critical thinking in healthcare management

The Value of Critical Thinking in Nursing

• How Nurses Use Critical Thinking
• How to Improve Critical Thinking
• Common Mistakes

Some experts describe a person’s ability to question belief systems, test previously held assumptions, and recognize ambiguity as evidence of critical thinking. Others identify specific skills that demonstrate critical thinking, such as the ability to identify problems and biases, infer and draw conclusions, and determine the relevance of information to a situation.

Nicholas McGowan, BSN, RN, CCRN, has been a critical care nurse for 10 years in neurological trauma nursing and cardiovascular and surgical intensive care. He defines critical thinking as “necessary for problem-solving and decision-making by healthcare providers. It is a process where people use a logical process to gather information and take purposeful action based on their evaluation.”

“This cognitive process is vital for excellent patient outcomes because it requires that nurses make clinical decisions utilizing a variety of different lenses, such as fairness, ethics, and evidence-based practice,” he says.

How Do Nurses Use Critical Thinking?

Successful nurses think beyond their assigned tasks to deliver excellent care for their patients. For example, a nurse might be tasked with changing a wound dressing, delivering medications, and monitoring vital signs during a shift. However, it requires critical thinking skills to understand how a difference in the wound may affect blood pressure and temperature and when those changes may require immediate medical intervention.

Nurses care for many patients during their shifts. Strong critical thinking skills are crucial when juggling various tasks so patient safety and care are not compromised.

Jenna Liphart Rhoads, Ph.D., RN, is a nurse educator with a clinical background in surgical-trauma adult critical care, where critical thinking and action were essential to the safety of her patients. She talks about examples of critical thinking in a healthcare environment, saying:

“Nurses must also critically think to determine which patient to see first, which medications to pass first, and the order in which to organize their day caring for patients. Patient conditions and environments are continually in flux, therefore nurses must constantly be evaluating and re-evaluating information they gather (assess) to keep their patients safe.”

The COVID-19 pandemic created hospital care situations where critical thinking was essential. It was expected of the nurses on the general floor and in intensive care units. Crystal Slaughter is an advanced practice nurse in the intensive care unit (ICU) and a nurse educator. She observed critical thinking throughout the pandemic as she watched intensive care nurses test the boundaries of previously held beliefs and master providing excellent care while preserving resources.

“Nurses are at the patient’s bedside and are often the first ones to detect issues. Then, the nurse needs to gather the appropriate subjective and objective data from the patient in order to frame a concise problem statement or question for the physician or advanced practice provider,” she explains.

Top 5 Ways Nurses Can Improve Critical Thinking Skills

We asked our experts for the top five strategies nurses can use to purposefully improve their critical thinking skills.

Case-Based Approach

Slaughter is a fan of the case-based approach to learning critical thinking skills.

In much the same way a detective would approach a mystery, she mentors her students to ask questions about the situation that help determine the information they have and the information they need. “What is going on? What information am I missing? Can I get that information? What does that information mean for the patient? How quickly do I need to act?”

Consider forming a group and working with a mentor who can guide you through case studies. This provides you with a learner-centered environment in which you can analyze data to reach conclusions and develop communication, analytical, and collaborative skills with your colleagues.

Practice Self-Reflection

Rhoads is an advocate for self-reflection. “Nurses should reflect upon what went well or did not go well in their workday and identify areas of improvement or situations in which they should have reached out for help.” Self-reflection is a form of personal analysis to observe and evaluate situations and how you responded.

This gives you the opportunity to discover mistakes you may have made and to establish new behavior patterns that may help you make better decisions. You likely already do this. For example, after a disagreement or contentious meeting, you may go over the conversation in your head and think about ways you could have responded.

It’s important to go through the decisions you made during your day and determine if you should have gotten more information before acting or if you could have asked better questions.

During self-reflection, you may try thinking about the problem in reverse. This may not give you an immediate answer, but can help you see the situation with fresh eyes and a new perspective. How would the outcome of the day be different if you planned the dressing change in reverse with the assumption you would find a wound infection? How does this information change your plan for the next dressing change?

Develop a Questioning Mind

McGowan has learned that “critical thinking is a self-driven process. It isn’t something that can simply be taught. Rather, it is something that you practice and cultivate with experience. To develop critical thinking skills, you have to be curious and inquisitive.”

To gain critical thinking skills, you must undergo a purposeful process of learning strategies and using them consistently so they become a habit. One of those strategies is developing a questioning mind. Meaningful questions lead to useful answers and are at the core of critical thinking .

However, learning to ask insightful questions is a skill you must develop. Faced with staff and nursing shortages , declining patient conditions, and a rising number of tasks to be completed, it may be difficult to do more than finish the task in front of you. Yet, questions drive active learning and train your brain to see the world differently and take nothing for granted.

It is easier to practice questioning in a non-stressful, quiet environment until it becomes a habit. Then, in the moment when your patient’s care depends on your ability to ask the right questions, you can be ready to rise to the occasion.

Practice Self-Awareness in the Moment

Critical thinking in nursing requires self-awareness and being present in the moment. During a hectic shift, it is easy to lose focus as you struggle to finish every task needed for your patients. Passing medication, changing dressings, and hanging intravenous lines all while trying to assess your patient’s mental and emotional status can affect your focus and how you manage stress as a nurse .

Staying present helps you to be proactive in your thinking and anticipate what might happen, such as bringing extra lubricant for a catheterization or extra gloves for a dressing change.

By staying present, you are also better able to practice active listening. This raises your assessment skills and gives you more information as a basis for your interventions and decisions.

Use a Process

As you are developing critical thinking skills, it can be helpful to use a process. For example:

• Ask questions.
• Gather information.
• Implement a strategy.
• Evaluate the results.
• Consider another point of view.

These are the fundamental steps of the nursing process (assess, diagnose, plan, implement, evaluate). The last step will help you overcome one of the common problems of critical thinking in nursing — personal bias.

Common Critical Thinking Pitfalls in Nursing

Your brain uses a set of processes to make inferences about what’s happening around you. In some cases, your unreliable biases can lead you down the wrong path. McGowan places personal biases at the top of his list of common pitfalls to critical thinking in nursing.

“We all form biases based on our own experiences. However, nurses have to learn to separate their own biases from each patient encounter to avoid making false assumptions that may interfere with their care,” he says. Successful critical thinkers accept they have personal biases and learn to look out for them. Awareness of your biases is the first step to understanding if your personal bias is contributing to the wrong decision.

