There are two main steps to evaluating critical thinking (CT), both of which require group thinking and thoughtful dialogue and discussion. First, get agreement from key leaders about how CT is defined. Second, be explicit about the behaviors observed when a nurse is thinking critically. Here’s what’s involved:

Defining CT. CT definitions and descriptions abound in the literature, with most of them complimenting and clarifying each other.¹ For the purpose of evaluating CT in the clinical setting, CT —

• entails purposeful, outcomes-directed (results-oriented) thinking
• is driven by patient, family, and community needs
• is based on principles of the nursing process and scientific method
• requires knowledge, skills, experience, and commitment to developing CT characteristics
• is guided by professional standards and ethics codes
• requires strategies that make the most of human potential (e.g., using individual talents and strengths) and compensate for problems created by human nature (e.g., the powerful influence of personal perspectives, values, and beliefs)
• is constantly reevaluating, self-correcting, and striving to improve²

Determining Critical Thinking Indicators (CTIs)

After clarifying and agreeing upon a CT definition, the next step is to determine CTIs: What exactly do you observe when a nurse is thinking critically? Answering this question and developing CTIs requires solid knowledge of the CT literature and careful analysis of the roles and responsibilities of nurses in each particular clinical setting. I find the best way to determine CTIs is to look at three related aspects of critical thinking:

1. knowledge required
2. attitudes or characteristics demonstrated by critical thinkers
3. intellectual skills required

The box to the right gives examples of CTIs for nurses working in medical/surgical nursing. Keep in mind that, due to space constraints, this isn’t a comprehensive list. Also remember that, because critical thinking is focused, deep, and clear, the CTIs are as explicit as possible. To measure each indicator, use a scale of 0-10 (0 = never demonstrates the CTI and 10 = demonstrates the CTI consistently).

Walk the Talk

It takes a critical thinker to evaluate CT. You must put in the time and reflection needed to truly understand what CT is before you can evaluate it. You must walk the talk, modeling the skills and behaviors yourself. All nurses must be clear that, while you can’t measure what goes on in someone’s head, people get a good idea by looking at behavior over time. Make the link between behavior and thinking explicit. For example, you can say something like, “When I see you double-checking your charting, I know you’re thinking critically because checking accuracy and reliability is an important part of critical thinking,” or, “When I see you backpedaling all the time, I know you aren’t thinking critically because being proactive is essential to critical thinking.”

Finally, become cognizant of your own strengths and limitations. Remember, thinking isn’t a one-size-fits-all proposition. You and someone else may approach the same issues and problems in different ways and get equal results. What works in one situation may fail in another, depending on circumstances. Recognize, respect, and support natural learning preferences and thinking styles. Establish honest dialogue. Have nurses review the CTIs. Apply coaching principles, keeping in mind that having someone tell you they’ll be evaluating your thinking can be a threatening experience that raises anxiety levels. Give nurses the opportunity to gain insight into how and why they think the way they do. For example, help them learn whether they are left- or right-brain thinkers and how personality traits influence thinking.

If you give nurses the support, tools, and strategies to improve thinking and help them evaluate progress through honest and supportive feedback, you’ll see what happens when you release the power of some good minds!