Critical Thinking in Nursing Practice

Consider several definitions:

Critical thinkers: distinguish between fact and opinion; ask questions; make detailed observations; uncover assumptions and define their terms; and make assertions based on sound logic and solid evidence.

Ellis, D. Becoming a Master Student, 1997


Critical thinking is best understood as the ability of thinkers to take charge of their own thinking. This requires that they develop sound criteria and standards for analyzing and assessing their own thinking and routinely use those criteria and standards to improve its quality.

Elder , L. and Paul, R. "Critical thinking: why we must transform our teaching." Journal of Developmental Education, Fall 1994.



  • asks pertinent questions 

  • assesses statements and arguments 

  • is able to admit a lack of understanding or information 

  • has a sense of curiosity 

  • is interested in finding new solutions 

  • is able to clearly define a set of criteria for analyzing ideas

  • is willing to examine beliefs, assumptions, and opinions and weigh them against facts 

  • listens carefully to others and is able to give feedback 

  • sees that critical thinking is a lifelong process of self-assessment 

  • suspends judgment until all facts have been gathered and considered 

  • looks for evidence to support assumption and beliefs 

  • is able to adjust opinions when new facts are found 

  • looks for proof 

  • examines problems closely

  • is able to reject information that is incorrect or irrelevant 

Ferrett, S. Peak Performance (1997). 




(from Longview Community College, Lee's Summit, Missouri)


These seven critical reading strategies can be learned readily and then applied not only to reading selections in a Literature class, but also to your other college reading. Mastering these strategies will help you handle difficult material with confidence. 


·                     Annotating:

·                     Fundamental to each of these strategies is annotating directly on the page: underlining key words, phrases, or sentences; writing comments or questions in the margins; bracketing important sections of the text; constructing ideas with lines or arrows; numbering related points in sequence; and making note of anything that strikes you as interesting, important, or questionable. 

o                     Most readers annotate in layers, adding further annotations on second and third readings.

o                     Annotations can be light or heavy, depending on the reader's purpose and the difficulty of the material.



·                     Previewing:

·                     Learning about a text before really reading it. Previewing enables readers to get a sense of what the text is about and how it is organized before reading it closely. This simple strategy includes seeing what you can learn from the headnotes or other introductory material, skimming to get an overview of the content and organization, and identifying the rhetorical situation.



·                     Contextualizing:

·                     Placing a text in its historical, biographical, and cultural contexts. When you read a text, you read it through the lens of your own experience.

o                     Your understanding of the words on the page and their significance is informed by what you have come to know and value from living in a particular time and place. But the texts you read were all written in the past, sometimes in a radically different time and place.

o                     To read critically, you need to contextualize, to recognize the differences between your contemporary values and attitudes and those represented in the text.



·                     Questioning to understand and remember:

·                     Asking questions about the content. As students, you are accustomed to teachers asking you questions about your reading.

o                     Questions are designed to help you understand a reading and respond to it more fully, and often this technique works.

o                     When you need to understand and use new information though it is most beneficial if you write the questions, as you read the text for the first time.

o                     With this strategy, you can write questions any time, but in difficult academic readings, you will understand the material better and remember it longer if you write a question for every paragraph or brief section.

o                     Each question should focus on a main idea, not on illustrations or details, and each should be expressed in your own words, not just copied from parts of the paragraph.



 Reflecting on challenges to your beliefs and values:

Examining your personal responses. The reading that you do for this class might challenge your attitudes, your unconsciously held beliefs, or your positions on current issues.

o                     As you read a text for the first time, mark an X in the margin at each point where you fell a personal challenge to your attitudes, beliefs, or status.

o                     Make a brief note in the margin about what you feel or about what in the text created the challenge.

o                     Now look again at the places you marked in the text where you felt personally challenged.

o                     What patterns do you see?



·                     Outlining and summarizing:

·                     Identifying the main ideas and restating them in your own words.

o                     Outlining and summarizing are especially helpful strategies for understanding the content and structure of a reading selection.

o                     Whereas outlining reveals the basic structure of the text, summarizing synopsizes a selection's main argument in brief.

o                     Outlining may be part of the annotating process, or it may be done separately (as it is in this class).

o                     The key to both outlining and summarizing is being able to distinguish between the main ideas and the supporting ideas and examples.

o                     The main ideas form the backbone, the strand that hold the various parts and pieces of the text together.

o                     Outlining the main ideas helps you to discover this structure.

o                     When you make an outline, don't use the text's exact words.



·                     Summarizing begins with outlining, but instead of merely listing the main ideas, a summary recomposes them to form a new text. Whereas outlining depends on a close analysis of each paragraph, summarizing also requires creative synthesis. Putting ideas together again -- in your own words and in a condensed form -- shows how reading critically can lead to deeper understanding of any text. 



