Journal of Nursing Education

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Congruency in Defining Critical Thinking by Nurse Educators and Non-nurse Scholars

Joanne M Gordon, PhD, RN, CS

Abstract

ABSTRACT

This study investigated nurse educators' definition of the concept critical thinking. A sample of 201 baccalaureate nurse educators in midwest nursing programs completed a questionnaire identifying their perception of critical-thinking skills and characteristics, and their agreement with non-nurse critical-thinking experts on items often considered to be critical thinking. This study found that nurse educators agreed with non-nurse critical-thinking experts on the skills and dispositions; however, significant differences were found between nurse educators and non-nurse experts regarding concepts related to critical thinking. Nurse educators were more likely to identify researching, problem-solving, decision-making, and planning as critical thinking. Despite their assertion otherwise, it is apparent from this study that nurse educators have a different perception of critical thinking than scholars in other disciplines. This study suggests that practice disciplines such as nursing may perceive critical thinking differently than educators in nonpractice disciplines.

Abstract

ABSTRACT

This study investigated nurse educators' definition of the concept critical thinking. A sample of 201 baccalaureate nurse educators in midwest nursing programs completed a questionnaire identifying their perception of critical-thinking skills and characteristics, and their agreement with non-nurse critical-thinking experts on items often considered to be critical thinking. This study found that nurse educators agreed with non-nurse critical-thinking experts on the skills and dispositions; however, significant differences were found between nurse educators and non-nurse experts regarding concepts related to critical thinking. Nurse educators were more likely to identify researching, problem-solving, decision-making, and planning as critical thinking. Despite their assertion otherwise, it is apparent from this study that nurse educators have a different perception of critical thinking than scholars in other disciplines. This study suggests that practice disciplines such as nursing may perceive critical thinking differently than educators in nonpractice disciplines.

Over the past several decades, educators have been interested in designing learning experiences to enhance students' critical-thinking skills. Collegelevel critical-thinking courses have been developed and critical thinking has been incorporated in general education curricula to enhance students' ability to think critically (Facione, 1990b). Seminars and conferences have been offered throughout the nation to facilitate faculty's ability to incorporate critical thinking into their teaching. A number of articles and also books have been written on ways to enhance critical thinking, including several books specific to critical thinking in nursing (Alfaro-LeFevre, 1995; Miller & Babcock, 1996).

Morin (1997) is among a number of nurse educators who have raised questions about the definitions used by nurses to describe critical thinking and the instruments used to measure the concept. Lack of consensus on a definition and measurement of critical thinking is evidenced by Videbeck's study (1997) that found that 55 nursing programs used 10 different definitions of critical thinking and assessed critical thinking using a variety of measurement tools, including standardized tests and locally developed instruments.

Despite interest in developing and assessing students' critical-thinking skills, a universally agreed upon definition of critical thinking does not exist. Although a number of definitions have been proposed (Facione, 1990a, 1990b; Kennedy, Fisher, & Ennis, 1991; Paul, 1984; Watson & Glaser, 1964), and a variety of tests have been developed to measure critical-thinking ability (e.g., California Critical Thinking Skills Test, Cornell Critical Thinking Test, and the Watson-Glaser Critical Thinking Appraisal Test), questions have been raised whether tests of critical thinking can be used to measure the concept when a concise definition of critical thinking is elusive. Some educators have stressed the need to develop a clear, accurate conceptualization of critical thinking as a basis for constructing valid assessment tools. According to Kennedy, Fisher, and Ennis (1991), "Agreement on a definition of and a vocabulary for critical thinking is needed in order to get a better idea of what should be assessed by a critical thinking evaluation instrument" (p. 29). Tanner (1996) acknowledged that the critical-thinking measures in nursing have "suffered from lack of clear conceptualization" (p. 3). Hiraki (1989) suggested that a common language would facilitate more effective communication among professionals in order to describe, explain, and interpret concepts such as critical thinking.

