critical thinking is based on quizlet

• The Big Think Interview
• Your Brain on Money
• Explore the Library
• The Universe. A History.
• The Progress Issue
• A Brief History Of Quantum Mechanics
• 6 Flaws In Our Understanding Of The Universe
• Michio Kaku
• Neil deGrasse Tyson
• Michelle Thaller
• Steven Pinker
• Ray Kurzweil
• Cornel West
• Helen Fisher
• Smart Skills
• High Culture
• The Present
• Hard Science
• Special Issues
• Starts With A Bang
• Everyday Philosophy
• The Learning Curve
• The Long Game
• Perception Box
• Strange Maps
• Free Newsletters
• Memberships

How to think effectively: Six stages of critical thinking

Credit: Elder / Paul

• Researchers propose six levels of critical thinkers: Unreflective thinkers, Challenged thinkers, Beginning thinkers, Practicing thinkers, Advanced thinkers, and Master thinkers.
• The framework comes from educational psychologists Linda Elder and Richard Paul.
• Teaching critical thinking skills is a crucial challenge in our times.

The coronavirus has not only decimated our populations, its spread has also attacked the very nature of truth and stoked inherent tensions between many different groups of people, both at local and international levels. Spawning widespread conspiracy theories and obfuscation by governments, the virus has also been a vivid demonstration of the need for teaching critical thinking skills necessary to survive in the 21st century. The stage theory of critical thinking development, devised by psychologists Linda Elder and Richard Paul , can help us gauge the sophistication of our current mental approaches and provides a roadmap to the thinking of others.

The researchers identified six predictable levels of critical thinkers, from ones lower in depth and effort to the advanced mind-masters, who are always steps ahead.

As the scientists write , moving up on this pyramid of thinking “is dependent upon a necessary level of commitment on the part of an individual to develop as a critical thinker.” Using your mind more effectively is not automatic and “is unlikely to take place “subconsciously.” In other words – you have to put in the work and keep doing it, or you’ll lose the faculty.

Here’s how the stages of intellectual development break down:

Unreflective thinker

These are people who don’t reflect about thinking and the effect it has on their lives. As such, they form opinions and make decisions based on prejudices and misconceptions while their thinking doesn’t improve.

Unreflective thinkers lack crucial skills that would allow them to parse their thought processes. They also do not apply standards like accuracy, relevance, precision, and logic in a consistent fashion.

How many such people are out there? You probably can guess based on social media comments. As Elder and Paul write , “it is perfectly possible for students to graduate from high school, or even college, and still be largely unreflective thinkers.”

Challenged thinker

This next level up thinker has awareness of the importance of thinking on their existence and knows that deficiencies in thinking can bring about major issues. As the psychologists explain, to solve a problem, you must first admit you have one.

People at this intellectual stage begin to understand that “high quality thinking requires deliberate reflective thinking about thinking”, and can acknowledge that their own mental processes might have many flaws. They might not be able to identify all the flaws, however.

A challenged thinker may have a sense that solid thinking involves navigating assumptions, inferences, and points of view, but only on an initial level. They may also be able to spot some instances of their own self-deception. The true difficulty for thinkers of this category is in not “believing that their thinking is better than it actually is, making it more difficult to recognize the problems inherent in poor thinking,” explain the researchers.

Thinkers at this level can go beyond the nascent intellectual humility and actively look to take control of their thinking across areas of their lives. They know that their own thinking can have blind spots and other problems and take steps to address those, but in a limited capacity.

Beginning thinker

Beginning thinkers place more value in reason, becoming self-aware in their thoughts. They may also be able to start looking at the concepts and biases underlying their ideas. Additionally, such thinkers develop higher internal standards of clarity, accuracy and logic, realizing that their ego plays a key role in their decisions.

Another big aspect that differentiates this stronger thinker – some ability to take criticism of their mental approach, even though they still have work to do and might lack clear enough solutions to the issues they spot.

Practicing thinker

This more experienced kind of thinker not only appreciates their own deficiencies, but has skills to deal with them. A thinker of this level will practice better thinking habits and will analyze their mental processes with regularity.

While they might be able to express their mind’s strengths and weaknesses, as a negative, practicing thinkers might still not have a systematic way of gaining insight into their thoughts and can fall prey to egocentric and self-deceptive reasoning.

How do you get to this stage? An important trait to gain, say the psychologists, is “intellectual perseverance.” This quality can provide “the impetus for developing a realistic plan for systematic practice (with a view to taking greater command of one’s thinking).”

“We must teach in such a way that students come to understand the power in knowing that whenever humans reason, they have no choice but to use certain predictable structures of thought: that thinking is inevitably driven by the questions, that we seek answers to questions for some purpose, that to answer questions, we need information, that to use information we must interpret it (i.e., by making inferences), and that our inferences, in turn, are based on assumptions, and have implications, all of which involves ideas or concepts within some point of view,” explain Elder and Paul.

One doesn’t typically get to this stage until college and beyond, estimate the scientists. This higher-level thinker would have strong habits that would allow them to analyze their thinking with insight about different areas of life. They would be fair-minded and able to spot the prejudicial aspects in the points of view of others and their own understanding.

While they’d have a good handle on the role of their ego in the idea flow, such thinkers might still not be able to grasp all the influences that affect their mentality.

Advanced thinker

The advanced thinker is at ease with self-critique and does so systematically, looking to improve. Among key traits required for this level are “intellectual insight” to develop new thought habits, “ intellectual integrity” to “recognize areas of inconsistency and contradiction in one’s life,” intellectual empathy ” to put oneself in the place of others in order to genuinely understand them, and the “ intellectual courage” to confront ideas and beliefs they don’t necessarily believe in and have negative emotions towards.

Master thinker

This is the super-thinker, the one who is totally in control of how they process information and make decisions. Such people constantly seek to improve their thought skills, and through experience “regularly raise their thinking to the level of conscious realization.”

