Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
The participants felt their tacit knowledge validated their rationale
to initiate a change in nursing management. Also, they linked
clinical decision-making with CT and the activity of a ‘safe
practitioner’.
Implications:
Critical thinking empowers decision-making skills, enhances job
satisfaction and achieves expertise in practice (Rubenfeld and
Scheffer 2006). A competent nurse is involved in continuous
professional development and lifelong learning. Therefore, nurses
become empowered when they have an opportunity to perform as
an autonomous practitioner. Although, the patient receives holistic
care from the interdisciplinary team, this should not prevent the
critical care nurse from proactive participation. Nurses that practice
proficiently or have expertise in their specialised field should be
encouraged to utilise these skills accordingly. Additionally,
strategies to enhance critical thinking for less experienced nurses,
should be integrated into the learning process.
Recommendations
This study was preformed to discover ways to enhance critical
thinking skills of nurses, and to incorporate these strategies into
educational programmes, at a theoretical and a practical level. The
terminology of critical thinking should be clarified within a
framework of learning in clinical practice, with an opportunity to use
these skills through structured experiences. Critical thinking can be
facilitated in clinical practice, through clinical supervision tailored to
meet the individual’s tacit knowledge and preferred learning style.
Metacognition, thinking about ones thinking and reflection can be
facilitated during clinical activities with ‘think aloud’ protocols,
where the nurse demonstrates their conscious thoughts.
Questioning techniques can be used within orientation programmes
and preceptorship relationships. These questions should be pitched
at an appropriate higher-order level. Open-ended questions are
advocated, so nurses can explain the rationale behind their thinking
and decisions (Brunt 2005a).
The use if vignettes capturing clinical case scenarios proved an
effective educative tool and a way to introduce problem-based
learning into programmes. Finally, it would be interesting to
explore how to enhance critical thinking skills in novice nurses, in
the paediatric critical care environment.
Conclusion
By using qualitative methods through an action research approach,
I had an opportunity to explore the culture of critical care nurses,
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