Critical Thinking Skills for the Learner

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A Professional Growth Module: CRITICAL THINKING SKILLS

Developing Top-Notch CNAs, One Inservice at a Time

Inside This A Professional Growth Module: Inservice: Critical Thinking Skills The Way We Think 2 USING YOUR HEAD! Facts VS Opinions 3 Let’s Start With a Laugh! You are thinking critically when Other Ways of Thinking 4 Jim knocked on a client’s you: bathroom door and How to Think Critically 5-6  Look for things that may be asked, “Is anyone in clouding your judgment. there?” The Nursing Process 7  Explore ideas that might bring a He heard a mumbled new solution to an old problem. Tips & More Tips! 8-10 response, to which he said, “Is that a yes or a  Take responsibility for what you no?” say and do instead of just blindly (Oh, Jim...use your following other people. head!)  Expose yourself to new information and keep an open mind about what you learn.

 Recognize that there is usually Do you know people who seem to: more than one way of looking at  Speak without thinking first? things...and that things are NOT always what they seem.  Believe everything they hear?  Make the same mistakes over  Figure out what you really and over? believe—instead of letting others tell you what to believe. If so, these people probably need to “beef up” their critical thinking skills.  Are more concerned with finding In fact, most of us can benefit from the best solution rather than just using our heads a bit more often! being “right”.

Using your head means that you are  Avoid making snap judgments. © 201 In the Know, Inc. www.knowingmore.com thinking critically. And, critical May be copied for use within thinking happens when you pay What’s the bottom line? close attention to what you hear, say each physical location that When you think critically, and do—and think it all through purchases this inservice from you are taking charge of In the Know. All other carefully. copying or distribution is your own mind! A Professional Growth Module: Critical Thinking Skills Page 2

The Way We Think!

 The human brain is the most  It’s possible to train ourselves to complex brain of any animal on think faster and be “smarter” by Earth. There are more nerve cells creating new brain connections. in the brain than there are stars Every time we learn something in the Milky Way. new, we add another connection between two brain cells.  In fact, the brain contains over The human brain is about the 100,000 million cells! These brain  A simple activity, like doing a size of a cantaloupe, has cells connect to each other to crossword puzzle, helps to wrinkles like a walnut and feels like a ripe avocado! form a gigantic “network”. exercise the brain and create new connections.  Every time we have a creative thought, see something different or smell a new odor, we are Time For a Laugh! creating additional connections It was after midnight when between brain cells. Sue finished her Sunday Do you enjoy crossword and turned off learning new the bedside light. Leaning things? Well, Did You Know? over to kiss her tired think about this: husband, she quietly The Cray Computer is one Every year, around remarked, “I do those of the world’s largest the world, over puzzles to keep my brain computers. It can make 1,000,000 new sharp.” books are 400 million calculations in published. That’s just one second. If it kept Out of the darkness, her a lot to read! that up for one hundred husband replied, “Don’t years, it would equal what point that thing at me!” the human brain can do in one minute!  If you’d like to learn something new, there is certainly no  Do smart people have bigger shortage of information. 75% of brains? Not necessarily. In fact, all the knowledge in existence Albert Einstein’s brain was today has been created since we smaller than average. However, were born. studies have shown that smart  Here’s another way to look at it: people have more connections Just one issue of The New York between their brain cells. And, Times newspaper contains the the more connections, the same amount of information that better! Did you know that, during people in the 1600’s obtained our lives, we use less than during their entire lives! one percent of our brain’s potential?

Critical Thinkers Tend To...

 Listen carefully. They don’t  Avoid shooting down ideas just automatically believe everything because they didn’t think of them. they hear or read.  Discover better ways to deal with  Ask questions and spend time their problems—instead of analyzing information. avoiding them. Remember… People who  Look for ways to prove information  Learn how to react to problems always have to be right are rather than just believing it to be logically instead of emotionally. probably not thinking true. critically or creatively.  Catch their own mistakes by  Remain open to new ideas and are thinking about what they are able to look at things in a new way. doing.

 Protect themselves from being  Perform their duties at work manipulated because they think for without needing to be told what to Knowledge by themselves. do every step of the way. itself is useless. People have to be able to “transfer” their knowledge to the real world. The Diﬀerence Between Facts & Opinions For example, John passed his nursing Facts are pieces of information that 3. Opinion or Fact? assistant exam are objective and can be proven. There will be 10% fewer cases of with ﬂying colors Fact: It’s raining outside. tuberculosis by the year 2015. but he can’t seem to complete his Opinions are beliefs or judgments 4. Opinion or Fact? client care and are nearly impossible to prove. ABC Nursing Home has employed properly. Opinion: This is the worst rainstorm 20% more nursing assistants I’ve ever seen. since last year.