New nurses may be overwhelmed by the transition from academics to clinical practice, leading to a task-oriented mindset and a common new nurse mistake ; this conflicts with critical thinking skills.

“Consider a patient whose blood pressure is low but who also needs to take a blood pressure medication at a scheduled time. A task-oriented nurse may provide the medication without regard for the patient’s blood pressure because medication administration is a task that must be completed,” Slaughter says. “A nurse employing critical thinking skills would address the low blood pressure, review the patient’s blood pressure history and trends, and potentially call the physician to discuss whether medication should be withheld.”

Fear and pride may also stand in the way of developing critical thinking skills. Your belief system and worldview provide comfort and guidance, but this can impede your judgment when you are faced with an individual whose belief system or cultural practices are not the same as yours. Fear or pride may prevent you from pursuing a line of questioning that would benefit the patient. Nurses with strong critical thinking skills exhibit:

• Learn from their mistakes and the mistakes of other nurses
• Look forward to integrating changes that improve patient care
• Treat each patient interaction as a part of a whole
• Evaluate new events based on past knowledge and adjust decision-making as needed
• Solve problems with their colleagues
• Are self-confident
• Acknowledge biases and seek to ensure these do not impact patient care

An Essential Skill for All Nurses

Critical thinking in nursing protects patient health and contributes to professional development and career advancement. Administrative and clinical nursing leaders are required to have strong critical thinking skills to be successful in their positions.

By using the strategies in this guide during your daily life and in your nursing role, you can intentionally improve your critical thinking abilities and be rewarded with better patient outcomes and potential career advancement.

Frequently Asked Questions About Critical Thinking in Nursing

How are critical thinking skills utilized in nursing practice.

Nursing practice utilizes critical thinking skills to provide the best care for patients. Often, the patient’s cause of pain or health issue is not immediately clear. Nursing professionals need to use their knowledge to determine what might be causing distress, collect vital information, and make quick decisions on how best to handle the situation.

How does nursing school develop critical thinking skills?

Nursing school gives students the knowledge professional nurses use to make important healthcare decisions for their patients. Students learn about diseases, anatomy, and physiology, and how to improve the patient’s overall well-being. Learners also participate in supervised clinical experiences, where they practice using their critical thinking skills to make decisions in professional settings.

Do only nurse managers use critical thinking?

Nurse managers certainly use critical thinking skills in their daily duties. But when working in a health setting, anyone giving care to patients uses their critical thinking skills. Everyone — including licensed practical nurses, registered nurses, and advanced nurse practitioners —needs to flex their critical thinking skills to make potentially life-saving decisions.

Meet Our Contributors

Crystal Slaughter, DNP, APRN, ACNS-BC, CNE

Crystal Slaughter is a core faculty member in Walden University’s RN-to-BSN program. She has worked as an advanced practice registered nurse with an intensivist/pulmonary service to provide care to hospitalized ICU patients and in inpatient palliative care. Slaughter’s clinical interests lie in nursing education and evidence-based practice initiatives to promote improving patient care.

Jenna Liphart Rhoads, Ph.D., RN

Jenna Liphart Rhoads is a nurse educator and freelance author and editor. She earned a BSN from Saint Francis Medical Center College of Nursing and an MS in nursing education from Northern Illinois University. Rhoads earned a Ph.D. in education with a concentration in nursing education from Capella University where she researched the moderation effects of emotional intelligence on the relationship of stress and GPA in military veteran nursing students. Her clinical background includes surgical-trauma adult critical care, interventional radiology procedures, and conscious sedation in adult and pediatric populations.

Nicholas McGowan, BSN, RN, CCRN

Nicholas McGowan is a critical care nurse with 10 years of experience in cardiovascular, surgical intensive care, and neurological trauma nursing. McGowan also has a background in education, leadership, and public speaking. He is an online learner who builds on his foundation of critical care nursing, which he uses directly at the bedside where he still practices. In addition, McGowan hosts an online course at Critical Care Academy where he helps nurses achieve critical care (CCRN) certification.

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Cultivating Critical Thinking in Healthcare

Published: 06 January 2019

Critical thinking skills have been linked to improved patient outcomes, better quality patient care and improved safety outcomes in healthcare (Jacob et al. 2017).

Given this, it's necessary for educators in healthcare to stimulate and lead further dialogue about how these skills are taught , assessed and integrated into the design and development of staff and nurse education and training programs (Papp et al. 2014).

So, what exactly is critical thinking and how can healthcare educators cultivate it amongst their staff?

What is Critical Thinking?

In general terms, ‘ critical thinking ’ is often used, and perhaps confused, with problem-solving and clinical decision-making skills .

In practice, however, problem-solving tends to focus on the identification and resolution of a problem, whilst critical thinking goes beyond this to incorporate asking skilled questions and critiquing solutions .

Several formal definitions of critical thinking can be found in literature, but in the view of Kahlke and Eva (2018), most of these definitions have limitations. That said, Papp et al. (2014) offer a useful starting point, suggesting that critical thinking is:

‘The ability to apply higher order cognitive skills and the disposition to be deliberate about thinking that leads to action that is logical and appropriate.’

The Foundation for Critical Thinking (2017) expands on this and suggests that:

‘Critical thinking is that mode of thinking, about any subject, content, or problem, in which the thinker improves the quality of his or her thinking by skillfully analysing, assessing, and reconstructing it.’

They go on to suggest that critical thinking is:

• Self-directed
• Self-disciplined
• Self-monitored
• Self-corrective.

Key Qualities and Characteristics of a Critical Thinker

Given that critical thinking is a process that encompasses conceptualisation , application , analysis , synthesis , evaluation and reflection , what qualities should be expected from a critical thinker?

In answering this question, Fortepiani (2018) suggests that critical thinkers should be able to:

• Formulate clear and precise questions
• Gather, assess and interpret relevant information
• Reach relevant well-reasoned conclusions and solutions
• Think open-mindedly, recognising their own assumptions
• Communicate effectively with others on solutions to complex problems.

All of these qualities are important, however, good communication skills are generally considered to be the bedrock of critical thinking. Why? Because they help to create a dialogue that invites questions, reflections and an open-minded approach, as well as generating a positive learning environment needed to support all forms of communication.