A master thinker achieves great insights into deep mental levels, strongly committed to being fair and gaining control over their own egocentrism.

Such a high-level thinker also exhibits superior practical knowledge and insight, always re-examining their assumptions for weaknesses, logic, and biases.

And, of course, a master thinker wouldn’t get upset with being intellectually confronted and spends a considerable amount of time analyzing their own responses.

“Why is this so important? Precisely because the human mind, left to its own, pursues that which is immediately easy, that which is comfortable, and that which serves its selfish interests. At the same time, it naturally resists that which is difficult to understand, that which involves complexity, that which requires entering the thinking and predicaments of others,” write the researchers.

So how do you become a master thinker? The psychologists think most students will never get there. But a lifetime of practicing the best intellectual traits can get you to that point when “people of good sense seek out master thinkers, for they recognize and value the ability of master thinkers to think through complex issues with judgment and insight.”

The significance of critical thinking in our daily lives, especially in these confusing times, so rife with quick and often-misleading information, cannot be overstated. The decisions we make today can truly be life and death.

Have a language expert improve your writing

Run a free plagiarism check in 10 minutes, generate accurate citations for free.

• Knowledge Base
• Working with sources
• 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.

Scribbr Citation Checker New

The AI-powered Citation Checker helps you avoid common mistakes such as:

• Missing commas and periods
• Incorrect usage of “et al.”
• Ampersands (&) in narrative citations
• Missing reference entries

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

 Plagiarism

• Types of plagiarism
• Self-plagiarism
• Avoiding plagiarism
• Academic integrity
• Consequences of plagiarism
• Common knowledge

Don't submit your assignments before you do this

The academic proofreading tool has been trained on 1000s of academic texts. Making it the most accurate and reliable proofreading tool for students. Free citation check included.

Try for free

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.

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

Ryan, E. (2023, May 31). What Is Critical Thinking? | Definition & Examples. Scribbr. Retrieved August 19, 2024, from https://www.scribbr.com/working-with-sources/critical-thinking/

Is this article helpful?

Eoghan Ryan

Other students also liked, student guide: information literacy | meaning & examples, what are credible sources & how to spot them | examples, applying the craap test & evaluating sources, "i thought ai proofreading was useless but..".

I've been using Scribbr for years now and I know it's a service that won't disappoint. It does a good job spotting mistakes”

Critical Thinking Definition, Skills, and Examples

• Homework Help
• Private School
• College Admissions
• College Life
• Graduate School
• Business School
• Distance Learning

• Indiana University, Bloomington
• State University of New York at Oneonta

Critical thinking refers to the ability to analyze information objectively and make a reasoned judgment. It involves the evaluation of sources, such as data, facts, observable phenomena, and research findings.

Good critical thinkers can draw reasonable conclusions from a set of information, and discriminate between useful and less useful details to solve problems or make decisions. These skills are especially helpful at school and in the workplace, where employers prioritize the ability to think critically. Find out why and see how you can demonstrate that you have this ability.

Examples of Critical Thinking

The circumstances that demand critical thinking vary from industry to industry. Some examples include:

• A triage nurse analyzes the cases at hand and decides the order by which the patients should be treated.
• A plumber evaluates the materials that would best suit a particular job.
• An attorney reviews the evidence and devises a strategy to win a case or to decide whether to settle out of court.
• A manager analyzes customer feedback forms and uses this information to develop a customer service training session for employees.

Why Do Employers Value Critical Thinking Skills?

Employers want job candidates who can evaluate a situation using logical thought and offer the best solution.

Someone with critical thinking skills can be trusted to make decisions independently, and will not need constant handholding.

Hiring a critical thinker means that micromanaging won't be required. Critical thinking abilities are among the most sought-after skills in almost every industry and workplace. You can demonstrate critical thinking by using related keywords in your resume and cover letter and during your interview.

How to Demonstrate Critical Thinking in a Job Search

If critical thinking is a key phrase in the job listings you are applying for, be sure to emphasize your critical thinking skills throughout your job search.

Add Keywords to Your Resume

You can use critical thinking keywords (analytical, problem solving, creativity, etc.) in your resume. When describing your work history, include top critical thinking skills that accurately describe you. You can also include them in your resume summary, if you have one.

For example, your summary might read, “Marketing Associate with five years of experience in project management. Skilled in conducting thorough market research and competitor analysis to assess market trends and client needs, and to develop appropriate acquisition tactics.”

Mention Skills in Your Cover Letter

Include these critical thinking skills in your cover letter. In the body of your letter, mention one or two of these skills, and give specific examples of times when you have demonstrated them at work. Think about times when you had to analyze or evaluate materials to solve a problem.

Show the Interviewer Your Skills

You can use these skill words in an interview. Discuss a time when you were faced with a particular problem or challenge at work and explain how you applied critical thinking to solve it.

Some interviewers will give you a hypothetical scenario or problem, and ask you to use critical thinking skills to solve it. In this case, explain your thought process thoroughly to the interviewer. He or she is typically more focused on how you arrive at your solution rather than the solution itself. The interviewer wants to see you analyze and evaluate (key parts of critical thinking) the given scenario or problem.

Of course, each job will require different skills and experiences, so make sure you read the job description carefully and focus on the skills listed by the employer.

Top Critical Thinking Skills

Keep these in-demand skills in mind as you refine your critical thinking practice —whether for work or school.

Part of critical thinking is the ability to carefully examine something, whether it is a problem, a set of data, or a text. People with analytical skills can examine information, understand what it means, and properly explain to others the implications of that information.

• Asking Thoughtful Questions
• Data Analysis
• Interpretation
• Questioning Evidence
• Recognizing Patterns

Communication

Often, you will need to share your conclusions with your employers or with a group of classmates or colleagues. You need to be able to communicate with others to share your ideas effectively. You might also need to engage in critical thinking in a group. In this case, you will need to work with others and communicate effectively to figure out solutions to complex problems.

