critical thinking ethical analysis

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In CORE 101, you completed the Opposing Viewpoints assignments, which asked you to analyze two arguments in order to compare the authors’ approaches. In CORE 102 you completed the Approaches to Oral Argument assignment, and in CORE 201, you completed an Argument Analysis. Now, in CORE 202, you will apply the analytical skills that you have been practicing and strengthening to an analysis of an argument that addresses an issue that involves ethical reasoning.

The Ethical Analysis assignment is designed to help you meet two objectives that are important for analyzing an ethical issue. It will help you to

• apply critical reasoning to an ethical issue and
• utilize reasons and arguments appropriate to debate over an ethical issue.

In addition, this project provides an opportunity to revisit an objective that was introduced earlier in the University Core A sequence:

• use tone, mechanics, and style appropriate to an academic audience.

Apply critical reasoning to an ethical issue.

In order to analyze an issue in ethical terms, a critical thinker needs to distinguish ethical issues from non-ethical ones, determine what types of ethical concerns are raised by a situation, and recognize and remove obstacles to clear thinking about those questions. The following section will introduce you to the vocabulary and concepts that will allow you to develop and strengthen these skills.

Specifically, this section of the Handbook offers answers to these questions:

• What are some examples of ethical issues?
• How can I effectively apply critical reasoning to an ethical issue?
• When I debate ethical issues, what is my responsibility to people who are part of the dialogue?
• Do “ethical” and “moral” mean the same thing?
• What is ethical analysis?
• What are ethical judgments?
• How can I distinguish ethical judgments from other kinds of value judgments?
• What are ethical arguments?
• How can I best frame an ethical issue?
• What is an ethical conflict?
• What is an ethical dilemma?
• What does it mean to “take responsibility” in conflict or dilemma situations?
• What biases may affect critical reflection on an ethical issue?
• How does self-interest affect people’s ethical choices?
• What is the difference between good ethical reasoning and mere rationalization?
• What kinds of rationalizations do people make for their actions?
• What fallacies are most prevalent in debates over ethical issues?

1. What are some examples of ethical issues?

Ethical (sometimes also called moral) issues abound in contemporary society. Ethical issues involve questions of the ethical/moral rightness or wrongness of public policy or personal behavior.  Actions or policies that affect other people always have an ethical dimension, but while some people restrict ethical issues to actions that can help or harm others (social ethics) others include personal and self-regarding conduct (personal ethics).

Many of today’s most pressing issues of social ethics are complex and multifaceted and require clear and careful thought. Some of these issues include:

• Should states allow physician-assisted suicide?
• Is the death penalty an ethically acceptable type of punishment?
• Should animals have rights?
• Is society ever justified in regulating so-called victimless crimes like drug use, not wearing a helmet or a seatbelt, etc.?
• What are our responsibilities to future generations?
• Are affluent individuals and countries obligated to try to prevent starvation, malnutrition, and poverty wherever we find them in the world?
• Is there such a thing as a just war?
• How does business ethics relate to corporate responsibility?

To reach careful conclusions, these public policy issues require people to engage in complicated ethical reasoning, but the ethical reasoning involving personal issues can be just as complex and multifaceted:

• What principles do I apply to the way I treat other people?
• What guides my own choices and my own goals in life?
• Should I have the same expectations of others in terms of their behavior and choices as I have of myself?
• Is living ethically compatible or incompatible with what I call living well or happily?

2. How can I effectively apply critical reasoning to an ethical issue?

People care quite a bit about ethical issues and often voice varied and even sharply opposed perspectives. So when looking at how we debate ethical issues publicly, it is not surprising to find debate ranging from formal to informal argumentation, and from very carefully constructed arguments with well-qualified conclusions, to very biased positions and quite fallacious forms of persuasion. It’s easy to be dismayed by the discord we find over volatile issues like gun control, immigration policy, and equality in marriage or in the workplace, gender and race equality, abortion and birth control, jobs versus environment, freedom versus security, free speech and censorship, etc. But it is also easy to go the other direction and be drawn into the often fallacious reasoning we hear all around us.

Critical thinkers want to conduct civil, respectful discourse, and to build bridges in ways that allow progress to be made on difficult issues of common concern. Progress and mutual understanding is not possible when name-calling, inflammatory language, and fallacious discourse are the norm. Some mutual respect, together with the skill of being able to offer a clearly-structured argument for one’s position, undercuts the need to resort to such tactics. So critical thinkers resist trading fallacy for fallacy, and try to introduce common ground that can help resolve disputes by remaining respectful of differences, even about issues personally quite important to them. When we support a thesis (such as a position on one of the above ethical issues) with a clear and well-structured argument, we allow and invite others to engage with us in more constructive fashion. We say essentially, “Here is my thesis and here are my reasons for holding it. If you don’t agree with my claim, then show me what is wrong with my argument and I will reconsider my view, as any rational person should.”

3. When I debate ethical issues, what is my responsibility to people who are part of the dialogue?

When we evaluate (analyze) somebody else’s position on an ethical issue, we are not free to simply reject out-of-hand a conclusion we don’t initially agree with. To be reasonable, we must accept the burden of showing where the other person errs in his facts or reasoning. If we cannot show that there are errors in the person’s facts or reasoning, to be reasonable we must reconsider whether we should reject the other person’s conclusion.

By applying the common standards of critical thinking to our reasoning about ethical issues, our arguments will become less emotionally driven and more rational and our reasoning will become less dependent upon unquestioned beliefs or assumptions that the other people in the conversation may not accept. We become better able to contribute to progressive public debate and conflict resolution through a well-developed ability to articulate a well-reasoned position on an ethical issue.

4. Do “ethical” and “moral” mean the same thing?

For the purposes of this Handbook, the answer is ‘yes’. The terms ethical and moral are often used as synonyms, and we will adopt this convention and use these terms interchangeably. For most purposes this works fine, but some authors and teachers do see a distinction between these ideas. Usually when the terms are distinguished it is because “morals” can connote very culture-specific norms or expectations. Hence ‘the mores of the Azande” describes the moral norms of that particular tribe or culture, but without expectation that these norms are universally valid. When “ethics” is contrasted with “morals,” the writer is usually discussing certain normative ethical theories that maintain that certain principles, rules, or virtues have universal ethical validity.

5. What is ethical analysis?

Ethicist Judith Boss (2010) writes, “We engage in moral reasoning when we make a decision about what we ought or ought not to do, or about what is the most reasonable or just position regarding a particular issue. Effective moral decision-making depends on good critical-thinking skills….” (p. 275). We will use the term ethical analysis to refer to what Boss calls effective moral decision-making that employs critical thinking skills . Ethical analysis critically and reflectively examines different viewpoints and arguments on today’s ethical issues.  In the ethical analysis assignment, students will engage in moral reasoning with the aim of developing their ability to contribute to public debate.  Students will learn to frame a thoughtful thesis on an ethical issue and construct a reasoned argument in support of it.   A central requirement for effective ethical analysis, or moral reasoning, is the ability to identify ethical issues , ethical judgments , and ethical arguments . We have already discussed ethical issues. The sections below discuss ethical judgments and ethical arguments.

6. What are ethical judgments?

Ethical judgments are a subclass of value judgments. A value judgment involves an argument as to what is correct, superior, or preferable. In the case of ethics, the value judgment involves making a judgment, claim, or statement about whether an action is morally right or wrong or whether a person’s motives are morally good or bad. Ethical judgments often prescribe as well as evaluate actions, so that to state that someone (or perhaps everyone) ethically “should” or “ought to” do something is also to make an ethical judgment.

7. How can I distinguish ethical judgments from other kinds of value judgments?

If ethical judgments are a subclass of value judgments, how do we distinguish them?  Ethical judgments typically state that some action is good or bad, or right or wrong, in a specifically ethical sense. It is usually not difficult to distinguish non-ethical judgments of goodness and badness from ethical ones. When someone says “That was a good action, because it was caring,” or “That was bad action, because it was cruel” they are clearly intending goodness or badness in a distinctly ethical sense.

By contrast, non-moral value judgments typically say that something is good (or bad) simply for the kind of thing it is; or that some action is right or wrong, given the practical goal or purpose that one has in mind. “That’s a good car” or “That’s a bad bike” would not be considered to moral judgments about those objects. Goodness and badness here are still value judgments, but value judgments that likely track features like comfort, styling, reliability, safety and mileage ratings, etc.

The use of “should” or “ought to” for non-moral value judgments is also easy to recognize. “You ought to enroll early” or “You made the right decision to go to Radford” are value-judgments, but no one would say they are ethical judgments. They reflect a concern with wholly practical aims rather than ethical ones and with the best way to attain those practical aims.

8. What are ethical arguments?

Ethical arguments are another important aspect of ethical analysis. Ethical arguments are arguments whose conclusion makes an ethical judgment. Ethical arguments are most typically arguments that try to show a certain policy or behavior to be either ethical or unethical. Suppose you want to argue that “The death penalty is unjust (or just) punishment” for a certain range of violent crimes. Here we have an ethical judgment, and one that with a bit more detail could serve as the thesis of a position paper on the death penalty debate.

An ethical judgment rises above mere opinion and becomes the conclusion of an ethical argument when you support it with ethical reasoning. You must say why you hold the death penalty to be ethically right or wrong, just or unjust. For instance, you might argue that it is unjust because of one or more of the reasons below:

• It is cruel, and cruel actions are wrong.
• Two wrongs don’t make a right.
• It disrespects human life.
• In some states the penalty falls unevenly on members of a racial group.
• The penalty sometimes results in the execution of innocent people.

Of course you could also give reasons to support the view that the death penalty is a just punishment for certain crimes. The point is that whichever side of the debate you take, your ethical argument should develop ethical reasons and principles rather than economic or other practical but non-moral concerns. To argue merely that the death penalty be abolished because that would save us all money is a possible policy-position, but it is essentially an economic argument rather than an ethical argument.

9. How can I best frame an ethical issue?

In analyzing any ethically problematic situation or issue, developing a clear statement of the problem is often half the battle. You should state what the problem is, proceed to identify the most reasonable responses to it, and compare those alternative responses. If you improperly describe an ethical problem, you have little chance of successfully resolving it. We will later look at some examples of how to clarify and describe an ethical issue, utilizing ethical theories and principles. We will also see how “stakeholder analysis” works as an approach to ethical analysis. For now, one important distinction should be introduced between two kinds of moral problems, ethical conflicts and ethical dilemmas .

10. What is an ethical conflict?

Sometimes it can seem as if there is a clash between what we ‘ought to do’ and what we ‘want to do’ (perhaps what we think will make us happy). An ethical conflict is a term for that situation in which tension arises between a clearly ethical consideration (for example, abiding by a professional code of conduct) and personal desires (fame, fortune, or other forms of self-interest). Philosophers tend to think that in such cases, ethical considerations should always trump personal or self-interested ones and that to resist following one’s personal desires is a matter of having the right moral motivation—the motivation to do the right thing—and of having strength of will to repel temptation.

11. What is an ethical dilemma?

An ethical dilemma is a term for a situation in which a person faces an ethically problematic situation and is not sure of what she ought to do. Those who experience ethical dilemmas feel themselves being pulled by competing ethical demands and perhaps feel that they will be blameworthy or experience guilt no matter what course of action they take. The philosopher Jean-Paul Sartre gives the example of a young Frenchman of military age during the wartime Nazi occupation who finds himself faced, through no fault of his own, with the choice of staying home and caring for his ailing mother or going off to join the resistance to fight for his country’s future:

He fully realized that this woman lived only for him and that his disappearance – or perhaps his death – would plunge her into despair…. Consequently, he found himself confronted by two very different modes of action; the one concrete, immediate, but directed towards only one individual; and the other an action addressed to an end infinitely greater, a national collectivity, but for that very reason ambiguous – and it might be frustrated on the way. (Sartre, 1977)

12. What does it mean to “take responsibility” in conflict or dilemma situations?

The ethical dilemma described above hinges on a tension between a more “particular” obligation or duty to a dependent and a family member, and the more “universal” obligation of the able-bodied to serve their country to defend it against military aggression. The philosopher Sartre describes the young man as “hesitating between two kinds of morality; on the one side the morality of sympathy, of personal devotion and, on the other side, a morality of wider scope but of more debatable validity. He had to choose between those two. What could help him to choose?”

While we must always weigh special obligations we may have to family and friends with obligations to a wider community of persons, ethical dilemmas like this are, thankfully, pretty rare.  But literature and film are full of ethical conflicts and dilemmas, as they allow us to reflect on the human struggle as well as presenting tests of individual character. For example in World War Z, Gerry Lane (played by Brad Pitt in the movie version) has to make a similar choice as Sartre’s Frenchman: between serving the world-community of humans in their just war against Zombies, and serving his own immediate family. It adds depth and substance to the character to see him struggling with this choice over the right thing to do.

13. What biases may affect critical reflection on an ethical issue?

Some of the biases that affect critical reflection on an ethical issue are the same as those that affect reflection on any issue. They include

• the bandwagon effect—if many people make a particular choice, you may unconsciously gravitate toward that choice and fail to examine the rationale for it as critically as you should,
• belief bias—if from the outset you agree with the choice a person has made, you may be unable to examine the rationale for her choice as critically as you should,
• in-group bias—if you identify with a group, you may have difficulty acknowledging the ethical claims of people with whom you do not sympathize (or perhaps are even hostile toward), and
• obedience to authority—if you greatly respect someone (or some institution), you may find it difficult to question that person’s or that institution’s choices.

All of the above are cognitive biases . That is, they are ways of responding that are built into our brains and that we will engage in unless we become conscious of the way they may influence decision-making. In addition to these cognitive biases, you may have a philosophical bias. That is, you may be applying an ethical yardstick to an issue without being aware that there are other yardsticks. Several different ethical theories may be used to judge the “rightness” and “wrongness” of people’s choices. You may have never studied these theories, but you may have unconsciously adopted a rough-and-ready version of one. Among these theories are

• utilitarian ethics—an action is right or wrong depending upon its consequences,
• duty-based ethics—certain actions are by their nature (or by definition) good, and each individual should perform those actions and avoid actions that are by their nature (or by definition) bad.
• rights-based ethics—each individual has a right not to be harmed; at the same time, each individual has a duty not to cause harm to others, and
• virtue-based ethics—certain traits are virtuous, and each individual should aspire to develop those traits in order to behave in a way that is consistent with them.

If you are unknowingly following applying a simple version of an ethical theory, without first critically examining it and considering competing theories, then you are entering into the conversation with a bias.

14. How does self-interest affect people’s ethical choices?

In a perfect world, morality and happiness would always align: living ethically and living well wouldn’t collide because living virtuously—being honest, trustworthy, caring, etc.—would provide the deepest human happiness and would best allow humans to flourish. Some would say, however, that we do not live in a perfect world, and that our society entices us to think of happiness in terms of status and material possessions at the cost of principles. Some even claim that all persons act exclusively out of self-interest —that is, out of psychological egoism —and that genuine concern for the well-being of others— altruism —is impossible. As you explore an ethical issue, consider whether people making choices within the context of the issue are acting altruistically or out of self-interest.

15. What is the difference between good ethical reasoning and mere rationalization?

When pressed to justify their choices, people may try to evade responsibility and to justify decisions that may be unethical but that serve their self-interest. People are amazingly good at passing the buck in this fashion, yet pretty poor at recognizing and admitting that they are doing so. When a person is said to be rationalizing his actions and choices, this doesn’t mean he is applying critical thinking, or what we have described as ethical analysis. Quite the opposite: it means that he is trying to convince others—or often just himself—using reasons that he should be able to recognize as faulty or poor reasons. Perhaps the most common rationalization of unethical action has come to be called the Nuremberg Defense: ‘I was just doing what I was told to do—following orders or the example of my superior. So blame them and exonerate me.’ This defense was used by Nazi officials during the Nuremberg trials after World War II in order to rationalize behavior such as participation in the administration of concentration camps. This rationalization didn’t work then, and it doesn’t work now.

16. What kinds of rationalizations do people make for their actions?

Rationalization is a common human coping strategy. In addition to the Nuremberg Defense, some common rationalizations about ethical conduct or decisions are that it is not unethical if

• no law was broken,
• others do the same thing,
• I didn’t mean to hurt anyone,
• they ‘had it coming’ (the two-wrongs-make-a-right fallacy), and
• it ‘would have happened to them anyway, sooner or later’.

17.  What fallacies are most prevalent in debates over ethical issues?

In addition to self-deception and rationalizations, we often find overtly fallacious reasoning that undermines open, constructive debate of ethical issues. Of the common fallacies described in CORE 201 , those most common in ethics debate include ad hominem (personal) attacks, appeals to false authority, appeals to fear, the slippery slope fallacy, false dilemmas , the two-wrongs-make-a-right fallacy, and the strawman fallacy . Fallacious reasoning, especially the attempt to sway sentiment through language manipulation, is ever-present in popular sources of information and opinion pieces, like blogs and special-interest-group sites. It may take practice to spot fallacious reasoning, but being able to give names to these strategies of trickery and manipulation provides the aspiring critical thinker with a solid start.

Objective II. Utilize reasons and arguments appropriate to debate over an ethical issue.

To discuss ethical decision-making, you need to consider different ethical theories and what they imply. Without a systematic look at these theories, you may have a sense of what is right and wrong, but you won’t possess the language or the concepts necessary to carefully analyze an ethical issue. You also will be unable to explain to an audience how you went about evaluating whether people were making ethical choices.

To help you evaluate ethical issues, this section of the Handbook surveys broad approaches to ethics. In addition, it looks at several of the most widely discussed ethical theories.

The specific questions that this section answers are

• What are ethical theories?
• What is hard universalism?
• What is the main weakness of hard universalism?
• What is moral relativism?
• What is the main weakness of moral relativism?
• Is there a middle ground between hard universalism and relativism?
• What is deontology?
• What two requirements are built into deontology?
• How is deontology applied?
• What is duty-based ethics?
• What is rights-based ethics?
• What is the main weakness of duty and rights-based ethics?
• What is utilitarianism?
• How does utilitarian reasoning operate?
• How has utilitarian reasoning been applied?
• What is the main weakness of utilitarianism?
• What is virtue ethics?
• How does virtue ethics operate?
• What kinds of questions are asked by virtue ethics?
• What is the main weakness of virtue ethics?
• How do these theories fit into my ethics toolbox?

  1.  What are ethical theories?  

Ethical theories describe the rules or principles that guide people when the rightness or wrongness of an action becomes an issue. Sometimes ethical theories are called “normative.” You may recognize the word “norm” tucked inside “normative.” A normative ethical theory establishes the standards—the norms—that people apply in deciding how to act.

You will be reading about several very important ways of approaching ethics. One approach is called hard universalism and the other is called moral relativism .

You also will learn about several frequently-discussed ethical theories, such utilitarianism , duty-based ethics , rights-based ethics, and virtue ethics. By learning about these ethical theories, you will be able to evaluate complex ethical issues from different perspectives.

2. What is hard universalism?

Imagine that there is one never-changing and universal set of standard for deciding whether an action is ethical. That approach to judging behavior is called hard universalism . A person who follows this approach believes that guidelines for judging behavior are not affected by time and culture. What is right is always right, and what is wrong is always wrong—without exception and everywhere in the world.

One example of hard universalism is the belief that moral principles are handed down as divine commands: a god (or group of gods) gives humans a set of guidelines to live by. According to this view, the wrongness of murder and the rightness of loving one’s neighbor are timeless moral truths, backed up by the authority of a sacred text or a religious authority.

Two of the best-known ethical theories, utilitarianism and duty-based ethics , are considered to be hard-universalist theories.

3. What is the main weakness of hard universalism?

Philosophers have questioned the idea that rules handed down by gods determine what is good or right. What if the gods (or different religious scriptures or traditions) disagree? How can such disagreements be settled if different gods ‘throw their weight’ behind competing ethical guidelines?

Some philosophers argue that any system of hard universalism should be based on reason rather than religious authority. Yet hard universalism based on philosophical reasoning seems to share the weakness of divine command universalism because philosophers also offer different accounts of what makes actions right or wrong. If two different philosophers back the notion that there are timeless and universal truths, but each comes up with different timeless and universal truths, how are the differences to be sorted out?

4. What is moral relativism?

Moral relativism rejects the view that there are universal and never-changing ethical standards that can always be used to judge whether actions are right and wrong. Instead, a moral relativist might argue that ethical judgments are made within the context of a culture and time period. People in one culture or time period may judge an action to be ethical; people in another culture or time period may judge the same action to be unethical.

Some moral relativists even reject the notion that cultures determine what is right and wrong. Instead, these moral relativists argue that each individual must develop his or her own standards for determining what is ethical. These standards might be based on reason or on intuition, something like a ‘gut feeling’ that an action is ethical.

People may be drawn to moral relativism because it appears to be a tolerant view. They may feel that adopting moral relativism will eliminate the conflicts that may arise between people and cultures that reach different conclusions about what is right or wrong.

5. What is the main weakness of moral relativism?

Moral relativism may be embraced by people who value tolerance. However, you could argue that a moral relativist who treats tolerance as something that is unquestionably good has actually abandoned moral relativism. Critics of moral relativism sometimes ask this question: Is it logically possible to be a moral relativist and to simultaneously behave as if tolerance is a universal value.

Another apparent contradiction may arise when an individual’s (or culture’s) right to decide what is ethical runs up against another individual’s (or culture’s) right to do the same. This paradox can be illustrated by looking at   The Universal Declaration of Human Rights . This document was approved by the United Nations after World War II. Near its beginning, it states that “All human beings are born free and equal in dignity and rights.” With this statement as a starting point, a number of principles follow: a universal right to be safe from enslavement, for example, or a universal right to education regardless of gender.

Taken as a whole, the Declaration argues that people have autonomy: the freedom to act in their own interests.

However, if what is right is whatevera culture determines to be right, then slavery is ethical in a slave-owning society or household. If what is right is whatever an individual determines to be right, then denying a girl access to education is ethical in a household whose head believes it is inappropriate for girls to be educated.

On the one hand, then, moral relativism does not impose value systems on people. On the other hand, it seems to grant humans autonomy—the freedom to act in one’s own interest—to people who would deny that autonomy to other people.

6.  Is there a middle ground between hard universalism and moral relativism?

Most philosophers are neither hard universalists nor moral relativists . Between these two views are various sorts of soft universalist theories.

Soft universalists recognize that values and customs do vary across cultures but argue that some values may be universal. For example, standards for determining well-being cut across cultural boundaries: universally, people desire to live and to be happy. Similarly, nearly all ethical traditions embrace a version of the “Golden Rule” that calls for treating others as you would like to be treated. Worldwide, almost all cultures believe that compassion, caring, and honesty are ethical virtues and that cruelty, insensitivity to suffering, and dishonesty are vices.

Soft universalists claim that they can endorse universal human rights as principles that all societies should respect and aspire to. They also may argue that genuine injustices in the world can and should be eliminated. For example, an advocate of soft universalism may maintain that elimination of slavery constitutes genuine moral progress.

7.  What is deontology?

Under hard-universalism, one approach to ethics is called deontology . This approach relies upon three principles for determining whether behavior was ethical.

First, ethical duties and the motivation to fulfill those duties should always outweigh competing motivations and desires.

Second, certain kinds of actions, like lying, are always wrong—for example, no situation justifies lying.

Third, a single, unarguable principle of reason exists that we can use to determine what our ethical duties are. Because this principle is unquestionable or undebatable, it is called self-evident .

Categorical imperative is the name for this single, self-evident principle. The name is meant to communicate the idea that this principle must be applied without any exceptions.

8.  What two requirements are built into deontology?

Although the categorical imperative is described as being a “single” principle, it actually includes two requirements that must be met for behavior to be ethical.

One requirement is that you treat people as if they are valuable for their own sakes. This means that you must treat people as having dignity or worth in their own right, rather than evaluating (and treating them) according to what use may be made of them.

Sometimes this requirement is stated this way: Treat people as an end in themselves and never merely as a means to an end.

The second requirement is that you should always behave the way you wish everyone else would behave, an idea captured in the “Golden Rule” that you should treat others as you would like to be treated. Imagine that you are deciding whether to commit an act. You realize that you would not want anyone else to commit that act. Applying this second requirement, you must choose a different course of action if you wish to behave ethically.

Following the second requirement generates standards for behavior that apply to all people at all times. That fact means that you can consider to deontology to be a kind of universalism .

9.  How is deontology applied?

Here are two examples that show how deontology is applied.

According to the Golden Rule, you should “Do unto others as you would have them do unto you.”

Applying the Categorical Imperative, this rule is ethical. It respects the dignity and worth of others, and it is universal in its application.

It is no longer convenient to honor this contract, so I will break it.

Applying the Categorical Imperative, this behavior is unethical. You are not respecting the dignity or worth of people that you have made promises to.

In addition, breaking a contract is a behavior that cannot be universalized. You may benefit from making yourself an exception to the principles of honoring contracts and speaking truthfully, but if everyone acted in this way, no one (including yourself) could rely on the commitments that people make when they sign contracts. A world where you cannot rely on people’s promises is probably not a world where you would wish to live.

As the two examples demonstrate, deontology treats everyone equally and embraces justice as an absolute goal.

Deontology often is seen as an overarching ethical theory that encompasses duty ethics and rights-based ethics ; these theories are described below.

10. What is duty-based ethics?

Duty-based ethics maintains that you should follow an ethical code without considering the consequences of your actions. If an act is by its nature right, you should perform that act even if someone is harmed as a result. If an act is by its nature wrong, you should not perform that act even if someone might be helped. For example, if by definition stealing is wrong, you do not steal. If by definition lying is wrong, you do not lie.

The actions taken in the two scenarios below may benefit people who need help but would be wrong according to a strict application of duty-based ethics:

Your city has been hit by a hurricane that suddenly strengthened from a Category 1 to a Category 3 and took an unexpected path. No one was properly prepared. A storm surge has flooded the streets, and the electric system has failed. It will take several days to reopen roads and restore power. Your family includes young children. You run out of food and water. Stores have not yet reopened. You break into a store and take food and bottled water.

Duty violated: Stealing by its nature is wrong because you have a duty to respect the property rights of others.

Your recently-hired assistant has left an abusive relationship. She has rented an apartment without leaving any forwarding information at her previous address, she has changed her number to an unlisted one, and she has avoided mentioning her new place of employment on any form of social media. Somehow her former boyfriend has found out where she is working. He shows up and demands to see her. You tell him that no one of that name is working for you.

Duty violated: Lying by its nature is wrong because you have a duty to tell the truth.

A duty-based ethical system falls into the category of hard universalism: an ethical yardstick must be applied universally—for all people and at all times.

The duties themselves may be tied to professional roles, too. Teachers have a duty to grade students fairly; police officers have a duty to enforce the law; psychologists have a duty to respect the confidentiality of their patients. When you encounter codes of professional conduct—either written or unwritten—likely you are dealing with duty-based ethics.

11.  What is rights-based ethics?

A right is something you are entitled to. In terms of ethics, it is the treatment you should be able to expect from other people. For example, under most ethical codes, as a human you are entitled—have a right—to exist in safety.

Another way of stating this idea is that you have a right not be harmed by anyone. When the idea is put that way, it is apparent that duties and rights are closely related concepts. You have a right to exist in safety, which means that other people have a duty not to harm you.

Since duties and rights are so closely related, a version of a duty-based ethics can be created by identifying the rights that someone has a duty to respect.

Rights-based ethics are built upon four claims. Rights are

• “ natural insofar as they are not invented or created by governments,”
• “ universal insofar as they do not change from country to country,”
• “ equal in the sense that rights are the same for all people, irrespective of gender, race, or handicap,” and
• “ inalienable which means that I cannot hand over my rights to another person, such as by selling myself into slavery.” ( Fieser, n.d. )

A noteworthy example of an argument grounded in rights-based ethics is found in the Declaration of Independence , where Thomas Jefferson states that humans are “endowed by their Creator with certain unalienable rights, that among these are Life, Liberty and the pursuit of Happiness.” By drawing attention to these rights , Jefferson provides the context for a lengthy list of the ways in which George III had not fulfilled his duty to uphold these rights.

12.  What is the main weakness of duty and rights-based ethics?

Both duty and rights-based ethics are forms of universalism because they rely on principles that must be applied at all times to all people. Some people object that the universalism of duty and rights-based ethics make these theories too inflexible.

In the case of duty-based ethics, people may object to the principle that people deciding on a course of action should ignore the circumstances in which they and other individuals find themselves. Duty ethics allows little room for context. In Les Misérables, was Jean Valjean wrong to steal bread to feed his starving sister’s children? Would it have been wrong to lie to a Gestapo officer asking where Jews were hidden or to slave-catchers in pursuit of runaways in the pre-war South? Some would say that the answers depend upon the circumstances and options available to us, rather than on it being the case that certain types of actions are always and necessarily wrong.

Duty-based ethics accepts as a principle that one should never use another person merely as a means to someone else’s ends. So it would never be justified to cause the death of one to save several. But is that action always wrong, as a duty ethicist would argue? Societies regularly sacrifice individuals. For example, people are drafted into armies and regularly sent into battle, even though it is certain that some of them will die. Is it ethical for a government to draft people and send them into harm’s way? Is this a case of treating a person as a means to an end?

We have seen that duty and rights-based ethics are ‘flip sides’ of the same coin. One theory emphasizes how people should behave toward each another; the other emphasizes that an individual should be confident that her human rights will be acknowledged and respected. So the above example could be rewritten from the perspective of the rights-based approach. A person has a right to be respected on her own account rather than treated as a means to an end, yet we see that societies regularly sacrifice their members. The universalism of rights-based ethics does not appear to allow for this societal choice.

13.  What is utilitarianism?

The utilitarian theory is one of the best-known ethical theories.

The utilitarian theoryis another form of universalism . It is based on a principle that applies to all people at all times. Unlike duty-based ethics, however, utilitarianism does not allow people to label categoriesof actions—like lying or stealing—as always wrong.

Instead, utilitarianism is based on the idea that an action is right or wrong depending on its consequences . To determine whether an action is ethical, utilitarianism applies something called the utilitarian principle. This principle claims that an action is right if, as a whole, it brings about the greatest happiness and the least amount of pain or unhappiness. If two actions are being compared, the one that should be chosen—the ethical one—would be the action that secures the maximum possible happiness for the greatest number of people. For this reason, the utilitarian principle is also called the greatest-happiness principle.

14.  How does utilitarian reasoning operate?

Early utilitarian thinkers sought to ‘scientize’ ethical decision-making. They developed a ‘calculus’ comparable to a modern cost/benefit analysis. This calculus weighed the consequences of an action in terms of its impact on all the sentient beings that might be affected. Sentient beings feel pain or pleasure, so the calculus could consider the effect an action might have on animals as well as humans.

The calculus took into account several factors, such as

■    the number of humans and animals that would benefit

■    the number of humans and animals that would be harmed

■    how intense any resulting pleasure would be

■    how long any resulting pleasure might last

■    how intense any resulting pain would be

■    how long any resulting pain might last

While such a calculus for resolving ethical problems may seem idealized, utilitarian thinking coincided with a genuine desire to eliminate unnecessary suffering through seeking to answer the question, “Which option will serve the greater good?”

15.  How has utilitarian reasoning been applied?

Utilitarian thinking led to many reforms. It helped bring an end to the mistreatment of animals, orphans and child laborers, as well as to the harsh treatment of adult laborers, prisoners, the poor, and the mentally ill. It provided arguments for abolishing slavery and for eliminating inequalities between the sexes. For John Stuart Mill, one of the founders of the theory, both logic and morality dictated that one person’s happiness should count as much as another person’s happiness. This principle was applied to people whether they were wealthy or poor, powerful or weak.

Today few people think an ethical calculus can tell us exactly how competing interests should be weighed. But the more general utilitarian approach to ethical reasoning is still immensely influential. The principle that each person’s happiness should be as important as any other person’s happiness requires a society to make decisions in which the interests of all its members are considered in a balanced, rational fashion.

16.  What is the main weakness of utilitarianism?

The utilitarian principle says that people should act to promote overall happiness, but this principle appears to justify using people in ways that do not respect the idea that individual rights may not be violated. That is, the utilitarian approach seems to imply that it would be ethical to inflict pain on one person if that action results in a net increase in happiness.

Here is a classic question that is posed to expose this potential weakness in the utilitarian approach to ethical reasoning: Why not kill and harvest the organs of one healthy person in order to save five patients who will go on to live happy lives?

The philosopher William James argued that it would be a “hideous…thing” if “millions [were] kept permanently happy on the one simple condition that a certain lost soul on the far-off edge of things should lead a life of lonely torture,” but that situation would seem consistent with utilitarianism (James, 1891, n.p.).

James’s scenario inspired a short story by Ursula Le Guin, “Those Who Walk Away from Omelas,” in which the happiness of a society depends upon the suffering of one child. Some members of this society are unable to live with this fact and “walk away from Omelas.”

Utilitarian’s emphasis on consequences can also be a weakness. That emphasis can lead to “all’s well that ends well” thinking, allowing people to justify immoral acts if the outcome is beneficial. One must also ask, can we ever be sure of the consequences of our actions? If we take an action that we expected would have good consequences, but it ends up harming people, have we behaved unethically regardless of our intentions?

17.  What is virtue ethics?

Thinkers who embrace virtue ethics emphasize that the sort of person we choose to be constitutes the heart of our ethical being. If you want to behave virtuously, become a virtuous person.

Certain traits—for instance, honesty, compassion, generosity, courage—seem to be universally admired. These strengths of character are virtues. To acquire these virtues, follow the example of persons who possess them. Once acquired, these virtues may be trusted to guide our decisions about how to act, even in difficult situations.

18.  How does virtue ethics operate?

Virtue ethicists think that the main question in ethical reasoning should be not “How should I now act?” but “What kind of person do I want to be?” Developing virtues that we admire in others and avoiding actions that we recognize as vicious develops our moral sensitivity: our awareness of how our actions affect others. Virtuous persons are able to empathize, to imagine themselves in another person’s shoes, and to look at an issue from other people’s perspectives.