Sometimes, it’s not so easy to tell the 5. Opinion or Fact? diﬀerence between facts and It is pointless to rush through opinions. For example, which are your work. each of these? 6. Opinion or Fact? 1. Opinion or Fact? When lifting a client, it’s a Mr. Black has diabetes. good idea to ask for help from your coworkers.

2. Opinion or Fact?

4. Fact 5. Opinion 6. Opinion Opinion 6. Opinion 5. Fact 4. Exercise is the main key to Opinion 3. Opinion 2. Fact 1. People who are critical thinkers

are valuable employees! successful weight loss. answers: the are Here

What Other Ways Do People Think?

In addition to critical thinking, there For example: Jim hears a rumor at are a number of other ways that work that all the CNA’s will be getting a people tend to think. Everyone is 10% raise. He is so happy about this guilty of not thinking “straight” that he doesn’t bother to check with his sometimes, but people who supervisor. Instead, he buys a new TV Remember...critical thinkers are frequently think in the following he’s been wanting. in charge of their own minds! ways may need to “use their heads” a bit more! 4. Authoritarian Thinking 1. Illogical Thinking People who tend to blindly accept People who use illogical thinking to what someone in authority says are using authoritarian thinking. When solve a problem are usually on shaky Here’s an ground. They base their ideas on they are told something by a boss or example of false information. For example: a minister or a family member, they authoritarian Sue notices that Mrs. Brown never eats accept what they hear as correct— thinking! without questioning it! carrots when they are served to her. Dan had just For example: The nursing supervisor Carrots are orange. So, Sue figures that finished military Mrs. Brown doesn’t like orange foods. tells Marsha that her client, Mr. Baxter, boot camp when slept poorly the night before. She he took a two- day instructs Marsha to let Mr. Baxter sleep 2. Wishful Thinking drive across through breakfast and lunch so he can country to his new Often, wishful thinking keeps people catch up on his sleep. Marsha doesn’t assignment. from facing reality. When faced with question the supervisor. Midmorning of the a problem, they don’t look for second day, Dan solutions. Instead, they try to “wish” 5. Intuitive Thinking called his father the problem away or simply hope from the hotel. that it will disappear on its own. People who think intuitively tend to For example: Jim’s favorite client, Mr. rely on their “gut” to solve a problem. “Why aren’t you on the road yet?” Washington, has terminal cancer. Jim They believe that the best solution to asked Dan’s father. keeps telling himself...and the client’s a problem will just “come to them” family...that Mr. Washington is getting because of their own life experiences. “Well, Dad, I’m all better. For example: Sam has a new client, ready to go,” Mrs. Norton, who has multiple sclerosis. replied Sam has never worked with someone Dan, “but 3. Emotional Thinking with MS, but he figures that his the sign on the Some people tend to rely on their experience with stroke victims will help emotions when they think about door says him know what to do with Mrs. Norton. ‘Checkout things. If they feel “good” about He doesn’t bother to learn anything at something, it must be true. But, if the about MS. 11a.m.’” information makes them feel “bad”, it must be false.

How to Think Critically

To think critically, the first step is to coworker to another. She feels sure collect information. It’s important to that they are talking about her. She make sure that the information you spends the rest of the day feeling gather is accurate and complete— angry and decides to ignore both and that you don’t make snap those coworkers—even when they judgments about it. ask for her help. The next day, Tammy finds out that the negative Critical thinking leaves you  We are living in the “information comment was not about her...but open to learning new things— age”. You can gather information about a coworker’s sister. Tammy every day! about most any subject by: put unnecessary stress on herself by  Watching television. acting on incomplete information!  Reading newspapers, books and magazines.  Be sure you read carefully, too. It’s easy to rush through Critical thinking is  Listening to the radio. information—and get it wrong. not just for  Surfing the internet. “smart” people. It For example: Ted reads Mrs. is not some secret Carter’s care plan and remembers it  At work, you gather information process that only saying, “turn client every four professors do. We by: hours”. Ted performs his care, all think critically  Talking to coworkers—and turning Mrs. Carter at 11 and again every day— without watching them work. at 3. He documents his care knowing it!  Talking—and listening—to thoroughly. Several days later, Ted your supervisor. is reprimanded by his supervisor for  Observing your clients. not following Mrs. Carter’s care  Talking to your clients and plan. When Ted reads it again, he their family members. sees it actually says, “turn client every two hours”.  Reading your workplace policies and procedures.  Remember, it’s possible to think critically about information and  In order to make sure you are still make mistakes—if you are gathering the facts, you need to working with false information. Do listen carefully. Otherwise, you your best to make sure the might make decisions based on information you collect is false information. For example: accurate and complete! Tammy overhears part of a negative comment made by one Critical thinking increases your understanding of the world.