• Active Listening
• Collaboration
• Explanation
• Interpersonal
• Presentation
• Verbal Communication
• Written Communication

Critical thinking often involves creativity and innovation. You might need to spot patterns in the information you are looking at or come up with a solution that no one else has thought of before. All of this involves a creative eye that can take a different approach from all other approaches.

• Flexibility
• Conceptualization
• Imagination
• Drawing Connections
• Synthesizing

Open-Mindedness

To think critically, you need to be able to put aside any assumptions or judgments and merely analyze the information you receive. You need to be objective, evaluating ideas without bias.

• Objectivity
• Observation

Problem-Solving

Problem-solving is another critical thinking skill that involves analyzing a problem, generating and implementing a solution, and assessing the success of the plan. Employers don’t simply want employees who can think about information critically. They also need to be able to come up with practical solutions.

• Attention to Detail
• Clarification
• Decision Making
• Groundedness
• Identifying Patterns

More Critical Thinking Skills

• Inductive Reasoning
• Deductive Reasoning
• Noticing Outliers
• Adaptability
• Emotional Intelligence
• Brainstorming
• Optimization
• Restructuring
• Integration
• Strategic Planning
• Project Management
• Ongoing Improvement
• Causal Relationships
• Case Analysis
• Diagnostics
• SWOT Analysis
• Business Intelligence
• Quantitative Data Management
• Qualitative Data Management
• Risk Management
• Scientific Method
• Consumer Behavior

Key Takeaways

• Demonstrate you have critical thinking skills by adding relevant keywords to your resume.
• Mention pertinent critical thinking skills in your cover letter, too, and include an example of a time when you demonstrated them at work.
• Finally, highlight critical thinking skills during your interview. For instance, you might discuss a time when you were faced with a challenge at work and explain how you applied critical thinking skills to solve it.

University of Louisville. " What is Critical Thinking ."

American Management Association. " AMA Critical Skills Survey: Workers Need Higher Level Skills to Succeed in the 21st Century ."

• 18 Ways to Practice Spelling Words
• The 16 SEC Schools
• Sample Appeal Letter for an Academic Dismissal
• List of Supplies for High School Students
• Higher-Order Thinking Skills (HOTS) in Education
• How to Find the Main Idea
• Understanding Very Big Numbers
• 100 Persuasive Speech Topics for Students
• Introduction to Critical Thinking
• Fostering Cultural Diversity in Your School
• GRE Text Completion Examples
• Free Online Computer Classes
• ACT Science Reasoning Information
• Undergraduate Courses That Are Recommended for Law School
• 2020-21 Common Application Essay Option 4—Solving a Problem
• Best Majors for Pre-med Students

Translate this page from English...

*Machine translated pages not guaranteed for accuracy. Click Here for our professional translations.

Our Concept and Definition of Critical Thinking

• Campus Life
• ...a student.
• ...a veteran.
• ...an alum.
• ...a parent.
• ...faculty or staff.
• Class Schedule
• Crisis Resources
• People Finder
• Change Password

UTC RAVE Alert

Critical thinking and problem-solving, jump to: , what is critical thinking, characteristics of critical thinking, why teach critical thinking.

• Teaching Strategies to Help Promote Critical Thinking Skills

References and Resources

When examining the vast literature on critical thinking, various definitions of critical thinking emerge. Here are some samples:

• "Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action" (Scriven, 1996).
• "Most formal definitions characterize critical thinking as the intentional application of rational, higher order thinking skills, such as analysis, synthesis, problem recognition and problem solving, inference, and evaluation" (Angelo, 1995, p. 6).
• "Critical thinking is thinking that assesses itself" (Center for Critical Thinking, 1996b).
• "Critical thinking is the ability to think about one's thinking in such a way as 1. To recognize its strengths and weaknesses and, as a result, 2. To recast the thinking in improved form" (Center for Critical Thinking, 1996c).

Perhaps the simplest definition is offered by Beyer (1995) : "Critical thinking... means making reasoned judgments" (p. 8). Basically, Beyer sees critical thinking as using criteria to judge the quality of something, from cooking to a conclusion of a research paper. In essence, critical thinking is a disciplined manner of thought that a person uses to assess the validity of something (statements, news stories, arguments, research, etc.).

Back        

Wade (1995) identifies eight characteristics of critical thinking. Critical thinking involves asking questions, defining a problem, examining evidence, analyzing assumptions and biases, avoiding emotional reasoning, avoiding oversimplification, considering other interpretations, and tolerating ambiguity. Dealing with ambiguity is also seen by Strohm & Baukus (1995) as an essential part of critical thinking, "Ambiguity and doubt serve a critical-thinking function and are a necessary and even a productive part of the process" (p. 56).

Another characteristic of critical thinking identified by many sources is metacognition. Metacognition is thinking about one's own thinking. More specifically, "metacognition is being aware of one's thinking as one performs specific tasks and then using this awareness to control what one is doing" (Jones & Ratcliff, 1993, p. 10 ).

In the book, Critical Thinking, Beyer elaborately explains what he sees as essential aspects of critical thinking. These are:

• Dispositions: Critical thinkers are skeptical, open-minded, value fair-mindedness, respect evidence and reasoning, respect clarity and precision, look at different points of view, and will change positions when reason leads them to do so.
• Criteria: To think critically, must apply criteria. Need to have conditions that must be met for something to be judged as believable. Although the argument can be made that each subject area has different criteria, some standards apply to all subjects. "... an assertion must... be based on relevant, accurate facts; based on credible sources; precise; unbiased; free from logical fallacies; logically consistent; and strongly reasoned" (p. 12).
• Argument: Is a statement or proposition with supporting evidence. Critical thinking involves identifying, evaluating, and constructing arguments.
• Reasoning: The ability to infer a conclusion from one or multiple premises. To do so requires examining logical relationships among statements or data.
• Point of View: The way one views the world, which shapes one's construction of meaning. In a search for understanding, critical thinkers view phenomena from many different points of view.
• Procedures for Applying Criteria: Other types of thinking use a general procedure. Critical thinking makes use of many procedures. These procedures include asking questions, making judgments, and identifying assumptions.