The National League for Nursing (NLN) included evaluation of students' critical thinking in its accreditation criteria for baccalaureate and higher degree programs (NLN, 1991). The NLN encouraged faculty to agree on a definition of critical thinking and determine how critical thinking will be evaluated in each educational program. According to Brigham (1993), since experts in critical tiiinking have not agreed on a definition of the concept, "the specific definition of critical thinking adopted by nurse educators may be insignificant" (p. 50). She suggested that nursing faculty study the definitions found in the literature and then develop a definition that can be integrated and implemented in the curriculum. However, Hickman (1993) cautioned that development of one's own definition of critical thinking could be self-serving, allowing a program to justify curricular outcomes by "tinkering with definitions" (p. 38).

Because of the apparent misconceptions about critical thinking, this study was designed as a part of a larger study that explored nurse educators' perception of critical thinking (Gordon, 1995). The diversity of definitions and skills of critical thinking, as well as the lack of consensus on characteristics of critical thinkers, prompted the author to investigate whether nurse educators and nonnurse critical thinking experts held common perceptions of the concept critical thinking. Although non-nurse experts had developed a consensus statement defining critical thinking and identifying skills and dispositions (Facione, 1990a), the perception of critical thinking by nurses had not clearly been delineated.

This research was designed to identify nurse educators' perception of the definition, skills, and characteristics of critical thinking. This study explored three specific questions: 1) How do nurse educators' perceptions of critical thinking compare with that of experts in critical thinking in other disciplines? 2) Is there agreement in the perception of critical thinking among nurse educators teaching in baccalaureate nursing programs? 3) Are nurse educators' perceptions of critical thinking congruent with the conceptualization of critical thinking in the nursing literature?

REVIEW OF THE LITERATURE

The lack of consensus on a definition of critical thinking is evident in the literature. Kennedy, Fisher, and Ennis (1991) asserted, "just what is meant by critical thinking is not a matter of total agreement" (p. 13). Brookfield (1987) suggested that critical analysis, critical awareness, critical consciousness, and critical reflection are often used synonymously with critical thinking despite differences in the understanding of these concepts. According to Cuban (1984), the terms critical thinking, higher cognitive skills, metacognition, problem-solving, creative thinking, and reasoning are too often used interchangeably by educators in the classroom. He suggested, "Defining thinking skills, reasoning, critical thought, and problem-solving is troublesome to both social scientists and practitioners. Troublesome is a polite word; the area is a conceptual swamp" (p. 676).

Ennis' broad definition of critical thinking has been widely used (Kennedy, Fisher, & Ennis, 1991). Ennis defined critical thinking as a process involving "reasonable and reflective thinking that is focused upon deciding what to believe or do" (p. 46). According to McPeck (1981), critical thinking is the "propensity and skill to engage in an activity with reflective skepticism" (p. 8). McPeck viewed critical thinking as a particular type of thinking finked to specific areas of expertise and knowledge. Brookfield (1987) defined critical thinking as "reflecting on the assumptions underlying our and others' ideas and action, and contemplating alternative ways of thinking and living."

Reflection is a component of several definitions of critical thinking. Reflection was first described by Dewey in 1910 as an aspect of reflective thinking. Dewey suggested that thinking was grounded in reflective thought, and described reflective thinking as "the kind of thinking that consists in turning a subject over in the mind and giving it serious consecutive consideration" (Dewey, 1933, p. 3). Dewey believed that reflective thinking was a recursive process stimulated by a perplexing situation that prompted the individual to guess on how to solve the problem.

Mezirow (1991) described reflection as a higher order mental process involving making inferences, generalizations, analogies, discriminations, and evaluation. According to Mezirow, "reflection on premises allows a critical review of distorted presuppositions that may be epistemic, sociocultural, or psychic" (p. 18). Mezirow perceived transformative learning as an outcome of reflection on one's own premises.

The theme of judgment permeates some definitions of critical thinking. A panel of critical thinking experts defined critical thinking as "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" (Facione, 1990a, p. 3).