Virtuous individuals are also thought to be able to draw upon willpower not possessed by those who compromise their moral principles in favor of fame, money, sex, or power.

19.  What kinds of questions are asked by virtue ethics?

Virtue ethics focuses more on a person’s approach to living than on particular choices and actions and so has less to say about specific courses of action or public policies. Instead, this ethical approach posed broader questions such as these:

• How should I live?
• What is the good life?
• Are ethical virtue and genuine happiness compatible?
• What are proper family, civic, and cosmopolitan virtues?

Because of the broad nature of the questions posed by virtue ethics, ethicists sometimes disagree as to whether this theory actually offers an alternative to the utilitarian and deontological approaches to ethical reasoning. How does someone who follows virtue ethics determine what the virtues are without applying some yardstick such as those provided by utilitarian and deontological ethics?

Utilitarianism and deontology are hard-universalist theories, each claiming that there is one ethical principle that is binding on all people regardless of time or place. Virtue ethics does not make this claim. Those who favor this theory may hold that there are certain virtues like compassion, honesty, and integrity that transcend time and culture. But they do not aim to identify universal principles that can be applied in all moral situations. Instead they accept that many things described as virtues and vices are cultural and that some of our primary ethical obligations are based on our emotional relationships and what we owe to people we care about. In the end, though, virtue ethicists will always ask themselves, “What would a good person do?”

20.  What is the main weakness of virtue ethics?

Virtue ethics may seem to avoid some of the apparent flaws of duty-based ethics and of utilitarianism. A person guided by virtue ethics would not be bound by strict rules or the duty to abide by a state’s legal code. Presumably, then, an individual who has cultivated a compassionate personality consistent with virtue ethics would not easily surrender a friend’s hiding place in order to avoid having to tell a lie, as would seem to be required by duty ethics. Nor would a person guided by virtue ethics be bound by the ‘tyranny of the (happy) majority’ that appears to be an aspect of utilitarianism.

On the other hand, some thinkers argue that virtue ethics provides vague and ambiguous advice. Because of its emphasis on the imprecise and highly contextual nature of ethics, virtue ethics is often criticized as insufficient as a guide to taking specific action.

21.  How do these theories fit into my ethics toolbox?

The ethical theories described in this section are powerful tools that should be included in a critical thinker’s ‘ethics toolbox’. Perspectives rooted on ethical theories often play very direct roles in ethical analysis. In addition, such perspectives can help you develop you own ethics-based arguments. Equip your ethics toolbox with all of these tools: your ethical intuitions and sense your conscience; your awareness of cultural traditions; and the insights you can gained from psychological studies and philosophical theories. These tools allow people with even opposing perspectives on today’s ethical issues to debate each other courteously and skillfully.

 References

Bentham, J. (1776). A fragment on government . London: T. Payne. http://books.google.com/books?id=epMIAAAAQAAJ&printsec=frontcover&dq=a+fragment+on+government&hl=en&sa=X&ei=zRLwUpmaFqTksATdtoDQDg&ved=0CEMQ6AEwAQ#v=onepage&q=a%20fragment%20on%20government&f=false

Fieser, J. (n.d.). Ethics. Internet encyclopedia of philosophy. Ed. J. Fieser & B. Dowden. http://www.iep.utm.edu/ethics

James, W. (1891). The moral philosopher and the moral life: An address to the Yale Philosophical Club, published in the International Journal of Ethics , April 1891. http://www.philosophy.uncc.edu/mleldrid/American/mp&ml.htm

Le Guin, U. (1975) Those who walk away from Omelas. The wind’s twelve quarters . New York, NY: Harper Perennial.

Sartre, J.P. (1977). Existentialism and humanism , trans. Philip Mairet. Brooklyn, NY: Haskel House, 35-36.

This work ( Radford University Core Handbook by Radford University) is free of known copyright restrictions.

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Thinking Ethically

• Markkula Center for Applied Ethics
• Ethics Resources
• Ethical Decision Making

Moral issues greet us each morning in the newspaper, confront us in the memos on our desks, nag us from our children's soccer fields, and bid us good night on the evening news. We are bombarded daily with questions about the justice of our foreign policy, the morality of medical technologies that can prolong our lives, the rights of the homeless, the fairness of our children's teachers to the diverse students in their classrooms.

Dealing with these moral issues is often perplexing. How, exactly, should we think through an ethical issue? What questions should we ask? What factors should we consider?

The first step in analyzing moral issues is obvious but not always easy: Get the facts. Some moral issues create controversies simply because we do not bother to check the facts. This first step, although obvious, is also among the most important and the most frequently overlooked.

But having the facts is not enough. Facts by themselves only tell us what is ; they do not tell us what ought to be. In addition to getting the facts, resolving an ethical issue also requires an appeal to values. Philosophers have developed five different approaches to values to deal with moral issues.

The Utilitarian Approach Utilitarianism was conceived in the 19th century by Jeremy Bentham and John Stuart Mill to help legislators determine which laws were morally best. Both Bentham and Mill suggested that ethical actions are those that provide the greatest balance of good over evil.

To analyze an issue using the utilitarian approach, we first identify the various courses of action available to us. Second, we ask who will be affected by each action and what benefits or harms will be derived from each. And third, we choose the action that will produce the greatest benefits and the least harm. The ethical action is the one that provides the greatest good for the greatest number.

The Rights Approach The second important approach to ethics has its roots in the philosophy of the 18th-century thinker Immanuel Kant and others like him, who focused on the individual's right to choose for herself or himself. According to these philosophers, what makes human beings different from mere things is that people have dignity based on their ability to choose freely what they will do with their lives, and they have a fundamental moral right to have these choices respected. People are not objects to be manipulated; it is a violation of human dignity to use people in ways they do not freely choose.

Of course, many different, but related, rights exist besides this basic one. These other rights (an incomplete list below) can be thought of as different aspects of the basic right to be treated as we choose.

The right to the truth: We have a right to be told the truth and to be informed about matters that significantly affect our choices.

The right of privacy: We have the right to do, believe, and say whatever we choose in our personal lives so long as we do not violate the rights of others.

The right not to be injured: We have the right not to be harmed or injured unless we freely and knowingly do something to deserve punishment or we freely and knowingly choose to risk such injuries.

The right to what is agreed: We have a right to what has been promised by those with whom we have freely entered into a contract or agreement.

In deciding whether an action is moral or immoral using this second approach, then, we must ask, Does the action respect the moral rights of everyone? Actions are wrong to the extent that they violate the rights of individuals; the more serious the violation, the more wrongful the action.

The Fairness or Justice Approach The fairness or justice approach to ethics has its roots in the teachings of the ancient Greek philosopher Aristotle, who said that "equals should be treated equally and unequals unequally." The basic moral question in this approach is: How fair is an action? Does it treat everyone in the same way, or does it show favoritism and discrimination?

Favoritism gives benefits to some people without a justifiable reason for singling them out; discrimination imposes burdens on people who are no different from those on whom burdens are not imposed. Both favoritism and discrimination are unjust and wrong.

The Common-Good Approach This approach to ethics assumes a society comprising individuals whose own good is inextricably linked to the good of the community. Community members are bound by the pursuit of common values and goals.

The common good is a notion that originated more than 2,000 years ago in the writings of Plato, Aristotle, and Cicero. More recently, contemporary ethicist John Rawls defined the common good as "certain general conditions that are...equally to everyone's advantage."

In this approach, we focus on ensuring that the social policies, social systems, institutions, and environments on which we depend are beneficial to all. Examples of goods common to all include affordable health care, effective public safety, peace among nations, a just legal system, and an unpolluted environment.

Appeals to the common good urge us to view ourselves as members of the same community, reflecting on broad questions concerning the kind of society we want to become and how we are to achieve that society. While respecting and valuing the freedom of individuals to pursue their own goals, the common-good approach challenges us also to recognize and further those goals we share in common.

The Virtue Approach The virtue approach to ethics assumes that there are certain ideals toward which we should strive, which provide for the full development of our humanity. These ideals are discovered through thoughtful reflection on what kind of people we have the potential to become.

Virtues are attitudes or character traits that enable us to be and to act in ways that develop our highest potential. They enable us to pursue the ideals we have adopted. Honesty, courage, compassion, generosity, fidelity, integrity, fairness, self-control, and prudence are all examples of virtues.

Virtues are like habits; that is, once acquired, they become characteristic of a person. Moreover, a person who has developed virtues will be naturally disposed to act in ways consistent with moral principles. The virtuous person is the ethical person.

In dealing with an ethical problem using the virtue approach, we might ask, What kind of person should I be? What will promote the development of character within myself and my community?

Ethical Problem Solving These five approaches suggest that once we have ascertained the facts, we should ask ourselves five questions when trying to resolve a moral issue:

What benefits and what harms will each course of action produce, and which alternative will lead to the best overall consequences?

What moral rights do the affected parties have, and which course of action best respects those rights?

Which course of action treats everyone the same, except where there is a morally justifiable reason not to, and does not show favoritism or discrimination?

Which course of action advances the common good?

Which course of action develops moral virtues?

This method, of course, does not provide an automatic solution to moral problems. It is not meant to. The method is merely meant to help identify most of the important ethical considerations. In the end, we must deliberate on moral issues for ourselves, keeping a careful eye on both the facts and on the ethical considerations involved.

This article updates several previous pieces from Issues in Ethics by Manuel Velasquez - Dirksen Professor of Business Ethics at Santa Clara University and former Center director - and Claire Andre, associate Center director. "Thinking Ethically" is based on a framework developed by the authors in collaboration with Center Director Thomas Shanks, S.J., Presidential Professor of Ethics and the Common Good Michael J. Meyer, and others. The framework is used as the basis for many programs and presentations at the Markkula Center for Applied Ethics.

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Critical Thinking

Critical thinking is a widely accepted educational goal. Its definition is contested, but the competing definitions can be understood as differing conceptions of the same basic concept: careful thinking directed to a goal. Conceptions differ with respect to the scope of such thinking, the type of goal, the criteria and norms for thinking carefully, and the thinking components on which they focus. Its adoption as an educational goal has been recommended on the basis of respect for students’ autonomy and preparing students for success in life and for democratic citizenship. “Critical thinkers” have the dispositions and abilities that lead them to think critically when appropriate. The abilities can be identified directly; the dispositions indirectly, by considering what factors contribute to or impede exercise of the abilities. Standardized tests have been developed to assess the degree to which a person possesses such dispositions and abilities. Educational intervention has been shown experimentally to improve them, particularly when it includes dialogue, anchored instruction, and mentoring. Controversies have arisen over the generalizability of critical thinking across domains, over alleged bias in critical thinking theories and instruction, and over the relationship of critical thinking to other types of thinking.

2.1 Dewey’s Three Main Examples

2.2 dewey’s other examples, 2.3 further examples, 2.4 non-examples, 3. the definition of critical thinking, 4. its value, 5. the process of thinking critically, 6. components of the process, 7. contributory dispositions and abilities, 8.1 initiating dispositions, 8.2 internal dispositions, 9. critical thinking abilities, 10. required knowledge, 11. educational methods, 12.1 the generalizability of critical thinking, 12.2 bias in critical thinking theory and pedagogy, 12.3 relationship of critical thinking to other types of thinking, other internet resources, related entries.

Use of the term ‘critical thinking’ to describe an educational goal goes back to the American philosopher John Dewey (1910), who more commonly called it ‘reflective thinking’. He defined it as

active, persistent and careful consideration of any belief or supposed form of knowledge in the light of the grounds that support it, and the further conclusions to which it tends. (Dewey 1910: 6; 1933: 9)

and identified a habit of such consideration with a scientific attitude of mind. His lengthy quotations of Francis Bacon, John Locke, and John Stuart Mill indicate that he was not the first person to propose development of a scientific attitude of mind as an educational goal.

In the 1930s, many of the schools that participated in the Eight-Year Study of the Progressive Education Association (Aikin 1942) adopted critical thinking as an educational goal, for whose achievement the study’s Evaluation Staff developed tests (Smith, Tyler, & Evaluation Staff 1942). Glaser (1941) showed experimentally that it was possible to improve the critical thinking of high school students. Bloom’s influential taxonomy of cognitive educational objectives (Bloom et al. 1956) incorporated critical thinking abilities. Ennis (1962) proposed 12 aspects of critical thinking as a basis for research on the teaching and evaluation of critical thinking ability.

Since 1980, an annual international conference in California on critical thinking and educational reform has attracted tens of thousands of educators from all levels of education and from many parts of the world. Also since 1980, the state university system in California has required all undergraduate students to take a critical thinking course. Since 1983, the Association for Informal Logic and Critical Thinking has sponsored sessions in conjunction with the divisional meetings of the American Philosophical Association (APA). In 1987, the APA’s Committee on Pre-College Philosophy commissioned a consensus statement on critical thinking for purposes of educational assessment and instruction (Facione 1990a). Researchers have developed standardized tests of critical thinking abilities and dispositions; for details, see the Supplement on Assessment . Educational jurisdictions around the world now include critical thinking in guidelines for curriculum and assessment.

For details on this history, see the Supplement on History .

2. Examples and Non-Examples

Before considering the definition of critical thinking, it will be helpful to have in mind some examples of critical thinking, as well as some examples of kinds of thinking that would apparently not count as critical thinking.

Dewey (1910: 68–71; 1933: 91–94) takes as paradigms of reflective thinking three class papers of students in which they describe their thinking. The examples range from the everyday to the scientific.

Transit : “The other day, when I was down town on 16th Street, a clock caught my eye. I saw that the hands pointed to 12:20. This suggested that I had an engagement at 124th Street, at one o’clock. I reasoned that as it had taken me an hour to come down on a surface car, I should probably be twenty minutes late if I returned the same way. I might save twenty minutes by a subway express. But was there a station near? If not, I might lose more than twenty minutes in looking for one. Then I thought of the elevated, and I saw there was such a line within two blocks. But where was the station? If it were several blocks above or below the street I was on, I should lose time instead of gaining it. My mind went back to the subway express as quicker than the elevated; furthermore, I remembered that it went nearer than the elevated to the part of 124th Street I wished to reach, so that time would be saved at the end of the journey. I concluded in favor of the subway, and reached my destination by one o’clock.” (Dewey 1910: 68–69; 1933: 91–92)

Ferryboat : “Projecting nearly horizontally from the upper deck of the ferryboat on which I daily cross the river is a long white pole, having a gilded ball at its tip. It suggested a flagpole when I first saw it; its color, shape, and gilded ball agreed with this idea, and these reasons seemed to justify me in this belief. But soon difficulties presented themselves. The pole was nearly horizontal, an unusual position for a flagpole; in the next place, there was no pulley, ring, or cord by which to attach a flag; finally, there were elsewhere on the boat two vertical staffs from which flags were occasionally flown. It seemed probable that the pole was not there for flag-flying.

“I then tried to imagine all possible purposes of the pole, and to consider for which of these it was best suited: (a) Possibly it was an ornament. But as all the ferryboats and even the tugboats carried poles, this hypothesis was rejected. (b) Possibly it was the terminal of a wireless telegraph. But the same considerations made this improbable. Besides, the more natural place for such a terminal would be the highest part of the boat, on top of the pilot house. (c) Its purpose might be to point out the direction in which the boat is moving.

“In support of this conclusion, I discovered that the pole was lower than the pilot house, so that the steersman could easily see it. Moreover, the tip was enough higher than the base, so that, from the pilot’s position, it must appear to project far out in front of the boat. Moreover, the pilot being near the front of the boat, he would need some such guide as to its direction. Tugboats would also need poles for such a purpose. This hypothesis was so much more probable than the others that I accepted it. I formed the conclusion that the pole was set up for the purpose of showing the pilot the direction in which the boat pointed, to enable him to steer correctly.” (Dewey 1910: 69–70; 1933: 92–93)

Bubbles : “In washing tumblers in hot soapsuds and placing them mouth downward on a plate, bubbles appeared on the outside of the mouth of the tumblers and then went inside. Why? The presence of bubbles suggests air, which I note must come from inside the tumbler. I see that the soapy water on the plate prevents escape of the air save as it may be caught in bubbles. But why should air leave the tumbler? There was no substance entering to force it out. It must have expanded. It expands by increase of heat, or by decrease of pressure, or both. Could the air have become heated after the tumbler was taken from the hot suds? Clearly not the air that was already entangled in the water. If heated air was the cause, cold air must have entered in transferring the tumblers from the suds to the plate. I test to see if this supposition is true by taking several more tumblers out. Some I shake so as to make sure of entrapping cold air in them. Some I take out holding mouth downward in order to prevent cold air from entering. Bubbles appear on the outside of every one of the former and on none of the latter. I must be right in my inference. Air from the outside must have been expanded by the heat of the tumbler, which explains the appearance of the bubbles on the outside. But why do they then go inside? Cold contracts. The tumbler cooled and also the air inside it. Tension was removed, and hence bubbles appeared inside. To be sure of this, I test by placing a cup of ice on the tumbler while the bubbles are still forming outside. They soon reverse” (Dewey 1910: 70–71; 1933: 93–94).

Dewey (1910, 1933) sprinkles his book with other examples of critical thinking. We will refer to the following.

Weather : A man on a walk notices that it has suddenly become cool, thinks that it is probably going to rain, looks up and sees a dark cloud obscuring the sun, and quickens his steps (1910: 6–10; 1933: 9–13).

Disorder : A man finds his rooms on his return to them in disorder with his belongings thrown about, thinks at first of burglary as an explanation, then thinks of mischievous children as being an alternative explanation, then looks to see whether valuables are missing, and discovers that they are (1910: 82–83; 1933: 166–168).

Typhoid : A physician diagnosing a patient whose conspicuous symptoms suggest typhoid avoids drawing a conclusion until more data are gathered by questioning the patient and by making tests (1910: 85–86; 1933: 170).

Blur : A moving blur catches our eye in the distance, we ask ourselves whether it is a cloud of whirling dust or a tree moving its branches or a man signaling to us, we think of other traits that should be found on each of those possibilities, and we look and see if those traits are found (1910: 102, 108; 1933: 121, 133).

Suction pump : In thinking about the suction pump, the scientist first notes that it will draw water only to a maximum height of 33 feet at sea level and to a lesser maximum height at higher elevations, selects for attention the differing atmospheric pressure at these elevations, sets up experiments in which the air is removed from a vessel containing water (when suction no longer works) and in which the weight of air at various levels is calculated, compares the results of reasoning about the height to which a given weight of air will allow a suction pump to raise water with the observed maximum height at different elevations, and finally assimilates the suction pump to such apparently different phenomena as the siphon and the rising of a balloon (1910: 150–153; 1933: 195–198).

Diamond : A passenger in a car driving in a diamond lane reserved for vehicles with at least one passenger notices that the diamond marks on the pavement are far apart in some places and close together in others. Why? The driver suggests that the reason may be that the diamond marks are not needed where there is a solid double line separating the diamond lane from the adjoining lane, but are needed when there is a dotted single line permitting crossing into the diamond lane. Further observation confirms that the diamonds are close together when a dotted line separates the diamond lane from its neighbour, but otherwise far apart.

Rash : A woman suddenly develops a very itchy red rash on her throat and upper chest. She recently noticed a mark on the back of her right hand, but was not sure whether the mark was a rash or a scrape. She lies down in bed and thinks about what might be causing the rash and what to do about it. About two weeks before, she began taking blood pressure medication that contained a sulfa drug, and the pharmacist had warned her, in view of a previous allergic reaction to a medication containing a sulfa drug, to be on the alert for an allergic reaction; however, she had been taking the medication for two weeks with no such effect. The day before, she began using a new cream on her neck and upper chest; against the new cream as the cause was mark on the back of her hand, which had not been exposed to the cream. She began taking probiotics about a month before. She also recently started new eye drops, but she supposed that manufacturers of eye drops would be careful not to include allergy-causing components in the medication. The rash might be a heat rash, since she recently was sweating profusely from her upper body. Since she is about to go away on a short vacation, where she would not have access to her usual physician, she decides to keep taking the probiotics and using the new eye drops but to discontinue the blood pressure medication and to switch back to the old cream for her neck and upper chest. She forms a plan to consult her regular physician on her return about the blood pressure medication.

Candidate : Although Dewey included no examples of thinking directed at appraising the arguments of others, such thinking has come to be considered a kind of critical thinking. We find an example of such thinking in the performance task on the Collegiate Learning Assessment (CLA+), which its sponsoring organization describes as

a performance-based assessment that provides a measure of an institution’s contribution to the development of critical-thinking and written communication skills of its students. (Council for Aid to Education 2017)

A sample task posted on its website requires the test-taker to write a report for public distribution evaluating a fictional candidate’s policy proposals and their supporting arguments, using supplied background documents, with a recommendation on whether to endorse the candidate.

Immediate acceptance of an idea that suggests itself as a solution to a problem (e.g., a possible explanation of an event or phenomenon, an action that seems likely to produce a desired result) is “uncritical thinking, the minimum of reflection” (Dewey 1910: 13). On-going suspension of judgment in the light of doubt about a possible solution is not critical thinking (Dewey 1910: 108). Critique driven by a dogmatically held political or religious ideology is not critical thinking; thus Paulo Freire (1968 [1970]) is using the term (e.g., at 1970: 71, 81, 100, 146) in a more politically freighted sense that includes not only reflection but also revolutionary action against oppression. Derivation of a conclusion from given data using an algorithm is not critical thinking.

What is critical thinking? There are many definitions. Ennis (2016) lists 14 philosophically oriented scholarly definitions and three dictionary definitions. Following Rawls (1971), who distinguished his conception of justice from a utilitarian conception but regarded them as rival conceptions of the same concept, Ennis maintains that the 17 definitions are different conceptions of the same concept. Rawls articulated the shared concept of justice as

a characteristic set of principles for assigning basic rights and duties and for determining… the proper distribution of the benefits and burdens of social cooperation. (Rawls 1971: 5)

Bailin et al. (1999b) claim that, if one considers what sorts of thinking an educator would take not to be critical thinking and what sorts to be critical thinking, one can conclude that educators typically understand critical thinking to have at least three features.

• It is done for the purpose of making up one’s mind about what to believe or do.
• The person engaging in the thinking is trying to fulfill standards of adequacy and accuracy appropriate to the thinking.
• The thinking fulfills the relevant standards to some threshold level.

One could sum up the core concept that involves these three features by saying that critical thinking is careful goal-directed thinking. This core concept seems to apply to all the examples of critical thinking described in the previous section. As for the non-examples, their exclusion depends on construing careful thinking as excluding jumping immediately to conclusions, suspending judgment no matter how strong the evidence, reasoning from an unquestioned ideological or religious perspective, and routinely using an algorithm to answer a question.

If the core of critical thinking is careful goal-directed thinking, conceptions of it can vary according to its presumed scope, its presumed goal, one’s criteria and threshold for being careful, and the thinking component on which one focuses. As to its scope, some conceptions (e.g., Dewey 1910, 1933) restrict it to constructive thinking on the basis of one’s own observations and experiments, others (e.g., Ennis 1962; Fisher & Scriven 1997; Johnson 1992) to appraisal of the products of such thinking. Ennis (1991) and Bailin et al. (1999b) take it to cover both construction and appraisal. As to its goal, some conceptions restrict it to forming a judgment (Dewey 1910, 1933; Lipman 1987; Facione 1990a). Others allow for actions as well as beliefs as the end point of a process of critical thinking (Ennis 1991; Bailin et al. 1999b). As to the criteria and threshold for being careful, definitions vary in the term used to indicate that critical thinking satisfies certain norms: “intellectually disciplined” (Scriven & Paul 1987), “reasonable” (Ennis 1991), “skillful” (Lipman 1987), “skilled” (Fisher & Scriven 1997), “careful” (Bailin & Battersby 2009). Some definitions specify these norms, referring variously to “consideration of any belief or supposed form of knowledge in the light of the grounds that support it and the further conclusions to which it tends” (Dewey 1910, 1933); “the methods of logical inquiry and reasoning” (Glaser 1941); “conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication” (Scriven & Paul 1987); the requirement that “it is sensitive to context, relies on criteria, and is self-correcting” (Lipman 1987); “evidential, conceptual, methodological, criteriological, or contextual considerations” (Facione 1990a); and “plus-minus considerations of the product in terms of appropriate standards (or criteria)” (Johnson 1992). Stanovich and Stanovich (2010) propose to ground the concept of critical thinking in the concept of rationality, which they understand as combining epistemic rationality (fitting one’s beliefs to the world) and instrumental rationality (optimizing goal fulfillment); a critical thinker, in their view, is someone with “a propensity to override suboptimal responses from the autonomous mind” (2010: 227). These variant specifications of norms for critical thinking are not necessarily incompatible with one another, and in any case presuppose the core notion of thinking carefully. As to the thinking component singled out, some definitions focus on suspension of judgment during the thinking (Dewey 1910; McPeck 1981), others on inquiry while judgment is suspended (Bailin & Battersby 2009, 2021), others on the resulting judgment (Facione 1990a), and still others on responsiveness to reasons (Siegel 1988). Kuhn (2019) takes critical thinking to be more a dialogic practice of advancing and responding to arguments than an individual ability.

In educational contexts, a definition of critical thinking is a “programmatic definition” (Scheffler 1960: 19). It expresses a practical program for achieving an educational goal. For this purpose, a one-sentence formulaic definition is much less useful than articulation of a critical thinking process, with criteria and standards for the kinds of thinking that the process may involve. The real educational goal is recognition, adoption and implementation by students of those criteria and standards. That adoption and implementation in turn consists in acquiring the knowledge, abilities and dispositions of a critical thinker.

Conceptions of critical thinking generally do not include moral integrity as part of the concept. Dewey, for example, took critical thinking to be the ultimate intellectual goal of education, but distinguished it from the development of social cooperation among school children, which he took to be the central moral goal. Ennis (1996, 2011) added to his previous list of critical thinking dispositions a group of dispositions to care about the dignity and worth of every person, which he described as a “correlative” (1996) disposition without which critical thinking would be less valuable and perhaps harmful. An educational program that aimed at developing critical thinking but not the correlative disposition to care about the dignity and worth of every person, he asserted, “would be deficient and perhaps dangerous” (Ennis 1996: 172).

Dewey thought that education for reflective thinking would be of value to both the individual and society; recognition in educational practice of the kinship to the scientific attitude of children’s native curiosity, fertile imagination and love of experimental inquiry “would make for individual happiness and the reduction of social waste” (Dewey 1910: iii). Schools participating in the Eight-Year Study took development of the habit of reflective thinking and skill in solving problems as a means to leading young people to understand, appreciate and live the democratic way of life characteristic of the United States (Aikin 1942: 17–18, 81). Harvey Siegel (1988: 55–61) has offered four considerations in support of adopting critical thinking as an educational ideal. (1) Respect for persons requires that schools and teachers honour students’ demands for reasons and explanations, deal with students honestly, and recognize the need to confront students’ independent judgment; these requirements concern the manner in which teachers treat students. (2) Education has the task of preparing children to be successful adults, a task that requires development of their self-sufficiency. (3) Education should initiate children into the rational traditions in such fields as history, science and mathematics. (4) Education should prepare children to become democratic citizens, which requires reasoned procedures and critical talents and attitudes. To supplement these considerations, Siegel (1988: 62–90) responds to two objections: the ideology objection that adoption of any educational ideal requires a prior ideological commitment and the indoctrination objection that cultivation of critical thinking cannot escape being a form of indoctrination.

Despite the diversity of our 11 examples, one can recognize a common pattern. Dewey analyzed it as consisting of five phases:

• suggestions , in which the mind leaps forward to a possible solution;
• an intellectualization of the difficulty or perplexity into a problem to be solved, a question for which the answer must be sought;
• the use of one suggestion after another as a leading idea, or hypothesis , to initiate and guide observation and other operations in collection of factual material;
• the mental elaboration of the idea or supposition as an idea or supposition ( reasoning , in the sense on which reasoning is a part, not the whole, of inference); and
• testing the hypothesis by overt or imaginative action. (Dewey 1933: 106–107; italics in original)

The process of reflective thinking consisting of these phases would be preceded by a perplexed, troubled or confused situation and followed by a cleared-up, unified, resolved situation (Dewey 1933: 106). The term ‘phases’ replaced the term ‘steps’ (Dewey 1910: 72), thus removing the earlier suggestion of an invariant sequence. Variants of the above analysis appeared in (Dewey 1916: 177) and (Dewey 1938: 101–119).

The variant formulations indicate the difficulty of giving a single logical analysis of such a varied process. The process of critical thinking may have a spiral pattern, with the problem being redefined in the light of obstacles to solving it as originally formulated. For example, the person in Transit might have concluded that getting to the appointment at the scheduled time was impossible and have reformulated the problem as that of rescheduling the appointment for a mutually convenient time. Further, defining a problem does not always follow after or lead immediately to an idea of a suggested solution. Nor should it do so, as Dewey himself recognized in describing the physician in Typhoid as avoiding any strong preference for this or that conclusion before getting further information (Dewey 1910: 85; 1933: 170). People with a hypothesis in mind, even one to which they have a very weak commitment, have a so-called “confirmation bias” (Nickerson 1998): they are likely to pay attention to evidence that confirms the hypothesis and to ignore evidence that counts against it or for some competing hypothesis. Detectives, intelligence agencies, and investigators of airplane accidents are well advised to gather relevant evidence systematically and to postpone even tentative adoption of an explanatory hypothesis until the collected evidence rules out with the appropriate degree of certainty all but one explanation. Dewey’s analysis of the critical thinking process can be faulted as well for requiring acceptance or rejection of a possible solution to a defined problem, with no allowance for deciding in the light of the available evidence to suspend judgment. Further, given the great variety of kinds of problems for which reflection is appropriate, there is likely to be variation in its component events. Perhaps the best way to conceptualize the critical thinking process is as a checklist whose component events can occur in a variety of orders, selectively, and more than once. These component events might include (1) noticing a difficulty, (2) defining the problem, (3) dividing the problem into manageable sub-problems, (4) formulating a variety of possible solutions to the problem or sub-problem, (5) determining what evidence is relevant to deciding among possible solutions to the problem or sub-problem, (6) devising a plan of systematic observation or experiment that will uncover the relevant evidence, (7) carrying out the plan of systematic observation or experimentation, (8) noting the results of the systematic observation or experiment, (9) gathering relevant testimony and information from others, (10) judging the credibility of testimony and information gathered from others, (11) drawing conclusions from gathered evidence and accepted testimony, and (12) accepting a solution that the evidence adequately supports (cf. Hitchcock 2017: 485).

Checklist conceptions of the process of critical thinking are open to the objection that they are too mechanical and procedural to fit the multi-dimensional and emotionally charged issues for which critical thinking is urgently needed (Paul 1984). For such issues, a more dialectical process is advocated, in which competing relevant world views are identified, their implications explored, and some sort of creative synthesis attempted.

If one considers the critical thinking process illustrated by the 11 examples, one can identify distinct kinds of mental acts and mental states that form part of it. To distinguish, label and briefly characterize these components is a useful preliminary to identifying abilities, skills, dispositions, attitudes, habits and the like that contribute causally to thinking critically. Identifying such abilities and habits is in turn a useful preliminary to setting educational goals. Setting the goals is in its turn a useful preliminary to designing strategies for helping learners to achieve the goals and to designing ways of measuring the extent to which learners have done so. Such measures provide both feedback to learners on their achievement and a basis for experimental research on the effectiveness of various strategies for educating people to think critically. Let us begin, then, by distinguishing the kinds of mental acts and mental events that can occur in a critical thinking process.

• Observing : One notices something in one’s immediate environment (sudden cooling of temperature in Weather , bubbles forming outside a glass and then going inside in Bubbles , a moving blur in the distance in Blur , a rash in Rash ). Or one notes the results of an experiment or systematic observation (valuables missing in Disorder , no suction without air pressure in Suction pump )
• Feeling : One feels puzzled or uncertain about something (how to get to an appointment on time in Transit , why the diamonds vary in spacing in Diamond ). One wants to resolve this perplexity. One feels satisfaction once one has worked out an answer (to take the subway express in Transit , diamonds closer when needed as a warning in Diamond ).
• Wondering : One formulates a question to be addressed (why bubbles form outside a tumbler taken from hot water in Bubbles , how suction pumps work in Suction pump , what caused the rash in Rash ).
• Imagining : One thinks of possible answers (bus or subway or elevated in Transit , flagpole or ornament or wireless communication aid or direction indicator in Ferryboat , allergic reaction or heat rash in Rash ).
• Inferring : One works out what would be the case if a possible answer were assumed (valuables missing if there has been a burglary in Disorder , earlier start to the rash if it is an allergic reaction to a sulfa drug in Rash ). Or one draws a conclusion once sufficient relevant evidence is gathered (take the subway in Transit , burglary in Disorder , discontinue blood pressure medication and new cream in Rash ).
• Knowledge : One uses stored knowledge of the subject-matter to generate possible answers or to infer what would be expected on the assumption of a particular answer (knowledge of a city’s public transit system in Transit , of the requirements for a flagpole in Ferryboat , of Boyle’s law in Bubbles , of allergic reactions in Rash ).
• Experimenting : One designs and carries out an experiment or a systematic observation to find out whether the results deduced from a possible answer will occur (looking at the location of the flagpole in relation to the pilot’s position in Ferryboat , putting an ice cube on top of a tumbler taken from hot water in Bubbles , measuring the height to which a suction pump will draw water at different elevations in Suction pump , noticing the spacing of diamonds when movement to or from a diamond lane is allowed in Diamond ).
• Consulting : One finds a source of information, gets the information from the source, and makes a judgment on whether to accept it. None of our 11 examples include searching for sources of information. In this respect they are unrepresentative, since most people nowadays have almost instant access to information relevant to answering any question, including many of those illustrated by the examples. However, Candidate includes the activities of extracting information from sources and evaluating its credibility.
• Identifying and analyzing arguments : One notices an argument and works out its structure and content as a preliminary to evaluating its strength. This activity is central to Candidate . It is an important part of a critical thinking process in which one surveys arguments for various positions on an issue.
• Judging : One makes a judgment on the basis of accumulated evidence and reasoning, such as the judgment in Ferryboat that the purpose of the pole is to provide direction to the pilot.
• Deciding : One makes a decision on what to do or on what policy to adopt, as in the decision in Transit to take the subway.

