How do nurses promote critical thinking in acute care? A scoping literature review

Abstract

Aim: Critical thinking is essential to quality health care and patient outcomes in the acute care setting. It is important for educators to understand and apply teaching and learning strategies to promote critical thinking of nursing students and junior nurses in acute care.

Design: We followed Arksey and O'Malley's 2005 framework to undertake a scoping literature review to find out how critical thinking is promoted among nursing learners (i.e., nursing students and junior nurses) in acute care.

Methods: Between September and October 2018, four databases were searched: MEDLINE, CINAHL, ERIC, and Google Scholar. Search terms included: rapid, teaching, methods, nursing, promote, critical thinking and acute setting. A descriptive thematic analysis was undertaken.

Results: Twenty-three articles were included for review. Three main themes were identified from the analysis: learner-teacher relationship, reflection, and inquiry. Strong relationships promoted positive role modelling and effective feedback - both contributing to the teaching of critical thinking. Reflection strategies such as concept mapping and journaling were frequently used, while active student inquiry further promoted critical thinking in the acute setting.

Conclusions: The acute setting affords opportunities and challenges to promote critical thinking. Teachers/clinicians should incorporate learner-centred pedagogy and encourage reflective practice to embed critical thinking in teaching and clinical practice.

Keywords: Acute care; Critical thinking; Learning; Nurse education; Scoping review.