Lippincott Solutions (2018) outlines a broad spectrum of characteristics attributed to strong critical thinkers. They include:

• Inquisitiveness with regard to a wide range of issues
• A concern to become and remain well-informed
• Alertness to opportunities to use critical thinking
• Self-confidence in one’s own abilities to reason
• Open mindedness regarding divergent world views
• Flexibility in considering alternatives and opinions
• Understanding the opinions of other people
• Fair-mindedness in appraising reasoning
• Honesty in facing one’s own biases, prejudices, stereotypes or egocentric tendencies
• A willingness to reconsider and revise views where honest reflection suggests that change is warranted.

Papp et al. (2014) also helpfully suggest that the following five milestones can be used as a guide to help develop competency in critical thinking:

Stage 1: Unreflective Thinker

At this stage, the unreflective thinker can’t examine their own actions and cognitive processes and is unaware of different approaches to thinking.

Stage 2: Beginning Critical Thinker

Here, the learner begins to think critically and starts to recognise cognitive differences in other people. However, external motivation  is needed to sustain reflection on the learners’ own thought processes.

Stage 3: Practicing Critical Thinker

By now, the learner is familiar with their own thinking processes and makes a conscious effort to practice critical thinking.

Stage 4: Advanced Critical Thinker

As an advanced critical thinker, the learner is able to identify different cognitive processes and consciously uses critical thinking skills.

Stage 5: Accomplished Critical Thinker

At this stage, the skilled critical thinker can take charge of their thinking and habitually monitors, revises and rethinks approaches for continual improvement of their cognitive strategies.

Facilitating Critical Thinking in Healthcare

A common challenge for many educators and facilitators in healthcare is encouraging students to move away from passive learning towards active learning situations that require critical thinking skills.

Just as there are similarities among the definitions of critical thinking across subject areas and levels, there are also several generally recognised hallmarks of teaching for critical thinking . These include:

• Promoting interaction among students as they learn
• Asking open ended questions that do not assume one right answer
• Allowing sufficient time to reflect on the questions asked or problems posed
• Teaching for transfer - helping learners to see how a newly acquired skill can apply to other situations and experiences.

(Lippincott Solutions 2018)

Snyder and Snyder (2008) also make the point that it’s helpful for educators and facilitators to be aware of any initial resistance that learners may have and try to guide them through the process. They should aim to create a learning environment where learners can feel comfortable thinking through an answer rather than simply having an answer given to them.

Examples include using peer coaching techniques , mentoring or preceptorship to engage students in active learning and critical thinking skills, or integrating project-based learning activities that require students to apply their knowledge in a realistic healthcare environment.

Carvalhoa et al. (2017) also advocate problem-based learning as a widely used and successful way of stimulating critical thinking skills in the learner. This view is echoed by Tsui-Mei (2015), who notes that critical thinking, systematic analysis and curiosity significantly improve after practice-based learning .

Integrating Critical Thinking Skills Into Curriculum Design

Most educators agree that critical thinking can’t easily be developed if the program curriculum is not designed to support it. This means that a deep understanding of the nature and value of critical thinking skills needs to be present from the outset of the curriculum design process , and not just bolted on as an afterthought.

In the view of Fortepiani (2018), critical thinking skills can be summarised by the statement that 'thinking is driven by questions', which means that teaching materials need to be designed in such a way as to encourage students to expand their learning by asking questions that generate further questions and stimulate the thinking process. Ideal questions are those that:

• Embrace complexity
• Challenge assumptions and points of view
• Question the source of information
• Explore variable interpretations and potential implications of information.

To put it another way, asking questions with limiting, thought-stopping answers inhibits the development of critical thinking. This means that educators must ideally be critical thinkers themselves .

Drawing these threads together, The Foundation for Critical Thinking (2017) offers us a simple reminder that even though it’s human nature to be ‘thinking’ most of the time, most thoughts, if not guided and structured, tend to be biased, distorted, partial, uninformed or even prejudiced.

They also note that the quality of work depends precisely on the quality of the practitioners’ thought processes. Given that practitioners are being asked to meet the challenge of ever more complex care, the importance of cultivating critical thinking skills, alongside advanced problem-solving skills , seems to be taking on new importance.

Additional Resources

• The Emotionally Intelligent Nurse | Ausmed Article
• Refining Competency-Based Assessment | Ausmed Article
• Socratic Questioning in Healthcare | Ausmed Article
• Carvalhoa, D P S R P et al. 2017, 'Strategies Used for the Promotion of Critical Thinking in Nursing Undergraduate Education: A Systematic Review', Nurse Education Today , vol. 57, pp. 103-10, viewed 7 December 2018, https://www.sciencedirect.com/science/article/abs/pii/S0260691717301715
• Fortepiani, L A 2017, 'Critical Thinking or Traditional Teaching For Health Professionals', PECOP Blog , 16 January, viewed 7 December 2018, https://blog.lifescitrc.org/pecop/2017/01/16/critical-thinking-or-traditional-teaching-for-health-professions/
• Jacob, E, Duffield, C & Jacob, D 2017, 'A Protocol For the Development of a Critical Thinking Assessment Tool for Nurses Using a Delphi Technique', Journal of Advanced Nursing, vol. 73, no. 8, pp. 1982-1988, viewed 7 December 2018, https://onlinelibrary.wiley.com/doi/10.1111/jan.13306
• Kahlke, R & Eva, K 2018, 'Constructing Critical Thinking in Health Professional Education', Perspectives on Medical Education , vol. 7, no. 3, pp. 156-165, viewed 7 December 2018, https://link.springer.com/article/10.1007/s40037-018-0415-z
• Lippincott Solutions 2018, 'Turning New Nurses Into Critical Thinkers', Lippincott Solutions , viewed 10 December 2018, https://www.wolterskluwer.com/en/expert-insights/turning-new-nurses-into-critical-thinkers
• Papp, K K 2014, 'Milestones of Critical Thinking: A Developmental Model for Medicine and Nursing', Academic Medicine , vol. 89, no. 5, pp. 715-720, https://journals.lww.com/academicmedicine/Fulltext/2014/05000/Milestones_of_Critical_Thinking___A_Developmental.14.aspx
• Snyder, L G & Snyder, M J 2008, 'Teaching Critical Thinking and Problem Solving Skills', The Delta Pi Epsilon Journal , vol. L, no. 2, pp. 90-99, viewed 7 December 2018, https://dme.childrenshospital.org/wp-content/uploads/2019/02/Optional-_Teaching-Critical-Thinking-and-Problem-Solving-Skills.pdf
• The Foundation for Critical Thinking 2017, Defining Critical Thinking , The Foundation for Critical Thinking, viewed 7 December 2018, https://www.criticalthinking.org/pages/our-conception-of-critical-thinking/411
• Tsui-Mei, H, Lee-Chun, H & Chen-Ju MSN, K 2015, 'How Mental Health Nurses Improve Their Critical Thinking Through Problem-Based Learning', Journal for Nurses in Professional Development , vol. 31, no. 3, pp. 170-175, viewed 7 December 2018, https://journals.lww.com/jnsdonline/Abstract/2015/05000/How_Mental_Health_Nurses_Improve_Their_Critical.8.aspx

