and could differentiate the precise clinical problem in little time. 48

Expertise is acquired through professional experience and is indicative of a nurse who has moved beyond mere proficiency. As Gadamer 29 points out, experience involves a turning around of preconceived notions, preunderstandings, and extends or adds nuances to understanding. Dewey 49 notes that experience requires a prepared “creature” and an enriched environment. The opportunity to reflect and narrate one’s experiential learning can clarify, extend, or even refute experiential learning.

Experiential learning requires time and nurturing, but time alone does not ensure experiential learning. Aristotle linked experiential learning to the development of character and moral sensitivities of a person learning a practice. 50 New nurses/new graduates have limited work experience and must experience continuing learning until they have reached an acceptable level of performance. 51 After that, further improvements are not predictable, and years of experience are an inadequate predictor of expertise. 52

The most effective knower and developer of practical knowledge creates an ongoing dialogue and connection between lessons of the day and experiential learning over time. Gadamer, in a late life interview, highlighted the open-endedness and ongoing nature of experiential learning in the following interview response:

Being experienced does not mean that one now knows something once and for all and becomes rigid in this knowledge; rather, one becomes more open to new experiences. A person who is experienced is undogmatic. Experience has the effect of freeing one to be open to new experience … In our experience we bring nothing to a close; we are constantly learning new things from our experience … this I call the interminability of all experience 32 (p. 403).

Practical endeavor, supported by scientific knowledge, requires experiential learning, the development of skilled know-how, and perceptual acuity in order to make the scientific knowledge relevant to the situation. Clinical perceptual and skilled know-how helps the practitioner discern when particular scientific findings might be relevant. 53

Often experience and knowledge, confirmed by experimentation, are treated as oppositions, an either-or choice. However, in practice it is readily acknowledged that experiential knowledge fuels scientific investigation, and scientific investigation fuels further experiential learning. Experiential learning from particular clinical cases can help the clinician recognize future similar cases and fuel new scientific questions and study. For example, less experienced nurses—and it could be argued experienced as well—can use nursing diagnoses practice guidelines as part of their professional advancement. Guidelines are used to reflect their interpretation of patients’ needs, responses, and situation, 54 a process that requires critical thinking and decisionmaking. 55 , 56 Using guidelines also reflects one’s problem identification and problem-solving abilities. 56 Conversely, the ability to proficiently conduct a series of tasks without nursing diagnoses is the hallmark of expertise. 39 , 57

Experience precedes expertise. As expertise develops from experience and gaining knowledge and transitions to the proficiency stage, the nurses’ thinking moves from steps and procedures (i.e., task-oriented care) toward “chunks” or patterns 39 (i.e., patient-specific care). In doing so, the nurse thinks reflectively, rather than merely accepting statements and performing procedures without significant understanding and evaluation. 34 Expert nurses do not rely on rules and logical thought processes in problem-solving and decisionmaking. 39 Instead, they use abstract principles, can see the situation as a complex whole, perceive situations comprehensively, and can be fully involved in the situation. 48 Expert nurses can perform high-level care without conscious awareness of the knowledge they are using, 39 , 58 and they are able to provide that care with flexibility and speed. Through a combination of knowledge and skills gained from a range of theoretical and experiential sources, expert nurses also provide holistic care. 39 Thus, the best care comes from the combination of theoretical, tacit, and experiential knowledge. 59 , 60

Experts are thought to eventually develop the ability to intuitively know what to do and to quickly recognize critical aspects of the situation. 22 Some have proposed that expert nurses provide high-quality patient care, 61 , 62 but that is not consistently documented—particularly in consideration of patient outcomes—and a full understanding between the differential impact of care rendered by an “expert” nurse is not fully understood. In fact, several studies have found that length of professional experience is often unrelated and even negatively related to performance measures and outcomes. 63 , 64

In a review of the literature on expertise in nursing, Ericsson and colleagues 65 found that focusing on challenging, less-frequent situations would reveal individual performance differences on tasks that require speed and flexibility, such as that experienced during a code or an adverse event. Superior performance was associated with extensive training and immediate feedback about outcomes, which can be obtained through continual training, simulation, and processes such as root-cause analysis following an adverse event. Therefore, efforts to improve performance benefited from continual monitoring, planning, and retrospective evaluation. Even then, the nurse’s ability to perform as an expert is dependent upon their ability to use intuition or insights gained through interactions with patients. 39

