Exploring the meaning and behaviors of critical thinking in nursing practice

The purpose of this study was to explore the perceptions of practicing nurses regarding the definition and behaviors of critical thinking (CT) as it occurs in the practice of nursing. A sample of 21 registered nurses, with a baccalaureate degree and at least two years of nursing experience, was obtained through maximum variation purposive sampling. The qualitative methodology used for this study was naturalistic inquiry and included the use of critical incident technique. The data collection method used was the audiotaping of interviews, in which the perceptions and perspectives of these nurses were explored.;Participants were asked to describe a critical incident which challenged their practice. The analysis of these descriptions led to the development of a conceptual definition of CT. Participants were asked additional questions about their own CT attributes, their practice environments, and the behaviors of colleagues which they felt were indicative of CT. The coding of these responses into themes led to the following CT behaviors: (1) anticipatory, outcome-focused thinking; (2) maintaining a holistic view of the patient; (3) questioning and seeking out additional information; (4) prioritizing; (5) organizing and active planning; and (6) problem solving and step-by-step processing of information. Finally the behaviors and attributes as derived from the analysis of the data were compared to Scheffer and Rubenfeld's (2000) Consensus Statement on Critical Thinking in Nursing. Many similarities were found between the attributes and behaviors of CT identified in this study and the Consensus Statement. Additionally the barriers to and facilitators of CT in practice were explored to gain a more complete understanding of the nurses' perceptions and experiences with CT.;The findings from this study provide insight on the perspectives of practicing nurses on CT and point to implications for practice, education, and research. The participants expressed a need for a supportive, collaborative practice environment that included more time for CT. They identified that education needed to include more "hands-on experiences" and higher level questioning for students. Finally, more studies such as this one need to be conducted as a foundation for the development of an instrument that can measure CT in nursing.