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Developing critical thinking skills for delivering optimal care

Scott IA, Hubbard RE, Crock C, et al. Developing critical thinking skills for delivering optimal care. Intern Med J. 2021;51(4):488-493. doi: 10.1111/imj.15272

Sound critical thinking skills can help clinicians avoid cognitive biases and diagnostic errors. This article describes three critical thinking skills essential to effective clinical care – clinical reasoning, evidence-informed decision-making, and systems thinking – and approaches to develop these skills during clinician training.

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Teaching Critical Thinking and Problem-Solving Skills to Healthcare Professionals

Affiliation.

• 1 Department of Medical Education, Paul L Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX USA.
• PMID: 34457878
• PMCID: PMC8368273
• DOI: 10.1007/s40670-020-01128-3

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Critical thinking: what it is and why it counts. 2020. https://tinyurl.com/ybz73bnx (accessed 27 April 2021)

Faculty of Intensive Care Medicine. Curriculum for training for advanced critical care practitioners: syllabus (part III). version 1.1. 2018. https://www.ficm.ac.uk/accps/curriculum (accessed 27 April 2021)

Guerrero AP. Mechanistic case diagramming: a tool for problem-based learning. Acad Med.. 2001; 76:(4)385-9 https://doi.org/10.1097/00001888-200104000-00020

Harasym PH, Tsai TC, Hemmati P. Current trends in developing medical students' critical thinking abilities. Kaohsiung J Med Sci.. 2008; 24:(7)341-55 https://doi.org/10.1016/S1607-551X(08)70131-1

Hayes MM, Chatterjee S, Schwartzstein RM. Critical thinking in critical care: five strategies to improve teaching and learning in the intensive care unit. Ann Am Thorac Soc.. 2017; 14:(4)569-575 https://doi.org/10.1513/AnnalsATS.201612-1009AS

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Examining critical thinking skills in family medicine residents. 2016. https://www.stfm.org/FamilyMedicine/Vol48Issue2/Ross121

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Advanced practice: critical thinking and clinical reasoning

Sadie Diamond-Fox

Senior Lecturer in Advanced Critical Care Practice, Northumbria University, Advanced Critical Care Practitioner, Newcastle upon Tyne Hospitals NHS Foundation Trust, and Co-Lead, Advanced Critical/Clinical Care Practitioners Academic Network (ACCPAN)

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Advanced Critical Care Practitioner, South Tees Hospitals NHS Foundation Trust

Clinical reasoning is a multi-faceted and complex construct, the understanding of which has emerged from multiple fields outside of healthcare literature, primarily the psychological and behavioural sciences. The application of clinical reasoning is central to the advanced non-medical practitioner (ANMP) role, as complex patient caseloads with undifferentiated and undiagnosed diseases are now a regular feature in healthcare practice. This article explores some of the key concepts and terminology that have evolved over the last four decades and have led to our modern day understanding of this topic. It also considers how clinical reasoning is vital for improving evidence-based diagnosis and subsequent effective care planning. A comprehensive guide to applying diagnostic reasoning on a body systems basis will be explored later in this series.

The Multi-professional Framework for Advanced Clinical Practice highlights clinical reasoning as one of the core clinical capabilities for advanced clinical practice in England ( Health Education England (HEE), 2017 ). This is also identified in other specialist core capability frameworks and training syllabuses for advanced clinical practitioner (ACP) roles ( Faculty of Intensive Care Medicine, 2018 ; Royal College of Emergency Medicine, 2019 ; HEE, 2020 ; HEE et al, 2020 ).

Rencic et al (2020) defined clinical reasoning as ‘a complex ability, requiring both declarative and procedural knowledge, such as physical examination and communication skills’. A plethora of literature exists surrounding this topic, with a recent systematic review identifying 625 papers, spanning 47 years, across the health professions ( Young et al, 2020 ). A diverse range of terms are used to refer to clinical reasoning within the healthcare literature ( Table 1 ), which can make defining their influence on their use within the clinical practice and educational arenas somewhat challenging.

The concept of clinical reasoning has changed dramatically over the past four decades. What was once thought to be a process-dependent task is now considered to present a more dynamic state of practice, which is affected by ‘complex, non-linear interactions between the clinician, patient, and the environment’ ( Rencic et al, 2020 ).

Cognitive and meta-cognitive processes

As detailed in the table, multiple themes surrounding the cognitive and meta-cognitive processes that underpin clinical reasoning have been identified. Central to these processes is the practice of critical thinking. Much like the definition of clinical reasoning, there is also diversity with regard to definitions and conceptualisation of critical thinking in the healthcare setting. Facione (2020) described critical thinking as ‘purposeful reflective judgement’ that consists of six discrete cognitive skills: analysis, inference, interpretation, explanation, synthesis and self–regulation. Ross et al (2016) identified that critical thinking positively correlates with academic success, professionalism, clinical decision-making, wider reasoning and problem-solving capabilities. Jacob et al (2017) also identified that patient outcomes and safety are directly linked to critical thinking skills.

Harasym et al (2008) listed nine discrete cognitive steps that may be applied to the process of critical thinking, which integrates both cognitive and meta-cognitive processes:

• Gather relevant information
• Formulate clearly defined questions and problems
• Evaluate relevant information
• Utilise and interpret abstract ideas effectively
• Infer well-reasoned conclusions and solutions
• Pilot outcomes against relevant criteria and standards
• Use alternative thought processes if needed
• Consider all assumptions, implications, and practical consequences
• Communicate effectively with others to solve complex problems.

There are a number of widely used strategies to develop critical thinking and evidence-based diagnosis. These include simulated problem-based learning platforms, high-fidelity simulation scenarios, case-based discussion forums, reflective journals as part of continuing professional development (CPD) portfolios and journal clubs.