Intuition and Perception

Intuition is the instant understanding of knowledge without evidence of sensible thought. 66 According to Young, 67 intuition in clinical practice is a process whereby the nurse recognizes something about a patient that is difficult to verbalize. Intuition is characterized by factual knowledge, “immediate possession of knowledge, and knowledge independent of the linear reasoning process” 68 (p. 23). When intuition is used, one filters information initially triggered by the imagination, leading to the integration of all knowledge and information to problem solve. 69 Clinicians use their interactions with patients and intuition, drawing on tacit or experiential knowledge, 70 , 71 to apply the correct knowledge to make the correct decisions to address patient needs. Yet there is a “conflated belief in the nurses’ ability to know what is best for the patient” 72 (p. 251) because the nurses’ and patients’ identification of the patients’ needs can vary. 73

A review of research and rhetoric involving intuition by King and Appleton 62 found that all nurses, including students, used intuition (i.e., gut feelings). They found evidence, predominately in critical care units, that intuition was triggered in response to knowledge and as a trigger for action and/or reflection with a direct bearing on the analytical process involved in patient care. The challenge for nurses was that rigid adherence to checklists, guidelines, and standardized documentation, 62 ignored the benefits of intuition. This view was furthered by Rew and Barrow 68 , 74 in their reviews of the literature, where they found that intuition was imperative to complex decisionmaking, 68 difficult to measure and assess in a quantitative manner, and was not linked to physiologic measures. 74

Intuition is a way of explaining professional expertise. 75 Expert nurses rely on their intuitive judgment that has been developed over time. 39 , 76 Intuition is an informal, nonanalytically based, unstructured, deliberate calculation that facilitates problem solving, 77 a process of arriving at salient conclusions based on relatively small amounts of knowledge and/or information. 78 Experts can have rapid insight into a situation by using intuition to recognize patterns and similarities, achieve commonsense understanding, and sense the salient information combined with deliberative rationality. 10 Intuitive recognition of similarities and commonalities between patients are often the first diagnostic clue or early warning, which must then be followed up with critical evaluation of evidence among the competing conditions. This situation calls for intuitive judgment that can distinguish “expert human judgment from the decisions” made by a novice 79 (p. 23).

Shaw 80 equates intuition with direct perception. Direct perception is dependent upon being able to detect complex patterns and relationships that one has learned through experience are important. Recognizing these patterns and relationships generally occurs rapidly and is complex, making it difficult to articulate or describe. Perceptual skills, like those of the expert nurse, are essential to recognizing current and changing clinical conditions. Perception requires attentiveness and the development of a sense of what is salient. Often in nursing and medicine, means and ends are fused, as is the case for a “good enough” birth experience and a peaceful death.

• Applying Practice Evidence

Research continues to find that using evidence-based guidelines in practice, informed through research evidence, improves patients’ outcomes. 81–83 Research-based guidelines are intended to provide guidance for specific areas of health care delivery. 84 The clinician—both the novice and expert—is expected to use the best available evidence for the most efficacious therapies and interventions in particular instances, to ensure the highest-quality care, especially when deviations from the evidence-based norm may heighten risks to patient safety. Otherwise, if nursing and medicine were exact sciences, or consisted only of techne, then a 1:1 relationship could be established between results of aggregated evidence-based research and the best path for all patients.

Evaluating Evidence

Before research should be used in practice, it must be evaluated. There are many complexities and nuances in evaluating the research evidence for clinical practice. Evaluation of research behind evidence-based medicine requires critical thinking and good clinical judgment. Sometimes the research findings are mixed or even conflicting. As such, the validity, reliability, and generalizability of available research are fundamental to evaluating whether evidence can be applied in practice. To do so, clinicians must select the best scientific evidence relevant to particular patients—a complex process that involves intuition to apply the evidence. Critical thinking is required for evaluating the best available scientific evidence for the treatment and care of a particular patient.

Good clinical judgment is required to select the most relevant research evidence. The best clinical judgment, that is, reasoning across time about the particular patient through changes in the patient’s concerns and condition and/or the clinician’s understanding, are also required. This type of judgment requires clinicians to make careful observations and evaluations of the patient over time, as well as know the patient’s concerns and social circumstances. To evolve to this level of judgment, additional education beyond clinical preparation if often required.

Sources of Evidence

Evidence that can be used in clinical practice has different sources and can be derived from research, patient’s preferences, and work-related experience. 85 , 86 Nurses have been found to obtain evidence from experienced colleagues believed to have clinical expertise and research-based knowledge 87 as well as other sources.