By definition, a person who does something voluntarily is both willing and able to do that thing at that time. Both the willingness and the ability contribute causally to the person’s action, in the sense that the voluntary action would not occur if either (or both) of these were lacking. For example, suppose that one is standing with one’s arms at one’s sides and one voluntarily lifts one’s right arm to an extended horizontal position. One would not do so if one were unable to lift one’s arm, if for example one’s right side was paralyzed as the result of a stroke. Nor would one do so if one were unwilling to lift one’s arm, if for example one were participating in a street demonstration at which a white supremacist was urging the crowd to lift their right arm in a Nazi salute and one were unwilling to express support in this way for the racist Nazi ideology. The same analysis applies to a voluntary mental process of thinking critically. It requires both willingness and ability to think critically, including willingness and ability to perform each of the mental acts that compose the process and to coordinate those acts in a sequence that is directed at resolving the initiating perplexity.

Consider willingness first. We can identify causal contributors to willingness to think critically by considering factors that would cause a person who was able to think critically about an issue nevertheless not to do so (Hamby 2014). For each factor, the opposite condition thus contributes causally to willingness to think critically on a particular occasion. For example, people who habitually jump to conclusions without considering alternatives will not think critically about issues that arise, even if they have the required abilities. The contrary condition of willingness to suspend judgment is thus a causal contributor to thinking critically.

Now consider ability. In contrast to the ability to move one’s arm, which can be completely absent because a stroke has left the arm paralyzed, the ability to think critically is a developed ability, whose absence is not a complete absence of ability to think but absence of ability to think well. We can identify the ability to think well directly, in terms of the norms and standards for good thinking. In general, to be able do well the thinking activities that can be components of a critical thinking process, one needs to know the concepts and principles that characterize their good performance, to recognize in particular cases that the concepts and principles apply, and to apply them. The knowledge, recognition and application may be procedural rather than declarative. It may be domain-specific rather than widely applicable, and in either case may need subject-matter knowledge, sometimes of a deep kind.

Reflections of the sort illustrated by the previous two paragraphs have led scholars to identify the knowledge, abilities and dispositions of a “critical thinker”, i.e., someone who thinks critically whenever it is appropriate to do so. We turn now to these three types of causal contributors to thinking critically. We start with dispositions, since arguably these are the most powerful contributors to being a critical thinker, can be fostered at an early stage of a child’s development, and are susceptible to general improvement (Glaser 1941: 175)

8. Critical Thinking Dispositions

Educational researchers use the term ‘dispositions’ broadly for the habits of mind and attitudes that contribute causally to being a critical thinker. Some writers (e.g., Paul & Elder 2006; Hamby 2014; Bailin & Battersby 2016a) propose to use the term ‘virtues’ for this dimension of a critical thinker. The virtues in question, although they are virtues of character, concern the person’s ways of thinking rather than the person’s ways of behaving towards others. They are not moral virtues but intellectual virtues, of the sort articulated by Zagzebski (1996) and discussed by Turri, Alfano, and Greco (2017).

On a realistic conception, thinking dispositions or intellectual virtues are real properties of thinkers. They are general tendencies, propensities, or inclinations to think in particular ways in particular circumstances, and can be genuinely explanatory (Siegel 1999). Sceptics argue that there is no evidence for a specific mental basis for the habits of mind that contribute to thinking critically, and that it is pedagogically misleading to posit such a basis (Bailin et al. 1999a). Whatever their status, critical thinking dispositions need motivation for their initial formation in a child—motivation that may be external or internal. As children develop, the force of habit will gradually become important in sustaining the disposition (Nieto & Valenzuela 2012). Mere force of habit, however, is unlikely to sustain critical thinking dispositions. Critical thinkers must value and enjoy using their knowledge and abilities to think things through for themselves. They must be committed to, and lovers of, inquiry.

A person may have a critical thinking disposition with respect to only some kinds of issues. For example, one could be open-minded about scientific issues but not about religious issues. Similarly, one could be confident in one’s ability to reason about the theological implications of the existence of evil in the world but not in one’s ability to reason about the best design for a guided ballistic missile.

Facione (1990a: 25) divides “affective dispositions” of critical thinking into approaches to life and living in general and approaches to specific issues, questions or problems. Adapting this distinction, one can usefully divide critical thinking dispositions into initiating dispositions (those that contribute causally to starting to think critically about an issue) and internal dispositions (those that contribute causally to doing a good job of thinking critically once one has started). The two categories are not mutually exclusive. For example, open-mindedness, in the sense of willingness to consider alternative points of view to one’s own, is both an initiating and an internal disposition.

Using the strategy of considering factors that would block people with the ability to think critically from doing so, we can identify as initiating dispositions for thinking critically attentiveness, a habit of inquiry, self-confidence, courage, open-mindedness, willingness to suspend judgment, trust in reason, wanting evidence for one’s beliefs, and seeking the truth. We consider briefly what each of these dispositions amounts to, in each case citing sources that acknowledge them.

• Attentiveness : One will not think critically if one fails to recognize an issue that needs to be thought through. For example, the pedestrian in Weather would not have looked up if he had not noticed that the air was suddenly cooler. To be a critical thinker, then, one needs to be habitually attentive to one’s surroundings, noticing not only what one senses but also sources of perplexity in messages received and in one’s own beliefs and attitudes (Facione 1990a: 25; Facione, Facione, & Giancarlo 2001).
• Habit of inquiry : Inquiry is effortful, and one needs an internal push to engage in it. For example, the student in Bubbles could easily have stopped at idle wondering about the cause of the bubbles rather than reasoning to a hypothesis, then designing and executing an experiment to test it. Thus willingness to think critically needs mental energy and initiative. What can supply that energy? Love of inquiry, or perhaps just a habit of inquiry. Hamby (2015) has argued that willingness to inquire is the central critical thinking virtue, one that encompasses all the others. It is recognized as a critical thinking disposition by Dewey (1910: 29; 1933: 35), Glaser (1941: 5), Ennis (1987: 12; 1991: 8), Facione (1990a: 25), Bailin et al. (1999b: 294), Halpern (1998: 452), and Facione, Facione, & Giancarlo (2001).
• Self-confidence : Lack of confidence in one’s abilities can block critical thinking. For example, if the woman in Rash lacked confidence in her ability to figure things out for herself, she might just have assumed that the rash on her chest was the allergic reaction to her medication against which the pharmacist had warned her. Thus willingness to think critically requires confidence in one’s ability to inquire (Facione 1990a: 25; Facione, Facione, & Giancarlo 2001).
• Courage : Fear of thinking for oneself can stop one from doing it. Thus willingness to think critically requires intellectual courage (Paul & Elder 2006: 16).
• Open-mindedness : A dogmatic attitude will impede thinking critically. For example, a person who adheres rigidly to a “pro-choice” position on the issue of the legal status of induced abortion is likely to be unwilling to consider seriously the issue of when in its development an unborn child acquires a moral right to life. Thus willingness to think critically requires open-mindedness, in the sense of a willingness to examine questions to which one already accepts an answer but which further evidence or reasoning might cause one to answer differently (Dewey 1933; Facione 1990a; Ennis 1991; Bailin et al. 1999b; Halpern 1998, Facione, Facione, & Giancarlo 2001). Paul (1981) emphasizes open-mindedness about alternative world-views, and recommends a dialectical approach to integrating such views as central to what he calls “strong sense” critical thinking. In three studies, Haran, Ritov, & Mellers (2013) found that actively open-minded thinking, including “the tendency to weigh new evidence against a favored belief, to spend sufficient time on a problem before giving up, and to consider carefully the opinions of others in forming one’s own”, led study participants to acquire information and thus to make accurate estimations.
• Willingness to suspend judgment : Premature closure on an initial solution will block critical thinking. Thus willingness to think critically requires a willingness to suspend judgment while alternatives are explored (Facione 1990a; Ennis 1991; Halpern 1998).
• Trust in reason : Since distrust in the processes of reasoned inquiry will dissuade one from engaging in it, trust in them is an initiating critical thinking disposition (Facione 1990a, 25; Bailin et al. 1999b: 294; Facione, Facione, & Giancarlo 2001; Paul & Elder 2006). In reaction to an allegedly exclusive emphasis on reason in critical thinking theory and pedagogy, Thayer-Bacon (2000) argues that intuition, imagination, and emotion have important roles to play in an adequate conception of critical thinking that she calls “constructive thinking”. From her point of view, critical thinking requires trust not only in reason but also in intuition, imagination, and emotion.
• Seeking the truth : If one does not care about the truth but is content to stick with one’s initial bias on an issue, then one will not think critically about it. Seeking the truth is thus an initiating critical thinking disposition (Bailin et al. 1999b: 294; Facione, Facione, & Giancarlo 2001). A disposition to seek the truth is implicit in more specific critical thinking dispositions, such as trying to be well-informed, considering seriously points of view other than one’s own, looking for alternatives, suspending judgment when the evidence is insufficient, and adopting a position when the evidence supporting it is sufficient.

Some of the initiating dispositions, such as open-mindedness and willingness to suspend judgment, are also internal critical thinking dispositions, in the sense of mental habits or attitudes that contribute causally to doing a good job of critical thinking once one starts the process. But there are many other internal critical thinking dispositions. Some of them are parasitic on one’s conception of good thinking. For example, it is constitutive of good thinking about an issue to formulate the issue clearly and to maintain focus on it. For this purpose, one needs not only the corresponding ability but also the corresponding disposition. Ennis (1991: 8) describes it as the disposition “to determine and maintain focus on the conclusion or question”, Facione (1990a: 25) as “clarity in stating the question or concern”. Other internal dispositions are motivators to continue or adjust the critical thinking process, such as willingness to persist in a complex task and willingness to abandon nonproductive strategies in an attempt to self-correct (Halpern 1998: 452). For a list of identified internal critical thinking dispositions, see the Supplement on Internal Critical Thinking Dispositions .

Some theorists postulate skills, i.e., acquired abilities, as operative in critical thinking. It is not obvious, however, that a good mental act is the exercise of a generic acquired skill. Inferring an expected time of arrival, as in Transit , has some generic components but also uses non-generic subject-matter knowledge. Bailin et al. (1999a) argue against viewing critical thinking skills as generic and discrete, on the ground that skilled performance at a critical thinking task cannot be separated from knowledge of concepts and from domain-specific principles of good thinking. Talk of skills, they concede, is unproblematic if it means merely that a person with critical thinking skills is capable of intelligent performance.

Despite such scepticism, theorists of critical thinking have listed as general contributors to critical thinking what they variously call abilities (Glaser 1941; Ennis 1962, 1991), skills (Facione 1990a; Halpern 1998) or competencies (Fisher & Scriven 1997). Amalgamating these lists would produce a confusing and chaotic cornucopia of more than 50 possible educational objectives, with only partial overlap among them. It makes sense instead to try to understand the reasons for the multiplicity and diversity, and to make a selection according to one’s own reasons for singling out abilities to be developed in a critical thinking curriculum. Two reasons for diversity among lists of critical thinking abilities are the underlying conception of critical thinking and the envisaged educational level. Appraisal-only conceptions, for example, involve a different suite of abilities than constructive-only conceptions. Some lists, such as those in (Glaser 1941), are put forward as educational objectives for secondary school students, whereas others are proposed as objectives for college students (e.g., Facione 1990a).

The abilities described in the remaining paragraphs of this section emerge from reflection on the general abilities needed to do well the thinking activities identified in section 6 as components of the critical thinking process described in section 5 . The derivation of each collection of abilities is accompanied by citation of sources that list such abilities and of standardized tests that claim to test them.

Observational abilities : Careful and accurate observation sometimes requires specialist expertise and practice, as in the case of observing birds and observing accident scenes. However, there are general abilities of noticing what one’s senses are picking up from one’s environment and of being able to articulate clearly and accurately to oneself and others what one has observed. It helps in exercising them to be able to recognize and take into account factors that make one’s observation less trustworthy, such as prior framing of the situation, inadequate time, deficient senses, poor observation conditions, and the like. It helps as well to be skilled at taking steps to make one’s observation more trustworthy, such as moving closer to get a better look, measuring something three times and taking the average, and checking what one thinks one is observing with someone else who is in a good position to observe it. It also helps to be skilled at recognizing respects in which one’s report of one’s observation involves inference rather than direct observation, so that one can then consider whether the inference is justified. These abilities come into play as well when one thinks about whether and with what degree of confidence to accept an observation report, for example in the study of history or in a criminal investigation or in assessing news reports. Observational abilities show up in some lists of critical thinking abilities (Ennis 1962: 90; Facione 1990a: 16; Ennis 1991: 9). There are items testing a person’s ability to judge the credibility of observation reports in the Cornell Critical Thinking Tests, Levels X and Z (Ennis & Millman 1971; Ennis, Millman, & Tomko 1985, 2005). Norris and King (1983, 1985, 1990a, 1990b) is a test of ability to appraise observation reports.

Emotional abilities : The emotions that drive a critical thinking process are perplexity or puzzlement, a wish to resolve it, and satisfaction at achieving the desired resolution. Children experience these emotions at an early age, without being trained to do so. Education that takes critical thinking as a goal needs only to channel these emotions and to make sure not to stifle them. Collaborative critical thinking benefits from ability to recognize one’s own and others’ emotional commitments and reactions.

Questioning abilities : A critical thinking process needs transformation of an inchoate sense of perplexity into a clear question. Formulating a question well requires not building in questionable assumptions, not prejudging the issue, and using language that in context is unambiguous and precise enough (Ennis 1962: 97; 1991: 9).

Imaginative abilities : Thinking directed at finding the correct causal explanation of a general phenomenon or particular event requires an ability to imagine possible explanations. Thinking about what policy or plan of action to adopt requires generation of options and consideration of possible consequences of each option. Domain knowledge is required for such creative activity, but a general ability to imagine alternatives is helpful and can be nurtured so as to become easier, quicker, more extensive, and deeper (Dewey 1910: 34–39; 1933: 40–47). Facione (1990a) and Halpern (1998) include the ability to imagine alternatives as a critical thinking ability.

Inferential abilities : The ability to draw conclusions from given information, and to recognize with what degree of certainty one’s own or others’ conclusions follow, is universally recognized as a general critical thinking ability. All 11 examples in section 2 of this article include inferences, some from hypotheses or options (as in Transit , Ferryboat and Disorder ), others from something observed (as in Weather and Rash ). None of these inferences is formally valid. Rather, they are licensed by general, sometimes qualified substantive rules of inference (Toulmin 1958) that rest on domain knowledge—that a bus trip takes about the same time in each direction, that the terminal of a wireless telegraph would be located on the highest possible place, that sudden cooling is often followed by rain, that an allergic reaction to a sulfa drug generally shows up soon after one starts taking it. It is a matter of controversy to what extent the specialized ability to deduce conclusions from premisses using formal rules of inference is needed for critical thinking. Dewey (1933) locates logical forms in setting out the products of reflection rather than in the process of reflection. Ennis (1981a), on the other hand, maintains that a liberally-educated person should have the following abilities: to translate natural-language statements into statements using the standard logical operators, to use appropriately the language of necessary and sufficient conditions, to deal with argument forms and arguments containing symbols, to determine whether in virtue of an argument’s form its conclusion follows necessarily from its premisses, to reason with logically complex propositions, and to apply the rules and procedures of deductive logic. Inferential abilities are recognized as critical thinking abilities by Glaser (1941: 6), Facione (1990a: 9), Ennis (1991: 9), Fisher & Scriven (1997: 99, 111), and Halpern (1998: 452). Items testing inferential abilities constitute two of the five subtests of the Watson Glaser Critical Thinking Appraisal (Watson & Glaser 1980a, 1980b, 1994), two of the four sections in the Cornell Critical Thinking Test Level X (Ennis & Millman 1971; Ennis, Millman, & Tomko 1985, 2005), three of the seven sections in the Cornell Critical Thinking Test Level Z (Ennis & Millman 1971; Ennis, Millman, & Tomko 1985, 2005), 11 of the 34 items on Forms A and B of the California Critical Thinking Skills Test (Facione 1990b, 1992), and a high but variable proportion of the 25 selected-response questions in the Collegiate Learning Assessment (Council for Aid to Education 2017).

Experimenting abilities : Knowing how to design and execute an experiment is important not just in scientific research but also in everyday life, as in Rash . Dewey devoted a whole chapter of his How We Think (1910: 145–156; 1933: 190–202) to the superiority of experimentation over observation in advancing knowledge. Experimenting abilities come into play at one remove in appraising reports of scientific studies. Skill in designing and executing experiments includes the acknowledged abilities to appraise evidence (Glaser 1941: 6), to carry out experiments and to apply appropriate statistical inference techniques (Facione 1990a: 9), to judge inductions to an explanatory hypothesis (Ennis 1991: 9), and to recognize the need for an adequately large sample size (Halpern 1998). The Cornell Critical Thinking Test Level Z (Ennis & Millman 1971; Ennis, Millman, & Tomko 1985, 2005) includes four items (out of 52) on experimental design. The Collegiate Learning Assessment (Council for Aid to Education 2017) makes room for appraisal of study design in both its performance task and its selected-response questions.

Consulting abilities : Skill at consulting sources of information comes into play when one seeks information to help resolve a problem, as in Candidate . Ability to find and appraise information includes ability to gather and marshal pertinent information (Glaser 1941: 6), to judge whether a statement made by an alleged authority is acceptable (Ennis 1962: 84), to plan a search for desired information (Facione 1990a: 9), and to judge the credibility of a source (Ennis 1991: 9). Ability to judge the credibility of statements is tested by 24 items (out of 76) in the Cornell Critical Thinking Test Level X (Ennis & Millman 1971; Ennis, Millman, & Tomko 1985, 2005) and by four items (out of 52) in the Cornell Critical Thinking Test Level Z (Ennis & Millman 1971; Ennis, Millman, & Tomko 1985, 2005). The College Learning Assessment’s performance task requires evaluation of whether information in documents is credible or unreliable (Council for Aid to Education 2017).

Argument analysis abilities : The ability to identify and analyze arguments contributes to the process of surveying arguments on an issue in order to form one’s own reasoned judgment, as in Candidate . The ability to detect and analyze arguments is recognized as a critical thinking skill by Facione (1990a: 7–8), Ennis (1991: 9) and Halpern (1998). Five items (out of 34) on the California Critical Thinking Skills Test (Facione 1990b, 1992) test skill at argument analysis. The College Learning Assessment (Council for Aid to Education 2017) incorporates argument analysis in its selected-response tests of critical reading and evaluation and of critiquing an argument.

Judging skills and deciding skills : Skill at judging and deciding is skill at recognizing what judgment or decision the available evidence and argument supports, and with what degree of confidence. It is thus a component of the inferential skills already discussed.

Lists and tests of critical thinking abilities often include two more abilities: identifying assumptions and constructing and evaluating definitions.

In addition to dispositions and abilities, critical thinking needs knowledge: of critical thinking concepts, of critical thinking principles, and of the subject-matter of the thinking.

We can derive a short list of concepts whose understanding contributes to critical thinking from the critical thinking abilities described in the preceding section. Observational abilities require an understanding of the difference between observation and inference. Questioning abilities require an understanding of the concepts of ambiguity and vagueness. Inferential abilities require an understanding of the difference between conclusive and defeasible inference (traditionally, between deduction and induction), as well as of the difference between necessary and sufficient conditions. Experimenting abilities require an understanding of the concepts of hypothesis, null hypothesis, assumption and prediction, as well as of the concept of statistical significance and of its difference from importance. They also require an understanding of the difference between an experiment and an observational study, and in particular of the difference between a randomized controlled trial, a prospective correlational study and a retrospective (case-control) study. Argument analysis abilities require an understanding of the concepts of argument, premiss, assumption, conclusion and counter-consideration. Additional critical thinking concepts are proposed by Bailin et al. (1999b: 293), Fisher & Scriven (1997: 105–106), Black (2012), and Blair (2021).

According to Glaser (1941: 25), ability to think critically requires knowledge of the methods of logical inquiry and reasoning. If we review the list of abilities in the preceding section, however, we can see that some of them can be acquired and exercised merely through practice, possibly guided in an educational setting, followed by feedback. Searching intelligently for a causal explanation of some phenomenon or event requires that one consider a full range of possible causal contributors, but it seems more important that one implements this principle in one’s practice than that one is able to articulate it. What is important is “operational knowledge” of the standards and principles of good thinking (Bailin et al. 1999b: 291–293). But the development of such critical thinking abilities as designing an experiment or constructing an operational definition can benefit from learning their underlying theory. Further, explicit knowledge of quirks of human thinking seems useful as a cautionary guide. Human memory is not just fallible about details, as people learn from their own experiences of misremembering, but is so malleable that a detailed, clear and vivid recollection of an event can be a total fabrication (Loftus 2017). People seek or interpret evidence in ways that are partial to their existing beliefs and expectations, often unconscious of their “confirmation bias” (Nickerson 1998). Not only are people subject to this and other cognitive biases (Kahneman 2011), of which they are typically unaware, but it may be counter-productive for one to make oneself aware of them and try consciously to counteract them or to counteract social biases such as racial or sexual stereotypes (Kenyon & Beaulac 2014). It is helpful to be aware of these facts and of the superior effectiveness of blocking the operation of biases—for example, by making an immediate record of one’s observations, refraining from forming a preliminary explanatory hypothesis, blind refereeing, double-blind randomized trials, and blind grading of students’ work. It is also helpful to be aware of the prevalence of “noise” (unwanted unsystematic variability of judgments), of how to detect noise (through a noise audit), and of how to reduce noise: make accuracy the goal, think statistically, break a process of arriving at a judgment into independent tasks, resist premature intuitions, in a group get independent judgments first, favour comparative judgments and scales (Kahneman, Sibony, & Sunstein 2021). It is helpful as well to be aware of the concept of “bounded rationality” in decision-making and of the related distinction between “satisficing” and optimizing (Simon 1956; Gigerenzer 2001).

Critical thinking about an issue requires substantive knowledge of the domain to which the issue belongs. Critical thinking abilities are not a magic elixir that can be applied to any issue whatever by somebody who has no knowledge of the facts relevant to exploring that issue. For example, the student in Bubbles needed to know that gases do not penetrate solid objects like a glass, that air expands when heated, that the volume of an enclosed gas varies directly with its temperature and inversely with its pressure, and that hot objects will spontaneously cool down to the ambient temperature of their surroundings unless kept hot by insulation or a source of heat. Critical thinkers thus need a rich fund of subject-matter knowledge relevant to the variety of situations they encounter. This fact is recognized in the inclusion among critical thinking dispositions of a concern to become and remain generally well informed.

Experimental educational interventions, with control groups, have shown that education can improve critical thinking skills and dispositions, as measured by standardized tests. For information about these tests, see the Supplement on Assessment .

What educational methods are most effective at developing the dispositions, abilities and knowledge of a critical thinker? In a comprehensive meta-analysis of experimental and quasi-experimental studies of strategies for teaching students to think critically, Abrami et al. (2015) found that dialogue, anchored instruction, and mentoring each increased the effectiveness of the educational intervention, and that they were most effective when combined. They also found that in these studies a combination of separate instruction in critical thinking with subject-matter instruction in which students are encouraged to think critically was more effective than either by itself. However, the difference was not statistically significant; that is, it might have arisen by chance.

Most of these studies lack the longitudinal follow-up required to determine whether the observed differential improvements in critical thinking abilities or dispositions continue over time, for example until high school or college graduation. For details on studies of methods of developing critical thinking skills and dispositions, see the Supplement on Educational Methods .

12. Controversies

Scholars have denied the generalizability of critical thinking abilities across subject domains, have alleged bias in critical thinking theory and pedagogy, and have investigated the relationship of critical thinking to other kinds of thinking.

McPeck (1981) attacked the thinking skills movement of the 1970s, including the critical thinking movement. He argued that there are no general thinking skills, since thinking is always thinking about some subject-matter. It is futile, he claimed, for schools and colleges to teach thinking as if it were a separate subject. Rather, teachers should lead their pupils to become autonomous thinkers by teaching school subjects in a way that brings out their cognitive structure and that encourages and rewards discussion and argument. As some of his critics (e.g., Paul 1985; Siegel 1985) pointed out, McPeck’s central argument needs elaboration, since it has obvious counter-examples in writing and speaking, for which (up to a certain level of complexity) there are teachable general abilities even though they are always about some subject-matter. To make his argument convincing, McPeck needs to explain how thinking differs from writing and speaking in a way that does not permit useful abstraction of its components from the subject-matters with which it deals. He has not done so. Nevertheless, his position that the dispositions and abilities of a critical thinker are best developed in the context of subject-matter instruction is shared by many theorists of critical thinking, including Dewey (1910, 1933), Glaser (1941), Passmore (1980), Weinstein (1990), Bailin et al. (1999b), and Willingham (2019).

McPeck’s challenge prompted reflection on the extent to which critical thinking is subject-specific. McPeck argued for a strong subject-specificity thesis, according to which it is a conceptual truth that all critical thinking abilities are specific to a subject. (He did not however extend his subject-specificity thesis to critical thinking dispositions. In particular, he took the disposition to suspend judgment in situations of cognitive dissonance to be a general disposition.) Conceptual subject-specificity is subject to obvious counter-examples, such as the general ability to recognize confusion of necessary and sufficient conditions. A more modest thesis, also endorsed by McPeck, is epistemological subject-specificity, according to which the norms of good thinking vary from one field to another. Epistemological subject-specificity clearly holds to a certain extent; for example, the principles in accordance with which one solves a differential equation are quite different from the principles in accordance with which one determines whether a painting is a genuine Picasso. But the thesis suffers, as Ennis (1989) points out, from vagueness of the concept of a field or subject and from the obvious existence of inter-field principles, however broadly the concept of a field is construed. For example, the principles of hypothetico-deductive reasoning hold for all the varied fields in which such reasoning occurs. A third kind of subject-specificity is empirical subject-specificity, according to which as a matter of empirically observable fact a person with the abilities and dispositions of a critical thinker in one area of investigation will not necessarily have them in another area of investigation.

The thesis of empirical subject-specificity raises the general problem of transfer. If critical thinking abilities and dispositions have to be developed independently in each school subject, how are they of any use in dealing with the problems of everyday life and the political and social issues of contemporary society, most of which do not fit into the framework of a traditional school subject? Proponents of empirical subject-specificity tend to argue that transfer is more likely to occur if there is critical thinking instruction in a variety of domains, with explicit attention to dispositions and abilities that cut across domains. But evidence for this claim is scanty. There is a need for well-designed empirical studies that investigate the conditions that make transfer more likely.

It is common ground in debates about the generality or subject-specificity of critical thinking dispositions and abilities that critical thinking about any topic requires background knowledge about the topic. For example, the most sophisticated understanding of the principles of hypothetico-deductive reasoning is of no help unless accompanied by some knowledge of what might be plausible explanations of some phenomenon under investigation.

Critics have objected to bias in the theory, pedagogy and practice of critical thinking. Commentators (e.g., Alston 1995; Ennis 1998) have noted that anyone who takes a position has a bias in the neutral sense of being inclined in one direction rather than others. The critics, however, are objecting to bias in the pejorative sense of an unjustified favoring of certain ways of knowing over others, frequently alleging that the unjustly favoured ways are those of a dominant sex or culture (Bailin 1995). These ways favour:

• reinforcement of egocentric and sociocentric biases over dialectical engagement with opposing world-views (Paul 1981, 1984; Warren 1998)
• distancing from the object of inquiry over closeness to it (Martin 1992; Thayer-Bacon 1992)
• indifference to the situation of others over care for them (Martin 1992)
• orientation to thought over orientation to action (Martin 1992)
• being reasonable over caring to understand people’s ideas (Thayer-Bacon 1993)
• being neutral and objective over being embodied and situated (Thayer-Bacon 1995a)
• doubting over believing (Thayer-Bacon 1995b)
• reason over emotion, imagination and intuition (Thayer-Bacon 2000)
• solitary thinking over collaborative thinking (Thayer-Bacon 2000)
• written and spoken assignments over other forms of expression (Alston 2001)
• attention to written and spoken communications over attention to human problems (Alston 2001)
• winning debates in the public sphere over making and understanding meaning (Alston 2001)

A common thread in this smorgasbord of accusations is dissatisfaction with focusing on the logical analysis and evaluation of reasoning and arguments. While these authors acknowledge that such analysis and evaluation is part of critical thinking and should be part of its conceptualization and pedagogy, they insist that it is only a part. Paul (1981), for example, bemoans the tendency of atomistic teaching of methods of analyzing and evaluating arguments to turn students into more able sophists, adept at finding fault with positions and arguments with which they disagree but even more entrenched in the egocentric and sociocentric biases with which they began. Martin (1992) and Thayer-Bacon (1992) cite with approval the self-reported intimacy with their subject-matter of leading researchers in biology and medicine, an intimacy that conflicts with the distancing allegedly recommended in standard conceptions and pedagogy of critical thinking. Thayer-Bacon (2000) contrasts the embodied and socially embedded learning of her elementary school students in a Montessori school, who used their imagination, intuition and emotions as well as their reason, with conceptions of critical thinking as

thinking that is used to critique arguments, offer justifications, and make judgments about what are the good reasons, or the right answers. (Thayer-Bacon 2000: 127–128)

Alston (2001) reports that her students in a women’s studies class were able to see the flaws in the Cinderella myth that pervades much romantic fiction but in their own romantic relationships still acted as if all failures were the woman’s fault and still accepted the notions of love at first sight and living happily ever after. Students, she writes, should

be able to connect their intellectual critique to a more affective, somatic, and ethical account of making risky choices that have sexist, racist, classist, familial, sexual, or other consequences for themselves and those both near and far… critical thinking that reads arguments, texts, or practices merely on the surface without connections to feeling/desiring/doing or action lacks an ethical depth that should infuse the difference between mere cognitive activity and something we want to call critical thinking. (Alston 2001: 34)

Some critics portray such biases as unfair to women. Thayer-Bacon (1992), for example, has charged modern critical thinking theory with being sexist, on the ground that it separates the self from the object and causes one to lose touch with one’s inner voice, and thus stigmatizes women, who (she asserts) link self to object and listen to their inner voice. Her charge does not imply that women as a group are on average less able than men to analyze and evaluate arguments. Facione (1990c) found no difference by sex in performance on his California Critical Thinking Skills Test. Kuhn (1991: 280–281) found no difference by sex in either the disposition or the competence to engage in argumentative thinking.

The critics propose a variety of remedies for the biases that they allege. In general, they do not propose to eliminate or downplay critical thinking as an educational goal. Rather, they propose to conceptualize critical thinking differently and to change its pedagogy accordingly. Their pedagogical proposals arise logically from their objections. They can be summarized as follows:

• Focus on argument networks with dialectical exchanges reflecting contesting points of view rather than on atomic arguments, so as to develop “strong sense” critical thinking that transcends egocentric and sociocentric biases (Paul 1981, 1984).
• Foster closeness to the subject-matter and feeling connected to others in order to inform a humane democracy (Martin 1992).
• Develop “constructive thinking” as a social activity in a community of physically embodied and socially embedded inquirers with personal voices who value not only reason but also imagination, intuition and emotion (Thayer-Bacon 2000).
• In developing critical thinking in school subjects, treat as important neither skills nor dispositions but opening worlds of meaning (Alston 2001).
• Attend to the development of critical thinking dispositions as well as skills, and adopt the “critical pedagogy” practised and advocated by Freire (1968 [1970]) and hooks (1994) (Dalgleish, Girard, & Davies 2017).

A common thread in these proposals is treatment of critical thinking as a social, interactive, personally engaged activity like that of a quilting bee or a barn-raising (Thayer-Bacon 2000) rather than as an individual, solitary, distanced activity symbolized by Rodin’s The Thinker . One can get a vivid description of education with the former type of goal from the writings of bell hooks (1994, 2010). Critical thinking for her is open-minded dialectical exchange across opposing standpoints and from multiple perspectives, a conception similar to Paul’s “strong sense” critical thinking (Paul 1981). She abandons the structure of domination in the traditional classroom. In an introductory course on black women writers, for example, she assigns students to write an autobiographical paragraph about an early racial memory, then to read it aloud as the others listen, thus affirming the uniqueness and value of each voice and creating a communal awareness of the diversity of the group’s experiences (hooks 1994: 84). Her “engaged pedagogy” is thus similar to the “freedom under guidance” implemented in John Dewey’s Laboratory School of Chicago in the late 1890s and early 1900s. It incorporates the dialogue, anchored instruction, and mentoring that Abrami (2015) found to be most effective in improving critical thinking skills and dispositions.

What is the relationship of critical thinking to problem solving, decision-making, higher-order thinking, creative thinking, and other recognized types of thinking? One’s answer to this question obviously depends on how one defines the terms used in the question. If critical thinking is conceived broadly to cover any careful thinking about any topic for any purpose, then problem solving and decision making will be kinds of critical thinking, if they are done carefully. Historically, ‘critical thinking’ and ‘problem solving’ were two names for the same thing. If critical thinking is conceived more narrowly as consisting solely of appraisal of intellectual products, then it will be disjoint with problem solving and decision making, which are constructive.

Bloom’s taxonomy of educational objectives used the phrase “intellectual abilities and skills” for what had been labeled “critical thinking” by some, “reflective thinking” by Dewey and others, and “problem solving” by still others (Bloom et al. 1956: 38). Thus, the so-called “higher-order thinking skills” at the taxonomy’s top levels of analysis, synthesis and evaluation are just critical thinking skills, although they do not come with general criteria for their assessment (Ennis 1981b). The revised version of Bloom’s taxonomy (Anderson et al. 2001) likewise treats critical thinking as cutting across those types of cognitive process that involve more than remembering (Anderson et al. 2001: 269–270). For details, see the Supplement on History .