How to Think Critically, continued

Once you have gathered  As you go through this information, the second step to questioning process, remain open critical thinking is to question your to the world around you...and to information. It’s important not to other people’s ideas and beliefs. believe everything you hear or read! When people practice thinking  People who think critically ask a  Examine your own ideas and critically often enough, it beliefs to see if they are logical. becomes second nature number of questions about the to them. information they hear or read. Remember that there is always These questions include: the possibility that you might be wrong.  Did this information come from a reliable source? The third step in the critical thinking process is to use the information.  Can I prove this information to Information by itself doesn’t help us. Be sure to look be true? critically at the big It’s what we do with that picture, not just  Does this information go information that matters. the details, against what I already know?  Now that you have gathered the especially during  Is this information useful to facts and questioned the client care. For me? Why or why not? information to your satisfaction, example: Millie has a new client, it’s time to take action. For Mr. Wilson, who  When the information you’ve example, you might be able to must be moved collected is about a client, you use the information to: with a Hoyer lift. might ask yourself questions like:  Solve a problem. Millie has only  Do my observations of the used a Hoyer lift a  Make a decision—at home or few times and is client point to a serious at work. worried about situation? If so, who is doing it right. She available to help me?  Come up with a new idea to focuses so hard on improve client care.  What does the client expect using the lift that she doesn’t notice from me?  Help you get along better with that Mr. Wilson is your coworkers.  What are my workplace short of policies about this particular  Understand someone else’s breath, situation? beliefs or customs. pale and sweaty.  Do I have enough experience Remember...the critical thinking to handle this situation? process turns facts into thoughts and thoughts into actions!

Critical Thinking vs. Care Plans

Aren’t you supposed to follow each 2. Thought client’s care plan, without questions? Well, yes and no. It is important to It shows that you have thought about follow the care plan, but it is your your client care when you ask responsibility to think about your questions and when you spend time Robots and computers use information without thinking assignment before you perform the planning the best way to accomplish your assignment. about it. The human brain is client care. This means asking more advanced than that! yourself—and others—questions 3. Action about each care plan you read. You take action when you perform Remember, client care involves three the care that best helps your clients things: meet their needs.

1. Knowledge Time for a Keep in mind… Laugh! Your knowledge about each client comes from the care plan, what you It takes all three components— A brand new CNA learned in school and all your prior knowledge, thought and action— was seen lying in bed with her experiences as a nursing assistant. to make sure you provide quality client care. patient. When questioned about it, she responded, “I was told to take Using the Nursing Process the patient’s blood pressure The nursing process is a problem- The ﬁve steps include: lying down and solving approach to client care. It is standing up.” 1. Assessing the client by gathering based on the way scientists look at as much information about the their work—and involves a lot of client as possible. critical thinking. The nursing process provides the foundation for how 2. Identifying the client’s needs by nurses perform their jobs and for how sorting and studying the client’s care plans are created. information.

The nursing process involves ﬁve 3. Planning the client’s care by separate steps that are repeated over looking for ways to solve the and over throughout the delivery of client’s health care problems. client care. These ﬁve steps require people to think creatively. They also 4. Delivering the client’s care by require the use of problem-solving putting the plan into action. and decision-making skills. Nurses The nursing process involves 5. Evaluating the client’s status by are taught to use the nursing process gathering knowledge, thinking gathering new information about about that knowledge and to help them think critically! how the client is doing. taking action based on the facts.

Thinking About Health Information

There is so much health-related  “Four out of five doctors surveyed information available today. It’s in recommended Excedrin’s magazines, newspapers, books, on formula.” television and throughout the internet.  “Bufferin works better than any There is so much information other pain reliever tested.” available today. It’s important If people don’t practice critical to sort through it to determine thinking, they could end up being OK, so what is the truth? It’s what is useful to you and manipulated. Look at this example of impossible to know for sure. what is not. statements from TV commercials for The best approach to conflicting five different pain relievers: reports like these is to gather as much information as you can. For example:  “The medicine in Anacin is For years and recommended by doctors four to  What does your doctor say is the years, it was the one over substitutes like Tylenol.” best pain reliever...and why? doctors who knew  What has worked for you in the best. They  “Bayer Aspirin is recommended past...and what hasn’t worked? decided if and by doctors four to one over when patients substitutes.”  Are there other factors to consider such as how much each brand needed to know  “Tylenol is recommended by costs and whether it’s available about their own doctors more than any brand of near you? medical aspirin.” condition. Now, make up your own mind! “Informed consent” is a fairly new idea that came about when A Great Example of Critical Thinking patients began thinking critically “Informed consent” is a terrific example  Understand the information. about their own of the power of critical thinking. The  Be free to say yes or no...without health care. idea behind informed consent is that anyone forcing them into a certain people need to be able to make decision. medical treatment decisions for themselves. But, to do so, they must be Informed refusal is the opposite of given enough information to help informed consent. If, after hearing all them make good decisions. Doctors the information, clients decide not to and nurses are responsible for have a certain medical treatment, they providing this information. do not sign the consent form. To give an informed consent, clients Sometimes, they are asked to sign an must: informed refusal document to prove Both “informed consent” and that they made an educated decision. “informed refusal” require the  Be given enough information. use of critical thinking.