For many years now, randomized controlled trials (RCTs) have often been considered the best standard for evaluating clinical practice. Yet, unless the common threats to the validity (e.g., representativeness of the study population) and reliability (e.g., consistency in interventions and responses of study participants) of RCTs are addressed, the meaningfulness and generalizability of the study outcomes are very limited. Relevant patient populations may be excluded, such as women, children, minorities, the elderly, and patients with multiple chronic illnesses. The dropout rate of the trial may confound the results. And it is easier to get positive results published than it is to get negative results published. Thus, RCTs are generalizable (i.e., applicable) only to the population studied—which may not reflect the needs of the patient under the clinicians care. In instances such as these, clinicians need to also consider applied research using prospective or retrospective populations with case control to guide decisionmaking, yet this too requires critical thinking and good clinical judgment.

Another source of available evidence may come from the gold standard of aggregated systematic evaluation of clinical trial outcomes for the therapy and clinical condition in question, be generated by basic and clinical science relevant to the patient’s particular pathophysiology or care need situation, or stem from personal clinical experience. The clinician then takes all of the available evidence and considers the particular patient’s known clinical responses to past therapies, their clinical condition and history, the progression or stages of the patient’s illness and recovery, and available resources.

In clinical practice, the particular is examined in relation to the established generalizations of science. With readily available summaries of scientific evidence (e.g., systematic reviews and practice guidelines) available to nurses and physicians, one might wonder whether deep background understanding is still advantageous. Might it not be expendable, since it is likely to be out of date given the current scientific evidence? But this assumption is a false opposition and false choice because without a deep background understanding, the clinician does not know how to best find and evaluate scientific evidence for the particular case in hand. The clinician’s sense of salience in any given situation depends on past clinical experience and current scientific evidence.

Evidence-Based Practice

The concept of evidence-based practice is dependent upon synthesizing evidence from the variety of sources and applying it appropriately to the care needs of populations and individuals. This implies that evidence-based practice, indicative of expertise in practice, appropriately applies evidence to the specific situations and unique needs of patients. 88 , 89 Unfortunately, even though providing evidence-based care is an essential component of health care quality, it is well known that evidence-based practices are not used consistently.

Conceptually, evidence used in practice advances clinical knowledge, and that knowledge supports independent clinical decisions in the best interest of the patient. 90 , 91 Decisions must prudently consider the factors not necessarily addressed in the guideline, such as the patient’s lifestyle, drug sensitivities and allergies, and comorbidities. Nurses who want to improve the quality and safety of care can do so though improving the consistency of data and information interpretation inherent in evidence-based practice.

Initially, before evidence-based practice can begin, there needs to be an accurate clinical judgment of patient responses and needs. In the course of providing care, with careful consideration of patient safety and quality care, clinicians must give attention to the patient’s condition, their responses to health care interventions, and potential adverse reactions or events that could harm the patient. Nonetheless, there is wide variation in the ability of nurses to accurately interpret patient responses 92 and their risks. 93 Even though variance in interpretation is expected, nurses are obligated to continually improve their skills to ensure that patients receive quality care safely. 94 Patients are vulnerable to the actions and experience of their clinicians, which are inextricably linked to the quality of care patients have access to and subsequently receive.

The judgment of the patient’s condition determines subsequent interventions and patient outcomes. Attaining accurate and consistent interpretations of patient data and information is difficult because each piece can have different meanings, and interpretations are influenced by previous experiences. 95 Nurses use knowledge from clinical experience 96 , 97 and—although infrequently—research. 98–100

Once a problem has been identified, using a process that utilizes critical thinking to recognize the problem, the clinician then searches for and evaluates the research evidence 101 and evaluates potential discrepancies. The process of using evidence in practice involves “a problem-solving approach that incorporates the best available scientific evidence, clinicians’ expertise, and patient’s preferences and values” 102 (p. 28). Yet many nurses do not perceive that they have the education, tools, or resources to use evidence appropriately in practice. 103

Reported barriers to using research in practice have included difficulty in understanding the applicability and the complexity of research findings, failure of researchers to put findings into the clinical context, lack of skills in how to use research in practice, 104 , 105 amount of time required to access information and determine practice implications, 105–107 lack of organizational support to make changes and/or use in practice, 104 , 97 , 105 , 107 and lack of confidence in one’s ability to critically evaluate clinical evidence. 108

When Evidence Is Missing

In many clinical situations, there may be no clear guidelines and few or even no relevant clinical trials to guide decisionmaking. In these cases, the latest basic science about cellular and genomic functioning may be the most relevant science, or by default, guestimation. Consequently, good patient care requires more than a straightforward, unequivocal application of scientific evidence. The clinician must be able to draw on a good understanding of basic sciences, as well as guidelines derived from aggregated data and information from research investigations.