As to creative thinking, it overlaps with critical thinking (Bailin 1987, 1988). Thinking about the explanation of some phenomenon or event, as in Ferryboat , requires creative imagination in constructing plausible explanatory hypotheses. Likewise, thinking about a policy question, as in Candidate , requires creativity in coming up with options. Conversely, creativity in any field needs to be balanced by critical appraisal of the draft painting or novel or mathematical theory.

• Abrami, Philip C., Robert M. Bernard, Eugene Borokhovski, David I. Waddington, C. Anne Wade, and Tonje Person, 2015, “Strategies for Teaching Students to Think Critically: A Meta-analysis”, Review of Educational Research , 85(2): 275–314. doi:10.3102/0034654314551063
• Aikin, Wilford M., 1942, The Story of the Eight-year Study, with Conclusions and Recommendations , Volume I of Adventure in American Education , New York and London: Harper & Brothers. [ Aikin 1942 available online ]
• Alston, Kal, 1995, “Begging the Question: Is Critical Thinking Biased?”, Educational Theory , 45(2): 225–233. doi:10.1111/j.1741-5446.1995.00225.x
• –––, 2001, “Re/Thinking Critical Thinking: The Seductions of Everyday Life”, Studies in Philosophy and Education , 20(1): 27–40. doi:10.1023/A:1005247128053
• American Educational Research Association, 2014, Standards for Educational and Psychological Testing / American Educational Research Association, American Psychological Association, National Council on Measurement in Education , Washington, DC: American Educational Research Association.
• Anderson, Lorin W., David R. Krathwohl, Peter W. Airiasian, Kathleen A. Cruikshank, Richard E. Mayer, Paul R. Pintrich, James Raths, and Merlin C. Wittrock, 2001, A Taxonomy for Learning, Teaching and Assessing: A Revision of Bloom’s Taxonomy of Educational Objectives , New York: Longman, complete edition.
• Bailin, Sharon, 1987, “Critical and Creative Thinking”, Informal Logic , 9(1): 23–30. [ Bailin 1987 available online ]
• –––, 1988, Achieving Extraordinary Ends: An Essay on Creativity , Dordrecht: Kluwer. doi:10.1007/978-94-009-2780-3
• –––, 1995, “Is Critical Thinking Biased? Clarifications and Implications”, Educational Theory , 45(2): 191–197. doi:10.1111/j.1741-5446.1995.00191.x
• Bailin, Sharon and Mark Battersby, 2009, “Inquiry: A Dialectical Approach to Teaching Critical Thinking”, in Juho Ritola (ed.), Argument Cultures: Proceedings of OSSA 09 , CD-ROM (pp. 1–10), Windsor, ON: OSSA. [ Bailin & Battersby 2009 available online ]
• –––, 2016a, “Fostering the Virtues of Inquiry”, Topoi , 35(2): 367–374. doi:10.1007/s11245-015-9307-6
• –––, 2016b, Reason in the Balance: An Inquiry Approach to Critical Thinking , Indianapolis: Hackett, 2nd edition.
• –––, 2021, “Inquiry: Teaching for Reasoned Judgment”, in Daniel Fasko, Jr. and Frank Fair (eds.), Critical Thinking and Reasoning: Theory, Development, Instruction, and Assessment , Leiden: Brill, pp. 31–46. doi: 10.1163/9789004444591_003
• Bailin, Sharon, Roland Case, Jerrold R. Coombs, and Leroi B. Daniels, 1999a, “Common Misconceptions of Critical Thinking”, Journal of Curriculum Studies , 31(3): 269–283. doi:10.1080/002202799183124
• –––, 1999b, “Conceptualizing Critical Thinking”, Journal of Curriculum Studies , 31(3): 285–302. doi:10.1080/002202799183133
• Blair, J. Anthony, 2021, Studies in Critical Thinking , Windsor, ON: Windsor Studies in Argumentation, 2nd edition. [Available online at https://windsor.scholarsportal.info/omp/index.php/wsia/catalog/book/106]
• Berman, Alan M., Seth J. Schwartz, William M. Kurtines, and Steven L. Berman, 2001, “The Process of Exploration in Identity Formation: The Role of Style and Competence”, Journal of Adolescence , 24(4): 513–528. doi:10.1006/jado.2001.0386
• Black, Beth (ed.), 2012, An A to Z of Critical Thinking , London: Continuum International Publishing Group.
• Bloom, Benjamin Samuel, Max D. Engelhart, Edward J. Furst, Walter H. Hill, and David R. Krathwohl, 1956, Taxonomy of Educational Objectives. Handbook I: Cognitive Domain , New York: David McKay.
• Boardman, Frank, Nancy M. Cavender, and Howard Kahane, 2018, Logic and Contemporary Rhetoric: The Use of Reason in Everyday Life , Boston: Cengage, 13th edition.
• Browne, M. Neil and Stuart M. Keeley, 2018, Asking the Right Questions: A Guide to Critical Thinking , Hoboken, NJ: Pearson, 12th edition.
• Center for Assessment & Improvement of Learning, 2017, Critical Thinking Assessment Test , Cookeville, TN: Tennessee Technological University.
• Cleghorn, Paul. 2021. “Critical Thinking in the Elementary School: Practical Guidance for Building a Culture of Thinking”, in Daniel Fasko, Jr. and Frank Fair (eds.), Critical Thinking and Reasoning: Theory, Development, Instruction, and Assessmen t, Leiden: Brill, pp. 150–167. doi: 10.1163/9789004444591_010
• Cohen, Jacob, 1988, Statistical Power Analysis for the Behavioral Sciences , Hillsdale, NJ: Lawrence Erlbaum Associates, 2nd edition.
• College Board, 1983, Academic Preparation for College. What Students Need to Know and Be Able to Do , New York: College Entrance Examination Board, ERIC document ED232517.
• Commission on the Relation of School and College of the Progressive Education Association, 1943, Thirty Schools Tell Their Story , Volume V of Adventure in American Education , New York and London: Harper & Brothers.
• Council for Aid to Education, 2017, CLA+ Student Guide . Available at http://cae.org/images/uploads/pdf/CLA_Student_Guide_Institution.pdf ; last accessed 2022 07 16.
• Dalgleish, Adam, Patrick Girard, and Maree Davies, 2017, “Critical Thinking, Bias and Feminist Philosophy: Building a Better Framework through Collaboration”, Informal Logic , 37(4): 351–369. [ Dalgleish et al. available online ]
• Dewey, John, 1910, How We Think , Boston: D.C. Heath. [ Dewey 1910 available online ]
• –––, 1916, Democracy and Education: An Introduction to the Philosophy of Education , New York: Macmillan.
• –––, 1933, How We Think: A Restatement of the Relation of Reflective Thinking to the Educative Process , Lexington, MA: D.C. Heath.
• –––, 1936, “The Theory of the Chicago Experiment”, Appendix II of Mayhew & Edwards 1936: 463–477.
• –––, 1938, Logic: The Theory of Inquiry , New York: Henry Holt and Company.
• Dominguez, Caroline (coord.), 2018a, A European Collection of the Critical Thinking Skills and Dispositions Needed in Different Professional Fields for the 21st Century , Vila Real, Portugal: UTAD. Available at http://bit.ly/CRITHINKEDUO1 ; last accessed 2022 07 16.
• ––– (coord.), 2018b, A European Review on Critical Thinking Educational Practices in Higher Education Institutions , Vila Real: UTAD. Available at http://bit.ly/CRITHINKEDUO2 ; last accessed 2022 07 16.
• ––– (coord.), 2018c, The CRITHINKEDU European Course on Critical Thinking Education for University Teachers: From Conception to Delivery , Vila Real: UTAD. Available at http:/bit.ly/CRITHINKEDU03; last accessed 2022 07 16.
• Dominguez Caroline and Rita Payan-Carreira (eds.), 2019, Promoting Critical Thinking in European Higher Education Institutions: Towards an Educational Protocol , Vila Real: UTAD. Available at http:/bit.ly/CRITHINKEDU04; last accessed 2022 07 16.
• Ennis, Robert H., 1958, “An Appraisal of the Watson-Glaser Critical Thinking Appraisal”, The Journal of Educational Research , 52(4): 155–158. doi:10.1080/00220671.1958.10882558
• –––, 1962, “A Concept of Critical Thinking: A Proposed Basis for Research on the Teaching and Evaluation of Critical Thinking Ability”, Harvard Educational Review , 32(1): 81–111.
• –––, 1981a, “A Conception of Deductive Logical Competence”, Teaching Philosophy , 4(3/4): 337–385. doi:10.5840/teachphil198143/429
• –––, 1981b, “Eight Fallacies in Bloom’s Taxonomy”, in C. J. B. Macmillan (ed.), Philosophy of Education 1980: Proceedings of the Thirty-seventh Annual Meeting of the Philosophy of Education Society , Bloomington, IL: Philosophy of Education Society, pp. 269–273.
• –––, 1984, “Problems in Testing Informal Logic, Critical Thinking, Reasoning Ability”, Informal Logic , 6(1): 3–9. [ Ennis 1984 available online ]
• –––, 1987, “A Taxonomy of Critical Thinking Dispositions and Abilities”, in Joan Boykoff Baron and Robert J. Sternberg (eds.), Teaching Thinking Skills: Theory and Practice , New York: W. H. Freeman, pp. 9–26.
• –––, 1989, “Critical Thinking and Subject Specificity: Clarification and Needed Research”, Educational Researcher , 18(3): 4–10. doi:10.3102/0013189X018003004
• –––, 1991, “Critical Thinking: A Streamlined Conception”, Teaching Philosophy , 14(1): 5–24. doi:10.5840/teachphil19911412
• –––, 1996, “Critical Thinking Dispositions: Their Nature and Assessability”, Informal Logic , 18(2–3): 165–182. [ Ennis 1996 available online ]
• –––, 1998, “Is Critical Thinking Culturally Biased?”, Teaching Philosophy , 21(1): 15–33. doi:10.5840/teachphil19982113
• –––, 2011, “Critical Thinking: Reflection and Perspective Part I”, Inquiry: Critical Thinking across the Disciplines , 26(1): 4–18. doi:10.5840/inquiryctnews20112613
• –––, 2013, “Critical Thinking across the Curriculum: The Wisdom CTAC Program”, Inquiry: Critical Thinking across the Disciplines , 28(2): 25–45. doi:10.5840/inquiryct20132828
• –––, 2016, “Definition: A Three-Dimensional Analysis with Bearing on Key Concepts”, in Patrick Bondy and Laura Benacquista (eds.), Argumentation, Objectivity, and Bias: Proceedings of the 11th International Conference of the Ontario Society for the Study of Argumentation (OSSA), 18–21 May 2016 , Windsor, ON: OSSA, pp. 1–19. Available at http://scholar.uwindsor.ca/ossaarchive/OSSA11/papersandcommentaries/105 ; last accessed 2022 07 16.
• –––, 2018, “Critical Thinking Across the Curriculum: A Vision”, Topoi , 37(1): 165–184. doi:10.1007/s11245-016-9401-4
• Ennis, Robert H., and Jason Millman, 1971, Manual for Cornell Critical Thinking Test, Level X, and Cornell Critical Thinking Test, Level Z , Urbana, IL: Critical Thinking Project, University of Illinois.
• Ennis, Robert H., Jason Millman, and Thomas Norbert Tomko, 1985, Cornell Critical Thinking Tests Level X & Level Z: Manual , Pacific Grove, CA: Midwest Publication, 3rd edition.
• –––, 2005, Cornell Critical Thinking Tests Level X & Level Z: Manual , Seaside, CA: Critical Thinking Company, 5th edition.
• Ennis, Robert H. and Eric Weir, 1985, The Ennis-Weir Critical Thinking Essay Test: Test, Manual, Criteria, Scoring Sheet: An Instrument for Teaching and Testing , Pacific Grove, CA: Midwest Publications.
• Facione, Peter A., 1990a, Critical Thinking: A Statement of Expert Consensus for Purposes of Educational Assessment and Instruction , Research Findings and Recommendations Prepared for the Committee on Pre-College Philosophy of the American Philosophical Association, ERIC Document ED315423.
• –––, 1990b, California Critical Thinking Skills Test, CCTST – Form A , Millbrae, CA: The California Academic Press.
• –––, 1990c, The California Critical Thinking Skills Test--College Level. Technical Report #3. Gender, Ethnicity, Major, CT Self-Esteem, and the CCTST , ERIC Document ED326584.
• –––, 1992, California Critical Thinking Skills Test: CCTST – Form B, Millbrae, CA: The California Academic Press.
• –––, 2000, “The Disposition Toward Critical Thinking: Its Character, Measurement, and Relationship to Critical Thinking Skill”, Informal Logic , 20(1): 61–84. [ Facione 2000 available online ]
• Facione, Peter A. and Noreen C. Facione, 1992, CCTDI: A Disposition Inventory , Millbrae, CA: The California Academic Press.
• Facione, Peter A., Noreen C. Facione, and Carol Ann F. Giancarlo, 2001, California Critical Thinking Disposition Inventory: CCTDI: Inventory Manual , Millbrae, CA: The California Academic Press.
• Facione, Peter A., Carol A. Sánchez, and Noreen C. Facione, 1994, Are College Students Disposed to Think? , Millbrae, CA: The California Academic Press. ERIC Document ED368311.
• Fisher, Alec, and Michael Scriven, 1997, Critical Thinking: Its Definition and Assessment , Norwich: Centre for Research in Critical Thinking, University of East Anglia.
• Freire, Paulo, 1968 [1970], Pedagogia do Oprimido . Translated as Pedagogy of the Oppressed , Myra Bergman Ramos (trans.), New York: Continuum, 1970.
• Gigerenzer, Gerd, 2001, “The Adaptive Toolbox”, in Gerd Gigerenzer and Reinhard Selten (eds.), Bounded Rationality: The Adaptive Toolbox , Cambridge, MA: MIT Press, pp. 37–50.
• Glaser, Edward Maynard, 1941, An Experiment in the Development of Critical Thinking , New York: Bureau of Publications, Teachers College, Columbia University.
• Groarke, Leo A. and Christopher W. Tindale, 2012, Good Reasoning Matters! A Constructive Approach to Critical Thinking , Don Mills, ON: Oxford University Press, 5th edition.
• Halpern, Diane F., 1998, “Teaching Critical Thinking for Transfer Across Domains: Disposition, Skills, Structure Training, and Metacognitive Monitoring”, American Psychologist , 53(4): 449–455. doi:10.1037/0003-066X.53.4.449
• –––, 2016, Manual: Halpern Critical Thinking Assessment , Mödling, Austria: Schuhfried. Available at https://pdfcoffee.com/hcta-test-manual-pdf-free.html; last accessed 2022 07 16.
• Hamby, Benjamin, 2014, The Virtues of Critical Thinkers , Doctoral dissertation, Philosophy, McMaster University. [ Hamby 2014 available online ]
• –––, 2015, “Willingness to Inquire: The Cardinal Critical Thinking Virtue”, in Martin Davies and Ronald Barnett (eds.), The Palgrave Handbook of Critical Thinking in Higher Education , New York: Palgrave Macmillan, pp. 77–87.
• Haran, Uriel, Ilana Ritov, and Barbara A. Mellers, 2013, “The Role of Actively Open-minded Thinking in Information Acquisition, Accuracy, and Calibration”, Judgment and Decision Making , 8(3): 188–201.
• Hatcher, Donald and Kevin Possin, 2021, “Commentary: Thinking Critically about Critical Thinking Assessment”, in Daniel Fasko, Jr. and Frank Fair (eds.), Critical Thinking and Reasoning: Theory, Development, Instruction, and Assessment , Leiden: Brill, pp. 298–322. doi: 10.1163/9789004444591_017
• Haynes, Ada, Elizabeth Lisic, Kevin Harris, Katie Leming, Kyle Shanks, and Barry Stein, 2015, “Using the Critical Thinking Assessment Test (CAT) as a Model for Designing Within-Course Assessments: Changing How Faculty Assess Student Learning”, Inquiry: Critical Thinking Across the Disciplines , 30(3): 38–48. doi:10.5840/inquiryct201530316
• Haynes, Ada and Barry Stein, 2021, “Observations from a Long-Term Effort to Assess and Improve Critical Thinking”, in Daniel Fasko, Jr. and Frank Fair (eds.), Critical Thinking and Reasoning: Theory, Development, Instruction, and Assessment , Leiden: Brill, pp. 231–254. doi: 10.1163/9789004444591_014
• Hiner, Amanda L. 2021. “Equipping Students for Success in College and Beyond: Placing Critical Thinking Instruction at the Heart of a General Education Program”, in Daniel Fasko, Jr. and Frank Fair (eds.), Critical Thinking and Reasoning: Theory, Development, Instruction, and Assessment , Leiden: Brill, pp. 188–208. doi: 10.1163/9789004444591_012
• Hitchcock, David, 2017, “Critical Thinking as an Educational Ideal”, in his On Reasoning and Argument: Essays in Informal Logic and on Critical Thinking , Dordrecht: Springer, pp. 477–497. doi:10.1007/978-3-319-53562-3_30
• –––, 2021, “Seven Philosophical Implications of Critical Thinking: Themes, Variations, Implications”, in Daniel Fasko, Jr. and Frank Fair (eds.), Critical Thinking and Reasoning: Theory, Development, Instruction, and Assessment , Leiden: Brill, pp. 9–30. doi: 10.1163/9789004444591_002
• hooks, bell, 1994, Teaching to Transgress: Education as the Practice of Freedom , New York and London: Routledge.
• –––, 2010, Teaching Critical Thinking: Practical Wisdom , New York and London: Routledge.
• Johnson, Ralph H., 1992, “The Problem of Defining Critical Thinking”, in Stephen P, Norris (ed.), The Generalizability of Critical Thinking , New York: Teachers College Press, pp. 38–53.
• Kahane, Howard, 1971, Logic and Contemporary Rhetoric: The Use of Reason in Everyday Life , Belmont, CA: Wadsworth.
• Kahneman, Daniel, 2011, Thinking, Fast and Slow , New York: Farrar, Straus and Giroux.
• Kahneman, Daniel, Olivier Sibony, & Cass R. Sunstein, 2021, Noise: A Flaw in Human Judgment , New York: Little, Brown Spark.
• Kenyon, Tim, and Guillaume Beaulac, 2014, “Critical Thinking Education and Debasing”, Informal Logic , 34(4): 341–363. [ Kenyon & Beaulac 2014 available online ]
• Krathwohl, David R., Benjamin S. Bloom, and Bertram B. Masia, 1964, Taxonomy of Educational Objectives, Handbook II: Affective Domain , New York: David McKay.
• Kuhn, Deanna, 1991, The Skills of Argument , New York: Cambridge University Press. doi:10.1017/CBO9780511571350
• –––, 2019, “Critical Thinking as Discourse”, Human Development, 62 (3): 146–164. doi:10.1159/000500171
• Lipman, Matthew, 1987, “Critical Thinking–What Can It Be?”, Analytic Teaching , 8(1): 5–12. [ Lipman 1987 available online ]
• –––, 2003, Thinking in Education , Cambridge: Cambridge University Press, 2nd edition.
• Loftus, Elizabeth F., 2017, “Eavesdropping on Memory”, Annual Review of Psychology , 68: 1–18. doi:10.1146/annurev-psych-010416-044138
• Makaiau, Amber Strong, 2021, “The Good Thinker’s Tool Kit: How to Engage Critical Thinking and Reasoning in Secondary Education”, in Daniel Fasko, Jr. and Frank Fair (eds.), Critical Thinking and Reasoning: Theory, Development, Instruction, and Assessment , Leiden: Brill, pp. 168–187. doi: 10.1163/9789004444591_011
• Martin, Jane Roland, 1992, “Critical Thinking for a Humane World”, in Stephen P. Norris (ed.), The Generalizability of Critical Thinking , New York: Teachers College Press, pp. 163–180.
• Mayhew, Katherine Camp, and Anna Camp Edwards, 1936, The Dewey School: The Laboratory School of the University of Chicago, 1896–1903 , New York: Appleton-Century. [ Mayhew & Edwards 1936 available online ]
• McPeck, John E., 1981, Critical Thinking and Education , New York: St. Martin’s Press.
• Moore, Brooke Noel and Richard Parker, 2020, Critical Thinking , New York: McGraw-Hill, 13th edition.
• Nickerson, Raymond S., 1998, “Confirmation Bias: A Ubiquitous Phenomenon in Many Guises”, Review of General Psychology , 2(2): 175–220. doi:10.1037/1089-2680.2.2.175
• Nieto, Ana Maria, and Jorge Valenzuela, 2012, “A Study of the Internal Structure of Critical Thinking Dispositions”, Inquiry: Critical Thinking across the Disciplines , 27(1): 31–38. doi:10.5840/inquiryct20122713
• Norris, Stephen P., 1985, “Controlling for Background Beliefs When Developing Multiple-choice Critical Thinking Tests”, Educational Measurement: Issues and Practice , 7(3): 5–11. doi:10.1111/j.1745-3992.1988.tb00437.x
• Norris, Stephen P. and Robert H. Ennis, 1989, Evaluating Critical Thinking (The Practitioners’ Guide to Teaching Thinking Series), Pacific Grove, CA: Midwest Publications.
• Norris, Stephen P. and Ruth Elizabeth King, 1983, Test on Appraising Observations , St. John’s, NL: Institute for Educational Research and Development, Memorial University of Newfoundland.
• –––, 1984, The Design of a Critical Thinking Test on Appraising Observations , St. John’s, NL: Institute for Educational Research and Development, Memorial University of Newfoundland. ERIC Document ED260083.
• –––, 1985, Test on Appraising Observations: Manual , St. John’s, NL: Institute for Educational Research and Development, Memorial University of Newfoundland.
• –––, 1990a, Test on Appraising Observations , St. John’s, NL: Institute for Educational Research and Development, Memorial University of Newfoundland, 2nd edition.
• –––, 1990b, Test on Appraising Observations: Manual , St. John’s, NL: Institute for Educational Research and Development, Memorial University of Newfoundland, 2nd edition.
• OCR [Oxford, Cambridge and RSA Examinations], 2011, AS/A Level GCE: Critical Thinking – H052, H452 , Cambridge: OCR. Past papers available at https://pastpapers.co/ocr/?dir=A-Level/Critical-Thinking-H052-H452; last accessed 2022 07 16.
• Ontario Ministry of Education, 2013, The Ontario Curriculum Grades 9 to 12: Social Sciences and Humanities . Available at http://www.edu.gov.on.ca/eng/curriculum/secondary/ssciences9to122013.pdf ; last accessed 2022 07 16.
• Passmore, John Arthur, 1980, The Philosophy of Teaching , London: Duckworth.
• Paul, Richard W., 1981, “Teaching Critical Thinking in the ‘Strong’ Sense: A Focus on Self-Deception, World Views, and a Dialectical Mode of Analysis”, Informal Logic , 4(2): 2–7. [ Paul 1981 available online ]
• –––, 1984, “Critical Thinking: Fundamental to Education for a Free Society”, Educational Leadership , 42(1): 4–14.
• –––, 1985, “McPeck’s Mistakes”, Informal Logic , 7(1): 35–43. [ Paul 1985 available online ]
• Paul, Richard W. and Linda Elder, 2006, The Miniature Guide to Critical Thinking: Concepts and Tools , Dillon Beach, CA: Foundation for Critical Thinking, 4th edition.
• Payette, Patricia, and Edna Ross, 2016, “Making a Campus-Wide Commitment to Critical Thinking: Insights and Promising Practices Utilizing the Paul-Elder Approach at the University of Louisville”, Inquiry: Critical Thinking Across the Disciplines , 31(1): 98–110. doi:10.5840/inquiryct20163118
• Possin, Kevin, 2008, “A Field Guide to Critical-Thinking Assessment”, Teaching Philosophy , 31(3): 201–228. doi:10.5840/teachphil200831324
• –––, 2013a, “Some Problems with the Halpern Critical Thinking Assessment (HCTA) Test”, Inquiry: Critical Thinking across the Disciplines , 28(3): 4–12. doi:10.5840/inquiryct201328313
• –––, 2013b, “A Serious Flaw in the Collegiate Learning Assessment (CLA) Test”, Informal Logic , 33(3): 390–405. [ Possin 2013b available online ]
• –––, 2013c, “A Fatal Flaw in the Collegiate Learning Assessment Test”, Assessment Update , 25 (1): 8–12.
• –––, 2014, “Critique of the Watson-Glaser Critical Thinking Appraisal Test: The More You Know, the Lower Your Score”, Informal Logic , 34(4): 393–416. [ Possin 2014 available online ]
• –––, 2020, “CAT Scan: A Critical Review of the Critical-Thinking Assessment Test”, Informal Logic , 40 (3): 489–508. [Available online at https://informallogic.ca/index.php/informal_logic/article/view/6243]
• Rawls, John, 1971, A Theory of Justice , Cambridge, MA: Harvard University Press.
• Rear, David, 2019, “One Size Fits All? The Limitations of Standardised Assessment in Critical Thinking”, Assessment & Evaluation in Higher Education , 44(5): 664–675. doi: 10.1080/02602938.2018.1526255
• Rousseau, Jean-Jacques, 1762, Émile , Amsterdam: Jean Néaulme.
• Scheffler, Israel, 1960, The Language of Education , Springfield, IL: Charles C. Thomas.
• Scriven, Michael, and Richard W. Paul, 1987, Defining Critical Thinking , Draft statement written for the National Council for Excellence in Critical Thinking Instruction. Available at http://www.criticalthinking.org/pages/defining-critical-thinking/766 ; last accessed 2022 07 16.
• Sheffield, Clarence Burton Jr., 2018, “Promoting Critical Thinking in Higher Education: My Experiences as the Inaugural Eugene H. Fram Chair in Applied Critical Thinking at Rochester Institute of Technology”, Topoi , 37(1): 155–163. doi:10.1007/s11245-016-9392-1
• Siegel, Harvey, 1985, “McPeck, Informal Logic and the Nature of Critical Thinking”, in David Nyberg (ed.), Philosophy of Education 1985: Proceedings of the Forty-First Annual Meeting of the Philosophy of Education Society , Normal, IL: Philosophy of Education Society, pp. 61–72.
• –––, 1988, Educating Reason: Rationality, Critical Thinking, and Education , New York: Routledge.
• –––, 1999, “What (Good) Are Thinking Dispositions?”, Educational Theory , 49(2): 207–221. doi:10.1111/j.1741-5446.1999.00207.x
• Simon, Herbert A., 1956, “Rational Choice and the Structure of the Environment”, Psychological Review , 63(2): 129–138. doi: 10.1037/h0042769
• Simpson, Elizabeth, 1966–67, “The Classification of Educational Objectives: Psychomotor Domain”, Illinois Teacher of Home Economics , 10(4): 110–144, ERIC document ED0103613. [ Simpson 1966–67 available online ]
• Skolverket, 2018, Curriculum for the Compulsory School, Preschool Class and School-age Educare , Stockholm: Skolverket, revised 2018. Available at https://www.skolverket.se/download/18.31c292d516e7445866a218f/1576654682907/pdf3984.pdf; last accessed 2022 07 15.
• Smith, B. Othanel, 1953, “The Improvement of Critical Thinking”, Progressive Education , 30(5): 129–134.
• Smith, Eugene Randolph, Ralph Winfred Tyler, and the Evaluation Staff, 1942, Appraising and Recording Student Progress , Volume III of Adventure in American Education , New York and London: Harper & Brothers.
• Splitter, Laurance J., 1987, “Educational Reform through Philosophy for Children”, Thinking: The Journal of Philosophy for Children , 7(2): 32–39. doi:10.5840/thinking1987729
• Stanovich Keith E., and Paula J. Stanovich, 2010, “A Framework for Critical Thinking, Rational Thinking, and Intelligence”, in David D. Preiss and Robert J. Sternberg (eds), Innovations in Educational Psychology: Perspectives on Learning, Teaching and Human Development , New York: Springer Publishing, pp 195–237.
• Stanovich Keith E., Richard F. West, and Maggie E. Toplak, 2011, “Intelligence and Rationality”, in Robert J. Sternberg and Scott Barry Kaufman (eds.), Cambridge Handbook of Intelligence , Cambridge: Cambridge University Press, 3rd edition, pp. 784–826. doi:10.1017/CBO9780511977244.040
• Tankersley, Karen, 2005, Literacy Strategies for Grades 4–12: Reinforcing the Threads of Reading , Alexandria, VA: Association for Supervision and Curriculum Development.
• Thayer-Bacon, Barbara J., 1992, “Is Modern Critical Thinking Theory Sexist?”, Inquiry: Critical Thinking Across the Disciplines , 10(1): 3–7. doi:10.5840/inquiryctnews199210123
• –––, 1993, “Caring and Its Relationship to Critical Thinking”, Educational Theory , 43(3): 323–340. doi:10.1111/j.1741-5446.1993.00323.x
• –––, 1995a, “Constructive Thinking: Personal Voice”, Journal of Thought , 30(1): 55–70.
• –––, 1995b, “Doubting and Believing: Both are Important for Critical Thinking”, Inquiry: Critical Thinking across the Disciplines , 15(2): 59–66. doi:10.5840/inquiryctnews199515226
• –––, 2000, Transforming Critical Thinking: Thinking Constructively , New York: Teachers College Press.
• Toulmin, Stephen Edelston, 1958, The Uses of Argument , Cambridge: Cambridge University Press.
• Turri, John, Mark Alfano, and John Greco, 2017, “Virtue Epistemology”, in Edward N. Zalta (ed.), The Stanford Encyclopedia of Philosophy (Winter 2017 Edition). URL = < https://plato.stanford.edu/archives/win2017/entries/epistemology-virtue/ >
• Vincent-Lancrin, Stéphan, Carlos González-Sancho, Mathias Bouckaert, Federico de Luca, Meritxell Fernández-Barrerra, Gwénaël Jacotin, Joaquin Urgel, and Quentin Vidal, 2019, Fostering Students’ Creativity and Critical Thinking: What It Means in School. Educational Research and Innovation , Paris: OECD Publishing.
• Warren, Karen J. 1988. “Critical Thinking and Feminism”, Informal Logic , 10(1): 31–44. [ Warren 1988 available online ]
• Watson, Goodwin, and Edward M. Glaser, 1980a, Watson-Glaser Critical Thinking Appraisal, Form A , San Antonio, TX: Psychological Corporation.
• –––, 1980b, Watson-Glaser Critical Thinking Appraisal: Forms A and B; Manual , San Antonio, TX: Psychological Corporation,
• –––, 1994, Watson-Glaser Critical Thinking Appraisal, Form B , San Antonio, TX: Psychological Corporation.
• Weinstein, Mark, 1990, “Towards a Research Agenda for Informal Logic and Critical Thinking”, Informal Logic , 12(3): 121–143. [ Weinstein 1990 available online ]
• –––, 2013, Logic, Truth and Inquiry , London: College Publications.
• Willingham, Daniel T., 2019, “How to Teach Critical Thinking”, Education: Future Frontiers , 1: 1–17. [Available online at https://prod65.education.nsw.gov.au/content/dam/main-education/teaching-and-learning/education-for-a-changing-world/media/documents/How-to-teach-critical-thinking-Willingham.pdf.]
• Zagzebski, Linda Trinkaus, 1996, Virtues of the Mind: An Inquiry into the Nature of Virtue and the Ethical Foundations of Knowledge , Cambridge: Cambridge University Press. doi:10.1017/CBO9781139174763

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Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr.

Patient Safety and Quality: An Evidence-Based Handbook for Nurses.

Chapter 6 clinical reasoning, decisionmaking, and action: thinking critically and clinically.

Patricia Benner ; Ronda G. Hughes ; Molly Sutphen .

Affiliations

This chapter examines multiple thinking strategies that are needed for high-quality clinical practice. Clinical reasoning and judgment are examined in relation to other modes of thinking used by clinical nurses in providing quality health care to patients that avoids adverse events and patient harm. The clinician’s ability to provide safe, high-quality care can be dependent upon their ability to reason, think, and judge, which can be limited by lack of experience. The expert performance of nurses is dependent upon continual learning and evaluation of performance.

• Critical Thinking

Nursing education has emphasized critical thinking as an essential nursing skill for more than 50 years. 1 The definitions of critical thinking have evolved over the years. There are several key definitions for critical thinking to consider. The American Philosophical Association (APA) defined critical thinking as purposeful, self-regulatory judgment that uses cognitive tools such as interpretation, analysis, evaluation, inference, and explanation of the evidential, conceptual, methodological, criteriological, or contextual considerations on which judgment is based. 2 A more expansive general definition of critical thinking is

. . . in short, self-directed, self-disciplined, self-monitored, and self-corrective thinking. It presupposes assent to rigorous standards of excellence and mindful command of their use. It entails effective communication and problem solving abilities and a commitment to overcome our native egocentrism and sociocentrism. Every clinician must develop rigorous habits of critical thinking, but they cannot escape completely the situatedness and structures of the clinical traditions and practices in which they must make decisions and act quickly in specific clinical situations. 3

There are three key definitions for nursing, which differ slightly. Bittner and Tobin defined critical thinking as being “influenced by knowledge and experience, using strategies such as reflective thinking as a part of learning to identify the issues and opportunities, and holistically synthesize the information in nursing practice” 4 (p. 268). Scheffer and Rubenfeld 5 expanded on the APA definition for nurses through a consensus process, resulting in the following definition:

Critical thinking in nursing is an essential component of professional accountability and quality nursing care. Critical thinkers in nursing exhibit these habits of the mind: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, openmindedness, perseverance, and reflection. Critical thinkers in nursing practice the cognitive skills of analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting, and transforming knowledge 6 (Scheffer & Rubenfeld, p. 357).

The National League for Nursing Accreditation Commission (NLNAC) defined critical thinking as:

the deliberate nonlinear process of collecting, interpreting, analyzing, drawing conclusions about, presenting, and evaluating information that is both factually and belief based. This is demonstrated in nursing by clinical judgment, which includes ethical, diagnostic, and therapeutic dimensions and research 7 (p. 8).