Dual process theory and cognitive bias in diagnostic reasoning

A lack of understanding of the interrelationship between critical thinking and clinical reasoning can result in cognitive bias, which can in turn lead to diagnostic errors ( Hayes et al, 2017 ). Embedded within our understanding of how diagnostic errors occur is dual process theory—system 1 and system 2 thinking. The characteristics of these are described in Table 2 . Although much of the literature in this area regards dual process theory as a valid representation of clinical reasoning, the exact causes of diagnostic errors remain unclear and require further research ( Norman et al, 2017 ). The most effective way in which to teach critical thinking skills in healthcare education also remains unclear; however, Hayes et al (2017) proposed five strategies, based on well-known educational theory and principles, that they have found to be effective for teaching and learning critical thinking within the ‘high-octane’ and ‘high-stakes’ environment of the intensive care unit ( Table 3 ). This is arguably a setting that does not always present an ideal environment for learning given its fast pace and constant sensory stimulation. However, it may be argued that if a model has proven to be effective in this setting, it could be extrapolated to other busy clinical environments and may even provide a useful aide memoire for self-assessment and reflective practices.

Integrating the clinical reasoning process into the clinical consultation

Linn et al (2012) described the clinical consultation as ‘the practical embodiment of the clinical reasoning process by which data are gathered, considered, challenged and integrated to form a diagnosis that can lead to appropriate management’. The application of the previously mentioned psychological and behavioural science theories is intertwined throughout the clinical consultation via the following discrete processes:

• The clinical history generates an initial hypothesis regarding diagnosis, and said hypothesis is then tested through skilled and specific questioning
• The clinician formulates a primary diagnosis and differential diagnoses in order of likelihood
• Physical examination is carried out, aimed at gathering further data necessary to confirm or refute the hypotheses
• A selection of appropriate investigations, using an evidence-based approach, may be ordered to gather additional data
• The clinician (in partnership with the patient) then implements a targeted and rationalised management plan, based on best-available clinical evidence.

Linn et al (2012) also provided a very useful framework of how the above methods can be applied when teaching consultation with a focus on clinical reasoning (see Table 4 ). This framework may also prove useful to those new to the process of undertaking the clinical consultation process.

Evidence-based diagnosis and diagnostic accuracy

The principles of clinical reasoning are embedded within the practices of formulating an evidence-based diagnosis (EBD). According to Kohn (2014) EBD quantifies the probability of the presence of a disease through the use of diagnostic tests. He described three pertinent questions to consider in this respect:

• ‘How likely is the patient to have a particular disease?’
• ‘How good is this test for the disease in question?’
• ‘Is the test worth performing to guide treatment?’

EBD gives a statistical discriminatory weighting to update the probability of a disease to either support or refute the working and differential diagnoses, which can then determine the appropriate course of further diagnostic testing and treatments.

Diagnostic accuracy refers to how positive or negative findings change the probability of the presence of disease. In order to understand diagnostic accuracy, we must begin to understand the underlying principles and related statistical calculations concerning sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios.

The construction of a two-by-two square (2 x 2) table ( Figure 1 ) allows the calculation of several statistical weightings for pertinent points of the history-taking exercise, a finding/sign on physical examination, or a test result. From this construct we can then determine the aforementioned statistical calculations as follows ( McGee, 2018 ):

• Sensitivity , the proportion of patients with the diagnosis who have the physical sign or a positive test result = A ÷ (A + C)
• Specificity , the proportion of patients without the diagnosis who lack the physical sign or have a negative test result = D ÷ (B + D)
• Positive predictive value , the proportion of patients with disease who have a physical sign divided by the proportion of patients without disease who also have the same sign = A ÷ (A + B)
• Negative predictive value , proportion of patients with disease lacking a physical sign divided by the proportion of patients without disease also lacking the sign = D ÷ (C + D)
• Likelihood ratio , a finding/sign/test results sensitivity divided by the false-positive rate. A test of no value has an LR of 1. Therefore the test would have no impact upon the patient's odds of disease
• Positive likelihood ratio = proportion of patients with disease who have a positive finding/sign/test, divided by proportion of patients without disease who have a positive finding/sign/test OR (A ÷ N1) ÷ (B÷ N2), or sensitivity ÷ (1 – specificity) The more positive an LR (the further above 1), the more the finding/sign/test result raises a patient's probability of disease. Thresholds of ≥ 4 are often considered to be significant when focusing a clinician's interest on the most pertinent positive findings, clinical signs or tests
• Negative likelihood ratio = proportion of patients with disease who have a negative finding/sign/test result, divided by the proportion of patients without disease who have a positive finding/sign/test OR (C ÷ N1) ÷ (D÷N1) or (1 – sensitivity) ÷ specificity The more negative an LR (the closer to 0), the more the finding/sign/test result lowers a patient's probability of disease. Thresholds <0.4 are often considered to be significant when focusing clinician's interest on the most pertinent negative findings, clinical signs or tests.

There are various online statistical calculators that can aid in the above calculations, such as the BMJ Best Practice statistical calculators, which may used as a guide (https://bestpractice.bmj.com/info/toolkit/ebm-toolbox/statistics-calculators/).

Clinical scoring systems

Evidence-based literature supports the practice of determining clinical pretest probability of certain diseases prior to proceeding with a diagnostic test. There are numerous validated pretest clinical scoring systems and clinical prediction tools that can be used in this context and accessed via various online platforms such as MDCalc (https://www.mdcalc.com/#all). Such clinical prediction tools include:

• 4Ts score for heparin-induced thrombocytopenia
• ABCD² score for transient ischaemic attack (TIA)
• CHADS₂ score for atrial fibrillation stroke risk
• Aortic Dissection Detection Risk Score (ADD-RS).

Conclusions

Critical thinking and clinical reasoning are fundamental skills of the advanced non-medical practitioner (ANMP) role. They are complex processes and require an array of underpinning knowledge of not only the clinical sciences, but also psychological and behavioural science theories. There are multiple constructs to guide these processes, not all of which will be suitable for the vast array of specialist areas in which ANMPs practice. There are multiple opportunities throughout the clinical consultation process in which ANMPs can employ the principles of critical thinking and clinical reasoning in order to improve patient outcomes. There are also multiple online toolkits that may be used to guide the ANMP in this complex process.