The nursing literature does not demonstrate a clear consensus on a definition of critical thinking. A study by Jones and Brown (1991) demonstrated unclear perceptions of critical thinking among deans and directors in baccalaureate nursing programs who perceived critical thinking as a rational-linear problem-solving process and a variant of the scientific method. Although the National League for Nursing did not define critical thinking, the critical thinking evaluative criterion described reasoning, analysis, research, and decisionmaking as skills resulting from thinking critically (NLN, 1991).

Two broad definitions of critical thinking in nursing have been proposed by Alfaro-LeFevre (1995) and Miller and Babcock (1996). Alfaro-LeFevre defined critical thinking as purposeful, goal-directed thinking based on scientific principles and the scientific method that was directed toward making judgments based on facts (1995). Miller and Babcock described critical thinking as "purposeful thinking that takes into consideration focus, language, frame of reference, attitudes, assumptions, evidence, reasoning, conclusions, implications, and context when they matter in deciding what to believe or do" (1996, p. 8). Videbeck (1997) found that in an analysis of 55 nursing programs' response to the NLN criterion on critical thinking, more than 60% of the definitions used by the programs were derived from four major authors, including 22% from Bandman and Bandman (1995), 20% from Miller and Malcolm (1990), and 16% each from nonnurses Watson and Glaser (1964), and Paul (1993). Considering that Miller and Malcolm's definition was derived from the definition described by Watson and Glaser, it is apparent that the majority of programs in Videbeck's study derived the definitions of critical thinking from sources outside the discipline of nursing.

There is also a lack of agreement regarding the purpose of critical thinking. Halpern (1984) described the purpose of critical thinking as a strategy to solve problems. According to Yinger (1980), four types of thinking exist: problem-solving, decision-making, creativity, and invention. He described critical thinking as a process used to test and evaluate the products of creative thinking. Paul (1984) suggested that critical thinking allows the individual to work toward a conclusion rather than accepting someone else's conclusions. Kurfiss (1988) perceived critical thinking to be a form of inquiry, with the goal of constructing a "plausible representation of the situation or issue that could be presented in a convincing argument" (p. 28). Brookfield (1987) described the purpose of critical thinking as a way to understand personal relationships, perceiving new ways of organizing the workplace, and to become "politically literate" (p. 14).

For almost a quarter of a century the relationship between critical thinking and problem-solving has been debated. Siegel (1980) and Ennis (1962) suggested that critical thinking and problem-solving were the same. Loving (1993) described critical thinking as encompassing "problem-solving, decision-making, clinical judgment, and creativity .... Decision-making and clinical judgment have often been used interchangeably in the literature to describe the process whereby decisions regarding intervention are formulated" (p. 415). However, Ken worthy (1969) viewed critical thinking as a broader term than problem-solving, and that "problemsolving relates more to the situation in which critical thinking took place" (p. 92). Gezi and Hadley (1970) suggested that critical thinking and problem-solving were two distinct concepts. According to Bevis (1993), "nurses too often confuse problem-solving or nursing process and critical thinking. Problem-solving or nursing process is a framework for solving problems; it may or may not have critical thinking as an element" (p. 104).

Nurses have frequently correlated critical thinking with the scientific method (Hahnemann, 1986; Malek, 1986; Sullivan, 1987) and the scientific method with the nursing process and problem-solving (Alfaro-LeFevre, 1995; Brigham, 1989). According to Brigham, "the nursing process is equated with problem-solving. Problemsolving is equated with critical thinking. Critical thinking is the ability to collect facts, interpret those facts, develop a problem statement, identify interventions to solve the problem, and evaluate the quality of the outcome" (p. 6). Tanner (1988) posited that the nursing process may not be a linear problem-solving process and that it "does not capture the dynamic interactive thinking process of diagnosis or planning. The process clearly is not as linear as we might think" (p. 428).

Assumptions have been made that clinical judgment is critical thinking, and that clinical judgment involves problem-solving, decision-making, and the cognitive components of the nursing process (Tanner, 1993). Miller and Malcolm (1990) posited that the relationship between critical thinking and clinical judgment is unclear. Tanner (1983) suggested critical thinking and clinical judgment were related but not synonymous. She viewed clinical judgment as a broad concept that encompassed clinical decision-making, the nursing process, and diagnostic reasoning.

