Reflection 1: Critical Thinking, Critical Reasoning, and Clinical Judgment
As frontline workers in health practice, nurses encounter many patients and health problems requiring timely interventions. Due to patient care’s complexity and demanding nature, nurses must be critical thinkers who embrace evidence-based practice. From a health dimension, critical thinking enables nurses to minimize errors and apply reflective thinking to maximize patient outcomes (Van Nguyen & Liu, 2021). EBP is encouraged since nurses’ clinical knowledge is insufficient to address patient needs. EBP integrates scientific evidence, clinical expertise, and patient values and preferences to improve patient care (Li et al., 2019). The purpose of this reflection is to explore how critical thinking, clinical reasoning, and clinical judgment intersect and their application in making nursing practice decisions.
Application in Evidence-Based Practice
Nurses must make informed health decisions. Understanding the meaning and importance of critical thinking, clinical reasoning, and clinical judgment is instrumental to enabling nurses to achieve excellence in care delivery. Since nursing practice is evidence-based, critical thinking requires nurses to examine ideas, analyze arguments, and query evidence regarding patient care decisions. As critical thinkers, nurses can improve patient outcomes by avoiding habitual thinking since they analyze clinical situations to make fast and correct decisions (Van Nguyen & Liu, 2021). Clinical reasoning entails defining a problem, hypothesizing outcomes, drawing conclusions, and judging the validity of inferences. Like critical thinking, clinical reasoning emphasizes the analytical evaluation of issues and the application of appropriate evidence. As Guerrero (2019) noted, clinical judgment is the outcome of critical thinking and clinical reasoning. It is the decision that nurses make after a cycle of clinical reasoning and critical thinking.
Using EBP as a Practitioner Providing Direct Care
Health outcomes depend on nurses’ decision-making ability. Embracing EBP as direct care providers is crucial for nurses to offer holistic and satisfactory care. To achieve the best outcomes, nurses analyze available evidence and its implications in nursing practice. Critical thinking helps nurses to reflect and analyze situations and interventions to choose what maximizes positive outcomes (Van Nguyen & Liu, 2021). Clinical reasoning allows nurses to embrace interventions that optimize outcomes through a problem-solving approach. Eventually, combining their skills and reflective analysis of situations to make the best decisions helps nurses to achieve the best possible care for patients.
Using EBP as a Leader
The demand for quality patient care is universal across health care organizations. As leaders and EBP implementers, nurses must continually engage in practice change. Leading change entails in-depth thinking of the best interventions to improve patient care and overcoming resistance that characterize practice change (Nilsen et al., 2020). The process also entails collecting, analyzing, and implementing evidence from current literature to improve patient outcomes. Essential skills to succeed in this role include problem-solving, communication, and clinical judgment.
Using EBP as an Educator
As educators, nurses primarily engage in behavior change. As Arlinghaus and Johnston (2018) noted, health education imparts knowledge to allow patients to make informed health decisions. Nurses utilize EBP to execute this role by exploring problems hampering patient care and the suitability of patient education in different situations. Through critical thinking and clinical reasoning, nurses analyze the best education strategy to improve patients’ knowledge. Next, nurses also evaluate outcomes to determine the effectiveness of different education programs.
How Experience Influence Critical Thinking, Clinical Reasoning, and Clinical Judgment
In regular practice, nurses gain massive experience regarding the value of evidence-based interventions, evolving patient care needs, innovation, and other critical aspects of care. As Van Nguyen and Liu (2021) observed, experience and knowledge gathering during regular practice influence critical thinking since patient care issues require clarification, reflection, and accurate decision-making. Experience also allows nurses to embrace the problem-solving approach and procedural decision-making. As a result, they recognize the need for clinical reasoning as the foundation of clinical judgment.
Conclusion
Critical thinking and clinical reasoning are the foundation of clinical judgment. As nurses continue integrating EBP into the evolving practice, they must understand the meaning and importance of critical thinking and clinical reasoning. As discussed in this reflection, nurses can effectively handle complex and demanding patient issues with critical thinking and clinical reasoning. Such an approach allows them to optimize patient outcomes by avoiding habitual thinking that can lead to errors.
References
Arlinghaus, K. R., & Johnston, C. A. (2018). Advocating for behavior change with education. American Journal of Lifestyle Medicine, 12(2), 113–116. https://doi.org/10.1177/1559827617745479
Guerrero, J. G. (2019). Practice rationale care model: the art and science of clinical reasoning, decision making and judgment in the nursing process. Open Journal of Nursing, 9(2), 79-88. https://doi.org/10.4236/ojn.2019.92008
Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine, 98(39), e17209. https://doi.org/10.1097/MD.0000000000017209
Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses. BMC Health Services Research, 20(1), 1-8. https://doi.org/10.1186/s12913-020-4999-8
Van Nguyen, T., & Liu, H. E. (2021). Factors associated with the critical thinking ability of professional nurses: a cross‐sectional study. Nursing Open, 8(4), 1970-1980. https://doi.org/10.1002/nop2.875