These concepts are furthered by the American Association of Colleges of Nurses’ definition of critical thinking in their Essentials of Baccalaureate Nursing :

Critical thinking underlies independent and interdependent decision making. Critical thinking includes questioning, analysis, synthesis, interpretation, inference, inductive and deductive reasoning, intuition, application, and creativity 8 (p. 9).

Course work or ethical experiences should provide the graduate with the knowledge and skills to:

• Use nursing and other appropriate theories and models, and an appropriate ethical framework;
• Apply research-based knowledge from nursing and the sciences as the basis for practice;
• Use clinical judgment and decision-making skills;
• Engage in self-reflective and collegial dialogue about professional practice;
• Evaluate nursing care outcomes through the acquisition of data and the questioning of inconsistencies, allowing for the revision of actions and goals;
• Engage in creative problem solving 8 (p. 10).

Taken together, these definitions of critical thinking set forth the scope and key elements of thought processes involved in providing clinical care. Exactly how critical thinking is defined will influence how it is taught and to what standard of care nurses will be held accountable.

Professional and regulatory bodies in nursing education have required that critical thinking be central to all nursing curricula, but they have not adequately distinguished critical reflection from ethical, clinical, or even creative thinking for decisionmaking or actions required by the clinician. Other essential modes of thought such as clinical reasoning, evaluation of evidence, creative thinking, or the application of well-established standards of practice—all distinct from critical reflection—have been subsumed under the rubric of critical thinking. In the nursing education literature, clinical reasoning and judgment are often conflated with critical thinking. The accrediting bodies and nursing scholars have included decisionmaking and action-oriented, practical, ethical, and clinical reasoning in the rubric of critical reflection and thinking. One might say that this harmless semantic confusion is corrected by actual practices, except that students need to understand the distinctions between critical reflection and clinical reasoning, and they need to learn to discern when each is better suited, just as students need to also engage in applying standards, evidence-based practices, and creative thinking.

The growing body of research, patient acuity, and complexity of care demand higher-order thinking skills. Critical thinking involves the application of knowledge and experience to identify patient problems and to direct clinical judgments and actions that result in positive patient outcomes. These skills can be cultivated by educators who display the virtues of critical thinking, including independence of thought, intellectual curiosity, courage, humility, empathy, integrity, perseverance, and fair-mindedness. 9

The process of critical thinking is stimulated by integrating the essential knowledge, experiences, and clinical reasoning that support professional practice. The emerging paradigm for clinical thinking and cognition is that it is social and dialogical rather than monological and individual. 10–12 Clinicians pool their wisdom and multiple perspectives, yet some clinical knowledge can be demonstrated only in the situation (e.g., how to suction an extremely fragile patient whose oxygen saturations sink too low). Early warnings of problematic situations are made possible by clinicians comparing their observations to that of other providers. Clinicians form practice communities that create styles of practice, including ways of doing things, communication styles and mechanisms, and shared expectations about performance and expertise of team members.

By holding up critical thinking as a large umbrella for different modes of thinking, students can easily misconstrue the logic and purposes of different modes of thinking. Clinicians and scientists alike need multiple thinking strategies, such as critical thinking, clinical judgment, diagnostic reasoning, deliberative rationality, scientific reasoning, dialogue, argument, creative thinking, and so on. In particular, clinicians need forethought and an ongoing grasp of a patient’s health status and care needs trajectory, which requires an assessment of their own clarity and understanding of the situation at hand, critical reflection, critical reasoning, and clinical judgment.

Critical Reflection, Critical Reasoning, and Judgment

Critical reflection requires that the thinker examine the underlying assumptions and radically question or doubt the validity of arguments, assertions, and even facts of the case. Critical reflective skills are essential for clinicians; however, these skills are not sufficient for the clinician who must decide how to act in particular situations and avoid patient injury. For example, in everyday practice, clinicians cannot afford to critically reflect on the well-established tenets of “normal” or “typical” human circulatory systems when trying to figure out a particular patient’s alterations from that typical, well-grounded understanding that has existed since Harvey’s work in 1628. 13 Yet critical reflection can generate new scientifically based ideas. For example, there is a lack of adequate research on the differences between women’s and men’s circulatory systems and the typical pathophysiology related to heart attacks. Available research is based upon multiple, taken-for-granted starting points about the general nature of the circulatory system. As such, critical reflection may not provide what is needed for a clinician to act in a situation. This idea can be considered reasonable since critical reflective thinking is not sufficient for good clinical reasoning and judgment. The clinician’s development of skillful critical reflection depends upon being taught what to pay attention to, and thus gaining a sense of salience that informs the powers of perceptual grasp. The powers of noticing or perceptual grasp depend upon noticing what is salient and the capacity to respond to the situation.

Critical reflection is a crucial professional skill, but it is not the only reasoning skill or logic clinicians require. The ability to think critically uses reflection, induction, deduction, analysis, challenging assumptions, and evaluation of data and information to guide decisionmaking. 9 , 14 , 15 Critical reasoning is a process whereby knowledge and experience are applied in considering multiple possibilities to achieve the desired goals, 16 while considering the patient’s situation. 14 It is a process where both inductive and deductive cognitive skills are used. 17 Sometimes clinical reasoning is presented as a form of evaluating scientific knowledge, sometimes even as a form of scientific reasoning. Critical thinking is inherent in making sound clinical reasoning. 18

An essential point of tension and confusion exists in practice traditions such as nursing and medicine when clinical reasoning and critical reflection become entangled, because the clinician must have some established bases that are not questioned when engaging in clinical decisions and actions, such as standing orders. The clinician must act in the particular situation and time with the best clinical and scientific knowledge available. The clinician cannot afford to indulge in either ritualistic unexamined knowledge or diagnostic or therapeutic nihilism caused by radical doubt, as in critical reflection, because they must find an intelligent and effective way to think and act in particular clinical situations. Critical reflection skills are essential to assist practitioners to rethink outmoded or even wrong-headed approaches to health care, health promotion, and prevention of illness and complications, especially when new evidence is available. Breakdowns in practice, high failure rates in particular therapies, new diseases, new scientific discoveries, and societal changes call for critical reflection about past assumptions and no-longer-tenable beliefs.

Clinical reasoning stands out as a situated, practice-based form of reasoning that requires a background of scientific and technological research-based knowledge about general cases, more so than any particular instance. It also requires practical ability to discern the relevance of the evidence behind general scientific and technical knowledge and how it applies to a particular patient. In dong so, the clinician considers the patient’s particular clinical trajectory, their concerns and preferences, and their particular vulnerabilities (e.g., having multiple comorbidities) and sensitivities to care interventions (e.g., known drug allergies, other conflicting comorbid conditions, incompatible therapies, and past responses to therapies) when forming clinical decisions or conclusions.

Situated in a practice setting, clinical reasoning occurs within social relationships or situations involving patient, family, community, and a team of health care providers. The expert clinician situates themselves within a nexus of relationships, with concerns that are bounded by the situation. Expert clinical reasoning is socially engaged with the relationships and concerns of those who are affected by the caregiving situation, and when certain circumstances are present, the adverse event. Halpern 19 has called excellent clinical ethical reasoning “emotional reasoning” in that the clinicians have emotional access to the patient/family concerns and their understanding of the particular care needs. Expert clinicians also seek an optimal perceptual grasp, one based on understanding and as undistorted as possible, based on an attuned emotional engagement and expert clinical knowledge. 19 , 20

Clergy educators 21 and nursing and medical educators have begun to recognize the wisdom of broadening their narrow vision of rationality beyond simple rational calculation (exemplified by cost-benefit analysis) to reconsider the need for character development—including emotional engagement, perception, habits of thought, and skill acquisition—as essential to the development of expert clinical reasoning, judgment, and action. 10 , 22–24 Practitioners of engineering, law, medicine, and nursing, like the clergy, have to develop a place to stand in their discipline’s tradition of knowledge and science in order to recognize and evaluate salient evidence in the moment. Diagnostic confusion and disciplinary nihilism are both threats to the clinician’s ability to act in particular situations. However, the practice and practitioners will not be self-improving and vital if they cannot engage in critical reflection on what is not of value, what is outmoded, and what does not work. As evidence evolves and expands, so too must clinical thought.

Clinical judgment requires clinical reasoning across time about the particular, and because of the relevance of this immediate historical unfolding, clinical reasoning can be very different from the scientific reasoning used to formulate, conduct, and assess clinical experiments. While scientific reasoning is also socially embedded in a nexus of social relationships and concerns, the goal of detached, critical objectivity used to conduct scientific experiments minimizes the interactive influence of the research on the experiment once it has begun. Scientific research in the natural and clinical sciences typically uses formal criteria to develop “yes” and “no” judgments at prespecified times. The scientist is always situated in past and immediate scientific history, preferring to evaluate static and predetermined points in time (e.g., snapshot reasoning), in contrast to a clinician who must always reason about transitions over time. 25 , 26

Techne and Phronesis

Distinctions between the mere scientific making of things and practice was first explored by Aristotle as distinctions between techne and phronesis. 27 Learning to be a good practitioner requires developing the requisite moral imagination for good practice. If, for example, patients exercise their rights and refuse treatments, practitioners are required to have the moral imagination to understand the probable basis for the patient’s refusal. For example, was the refusal based upon catastrophic thinking, unrealistic fears, misunderstanding, or even clinical depression?

Techne, as defined by Aristotle, encompasses the notion of formation of character and habitus 28 as embodied beings. In Aristotle’s terms, techne refers to the making of things or producing outcomes. 11 Joseph Dunne defines techne as “the activity of producing outcomes,” and it “is governed by a means-ends rationality where the maker or producer governs the thing or outcomes produced or made through gaining mastery over the means of producing the outcomes, to the point of being able to separate means and ends” 11 (p. 54). While some aspects of medical and nursing practice fall into the category of techne, much of nursing and medical practice falls outside means-ends rationality and must be governed by concern for doing good or what is best for the patient in particular circumstances, where being in a relationship and discerning particular human concerns at stake guide action.

Phronesis, in contrast to techne, includes reasoning about the particular, across time, through changes or transitions in the patient’s and/or the clinician’s understanding. As noted by Dunne, phronesis is “characterized at least as much by a perceptiveness with regard to concrete particulars as by a knowledge of universal principles” 11 (p. 273). This type of practical reasoning often takes the form of puzzle solving or the evaluation of immediate past “hot” history of the patient’s situation. Such a particular clinical situation is necessarily particular, even though many commonalities and similarities with other disease syndromes can be recognized through signs and symptoms and laboratory tests. 11 , 29 , 30 Pointing to knowledge embedded in a practice makes no claim for infallibility or “correctness.” Individual practitioners can be mistaken in their judgments because practices such as medicine and nursing are inherently underdetermined. 31

While phronetic knowledge must remain open to correction and improvement, real events, and consequences, it cannot consistently transcend the institutional setting’s capacities and supports for good practice. Phronesis is also dependent on ongoing experiential learning of the practitioner, where knowledge is refined, corrected, or refuted. The Western tradition, with the notable exception of Aristotle, valued knowledge that could be made universal and devalued practical know-how and experiential learning. Descartes codified this preference for formal logic and rational calculation.

Aristotle recognized that when knowledge is underdetermined, changeable, and particular, it cannot be turned into the universal or standardized. It must be perceived, discerned, and judged, all of which require experiential learning. In nursing and medicine, perceptual acuity in physical assessment and clinical judgment (i.e., reasoning across time about changes in the particular patient or the clinician’s understanding of the patient’s condition) fall into the Greek Aristotelian category of phronesis. Dewey 32 sought to rescue knowledge gained by practical activity in the world. He identified three flaws in the understanding of experience in Greek philosophy: (1) empirical knowing is the opposite of experience with science; (2) practice is reduced to techne or the application of rational thought or technique; and (3) action and skilled know-how are considered temporary and capricious as compared to reason, which the Greeks considered as ultimate reality.

In practice, nursing and medicine require both techne and phronesis. The clinician standardizes and routinizes what can be standardized and routinized, as exemplified by standardized blood pressure measurements, diagnoses, and even charting about the patient’s condition and treatment. 27 Procedural and scientific knowledge can often be formalized and standardized (e.g., practice guidelines), or at least made explicit and certain in practice, except for the necessary timing and adjustments made for particular patients. 11 , 22

Rational calculations available to techne—population trends and statistics, algorithms—are created as decision support structures and can improve accuracy when used as a stance of inquiry in making clinical judgments about particular patients. Aggregated evidence from clinical trials and ongoing working knowledge of pathophysiology, biochemistry, and genomics are essential. In addition, the skills of phronesis (clinical judgment that reasons across time, taking into account the transitions of the particular patient/family/community and transitions in the clinician’s understanding of the clinical situation) will be required for nursing, medicine, or any helping profession.

Thinking Critically

Being able to think critically enables nurses to meet the needs of patients within their context and considering their preferences; meet the needs of patients within the context of uncertainty; consider alternatives, resulting in higher-quality care; 33 and think reflectively, rather than simply accepting statements and performing tasks without significant understanding and evaluation. 34 Skillful practitioners can think critically because they have the following cognitive skills: information seeking, discriminating, analyzing, transforming knowledge, predicating, applying standards, and logical reasoning. 5 One’s ability to think critically can be affected by age, length of education (e.g., an associate vs. a baccalaureate decree in nursing), and completion of philosophy or logic subjects. 35–37 The skillful practitioner can think critically because of having the following characteristics: motivation, perseverance, fair-mindedness, and deliberate and careful attention to thinking. 5 , 9

Thinking critically implies that one has a knowledge base from which to reason and the ability to analyze and evaluate evidence. 38 Knowledge can be manifest by the logic and rational implications of decisionmaking. Clinical decisionmaking is particularly influenced by interpersonal relationships with colleagues, 39 patient conditions, availability of resources, 40 knowledge, and experience. 41 Of these, experience has been shown to enhance nurses’ abilities to make quick decisions 42 and fewer decision errors, 43 support the identification of salient cues, and foster the recognition and action on patterns of information. 44 , 45

Clinicians must develop the character and relational skills that enable them to perceive and understand their patient’s needs and concerns. This requires accurate interpretation of patient data that is relevant to the specific patient and situation. In nursing, this formation of moral agency focuses on learning to be responsible in particular ways demanded by the practice, and to pay attention and intelligently discern changes in patients’ concerns and/or clinical condition that require action on the part of the nurse or other health care workers to avert potential compromises to quality care.

Formation of the clinician’s character, skills, and habits are developed in schools and particular practice communities within a larger practice tradition. As Dunne notes,

A practice is not just a surface on which one can display instant virtuosity. It grounds one in a tradition that has been formed through an elaborate development and that exists at any juncture only in the dispositions (slowly and perhaps painfully acquired) of its recognized practitioners. The question may of course be asked whether there are any such practices in the contemporary world, whether the wholesale encroachment of Technique has not obliterated them—and whether this is not the whole point of MacIntyre’s recipe of withdrawal, as well as of the post-modern story of dispossession 11 (p. 378).

Clearly Dunne is engaging in critical reflection about the conditions for developing character, skills, and habits for skillful and ethical comportment of practitioners, as well as to act as moral agents for patients so that they and their families receive safe, effective, and compassionate care.

Professional socialization or professional values, while necessary, do not adequately address character and skill formation that transform the way the practitioner exists in his or her world, what the practitioner is capable of noticing and responding to, based upon well-established patterns of emotional responses, skills, dispositions to act, and the skills to respond, decide, and act. 46 The need for character and skill formation of the clinician is what makes a practice stand out from a mere technical, repetitious manufacturing process. 11 , 30 , 47

In nursing and medicine, many have questioned whether current health care institutions are designed to promote or hinder enlightened, compassionate practice, or whether they have deteriorated into commercial institutional models that focus primarily on efficiency and profit. MacIntyre points out the links between the ongoing development and improvement of practice traditions and the institutions that house them:

Lack of justice, lack of truthfulness, lack of courage, lack of the relevant intellectual virtues—these corrupt traditions, just as they do those institutions and practices which derive their life from the traditions of which they are the contemporary embodiments. To recognize this is of course also to recognize the existence of an additional virtue, one whose importance is perhaps most obvious when it is least present, the virtue of having an adequate sense of the traditions to which one belongs or which confront one. This virtue is not to be confused with any form of conservative antiquarianism; I am not praising those who choose the conventional conservative role of laudator temporis acti. It is rather the case that an adequate sense of tradition manifests itself in a grasp of those future possibilities which the past has made available to the present. Living traditions, just because they continue a not-yet-completed narrative, confront a future whose determinate and determinable character, so far as it possesses any, derives from the past 30 (p. 207).

It would be impossible to capture all the situated and distributed knowledge outside of actual practice situations and particular patients. Simulations are powerful as teaching tools to enable nurses’ ability to think critically because they give students the opportunity to practice in a simplified environment. However, students can be limited in their inability to convey underdetermined situations where much of the information is based on perceptions of many aspects of the patient and changes that have occurred over time. Simulations cannot have the sub-cultures formed in practice settings that set the social mood of trust, distrust, competency, limited resources, or other forms of situated possibilities.

One of the hallmark studies in nursing providing keen insight into understanding the influence of experience was a qualitative study of adult, pediatric, and neonatal intensive care unit (ICU) nurses, where the nurses were clustered into advanced beginner, intermediate, and expert level of practice categories. The advanced beginner (having up to 6 months of work experience) used procedures and protocols to determine which clinical actions were needed. When confronted with a complex patient situation, the advanced beginner felt their practice was unsafe because of a knowledge deficit or because of a knowledge application confusion. The transition from advanced beginners to competent practitioners began when they first had experience with actual clinical situations and could benefit from the knowledge gained from the mistakes of their colleagues. Competent nurses continuously questioned what they saw and heard, feeling an obligation to know more about clinical situations. In doing do, they moved from only using care plans and following the physicians’ orders to analyzing and interpreting patient situations. Beyond that, the proficient nurse acknowledged the changing relevance of clinical situations requiring action beyond what was planned or anticipated. The proficient nurse learned to acknowledge the changing needs of patient care and situation, and could organize interventions “by the situation as it unfolds rather than by preset goals 48 (p. 24). Both competent and proficient nurses (that is, intermediate level of practice) had at least two years of ICU experience. 48 Finally, the expert nurse had a more fully developed grasp of a clinical situation, a sense of confidence in what is known about the situation, and could differentiate the precise clinical problem in little time. 48

Expertise is acquired through professional experience and is indicative of a nurse who has moved beyond mere proficiency. As Gadamer 29 points out, experience involves a turning around of preconceived notions, preunderstandings, and extends or adds nuances to understanding. Dewey 49 notes that experience requires a prepared “creature” and an enriched environment. The opportunity to reflect and narrate one’s experiential learning can clarify, extend, or even refute experiential learning.

Experiential learning requires time and nurturing, but time alone does not ensure experiential learning. Aristotle linked experiential learning to the development of character and moral sensitivities of a person learning a practice. 50 New nurses/new graduates have limited work experience and must experience continuing learning until they have reached an acceptable level of performance. 51 After that, further improvements are not predictable, and years of experience are an inadequate predictor of expertise. 52

The most effective knower and developer of practical knowledge creates an ongoing dialogue and connection between lessons of the day and experiential learning over time. Gadamer, in a late life interview, highlighted the open-endedness and ongoing nature of experiential learning in the following interview response:

Being experienced does not mean that one now knows something once and for all and becomes rigid in this knowledge; rather, one becomes more open to new experiences. A person who is experienced is undogmatic. Experience has the effect of freeing one to be open to new experience … In our experience we bring nothing to a close; we are constantly learning new things from our experience … this I call the interminability of all experience 32 (p. 403).

Practical endeavor, supported by scientific knowledge, requires experiential learning, the development of skilled know-how, and perceptual acuity in order to make the scientific knowledge relevant to the situation. Clinical perceptual and skilled know-how helps the practitioner discern when particular scientific findings might be relevant. 53

Often experience and knowledge, confirmed by experimentation, are treated as oppositions, an either-or choice. However, in practice it is readily acknowledged that experiential knowledge fuels scientific investigation, and scientific investigation fuels further experiential learning. Experiential learning from particular clinical cases can help the clinician recognize future similar cases and fuel new scientific questions and study. For example, less experienced nurses—and it could be argued experienced as well—can use nursing diagnoses practice guidelines as part of their professional advancement. Guidelines are used to reflect their interpretation of patients’ needs, responses, and situation, 54 a process that requires critical thinking and decisionmaking. 55 , 56 Using guidelines also reflects one’s problem identification and problem-solving abilities. 56 Conversely, the ability to proficiently conduct a series of tasks without nursing diagnoses is the hallmark of expertise. 39 , 57

Experience precedes expertise. As expertise develops from experience and gaining knowledge and transitions to the proficiency stage, the nurses’ thinking moves from steps and procedures (i.e., task-oriented care) toward “chunks” or patterns 39 (i.e., patient-specific care). In doing so, the nurse thinks reflectively, rather than merely accepting statements and performing procedures without significant understanding and evaluation. 34 Expert nurses do not rely on rules and logical thought processes in problem-solving and decisionmaking. 39 Instead, they use abstract principles, can see the situation as a complex whole, perceive situations comprehensively, and can be fully involved in the situation. 48 Expert nurses can perform high-level care without conscious awareness of the knowledge they are using, 39 , 58 and they are able to provide that care with flexibility and speed. Through a combination of knowledge and skills gained from a range of theoretical and experiential sources, expert nurses also provide holistic care. 39 Thus, the best care comes from the combination of theoretical, tacit, and experiential knowledge. 59 , 60

Experts are thought to eventually develop the ability to intuitively know what to do and to quickly recognize critical aspects of the situation. 22 Some have proposed that expert nurses provide high-quality patient care, 61 , 62 but that is not consistently documented—particularly in consideration of patient outcomes—and a full understanding between the differential impact of care rendered by an “expert” nurse is not fully understood. In fact, several studies have found that length of professional experience is often unrelated and even negatively related to performance measures and outcomes. 63 , 64

In a review of the literature on expertise in nursing, Ericsson and colleagues 65 found that focusing on challenging, less-frequent situations would reveal individual performance differences on tasks that require speed and flexibility, such as that experienced during a code or an adverse event. Superior performance was associated with extensive training and immediate feedback about outcomes, which can be obtained through continual training, simulation, and processes such as root-cause analysis following an adverse event. Therefore, efforts to improve performance benefited from continual monitoring, planning, and retrospective evaluation. Even then, the nurse’s ability to perform as an expert is dependent upon their ability to use intuition or insights gained through interactions with patients. 39

Intuition and Perception

Intuition is the instant understanding of knowledge without evidence of sensible thought. 66 According to Young, 67 intuition in clinical practice is a process whereby the nurse recognizes something about a patient that is difficult to verbalize. Intuition is characterized by factual knowledge, “immediate possession of knowledge, and knowledge independent of the linear reasoning process” 68 (p. 23). When intuition is used, one filters information initially triggered by the imagination, leading to the integration of all knowledge and information to problem solve. 69 Clinicians use their interactions with patients and intuition, drawing on tacit or experiential knowledge, 70 , 71 to apply the correct knowledge to make the correct decisions to address patient needs. Yet there is a “conflated belief in the nurses’ ability to know what is best for the patient” 72 (p. 251) because the nurses’ and patients’ identification of the patients’ needs can vary. 73

A review of research and rhetoric involving intuition by King and Appleton 62 found that all nurses, including students, used intuition (i.e., gut feelings). They found evidence, predominately in critical care units, that intuition was triggered in response to knowledge and as a trigger for action and/or reflection with a direct bearing on the analytical process involved in patient care. The challenge for nurses was that rigid adherence to checklists, guidelines, and standardized documentation, 62 ignored the benefits of intuition. This view was furthered by Rew and Barrow 68 , 74 in their reviews of the literature, where they found that intuition was imperative to complex decisionmaking, 68 difficult to measure and assess in a quantitative manner, and was not linked to physiologic measures. 74

Intuition is a way of explaining professional expertise. 75 Expert nurses rely on their intuitive judgment that has been developed over time. 39 , 76 Intuition is an informal, nonanalytically based, unstructured, deliberate calculation that facilitates problem solving, 77 a process of arriving at salient conclusions based on relatively small amounts of knowledge and/or information. 78 Experts can have rapid insight into a situation by using intuition to recognize patterns and similarities, achieve commonsense understanding, and sense the salient information combined with deliberative rationality. 10 Intuitive recognition of similarities and commonalities between patients are often the first diagnostic clue or early warning, which must then be followed up with critical evaluation of evidence among the competing conditions. This situation calls for intuitive judgment that can distinguish “expert human judgment from the decisions” made by a novice 79 (p. 23).

Shaw 80 equates intuition with direct perception. Direct perception is dependent upon being able to detect complex patterns and relationships that one has learned through experience are important. Recognizing these patterns and relationships generally occurs rapidly and is complex, making it difficult to articulate or describe. Perceptual skills, like those of the expert nurse, are essential to recognizing current and changing clinical conditions. Perception requires attentiveness and the development of a sense of what is salient. Often in nursing and medicine, means and ends are fused, as is the case for a “good enough” birth experience and a peaceful death.

• Applying Practice Evidence

Research continues to find that using evidence-based guidelines in practice, informed through research evidence, improves patients’ outcomes. 81–83 Research-based guidelines are intended to provide guidance for specific areas of health care delivery. 84 The clinician—both the novice and expert—is expected to use the best available evidence for the most efficacious therapies and interventions in particular instances, to ensure the highest-quality care, especially when deviations from the evidence-based norm may heighten risks to patient safety. Otherwise, if nursing and medicine were exact sciences, or consisted only of techne, then a 1:1 relationship could be established between results of aggregated evidence-based research and the best path for all patients.

Evaluating Evidence

Before research should be used in practice, it must be evaluated. There are many complexities and nuances in evaluating the research evidence for clinical practice. Evaluation of research behind evidence-based medicine requires critical thinking and good clinical judgment. Sometimes the research findings are mixed or even conflicting. As such, the validity, reliability, and generalizability of available research are fundamental to evaluating whether evidence can be applied in practice. To do so, clinicians must select the best scientific evidence relevant to particular patients—a complex process that involves intuition to apply the evidence. Critical thinking is required for evaluating the best available scientific evidence for the treatment and care of a particular patient.

Good clinical judgment is required to select the most relevant research evidence. The best clinical judgment, that is, reasoning across time about the particular patient through changes in the patient’s concerns and condition and/or the clinician’s understanding, are also required. This type of judgment requires clinicians to make careful observations and evaluations of the patient over time, as well as know the patient’s concerns and social circumstances. To evolve to this level of judgment, additional education beyond clinical preparation if often required.

Sources of Evidence

Evidence that can be used in clinical practice has different sources and can be derived from research, patient’s preferences, and work-related experience. 85 , 86 Nurses have been found to obtain evidence from experienced colleagues believed to have clinical expertise and research-based knowledge 87 as well as other sources.

For many years now, randomized controlled trials (RCTs) have often been considered the best standard for evaluating clinical practice. Yet, unless the common threats to the validity (e.g., representativeness of the study population) and reliability (e.g., consistency in interventions and responses of study participants) of RCTs are addressed, the meaningfulness and generalizability of the study outcomes are very limited. Relevant patient populations may be excluded, such as women, children, minorities, the elderly, and patients with multiple chronic illnesses. The dropout rate of the trial may confound the results. And it is easier to get positive results published than it is to get negative results published. Thus, RCTs are generalizable (i.e., applicable) only to the population studied—which may not reflect the needs of the patient under the clinicians care. In instances such as these, clinicians need to also consider applied research using prospective or retrospective populations with case control to guide decisionmaking, yet this too requires critical thinking and good clinical judgment.

Another source of available evidence may come from the gold standard of aggregated systematic evaluation of clinical trial outcomes for the therapy and clinical condition in question, be generated by basic and clinical science relevant to the patient’s particular pathophysiology or care need situation, or stem from personal clinical experience. The clinician then takes all of the available evidence and considers the particular patient’s known clinical responses to past therapies, their clinical condition and history, the progression or stages of the patient’s illness and recovery, and available resources.

In clinical practice, the particular is examined in relation to the established generalizations of science. With readily available summaries of scientific evidence (e.g., systematic reviews and practice guidelines) available to nurses and physicians, one might wonder whether deep background understanding is still advantageous. Might it not be expendable, since it is likely to be out of date given the current scientific evidence? But this assumption is a false opposition and false choice because without a deep background understanding, the clinician does not know how to best find and evaluate scientific evidence for the particular case in hand. The clinician’s sense of salience in any given situation depends on past clinical experience and current scientific evidence.

Evidence-Based Practice

The concept of evidence-based practice is dependent upon synthesizing evidence from the variety of sources and applying it appropriately to the care needs of populations and individuals. This implies that evidence-based practice, indicative of expertise in practice, appropriately applies evidence to the specific situations and unique needs of patients. 88 , 89 Unfortunately, even though providing evidence-based care is an essential component of health care quality, it is well known that evidence-based practices are not used consistently.

Conceptually, evidence used in practice advances clinical knowledge, and that knowledge supports independent clinical decisions in the best interest of the patient. 90 , 91 Decisions must prudently consider the factors not necessarily addressed in the guideline, such as the patient’s lifestyle, drug sensitivities and allergies, and comorbidities. Nurses who want to improve the quality and safety of care can do so though improving the consistency of data and information interpretation inherent in evidence-based practice.

Initially, before evidence-based practice can begin, there needs to be an accurate clinical judgment of patient responses and needs. In the course of providing care, with careful consideration of patient safety and quality care, clinicians must give attention to the patient’s condition, their responses to health care interventions, and potential adverse reactions or events that could harm the patient. Nonetheless, there is wide variation in the ability of nurses to accurately interpret patient responses 92 and their risks. 93 Even though variance in interpretation is expected, nurses are obligated to continually improve their skills to ensure that patients receive quality care safely. 94 Patients are vulnerable to the actions and experience of their clinicians, which are inextricably linked to the quality of care patients have access to and subsequently receive.

The judgment of the patient’s condition determines subsequent interventions and patient outcomes. Attaining accurate and consistent interpretations of patient data and information is difficult because each piece can have different meanings, and interpretations are influenced by previous experiences. 95 Nurses use knowledge from clinical experience 96 , 97 and—although infrequently—research. 98–100

Once a problem has been identified, using a process that utilizes critical thinking to recognize the problem, the clinician then searches for and evaluates the research evidence 101 and evaluates potential discrepancies. The process of using evidence in practice involves “a problem-solving approach that incorporates the best available scientific evidence, clinicians’ expertise, and patient’s preferences and values” 102 (p. 28). Yet many nurses do not perceive that they have the education, tools, or resources to use evidence appropriately in practice. 103

Reported barriers to using research in practice have included difficulty in understanding the applicability and the complexity of research findings, failure of researchers to put findings into the clinical context, lack of skills in how to use research in practice, 104 , 105 amount of time required to access information and determine practice implications, 105–107 lack of organizational support to make changes and/or use in practice, 104 , 97 , 105 , 107 and lack of confidence in one’s ability to critically evaluate clinical evidence. 108

When Evidence Is Missing

In many clinical situations, there may be no clear guidelines and few or even no relevant clinical trials to guide decisionmaking. In these cases, the latest basic science about cellular and genomic functioning may be the most relevant science, or by default, guestimation. Consequently, good patient care requires more than a straightforward, unequivocal application of scientific evidence. The clinician must be able to draw on a good understanding of basic sciences, as well as guidelines derived from aggregated data and information from research investigations.

Practical knowledge is shaped by one’s practice discipline and the science and technology relevant to the situation at hand. But scientific, formal, discipline-specific knowledge are not sufficient for good clinical practice, whether the discipline be law, medicine, nursing, teaching, or social work. Practitioners still have to learn how to discern generalizable scientific knowledge, know how to use scientific knowledge in practical situations, discern what scientific evidence/knowledge is relevant, assess how the particular patient’s situation differs from the general scientific understanding, and recognize the complexity of care delivery—a process that is complex, ongoing, and changing, as new evidence can overturn old.

Practice communities like individual practitioners may also be mistaken, as is illustrated by variability in practice styles and practice outcomes across hospitals and regions in the United States. This variability in practice is why practitioners must learn to critically evaluate their practice and continually improve their practice over time. The goal is to create a living self-improving tradition.

Within health care, students, scientists, and practitioners are challenged to learn and use different modes of thinking when they are conflated under one term or rubric, using the best-suited thinking strategies for taking into consideration the purposes and the ends of the reasoning. Learning to be an effective, safe nurse or physician requires not only technical expertise, but also the ability to form helping relationships and engage in practical ethical and clinical reasoning. 50 Good ethical comportment requires that both the clinician and the scientist take into account the notions of good inherent in clinical and scientific practices. The notions of good clinical practice must include the relevant significance and the human concerns involved in decisionmaking in particular situations, centered on clinical grasp and clinical forethought.

The Three Apprenticeships of Professional Education

We have much to learn in comparing the pedagogies of formation across the professions, such as is being done currently by the Carnegie Foundation for the Advancement of Teaching. The Carnegie Foundation’s broad research program on the educational preparation of the profession focuses on three essential apprenticeships:

To capture the full range of crucial dimensions in professional education, we developed the idea of a three-fold apprenticeship: (1) intellectual training to learn the academic knowledge base and the capacity to think in ways important to the profession; (2) a skill-based apprenticeship of practice; and (3) an apprenticeship to the ethical standards, social roles, and responsibilities of the profession, through which the novice is introduced to the meaning of an integrated practice of all dimensions of the profession, grounded in the profession’s fundamental purposes. 109

This framework has allowed the investigators to describe tensions and shortfalls as well as strengths of widespread teaching practices, especially at articulation points among these dimensions of professional training.