Lack of clarity or consensus on a definition of critical thinking also is reflected in the differences in criticalthinking skills identified by Facione (1990a), and Kennedy, Fisher, and Ennis (1991) (Table 1). Although some similarities exist in the two lists of skills, Facione included self-regulation (e.g., metacognition) as one of six key critical thinking skills.

The characteristics or dispositions of critical thinkers are perceived differently by various critical-thinking experts. According to Watson and Glaser (1964), a critical thinker needs an attitude of inquiry and a frame of mind that recognizes problems. Nickerson, Perkins, and Smith (1987) suggested that the critical thinker is able to transfer learning to new situations. They suggested that a critical thinker recognizes the complexity of the world and realizes there is more than one answer to a problem. Kennedy, Fisher, and Ennis (1991) described a number of characteristics of critical thinkers, including seeking reasons, being well informed, taking into account the total situation, looking for alternatives, being open-minded, taking a position, seeking precision, and dealing in an orderly manner with complex parts. Facione (1990a) identified a variety of critical-thinking affective dispositions, including inquisiti veness, confidence in one's reasoning ability, being open-minded to diverse views, flexible in considering views and opinions of others, willing to revise one's opinions, and being cognizant of one's own biases.

Prompted by questions regarding the skills and dispositions of critical thinking, how critical thinking should be taught, and how critical thinking should be assessed, the American Philosophical Association convened a committee in 1987 to study critical thinking (Facione, 1990b). The project director Peter Facione used a Delphi method to gain consensus regarding the skills of critical thinking and the dispositions of critical thinkers. A panel of 46 individuals recognized as experts in critical thinking participated on the panel, including Robert Ennis, Matthew Lipman, Stephen Norris, Richard Parker, Richard Paul, and Peter Winograd (Facione, 1990b, p. 21-22). The discipline-focus of the college and universitybased participants included 52% from philosophy, 22% from education, 20% from the social sciences, and 6% from the physical sciences. The Facione Delphi study resulted in the formation of a consensus statement on critical thinking, the identification of six core cognitive critical- thinking skills and a set of subskills, a list of affective dispositions of critical thinking, and suggestions for teaching and measuring critical-thinking skills. The outcomes of the study led to the development of the California Critical Thinking Skills Test (CCTST) and California Critical Thinking Disposition Inventory (CCTDI).

In her study of baccalaureate schools of nursing, Videbeck (1997) found that 11 different standardized tests were used to assess critical-thinking abilities, including the CCTST and CCTDI. The Watson-Glaser Critical Thinking Appraisal was the standardized test used most often. Locally developed instruments were also used to assess critical-thinking skills, including endof-course self-assessments and graduate/alumni postgraduation surveys. College-based outcome measures were administered to all graduating students in some academic institutions.

METHODOLOGY

A descriptive design was used in this exploratory study. The instrument used was a researcher-developed questionnaire based on a survey described by Jones and Brown (1991) and the description of critical-thinking skills, dispositions, and concepts identified in the Facione Delphi study (1990a). The Critical Thinking Survey (Gordon, 1995) included 12 demographic questions, and four subsections. The first subsection included 23 criticalthinking skills identified by Facione (Tables 2 and 3). The second subsection, dispositions, included the 19 characteristics described by the Facione panelists (Table 4). Distracters described in the nursing literature were added to both of these subsections. Respondents were asked to rate on a Likert-type scale the degree to which they agreed that the items in these two subsections were critical-thinking skills or dispositions. For the third subsection on concepts (Table 5), 13 items from Facione's study were used as core items. In this section, respondents were asked to indicate whether they felt the items were the same as critical thinking, partly critical thinking, or not critical thinking. In the fourth subsection, the respondents were asked to rate on a Likert-type scale the degree to which they agreed with statements about critical thinking found in the nursing literature (Table 6).