·                     Evaluating an argument means testing the logic of a text as well as its credibility and emotional impact. All writers make assertions that want you to accept as true.

o                     As a critical reader, you should not accept anything on face value but to recognize every assertion as an argument that must be carefully evaluated.

o                     An argument has two essential parts: a claim and support.

o                     The claim asserts a conclusion -- an idea, an opinion, a judgment, or a point of view - that the writer wants you to accept.

o                     The support includes reasons (shared beliefs, assumptions, and values) and evidence (facts, examples, statistics, and authorities) that give readers the basis for accepting the conclusion.

o                     When you assess an argument, you are concerned with the process of reasoning as well as its truthfulness (these are not the same thing).

o                     At the most basic level, in order for an argument to be acceptable, the support must be appropriate to the claim and the statements must be consistent with one another.



·                     Comparing and contrasting related readings:

·                     Exploring likenesses and differences between texts to understand them better. 

Many of the authors on the subject of thinking critically approach the topic in different ways. Fitting a text into an ongoing dialectic helps increase understanding of why an author approached a particular issue or question in the way he or she did.





Being able to distinguish between a statement of fact, an opinion or an inference is an important skill to critical thinking. It involves knowing what can be proven directly, what is a legitimate implication derived from the facts, and what is fair to conclude from the historical record. 

Historians typically interweave statements of fact, inferences they derive from the facts, and statements of their own opinion into a seamless historical narrative. Critical thinkers must be able to distinguish among these three types of communication. 


·                     FACT: reports information that can be directly observed or can be verified or checked for accuracy. 



·                     OPINION: expresses an evaluation based on a personal judgment or belief which may or may not be verifiable. 



·                     INFERENCE: a logical conclusion or a legitimate implication based on factual information. 



Generally, facts are constants in historical study. But a compendium of facts is inevitably incomplete and deathly dull to read. Historians construct history by closing the gaps in their knowledge about the past, enlarge our under- standing, and enliven their narrative by drawing logical inferences from their assembled facts. Often, they then use their expertise to arrive at a considered judgment about the wisdom or significance of past decisions and events. 

Distinguishing statements of fact, opinion, and inference may at first seem difficult to do. That is because they are often closely interwoven. Develop your own critical thinking abilities by placing an "F" before each factual statement, an "O" before each opinion, and an "I" before each inference in the practice exercise below. 


This type of critical thinking exercise is used often in quizzes and tests. 

____1. The real rulers of the "black Republican" governments of the South were white "scalawags" and "carbetbaggers." 

____2. Scalawags were by far the more numerous of the two.

____3. Blacks lacked experience in politics and were mostly poor and uneducated. 

____4. That blacks should fail to dominate southern governments is certainly understandable.

____5. Graft and callous disregard of the public interest characterized government in all regions and at every level during the decade after Appomattox.

____6. However, the corruption must be seen in perspective. 

____7. The New York City Tweed Ring probably made off with more money that all the southern thieves, black and white, combined. 

____8. The evidence does not justify southern corruption.

____9. The evidence suggests that the unique features of Reconstruction politics do not explain it either. 

___10. In fact, Radical southern governments accomplished much. 


What is Critical Thinking?

No one always acts purely objectively and rationally. We connive for selfish interests.  We gossip, boast, exaggerate, and equivocate. It is "only human" to wish to validate our prior knowledge, to vindicate our prior decisions, or to sustain our earlier beliefs. In the process of satisfying our ego, however, we can often deny ourselves intellectual growth and opportunity. We may not always want to apply critical thinking skills, but we should have those skills available to be employed when needed.

Critical thinking includes a complex combination of skills.  Among the main characteristics are the following:



We are thinking critically when we

·                     rely on reason rather than emotion,

·                     require evidence, ignore no known evidence, and follow evidence where it leads, and

·                     are concerned more with finding the best explanation than being right analyzing apparent confusion and asking questions.



We are thinking critically when we

·                     weigh the influences of motives and bias, and

·                     recognize our own assumptions, prejudices, biases, or point of view.



We are thinking critically when we recognize emotional impulses, selfish motives, nefarious purposes, or other modes of self-deception.



We are thinking critically when we

·                     evaluate all reasonable inferences

·                     consider a variety of possible viewpoints or perspectives,

·                     remain open to alternative interpretations

·                     accept a new explanation, model, or paradigm because it explains the evidence better, is simpler, or has fewer inconsistencies or covers more data

·                     accept new priorities in response to a reevaluation of the evidence or reassessment of our real interests, and

·                     do not reject unpopular views out of hand.



We are thinking critically when we

·                     are precise, meticulous, comprehensive, and exhaustive

·                     resist manipulation and irrational appeals, and

·                     avoid snap judgments.



We are thinking critically when we

·                     recognize the relevance and/or merit of alternative assumptions and perspectives

·                     recognize the extent and weight of evidence

In sum,

·                     Critical thinkers are by nature skeptical. They approach texts with the same skepticism and suspicion as they approach spoken remarks.

·                     Critical thinkers are active, not passive.  They ask questions and analyze. They consciously apply tactics and strategies to uncover meaning or assure their understanding. 

·                     Critical thinkers do not take an egotistical view of the world. They are open to new ideas and perspectives.  They are willing to challenge their beliefs and investigate competing evidence.