Research has demonstrated that these three apprenticeships are taught best when they are integrated so that the intellectual training includes skilled know-how, clinical judgment, and ethical comportment. In the study of nursing, exemplary classroom and clinical teachers were found who do integrate the three apprenticeships in all of their teaching, as exemplified by the following anonymous student’s comments:

With that as well, I enjoyed the class just because I do have clinical experience in my background and I enjoyed it because it took those practical applications and the knowledge from pathophysiology and pharmacology, and all the other classes, and it tied it into the actual aspects of like what is going to happen at work. For example, I work in the emergency room and question: Why am I doing this procedure for this particular patient? Beforehand, when I was just a tech and I wasn’t going to school, I’d be doing it because I was told to be doing it—or I’d be doing CPR because, you know, the doc said, start CPR. I really enjoy the Care and Illness because now I know the process, the pathophysiological process of why I’m doing it and the clinical reasons of why they’re making the decisions, and the prioritization that goes on behind it. I think that’s the biggest point. Clinical experience is good, but not everybody has it. Yet when these students transition from school and clinicals to their job as a nurse, they will understand what’s going on and why.

The three apprenticeships are equally relevant and intertwined. In the Carnegie National Study of Nursing Education and the companion study on medical education as well as in cross-professional comparisons, teaching that gives an integrated access to professional practice is being examined. Once the three apprenticeships are separated, it is difficult to reintegrate them. The investigators are encouraged by teaching strategies that integrate the latest scientific knowledge and relevant clinical evidence with clinical reasoning about particular patients in unfolding rather than static cases, while keeping the patient and family experience and concerns relevant to clinical concerns and reasoning.

Clinical judgment or phronesis is required to evaluate and integrate techne and scientific evidence.

Within nursing, professional practice is wise and effective usually to the extent that the professional creates relational and communication contexts where clients/patients can be open and trusting. Effectiveness depends upon mutual influence between patient and practitioner, student and learner. This is another way in which clinical knowledge is dialogical and socially distributed. The following articulation of practical reasoning in nursing illustrates the social, dialogical nature of clinical reasoning and addresses the centrality of perception and understanding to good clinical reasoning, judgment and intervention.

Clinical Grasp *

Clinical grasp describes clinical inquiry in action. Clinical grasp begins with perception and includes problem identification and clinical judgment across time about the particular transitions of particular patients. Garrett Chan 20 described the clinician’s attempt at finding an “optimal grasp” or vantage point of understanding. Four aspects of clinical grasp, which are described in the following paragraphs, include (1) making qualitative distinctions, (2) engaging in detective work, (3) recognizing changing relevance, and (4) developing clinical knowledge in specific patient populations.

Making Qualitative Distinctions

Qualitative distinctions refer to those distinctions that can be made only in a particular contextual or historical situation. The context and sequence of events are essential for making qualitative distinctions; therefore, the clinician must pay attention to transitions in the situation and judgment. Many qualitative distinctions can be made only by observing differences through touch, sound, or sight, such as the qualities of a wound, skin turgor, color, capillary refill, or the engagement and energy level of the patient. Another example is assessing whether the patient was more fatigued after ambulating to the bathroom or from lack of sleep. Likewise the quality of the clinician’s touch is distinct as in offering reassurance, putting pressure on a bleeding wound, and so on. 110

Engaging in Detective Work, Modus Operandi Thinking, and Clinical Puzzle Solving

Clinical situations are open ended and underdetermined. Modus operandi thinking keeps track of the particular patient, the way the illness unfolds, the meanings of the patient’s responses as they have occurred in the particular time sequence. Modus operandi thinking requires keeping track of what has been tried and what has or has not worked with the patient. In this kind of reasoning-in-transition, gains and losses of understanding are noticed and adjustments in the problem approach are made.

We found that teachers in a medical surgical unit at the University of Washington deliberately teach their students to engage in “detective work.” Students are given the daily clinical assignment of “sleuthing” for undetected drug incompatibilities, questionable drug dosages, and unnoticed signs and symptoms. For example, one student noted that an unusual dosage of a heart medication was being given to a patient who did not have heart disease. The student first asked her teacher about the unusually high dosage. The teacher, in turn, asked the student whether she had asked the nurse or the patient about the dosage. Upon the student’s questioning, the nurse did not know why the patient was receiving the high dosage and assumed the drug was for heart disease. The patient’s staff nurse had not questioned the order. When the student asked the patient, the student found that the medication was being given for tremors and that the patient and the doctor had titrated the dosage for control of the tremors. This deliberate approach to teaching detective work, or modus operandi thinking, has characteristics of “critical reflection,” but stays situated and engaged, ferreting out the immediate history and unfolding of events.

Recognizing Changing Clinical Relevance

The meanings of signs and symptoms are changed by sequencing and history. The patient’s mental status, color, or pain level may continue to deteriorate or get better. The direction, implication, and consequences for the changes alter the relevance of the particular facts in the situation. The changing relevance entailed in a patient transitioning from primarily curative care to primarily palliative care is a dramatic example, where symptoms literally take on new meanings and require new treatments.

Developing Clinical Knowledge in Specific Patient Populations

Extensive experience with a specific patient population or patients with particular injuries or diseases allows the clinician to develop comparisons, distinctions, and nuanced differences within the population. The comparisons between many specific patients create a matrix of comparisons for clinicians, as well as a tacit, background set of expectations that create population- and patient-specific detective work if a patient does not meet the usual, predictable transitions in recovery. What is in the background and foreground of the clinician’s attention shifts as predictable changes in the patient’s condition occurs, such as is seen in recovering from heart surgery or progressing through the predictable stages of labor and delivery. Over time, the clinician develops a deep background understanding that allows for expert diagnostic and interventions skills.

Clinical Forethought

Clinical forethought is intertwined with clinical grasp, but it is much more deliberate and even routinized than clinical grasp. Clinical forethought is a pervasive habit of thought and action in nursing practice, and also in medicine, as clinicians think about disease and recovery trajectories and the implications of these changes for treatment. Clinical forethought plays a role in clinical grasp because it structures the practical logic of clinicians. At least four habits of thought and action are evident in what we are calling clinical forethought: (1) future think, (2) clinical forethought about specific patient populations, (3) anticipation of risks for particular patients, and (4) seeing the unexpected.

Future think

Future think is the broadest category of this logic of practice. Anticipating likely immediate futures helps the clinician make good plans and decisions about preparing the environment so that responding rapidly to changes in the patient is possible. Without a sense of salience about anticipated signs and symptoms and preparing the environment, essential clinical judgments and timely interventions would be impossible in the typically fast pace of acute and intensive patient care. Future think governs the style and content of the nurse’s attentiveness to the patient. Whether in a fast-paced care environment or a slower-paced rehabilitation setting, thinking and acting with anticipated futures guide clinical thinking and judgment. Future think captures the way judgment is suspended in a predictive net of anticipation and preparing oneself and the environment for a range of potential events.

Clinical forethought about specific diagnoses and injuries

This habit of thought and action is so second nature to the experienced nurse that the new or inexperienced nurse may have difficulty finding out about what seems to other colleagues as “obvious” preparation for particular patients and situations. Clinical forethought involves much local specific knowledge about who is a good resource and how to marshal support services and equipment for particular patients.

Examples of preparing for specific patient populations are pervasive, such as anticipating the need for a pacemaker during surgery and having the equipment assembled ready for use to save essential time. Another example includes forecasting an accident victim’s potential injuries, and recognizing that intubation might be needed.

Anticipation of crises, risks, and vulnerabilities for particular patients

This aspect of clinical forethought is central to knowing the particular patient, family, or community. Nurses situate the patient’s problems almost like a topography of possibilities. This vital clinical knowledge needs to be communicated to other caregivers and across care borders. Clinical teaching could be improved by enriching curricula with narrative examples from actual practice, and by helping students recognize commonly occurring clinical situations in the simulation and clinical setting. For example, if a patient is hemodynamically unstable, then managing life-sustaining physiologic functions will be a main orienting goal. If the patient is agitated and uncomfortable, then attending to comfort needs in relation to hemodynamics will be a priority. Providing comfort measures turns out to be a central background practice for making clinical judgments and contains within it much judgment and experiential learning.

When clinical teaching is too removed from typical contingencies and strong clinical situations in practice, students will lack practice in active thinking-in-action in ambiguous clinical situations. In the following example, an anonymous student recounted her experiences of meeting a patient:

I was used to different equipment and didn’t know how things went, didn’t know their routine, really. You can explain all you want in class, this is how it’s going to be, but when you get there … . Kim was my first instructor and my patient that she assigned me to—I walked into the room and he had every tube imaginable. And so I was a little overwhelmed. It’s not necessarily even that he was that critical … . She asked what tubes here have you seen? Well, I know peripheral lines. You taught me PICC [peripherally inserted central catheter] lines, and we just had that, but I don’t really feel comfortable doing it by myself, without you watching to make sure that I’m flushing it right and how to assess it. He had a chest tube and I had seen chest tubes, but never really knew the depth of what you had to assess and how you make sure that it’s all kosher and whatever. So she went through the chest tube and explained, it’s just bubbling a little bit and that’s okay. The site, check the site. The site looked okay and that she’d say if it wasn’t okay, this is what it might look like … . He had a feeding tube. I had done feeding tubes but that was like a long time ago in my LPN experiences schooling. So I hadn’t really done too much with the feeding stuff either … . He had a [nasogastric] tube, and knew pretty much about that and I think at the time it was clamped. So there were no issues with the suction or whatever. He had a Foley catheter. He had a feeding tube, a chest tube. I can’t even remember but there were a lot.

As noted earlier, a central characteristic of a practice discipline is that a self-improving practice requires ongoing experiential learning. One way nurse educators can enhance clinical inquiry is by increasing pedagogies of experiential learning. Current pedagogies for experiential learning in nursing include extensive preclinical study, care planning, and shared postclinical debriefings where students share their experiential learning with their classmates. Experiential learning requires open learning climates where students can discuss and examine transitions in understanding, including their false starts, or their misconceptions in actual clinical situations. Nursing educators typically develop open and interactive clinical learning communities, so that students seem committed to helping their classmates learn from their experiences that may have been difficult or even unsafe. One anonymous nurse educator described how students extend their experiential learning to their classmates during a postclinical conference:

So for example, the patient had difficulty breathing and the student wanted to give the meds instead of addressing the difficulty of breathing. Well, while we were sharing information about their patients, what they did that day, I didn’t tell the student to say this, but she said, ‘I just want to tell you what I did today in clinical so you don’t do the same thing, and here’s what happened.’ Everybody’s listening very attentively and they were asking her some questions. But she shared that. She didn’t have to. I didn’t tell her, you must share that in postconference or anything like that, but she just went ahead and shared that, I guess, to reinforce what she had learned that day but also to benefit her fellow students in case that thing comes up with them.

The teacher’s response to this student’s honesty and generosity exemplifies her own approach to developing an open community of learning. Focusing only on performance and on “being correct” prevents learning from breakdown or error and can dampen students’ curiosity and courage to learn experientially.

Seeing the unexpected

One of the keys to becoming an expert practitioner lies in how the person holds past experiential learning and background habitual skills and practices. This is a skill of foregrounding attention accurately and effectively in response to the nature of situational demands. Bourdieu 29 calls the recognition of the situation central to practical reasoning. If nothing is routinized as a habitual response pattern, then practitioners will not function effectively in emergencies. Unexpected occurrences may be overlooked. However, if expectations are held rigidly, then subtle changes from the usual will be missed, and habitual, rote responses will inappropriately rule. The clinician must be flexible in shifting between what is in background and foreground. This is accomplished by staying curious and open. The clinical “certainty” associated with perceptual grasp is distinct from the kind of “certainty” achievable in scientific experiments and through measurements. Recognition of similar or paradigmatic clinical situations is similar to “face recognition” or recognition of “family resemblances.” This concept is subject to faulty memory, false associative memories, and mistaken identities; therefore, such perceptual grasp is the beginning of curiosity and inquiry and not the end. Assessment and validation are required. In rapidly moving clinical situations, perceptual grasp is the starting point for clarification, confirmation, and action. Having the clinician say out loud how he or she is understanding the situation gives an opportunity for confirmation and disconfirmation from other clinicians present. 111 The relationship between foreground and background of attention needs to be fluid, so that missed expectations allow the nurse to see the unexpected. For example, when the background rhythm of a cardiac monitor changes, the nurse notices, and what had been background tacit awareness becomes the foreground of attention. A hallmark of expertise is the ability to notice the unexpected. 20 Background expectations of usual patient trajectories form with experience. Tacit expectations for patient trajectories form that enable the nurse to notice subtle failed expectations and pay attention to early signs of unexpected changes in the patient's condition. Clinical expectations gained from caring for similar patient populations form a tacit clinical forethought that enable the experienced clinician to notice missed expectations. Alterations from implicit or explicit expectations set the stage for experiential learning, depending on the openness of the learner.

Learning to provide safe and quality health care requires technical expertise, the ability to think critically, experience, and clinical judgment. The high-performance expectation of nurses is dependent upon the nurses’ continual learning, professional accountability, independent and interdependent decisionmaking, and creative problem-solving abilities.

This section of the paper was condensed and paraphrased from Benner, Hooper-Kyriakidis, and Stannard. 23 Patricia Hooper-Kyriakidis wrote the section on clinical grasp, and Patricia Benner wrote the section on clinical forethought.

• Cite this Page Benner P, Hughes RG, Sutphen M. Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 6.
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• What Is Critical Thinking? | Definition & Examples

What Is Critical Thinking? | Definition & Examples

Published on May 30, 2022 by Eoghan Ryan . Revised on May 31, 2023.

Critical thinking is the ability to effectively analyze information and form a judgment .

To think critically, you must be aware of your own biases and assumptions when encountering information, and apply consistent standards when evaluating sources .

Critical thinking skills help you to:

• Identify credible sources
• Evaluate and respond to arguments
• Assess alternative viewpoints
• Test hypotheses against relevant criteria

Table of contents

Why is critical thinking important, critical thinking examples, how to think critically, other interesting articles, frequently asked questions about critical thinking.

Critical thinking is important for making judgments about sources of information and forming your own arguments. It emphasizes a rational, objective, and self-aware approach that can help you to identify credible sources and strengthen your conclusions.

Critical thinking is important in all disciplines and throughout all stages of the research process . The types of evidence used in the sciences and in the humanities may differ, but critical thinking skills are relevant to both.

In academic writing , critical thinking can help you to determine whether a source:

• Is free from research bias
• Provides evidence to support its research findings
• Considers alternative viewpoints

Outside of academia, critical thinking goes hand in hand with information literacy to help you form opinions rationally and engage independently and critically with popular media.

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Critical thinking can help you to identify reliable sources of information that you can cite in your research paper . It can also guide your own research methods and inform your own arguments.

Outside of academia, critical thinking can help you to be aware of both your own and others’ biases and assumptions.

Academic examples

However, when you compare the findings of the study with other current research, you determine that the results seem improbable. You analyze the paper again, consulting the sources it cites.

You notice that the research was funded by the pharmaceutical company that created the treatment. Because of this, you view its results skeptically and determine that more independent research is necessary to confirm or refute them. Example: Poor critical thinking in an academic context You’re researching a paper on the impact wireless technology has had on developing countries that previously did not have large-scale communications infrastructure. You read an article that seems to confirm your hypothesis: the impact is mainly positive. Rather than evaluating the research methodology, you accept the findings uncritically.

Nonacademic examples

However, you decide to compare this review article with consumer reviews on a different site. You find that these reviews are not as positive. Some customers have had problems installing the alarm, and some have noted that it activates for no apparent reason.

You revisit the original review article. You notice that the words “sponsored content” appear in small print under the article title. Based on this, you conclude that the review is advertising and is therefore not an unbiased source. Example: Poor critical thinking in a nonacademic context You support a candidate in an upcoming election. You visit an online news site affiliated with their political party and read an article that criticizes their opponent. The article claims that the opponent is inexperienced in politics. You accept this without evidence, because it fits your preconceptions about the opponent.

There is no single way to think critically. How you engage with information will depend on the type of source you’re using and the information you need.

However, you can engage with sources in a systematic and critical way by asking certain questions when you encounter information. Like the CRAAP test , these questions focus on the currency , relevance , authority , accuracy , and purpose of a source of information.

When encountering information, ask:

• Who is the author? Are they an expert in their field?
• What do they say? Is their argument clear? Can you summarize it?
• When did they say this? Is the source current?
• Where is the information published? Is it an academic article? Is it peer-reviewed ?
• Why did the author publish it? What is their motivation?
• How do they make their argument? Is it backed up by evidence? Does it rely on opinion, speculation, or appeals to emotion ? Do they address alternative arguments?

Critical thinking also involves being aware of your own biases, not only those of others. When you make an argument or draw your own conclusions, you can ask similar questions about your own writing:

• Am I only considering evidence that supports my preconceptions?
• Is my argument expressed clearly and backed up with credible sources?
• Would I be convinced by this argument coming from someone else?

If you want to know more about ChatGPT, AI tools , citation , and plagiarism , make sure to check out some of our other articles with explanations and examples.

• ChatGPT vs human editor
• ChatGPT citations
• Is ChatGPT trustworthy?
• Using ChatGPT for your studies
• What is ChatGPT?
• Chicago style
• Paraphrasing

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• Types of plagiarism
• Self-plagiarism
• Avoiding plagiarism
• Academic integrity
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Critical thinking refers to the ability to evaluate information and to be aware of biases or assumptions, including your own.

Like information literacy , it involves evaluating arguments, identifying and solving problems in an objective and systematic way, and clearly communicating your ideas.

Critical thinking skills include the ability to:

You can assess information and arguments critically by asking certain questions about the source. You can use the CRAAP test , focusing on the currency , relevance , authority , accuracy , and purpose of a source of information.

Ask questions such as:

• Who is the author? Are they an expert?
• How do they make their argument? Is it backed up by evidence?

A credible source should pass the CRAAP test  and follow these guidelines:

• The information should be up to date and current.
• The author and publication should be a trusted authority on the subject you are researching.
• The sources the author cited should be easy to find, clear, and unbiased.
• For a web source, the URL and layout should signify that it is trustworthy.

Information literacy refers to a broad range of skills, including the ability to find, evaluate, and use sources of information effectively.

Being information literate means that you:

• Know how to find credible sources
• Use relevant sources to inform your research
• Understand what constitutes plagiarism
• Know how to cite your sources correctly

Confirmation bias is the tendency to search, interpret, and recall information in a way that aligns with our pre-existing values, opinions, or beliefs. It refers to the ability to recollect information best when it amplifies what we already believe. Relatedly, we tend to forget information that contradicts our opinions.

Although selective recall is a component of confirmation bias, it should not be confused with recall bias.

On the other hand, recall bias refers to the differences in the ability between study participants to recall past events when self-reporting is used. This difference in accuracy or completeness of recollection is not related to beliefs or opinions. Rather, recall bias relates to other factors, such as the length of the recall period, age, and the characteristics of the disease under investigation.

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Critical Thinking and Decision-Making  - What is Critical Thinking?

Critical thinking and decision-making  -, what is critical thinking, critical thinking and decision-making what is critical thinking.

Critical Thinking and Decision-Making: What is Critical Thinking?

Lesson 1: what is critical thinking, what is critical thinking.

Critical thinking is a term that gets thrown around a lot. You've probably heard it used often throughout the years whether it was in school, at work, or in everyday conversation. But when you stop to think about it, what exactly is critical thinking and how do you do it ?

Watch the video below to learn more about critical thinking.

Simply put, critical thinking is the act of deliberately analyzing information so that you can make better judgements and decisions . It involves using things like logic, reasoning, and creativity, to draw conclusions and generally understand things better.

This may sound like a pretty broad definition, and that's because critical thinking is a broad skill that can be applied to so many different situations. You can use it to prepare for a job interview, manage your time better, make decisions about purchasing things, and so much more.

The process

As humans, we are constantly thinking . It's something we can't turn off. But not all of it is critical thinking. No one thinks critically 100% of the time... that would be pretty exhausting! Instead, it's an intentional process , something that we consciously use when we're presented with difficult problems or important decisions.

Improving your critical thinking

In order to become a better critical thinker, it's important to ask questions when you're presented with a problem or decision, before jumping to any conclusions. You can start with simple ones like What do I currently know? and How do I know this? These can help to give you a better idea of what you're working with and, in some cases, simplify more complex issues.  

Real-world applications

Let's take a look at how we can use critical thinking to evaluate online information . Say a friend of yours posts a news article on social media and you're drawn to its headline. If you were to use your everyday automatic thinking, you might accept it as fact and move on. But if you were thinking critically, you would first analyze the available information and ask some questions :

• What's the source of this article?
• Is the headline potentially misleading?
• What are my friend's general beliefs?
• Do their beliefs inform why they might have shared this?

After analyzing all of this information, you can draw a conclusion about whether or not you think the article is trustworthy.

Critical thinking has a wide range of real-world applications . It can help you to make better decisions, become more hireable, and generally better understand the world around you.

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• Paul-Elder Critical Thinking Framework

Critical thinking is that mode of thinking – about any subject, content, or problem — in which the thinker improves the quality of his or her thinking by skillfully taking charge of the structures inherent in thinking and imposing intellectual standards upon them. (Paul and Elder, 2001). The Paul-Elder framework has three components:

• The elements of thought (reasoning)
• The  intellectual standards that should be applied to the elements of reasoning
• The intellectual traits associated with a cultivated critical thinker that result from the consistent and disciplined application of the intellectual standards to the elements of thought

According to Paul and Elder (1997), there are two essential dimensions of thinking that students need to master in order to learn how to upgrade their thinking. They need to be able to identify the "parts" of their thinking, and they need to be able to assess their use of these parts of thinking.

Elements of Thought (reasoning)

The "parts" or elements of thinking are as follows:

• All reasoning has a purpose
• All reasoning is an attempt to figure something out, to settle some question, to solve some problem
• All reasoning is based on assumptions
• All reasoning is done from some point of view
• All reasoning is based on data, information and evidence
• All reasoning is expressed through, and shaped by, concepts and ideas
• All reasoning contains inferences or interpretations by which we draw conclusions and give meaning to data
• All reasoning leads somewhere or has implications and consequences

Universal Intellectual Standards

The intellectual standards that are to these elements are used to determine the quality of reasoning. Good critical thinking requires having a command of these standards. According to Paul and Elder (1997 ,2006), the ultimate goal is for the standards of reasoning to become infused in all thinking so as to become the guide to better and better reasoning. The intellectual standards include:

Intellectual Traits

Consistent application of the standards of thinking to the elements of thinking result in the development of intellectual traits of:

• Intellectual Humility
• Intellectual Courage
• Intellectual Empathy
• Intellectual Autonomy
• Intellectual Integrity
• Intellectual Perseverance
• Confidence in Reason
• Fair-mindedness

Characteristics of a Well-Cultivated Critical Thinker

Habitual utilization of the intellectual traits produce a well-cultivated critical thinker who is able to:

• Raise vital questions and problems, formulating them clearly and precisely
• Gather and assess relevant information, using abstract ideas to interpret it effectively
• Come to well-reasoned conclusions and solutions, testing them against relevant criteria and standards;
• Think open-mindedly within alternative systems of thought, recognizing and assessing, as need be, their assumptions, implications, and practical consequences; and
• Communicate effectively with others in figuring out solutions to complex problems

Paul, R. and Elder, L. (2010). The Miniature Guide to Critical Thinking Concepts and Tools. Dillon Beach: Foundation for Critical Thinking Press.

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The Peak Performance Center

The pursuit of performance excellence, critical thinking.

Critical thinking refers to the process of actively analyzing, assessing, synthesizing, evaluating and reflecting on information gathered from observation, experience, or communication. It is thinking in a clear, logical, reasoned, and reflective manner to solve problems or make decisions. Basically, critical thinking is taking a hard look at something to understand what it really means.

Critical Thinkers

Critical thinkers do not simply accept all ideas, theories, and conclusions as facts. They have a mindset of questioning ideas and conclusions. They make reasoned judgments that are logical and well thought out by assessing the evidence that supports a specific theory or conclusion.

When presented with a new piece of new information, critical thinkers may ask questions such as;

“What information supports that?”

“How was this information obtained?”

“Who obtained the information?”

“How do we know the information is valid?”

“Why is it that way?”

“What makes it do that?”

“How do we know that?”

“Are there other possibilities?”

Combination of Analytical and Creative Thinking

Many people perceive critical thinking just as analytical thinking. However, critical thinking incorporates both analytical thinking and creative thinking. Critical thinking does involve breaking down information into parts and analyzing the parts in a logical, step-by-step manner. However, it also involves challenging consensus to formulate new creative ideas and generate innovative solutions. It is critical thinking that helps to evaluate and improve your creative ideas.

Elements of Critical Thinking

Critical thinking involves:

• Gathering relevant information
• Evaluating information
• Asking questions
• Assessing bias or unsubstantiated assumptions
• Making inferences from the information and filling in gaps
• Using abstract ideas to interpret information
• Formulating ideas
• Weighing opinions
• Reaching well-reasoned conclusions
• Considering alternative possibilities
• Testing conclusions
• Verifying if evidence/argument support the conclusions

Developing Critical Thinking Skills

Critical thinking is considered a higher order thinking skills, such as analysis, synthesis, deduction, inference, reason, and evaluation. In order to demonstrate critical thinking, you would need to develop skills in;

Interpreting : understanding the significance or meaning of information

Analyzing : breaking information down into its parts

Connecting : making connections between related items or pieces of information.

Integrating : connecting and combining information to better understand the relationship between the information.

Evaluating : judging the value, credibility, or strength of something

Reasoning : creating an argument through logical steps

Deducing : forming a logical opinion about something based on the information or evidence that is available

Inferring : figuring something out through reasoning based on assumptions and ideas

Generating : producing new information, ideas, products, or ways of viewing things.

Blooms Taxonomy

Bloom’s Taxonomy Revised

Mind Mapping

Chunking Information

Brainstorming

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Critical thinking: definition and how to improve its skills

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Critical thinking is based on the observation and analysis of facts and evidences to return rational, skeptical and unbiased judgments.   

This type of thinking involves a series of skills that can be created but also improved, as we will see throughout this article in which we will begin by defining the concept and end with tips to build and improve the skills related to critical thinking.

What is critical thinking?

Critical thinking is a discipline based on the ability of people to observe, elucidate and analyze information, facts and evidences in order to judge or decide if it is right or wrong.

It goes beyond mere curiosity, simple knowledge or analysis of any kind of fact or information.

People who develop this type of outlook are able to logically connect ideas and defend them with weighty opinions that ultimately help them make better decisions.

How to build and improve critical thinking skills?

Building and improving critical thinking skills involves focusing on a number of abilities and capacities .

To begin the critical thinking process all ideas must be open and all options must be understood as much as possible.

Even the dumbest or craziest idea can end up being the gateway to the most intelligent and successful conclusion.

The problem with having an open mind is that it is the most difficult path and often involves a greater challenge and effort. It is well known that the easy thing to do is to go with the obvious and the commonly accepted but this has no place in critical thinking.

By contrast, it is helpful not to make hasty decisions and to weigh the problem in its entirety after a first moment of awareness.

Finally, practicing active listening will help you to receive feedback from others and to understand other points of view that may help you as a reference.

Impartiality

An important point in the critical thinking process is the development of the ability to identify biases and maintain an impartial view in evaluations.

To improve this aspect it is advisable to have tools to be able to identify and recognize the prejudices and biases you have and try to leave them completely aside when thinking about the solution.

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Observation

Observation allows you to see each and every detail , no matter how small, subtle or inconsequential they may be or seem to be.

Behind the superficial information hides a universe of data, sources and experiences that help you make the best decision.

One of the pillars of critical thinking is objectivity. This forces you to base your value judgments on established facts that you will have gathered after a correct research process. 

At this point in the process you should also be clear about the influencing factors to be taken into account and those that can be left out.

Remember that your research is not only about gathering a good amount of information that puts the maximum number of options, variables or situations on the table. 

For the information to be of quality, it must be based on reliable and trustworthy sources.

If the information you have to collect is based on the comments and opinions of third parties, try to exercise quality control but without interference. 

To do this, ask open-ended questions that bring all the nuances to the table and at the same time serve to sift out possible biases.

With the research process completed, it is time to analyze the sources and information gathered.

At this point, your analytical skills will help you to discard what does not conform to unconventional thinking, to prioritize among the information that is of value, to identify possible trends and to draw your own conclusions.

One of the skills that characterize a person with critical thinking is their ability to recognize patterns and connections between all the pieces of information they handle in their research.

This allows them to draw conclusions of great relevance on which to base their predictions with weighty foundations.

Analytical thinking is sometimes confused with critical thinking. The former only uses facts and data, while the latter incorporates other nuances such as emotions, experiences or opinions.

One of the problems with critical thinking is that it can be developed to infinity and beyond. You can always keep looking for new avenues of investigation and new lines of argument by stretching inference to limits that may not be necessary.

At this point it is important to clarify that inference is the process of drawing conclusions from initial premises or hypotheses.

Knowing when to stop the research and thinking process and move on to the next stage in which you put into practice the actions considered appropriate is necessary.

Communication

The information you collect in your research is not top secret material. On the contrary, your knowledge sharing with other people who are involved in the next steps of the process is so important.

Think that your analytical ability to extract the information and your conclusions can serve to guide others .

Problem solving

It is important to note at this point that critical thinking can be aimed at solving a problem but can also be used to simply answer questions or even to identify areas for improvement in certain situations. 

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Critical thinking definition

Critical thinking, as described by Oxford Languages, is the objective analysis and evaluation of an issue in order to form a judgement.

Active and skillful approach, evaluation, assessment, synthesis, and/or evaluation of information obtained from, or made by, observation, knowledge, reflection, acumen or conversation, as a guide to belief and action, requires the critical thinking process, which is why it's often used in education and academics.

Some even may view it as a backbone of modern thought.

However, it's a skill, and skills must be trained and encouraged to be used at its full potential.

People turn up to various approaches in improving their critical thinking, like:

• Developing technical and problem-solving skills
• Engaging in more active listening
• Actively questioning their assumptions and beliefs
• Seeking out more diversity of thought
• Opening up their curiosity in an intellectual way etc.

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Ethical ai in financial inclusion: the role of algorithmic fairness on user satisfaction and recommendation.

1. Introduction

2. theoretical background, 2.1. ai in financial inclusion, 2.2. organizational justice theory, 2.3. heuristics–systematic model, 2.4. perceived algorithmic fairness, 3. hypotheses development, 3.1. ethical considerations and users’ perceived algorithmic fairness, 3.2. perceived algorithmic fairness, users’ satisfaction, and recommendation, 3.3. satisfaction with ai-driven financial inclusion and recommendation, 4. research methodology and research design, 4.1. questionnaire design and measurements, 4.2. sampling and data collection, 5. data analysis and results, 5.1. measurement model, 5.2. structural model, 5.3. mediating effect of perceived algorithmic fairness between ethical considerations, users’ satisfaction, and recommendation, 6. discussion and implications for research and practice, 6.1. discussion of key findings, 6.2. implications for research, 6.3. implications for practice, 7. limitations and future research directions, author contributions, data availability statement, conflicts of interest, appendix a. measurement items.

