The Development of an Alternative Method in the Assessment of Critical Thinking as an Outcome of Nursing Education - Article Example

Article Critique: The development of an alternative method in the assessment of critical thinking as an outcome of nursing education Name Institution Course Date Background and Statement of Problem The paper talks about the importance of critical thinking among the nursing fraternity and the manner that such a skill would impact on the practice of nursing. Critical nursing is defined as the process of applying a number of cognitive skills such as contextual analysis, inference of the information and data available, the ability to generate alternatives to the nursing practice, the ability to evaluate the information or observations made (Daly 1999), open mindedness, developing effective characteristic affective dispositions, and developing and applying intellectual standards in the assessment of the situations as presented (Paul 1991). Miller (1992) suggests that critical thinking is an integral and important aspect of the nurse’s profession with regard to the art and practice of decision making. Decision making on the part of the nurse is a daily routine, and thus the importance of the ability of the nurse to develop competent decision making abilities through critical thinking. The critical relationship between the nurse’s competent practice and critical skills is reinforced by the fact that it is an integral role of the nurse to develop competent nursing skills based on the ability to critical thinking as an outcome of research. In their every day practice, nurses are faced with a number of dilemma situations that they have to decide on and select the most appropriate option that bears the best interests of the patient as well as the nursing ethics. Critical thinking is an important component in enabling the nurse to make such a decision, as the skill enables one develop competent arguments and resolution skills, which help the nurse resolve such conflicts in decision making. The problem in the study of critical thinking is that while there is evidence suggesting the relationship between nursing education and the development of critical thinking in the nurse, the amount and nature of this evidence is not conclusive enough for substantial reference. This problem is often attributed to the type of instruments used for such studies as not being sufficiently domain specific in order to capture the articulate issues pertaining to the study. The purpose of this paper, therefore, is to explore and develop an alternative method of identifying and studying the relationship between nursing education and the development of critical thinking among the nurses. This method will aim at being unlike the other methods previously used for such studies by being domain specific. Research Perspective and Approach This research was conducted using the triangulation method. This method employs both the quantitative and interpretative approaches in order to make the study more complete and conclusive. The triangulation method of study is highly effective in explorative studies such as the one that was being undertaken. Besides, this method would provide a reference point when it would come to the development of an alternative method of study. For the quantitative part of the study, the researcher used the Watson Glaser critical thinking appraisal of 1991. Some of the advantages of this method include: it is highly suitable when being used with studies of groups, it has a long and successful history in research and recruitment and selection processes, it defines critical thinking in a practice-focused manner, and the fact that it is available in the UK with an anglicized version of the test. The quantitative element of the study was based on the raw score data that measured the performance of participants in the WGCTA (Maynard 1996). This measures the participant’s level of inference, ability to recognize assumptions, his ability to make deductions, and the ability to interpret and evaluate arguments involved in the study. A participant can score a maximum of 80 points, thus representing his raw score. The results of the study were interpreted through the examination of the participant’s behavior through the phenomenological approach and not the social meaning that they had associated behavior with. The study used a longitudinal approach in order to ensure that the study was done in total completeness and that the activities and progress of the participants were effectively monitored through the entire study for conclusive results. The multi-method method was used so that respondents were sampled through a multi-phase process that saw the same respondents undertake various trainings and respond to the impact that the trainings had on their development of critical thinking (Sullivan 1987). Learners were subjected to four studies and assessment periods. The data analysis process was using the analytic templates that were provided with the test package. These were used to analyze the Watson Glaser critical thinking appraisal by aggregating the sub-test scores to produce the pre and post test raw scores for the study. The data collected was further subjected to bi-variate analyses with regard to the varying demographics of the respondents and their relationships to group scores. Unstructured verbal data was analyzed using the line by line coding, the vivo coding method, and the referring phrase analysis method. Findings and Conclusions The findings of the study indicated a lack of change in the performance of the groups under study in critical thinking ability as was measured by Watson Glaser critical thinking appraisal tool (Miller 1992). The WGCTA mean raw scores also indicated only minor differences in the standard deviations for the pre and post test phases for the groups under study. The performance of the groups between the first and final phase showed little differences in their performance in the assessment of critical thinking