How to Practice Thinking Critically

You’ve been thinking all your life, so it  Are there some coworkers to whom may seem silly to talk about how to you’ve never spoken? If so, spend “practice” thinking. However, some time trying to get to know thinking is like any other skill—it can them better. Really listen when improve with practice. they speak and keep an open mind about their opinions and beliefs. Here are some suggestions for how to Critical thinkers have flexible practice your critical thinking:  When you hear new information, minds and are willing to take risks! try to think about whether it can be  Listen carefully when people talk proven. Analyze the information and try your best to understand the before you react to it! reasoning behind their words.  Ask questions! And, pay careful  Read books, magazines or attention to the answers you get to newspapers to learn what new your questions. ideas are being discussed. When you read about something new,  Be prepared to change your mind Time For a think it over carefully and decide and to let other people be “right” Laugh! for yourself how you feel about it. sometimes! As Ruth was driving home with her kids, they all heard the car making rattling Think, Think, Think! noises. As you go through your day, think  On a baby stroller: “Remove child When Ruth about the things you hear and read. before folding.” arrived home, her For example, what’s wrong with these children rushed real-life product labels?  On a bottle of bathtub cleaner: into the house “For best results, start with a with news for their  On the bottom of a Coca-Cola clean bathtub before using.” father: “Daddy, bottle: “Do not open here.” the car was  On a bar of Dial soap: “Use like breaking down,  On a container of lighter fluid: regular soap.” but Mom made “WARNING: Contents are the noise stop!” flammable!”  On a Rowenta iron: “Do not iron Impressed, Ruth’s clothes on body.” husband asked,  On a blow dryer: “Do not blow “How did you fix dry in your sleep.”  On a chainsaw: “Do not attempt it?” to stop the chain with your Ruth replied, “I  On a can of Woolite carpet hands.” cleaner: “Safe for carpets.” turned up the volume on the  On Christmas lights: “For indoor radio.”  On a container of salt: “Warning: or outdoor use only.” High in sodium.”

Tips for Thinking Critically

 If you think that an idea or  Keep in mind that decisions are statement isn’t logical, try to choices. Making a decision ﬁgure out why you feel that way. involves looking at all the choices Don’t just brush the idea oﬀ as and narrowing them down to unimportant! one. Whenever you make a decision, you are practicing your  Being in the habit of pointing out critical thinking skills. People who think critically problems is a good thing. But, if tend to be observant—so practice your observation all you do is talk about problems,  Avoid relying on old “safe” habits. skills every day! it turns into complaining, not As long as you do things today the critical thinking. To be a critical same way you did them yesterday, thinker, you have to work toward you’ll probably feel secure. However, if you always follow old solving every problem that you habits, you’re probably not spot. thinking critically or creatively. Time For a Laugh!  Remember that most arguments  Keep in mind that when people lead nowhere—and rarely involve After examining a are under pressure and stressed patient, the critical thinking. When people out, their minds tend to shut doctor said, “You’ll argue, they seldom listen to each down. It’s hard to think when you be okay if you take other and they almost never feel overwhelmed—so try not to half of an aspirin come to a solution that solves the make important decisions if you pill every night before going to argument. are under stress. sleep.”

 Keep in mind that critical thinking  Remember that it’s important to The patient thanked the on the job requires: tell others what you have done doctor, but said throughout your work day. All  Knowing your own strengths she had a the critical thinking you do at and weaknesses. question. “What work means nothing if you don’t am I supposed to  Understanding the policies document it. do with the other and procedures of your half?” workplace.  Use your head as you document. (It’s important If you don’t think critically when for patients to  Recognizing what resources documenting your client care, use their heads, are available at work. too!) others may not understand what  Knowing the role of each of you write. This may cause harm the members of your health to the client. care team—including the client!