Practical knowledge is shaped by one’s practice discipline and the science and technology relevant to the situation at hand. But scientific, formal, discipline-specific knowledge are not sufficient for good clinical practice, whether the discipline be law, medicine, nursing, teaching, or social work. Practitioners still have to learn how to discern generalizable scientific knowledge, know how to use scientific knowledge in practical situations, discern what scientific evidence/knowledge is relevant, assess how the particular patient’s situation differs from the general scientific understanding, and recognize the complexity of care delivery—a process that is complex, ongoing, and changing, as new evidence can overturn old.

Practice communities like individual practitioners may also be mistaken, as is illustrated by variability in practice styles and practice outcomes across hospitals and regions in the United States. This variability in practice is why practitioners must learn to critically evaluate their practice and continually improve their practice over time. The goal is to create a living self-improving tradition.

Within health care, students, scientists, and practitioners are challenged to learn and use different modes of thinking when they are conflated under one term or rubric, using the best-suited thinking strategies for taking into consideration the purposes and the ends of the reasoning. Learning to be an effective, safe nurse or physician requires not only technical expertise, but also the ability to form helping relationships and engage in practical ethical and clinical reasoning. 50 Good ethical comportment requires that both the clinician and the scientist take into account the notions of good inherent in clinical and scientific practices. The notions of good clinical practice must include the relevant significance and the human concerns involved in decisionmaking in particular situations, centered on clinical grasp and clinical forethought.

The Three Apprenticeships of Professional Education

We have much to learn in comparing the pedagogies of formation across the professions, such as is being done currently by the Carnegie Foundation for the Advancement of Teaching. The Carnegie Foundation’s broad research program on the educational preparation of the profession focuses on three essential apprenticeships:

To capture the full range of crucial dimensions in professional education, we developed the idea of a three-fold apprenticeship: (1) intellectual training to learn the academic knowledge base and the capacity to think in ways important to the profession; (2) a skill-based apprenticeship of practice; and (3) an apprenticeship to the ethical standards, social roles, and responsibilities of the profession, through which the novice is introduced to the meaning of an integrated practice of all dimensions of the profession, grounded in the profession’s fundamental purposes. 109

This framework has allowed the investigators to describe tensions and shortfalls as well as strengths of widespread teaching practices, especially at articulation points among these dimensions of professional training.

Research has demonstrated that these three apprenticeships are taught best when they are integrated so that the intellectual training includes skilled know-how, clinical judgment, and ethical comportment. In the study of nursing, exemplary classroom and clinical teachers were found who do integrate the three apprenticeships in all of their teaching, as exemplified by the following anonymous student’s comments:

With that as well, I enjoyed the class just because I do have clinical experience in my background and I enjoyed it because it took those practical applications and the knowledge from pathophysiology and pharmacology, and all the other classes, and it tied it into the actual aspects of like what is going to happen at work. For example, I work in the emergency room and question: Why am I doing this procedure for this particular patient? Beforehand, when I was just a tech and I wasn’t going to school, I’d be doing it because I was told to be doing it—or I’d be doing CPR because, you know, the doc said, start CPR. I really enjoy the Care and Illness because now I know the process, the pathophysiological process of why I’m doing it and the clinical reasons of why they’re making the decisions, and the prioritization that goes on behind it. I think that’s the biggest point. Clinical experience is good, but not everybody has it. Yet when these students transition from school and clinicals to their job as a nurse, they will understand what’s going on and why.

The three apprenticeships are equally relevant and intertwined. In the Carnegie National Study of Nursing Education and the companion study on medical education as well as in cross-professional comparisons, teaching that gives an integrated access to professional practice is being examined. Once the three apprenticeships are separated, it is difficult to reintegrate them. The investigators are encouraged by teaching strategies that integrate the latest scientific knowledge and relevant clinical evidence with clinical reasoning about particular patients in unfolding rather than static cases, while keeping the patient and family experience and concerns relevant to clinical concerns and reasoning.

Clinical judgment or phronesis is required to evaluate and integrate techne and scientific evidence.

Within nursing, professional practice is wise and effective usually to the extent that the professional creates relational and communication contexts where clients/patients can be open and trusting. Effectiveness depends upon mutual influence between patient and practitioner, student and learner. This is another way in which clinical knowledge is dialogical and socially distributed. The following articulation of practical reasoning in nursing illustrates the social, dialogical nature of clinical reasoning and addresses the centrality of perception and understanding to good clinical reasoning, judgment and intervention.

