Identifying Critical Thinking Indicators and Critical Thinker Attributes in Nursing Practice

護理實務中的批判思考指標與批判思考者特質

10.1097/JNR.0b013e3182a0aee9

趙淑員(Shu-Yuan Chao)；劉杏元(Hsing-Yuan Liu)；巫銘昌(Ming-Chang Wu)；Mary Jo Clark；譚蓉瑩(Jung-Ying Tan)

指引 ； 特質 ； 批判思考 ； 護理教育 ； 德爾菲研究法 ； indicator ； attribute ； critical thinking ； nursing education ； Delphi research

The Journal of Nursing Research

21卷3期（2013 / 09 / 01）

204 - 211

英文

背景：批判思考是運用護理過程主要的能力之一。文獻上有關批判思考能力的評值雖已多有討論，但是，有關護理過程所需具備之批判思考能力的指標及工具仍舊相當有限。目的：本研究從護理的角度，探討批判思考的可能指標，以及批判思考者的特質。這些指標將有助臨床教學中，評量護生批判思考能力工具之發展。方法：本研究進行時間從2009年9月至2010年8月。分為兩階段進行，第一階段，先進行文獻探討及進行4次焦點團體，以初步發展在護理架構下批判思考的指標，以及批判思考者之特徵。第二階段，邀請30位護理專家參與修正式德爾菲研究法，以取得在第一階段所發展之指標與特質之適用性的共識。結果：共發展出37項批判思考指標與10項批判思考者特質。這些指標於護理過程之架構下，包括五大項：（1）評估－16項，係應用專業知識，分析與解釋個案的情形；（2）診斷－5項，對問題推論並提出假設；（3）計畫－5項，提出解決問題的策略及說明其理由；（4）執行－5項，有關計畫的執行；以及（5）評值－6項，為自我評值與反思。結論／實務應用：本研究將批判思考轉化為可操作的實用指標，以適用於護理情境中解決臨床問題之需。此外，所發展的指標與特質，可幫助臨床指導者評量學生批判思考的能力，並作為教師臨床指導教學策略之發展。

Background: Critical thinking is an essential skill in the nursing process. Although several studies have evaluated the critical thinking skills of nurses, there is limited information related to the indicators of critical thinking or evaluation of critical thinking in the context of the nursing process.Purpose: This study investigated the potential indicators of critical thinking and the attributes of critical thinkers in clinical nursing practice. Knowledge of these indicators can aid the development of tools to assess nursing students’ critical thinking skills.Methods: The study was conducted between September 2009 and August 2010. In phase 1, a literature review and four focus groups were conducted to identify the indicators of critical thinking in the context of nursing and the attributes of critical thinkers. In phase 2, 30 nursing professionals participated in a modified Delphi research survey to establish consensus and the appropriateness of each indicator and attribute identified in phase 1.Results: We identified 37 indicators of critical thinking and 10 attributes of critical thinkers. The indicators were categorized into five subscales within the context of the nursing process to reflect nursing clinical practice: assessment, 16 indicators of ability to apply professional knowledge and skills to analyze and interpret patient problems; diagnosis, five indicators of ability to propose preliminary suppositions; planning, five indicators of ability to develop problem-solving strategies; implementation, five indicators of ability to implement planning; and evaluation, six indicators of ability to self-assess and reflect.Conclusion/Implications for Practice: The study operationalized critical thinking into a practical indicator suitable for nursing contexts in which critical thinking is required for clinical problem solving. Identified indicators and attributes can assist clinical instructors to evaluate student critical thought skills and development-related teaching strategies.

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