Tool refinement included two reviews by registered nurses and nurse educators for readability and statement clarification. Content validity for the instrument was established through critique by educators considered to be expert in critical thinking. Construct validity was enhanced by using items included in Facione's Delphi study (Facione, 1990a) and items described or defined by experts in the nursing literature. A test/retest method was used to assess the reliability of the instrument. A group of eight masters-prepared nurse educators completed the questionnaire twice in a two-week period. Pearson's correlation coefficient for the test/retest score on the entire instrument was 0.96, with a range of 0.45 to 0.76 for each of the subsections of the questionnaire. The Spearman/Brown correlation was 0.80 and the Kuder/Richardson correlation was 0.77. Results of the reliability measures need to be viewed cautiously since the questionnaire was not designed to measure one construct and homogeneity of the instrument can not be assured.

Table

TABLE 1Critical-Thinking Skills

TABLE 1

Critical-Thinking Skills

A cluster sampling technique was used to select the sample of baccalaureate nurse educators, the subjects for this study. A sample of 83 schools was randomly selected from a population of 166 baccalaureate nursing programs located in the midwest region as defined by the NLN (NLN, 1994b). The deans and directors of baccalaureate nursing programs were sent an envelope that contained five packets of questionnaires. The administrators were asked to distribute the packets to faculty teaching fulltime in the baccalaureate nursing program. Each packet included a letter describing the study, a questionnaire, self-addressed stamped return envelope, and a researcher-developed bookmark designed to encourage participation in the study. Four schools chose not to participate. Of the 395 potential responses, 201 questionnaires were returned for a 51% return rate. Two returned questionnaires were unusable.

Table

TABLE 2Nurse Educators' View of Analysis, Evaluation, and Inference as Critical-Thinking Skills

TABLE 2

Nurse Educators' View of Analysis, Evaluation, and Inference as Critical-Thinking Skills

RESULTS

The sample that participated in this study was representative of nurse educators in the midwest region as described by the NLN (1994a) (Table 7). There were no statistically significant differences (p >0.05) between the survey respondents and the rank and highest level of education of nursing faculty teaching in midwest baccalaureate and higher degree programs. The majority of faculty (62%) had a masters degree as the highest level of academic preparation. The faculty had a wide range of teaching experience with slightly less than 14% having less than 5 years teaching experience, and almost 13% percent having 25 or more years of teaching experience. In addition, 81% of the faculty were involved in both lecture and clinical courses, and 95% thought they provided students with an opportunity to develop their criticalthinking skills. Their own perception of critical thinking was developed by 80% of the faculty through discussions with other nursing faculty, while 81% reported reading about critical thinking in professional nursing journals, and 73% attended conferences on critical thinking. Only 36% indicated reading non-nursing journals added to their understanding of critical thinking.

Table

TABLE 3Nurse Educators' View of Interpretation, Explanation, and Self-regulation as Critical-Thinking Skills

TABLE 3

Nurse Educators' View of Interpretation, Explanation, and Self-regulation as Critical-Thinking Skills

Question 1: How do nurse educators' perception of critical thinking compare with that of experts in critical thinking in other disciplines? Six skills and a set of subskills were identified by Facione (1990a) as critical-thinking skills (Table 1). Of the Facione Delphi panelists, 95% agreed that analysis, evaluation, and inference were skills and abilities central to critical thinking, and 87% agreed that interpretation, explanation, and self-regulation were central to critical thinking. Of the nurse educators, 91% perceived skills associated with analysis, evaluation, and inference as critical-thinking skills (Table 2), while 81% indicated interpretation, explanation, and selfregulation were skills used in thinking critically (Table 3). On a Chi-square Goodness of Fit analysis, the nurse educators were less likely (p <0.05) than the non-nurse experts in considering skills associated with interpretation, explanation, and self-regulation as critical-thinking skills.

On a Chi-square Goodness of Fit analysis, there was no statistically significant difference (p >0.05) between the Facione experts and the nurse educators in this study regarding 19 dispositions or characteristics of critical thinkers (Table 4). The nurse educators identified all of the dispositions as characteristics of critical thinkers, including those characteristics that were added to the list as abstracters and were not typically associated with dispositions of a critical thinker (e.g., demonstrates leadership, being trustworthy, and sensitive to the feelings of others).