Clinical Grasp *

Clinical grasp describes clinical inquiry in action. Clinical grasp begins with perception and includes problem identification and clinical judgment across time about the particular transitions of particular patients. Garrett Chan 20 described the clinician’s attempt at finding an “optimal grasp” or vantage point of understanding. Four aspects of clinical grasp, which are described in the following paragraphs, include (1) making qualitative distinctions, (2) engaging in detective work, (3) recognizing changing relevance, and (4) developing clinical knowledge in specific patient populations.

Making Qualitative Distinctions

Qualitative distinctions refer to those distinctions that can be made only in a particular contextual or historical situation. The context and sequence of events are essential for making qualitative distinctions; therefore, the clinician must pay attention to transitions in the situation and judgment. Many qualitative distinctions can be made only by observing differences through touch, sound, or sight, such as the qualities of a wound, skin turgor, color, capillary refill, or the engagement and energy level of the patient. Another example is assessing whether the patient was more fatigued after ambulating to the bathroom or from lack of sleep. Likewise the quality of the clinician’s touch is distinct as in offering reassurance, putting pressure on a bleeding wound, and so on. 110

Engaging in Detective Work, Modus Operandi Thinking, and Clinical Puzzle Solving

Clinical situations are open ended and underdetermined. Modus operandi thinking keeps track of the particular patient, the way the illness unfolds, the meanings of the patient’s responses as they have occurred in the particular time sequence. Modus operandi thinking requires keeping track of what has been tried and what has or has not worked with the patient. In this kind of reasoning-in-transition, gains and losses of understanding are noticed and adjustments in the problem approach are made.

We found that teachers in a medical surgical unit at the University of Washington deliberately teach their students to engage in “detective work.” Students are given the daily clinical assignment of “sleuthing” for undetected drug incompatibilities, questionable drug dosages, and unnoticed signs and symptoms. For example, one student noted that an unusual dosage of a heart medication was being given to a patient who did not have heart disease. The student first asked her teacher about the unusually high dosage. The teacher, in turn, asked the student whether she had asked the nurse or the patient about the dosage. Upon the student’s questioning, the nurse did not know why the patient was receiving the high dosage and assumed the drug was for heart disease. The patient’s staff nurse had not questioned the order. When the student asked the patient, the student found that the medication was being given for tremors and that the patient and the doctor had titrated the dosage for control of the tremors. This deliberate approach to teaching detective work, or modus operandi thinking, has characteristics of “critical reflection,” but stays situated and engaged, ferreting out the immediate history and unfolding of events.

Recognizing Changing Clinical Relevance

The meanings of signs and symptoms are changed by sequencing and history. The patient’s mental status, color, or pain level may continue to deteriorate or get better. The direction, implication, and consequences for the changes alter the relevance of the particular facts in the situation. The changing relevance entailed in a patient transitioning from primarily curative care to primarily palliative care is a dramatic example, where symptoms literally take on new meanings and require new treatments.

Developing Clinical Knowledge in Specific Patient Populations

Extensive experience with a specific patient population or patients with particular injuries or diseases allows the clinician to develop comparisons, distinctions, and nuanced differences within the population. The comparisons between many specific patients create a matrix of comparisons for clinicians, as well as a tacit, background set of expectations that create population- and patient-specific detective work if a patient does not meet the usual, predictable transitions in recovery. What is in the background and foreground of the clinician’s attention shifts as predictable changes in the patient’s condition occurs, such as is seen in recovering from heart surgery or progressing through the predictable stages of labor and delivery. Over time, the clinician develops a deep background understanding that allows for expert diagnostic and interventions skills.

Clinical Forethought

Clinical forethought is intertwined with clinical grasp, but it is much more deliberate and even routinized than clinical grasp. Clinical forethought is a pervasive habit of thought and action in nursing practice, and also in medicine, as clinicians think about disease and recovery trajectories and the implications of these changes for treatment. Clinical forethought plays a role in clinical grasp because it structures the practical logic of clinicians. At least four habits of thought and action are evident in what we are calling clinical forethought: (1) future think, (2) clinical forethought about specific patient populations, (3) anticipation of risks for particular patients, and (4) seeing the unexpected.

Future think

Future think is the broadest category of this logic of practice. Anticipating likely immediate futures helps the clinician make good plans and decisions about preparing the environment so that responding rapidly to changes in the patient is possible. Without a sense of salience about anticipated signs and symptoms and preparing the environment, essential clinical judgments and timely interventions would be impossible in the typically fast pace of acute and intensive patient care. Future think governs the style and content of the nurse’s attentiveness to the patient. Whether in a fast-paced care environment or a slower-paced rehabilitation setting, thinking and acting with anticipated futures guide clinical thinking and judgment. Future think captures the way judgment is suspended in a predictive net of anticipation and preparing oneself and the environment for a range of potential events.