Oliver & Utermohlen (1995) see students as too often being passive receptors of information. Through technology, the amount of information available today is massive. This information explosion is likely to continue in the future. Students need a guide to weed through the information and not just passively accept it. Students need to "develop and effectively apply critical thinking skills to their academic studies, to the complex problems that they will face, and to the critical choices they will be forced to make as a result of the information explosion and other rapid technological changes" (Oliver & Utermohlen, p. 1 ).

As mentioned in the section, Characteristics of Critical Thinking , critical thinking involves questioning. It is important to teach students how to ask good questions, to think critically, in order to continue the advancement of the very fields we are teaching. "Every field stays alive only to the extent that fresh questions are generated and taken seriously" (Center for Critical Thinking, 1996a ).

Beyer sees the teaching of critical thinking as important to the very state of our nation. He argues that to live successfully in a democracy, people must be able to think critically in order to make sound decisions about personal and civic affairs. If students learn to think critically, then they can use good thinking as the guide by which they live their lives.

Teaching Strategies to Help Promote Critical Thinking

The 1995, Volume 22, issue 1, of the journal, Teaching of Psychology , is devoted to the teaching critical thinking. Most of the strategies included in this section come from the various articles that compose this issue.

• CATS (Classroom Assessment Techniques): Angelo stresses the use of ongoing classroom assessment as a way to monitor and facilitate students' critical thinking. An example of a CAT is to ask students to write a "Minute Paper" responding to questions such as "What was the most important thing you learned in today's class? What question related to this session remains uppermost in your mind?" The teacher selects some of the papers and prepares responses for the next class meeting.
• Cooperative Learning Strategies: Cooper (1995) argues that putting students in group learning situations is the best way to foster critical thinking. "In properly structured cooperative learning environments, students perform more of the active, critical thinking with continuous support and feedback from other students and the teacher" (p. 8).
• Case Study /Discussion Method: McDade (1995) describes this method as the teacher presenting a case (or story) to the class without a conclusion. Using prepared questions, the teacher then leads students through a discussion, allowing students to construct a conclusion for the case.
• Using Questions: King (1995) identifies ways of using questions in the classroom:
• Reciprocal Peer Questioning: Following lecture, the teacher displays a list of question stems (such as, "What are the strengths and weaknesses of...). Students must write questions about the lecture material. In small groups, the students ask each other the questions. Then, the whole class discusses some of the questions from each small group.
• Reader's Questions: Require students to write questions on assigned reading and turn them in at the beginning of class. Select a few of the questions as the impetus for class discussion.
• Conference Style Learning: The teacher does not "teach" the class in the sense of lecturing. The teacher is a facilitator of a conference. Students must thoroughly read all required material before class. Assigned readings should be in the zone of proximal development. That is, readings should be able to be understood by students, but also challenging. The class consists of the students asking questions of each other and discussing these questions. The teacher does not remain passive, but rather, helps "direct and mold discussions by posing strategic questions and helping students build on each others' ideas" (Underwood & Wald, 1995, p. 18 ).
• Use Writing Assignments: Wade sees the use of writing as fundamental to developing critical thinking skills. "With written assignments, an instructor can encourage the development of dialectic reasoning by requiring students to argue both [or more] sides of an issue" (p. 24).
• Written dialogues: Give students written dialogues to analyze. In small groups, students must identify the different viewpoints of each participant in the dialogue. Must look for biases, presence or exclusion of important evidence, alternative interpretations, misstatement of facts, and errors in reasoning. Each group must decide which view is the most reasonable. After coming to a conclusion, each group acts out their dialogue and explains their analysis of it.
• Spontaneous Group Dialogue: One group of students are assigned roles to play in a discussion (such as leader, information giver, opinion seeker, and disagreer). Four observer groups are formed with the functions of determining what roles are being played by whom, identifying biases and errors in thinking, evaluating reasoning skills, and examining ethical implications of the content.
• Ambiguity: Strohm & Baukus advocate producing much ambiguity in the classroom. Don't give students clear cut material. Give them conflicting information that they must think their way through.
• Angelo, T. A. (1995). Beginning the dialogue: Thoughts on promoting critical thinking: Classroom assessment for critical thinking. Teaching of Psychology, 22(1), 6-7.
• Beyer, B. K. (1995). Critical thinking. Bloomington, IN: Phi Delta Kappa Educational Foundation.
• Center for Critical Thinking (1996a). The role of questions in thinking, teaching, and learning. [On-line]. Available HTTP: http://www.criticalthinking.org/University/univlibrary/library.nclk
• Center for Critical Thinking (1996b). Structures for student self-assessment. [On-line]. Available HTTP: http://www.criticalthinking.org/University/univclass/trc.nclk
• Center for Critical Thinking (1996c). Three definitions of critical thinking [On-line]. Available HTTP: http://www.criticalthinking.org/University/univlibrary/library.nclk
• Cooper, J. L. (1995). Cooperative learning and critical thinking. Teaching of Psychology, 22(1), 7-8.
• Jones, E. A. & Ratcliff, G. (1993). Critical thinking skills for college students. National Center on Postsecondary Teaching, Learning, and Assessment, University Park, PA. (Eric Document Reproduction Services No. ED 358 772)
• King, A. (1995). Designing the instructional process to enhance critical thinking across the curriculum: Inquiring minds really do want to know: Using questioning to teach critical thinking. Teaching of Psychology, 22 (1) , 13-17.
• McDade, S. A. (1995). Case study pedagogy to advance critical thinking. Teaching Psychology, 22(1), 9-10.
• Oliver, H. & Utermohlen, R. (1995). An innovative teaching strategy: Using critical thinking to give students a guide to the future.(Eric Document Reproduction Services No. 389 702)
• Robertson, J. F. & Rane-Szostak, D. (1996). Using dialogues to develop critical thinking skills: A practical approach. Journal of Adolescent & Adult Literacy, 39(7), 552-556.
• Scriven, M. & Paul, R. (1996). Defining critical thinking: A draft statement for the National Council for Excellence in Critical Thinking. [On-line]. Available HTTP: http://www.criticalthinking.org/University/univlibrary/library.nclk
• Strohm, S. M., & Baukus, R. A. (1995). Strategies for fostering critical thinking skills. Journalism and Mass Communication Educator, 50 (1), 55-62.
• Underwood, M. K., & Wald, R. L. (1995). Conference-style learning: A method for fostering critical thinking with heart. Teaching Psychology, 22(1), 17-21.
• Wade, C. (1995). Using writing to develop and assess critical thinking. Teaching of Psychology, 22(1), 24-28.