• Much like consultation and clinical assessment, the process of the application of clinical reasoning was once seen as solely the duty of a doctor, however the advanced non-medical practitioner (ANMP) role crosses those traditional boundaries
• Critical thinking and clinical reasoning are fundamental skills of the ANMP role
• The processes underlying clinical reasoning are complex and require an array of underpinning knowledge of not only the clinical sciences, but also psychological and behavioural science theories
• Through the use of the principles underlying critical thinking and clinical reasoning, there is potential to make a significant contribution to diagnostic accuracy, treatment options and overall patient outcomes

CPD reflective questions

• What assessment instruments exist for the measurement of cognitive bias?
• Think of an example of when cognitive bias may have impacted on your own clinical reasoning and decision making
• What resources exist to aid you in developing into the ‘advanced critical thinker’?
• What resources exist to aid you in understanding the statistical terminology surrounding evidence-based diagnosis?

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Walker (2003) highlighted that many individuals believe that the tendency to think critically must be nurtured. We have seen educated healthcare professionals in healthcare facilities but does that mean that they have critical thinking skills? I agree with Jonathan Sharples et al in the article, “Critical thinking in healthcare and education”arguing about the importance for clinicians and patients to learn to think critically and that the teaching and learning of these skills to be explicitly considered.

Critical thinking includes “analysis, inference, interpretation, explanation, synthesis and self –regulation” (Facione, 2011). The healthcare team should be able to utilize their critical thinking skills as they come in contact with their patients daily. Critical thinking has been well documented in nursing but the evidence in medicine is limited (Batool, 2010; Iranfar, Sepahi, Khoshay, Rezaei, Matin, Keshavarzi, & Bashiri, 2012; Mahmoodabad, Nadrian, & Nahangi, 2012; Maudsley & Strivens, 2000). Are nurses the only group of health professionals taking care of patients? Certainly not, other members of the healthcare team work collaboratively with each other to ensure optimal patient care. Thus critical thinking is essential among healthcare professionals.

Critical thinking is integral in caring for patients and before one can teach patients to think critically, he or she needs to model the behavior but how can one model what they do not know? Riddel (2007) emphasized that critical thinking is a complex process and not a single way of thinking. Cottrell (2011) concurred with Riddel and added that critical thinking includes identification of the views of individuals, evaluation of evidence to explore alternate views, being unbiased in weighing the evidence and opposing arguments.

However, Romeo (2010) defines critical thinking as an attribute that strengthens the decision making and problem solving skills of an individual. In order for students to develop critical thinking skills and depositions, the faculty needs to reconsider their philosophy of teaching and implement critical thinking in the curricula (Billings & Halstead, 2012). Educators can design their teaching plans to facilitate critical thinking disposition and critical learning. If students in healthcare professions are taught critical thinking early in their programs, they will be able to develop the skill and will be able to utilize same effectively in their practice.

The healthcare system is evolving and emphasis should be placed on healthcare professionals to develop creative and critical thinking skills so that they can administer optimal patient care and be able to teach their patients how to think critically.

References Batool, T. (2010). Hyposkillia and critical thinking: Lost skills of doctors.APS Journal of case reports, 1(1), 9. Billings, D. M., & Halstead, J. A. (2012). Teaching in nursing: A guide for faculty (4th ed.). St. Louis: Elsevier Health Sciences. Cottrell, S. (2011). Critical thinking skills: Developing effective analysis and argument. Palgrave Macmillan. Facione, P. A. (2011). Critical thinking: What it is and why it counts. Insight Assessment, 2007(1), 1-23. Iranfar, S., Sepahi, V., Khoshay, A., Rezaei, M., Matin, B. K., Keshavarzi, F., & Bashiri, H. (2012). Critical thinking disposition among medical students of Kermanshah University of Medical Sciences. ducational Research in Medical Sciences Journal, 1(2), 63-68. Mahmoodabad, S. S. M., Nadrian, H., & Nahangi, H. (2012). Critical thinking ability and its associated factors among preclinical students in Yazd Shaheed Sadoughi University of Medical Sciences (Iran). Medical Journal of the Islamic Republic of Iran, 26(2), 50. Maudsley, G., & Strivens, J. (2000). ‘Science’,‘critical thinking’and ‘competence’ for tomorrow’s doctors. A review of terms and concepts.Medical Education, 34(1), 53-60. Riddell, T. (2007). Critical assumptions: Thinking critically about critical thinking. Journal of Nursing Education, 46(3). Romeo, E. M. (2010). Quantitative research on critical thinking and predicting nursing students’ NCLEX-RN performance. Journal of Nursing Education, 49(7), 378-386. Walker, S. E. (2003). Active learning strategies to promote critical thinking. Journal of athletic training, 38(3), 263.

Competing interests: No competing interests

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A Short Guide to Building Your Team’s Critical Thinking Skills

• Matt Plummer

Critical thinking isn’t an innate skill. It can be learned.

Most employers lack an effective way to objectively assess critical thinking skills and most managers don’t know how to provide specific instruction to team members in need of becoming better thinkers. Instead, most managers employ a sink-or-swim approach, ultimately creating work-arounds to keep those who can’t figure out how to “swim” from making important decisions. But it doesn’t have to be this way. To demystify what critical thinking is and how it is developed, the author’s team turned to three research-backed models: The Halpern Critical Thinking Assessment, Pearson’s RED Critical Thinking Model, and Bloom’s Taxonomy. Using these models, they developed the Critical Thinking Roadmap, a framework that breaks critical thinking down into four measurable phases: the ability to execute, synthesize, recommend, and generate.

With critical thinking ranking among the most in-demand skills for job candidates , you would think that educational institutions would prepare candidates well to be exceptional thinkers, and employers would be adept at developing such skills in existing employees. Unfortunately, both are largely untrue.

• Matt Plummer (@mtplummer) is the founder of Zarvana, which offers online programs and coaching services to help working professionals become more productive by developing time-saving habits. Before starting Zarvana, Matt spent six years at Bain & Company spin-out, The Bridgespan Group, a strategy and management consulting firm for nonprofits, foundations, and philanthropists.  

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Critical thinking approaches can make hospitals safer, Broad College expert to tell state medical conference-goers

Avoiding tragedy may be considered simple luck. Then again, luck is preparation meeting opportunity, or so an old saying goes.

Rip will co-present a session titled “Critical Thinking for High Reliability” at the MHA Patient Safety & Quality Symposium in Ypsilanti, Mich., on Sept. 18–19. He will be joined by Mark Vroman, a battalion chief with the Meridian Township Fire Department in Okemos, Mich., in outlining why critical thinking and related techniques are important to problem-solving and decision-making.