Clinical forethought about specific diagnoses and injuries

This habit of thought and action is so second nature to the experienced nurse that the new or inexperienced nurse may have difficulty finding out about what seems to other colleagues as “obvious” preparation for particular patients and situations. Clinical forethought involves much local specific knowledge about who is a good resource and how to marshal support services and equipment for particular patients.

Examples of preparing for specific patient populations are pervasive, such as anticipating the need for a pacemaker during surgery and having the equipment assembled ready for use to save essential time. Another example includes forecasting an accident victim’s potential injuries, and recognizing that intubation might be needed.

Anticipation of crises, risks, and vulnerabilities for particular patients

This aspect of clinical forethought is central to knowing the particular patient, family, or community. Nurses situate the patient’s problems almost like a topography of possibilities. This vital clinical knowledge needs to be communicated to other caregivers and across care borders. Clinical teaching could be improved by enriching curricula with narrative examples from actual practice, and by helping students recognize commonly occurring clinical situations in the simulation and clinical setting. For example, if a patient is hemodynamically unstable, then managing life-sustaining physiologic functions will be a main orienting goal. If the patient is agitated and uncomfortable, then attending to comfort needs in relation to hemodynamics will be a priority. Providing comfort measures turns out to be a central background practice for making clinical judgments and contains within it much judgment and experiential learning.

When clinical teaching is too removed from typical contingencies and strong clinical situations in practice, students will lack practice in active thinking-in-action in ambiguous clinical situations. In the following example, an anonymous student recounted her experiences of meeting a patient:

I was used to different equipment and didn’t know how things went, didn’t know their routine, really. You can explain all you want in class, this is how it’s going to be, but when you get there … . Kim was my first instructor and my patient that she assigned me to—I walked into the room and he had every tube imaginable. And so I was a little overwhelmed. It’s not necessarily even that he was that critical … . She asked what tubes here have you seen? Well, I know peripheral lines. You taught me PICC [peripherally inserted central catheter] lines, and we just had that, but I don’t really feel comfortable doing it by myself, without you watching to make sure that I’m flushing it right and how to assess it. He had a chest tube and I had seen chest tubes, but never really knew the depth of what you had to assess and how you make sure that it’s all kosher and whatever. So she went through the chest tube and explained, it’s just bubbling a little bit and that’s okay. The site, check the site. The site looked okay and that she’d say if it wasn’t okay, this is what it might look like … . He had a feeding tube. I had done feeding tubes but that was like a long time ago in my LPN experiences schooling. So I hadn’t really done too much with the feeding stuff either … . He had a [nasogastric] tube, and knew pretty much about that and I think at the time it was clamped. So there were no issues with the suction or whatever. He had a Foley catheter. He had a feeding tube, a chest tube. I can’t even remember but there were a lot.

As noted earlier, a central characteristic of a practice discipline is that a self-improving practice requires ongoing experiential learning. One way nurse educators can enhance clinical inquiry is by increasing pedagogies of experiential learning. Current pedagogies for experiential learning in nursing include extensive preclinical study, care planning, and shared postclinical debriefings where students share their experiential learning with their classmates. Experiential learning requires open learning climates where students can discuss and examine transitions in understanding, including their false starts, or their misconceptions in actual clinical situations. Nursing educators typically develop open and interactive clinical learning communities, so that students seem committed to helping their classmates learn from their experiences that may have been difficult or even unsafe. One anonymous nurse educator described how students extend their experiential learning to their classmates during a postclinical conference:

So for example, the patient had difficulty breathing and the student wanted to give the meds instead of addressing the difficulty of breathing. Well, while we were sharing information about their patients, what they did that day, I didn’t tell the student to say this, but she said, ‘I just want to tell you what I did today in clinical so you don’t do the same thing, and here’s what happened.’ Everybody’s listening very attentively and they were asking her some questions. But she shared that. She didn’t have to. I didn’t tell her, you must share that in postconference or anything like that, but she just went ahead and shared that, I guess, to reinforce what she had learned that day but also to benefit her fellow students in case that thing comes up with them.

The teacher’s response to this student’s honesty and generosity exemplifies her own approach to developing an open community of learning. Focusing only on performance and on “being correct” prevents learning from breakdown or error and can dampen students’ curiosity and courage to learn experientially.