Chi-square Goodness of Fit analyses were performed on items in the concepts of critical-thinking subsection of the survey using data from Facione's study as the expected values (Facione, 1990a). A comparison of responses by nurse educators and the Facione Delphi experts was statistically significant at an alpha level of 0.01 for all 13 items (Table 5).

Table

TABLE 4Nurse Educators' View of Critical-Thinking Dispositions Identified by Non-nurse Experts

TABLE 4

Nurse Educators' View of Critical-Thinking Dispositions Identified by Non-nurse Experts

Question 2: Is there agreement in the perception of critical thinking among nurse educators teaching in baccalaureate nursing programs? The respondents were asked to indicate their agreement with 24 statements regarding critical thinking, problem-solving, decisionmaking, and the nursing process (Table 6). Analysis of variance, or ¿-test where appropriate, was used to determine whether there was a difference in the means in responses to the variables based on rank, educational preparation, type of courses taught, or years of teaching experience. There was no significant difference (p >0.05) by years of teaching experience or type of educational preparation. Assistant professors and instructors were more likely than associate and full professors to believe that a standard model or definition of critical thinking is needed in nursing (p <0.01). Those faculty teaching both lecture and clinical courses were more likely than faculty only teaching lecture courses to feel that the nursing process and critical thinking were synonymous (p <0.01), that problem-solving and critical thinking were synonymous (p <0.02) and that a standard model or definition in critical thinking is needed in nursing (p <0.02). Faculty teaching only lecture courses were more likely than those teaching both lecture and clinical courses to indicate that a critical thinker in nursing may not be a critical thinker in other areas or activities (p <0.05).

Question 3: Are nurse educators' perceptions of critical thinking congruent with the conceptualization of critical thinking in the nursing literature? The nurse educators perceived critical thinking as an abstract, generalizable, learnable, rational process, synonymous with decisionmaking. Critical thinking was also characterized as a step-by-step process that was the same as problem-solving, clinical decision-making, diagnostic reasoning, and the nursing process. This perception is similar to the description of critical thinking in the review of nursing literature.

DISCUSSION

The results of this study showed that nurse educators who teach in baccalaureate nursing programs in the midwest agreed with non-nursing critical thinking experts on the characteristics of critical thinkers. Distracters reflecting skills commonly associated with the nursing process, decision-making, and clinical reasoning were also identified as critical-thinking skills by nurse educators. Nurse educators agreed that critical-thinking skills included analysis, explanation, evaluation, inference, and self-regulation. However, the nurse educators were less likely than the expert panel to agree that interpretation was a critical-thinking skill, even though interpretation is a crucial component of the nursing process, diagnostic reasoning and clinical judgment (skills faculty accepted as critical-thinking skills). According to Facione (1990a, 1990b), interpretation involves categorizing information, decoding significance, and clarifying meaning. It would seem that interpretation of cues, facts, and information related to patient populations are important skills for nurses making judgments appropriate to nursing care.

Table

TABLE 5Chi-square Goodness of Fit Comparison of Nurse Educators and Delphi Experts on Concepts of Critical Thinking

TABLE 5

Chi-square Goodness of Fit Comparison of Nurse Educators and Delphi Experts on Concepts of Critical Thinking

The nurse educators who participated in this study tended to view all of the items in the disposition subsection as characteristics of critical thinkers. The distracters, including leadership, trustworthy, and being sensitive to others were also identified as critical-thinking dispositions. Yura and Walsh (1978) identified leadership and being trustworthy as characteristics of individuals using the nursing process. The respondents in this study also viewed these as characteristics of critical thinkers. Ennis (1985) included being sensitive to the feelings of others as one of his dispositions of critical thinkers. He acknowledged, however, that acting in a sensitive manner was not essential for a critical thinker but was a desirable social disposition.