“My work revolves around using critical thinking as a foundation for higher reliability, or achieving higher reliability, or embarking on a higher reliability journey,” Rip said. “Many of the major hospitals in the nation are beginning to tackle this very thorny problem of patient and staff safety in the hospital where they are operating in a very complex environment, and there are many opportunities for error, from simply falling down to killing patients on the operating tables.”

“We obviously want to prevent it from happening, but we have to have robust systems, organizational and personnel systems, to trap mistakes and not let them propagate and end up in a catastrophic or tragic outcome,” Rip said.

“One of the missing pieces, from my perspective, has been that while the hospitals have paid a lot of attention to practical things like checklists, having weekly or daily scrums to review near-misses and errors and so forth and their successes of course, one of the things we know from neuroscience and cognitive psychology is that a large amount of these errors are happening unconsciously, because we are not that observant,” Rip said.

“There is a significant foundation of neuroscience to explain why this is all happening,” Rip said. “My focus has been on thinking about how critical thinking as a disciplined, structured way of reasoning can assist and provide a floor upon which they can build their higher-reliability operations.”

The program “is really oriented toward providing best practices to the students so that they will acquire the very best business acumen to function in a modern healthcare setting as top-level administrators or even mid-managers,” Rip said. “One of the things I think we will be able to do is provide [assistance to] a group of people who traditionally not have been able to even begin seeking this kind of education and training simply because they were not able to access universities full-time.”

That’s because the first-of-its kind course will be offered online.

“There are many mid-career professionals who simply can’t give up two years to go do a master’s degree,” Rip said. “By coupling the accessibility by being online and then at the same time providing them top-quality people from a ranked business school with a singular focus on best practices for business and business acumen, I think we’ve achieved sort of a sweet spot in the marketplace.”

“There are many top-notch programs around, but they typically are face-to-face or are being offered from a healthcare setting … (where) the emphasis is really from healthcare-trained people who are trying to obtain business acumen,” Rip said. “We are approaching it from a different direction. We are coming with the business acumen and then are in fact providing them with the healthcare perspective.

Like with Rip’s MHA presentation, the program will have an underlying focus on critical thinking.

“One of the missing elements of many graduate programs, particularly in professional degrees such as our healthcare management degree, is that students are often thought what to think, not how to think,” Rip said.

“While people have discussed the importance of learning how to think and the rise of modern neuroscience and how we better understand how the human mind works for decision-making and problem-solving and learning, this is not really translated to tertiary education,” Rip said. “I’ve tried to arrive at a point where we have a training program teaching students how to think … in a very applied way.”

For more information on the master’s in healthcare management, visit the program’s home page.

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Management skills.

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Last Update: September 4, 2023 .

• Definition/Introduction

Management skills in the healthcare setting are composed of sets of competencies essential for healthcare professionals who effectively and efficiently manage a variety of medical, nursing, or public health resources to attain goals that ideally align with improving the overall health of the population and healthcare system.

In this activity, healthcare professionals who manage at any level of the health systems serve as healthcare managers, encompassing a wide range of specialties, including physicians (clinicians, surgeons, public health physicians, and other specialists), nurses, laboratory professionals, public health managers, dentists, among other healthcare professions.

As expressed in references both for theoretical and practical guidance documents, management skills are often separated from leadership skills as these two sets of skills were known to be generally different. [1] However, this activity does not constrain itself to the (theoretical) management skills per se. It is because effective and efficient healthcare managers require elements of leadership skills to fulfill managerial roles and responsibilities at the best possible level. The necessary skills of healthcare managers involve planning, organizing, implementing, monitoring, and evaluation skills. Planning refers to the preparation of the steps and protocols needed to achieve an ultimate end goal and the proper allocation of anticipated resources (including human resources) to the objectives and goals of the healthcare organization. Development of a plan can refer to action plans addressing small-scale activities for individual staff as well as operational and strategic plans for small groups (i.e., sections, units, departments) or organization-wide level. A pre-requisite to a well-developed plan with SMART (specific, measurable, attainable, realistic and time-bound) objectives is that the healthcare manager must be able to perform proper scanning and focusing skills, which are actually “leadership practices.” Scanning refers to knowing one’s self and environment together with the opportunities, threats, and risks to one’s staff and the organization as a whole while focusing refers to concentrating each staff member's work in the healthcare organization relative to its vision and mission statements. Organizing is the ability to bring together the systems, processes, and procedures with the designated staff in an organization so that the right people will be able to do the proper work for the right purpose. Implementing skills, on the other hand, is focused on the performance of the assigned work based on planned activities. As a healthcare manager, one must know how to harmonize workflow within all concerned staff, ensuring that the individual and overall plans get implemented effectively. The leadership practices essential in organizing and implementing (management) skills include aligning and mobilizing the staff. While management skills are focused on the use of organizational resources as mentioned, the goal of leadership skills centers on the mobilization of the members of the organization. For instance, a healthcare manager organizing human resource with the actual operations will not be complete and will not properly work in its implementation phase if some of the staff lack the motivation, which could be caused by the loss of teamwork. Or, in other circumstance, some staff may have unclear roles and responsibilities, resulting in their confusion at work and eventually low performance and productivity. Aligning and mobilizing is making all staff, including healthcare managers, share a common vision and commitment for the healthcare organization. Lastly, monitoring and evaluating skills must be part of the practice of healthcare managers on whatever type of healthcare organization. Monitoring skills mean the ability to check the progress of the organization in terms of achieving its plans while evaluating skills means that a healthcare manager can assess the attainment of desired results (output) after the whole process is carried out. In simpler terms, monitoring occurs “during” while evaluation is done “after” the implementation of an organizational project or program. Furthermore, these combined skills of monitoring and evaluation (often termed as M&E) involve the provision of feedback that will further improve plans and implementation. However, feedback must not be limited to the management systems and processes. It should also include feedback from staff, as to whether their commitment is sustainable, and they are still motivated to perform the work; this is where the leadership practice of inspiring the team applies. A good healthcare manager can provide trust and confidence to staff and can appreciate staff efforts. The inspiration of staff can manifest by providing supportive supervision to all members of the organization.In practicing these healthcare management skills, it is evident that leadership skills are equally vital. Healthcare organizations should not develop professionals who can only manage or who are leaders alone – because such a man will be unsuccessful. The development and enhancement of management skills can come from a variety of learning strategies and actual experiences. [2]  Healthcare management, as a specific profession, stresses its value and importance apart from the clinical aspects performed on the bedside. It is important to note that management skills applied in the fields of medicine and public health do not only intend to provide better health services but also to optimize the health status of the patients and the community at large.