Seeing the unexpected

One of the keys to becoming an expert practitioner lies in how the person holds past experiential learning and background habitual skills and practices. This is a skill of foregrounding attention accurately and effectively in response to the nature of situational demands. Bourdieu 29 calls the recognition of the situation central to practical reasoning. If nothing is routinized as a habitual response pattern, then practitioners will not function effectively in emergencies. Unexpected occurrences may be overlooked. However, if expectations are held rigidly, then subtle changes from the usual will be missed, and habitual, rote responses will inappropriately rule. The clinician must be flexible in shifting between what is in background and foreground. This is accomplished by staying curious and open. The clinical “certainty” associated with perceptual grasp is distinct from the kind of “certainty” achievable in scientific experiments and through measurements. Recognition of similar or paradigmatic clinical situations is similar to “face recognition” or recognition of “family resemblances.” This concept is subject to faulty memory, false associative memories, and mistaken identities; therefore, such perceptual grasp is the beginning of curiosity and inquiry and not the end. Assessment and validation are required. In rapidly moving clinical situations, perceptual grasp is the starting point for clarification, confirmation, and action. Having the clinician say out loud how he or she is understanding the situation gives an opportunity for confirmation and disconfirmation from other clinicians present. 111 The relationship between foreground and background of attention needs to be fluid, so that missed expectations allow the nurse to see the unexpected. For example, when the background rhythm of a cardiac monitor changes, the nurse notices, and what had been background tacit awareness becomes the foreground of attention. A hallmark of expertise is the ability to notice the unexpected. 20 Background expectations of usual patient trajectories form with experience. Tacit expectations for patient trajectories form that enable the nurse to notice subtle failed expectations and pay attention to early signs of unexpected changes in the patient's condition. Clinical expectations gained from caring for similar patient populations form a tacit clinical forethought that enable the experienced clinician to notice missed expectations. Alterations from implicit or explicit expectations set the stage for experiential learning, depending on the openness of the learner.

Learning to provide safe and quality health care requires technical expertise, the ability to think critically, experience, and clinical judgment. The high-performance expectation of nurses is dependent upon the nurses’ continual learning, professional accountability, independent and interdependent decisionmaking, and creative problem-solving abilities.

This section of the paper was condensed and paraphrased from Benner, Hooper-Kyriakidis, and Stannard. 23 Patricia Hooper-Kyriakidis wrote the section on clinical grasp, and Patricia Benner wrote the section on clinical forethought.

• Cite this Page Benner P, Hughes RG, Sutphen M. Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 6.
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Fostering Student Motivation to Think Critically: Critical Thinking Dispositions in Higher Education

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Instructors’ ability to foster students’ disposition to engage in critical thinking (CT) is instrumental for CT growth. University students’ (N = 1,352) semester-long gains across specific dispositions were compared when taught by professors who had received zero, one, two, or three semesters of training in CT pedagogy. All groups experienced statistically significant improvement (p < .001), but only the three-semester group demonstrated practically significant results across the majority of subscales (η2 > .20). The authors’ recommendations include implementing long-term faculty development programs to provide regular training in CT pedagogy and teaching strategies for attitude formation, authentic learning, student self-efficacy, and student academic control.

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JECT may terminate this Agreement if Customer violates any of the terms and conditions set forth herein. In the event of any termination of access, JECT will promptly notify the Customer of the basis for termination.

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FinanceBuzz

10 Job Skills Employers Want Younger People to Have

Posted: June 11, 2023 | Last updated: June 11, 2023

The education, skills, and experience you list on a resume are essential to getting your first job. But these aren’t the only things recruiters and interviewers have in mind when they’re looking for the right candidate.

They’re also on the lookout for soft skills — interpersonal and relationship management skills that are harder to quantify on paper.

If you’re new to the job market (or planning on re-entering it), it’s easy to overlook the importance of certain soft skills to would-be employers as you look for the right job to boost your bank account .

Here are some of the most important skills employers value beyond just degrees and expertise.

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Adaptability

Excelling at a job isn’t just a matter of knowing your trade. It’s also about how well you can work in a fast-paced, real-world environment. This is much different from the more structured learning environment you’d get at a high school, trade school, or university.

For instance, can you problem-solve on your feet? Are you able to easily pivot from one task to another without missing a beat? Can you adjust your skills and expectations to match the on-the-ground conditions of doing your job?

Your ability to adapt could differentiate you from a candidate with the same (or even better) qualifications who can’t adapt to changing demands of your job. It could be the difference maker in your ability to stop living paycheck to paycheck .

