The critical thinking of expert and novice nurses in an acute orthopaedic setting in Hong Kong

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The critical thinking of expert and novice nurses in an acute orthopaedic setting in Hong Kong

 

Author: Li, Fung-yee Teresa
Title: The critical thinking of expert and novice nurses in an acute orthopaedic setting in Hong Kong
Degree: D.H.Sc.
Year: 2008
Subject: Hong Kong Polytechnic University -- Dissertations
Orthopedic nursing
Orthopedic nursing -- China -- Hong Kong
Critical thinking -- China -- Hong Kong
Department: Faculty of Health and Social Sciences
Pages: xii, 216, 30 leaves : col. ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2321668
URI: http://theses.lib.polyu.edu.hk/handle/200/5360
Abstract: INTRODUCTION Despite the long history and the prevailing views of its importance in handling clinical situations, critical thinking is not yet a concept with consensual understanding (Girot, 2000). How the knowledge and skills of critical thinking are applied in the clinical settings remain far from clarity (Forneris, 2005). The conceptual framework for the study is drawn upon the seven cognitive skills and ten thinking habits (Scheffer and Rubenfeld, 2000) and other scholars (Brookfield, 1987; Paul & Elders, 2002) and the concepts of situated learning (Lave & Wenger, 1991). The study is guided by the following research questions: firstly, what is the nature of sociocultural field of critical thinking of novice and expert nurses in the orthopaedic wards? Secondly, what specific characteristics of critical thinking do novice and expert nurses utilize in clinical decision making and their differences? Thirdly, what cultural factors have enhanced or stifled the development of critical thinking of the novice and experts? METHODS In view of the inconsistent and inconclusive findings of quantitative measures on critical thinking (Walsh, 2006b) and due to its particularly broad and contextual nature, a qualitative approach is adopted because it can uncover more information on the essential content structure of critical thinking (Oermann, 1997; Vito-Thomas, 2000) and embedded knowledge (Benner, 2001), and give new insights to the understanding of critical thinking. A combination of ethnographic methods including participatory observation, ethnographic interviews and review of available documents were adopted. Apart from the expert and novice nurses in the acute orthopaedic setting, other informants included patients, their relatives and other nurses, making up a total of 25 informants.
RESULTS and DISCUSSION Seven cultural themes were identified: Emerging driving force for enhancement of orthopaedic nursing, virtual segregation, constraints requiring accommodations, efficiency and convenience as prime concerns, sense of responsibility, Just do, no wrong, and special meaning of teamwork. The implications were discussed and recommendations were made. The critical thinking of expert and novice nurses were both identified with diagrammatic presentations constructed. Synergies of critical thinking in the experts with the relevant enhancing factors were uncovered and discussed. CONCLUSION Five conclusions are drawn and listed below: 1. Culture has positive and negative impacts on the nurse practitioners' critical thinking in the clinical practice. The study provides insights into the measures to improve the workplace culture and practice. 2. Critical thinking of expert and novice nurses are identifiable in the clinical situations. They demonstrate different features of critical thinking skills and characteristics. 3. Synergy of critical thinking enhances safety and quality nursing care and improves patient outcomes. 4. 'Synergy groups' of critical thinking can be an amenable way of enhancing the learning, development and practice of critical thinking. 5. Education and training of critical thinking requires the inclusion of generic CT concepts in addition to the nursing specific ones whereas authentic situations are essential for learning critical thinking for the nurse practitioners.

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