Other Reading

• Bean, J. C. (1996). Engaging ideas: The professor's guide to integrating writing, critical thinking, & active learning in the classroom. Jossey-Bass.
• Bernstein, D. A. (1995). A negotiation model for teaching critical thinking. Teaching of Psychology, 22(1), 22-24.
• Carlson, E. R. (1995). Evaluating the credibility of sources. A missing link in the teaching of critical thinking. Teaching of Psychology, 22(1), 39-41.
• Facione, P. A., Sanchez, C. A., Facione, N. C., & Gainen, J. (1995). The disposition toward critical thinking. The Journal of General Education, 44(1), 1-25.
• Halpern, D. F., & Nummedal, S. G. (1995). Closing thoughts about helping students improve how they think. Teaching of Psychology, 22(1), 82-83.
• Isbell, D. (1995). Teaching writing and research as inseparable: A faculty-librarian teaching team. Reference Services Review, 23(4), 51-62.
• Jones, J. M. & Safrit, R. D. (1994). Developing critical thinking skills in adult learners through innovative distance learning. Paper presented at the International Conference on the practice of adult education and social development. Jinan, China. (Eric Document Reproduction Services No. ED 373 159)
• Sanchez, M. A. (1995). Using critical-thinking principles as a guide to college-level instruction. Teaching of Psychology, 22(1), 72-74.
• Spicer, K. L. & Hanks, W. E. (1995). Multiple measures of critical thinking skills and predisposition in assessment of critical thinking. Paper presented at the annual meeting of the Speech Communication Association, San Antonio, TX. (Eric Document Reproduction Services No. ED 391 185)
• Terenzini, P. T., Springer, L., Pascarella, E. T., & Nora, A. (1995). Influences affecting the development of students' critical thinking skills. Research in Higher Education, 36(1), 23-39.

On the Internet

• Carr, K. S. (1990). How can we teach critical thinking. Eric Digest. [On-line]. Available HTTP: http://ericps.ed.uiuc.edu/eece/pubs/digests/1990/carr90.html
• The Center for Critical Thinking (1996). Home Page. Available HTTP: http://www.criticalthinking.org/University/
• Ennis, Bob (No date). Critical thinking. [On-line], April 4, 1997. Available HTTP: http://www.cof.orst.edu/cof/teach/for442/ct.htm
• Montclair State University (1995). Curriculum resource center. Critical thinking resources: An annotated bibliography. [On-line]. Available HTTP: http://www.montclair.edu/Pages/CRC/Bibliographies/CriticalThinking.html
• No author, No date. Critical Thinking is ... [On-line], April 4, 1997. Available HTTP: http://library.usask.ca/ustudy/critical/
• Sheridan, Marcia (No date). Internet education topics hotlink page. [On-line], April 4, 1997. Available HTTP: http://sun1.iusb.edu/~msherida/topics/critical.html

Walker Center for Teaching and Learning

• 433 Library
• Dept 4354
• 615 McCallie Ave
•   423-425-4188

• Programs & Services
• Delphi Center

Ideas to Action (i2a)

• 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.

• SACS & QEP
• Planning and Implementation
• What is Critical Thinking?
• Why Focus on Critical Thinking?
• Culminating Undergraduate Experience
• Community Engagement
• Frequently Asked Questions
• What is i2a?

Copyright © 2012 - University of Louisville , Delphi Center

• Create A Quiz
• Relationship
• Personality
• Harry Potter
• Online Exam
• Entertainment
• Training Maker
• Survey Maker
• Brain Games
• ProProfs.com

Critical Thinking Quizzes, Questions & Answers

Top trending quizzes.

Popular Topics

Recent quizzes.

« Previous 1 2 Next »

Critical Thinking test

By 123test team . Updated May 12, 2023

Critical Thinking test reviews

This Critical Thinking test measures your ability to think critically and draw logical conclusions based on written information. Critical Thinking tests are often used in job assessments in the legal sector to assess a candidate's  analytical critical  thinking skills. A well known example of a critical thinking test is the Watson-Glaser Critical Thinking Appraisal .

Need more practice?

Score higher on your critical thinking test.

The test comprises of the following five sections with a total of 10 questions:

• Analysing Arguments
• Assumptions
• Interpreting Information

Instructions Critical Thinking test

Each question presents one or more paragraphs of text and a question about the information in the text. It's your job to figure out which of the options is the correct answer.

Below is a statement that is followed by an argument. You should consider this argument to be true. It is then up to you to determine whether the argument is strong or weak. Do not let your personal opinion about the statement play a role in your evaluation of the argument.

Statement: It would be good if people would eat vegetarian more often. Argument: No, because dairy also requires animals to be kept that will have to be eaten again later.

Is this a strong or weak argument?

Strong argument Weak argument

Statement: Germany should no longer use the euro as its currency Argument: No, because that means that the 10 billion Deutschmark that the introduction of the euro has cost is money thrown away.