When asked whether nurse educators thought that critical thinking was conceptually different in nursing than in other disciplines, the nurse educators indicated that there was no difference in how critical thinking was defined. However, this study showed that nurse educators do not view critical thinking the same way as the Facione experts. When Chi-square Goodness of Fit analyses were carried out on the 13 concepts Facione's group identified (Table 5), there were significant differences ip <0.01) between the nurse educators and Facione experts on all 13 items. Nurse educators were more likely to view empathizing and sensing as skills that are part of critical thinking than were the non-nurse experts, perhaps because these skills are important in assessing patients and developing plans of action to meet patient needs (Carpenito, 1987; Gordon, 1982; Yura & Walsh, 1978). More nurse educators than non-nurse expert panelists indicated that speaking, writing, reading, interrogating, and communication skills were partly critical-thinking skills. Valiga and Bruderle (1994) found that communication was a critical concept in many nursing curricula; thus, nurse educators may view communication skills as ways to demonstrate reflective judgment and critical thinking.

The greatest disparity between the nurse educators and the Facione panel was in the perception of critical thinking as planning, decision-making, problem-solving, and researching (Figure 1). All of the nurse educators considered planning as the same as or partly critical thinking, while approximately 43% of Facione's panel indicated planning was not a critical-thinking skill. Since nurse educators in this study perceived critical thinking to be the same as the nursing process, planning might be viewed as an important step that incorporates thinking involving comparison of alternatives for action.

Decision-making and problem-solving were viewed by the nurse educators as the same or partly the same as critical thinking. This view is congruent with the nurse educators' broad conceptualization of critical thinking as a thinking process used to solve problems and reflects the lack of discrimination among these concepts found in the nursing literature. Non-nurse critical thinking experts were less likely to view decision-making and problemsolving as critical thinking.

While only 5% of the nurse educators in this study believed researching in a discipline was not critical thinking, approximately 52% of the Facione panelists rejected researching as critical thinking. Nurse educators may be more likely than the Facione panelists to perceive the actions taken in critiquing the literature, synthesizing the review of the literature, analyzing the results, and synthesizing the findings in a discussion as activities requiring critical thinking (Dvorak, Brophy, Binder, & Carlson, 1993). Dvorak and her colleagues suggested that research fostered abstract thinking, making judgments about information, and drawing conclusions based on the information presented. These activities are similar to the critical-thinking skills described by Facione; however, the non-nurse experts did not perceive researching as the same as critical thinking. In the 1991 criteria for accreditation for baccalaureate and higher degree programs, the NLN indicated that research in nursing was an example of critical thinking. From this perspective, the nurse educators in this study appeared to concur with the League's description and may include researching as an inclusive process in their broad definition of critical thinking.

Table

TABLE 6Nurse Educators' Agreement with Statements about Critical Thinking from the Nursing Literature

TABLE 6

Nurse Educators' Agreement with Statements about Critical Thinking from the Nursing Literature

In the final section of the survey, faculty were asked to indicate the degree to which they agreed with 14 statements designed to elicit information about their perception of critical thinking. The nurse educators were consistent in identifying critical thinking as decision-making, problem-solving, and diagnostic reasoning. However, faculty were mixed in their view whether a critical thinker in nursing would be a critical thinker in other areas. There was disagreement with the statement in 42% of the faculty while 45% agreed and 13% were unsure. This disparity may reflect differing views regarding the generalizability or domain-specificity of critical thinking. This is congruent with the literature where there are proponents of generalizability (de Bono, 1983; Lipman, 1982) and supporters of domain specificity (Ennis, 1989; McPeck, 1981).

Table

TABLE 7Faculty Demographics

TABLE 7

Faculty Demographics

Despite the fact that many believed critical thinking was a generalizable skill, 70% of the nurse educators rejected the idea that critical thinking is best acquired in liberal arts non-nursing courses. This would suggest that nurse educators feel that students' critical thinking would be best developed in nursing courses. This might also suggest that nurse educators may have a combined generalizable/domain specificity view of critical thinking, a belief shared by Facione (1990a, 1990b) and Perkins and Salomon (1989).

