Happy semester with best wishes from all nursing staff Dr Naiema Gaber

Courses introduced by nursing department Fundamentals of Nursing II Health Assessment Evidenced Based in Nursing

Fundamentals of Nursing II Course syllabus Please read carefully the course guide and if you have any questions come and ask for clarification

Lecture I Critical thinking (CT) The intended learning outcomes (ILOs After this lecture the student will be able to: Define critical thinking (CT) Explain the importance of.C.T in nursing Determine the characteristics of CT Compare and contrast types of nursing knowledge Describe the skills and attitudes of C.T Discuss the relationship between nursing & C.T List guidelines help in developing critical thinking

Mental activities (student exercise) Before starting the lecture, answer the following questions 1.What is CT? 2.Are you a critical thinker? 3.When people think better? 4.What is going inside our heads? 5.Do, as nurses, need CT

What is critical thinking? (CT) CT is an active purposeful, organized cognitive process we use to carefully examine our thinking and the thinking of others, in order to clarify and improve our understanding. (Chaffee 1994) CT is “a rational response to questions that cannot be answered definitively and for which all relevant information may not be available.

Collaborative thinking People think better when they: understand, like and trust one another. Move from I to we Empower partnership What is going inside our heads? A person’s mind once stretched by a new idea, never regains its original dimension. (Olive Wend)

What is the Importance of.C.T? CT teaches us: how to learn, reason situations and think creatively generate and evaluate ideas see things in mind’s eye make decisions and solve problem Without CT, it is easy to be narrow mindedness, prejudice and intellectually arrogance (self importance & pride)

Are you a critical thinker? To answer this question you can ask yourself the following questions: Do you  Explore the thinking &assumption that underline your emotion and feeling?  Base your judgments on facts and reasoning, not personal feelings?  Suspect judgment until you have all the necessary data?

Are you a critical thinker? (cont.)  Support your views with evidence?  Evaluate the sources you use to justify your belief?  Differentiate among facts, opinions and inferences?  Ask for clarification when you don’t understand  Turn mistakes into learning opportunities by thinking of ways to avoid it again?

Do we need to improve thinking? Why? Yes, we need to improve our thinking because:  Things aren’t what they used to be, nor what they will be.  People are sicker with multiple problems.  Rapid change and information exploration require us to develop new learning and workplace skills.  Today's progress often creates new problems that can’t be solved by old ways of thinking

Why do nurses need to think critically? Nursing is both thinking and doing. Nurses use stored-up facts, along with new information to make decisions, generate new ideas, and solve problems. In order to transfer nursing knowledge into nursing practice nurses need CT

Why do nurses need to think critically ( cont.)? To manage client’s and community problems In an applied discipline as nursing, problems are messy, complex, instable, uncertain, unique, confusing, and having value conflicts. There may be insufficient or conflicting data and unknown cause. No single correct or best solution., the nurse must know how to identify knowledge and data gaps, find and use new information, initiate and manage change. All of these skills need CT.

Why do nurses need to think critically ( cont.)? Nursing draws on knowledge from other fields which need CT. Nurses deal with change in stressful environments and this need CT. Nurses use CT to collect and interpret information to make sound judgments and good decisions.

Principles of CT in nursing CT is driven from clients, families and communities needs. Use both logic and intuition (insight and feelings) Require knowledge, skills and experience Is guided by professional standard & ethics Nursing process and CT are interdependent, but not identical. CT entails purposeful, informed outcome focused thinking.

Critical Thinking &nursing process Critical CriticalThinking Planning intervention Diagnosing Planning Outcomes (objectives) Assessment Evaluation Implementation

What is the characteristics of critical thinking? CT is rational and reasonable: based on reason rather than self-interest or fears CT involves conceptualization: intellectual process. NB: A concept is a mental image of reality as idea, objects and properties. CT requires reflection. NB: reflection means ponder something, it integrate past experiences

What is the characteristics of critical thinking? (cont.) CT involves both cognitive (mental) skills and attitudes (feelings which is a motivation or desire to use thinking). CT involves creative thinking. Creative means breaking out of established patterns of thinking and approaching situations from new directions to have a new idea or product. Healthy, constructive and skepticism (doubt or disbelieve) CT requires knowledge

Types of nursing knowledge Scientific knowledge: includes facts, information, principles and theories in nursing Nursing art: the way the nurses use their knowledge. Art must include attitudes, beliefs and values. It includes feeling and empathy (the ability to imagine what another person is feeling)

Types of nursing knowledge (cont.) Nursing ethics: Professional standards of conduct. It is concerned with matters of obligation or what ought to be done. Personal knowledge: knowing and actualizing one’s self in relation to another human being. Practice wisdom: It is acquired from intuition, tradition, authority, trial and error beside clinical experience.