Overfishing is the phenomenon that too much fish is caught in a certain area, which leads to the disappearance of the fish species in that area. This trend can only be reversed by means of catch reduction measures. These must therefore be introduced and enforced.

Assumption: The disappearance of fish species in areas of the oceans is undesirable.

Is the assumption made from the text?

Assumption is made Assumption is not made

As a company, we strive for satisfied customers. That's why from now on we're going to keep track of how quickly our help desk employees pick up the phone. Our goal is for that phone to ring for a maximum of 20 seconds.

Assumption: The company has tools or ways to measure how quickly help desk employees pick up the phone.

• All reptiles lay eggs
• All reptiles are vertebrates
• All snakes are reptiles
• All vertebrates have brains
• Some reptiles hatch their eggs themselves
• Most reptiles have two lungs
• Many snakes only have one lung
• Cobras are poisonous snakes
• All reptiles are animals

Conclusion: Some snakes hatch their eggs themselves.

Does the conclusion follow the statements?

Conclusion follows Conclusion does not follow

(Continue with the statements from question 5.)

Conclusion: Some animals that lay eggs only have one lung.

In the famous 1971 Stanford experiment, 24 normal, healthy male students were randomly assigned as 'guards' (12) or 'prisoners' (12). The guards were given a uniform and instructed to keep order, but not to use force. The prisoners were given prison uniforms. Soon after the start of the experiment, the guards made up all kinds of sentences for the prisoners. Insurgents were shot down with a fire extinguisher and public undressing or solitary confinement was also a punishment. The aggression of the guards became stronger as the experiment progressed. At one point, the abuses took place at night, because the guards thought that the researchers were not watching. It turned out that some guards also had fun treating the prisoners very cruelly. For example, prisoners got a bag over their heads and were chained to their ankles. Originally, the experiment would last 14 days. However, after six days the experiment was stopped.

The students who took part in the research did not expect to react the way they did in such a situation.

To what extent is this conclusion true, based on the given text?

True Probably true More information required Probably false False

(Continue with the text from 'Stanford experiment' in question 7.)

The results of the experiment support the claim that every young man (or at least some young men) is capable of turning into a sadist fairly quickly.

• A flag is a tribute to the nation and should therefore not be hung outside at night. Hoisting the flag therefore happens at sunrise, bringing it down at sunset. Only when a country flag is illuminated by spotlights on both sides, it may remain hanging after sunset. There is a simple rule of thumb for the time of bringing down the flag. This is the moment when there is no longer any visible difference between the individual colors of the flag.
• A flag may not touch the ground.
• On the Dutch flag, unless entitled to do so, no decorations or other additions should be made. Also the use of a flag purely for decoration should be avoided. However, flag cloth may be used for decoration - for example in the form of drapes.
• The orange pennant is only used on birthdays of members of the Royal House and on King's Day. The orange pennant should be as long or slightly longer than the diagonal of the flag.

Conclusion: One can assume that no Dutch flag will fly at government buildings at night, unless it is illuminated by spotlights on both sides.

Does the conclusion follow, based on the given text?

(Continue with the text from 'Dutch flag protocol' in question 9.)

Conclusion: If the protocol is followed, the orange pennant will always be longer than the horizontal bands/stripes of the flag.

Please answer the questions below. Not all questions are required but it will help us improve this test.

My educational level is

-- please select -- primary school high school college university PhD other

ANA Nursing Resources Hub

Search Resources Hub

Critical Thinking in Nursing: Tips to Develop the Skill

4 min read • February, 09 2024

Critical thinking in nursing helps caregivers make decisions that lead to optimal patient care. In school, educators and clinical instructors introduced you to critical-thinking examples in nursing. These educators encouraged using learning tools for assessment, diagnosis, planning, implementation, and evaluation.

Nurturing these invaluable skills continues once you begin practicing. Critical thinking is essential to providing quality patient care and should continue to grow throughout your nursing career until it becomes second nature. 

What Is Critical Thinking in Nursing?

Critical thinking in nursing involves identifying a problem, determining the best solution, and implementing an effective method to resolve the issue using clinical decision-making skills.

Reflection comes next. Carefully consider whether your actions led to the right solution or if there may have been a better course of action.

Remember, there's no one-size-fits-all treatment method — you must determine what's best for each patient.

How Is Critical Thinking Important for Nurses? 

As a patient's primary contact, a nurse is typically the first to notice changes in their status. One example of critical thinking in nursing is interpreting these changes with an open mind. Make impartial decisions based on evidence rather than opinions. By applying critical-thinking skills to anticipate and understand your patients' needs, you can positively impact their quality of care and outcomes.

Elements of Critical Thinking in Nursing

To assess situations and make informed decisions, nurses must integrate these specific elements into their practice:

• Clinical judgment. Prioritize a patient's care needs and make adjustments as changes occur. Gather the necessary information and determine what nursing intervention is needed. Keep in mind that there may be multiple options. Use your critical-thinking skills to interpret and understand the importance of test results and the patient’s clinical presentation, including their vital signs. Then prioritize interventions and anticipate potential complications. 
• Patient safety. Recognize deviations from the norm and take action to prevent harm to the patient. Suppose you don't think a change in a patient's medication is appropriate for their treatment. Before giving the medication, question the physician's rationale for the modification to avoid a potential error. 
• Communication and collaboration. Ask relevant questions and actively listen to others while avoiding judgment. Promoting a collaborative environment may lead to improved patient outcomes and interdisciplinary communication. 
• Problem-solving skills. Practicing your problem-solving skills can improve your critical-thinking skills. Analyze the problem, consider alternate solutions, and implement the most appropriate one. Besides assessing patient conditions, you can apply these skills to other challenges, such as staffing issues . 

How to Develop and Apply Critical-Thinking Skills in Nursing

Critical-thinking skills develop as you gain experience and advance in your career. The ability to predict and respond to nursing challenges increases as you expand your knowledge and encounter real-life patient care scenarios outside of what you learned from a textbook. 