Critical thinking enables us to recognize a wide range of subjective analyses of otherwise objective data, and to evaluate how well each analysis might meet our needs. Facts may be facts, but how we interpret them may vary.

By contrast, passive, non-critical thinkers take a simplistic view of the world.

·                     They see things in black and white, as either-or, rather than recognizing a variety of possible understanding.

·                     They see questions as yes or no with no subtleties.

·                     They fail to see linkages and complexities.

·                     They fail to recognize related elements.

Non-critical thinkers take an egotistical view of the world

·                     They take their facts as the only relevant ones.

·                     They take their own perspective as the only sensible one.

·                     They take their goal as the only valid one.


Critical Thinking Web

This educational web site provides over 100 free online tutorials on critical thinking, logic, scientific reasoning, creativity, and other aspects of thinking skills. Our online tutorials have been used by universities, community colleges, and high schools across the world.

The online tutorials are organized into over 10 modules listed on the left. You can also check out the following:

·                     Introduction - What is critical thinking?

·                     Sitemap - A complete list of the online tutorials



·                     Free download: Critical thinking mini-guide - a short booklet (PDF) (via google docs)



·                     Free download: Class exercises - Critical thinking exercises for teaching (PDF) (via google docs)

·                     Quiz - Test the consistency of your moral beliefs

·                     Puzzle - The hardest logic puzzle in the world!

·                     101 philosophical questions to think about - one a day posting on twitter!

This site is maintained by Dr. Joe Lau at the Philosophy Department, The University of Hong Kong.


Thinking and recall series


Critical thinking I


Strategies for critical thinking in learning and project management

Critical thinking studies a topic or problem with open-mindedness.

This exercise outlines the first stage of applying a critical thinking approach to developing and understanding a topic. You will:

o                     Develop a statement of the topic

o                     List what you understand, what you've been told and what opinions you hold about it

o                     Identify resources available for research

o                     Define timelines and due dates and how they affect the development of your study

o                     Print the list as your reference


Here is more on the first stage:


Define your destination, what you want to learn

Clarify or verify with your teacher or an "expert" on your subject


Topics can be simple phrases:

"The role of gender in video game playing"

"Causes of the war before 1939"

"Mahogany trees in Central America"

"Plumbing regulations in the suburbs"

"Regions of the human brain"


o                     Develop your frame of reference, your starting point,

by listing what you already know about the subject


o                     What opinions and prejudices do you already have about this?

What have you been told, or read about, this topic?


o                     What resources are available to you for research When gathering information, keep an open mind Look for chance resources that pop up! Play the "reporter" and follow leads If you don't seem to find what you need, ask librarians or your teacher.



o                     How does your timeline and due dates affect your research?

Keep in mind that you need to follow a schedule.

Work back from the due date and define stages of development, not just with this first phase, but in completing the whole project.


Critical thinking I | Critical thinking II | Critical reading


Summary of critical thinking:

o                     Determine the facts of a new situation or subject without prejudice

o                     Place these facts and information in a pattern so that you can understand them

o                     Accept or reject the source values and conclusions based upon your experience, judgment, and beliefs


Critical thinking II


Second stage exercise in critical thinking:


Critical thinking studies a topic or problem with open-mindedness.

This exercise outlines the second stage of applying a critical thinking approach to developing and understanding a topic.

With the second stage:

o                     Refine/revise the topic

either narrowing or broadening it according to outcomes of research

o                     Rank or indicate the importance

of three sources of research

o                     Clarify any opinion, prejudice, or bias their authors have

While an opinion is a belief or attitude toward someone or some thing, a prejudice is preconceived opinion without basis of fact while bias is an opinion based on fact or research.

o                     Identify key words and concepts that seem to repeat

Is there vocabulary you need to define?

Are there concepts you need to understand better?

o                     In reviewing your research, are there

Sequences or patterns that emerge?

Opposing points of view, contradictions, or facts that don't "fit?"

Summarize two points of view that you need to address

o                     What questions remain to be answered?


Critical thinking, first stage helped you to

o                     Develop a statement of the topic

o                     List what you understand, what you've been told and what opinions you hold about it

o                     Identify resources available for research

o                     Define timelines and due dates and how they affect the development of your study

o                     Print the list as your reference


With this second exercise, think in terms of how you would demonstrate your learning for your topic

How would you create a test on what you have learned?

How would you best explain or demonstrate your findings?

From simple to more complex (1-6) learning operations:

1.                 List, label, identify: demonstrate knowledge

2.                 Define, explain, summarize in your own words: Comprehend/understand

3.                 Solve, apply to a new situation: Apply what you have learned

4.                 Compare and contrast, differentiate between items: analyze

5.                 Create, combine, invent: Synthesize

6.                 Assess, recommend, value: Evaluate and explain why


Summary of critical thinking:

o                     Determine the facts of a new situation or subject without prejudice

o                     Place these facts and information in a pattern so that you can understand and explain them

o                     Accept or reject your resource values and conclusions based upon your experience, judgment, and beliefs


Oddsei - What are the odds of anything.