• Mhlanga, D. Industry 4.0 in finance: The impact of artificial intelligence (AI) on digital financial inclusion. Int. J. Financ. Stud. 2020 , 8 , 45. [ Google Scholar ] [ CrossRef ]
• Shin, D. User perceptions of algorithmic decisions in the personalized AI system: Perceptual evaluation of fairness, accountability, transparency, and explainability. J. Broadcast. Electron. Media 2020 , 64 , 541–565. [ Google Scholar ] [ CrossRef ]
• Martin, K.; Waldman, A. Are algorithmic decisions legitimate? The effect of process and outcomes on perceptions of legitimacy of AI decisions. J. Bus. Ethics 2023 , 183 , 653–670. [ Google Scholar ] [ CrossRef ]
• Colquitt, J.A. On the dimensionality of organizational justice: A construct validation of a measure. J. Appl. Psychol. 2001 , 86 , 386–400. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Todorov, A.; Chaiken, S.; Henderson, M.D. The heuristic-systematic model of social information processing. In The Persuasion Handbook: Developments in Theory and Practice ; Dillard, J.P., Pfau, M., Eds.; Sage: Thousand Oaks, CA, USA, 2002; pp. 195–211. [ Google Scholar ] [ CrossRef ]
• Jejeniwa, T.O.; Mhlongo, N.Z.; Jejeniwa, T.O. AI solutions for developmental economics: Opportunities and challenges in financial inclusion and poverty alleviation. Int. J. Adv. Econ. 2024 , 6 , 108–123. [ Google Scholar ] [ CrossRef ]
• Uzougbo, N.S.; Ikegwu, C.G.; Adewusi, A.O. Legal accountability and ethical considerations of AI in financial services. GSC Adv. Res. Rev. 2024 , 19 , 130–142. [ Google Scholar ] [ CrossRef ]
• Yasir, A.; Ahmad, A.; Abbas, S.; Inairat, M.; Al-Kassem, A.H.; Rasool, A. How Artificial Intelligence Is Promoting Financial Inclusion? A Study on Barriers of Financial Inclusion. In Proceedings of the 2022 International Conference on Business Analytics for Technology and Security (ICBATS), Dubai, United Arab Emirates, 16 February 2022; pp. 1–6. [ Google Scholar ]
• Kshetri, N. The role of artificial intelligence in promoting financial inclusion in developing countries. J. Glob. Inf. Technol. Manag. 2021 , 24 , 1–6. [ Google Scholar ] [ CrossRef ]
• Max, R.; Kriebitz, A.; Von Websky, C. Ethical considerations about the implications of artificial intelligence in finance. In Handbook on Ethics in Finance ; Springer: Cham, Switzerland, 2021; pp. 577–592. [ Google Scholar ] [ CrossRef ]
• Aldboush, H.H.; Ferdous, M. Building Trust in Fintech: An Analysis of Ethical and Privacy Considerations in the Intersection of Big Data, AI, and Customer Trust. Int. J. Financ. Stud. 2023 , 11 , 90. [ Google Scholar ] [ CrossRef ]
• Telukdarie, A.; Mungar, A. The impact of digital financial technology on accelerating financial inclusion in developing economies. Procedia Comput. Sci. 2023 , 217 , 670–678. [ Google Scholar ] [ CrossRef ]
• Ozili, P.K. Financial inclusion, sustainability and sustainable development. In Smart Analytics, Artificial Intelligence and Sustainable Performance Management in a Global Digitalised Economy ; Springer: Cham, Switzerland, 2023; pp. 233–241. [ Google Scholar ] [ CrossRef ]
• Lee, C.C.; Lou, R.; Wang, F. Digital financial inclusion and poverty alleviation: Evidence from the sustainable development of China. Econ. Anal. Policy 2023 , 77 , 418–434. [ Google Scholar ] [ CrossRef ]
• Adeoye, O.B.; Addy, W.A.; Ajayi-Nifise, A.O.; Odeyemi, O.; Okoye, C.C.; Ofodile, O.C. Leveraging AI and data analytics for enhancing financial inclusion in developing economies. Financ. Account. Res. J. 2024 , 6 , 288–303. [ Google Scholar ] [ CrossRef ]
• Owolabi, O.S.; Uche, P.C.; Adeniken, N.T.; Ihejirika, C.; Islam, R.B.; Chhetri, B.J.T. Ethical implication of artificial intelligence (AI) adoption in financial decision making. Comput. Inf. Sci. 2024 , 17 , 49–56. [ Google Scholar ] [ CrossRef ]
• Mhlanga, D. The role of big data in financial technology toward financial inclusion. Front. Big Data 2024 , 7 , 1184444. [ Google Scholar ] [ CrossRef ]
• Akter, S.; McCarthy, G.; Sajib, S.; Michael, K.; Dwivedi, Y.K.; D’Ambra, J.; Shen, K.N. Algorithmic bias in data-driven innovation in the age of AI. Int. J. Inf. Manag. 2021 , 60 , 102387. [ Google Scholar ] [ CrossRef ]
• Ntoutsi, E.; Fafalios, P.; Gadiraju, U.; Iosifidis, V.; Nejdl, W.; Vidal, M.E.; Ruggieri, S.; Turini, F.; Papadopoulos, S.; Krasanakis, E.; et al. Bias in data-driven artificial intelligence systems—An introductory survey. WIREs Data Min. Knowl. Discov. 2020 , 10 , e1356. [ Google Scholar ] [ CrossRef ]
• Munoko, I.; Brown-Liburd, H.L.; Vasarhelyi, M. The ethical implications of using artificial intelligence in auditing. J. Bus. Ethics 2020 , 167 , 209–234. [ Google Scholar ] [ CrossRef ]
• Schönberger, D. Artificial intelligence in healthcare: A critical analysis of the legal and ethical implications. Int. J. Law Inf. Technol. 2019 , 27 , 171–203. [ Google Scholar ] [ CrossRef ]
• Agarwal, A.; Agarwal, H.; Agarwal, N. Fairness Score and process standardization: Framework for fairness certification in artificial intelligence systems. AI Ethics 2023 , 3 , 267–279. [ Google Scholar ] [ CrossRef ]
• Purificato, E.; Lorenzo, F.; Fallucchi, F.; De Luca, E.W. The use of responsible artificial intelligence techniques in the context of loan approval processes. Int. J. Hum.-Comput. Interact. 2023 , 39 , 1543–1562. [ Google Scholar ] [ CrossRef ]
• Greenberg, J. Organizational justice: Yesterday, today, and tomorrow. J. Manag. 1990 , 16 , 399–432. [ Google Scholar ] [ CrossRef ]
• Robert, L.P.; Pierce, C.; Marquis, L.; Kim, S.; Alahmad, R. Designing fair AI for managing employees in organizations: A review, critique, and design agenda. Hum.-Comput. Interact. 2020 , 35 , 545–575. [ Google Scholar ] [ CrossRef ]
• Novelli, C.; Taddeo, M.; Floridi, L. Accountability in artificial intelligence: What it is and how it works. AI Soc. 2023 , 39 , 1871–1882. [ Google Scholar ] [ CrossRef ]
• Busuioc, M. Accountable artificial intelligence: Holding algorithms to account. Public Adm. Rev. 2021 , 81 , 825–836. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Morse, L.; Teodorescu, M.H.M.; Awwad, Y.; Kane, G.C. Do the ends justify the means? Variation in the distributive and procedural fairness of machine learning algorithms. J. Bus. Ethics 2021 , 181 , 1083–1095. [ Google Scholar ] [ CrossRef ]
• Liu, Y.; Sun, X. Towards more legitimate algorithms: A model of algorithmic ethical perception, legitimacy, and continuous usage intentions of e-commerce platforms. Comput. Hum. Behav. 2024 , 150 , 108006. [ Google Scholar ] [ CrossRef ]
• Shin, D. Embodying algorithms, enactive artificial intelligence and the extended cognition: You can see as much as you know about algorithm. J. Inf. Sci. 2023 , 49 , 18–31. [ Google Scholar ] [ CrossRef ]
• Shin, D.; Zhong, B.; Biocca, F.A. Beyond user experience: What constitutes algorithmic experiences? Int. J. Inf. Manag. 2020 , 52 , 102061. [ Google Scholar ] [ CrossRef ]
• König, P.D.; Wenzelburger, G. The legitimacy gap of algorithmic decision-making in the public sector: Why it arises and how to address it. Technol. Soc. 2021 , 67 , 101688. [ Google Scholar ] [ CrossRef ]
• Cabiddu, F.; Moi, L.; Patriotta, G.; Allen, D.G. Why do users trust algorithms? A review and conceptualization of initial trust and trust over time. Eur. Manag. J. 2022 , 40 , 685–706. [ Google Scholar ] [ CrossRef ]
• Shulner-Tal, A.; Kuflik, T.; Kliger, D. Fairness, explainability and in-between: Understanding the impact of different explanation methods on non-expert users’ perceptions of fairness toward an algorithmic system. Ethics Inf. Technol. 2022 , 24 , 2. [ Google Scholar ] [ CrossRef ]
• Narayanan, D.; Nagpal, M.; McGuire, J.; Schweitzer, S.; De Cremer, D. Fairness perceptions of artificial intelligence: A review and path forward. Int. J. Hum.-Comput. Interact. 2024 , 40 , 4–23. [ Google Scholar ] [ CrossRef ]
• Grimmelikhuijsen, S. Explaining why the computer says no: Algorithmic transparency affects the perceived trustworthiness of automated decision-making. Public Adm. Rev. 2023 , 83 , 241–262. [ Google Scholar ] [ CrossRef ]
• Starke, C.; Baleis, J.; Keller, B.; Marcinkowski, F. Fairness perceptions of algorithmic decision-making: A systematic review of the empirical literature. Big Data Soc. 2022 , 9 , 1–16. [ Google Scholar ] [ CrossRef ]
• Qin, S.; Jia, N.; Luo, X.; Liao, C.; Huang, Z. Perceived fairness of human managers compared with artificial intelligence in employee performance evaluation. J. Manag. Inf. Syst. 2023 , 40 , 1039–1070. [ Google Scholar ] [ CrossRef ]
• Sonboli, N.; Smith, J.J.; Cabral Berenfus, F.; Burke, R.; Fiesler, C. Fairness and transparency in recommendation: The users’ perspective. In Proceedings of the 29th ACM Conference on User Modeling, Adaptation and Personalization, Utrecht, The Netherlands, 21–25 June 2021; pp. 274–279. [ Google Scholar ] [ CrossRef ]
• Shin, D.; Lim, J.S.; Ahmad, N.; Ibahrine, M. Understanding user sensemaking in fairness and transparency in algorithms: Algorithmic sensemaking in over-the-top platform. AI Soc. 2024 , 39 , 477–490. [ Google Scholar ] [ CrossRef ]
• Kieslich, K.; Keller, B.; Starke, C. Artificial intelligence ethics by design. Evaluating public perception on the importance of ethical design principles of artificial intelligence. Big Data Soc. 2022 , 9 , 1–15. [ Google Scholar ] [ CrossRef ]
• Shin, D.; Park, Y.J. Role of fairness, accountability, and transparency in algorithmic affordance. Comput. Hum. Behav. 2019 , 98 , 277–284. [ Google Scholar ] [ CrossRef ]
• Ababneh, K.I.; Hackett, R.D.; Schat, A.C. The role of attributions and fairness in understanding job applicant reactions to selection procedures and decisions. J. Bus. Psychol. 2014 , 29 , 111–129. [ Google Scholar ] [ CrossRef ]
• Ochmann, J.; Michels, L.; Tiefenbeck, V.; Maier, C.; Laumer, S. Perceived algorithmic fairness: An empirical study of transparency and anthropomorphism in algorithmic recruiting. Inf. Syst. J. 2024 , 34 , 384–414. [ Google Scholar ] [ CrossRef ]
• Wu, W.; Huang, Y.; Qian, L. Social trust and algorithmic equity: The societal perspectives of users’ intention to interact with algorithm recommendation systems. Decis. Support Syst. 2024 , 178 , 114115. [ Google Scholar ] [ CrossRef ]
• Bambauer-Sachse, S.; Young, A. Consumers’ intentions to spread negative word of mouth about dynamic pricing for services: Role of confusion and unfairness perceptions. J. Serv. Res. 2023 , 27 , 364–380. [ Google Scholar ] [ CrossRef ]
• Schinkel, S.; van Vianen, A.E.; Ryan, A.M. Applicant reactions to selection events: Four studies into the role of attributional style and fairness perceptions. Int. J. Sel. Assess. 2016 , 24 , 107–118. [ Google Scholar ] [ CrossRef ]
• Yun, J.; Park, J. The effects of chatbot service recovery with emotion words on customer satisfaction, repurchase intention, and positive word-of-mouth. Front. Psychol. 2022 , 13 , 922503. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Jo, H. Understanding AI tool engagement: A study of ChatGPT usage and word-of-mouth among university students and office workers. Telemat. Inform. 2023 , 85 , 102067. [ Google Scholar ] [ CrossRef ]
• Li, Y.; Ma, X.; Li, Y.; Li, R.; Liu, H. How does platform’s fintech level affect its word of mouth from the perspective of user psychology? Front. Psychol. 2023 , 14 , 1085587. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Barbu, C.M.; Florea, D.L.; Dabija, D.C.; Barbu, M.C.R. Customer experience in fintech. J. Theor. Appl. Electron. Commer. Res. 2021 , 16 , 1415–1433. [ Google Scholar ] [ CrossRef ]
• Shin, D. Why does explainability matter in news analytic systems? Proposing explainable analytic journalism. Journal. Stud. 2021 , 22 , 1047–1065. [ Google Scholar ] [ CrossRef ]
• Mukerjee, K. Impact of self-service technologies in retail banking on cross-buying and word-of-mouth. Int. J. Retail Distrib. Manag. 2020 , 48 , 485–500. [ Google Scholar ] [ CrossRef ]
• Hair, J.F.; Black, W.C.; Babin, B.J.; Anderson, R.; Tatham, R. Multivariate Data Analysis , 6th ed.; Pearson Prentice-Hall: Upper Saddle River, NJ, USA, 2006. [ Google Scholar ]
• Hair, J.F.; Gabriel, M.; Patel, V. AMOS Covariance-Based Structural Equation Modeling (CBSEM): Guidelines on its Application as a Marketing Research Tool. Braz. J. Mark. 2014 , 13 , 44–55. [ Google Scholar ]
• Raza, S.A.; Qazi, W.; Khan, K.A.; Salam, J. Social isolation and acceptance of the learning management system (LMS) in the time of COVID-19 pandemic: An expansion of the UTAUT model. J. Educ. Comput. Res. 2021 , 59 , 183–208. [ Google Scholar ] [ CrossRef ]
• Fornell, C.; Larcker, D.F. Structural equation models with unobservable variables and measurement error: Algebra and statistics. J. Mark. Res. 1981 , 18 , 382–388. [ Google Scholar ] [ CrossRef ]
• Podsakoff, P.M.; Organ, D.W. Self-reports in organizational research: Problems and prospects. J. Manag. 1986 , 12 , 531–544. [ Google Scholar ] [ CrossRef ]
• Podsakoff, P.M.; MacKenzie, S.B.; Lee, J.Y.; Podsakoff, N.P. Common method biases in behavioral research: A critical review of the literature and recommended remedies. J. Appl. Psychol. 2003 , 88 , 879–903. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Newman, D.T.; Fast, N.J.; Harmon, D.J. When eliminating bias isn’t fair: Algorithmic reductionism and procedural justice in human resource decisions. Organ. Behav. Hum. Decis. Process. 2020 , 160 , 149–167. [ Google Scholar ] [ CrossRef ]
• Birzhandi, P.; Cho, Y.S. Application of fairness to healthcare, organizational justice, and finance: A survey. Expert Syst. Appl. 2023 , 216 , 119465. [ Google Scholar ] [ CrossRef ]
• Chen, S.; Chaiken, S. The heuristic-systematic model in its broader context. In Dual-Process Theories in Social Psychology ; Chaiken, S., Trope, Y., Eds.; Guilford Press: New York, NY, USA, 1999; pp. 73–96. [ Google Scholar ]
• Shi, S.; Gong, Y.; Gursoy, D. Antecedents of trust and adoption intention toward artificially intelligent recommendation systems in travel planning: A heuristic-systematic model. J. Travel Res. 2021 , 60 , 1714–1734. [ Google Scholar ] [ CrossRef ]
• Belanche, D.; Casaló, L.V.; Flavián, C. Artificial Intelligence in FinTech: Understanding robo-advisors adoption among customers. Ind. Manag. Data Syst. 2019 , 119 , 1411–1430. [ Google Scholar ] [ CrossRef ]
• Bao, L.; Krause, N.M.; Calice, M.N.; Scheufele, D.A.; Wirz, C.D.; Brossard, D.; Newman, T.P.; Xenos, M.A. Whose AI? How different publics think about AI and its social impacts. Comput. Hum. Behav. 2022 , 130 , 107182. [ Google Scholar ] [ CrossRef ]
• Khogali, H.O.; Mekid, S. The blended future of automation and AI: Examining some long-term societal and ethical impact features. Technol. Soc. 2023 , 73 , 102232. [ Google Scholar ] [ CrossRef ]

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Yang, Q.; Lee, Y.-C. Ethical AI in Financial Inclusion: The Role of Algorithmic Fairness on User Satisfaction and Recommendation. Big Data Cogn. Comput. 2024 , 8 , 105. https://doi.org/10.3390/bdcc8090105

Yang Q, Lee Y-C. Ethical AI in Financial Inclusion: The Role of Algorithmic Fairness on User Satisfaction and Recommendation. Big Data and Cognitive Computing . 2024; 8(9):105. https://doi.org/10.3390/bdcc8090105

Yang, Qin, and Young-Chan Lee. 2024. "Ethical AI in Financial Inclusion: The Role of Algorithmic Fairness on User Satisfaction and Recommendation" Big Data and Cognitive Computing 8, no. 9: 105. https://doi.org/10.3390/bdcc8090105

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• Open access
• Published: 02 September 2024

Clinical supervisor’s experiences of peer group clinical supervision during COVID-19: a mixed methods study

• Owen Doody   ORCID: orcid.org/0000-0002-3708-1647 1 ,
• Kathleen Markey   ORCID: orcid.org/0000-0002-3024-0828 1 ,
• James Turner   ORCID: orcid.org/0000-0002-8360-1420 2 ,
• Claire O. Donnell   ORCID: orcid.org/0000-0003-2386-7048 1 &
• Louise Murphy   ORCID: orcid.org/0000-0003-2381-3963 1  

BMC Nursing volume  23 , Article number:  612 ( 2024 ) Cite this article

Providing positive and supportive environments for nurses and midwives working in ever-changing and complex healthcare services is paramount. Clinical supervision is one approach that nurtures and supports professional guidance, ethical practice, and personal development, which impacts positively on staff morale and standards of care delivery. In the context of this study, peer group clinical supervision provides allocated time to reflect and discuss care provided and facilitated by clinical supervisors who are at the same grade/level as the supervisees.

To explore the clinical supervisor’s experiences of peer group clinical supervision a mixed methods study design was utilised within Irish health services (midwifery, intellectual disability, general, mental health). The Manchester Clinical Supervision Scale was used to survey clinical supervisors ( n  = 36) and semi-structured interviews ( n  = 10) with clinical supervisors were conducted. Survey data were analysed through SPSS and interview data were analysed utilising content analysis. The qualitative and quantitative data’s reporting rigour was guided by the CROSS and SRQR guidelines.

Participants generally had a positive encounter when providing clinical supervision. They highly appreciated the value of clinical supervision and expressed a considerable degree of contentment with the supervision they provided to supervisees. The advantages of peer group clinical supervision encompass aspects related to self (such as confidence, leadership, personal development, and resilience), service and organisation (including a positive working environment, employee retention, and safety), and patient care (involving critical thinking and evaluation, patient safety, adherence to quality standards, and elevated levels of care).

There are many benefits of peer group clinical supervision at an individual, service, organisation, and patient level. Nevertheless, there is a need to address a lack of awareness and misconceptions surrounding clinical supervision to create an environment and culture conducive to realising its full potential. It is crucial that clinical supervision be accessible to nurses and midwives of all grades across all healthcare services, with national planning to address capacity and sustainability.

Peer Review reports

Within a dynamic healthcare system, nurses and midwives face growing demands, underscoring the necessity for ongoing personal and professional development. This is essential to improve the effectiveness and efficiency of care delivery for patients, families, and societies. Despite the increased emphasis on increasing the quality and safety of healthcare services and delivery, there is evidence highlighting declining standards of nursing and midwifery care [ 1 ]. The recent focus on re-affirming and re-committing to core values guiding nursing and midwifery practice is encouraging such as compassion, care and commitment [ 2 ], competence, communication, and courage [ 3 ]. However, imposing value statements in isolation is unlikely to change behaviours and greater consideration needs to be given to ways in which compassion, care, and commitment are nurtured and ultimately applied in daily practice. Furthermore, concerns have been raised about global staff shortages [ 4 ], the evidence suggesting several contributing factors such as poor workforce planning [ 5 ], job dissatisfaction [ 6 ], and healthcare migration [ 7 ]. Without adequate resources and staffing, compromising standards of care and threats to patient safety will be imminent therefore the importance of developing effective strategies for retaining competent registered nurses and midwives is paramount in today’s climate of increased staff shortages [ 4 ]. Clinical supervision serves as a means to facilitate these advancements and has been linked to heightened job satisfaction, enhanced staff retention, improved staff effectiveness, and effective clinical governance, by aiding in quality improvements, risk management, and heightened accountability [ 8 ].

Clinical supervision is a key component of professional practice and while the aim is largely known, there is no universally accepted definition of clinical supervision [ 8 ]. Clinical supervision is a structured process where clinicians are allowed protected time to reflect on their practice within a supportive environment and with the purpose of developing high-quality clinical care [ 9 ]. Recent literature published on clinical supervision [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ] highlights the advantages and merits of clinical supervision. However, there are challenges also identified such as a lack of consensus regarding the meaning and goal, implementation issues, variations in approaches in its operationalisation, and an absence of research evidence on its effectiveness. Duration and experience in clinical supervision link to positive benefits [ 8 ], but there is little evidence of how clinical supervision altered individual behaviours and practices. This is reinforced by Kuhne et al., [ 15 ] who emphasise that satisfaction rather than effectiveness is more commonly examined. It is crucial to emphasise that reviews have pinpointed that clinical supervision lowers the risks of adverse patient outcomes [ 9 ] and demonstrates enhancements in the execution of certain care processes. Peer group clinical supervision is a form of clinical supervision whereby two or more practitioners engage in a supervision or consultation process to improve their professional practice [ 17 ]. There is limited evidence regarding peer group clinical supervision and research on the experiences of peer clinical supervision and stakeholders is needed [ 13 ]. In Ireland, peer group clinical supervision has been recommended and guidelines have been developed [ 18 ]. In the Irish context, peer clinical supervision is where both clinical supervisees and clinical supervisors are peers at the same level/grade. However, greater evidence is required to inform future decisions on the implementation of peer group clinical supervision and the purpose of this study is to explore clinical supervisors’ experiences of peer group clinical supervision. As the focus is on peer group supervisors and utilising mixed methods the experiences of the other stakeholders were investigated and reported separately.

A mixed methods approach was used (survey and semi-structured interviews) to capture clinical supervisor’s experiences of clinical supervision. The study adhered to the Consensus-Based Checklist for Reporting of Survey Studies guidelines [ 19 ] (Supplementary File S1 ) and Standards for Reporting Qualitative Research guidelines [ 20 ] (Supplementary File S2 ).

Participants

This study was conducted with participants who successfully completed a professionally credited award: clinical supervision module run by a university in Ireland (74 clinical supervisors across 5 programmes over 3 years). The specific selection criteria for participants were that they were registered nurses/midwives delivering peer group clinical supervision within the West region of Ireland. The specific exclusion criteria were as follows: (1) nurses and midwives who haven’t finished the clinical supervision module at the University, (2) newly appointed peer group clinical supervisors who have yet to establish their groups and initiate the delivery of peer group clinical supervision.

Measures and procedures

The Manchester Clinical Supervision Scale-26 was used to survey participants in February/March 2022 and measure the peer group clinical supervisors’ overall experiences of facilitating peer group clinical supervision. The Manchester Clinical Supervision Scale-26 is a validated 26-item self-report questionnaire with a Likert-type (1–5) scale ranging from strongly disagree (1) to strongly agree (5) [ 21 ]. The Manchester Clinical Supervision Scale-26 measures the efficiency of and satisfaction with supervision, to investigate the skills acquisition aspect of clinical supervision and its effect on the quality of clinical care [ 21 ]. The instrument consists of two main sections to measure three (normative, restorative, and formative) dimensions of clinical supervision utilising six sub-scales: (1) trust and rapport, (2) supervisor advice/support, (3) improved care/skills, (4) importance/value of clinical supervision, (5) finding time, (6) personal issues/reflections and a total score for the Manchester Clinical Supervision Scale-26 is also calculated. Section two consisted of the demographic section of the questionnaire and was tailored to include eight demographic questions concerning the supervisor’s demographics, supervisee characteristics, and characteristics of clinical supervision sessions. There were also two open field questions on the Manchester Clinical Supervision Scale-26 (model of clinical supervision used and any other comments about experience of peer group clinical supervision). The main question about participants’ experiences with peer clinical supervision was “What was your experience of peer clinical supervision?” This was gathered through individual semi-structured interviews lasting between 20 and 45 min, in March/April 2022 (Supplementary file 3 ).

Ethical considerations

Health service institutional review boards of two University hospitals approved this study (Ref: 091/19 and Ref: C.A. 2199). Participants were recruited after receiving a full explanation of the study’s purpose and procedure and all relevant information. Participants were aware of potential risks and benefits and could withdraw from the study, or the survey could be stopped at any time. Informed consent was recorded, and participant identities were protected by using a pseudonym to protect anonymity.

Data analysis method

Survey data was analysed using the data analysis software package Statistical Package for the Social Sciences, version 26 (SPSS Inc., Chicago, Il, USA). Descriptive analysis was undertaken to summarise responses to all items and categorical variables (nominal and ordinal) were analysed using frequencies to detail the number and percentage of responses to each question. Scores on the Manchester Clinical Supervision Scale-26 were reverse scored for 9 items (Q1-Q6, Q8, Q20,21) and total scores for each of the six sub-scales were calculated by adding the scores for each item. Raw scores for the individual sub-scales varied in range from 0 to 20 and these raw scores were then converted to percentages which were used in addition to the raw scores for each sub-scale to describe and summarise the results of the Manchester Clinical Supervision Scale-26. Cronbach’s alpha coefficient was undertaken with the 26 questions included within the Manchester Clinical Supervision Scale-26 and more importantly with each of the dimensions in the Manchester Clinical Supervision Scale-26. The open-ended questions on the Manchester Clinical Supervision Scale-26 and interviews were analysed using content analysis guided by Colorafi and Evans [ 22 ] and categories were generated using their eight steps, (1) creating a coding framework, (2) adding codes and memos, (3) applying the first level of coding, (4) categorising codes and applying the second level of coding, (5) revising and redefining the codes, (6) adding memos, (7) visualising data and (8) representing the data.

Research rigour

To ensure the validity and rigour of this study the researchers utilised the Manchester Clinical Supervision Scale-26 a recognised clinical supervision tool with good reliability and wide usage. Interviews were recorded, transcribed, and verified by four participants, data were collected until no new components appeared, data collection methods and analysis procedures were described, and the authors’ biases were minimised throughout the research process. The Manchester Clinical Supervision Scale-26 instrument internal consistency reliability was assessed which was overall good (α = 0.878) with individual subscale also good e.g., normative domain 0.765, restorative domain 0.864, and formative domain 0.900. Reporting rigour was demonstrated using the Consensus-Based Checklist for Reporting of Survey Studies guidelines [ 19 ] and Standards for Reporting Qualitative Research guidelines [ 20 ].

Quantitative data

Participant and clinical supervision characteristics.

Thirty-six of the fifty-two (69.2%) peer group clinical supervisors working across a particular region of Ireland responded to the Manchester Clinical Supervision Scale-26 survey online via Qualtrics. Table 1 identifies the demographics of the sample who were predominantly female (94.4%) with a mean age of 44.7 years (SD. 7.63).

Peer group clinical supervision session characteristics (Table  2 ) highlight over half of peer group clinical supervisors ( n  = 20, 55.6%) had been delivering peer group clinical supervision for less than one year and were mainly delivered to female supervisees ( n  = 28, 77.8%). Most peer group clinical supervision sessions took place monthly ( n  = 32, 88.9%) for 31–60 min ( n  = 27, 75%).

Manchester Clinical Supervision Scale-26 results

Participants generally viewed peer group clinical supervision as effective (Table  3 ), the total mean Manchester Clinical Supervision Scale-26 score among all peer group clinical supervisors was 76.47 (SD. 12.801) out of 104, Surpassing the clinical supervision threshold score of 73, which was established by the developers of the Manchester Clinical Supervision Scale-26 as the benchmark indicating proficient clinical supervision provision [ 21 ]. Of the three domains; normative, formative, and restorative, the restorative domain scored the highest (mean 28.56, SD. 6.67). The mean scores compare favourably to that of the Manchester Clinical Supervision Scale-26 benchmark data and suggest that the peer group clinical supervisors were satisfied with both the level of support, encouragement, and guidance they provided and the level of trust/rapport they had developed during the peer group clinical supervision sessions. 83.3% ( n  = 30) of peer group clinical supervisors reported being either very satisfied ( n  = 12, 33.3%) or moderately satisfied ( n  = 18, 50%) with the peer group clinical supervision they currently delivered. Within the peer group clinical supervisor’s supervisee related issues ( n  = 17, 47.2%), work environment-related issues ( n  = 16, 44.4%), staff-related issues ( n  = 15, 41.7%) were reported as the most frequent issues, with patient/client related issues being less frequent ( n  = 8, 22.2%). The most identified model used to facilitate peer group clinical supervision was the Proctors model ( n  = 8, 22.22%), which was followed by group ( n  = 2, 5.55%), peer ( n  = 2, 5.55%), and a combination of the seven-eyed model of clinical supervision and Proctors model ( n  = 1, 2.77%) with some not sure what model they used ( n  = 2, 5.553%) and 58.33% ( n  = 21) did not report what model they used.

Survey open-ended question

‘Please enter any additional comments , which are related to your current experience of delivering Peer Group Clinical Supervision.’ There were 22 response comments to this question, which represented 61.1% of the 36 survey respondents, which were analysed using content analysis guided by Colorafi & Evans [ 22 ]. Three categories were generated. These included: personal value/benefit of peer group clinical supervision, challenges with facilitating peer group clinical supervision, and new to peer group clinical supervision.

The first category ‘personal value/benefit of peer group clinical supervision’ highlighted positive experiences of both receiving and providing peer group clinical supervision. Peer group clinical supervisors reported that they enjoyed the sessions and found them both worthwhile and beneficial for both the group and them as peer group clinical supervisors in terms of creating a trusted supportive group environment and motivation to develop. Peer group clinical supervision was highlighted as very important for the peer group clinical supervisors working lives and they hoped that there would be more uptake from all staff. One peer group clinical supervisor expressed that external clinical supervision was a ‘lifeline’ to shaping their supervisory journey to date.

The second category ‘challenges with facilitating peer group clinical supervision’, identified time constraints, lack of buy-in/support from management, staff shortages, lack of commitment by supervisees, and COVID-19 pandemic restrictions and related sick leave, as potential barriers to facilitating peer group clinical supervision. COVID-19 was perceived to have a negative impact on peer group clinical supervision sessions due to staff shortages, which resulted in difficulties for supervisees attending the sessions during work time. Peer group clinical supervisors felt that peer group clinical supervision was not supported by management and there was limited ‘buy-in’ at times. There was also a feeling expressed that peer group clinical supervision was in its infancy, as COVID-19 and its related restrictions impacted on this by either slowing down the process of commencing peer group clinical supervision in certain areas or having to move online. However, more recently improvements in managerial support and supervisee engagement with the peer group clinical supervision process are noted.

The final category ‘new to peer group clinical supervision’ highlighted that some peer group clinical supervisors were new to the process of providing peer group clinical supervision and some felt that this survey was not a true reflection of their experience of delivering peer group clinical supervision, as they were not fully established yet as clinical supervisors due to the impact of COVID-19. Peer group clinical supervisors identified that while they were new to providing peer group clinical supervision, they were enjoying it and that it was a learning curve for them.

Qualitative data

The qualitative phase explored peer group clinical supervisors’ ( n  = 10) own experiences of preparation received and experiences of being a peer group clinical supervisor. Three themes were identified through data analysis, building the foundations, enacting engagement and actions, and realities (Table  4 ).

Building the foundations

This theme highlights the importance of prior knowledge, awareness, and training but also the recruitment process and education in preparing peer group clinical supervisors.

Knowledge and awareness

Participant’s prior knowledge and awareness of peer group clinical supervision was mixed with some reporting having little or no knowledge of clinical supervision.

I’m 20 years plus trained as a nurse , and I had no awareness of clinical supervision beforehand , I really hadn’t got a clue what all of this was about , so it was a very new concept to me (Bernie) .

Others were excited about peer group clinical supervision and while they could see the need they were aware that there may be limited awareness of the value and process of clinical supervision among peers.

I find that there’s great enthusiasm and passion for clinical supervision as it’s a great support mechanism for staff in practice , however , there’s a lack of awareness of clinical supervision (Jane) .

Recruitment

Some participants highlighted that the recruitment process to become a peer group clinical supervisor was vague in some organisations with an unclear and non-transparent process evident where people were chosen by the organisation’s management rather than self-selecting interested parties.

It was just the way the training was put to the people , they were kind of nominated and told they were going and there was a lot of upset over that , so they ended up in some not going at all (Ailbhe) .

In addition, the recruitment process was seen as top loaded where senior grades of staff were chosen, and this limited staff nurse grade opportunities where there was a clear need for peer group clinical supervisors and support.

We haven’t got down to the ground level like you know we’ve done the directors , we’ve done the CNM3s the CNM2s we are at the CNM1s , so we need to get down to the staff nurse level so the nurses at the direct frontline are left out and aren’t receiving supervision because we don’t have them trained (Bernie) .

Training and education

Participants valued the training and education provided but there was a clear sense of ‘imposter syndrome’ for some peer group clinical supervisors starting out. Participants questioned their qualifications, training duration, and confidence to undertake the role of peer group clinical supervisor.

Because it is group supervision and I know that you know they say that we are qualified to do supervision and you know we’re now qualified clinical supervisors but I’m not sure that a three-month module qualifies you to be at the top of your game (Maria) .

Participants when engaged in the peer group clinical supervisor educational programme did find it beneficial and the true benefit was the actual re-engagement in education and published evidence along with the mix of nursing and midwifery practice areas.

I found it very beneficial , I mean I hadn’t been engaged in education here in a while , so it was great to be back in that field and you know with the literature that’s big (Claire) .

Enacting engagement and actions

This theme highlights the importance of forming the groups, getting a clear message out, setting the scene, and grounding the group.

Forming the groups

Recruitment for the group was of key importance to the peer group clinical supervisor and they all sent out a general invitation to form their group. Some supervisors used invitation letters or posters in addition to a general email and this was effective in recruiting supervisees.

You’re reaching out to people , I linked in with the ADoN and I put together a poster and circulated that I wasn’t ‘cherry picking , and I set up a meeting through Webex so people could get a sense of what it was if they were on the fence about it or unsure if it was for them (Karen) .

In forming the peer clinical supervision groups consideration needs to be given to the actual number of supervisees and participants reported four to six supervisees as ideal but that number can alter due to attendance.

The ideal is having five or six consistent people and that they all come on board and that you get the dynamics of the group and everything working (Claire) .

Getting a clear message out

Within the recruitment process, it was evident that there was a limited and often misguided understanding or perception of peer group clinical supervision.

Greater awareness of what actually clinical supervision is , people misjudge it as a supervision where someone is appraising you , when in fact it is more of a support mechanism , I think peer support is the key element that needs to be brought out (Jane) .

Given the lack of clarity and understanding regarding peer group clinical supervision, the participants felt strongly that further clarity is needed and that the focus needs to be on the support it offers to self, practice, and the profession.

Clinical supervision to me is clinical leadership (Jane) .

Setting the scene and grounding the group

In the initial phase of the group coming together the aspect of setting the scene and grounding the group was seen as important. A key aspect of this process was establishing the ground rules which not only set the boundaries and gave structure but also ensured the adoption of principles of trust, confidentiality, and safety.

We start with the ground rules , they give us structure it’s our contract setting out the commitment the expectation for us all , and the confidentiality as that’s so important to the trust and safety and building the relationships (Brid) .

Awareness of group dynamics is important in this process along with awareness of the group members (supervisees) as to their role and expectations.

I reiterate the role of each person in relation to confidentiality and the relationship that they would have with each other within the group and the group is very much aware that it is based on respect for each person’s point of view people may have a fear of contributing to the group and setting the ground rules is important (Jane) .