Here are five ways to nurture your critical-thinking skills:

• Be a lifelong learner. Continuous learning through educational courses and professional development lets you stay current with evidence-based practice . That knowledge helps you make informed decisions in stressful moments.  
• Practice reflection. Allow time each day to reflect on successes and areas for improvement. This self-awareness can help identify your strengths, weaknesses, and personal biases to guide your decision-making.
• Open your mind. Don't assume you're right. Ask for opinions and consider the viewpoints of other nurses, mentors , and interdisciplinary team members.
• Use critical-thinking tools. Structure your thinking by incorporating nursing process steps or a SWOT analysis (strengths, weaknesses, opportunities, and threats) to organize information, evaluate options, and identify underlying issues.
• Be curious. Challenge assumptions by asking questions to ensure current care methods are valid, relevant, and supported by evidence-based practice .

Critical thinking in nursing is invaluable for safe, effective, patient-centered care. You can successfully navigate challenges in the ever-changing health care environment by continually developing and applying these skills.

Images sourced from Getty Images

Related Resources

Item(s) added to cart

Warning: The NCBI web site requires JavaScript to function. more...

An official website of the United States government

The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings
• Browse Titles

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

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.
• PDF version of this page (147K)

In this Page

• Clinical Grasp

Other titles in this collection

• Advances in Patient Safety

Related information

• PMC PubMed Central citations
• PubMed Links to PubMed

Similar articles in PubMed

• Nurses' reasoning process during care planning taking pressure ulcer prevention as an example. A think-aloud study. [Int J Nurs Stud. 2007] Nurses' reasoning process during care planning taking pressure ulcer prevention as an example. A think-aloud study. Funkesson KH, Anbäcken EM, Ek AC. Int J Nurs Stud. 2007 Sep; 44(7):1109-19. Epub 2006 Jun 27.
• Registered nurses' clinical reasoning skills and reasoning process: A think-aloud study. [Nurse Educ Today. 2016] Registered nurses' clinical reasoning skills and reasoning process: A think-aloud study. Lee J, Lee YJ, Bae J, Seo M. Nurse Educ Today. 2016 Nov; 46:75-80. Epub 2016 Aug 15.
• Combining the arts: an applied critical thinking approach in the skills laboratory. [Nursingconnections. 2000] Combining the arts: an applied critical thinking approach in the skills laboratory. Peterson MJ, Bechtel GA. Nursingconnections. 2000 Summer; 13(2):43-9.
• Review About critical thinking. [Dynamics. 2004] Review About critical thinking. Hynes P, Bennett J. Dynamics. 2004 Fall; 15(3):26-9.
• Review The 'five rights' of clinical reasoning: an educational model to enhance nursing students' ability to identify and manage clinically 'at risk' patients. [Nurse Educ Today. 2010] Review The 'five rights' of clinical reasoning: an educational model to enhance nursing students' ability to identify and manage clinically 'at risk' patients. Levett-Jones T, Hoffman K, Dempsey J, Jeong SY, Noble D, Norton CA, Roche J, Hickey N. Nurse Educ Today. 2010 Aug; 30(6):515-20. Epub 2009 Nov 30.

Recent Activity

• Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinical... Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically - Patient Safety and Quality

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

Connect with NLM

National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894

Web Policies FOIA HHS Vulnerability Disclosure

Help Accessibility Careers

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• Review Article
• Open access
• Published: 11 January 2023

The effectiveness of collaborative problem solving in promoting students’ critical thinking: A meta-analysis based on empirical literature

• Enwei Xu   ORCID: orcid.org/0000-0001-6424-8169 1 ,
• Wei Wang 1 &
• Qingxia Wang 1  

Humanities and Social Sciences Communications volume  10 , Article number:  16 ( 2023 ) Cite this article

18k Accesses

21 Citations

3 Altmetric

Metrics details

• Science, technology and society

Collaborative problem-solving has been widely embraced in the classroom instruction of critical thinking, which is regarded as the core of curriculum reform based on key competencies in the field of education as well as a key competence for learners in the 21st century. However, the effectiveness of collaborative problem-solving in promoting students’ critical thinking remains uncertain. This current research presents the major findings of a meta-analysis of 36 pieces of the literature revealed in worldwide educational periodicals during the 21st century to identify the effectiveness of collaborative problem-solving in promoting students’ critical thinking and to determine, based on evidence, whether and to what extent collaborative problem solving can result in a rise or decrease in critical thinking. The findings show that (1) collaborative problem solving is an effective teaching approach to foster students’ critical thinking, with a significant overall effect size (ES = 0.82, z  = 12.78, P  < 0.01, 95% CI [0.69, 0.95]); (2) in respect to the dimensions of critical thinking, collaborative problem solving can significantly and successfully enhance students’ attitudinal tendencies (ES = 1.17, z  = 7.62, P  < 0.01, 95% CI[0.87, 1.47]); nevertheless, it falls short in terms of improving students’ cognitive skills, having only an upper-middle impact (ES = 0.70, z  = 11.55, P  < 0.01, 95% CI[0.58, 0.82]); and (3) the teaching type (chi 2  = 7.20, P  < 0.05), intervention duration (chi 2  = 12.18, P  < 0.01), subject area (chi 2  = 13.36, P  < 0.05), group size (chi 2  = 8.77, P  < 0.05), and learning scaffold (chi 2  = 9.03, P  < 0.01) all have an impact on critical thinking, and they can be viewed as important moderating factors that affect how critical thinking develops. On the basis of these results, recommendations are made for further study and instruction to better support students’ critical thinking in the context of collaborative problem-solving.

Similar content being viewed by others

A meta-analysis of the effects of design thinking on student learning

Fostering twenty-first century skills among primary school students through math project-based learning

A meta-analysis to gauge the impact of pedagogies employed in mixed-ability high school biology classrooms

Introduction.