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Reliability

The so-called "Great Resignation" followed by months of employees "quiet quitting" means most employers are desperate for workers they can rely on.

Along with knowing you’ll show up to work on time, employers like to know that they can rely on you to follow through on tasks you’ve committed to.

This doesn’t mean you have to commit to working at a company for an indefinite amount of time, nor does it mean taking on more tasks than you can reasonably handle without help.

Instead, it means building a reputation as a trusted employee who stays on task, gets to meetings on time, and consistently finishes work projects on or before a deadline.

Communication

One of the most important parts of any job is how well you get along with other people, including clients, customers, bosses, managers, and coworkers.

No matter how good you are at your job, if you can’t communicate effectively and respectfully with the people around you, you’ll be more of a liability than an asset to your company.

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Problem solving

Some employers still want (or at least think they want) employees who will stick to the status quo and won’t question the company’s practices or procedures.

In reality, though, the most valuable employees are often the ones who can see a longstanding slowdown, hang-up, or error and propose a working solution.

This doesn’t mean you should walk into a job and start criticizing everything you disagree with. However, you can demonstrate your unique value to a company by addressing problems head-on instead of ignoring them.

Your desire to learn doesn’t have to stop once you leave school and enter the job market.

There’s almost always something new to learn about a job, skill, or company. Demonstrating your willingness to learn shows that you’re a dedicated employee who’s committed to growth.

Go out of your way to ask questions, puzzle through solutions, and dedicate yourself to getting better at your craft.

Not only will it make your current workplace better, but it will also set you apart in a constantly shifting job market where the desire to learn is a valuable commodity.

Critical thinking

Critical thinking doesn’t mean criticizing or overthinking things. Instead, it refers to your ability to look at a problem from several perspectives, understand your own bias, analyze all available data, and create meaningful solutions.

Critical thinking is a crucial part of becoming a good problem solver and is also an essential component of self-improvement.

No one wants to hire an employee who can’t reflect on their own performance and commit to the constant process of getting better.

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Collaboration

In most workplaces, you’ll need to do more than just communicate with your coworkers. You’ll also need to collaborate with them on projects, which means speaking respectfully, contributing fairly, and speaking to your expertise without stepping on their toes.

The best collaborators always do their fair share of the work, but they also know when to ask for help and how to take feedback.

Being the best you can be at your job’s technical skills is important, whether you work mainly by yourself or on a team. But those skills are often secondary to getting along with others.

Given enough time and dedication, you can teach someone to pick up practically any skill or job process. But it’s much harder to teach creativity, which is one reason it’s such a valuable commodity in the workplace.

If you’re creative, you can think outside the box to find novel solutions to problems. You see the world in a unique way and can assemble the pieces of a puzzle to make something new rather than reproducing the same tired thing over and over again.

Creative innovation is the main way companies grow, so showcasing your creativity at work can absolutely set you apart as an employee to keep around for the long term.

Pro tip: If you're looking for a job you can enjoy but it doesn't pay enough, consider also finding a way to make some extra cash to offset the salary.

Few (if any) employers want to hire people they can’t trust. Being honest about things like when you get to work, how many tasks you accomplish in a day, and how you’ve spent your time at work helps you establish a reputation as an employee others can rely on.

Honesty is the best policy in a few other areas too. For example, it’s important to be honest with yourself about what you can and can’t do at work.

Otherwise, you’ll have a hard time taking feedback and improving. It’s similarly important, to be honest about any mistakes you make or questions you have.

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How comfortable are you seeing things from another person’s point of view?

Are you open to listening and learning from other people’s experiences rather than centering your own life experiences? Can you easily put yourself in someone’s shoes, or are you trapped in your own perspective?

Answering these questions is important to anyone who works in today’s globalized, diverse world. Developing empathy will make you a better coworker too. This will be an asset no matter what field you go into or where your career takes you after your first job.

Bottom line

Along with perfecting your resume, brushing up on these skills can set you apart in a candidate pool and make you even more appealing to your future employer. It could also help you get a better job so you can finally grow wealth and prepare for your future.

Plus, staying on top of skills like these is more than a great way to launch a career. It can prove crucial to establishing a decades-long career you’re both excited about and proud of.

More from FinanceBuzz:

• 6 genius hacks Costco shoppers should know
• 9 things you must do before the next recession.
• Can you retire early? Take this quiz and find out.
• 9 simple ways to make up to an extra $200/day

We may receive compensation from the products and services mentioned in this story, but the opinions are the author's own. Compensation may impact where offers appear. We have not included all available products or offers. Learn more about how we make money and our editorial policies .

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