abilities. The formal curriculum did not have a significant impact on the general college life and performance for the participants. The same sis not affect the level of maturation and other hidden curriculum effects of the participants in their college life all through the study. These results were common as registered in previous studies undertaken by other scholars in North America using the WGCTA (Sullivan 1987). These scholars found no correlation between nursing education and the advancement of the development of a nurse’s critical thinking skills as measured by the WGCTA. The second and third phases, however, showed a positive indication for the participants’ verbal responses to the cognitive tasks they were subjected to as well as the stimulated recall questions that they were to answer as complying to the reasoning that argument complexity was an index as pertaining to critical reasoning. Argument complexity was depicted in the participants of these groups’ responses to tasks that were domain specific and that were simulated for the participants to respond to. Despite these positive indications in the two groups, the participants did not, in general, exhibit the ability to critical thinking in a consistent manner and to be spread out across all the phases through the entire study in their responses to simulations. As such, the participants tended to use their natural reasoning abilities in rather than the prescribed critical thinking model as was expected (Paul 1991). From the above findings, it is clear that the study ascertained the use of absolute epistemology in the reasoning of nurses as opposed to critical thinking. Such reasoning serves to demean the entire definition of the practice of critical thinking and the many discrete characteristics that are associated with the definition such as affective dispositions, contextual abilities, intellectual standards, and many others. Nurses who, therefore, reason on this epistemological perspective tend to develop a single-sided perspective in their analysis and deduction of the situation facing them in their work. They do not factor in the other side of the story. As such, the nurse fails to capture alternative views or claims or possibilities and makes his decision from the single-sided analysis of the situation. This is a dangerous predicament for the nurse, who may leave out important information that could lead to him making a totally different decision to effectively reflect the situation of the patient and the correct medical intervention needed. With these findings, the researcher concludes that the absolutist reasoning framework for a nursing practitioner is an impediment to effective nursing practice. Using such a reasoning strategy could mean that the nurse uses his stereotyped assumptions and framework in assessing, diagnosing, and implementation as well as evaluating the most appropriate kind of patient care as needed by the patient. This should not be the case as the nurse needs to factor in the context of the patient including factors such as familial and societal issues that affect the patient. As such, the nurse will deny the patient alternative medical care that may be more effective in meeting the patient’s medical needs than the ones that he will appropriate. The abolitionist approach will also act as a deterrent for the nurses in empowering them to be partakers of active search for information regarding the medical needs of the patients they tend to rely on the information they have at hand through their limited assessment and the information that the patient discloses about him. Clinicians, however, have to ensure that they develop critical thinking and be enabled to think beyond the presented evidence to identify underlying issues that will enable them make effective and highly viable decisions regarding their patients’ health care needs (Hogarth 1981). Evidence Supporting the Conclusions The researcher quotes the work of Lange and the rest is his argument that the abolitionist perspective denies the nurse the opportunity to develop alternative interventions to the medical needs of the patient, and this limits his practice and requirement as a nurse. In defending the need for critical thinking despite the poor results of the study, the researcher emphasizes the need for nurses to develop critical nursing skills as required by the UK Central Council of 1999, which re-emphasized the need of critical thinking for nurses. I agree with the researcher on the need for critical thinking for nurses, as it enables them develop a deeper insight and perceive what may not be obvious but critical to the treatment of the patient. The amount of evidence to support this need is, however, few although it is convincing for the course. Assumptions The assumption that the researcher makes in convincing the reader to see the essence of critical thinking for nurses is epistemological, regarding the process that the nurse will undertake in gathering additional information about the patient. It is an assumption that patients are ready and willing to that the nurse delves into their private lives to discover issues and information that the patient may not have given them. There are patients who may not wish for the nurse to discover some aspects of their lives such as social backgrounds, previous medical histories, and many more. References Hogarth R.M., 1981. Beyond Discrete Biases: Functional and Dysfunctional Aspects of Judgmental Heuristics. Psychological Bulletin, 90, 197-217. Maynard C.A., 1996. The Relationship of Critical Thinking Ability to Professional Nursing Competence. Journal of Nursing Education 35, 12-18. Miller M.A., 1992. Outcomes Evaluation: Measuring Critical Thinking. Journal of Advanced Nursing 17, 1401-1407. Paul R.W., 1991. Dialogical and Dialectical Thinking. In Developing Minds: A Resource Book for Teaching Thinking, 1. Sullivan E. (1987) Critical Thinking, Creativity, Clinical Performance, and Achievements in RN students. Nurse Educator 12, 12-16. Read More