To ground the group, peer group clinical supervisors saw the importance of being present and allowing oneself to be in the room. This was evident in the time allocated at the start of each session to allow ‘grounding’ to occur in the form of techniques such as a short meditation, relaxation, or deep breathing.

At the start , I do a bit of relaxation and deep breathing , and I saw that with our own external supervisor how she settled us into place so very much about connecting with your body and you’ve arrived , then always come in with the contract in my first sentence , remember today you know we’re in a confidential space , of course , you can take away information , but the only information you will take from today is your own information and then the respect aspect (Mary Rose) .

This settling in and grounding was seen as necessary for people to feel comfortable and engage in the peer group clinical supervision process where they could focus, be open, converse, and be aware of their role and the role of peer group clinical supervision.

People have to be open, open about their practice and be willing to learn and this can only occur by sharing, clinical supervision gives us the space to do it in a space where we know we will be respected, and we can trust (Claire) .

This theme highlights the importance of the peer group clinical supervisors’ past experiences, delivering peer group clinical supervision sessions, responding to COVID-19, personal and professional development, and future opportunities.

Past experiences

Past experiences of peer group clinical supervisors were not always positive and for one participant this related to the lack of ground rules or focus of the sessions and the fact it was facilitated by a non-nurse.

In the past , I suppose I would have found it very frustrating as a participant because I just found that it was going round in circles , people moaning and you know it wasn’t very solution focused so I came from my situation where I was very frustrated with clinical supervision , it was facilitated by somebody that was non-nursing then it wasn’t very , there wasn’t the ground rules , it was very loose (Caroline) .

However, many did not have prior experience of peer group clinical supervision. Nonetheless, through the education and preparation received, there was a sense of commitment to embrace the concept, practice, and philosophy.

I did not really have any exposure or really much information on clinical supervision , but it has opened my eyes , and as one might say I am now a believer (Brid) .

Delivering peer group clinical supervision

In delivering peer group clinical supervision, participants felt supervisees were wary, as they did not know what peer group clinical supervision was, and they had focused more on the word supervision which was misleading to them. Nonetheless, the process was challenging, and buy-in was questioned at an individual and managerial level.

Buy-in wasn’t great I think now of course people will blame the pandemic , but this all happened before the pandemic , there didn’t seem to be you know , the same support from management that I would have expected so I kind of understood it in a way because then there wasn’t the same real respect from the practitioners either (Mary Rose) .

From the peer group clinical supervisor’s perspective, they were all novices in delivering/facilitating peer group clinical supervision sessions, and the support of the external clinical supervisors, and their own peer group clinical supervision sessions were invaluable along with a clinical supervision model.

Having supervision myself was key and something that is vital and needed , we all need to look at our practice and how we work it’s no good just facilitating others without being part of the process yourself but for me I would say the three principles of clinical supervision , you know the normative , formative and restorative , I keep hammering that home and bring that in regularly and revisit the contract and I have to do that often you know (Claire) .

All peer group clinical supervisors commented on the preparation for their peer group clinical supervision sessions and the importance of them having the right frame of mind and that often they needed to read over their course work and published evidence.

I want everybody to have a shared voice and you know that if one person , there is something that somebody feels very strongly and wants to talk about it that they e-mail in advance like we don’t have a set agenda but that’s agreed from the participant at the start (Caroline) .

To assist this, the peer group clinical supervisors noted the importance of their own peer group clinical supervision, the support of their peers, and external clinical supervisors. This preparation in an unpredictable situation can be difficult but drawing on one’s experience and the experience within the group can assist in navigating beyond unexpected situations.

I utilise the models of clinical supervision and this helps guide me , I am more of a facilitator of the group we are experts in our own area and our own role but you can only be an expert if you take the time to examine your practice and how you operate in your role (Brid) .

All clinical supervisors noted that the early sessions can be superficial, and the focus can be on other practice or management issues, but as time moves on and people become more engaged and involved it becomes easier as their understanding of supervision becomes clearer. In addition, there may be hesitancy and people may have difficulty opening up with certain people in the group and this is a reality that can put people off.

Initially there was so much managerial bashing and I think through supervision , I began to kind of think , I need the pillars of supervision , the governance , bringing more knowledge and it shifted everything in the room , trying to marry it with all the tensions that people have (Mary Rose) .

For some clinical supervisors, there were expected and unexpected challenges for them as clinical supervisors in terms of the discussions veering off course and expectations of their own ability.

The other big challenge is when they go off , how do you bring him back , you know when they veer off and you’re expected to be a peer , but you have to try and recoil that you have to get the balance with that right (Mary Rose) .

While peer group clinical supervision is accepted and seen as a valuable process by the peer group clinical supervisors, facilitating peer group supervision with people known to you can be difficult and may affect the process.

I’d love to supervise a group where I actually don’t know the people , I don’t know the dynamics within the group , and I’d love to see what it would be like in a group (Bernie) .

Of concern to clinical supervisors was the aspect of non-attendance and while there may be valid reasons such as COVID-19 the absence of a supervisee for several sessions can affect the group dynamics, especially if the supervisee has only engaged with early group sessions.

One of the ones that couldn’t attend because of COVID and whatever , but she’s coming to the next one and I just feel there’s a lot of issues in her area and I suppose I’m mindful that I don’t want that sort of thing to seep in , so I suppose it’s just for me just to keep reiterating the ground rules and the boundaries , that’s something I just have to manage as a facilitator , but what if they don’t attend how far will the group have progressed before she attends (Caroline) .

Responding to COVID-19

The advent of COVID-19 forced peer group clinical supervisors to find alternative means of providing peer group clinical supervision sessions which saw the move from face-to-face to online sessions. The online transition was seen as seamless for many established groups while others struggled to deliver sessions.

With COVID we did online for us it was fine because we were already formed (Corina) .

While the transition may have been positive many clinical supervisors came across issues because they were using an online format that would not be present in the face-to-face session.

We did have a session where somebody was in the main office and they have a really loud booming voice and they were saying stuff that was not appropriate to say outside of clinical supervision and I was like are you in the office can you lower it down a bit can you put your headphones on (Maria) .

However, two peer group clinical supervisors ceased or hasted the progress of rolling out peer group clinical supervision sessions mainly due to redeployment and staff availability.

With COVID it just had to be canceled here , it’s just the whole thing was canceled so it was very , very difficult for people (Mary Rose) .

It was clear from clinical supervisors that online sessions were appropriate but that they felt they were only appropriate for existing established groups that have had the opportunity to build relationships, develop trust, embed the ground rules, and create the space for open communication and once established a combined approach would be appropriate.

Since we weren’t as established as a group , not everybody knew each other it would be difficult to establish that so we would hold off/reschedule , obviously COVID is a major one but also I suppose if you have an established group now , and again , you could go to a remote one , but I felt like since we weren’t established as a group it would be difficult to develop it in that way (Karen) .

Within practice COVID-19 took priority and other aspects such as peer group clinical supervision moved lower down on the priority list for managers but not for the clinical supervisors even where redeployment occurred.

With COVID all the practical side , if one of the managers is dealing with an outbreak , they won’t be attending clinical supervision , because that has to be prioritised , whereas we’ve prioritised clinical supervision (Maria) .

The valuing of peer group clinical supervision was seen as important by clinical supervisors, and they saw it as particularly needed during COVID-19 as staff were dealing with many personal and professional issues.

During the height of COVID , we had to take a bit of a break for four months as things were so demanding at work for people but then I realised that clinical supervision was needed and started back up and they all wanted to come back (Brid) .

Having peer group clinical supervision during COVID-19 supported staff and enabled the group to form supportive relationships.

COVID has impacted over the last two years in every shape and they needed the supervision and the opportunity to have a safe supportive space and it gelled the group I think as we all were there for each other (Claire) .

While COVID-19 posed many challenges it also afforded clinical supervisors and supervisees the opportunity for change and to consider alternative means of running peer group clinical supervision sessions. This change resulted in online delivery and in reflecting on both forms of delivery (face-to-face and online) clinical supervisors saw the benefit in both. Face-to-face was seen as being needed to form the group and then the group could move online once the group was established with an occasional periodic face-to-face session to maintain motivation commitment and reinforce relationships and support.

Online formats can be effective if the group is already established or the group has gone through the storming and forming phase and the ground rules have been set and trust built , then I don’t see any problem with a blended online version of clinical supervision , and I think it will be effective (Jane) .

Personal and professional development

Growth and development were evident from peer group clinical supervisors’ experiences and this growth and development occurred at a personal, professional, and patient/client level. This development also produced an awakening and valuing of one’s passion for self and their profession.

I suppose clinical supervision is about development I can see a lot of development for me and my supervisees , you know personally and professionally , it’s the support really , clinical supervision can reinvigorate it’s very exciting and a great opportunity for nursing to support each other and in care provision (Claire) .

A key to the peer group clinical supervisor’s development was the aspect of transferable skills and the confidence they gained in fulfilling their role.

All of these skills that you learn are transferable and I am a better manager because of clinical supervision (Maria) .

The confidence and skills gained translated into the clinical supervisor’s own practice as a clinical practitioner and clinical supervisor but they were also realistic in predicting the impact on others.

I have empowered my staff , I empower them to use their voice and I give my supervisees a voice and hope they take that with them (Corina) .

Fundamental to the development process was the impact on care itself and while this cannot always be measured or identified, the clinical supervisors could see that care and support of the individual practitioner (supervisee) translated into better care for the patient/client.

Care is only as good as the person delivering it and what they know , how they function and what energy and passion they have , and clinical supervision gives the person support to begin to understand their practice and how and why they do things in a certain way and when they do that they can begin to question and even change their way of doing something (Brid) .

Future opportunities

Based on the clinical supervisor’s experiences there was a clear need identified regarding valuing and embedded peer group clinical supervision within nursing/midwifery practice.

There has to be an emphasis placed on supervision it needs to be part of the fabric of a service and valued by all in that service , we should be asking why is it not available if it’s not there but there is some work first on promoting it and people knowing what it actually is and address the misconceptions (Claire) .

While such valuing and buy-in are important, it is not to say that all staff need to have peer group clinical supervision so as to allow for personal choice. In addition, to value peer group clinical supervision it needs to be evident across all staffing grades and one could question where the best starting point is.

While we should not mandate that all staff do clinical supervision it should become embedded within practice more and I suppose really to become part of our custom and practice and be across all levels of staff (Brid) .

When peer group clinical supervision is embedded within practice then it should be custom and practice, where it is included in all staff orientations and is nationally driven.

I suppose we need to be driving it forward at the coal face at induction , at orientation and any development for the future will have to be driven by the NMPDUs or nationally (Ailbhe) .

A formalised process needs to address the release of peer group clinical supervisors but also the necessity to consider the number of peer group clinical supervisors at a particular grade.

The issue is release and the timeframe as they have a group but they also have their external supervision so you have to really work out how much time you’re talking about (Maria) .

Vital within the process of peer group clinical supervision is receiving peer group clinical supervision and peer support and this needs to underpin good peer group clinical supervision practice.

Receiving peer group supervision helps me , there are times where I would doubt myself , it’s good to have the other group that I can go to and put it out there to my own group and say , look at this , this is what we did , or this is what came up and this is how (Bernie) .

For future roll out to staff nurse/midwife grade resourcing needs to be considered as peer group clinical supervisors who were managers could see the impact of having several peer group clinical supervisors in their practice area may have on care delivery.

Facilitating groups is an issue and needs to be looked at in terms of the bigger picture because while I might be able to do a second group the question is how I would be supported and released to do so (Maria) .

While there was ambiguity regarding peer group clinical supervision there was an awareness of other disciplines availing of peer group clinical supervision, raising questions about the equality of supports available for all disciplines.

I always heard other disciplines like social workers would always have been very good saying I can’t meet you I have supervision that day and I used to think my God what’s this fabulous hour that these disciplines are getting and as a nursing staff it just wasn’t there and available (Bernie) .

To address this equity issue and the aspect of low numbers of certain grades an interdisciplinary approach within nursing and midwifery could be used or a broader interdisciplinary approach across all healthcare professionals. An interdisciplinary or across-services approach was seen as potentially fruitful.

I think the value of interprofessional or interdisciplinary learning is key it addresses problem-solving from different perspectives that mix within the group is important for cross-fertilisation and embedding the learning and developing the experience for each participant within the group (Jane) .

As we move beyond COVID-19 and into the future there is a need to actively promote peer group clinical supervision and this would clarify what peer group clinical supervision actually is, its uptake and stimulate interest.

I’d say it’s like promoting vaccinations if you could do a roadshow with people , I think that would be very beneficial , and to launch it , like you have a launch an official launch behind it (Mary Rose) .

The advantages of peer group clinical supervision highlighted in this study pertain to self-enhancement (confidence, leadership, personal development, resilience), organisational and service-related aspects (positive work environment, staff retention, safety), and professional patient care (critical thinking and evaluation, patient safety, adherence to quality standards, elevated care standards). These findings align with broader literature that acknowledges various areas, including self-confidence and facilitation [ 23 ], leadership [ 24 ], personal development [ 25 ], resilience [ 26 ], positive/supportive working environment [ 27 ], staff retention [ 28 ], sense of safety [ 29 ], critical thinking and evaluation [ 30 ], patient safety [ 31 ], quality standards [ 32 ] and increased standards of care [ 33 ].

In this study, peer group clinical supervision appeared to contribute to the alleviation of stress and anxiety. Participants recognised the significance of these sessions, where they could openly discuss and reflect on professional situations both emotionally and rationally. Central to these discussions was the creation of a safe, trustworthy, and collegial environment, aligning with evidence in the literature [ 34 ]. Clinical supervision provided a platform to share resources (information, knowledge, and skills) and address issues while offering mutual support [ 35 ]. The emergence of COVID-19 has stressed the significance of peer group clinical supervision and support for the nursing/midwifery workforce [ 36 ], highlighting the need to help nurses/midwifes preserve their well-being and participate in collaborative problem-solving. COVID-19 impacted and disrupted clinical supervision frequency, duration and access [ 37 ]. What was evident during COVID-19 was the stress and need for support for staff and given the restorative or supportive functions of clinical supervision it is a mechanism of support. However, clinical supervisors need support themselves to be able to better meet the supervisee’s needs [ 38 ].

The value of peer group clinical supervision in nurturing a conducive working environment cannot be overstated, as it indorses the understanding and adherence to workplace policies by empowering supervisees to understand the importance and rationale behind these policies [ 39 ]. This becomes vital in a continuously changing healthcare landscape, where guidelines and policies may be subject to change, especially in response to situations such as COVID-19. In an era characterised by international workforce mobility and a shortage of healthcare professionals, a supportive and positive working environment through the provision of peer group clinical supervision can positively influence staff retention [ 40 ], enhance job satisfaction [ 41 ], and mitigate burnout [ 42 ]. A critical aspect of the peer group clinical supervision process concerns providing staff the opportunity to reflect, step back, problem-solve and generate solutions. This, in turn, ensures critical thinking and evaluation within clinical supervision, focusing on understanding the issues and context, and problem-solving to draw constructive lessons for the future [ 30 ]. Research has determined a link between clinical supervision and improvements in the quality and standards of care [ 31 ]. Therefore, peer group clinical supervision plays a critical role in enhancing patient safety by nurturing improved communication among staff, facilitating reflection, promoting greater self-awareness, promoting the exchange of ideas, problem-solving, and facilitating collective learning from shared experiences.

Starting a group arose as a foundational aspect emphasised in this study. The creation of the environment through establishing ground rules, building relationships, fostering trust, displaying respect, and upholding confidentiality was evident. Vital to this process is the recruitment of clinical supervisees and deciding the suitable group size, with a specific emphasis on addressing individuals’ inclination to engage, their knowledge and understanding of peer group clinical supervision, and dissipating any lack of awareness or misconceptions regarding peer group supervision. Furthermore, the educational training of peer group clinical supervisors and the support from external clinical supervisors played a vital role in the rollout and formation of peer group clinical supervision. The evidence stresses the significance of an open and safe environment, wherein supervisees feel secure and trust their supervisor. In such an environment, they can effectively reflect on practice and related issues [ 41 ]. This study emphasises that the effectiveness of peer group supervision is more influenced by the process than the content. Clinical supervisors utilised the process to structure their sessions, fostering energy and interest to support their peers and cultivate new insights. For peer group clinical supervision to be effective, regularity is essential. Meetings should be scheduled in advance, allocate protected time, and take place in a private space [ 35 ]. While it is widely acknowledged that clinical supervisors need to be experts in their professional field to be credible, this study highlights that the crucial aspects of supervision lie in the quality of the relationship with the supervisor. The clinical supervisor should be supportive, caring, open, collaborative, sensitive, flexible, helpful, non-judgmental, and focused on tacit knowledge, experiential learning, and providing real-time feedback.

Critical to the success of peer group clinical supervision is the endorsement and support from management, considering the organisational culture and attitudes towards the practice of clinical supervision as an essential factor [ 43 ]. This support and buy-in are necessary at both the management and individual levels [ 28 ]. The primary obstacles to effective supervision often revolve around a lack of time and heavy workloads [ 44 ]. Clinical supervisors frequently struggle to find time amidst busy environments, impacting the flexibility and quality of the sessions [ 45 ]. Time constraints also limit the opportunity for reflection within clinical supervision sessions, leaving supervisees feeling compelled to resolve issues on their own without adequate support [ 45 ]. Nevertheless, time-related challenges are not unexpected, prompting a crucial question about the value placed on clinical supervision and its integration into the culture and fabric of the organisation or profession to make it a customary practice. Learning from experiences like those during the COVID-19 pandemic has introduced alternative ways of working, and the use of technology (such as Zoom, Microsoft Teams, Skype) may serve as a means to address time, resource, and travel issues associated with clinical supervision.

Despite clinical supervision having a long international history, persistent misconceptions require attention. Some of these include not considering clinical supervision a priority [ 46 ], perceiving it as a luxury [ 41 ], deeming it self-indulgent [ 47 ], or viewing it as mere casual conversation during work hours [ 48 ]. A significant challenge lies in the lack of a shared understanding regarding the role and purpose of clinical supervision, with past perceptions associating it with surveillance and being monitored [ 48 ]. These negative connotations often result in a lack of engagement [ 41 ]. Without encouragement and recognition of the importance of clinical supervision from management or the organisation, it is unlikely to become embedded in the organisational culture, impeding its normalisation [ 39 ].

In this study, some peer group clinical supervisors expressed feelings of being impostors and believed they lacked the knowledge, skills, and training to effectively fulfil their roles. While a deficiency in skills and competence are possible obstacles to providing effective clinical supervision [ 49 ], the peer group clinical supervisors in this study did not report such issues. Instead, their concerns were more about questioning their ability to function in the role of a peer group clinical supervisor, especially after a brief training program. The literature acknowledges a lack of training where clinical supervisors may feel unprepared and ill-equipped for their role [ 41 ]. To address these challenges, clinical supervisors need to be well-versed in professional guidelines and ethical standards, have clear roles, and understand the scope of practice and responsibilities associated with being a clinical supervisor [ 41 ].

The support provided by external clinical supervisors and the peer group clinical supervision sessions played a pivotal role in helping peer group clinical supervisors ease into their roles, gain experiential learning, and enhance their facilitation skills within a supportive structure. Educating clinical supervisors is an investment, but it should not be a one-time occurrence. Ongoing external clinical supervision for clinical supervisors [ 50 ] and continuous professional development [ 51 ] are crucial, as they contribute to the likelihood of clinical supervisors remaining in their roles. However, it is important to interpret the results of this study with caution due to the small sample size in the survey. Generalising the study results should be approached with care, particularly as the study was limited to two regions in Ireland. However, the addition of qualitative data in this mixed-methods study may have helped offset this limitation.

This study highlights the numerous advantages of peer group clinical supervision at individual, service, organisational, and patient/client levels. Success hinges on addressing the initial lack of awareness and misconceptions about peer group clinical supervision by creating the right environment and establishing ground rules. To unlock the full potential of peer group clinical supervision, it is imperative to secure management and organisational support for staff release. More crucially, there is a need for valuing and integrating peer group clinical supervision into nursing and midwifery education and practice. Making peer group clinical supervision accessible to all grades of nurses and midwives across various healthcare services is essential, necessitating strategic planning to tackle capacity and sustainability challenges.

Data availability

Data are available from the corresponding author upon request owing to privacy or ethical restrictions.

Zelenikova R, Gurkova E, Friganovic A, Uchmanowicz I, Jarosova D, Ziakova K, Plevova I, Papastavrou E. Unfinished nursing care in four central European countries. J Nurs Manage. 2020;28(8):1888–900. https://doi.org/10.1111/jonm.12896 .

Article   Google Scholar  

Department of Health, Office of the Chief Nursing Officer. Position paper 1: values for nurses and midwives in Ireland. Dublin: The Stationery Office; 2016.

Google Scholar  

Cummings J, Bennett V. Developing the culture of compassionate care: creating a new vision for nurses, midwives and care-givers. London: Department of Health; 2012.

Both-Nwabuwe JM, Dijkstra MT, Klink A, Beersma B. Maldistribution or scarcity of nurses: the devil is in the detail. J Nurs Manage. 2018;26(2):86–93. https://doi.org/10.1111/jonm.12531 .

Squires A, Jylha V, Jun J, Ensio A, Kinnunen J. A scoping review of nursing workforce planning and forecasting research. J Nurs Manage. 2017;25:587–96. https://doi.org/10.1111/jonm.12510 .

Sasso L, Bagnasco A, Catania G, Zanini M, Aleo G, Watson R. Push and pull factors of nurses’ intention to leave. J Nurs Manage. 2019;27:946–54. https://doi.org/10.1111/jonm.12745 .

Gea-Caballero V, Castro-Sánchez E, Díaz‐Herrera MA, Sarabia‐Cobo C, Juárez‐Vela R, Zabaleta‐Del Olmo E. Motivations, beliefs, and expectations of Spanish nurses planning migration for economic reasons: a cross‐sectional, web‐based survey. J Nurs Scholarsh. 2019;51(2):178–86. https://doi.org/10.1111/jnu.12455 .

Article   PubMed   Google Scholar  

Cutcliffe J, Sloan G, Bashaw M. A systematic review of clinical supervision evaluation studies in nursing. Int J Ment Health Nurs. 2018;27:1344–63. https://doi.org/10.1111/inm.12443 .

Snowdon DA, Hau R, Leggat SG, Taylor NF. Does clinical supervision of health professionals improve patient safety? A systematic review and meta-analysis. Int J Qual Health C. 2016;28(4):447–55. https://doi.org/10.1093/intqhc/mzw059 .

Turner J, Hill A. Implementing clinical supervision (part 1): a review of the literature. Ment Health Nurs. 2011;31(3):8–12.

Dilworth S, Higgins I, Parker V, Kelly B, Turner J. Finding a way forward: a literature review on the current debates around clinical supervision. Contemp Nurse. 2013;45(1):22–32. https://doi.org/10.5172/conu.2013.45.1.22 .

Buss N, Gonge H. Empirical studies of clinical supervision in psychiatric nursing: a systematic literature review and methodological critique. Int J Ment Health Nurs. 2009;18(4):250–64. https://doi.org/10.1111/j.1447-0349.2009.00612.x .

Pollock A, Campbell P, Deery R, Fleming M, Rankin J, Sloan G, Cheyne H. A systematic review of evidence relating to clinical supervision for nurses, midwives and allied health professionals. J Adv Nurs. 2017;73(8):1825–37. https://doi.org/10.1111/jan.13253 .

Snowdon DA, Leggat SG, Taylor NF. Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience: a systematic review. BMC Health Serv Res. 2017;17(1):1–11. https://doi.org/10.1186/s12913-017-2739-5 .

Kühne F, Maas J, Wiesenthal S, Weck F. Empirical research in clinical supervision: a systematic review and suggestions for future studies. BMC Psychol. 2019;7(1):1–11. https://doi.org/10.1186/s40359-019-0327-7 .

Snowdon DA, Sargent M, Williams CM, Maloney S, Caspers K, Taylor NF. Effective clinical supervision of allied health professionals: a mixed methods study. BMC Health Serv Res. 2020;20(1):1–11. https://doi.org/10.1186/s12913-019-4873-8 .

Borders LD. Dyadic, triadic, and group models of peer supervision/consultation: what are their components, and is there evidence of their effectiveness? Clin Psychol. 2012;16(2):59–71.

Health Service Executive. Guidance document on peer group clinical supervision. Mayo: Nursing and Midwifery Planning and Development Unit Health Service Executive West Mid West; 2023.

Sharma A, Minh Duc NT, Lam Thang L, Nam T, Ng NH, Abbas SJ, Huy KS, Marušić NT, Paul A, Kwok CL. Karamouzian, M. A consensus-based checklist for reporting of survey studies (CROSS). J Gen Intern Med. 2021;36(10):3179–87. https://doi.org/10.1007/s11606-021-06737-1 .

Article   PubMed   PubMed Central   Google Scholar  

O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;899:1245–51. https://doi.org/10.1097/ACM.0000000000000388 .

Winstanley J, White E. The MCSS-26©: revision of the Manchester Clinical Supervision Scale© using the Rasch Measurement Model. J Nurs Meas. 2011;193(2011):160–78. https://doi.org/10.1891/1061-3749.19.3.160 .

Colorafi KJ, Evans B. Qualitative descriptive methods in health science research. HERD-Health Env Res. 2016;9:16–25. https://doi.org/10.1177/1937586715614171 .

Agnew T, Vaught CC, Getz HG, Fortune J. Peer group clinical supervision program fosters confidence and professionalism. Prof Sch Couns. 2000;4(1):6–12.

Mc Carthy V, Goodwin J, Saab MM, Kilty C, Meehan E, Connaire S, O’Donovan A. Nurses and midwives’ experiences with peer-group clinical supervision intervention: a pilot study. J Nurs Manage. 2021;29:2523–33. https://doi.org/10.1111/jonm.13404 .

Rothwell C, Kehoe A, Farook SF, Illing J. Enablers and barriers to effective clinical supervision in the workplace: a rapid evidence review. BMJ Open. 2021;119:e052929. https://doi.org/10.1136/bmjopen-2021-052929 .

Francis A, Bulman C. In what ways might group clinical supervision affect the development of resilience in hospice nurses. Int J Palliat Nurs. 2019;25:387–96. https://doi.org/10.12968/ijpn.2019.25.8.387 .

Chircop Coleiro A, Creaner M, Timulak L. The good, the bad, and the less than ideal in clinical supervision: a qualitative meta-analysis of supervisee experiences. Couns Psychol Quart. 2023;36(2):189–210. https://doi.org/10.1080/09515070.2021.2023098 .

Stacey G, Cook G, Aubeeluck A, Stranks B, Long L, Krepa M, Lucre K. The implementation of resilience based clinical supervision to support transition to practice in newly qualified healthcare professionals. Nurs Educ Today. 2020;94:104564. https://doi.org/10.1016/j.nedt.2020.104564 .

Feerick A, Doyle L, Keogh B. Forensic mental health nurses’ perceptions of clinical supervision: a qualitative descriptive study. Issues Ment Health Nurs. 2021;42:682–9. https://doi.org/10.1080/01612840.2020.1843095 .

Corey G, Haynes RH, Moulton P, Muratori M. Clinical supervision in the helping professions: a practical guide. Alexandria, VA: American Counseling Association; 2021.

Sturman N, Parker M, Jorm C. Clinical supervision in general practice training: the interweaving of supervisor, trainee and patient entrustment with clinical oversight, patient safety and trainee learning. Adv Health Sci Educ. 2021;26:297–311. https://doi.org/10.1007/s10459-020-09986-7 .

Alfonsson S, Parling T, Spännargård Å, Andersson G, Lundgren T. The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: a systematic review. Cogn Behav Therapy. 2018;47(3):206–28. https://doi.org/10.1080/16506073.2017.1369559 .

Coelho M, Esteves I, Mota M, Pestana-Santos M, Santos MR, Pires R. Clinical supervision of the nurse in the community to promote quality of care provided by the caregiver: scoping review protocol. Millenium J Educ Technol Health. 2022;2:83–9. https://doi.org/10.29352/mill0218.26656 .

Toros K, Falch-Eriksen A. Structured peer group supervision: systematic case reflection for constructing new perspectives and solutions. Int Soc Work. 2022;65:1160–5. https://doi.org/10.1177/0020872820969774 .

Bifarin O, Stonehouse D. Clinical supervision: an important part of every nurse’s practice. Brit J Nurs. 2017;26(6):331–5. https://doi.org/10.12968/bjon.2017.26.6.331 .

Turner J, Simbani N, Doody O, Wagstaff C, McCarthy-Grunwald S. Clinical supervision in difficult times and at all times. Ment Health Nurs. 2022;42(1):10–3.

Martin P, Tian E, Kumar S, Lizarondo L. A rapid review of the impact of COVID-19 on clinical supervision practices of healthcare workers and students in healthcare settings. J Adv Nurs. 2022;78:3531–9. https://doi.org/10.1111/jan.15360 .

van Dam M, van Hamersvelt H, Schoonhoven L, Hoff RG, Cate OT, Marije P. Hennus. Clinical supervision under pressure: a qualitative study amongst health care professionals working on the ICU during COVID-19. Med Edu Online. 2023;28:1. https://doi.org/10.1080/10872981.2023.2231614 .

Martin P, Lizarondo L, Kumar S, Snowdon D. Impact of clinical supervision on healthcare organisational outcomes: a mixed methods systematic review. PLoS ONE. 2021;1611:e0260156. https://doi.org/10.1371/journal.pone.0260156 .

Article   CAS   Google Scholar  

Hussein R, Salamonson Y, Hu W, Everett B. Clinical supervision and ward orientation predict new graduate nurses’ intention to work in critical care: findings from a prospective observational study. Aust Crit Care. 2019;325:397–402. https://doi.org/10.1016/j.aucc.2018.09.003 .

Love B, Sidebotham M, Fenwick J, Harvey S, Fairbrother G. Unscrambling what’s in your head: a mixed method evaluation of clinical supervision for midwives. Women Birth. 2017;30:271–81. https://doi.org/10.1016/j.wombi.2016.11.002 .

Berry S, Robertson N. Burnout within forensic psychiatric nursing: its relationship with ward environment and effective clinical supervision? J Psychiatr Ment Health Nurs. 2019;26:7–8. https://doi.org/10.1111/jpm.12538 .

Markey K, Murphy L, O’Donnell C, Turner J, Doody O. Clinical supervision: a panacea for missed care. J Nurs Manage. 2020;28:2113–7. https://doi.org/10.1111/jonm.13001 .

Brody AA, Edelman L, Siegel EO, Foster V, Bailey DE Jr., Bryant AL, Bond SM. Evaluation of a peer mentoring program for early career gerontological nursing faculty and its potential for application to other fields in nursing and health sciences. Nurs Outlook. 2016;64(4):332–8. https://doi.org/10.1016/j.outlook.2016.03.004 .

Bulman C, Forde-Johnson C, Griffiths A, Hallworth S, Kerry A, Khan S, Mills K, Sharp P. The development of peer reflective supervision amongst nurse educator colleagues: an action research project. Nurs Educ Today. 2016;45:148–55. https://doi.org/10.1016/j.nedt.2016.07.010 .

Pack M. Unsticking the stuckness’: a qualitative study of the clinical supervisory needs of early-career health social workers. Brit J Soc Work. 2015;45:1821–36. https://doi.org/10.1093/bjsw/bcu069 .

Bayliss J. Clinical supervision for palliative care. London: Quay Books; 2006.

Kenny A, Allenby A. Implementing clinical supervision for Australian rural nurses. Nurs Educ Pract. 2013;13(3):165–9. https://doi.org/10.1016/j.nepr.2012.08.009 .

MacLaren J, Stenhouse R, Ritchie D. Mental health nurses’ experiences of managing work-related emotions through supervision. J Adv Nurs. 2016;72:2423–34. https://doi.org/10.1111/jan.12995 .

Wilson HM, Davies JS, Weatherhead S. Trainee therapists’ experiences of supervision during training: a meta-synthesis. Clinl Psychol Psychother. 2016;23:340–51. https://doi.org/10.1002/cpp.1957 .

Noelker LS, Ejaz FK, Menne HL, Bagaka’s JG. Factors affecting frontline workers’ satisfaction with supervision. J Aging Health. 2009;21(1):85–101. https://doi.org/10.1177/0898264308328641 .

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Acknowledgements

The research team would like to thank all participants for their collaboration, the HSE steering group members and Carmel Hoey, NMPDU Director, HSE West Mid West, Dr Patrick Glackin, NMPD Area Director, HSE West, Annette Cuddy, Director, Centre of Nurse and Midwifery Education Mayo/Roscommon; Ms Ruth Hoban, Assistant Director of Nursing and Midwifery (Prescribing), HSE West; Ms Annette Connolly, NMPD Officer, NMPDU HSE West Mid West.

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OD: Conceptualization, Methodology, Formal analysis, Investigation, Writing - Original Draft, Writing - Review & Editing, Project administration, Funding acquisition. COD: Methodology, Formal analysis, Investigation, Writing - Original Draft, Writing - Review & Editing, Funding acquisition. KM: Methodology, Formal analysis, Investigation, Writing - Original Draft, Writing - Review & Editing, Funding acquisition. JT: Methodology, Formal analysis, Writing - Original Draft, Writing - Review & Editing. LM: Methodology, Formal analysis, Investigation, Writing - Original Draft, Writing - Review & Editing, Funding acquisition.

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This study was approved by two health service institutional review boards University Hospital Limerick (Ref: 091/19) and Galway University Hospitals (Ref: C.A. 2199). The study was conducted in accordance with the principles of the Declaration of Helsinki and all study details were fully disclosed to participants, who were assured of the voluntary nature of participation and withdrawal. The study questionnaires were coded, and identities were not disclosed to guarantee participants’ anonymity and all participants provided written informed consent before interviews.

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Doody, O., Markey, K., Turner, J. et al. Clinical supervisor’s experiences of peer group clinical supervision during COVID-19: a mixed methods study. BMC Nurs 23 , 612 (2024). https://doi.org/10.1186/s12912-024-02283-3

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