Types of CT A- Attitudes and behavior B- Intellectual skills (theories, knowledge and experience) C- Interpersonal skills D- Technical skills

technical skills

A: Attitudes of C.T 1.Independent thinking 2.Intellectual humility, courage, empathy, integrity, perseverance, curiosity. 3.Fair mindedness 4.Interest in exploring thoughts and feelings (Assertiveness)

 Using language precisely  Perceiving, believing and knowing  Clarifying and comparing meaning, issues, view as well as beliefs  Judging and evaluating based on evidence and evaluation criteria  Reasoning (logic analysis): logic assumptions, distinguishing between relevant and irrelevant data, evaluate sources of data and generate solutions B- Intellectual CT

C- Interpersonal CT How to read minds: How people behave, what they say and do over time, tell how they think Results tell about people’s mind (check on nurse’s client relation

CT: Clinical skills Make the link between behavior and critical thinking explicit Classify or categorize data Compare & contrast ideal & actual practice Judge and evaluate, information, its sources, assumptions Provide evidence to support judgment Develop evaluation criteria reasoning and recognize best assumptions

Guidelines help in developing critical thinking 1.Perform self assessment to determine which critical thinking attitudes you already have and which need to be cultivated 2.Tolerate dissonance (disagreement or conflicts) and ambiguity (vagueness or uncertainty ) to develop fair-mindedness. For example you could practice being open to other viewpoint against yours.

3. Seek situation where good thinking is practiced. Attend conferences that support open discussion and respect opposing viewpoints. 4. Create environment that support critical thinking. Environment that encourage differences of opinion and fair examination of ideas & opinion. 5. Practice critical thinking when you realize that understanding is more important than memorizing and when you trust your own abilities to make sense of information.

summary Nurses: Must be critical thinkers because of the nature of their work Use critical thinking skills in each step of nursing process Use five types of nursing knowledge wisdom: science, art, ethics, personal knowledge and practice

critical thinking Involve both attitude (feelings) and cognitive thinking skills, clinical reasoning and interpersonal thinking Is rational and reasonable. Involve creative thinking. Involve cognitive skills Include complex intellectual activities as problem solving, nursing process, decision making, clinical reasoning, reflective judgment, clinical judgment and critical analysis. Can be improved with practice

Critical thinkers Consider issues before forming an opinion. Believe in their ability to think things through and make decision.

Feedback questions CT is an active purposeful, organized cognitive process we use to a- carefully examine our thinking b- test the thinking of others c- clarify and improve our understanding d-all of the above (d)

Feedback questions cont. People think better when they: a- do not trust one another. b- Move from I to we c- be away from people d- do not re cognize team work (b)

Feedback questions cont. What is the Importance of.C.T Teach us how to a- learn and solve problem b- be narrow mindedness c- be prejudice d- feel self importance & pride (a)

Feedback questions cont. In order to transfer nursing knowledge into nursing practice nurses need a- working hard b- concentrating in practice c- critical thinking d- read a lot (C)

Feedback questions cont. CT is driven from the needs of a- clients b- families c- communities d- all of the above (d)

Feedback questions cont. CT is based on a- reason rather than self-interest b- a mental image of reality c- integration of past experiences d- all of the above (d)

Matching the definition of each type of nursing knowledge: BA a- the way the nurses use their knowledge b- includes facts, information, principles and theories in nursing c- acquired from intuition, tradition, authority, trial and error beside clinical experience. d- knowing and actualizing one’s self in relation to another human being. e-Professional standards of conduct 1-Scientific knowledge 2- Nursing art 3-Nursing ethics. 4- Personal knowledge 5-Practice wisdom

Matching the definition of each type of nursing knowledge: BA a- the way the nurses use their knowledge b- includes facts, information, principles and theories in nursing c- acquired from intuition, tradition, authority, trial and error beside clinical experience. d- knowing and actualizing one’s self in relation to another human being. e-Professional standards of conduct 1-Scientific knowledge =b 2- Nursing art =a 3-Nursing ethics = e. 4- Personal knowledge = d 5-Practice wisdom = c

Feedback questions cont. Independent thinking, courage, empathy and fair mindedness is which type of critical thinking a- Attitudes and behavior b- Intellectual skills c- Interpersonal skills d- Technical (a)

Write 3 Guidelines help in developing critical thinking: 1.Perform self assessment to determine which critical thinking attitudes you already have 2.Tolerate dissonance (disagreement or conflicts) and ambiguity (vagueness or uncertainty ) to develop fair- mindedness. 3.Seek situation where good thinking is practiced. 4. Create environment that support critical thinking.. 5. Practice critical thinking when you realize that understanding is more important than memorizing

Next lecture Nursing process Each student need to read about nursing process for next lecture. Divide yourselves into 3 groups and choose one student from each group to be the leader. Formulate the outlines of the lecture that you want to know, read about, and prepare them for discussion. Sit in a circle and discuss the topic among you (the 3 group) under my direction and evaluation.

THANK YOU