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ABSTRACT
Increasingly, the characteristic that distinguishes a professional nurse is cognitive rather than psychomotor ability. Critical thinking is an essential component of nursing. Yet, no clear definition or conceptualization of critical thinking for nursing judgment has existed. Lack of consensus and overlapping definitions may well diminish the profession's ability to articulate this concept and facilitate its development. This article proposes the Critical Thinking Model for Nursing Judgment, which specifies five components: specific knowledge base, experience, competencies, attitudes, and standards. The model has three levels of critical thinking: basic, complex, and commitment. It provides a definition and conceptualization of critical thinking based on a review of the literature and input from nurses and nurse educators. The model provides a first step for development of further research and educational strategies to promote critical thinking as an essential part of autonomous, excellent nursing practice.
Introduction
Nurses need critical thinking in order to be safe, competent, skillful practitioners in their profession. The pace of knowledge development demands that nurses be critical thinkers. This article proposes the Critical Thinking Model for Nursing Judgment, which defines the concept of critical thinking as the first step toward analysis and utilization within nursing and nursing education.
Despite the interest in developing critical thinking among nurses and nursing students, few nursing studies have attempted to use a nursing critical thinking theoretical/ conceptual framework. Frameworks were applied from other disciplines to nursing education (Berger, 1984; Bowers & McCarthy, 1993; Gross, Takazawa, & Rose, 1987; Jones & Brown, 1991). Miller and Malcolm (1990) alone have adapted and developed a critical thinking framework in nursing curricula evaluation. Nursing lacks a critical thinking framework that is domain-specific and encompasses all areas of nursing. The Miller and Malcolm framework contains the general components of attitude, knowledge, skill, and levels of critical thinking. The Critical Thinking Model for Nursing Judgment builds upon the concepts of Miller and Malcolm, but expands to include components of nursing experience, competencies, and standards.
The National League for Nursing (NLN) recognizes the inclusion of critical thinking as a specific criterion for the accreditation of baccalaureate programs. The criterion states: "The curriculum emphasizes the development of critical thinking and of progressively independent decisionmaking*1 (NLN, 1989). Therefore, faculty need an understandable, workable, yet comprehensive definition of...