• Issues of Concern

In recent years, some issues on management (and leadership) skills, particularly in the healthcare setting, begin to arise. The emergence of these issues highlights the need for improvement of healthcare management:

Association between management skills and the efficiency of hospitals - The study looked at nurses and obstetrician’s managers. [3]  Another study found out that improving management skills can further enhance the quality of health services. [4]

Education and training needs for healthcare management as basic preconditions for the development and implementation of adequate programs - Researchers performed a needs assessment in this research, which served as a basis for developing solutions in meeting the gap between healthcare managers and the competencies that they need. [5]  In another study, it revealed that while there is a high demand for leadership roles for physicians, medical education is still lacking with appropriate management skills for training future medical doctors. [6] Communication and critical thinking skills in addition to other relational and organizations skills for healthcare management, were seen as essential competencies for development. [7] [8] Physicians are expected to be pivotal leaders, especially during transitional periods in the healthcare system.  In the last decade, there has been an increasing emphasis placed on targeting potential areas to improve the various facets of medical training.  Training in management skills, leadership, and practice management modalities have been gaining increasing traction in the literature. [8] [9]  Regardless of the approach, the current curriculum must be revisited and improved to address this issue according to the type of approach provided by medical schools (either traditional, system-based, or hybrid curriculum).

Training of practicing managers beyond clinical skills - For middle managers, additional skills for managing subordinates and coordinating with top-level managers is necessary, which includes capabilities such as communication skills (not with patients but with colleagues and other stakeholders), self-awareness, change management, conflict resolution, and other leadership skills. [10] For frontline managers, a study revealed that they experience challenges in terms of integrating different professions as required by the health services they provide. Clarity on the roles and responsibilities of existing and new professionals working in healthcare is necessary.

Collaborative interprofessional practice - Due to the reforms in transformational education and significant changes in health systems, there is a need to develop interprofessional education to cultivate the value of teamwork despite differences across health professions. [11]  In the past, the physicians alone were believed to fulfill leadership positions in healthcare because of their an interprofessional knowledge and clinical skills in terms of diagnosis and treatment of diseases. But as the health system evolves within countries, states, and communities, the need for other health professionals in performing leadership and management work has been observed. In one of the low-and-middle-income countries (LMICs) where the number of physicians is not adequate, an issue has been raised regarding the filling up of leadership positions for the ministry (department) of health offices where the basic qualifications contain a medical degree. Other competent professionals who are not physicians feel that such opportunities become limited from them and could be a factor for slow improvement in health systems implementation. While this needs further investigation, it can be addressed appropriately depending on the context of the health system concerned. Interprofessional healthcare management can resolve the issue of superiority and inferiority among healthcare professions – medicine, nursing, allied health including laboratory and pharmacy, among others. Furthermore, it reinforces humility and teamwork while acknowledging the importance of each profession for the improvement of health. In the hospitals, where clinicians and medical specialists work together, options for treatment and management of patients come in a team-based fashion wherein different medical specialists give their expert opinions to the case and will not merely depend on the decision of the attending physicians as in the past.  As the healthcare system continues to evolve, increasing emphasis should focus on cultivating physician, and hospital alignment strategies as mutually beneficial collaborative efforts are at least a significant component of delivering high-quality health care while keeping costs and resource utilization sustainable for the future of the healthcare system. [12]

The leadership of self as key to leading others - This paper discusses the course for public health leadership where participants are expected to develop their plans for nurturing their leadership skills. [13]  If a healthcare manager knows how to lead himself, it then becomes easier for him to familiarize and knowing more both the members and the organization well.

Healthcare management as a profession - This is a field of health service delivery where formal and informal learning opportunities become available across countries. There have been academic degrees which make it a distinct profession. [14] In other countries, training for healthcare management become available. Moreover, in other technical areas of expertise, healthcare management practices and principles have been incorporated into the training curriculum to address the needs of specific healthcare managers at work. Meanwhile, though a formal education makes learning systematic, students and trainees must be able to gain practical experiences in the field so that academic concepts will be fully realized and applied in the actual healthcare setting.

• Clinical Significance

The practice of management skills applied in the healthcare setting indirectly affects the patients. When healthcare managers manage the teams of the organization well, positive work culture (and work climate) become reinforced. In turn, the motivated staff at all levels of the organization increase their work performance as reflected through the optimal clinical (or health) services they provide to their patients. Therefore, the belief is that well-managed staff can lead to well-managed patients. Hence, sound management (and leadership) skills can impact positively on patients’ health outcomes.

The evolving healthcare system has been indicating that there is an increasing requirement for cultivated interprofessional relationships spanning across all health professions and subspecialties.  Physician-Hospital alignment strategies have been receiving increasing levels of attention in the literature given the already identified critical nature of optimizing these relationships. [12]   Despite their often tumultuous histories, physicians and hospitals collectively are recognizing more and more the driving forces leading toward common goals.  While each situation is inherently different, and each path toward idealized alignment is fraught with inevitable barriers and conflicts, it is essential for each party to identify and highlight the underlying principles that drive each other toward the process of achieving high-quality care at a reasonable cost. [15]

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Disclosure: Marlon Bayot declares no relevant financial relationships with ineligible companies.

Disclosure: Matthew Varacallo declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Bayot ML, Varacallo M. Management Skills. [Updated 2023 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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How Critical Thinking Skills Apply to Healthcare

Critical Thinking Includes

• The skill to draw conclusions.
• The skill to troubleshoot and problem-solve.
• The capability to use skills or knowledge in a variety of situations.

Examples of Everyday Critical Thinking

• Thinking about what steps should to be taken to avoid an accident.
•  Creating a list that gives ability to accomplish every task efficiently and effectively.
• Thinking through the process and dealing with issues that might arise. (missing an ingredient needed for a dish or finding out that the vacuum cleaner is broken)

Examples of Work-Related Critical Thinking

• Deciding how to deal with a customer who is upset over service or bill to ensure a happy customer.
• Handling a disagreement with another coworker.
• Presenting an issue or proposal to the supervisor.

Examples of Work-Related Critical Thinking Situations

• If you have worked in customer service then the same critical thinking skills that are used to deal with customers will be used to deal with patients in the medical field .
• If you have worked in a fast-paced environment requiring prioritizing then you will carry that skill over to the medical field.

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Critical Thinking in Health Information Management

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