Although 62% of the faculty supported critical thinking as an abstract concept, 46% viewed critical thinking as a step-by-step process. This linear perception of critical thinking correlates with the nursing literature where the nursing process and research process have been described as step-by-step processes.

It is apparent that nurse educators in this study and a panel of non-nurse experts in critical thinking do have different perceptions of critical thinking, although 62% of the faculty rejected the idea that critical thinking is conceptually different in nursing than in other disciplines. The majority of nursing faculty reported they obtained their perception of critical thinking through informal discussions with other nurse faculty and by reading articles in nursing journals. Only 35% indicated that they developed their perception of critical thinking by reading nonnursing journals. Reading literature outside of the discipline of nursing may provide nurse educators with greater understanding how critical thinking is defined by non-nurses.

Figure 1 : Comparison of nurse educators and non-nursing experts for four variables. CT = Critical thinking.

Figure 1 : Comparison of nurse educators and non-nursing experts for four variables. CT = Critical thinking.

IMPLICATIONS

This study adds to the limited body of knowledge exploring nurse educators' perception of the concept of critical thinking. The study confirmed that nurse educators perceived critical thinking as a process congruent with the nursing process, decision-making, diagnostic reasoning, and the research process. Despite the view that they feel otherwise, nurse educators in midwest baccalaureate nursing programs do have a different conceptualization of critical thinking than an expert panel of critical-thinking scholars from other disciplines.

Powers and Enright (1987) found that the importance attached to different kinds of reasoning differed markedly in various disciplines. Perhaps the nurse educators in this study viewed diagnostic reasoning, the nursing process, and the research process as important reasoning activities and have incorporated these processes in their broad definition of critical thinking. This study suggests that practice disciplines such as nursing may perceive critical thinking differently than educators in non-practice disciplines; however, further research is needed to validate this finding.

This study points out the importance of developing meaningful definitions for concepts. What is meant by critical thinking? What is diagnostic reasoning? What is clinical problem-solving? The NLN suggested that schools of nursing develop their own definition of critical thinking, and, based on that definition, evaluate students' critical thinking skills. What framework should be used by faculty to develop their definitions? What "expert" is the source of that definition? Is the definition based on theory or research?

If nurse scholars are not defining critical thinking in a similar way, what meaningful comparisons can be made regarding the body of knowledge being generated by research in nursing critical thinking? What tools are being used to measure critical thinking? Should these tools be domain-specific or generalized tests? If critical thinking is grounded in a firm foundation of domain-specific knowledge as suggested by McPeck (1981), then it would seem important for nurses to develop tests of critical thinking specific to the discipline. What type of test should be used to measure students' critical thinking? If critical thinking involves reflection and judgment, how are these abilities best measured?

Nurse educators must begin to look at the definitions of the concepts they are trying to evaluate. The profession needs to further explore the origins of the definitions of concepts used in nursing and to support those definitions with a theoretical or research foundation. To carry out meaningful dialog between nurse educators and other scholars, it is important to have a similar understanding of concepts such as critical thinking. If critical thinking is conceptually different in nursing than critical thinking in other disciplines, as demonstrated in this study, what is it that nurse educators are talking about when they are discussing critical thinking? Meaningful dialog can be enhanced when there is a common definition of terms and understanding of concepts discussed.

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TABLE 1

Critical-Thinking Skills

TABLE 2

Nurse Educators' View of Analysis, Evaluation, and Inference as Critical-Thinking Skills

TABLE 3

Nurse Educators' View of Interpretation, Explanation, and Self-regulation as Critical-Thinking Skills

TABLE 4

Nurse Educators' View of Critical-Thinking Dispositions Identified by Non-nurse Experts

TABLE 5

Chi-square Goodness of Fit Comparison of Nurse Educators and Delphi Experts on Concepts of Critical Thinking

TABLE 6

Nurse Educators' Agreement with Statements about Critical Thinking from the Nursing Literature

TABLE 7

Faculty Demographics

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