Although critical thinking has a long history in research, the concept of critical thinking, which is regarded as an essential competence for learners in the 21st century, has recently attracted more attention from researchers and teaching practitioners (National Research Council, 2012 ). Critical thinking should be the core of curriculum reform based on key competencies in the field of education (Peng and Deng, 2017 ) because students with critical thinking can not only understand the meaning of knowledge but also effectively solve practical problems in real life even after knowledge is forgotten (Kek and Huijser, 2011 ). The definition of critical thinking is not universal (Ennis, 1989 ; Castle, 2009 ; Niu et al., 2013 ). In general, the definition of critical thinking is a self-aware and self-regulated thought process (Facione, 1990 ; Niu et al., 2013 ). It refers to the cognitive skills needed to interpret, analyze, synthesize, reason, and evaluate information as well as the attitudinal tendency to apply these abilities (Halpern, 2001 ). The view that critical thinking can be taught and learned through curriculum teaching has been widely supported by many researchers (e.g., Kuncel, 2011 ; Leng and Lu, 2020 ), leading to educators’ efforts to foster it among students. In the field of teaching practice, there are three types of courses for teaching critical thinking (Ennis, 1989 ). The first is an independent curriculum in which critical thinking is taught and cultivated without involving the knowledge of specific disciplines; the second is an integrated curriculum in which critical thinking is integrated into the teaching of other disciplines as a clear teaching goal; and the third is a mixed curriculum in which critical thinking is taught in parallel to the teaching of other disciplines for mixed teaching training. Furthermore, numerous measuring tools have been developed by researchers and educators to measure critical thinking in the context of teaching practice. These include standardized measurement tools, such as WGCTA, CCTST, CCTT, and CCTDI, which have been verified by repeated experiments and are considered effective and reliable by international scholars (Facione and Facione, 1992 ). In short, descriptions of critical thinking, including its two dimensions of attitudinal tendency and cognitive skills, different types of teaching courses, and standardized measurement tools provide a complex normative framework for understanding, teaching, and evaluating critical thinking.

Cultivating critical thinking in curriculum teaching can start with a problem, and one of the most popular critical thinking instructional approaches is problem-based learning (Liu et al., 2020 ). Duch et al. ( 2001 ) noted that problem-based learning in group collaboration is progressive active learning, which can improve students’ critical thinking and problem-solving skills. Collaborative problem-solving is the organic integration of collaborative learning and problem-based learning, which takes learners as the center of the learning process and uses problems with poor structure in real-world situations as the starting point for the learning process (Liang et al., 2017 ). Students learn the knowledge needed to solve problems in a collaborative group, reach a consensus on problems in the field, and form solutions through social cooperation methods, such as dialogue, interpretation, questioning, debate, negotiation, and reflection, thus promoting the development of learners’ domain knowledge and critical thinking (Cindy, 2004 ; Liang et al., 2017 ).

Collaborative problem-solving has been widely used in the teaching practice of critical thinking, and several studies have attempted to conduct a systematic review and meta-analysis of the empirical literature on critical thinking from various perspectives. However, little attention has been paid to the impact of collaborative problem-solving on critical thinking. Therefore, the best approach for developing and enhancing critical thinking throughout collaborative problem-solving is to examine how to implement critical thinking instruction; however, this issue is still unexplored, which means that many teachers are incapable of better instructing critical thinking (Leng and Lu, 2020 ; Niu et al., 2013 ). For example, Huber ( 2016 ) provided the meta-analysis findings of 71 publications on gaining critical thinking over various time frames in college with the aim of determining whether critical thinking was truly teachable. These authors found that learners significantly improve their critical thinking while in college and that critical thinking differs with factors such as teaching strategies, intervention duration, subject area, and teaching type. The usefulness of collaborative problem-solving in fostering students’ critical thinking, however, was not determined by this study, nor did it reveal whether there existed significant variations among the different elements. A meta-analysis of 31 pieces of educational literature was conducted by Liu et al. ( 2020 ) to assess the impact of problem-solving on college students’ critical thinking. These authors found that problem-solving could promote the development of critical thinking among college students and proposed establishing a reasonable group structure for problem-solving in a follow-up study to improve students’ critical thinking. Additionally, previous empirical studies have reached inconclusive and even contradictory conclusions about whether and to what extent collaborative problem-solving increases or decreases critical thinking levels. As an illustration, Yang et al. ( 2008 ) carried out an experiment on the integrated curriculum teaching of college students based on a web bulletin board with the goal of fostering participants’ critical thinking in the context of collaborative problem-solving. These authors’ research revealed that through sharing, debating, examining, and reflecting on various experiences and ideas, collaborative problem-solving can considerably enhance students’ critical thinking in real-life problem situations. In contrast, collaborative problem-solving had a positive impact on learners’ interaction and could improve learning interest and motivation but could not significantly improve students’ critical thinking when compared to traditional classroom teaching, according to research by Naber and Wyatt ( 2014 ) and Sendag and Odabasi ( 2009 ) on undergraduate and high school students, respectively.

The above studies show that there is inconsistency regarding the effectiveness of collaborative problem-solving in promoting students’ critical thinking. Therefore, it is essential to conduct a thorough and trustworthy review to detect and decide whether and to what degree collaborative problem-solving can result in a rise or decrease in critical thinking. Meta-analysis is a quantitative analysis approach that is utilized to examine quantitative data from various separate studies that are all focused on the same research topic. This approach characterizes the effectiveness of its impact by averaging the effect sizes of numerous qualitative studies in an effort to reduce the uncertainty brought on by independent research and produce more conclusive findings (Lipsey and Wilson, 2001 ).

This paper used a meta-analytic approach and carried out a meta-analysis to examine the effectiveness of collaborative problem-solving in promoting students’ critical thinking in order to make a contribution to both research and practice. The following research questions were addressed by this meta-analysis:

What is the overall effect size of collaborative problem-solving in promoting students’ critical thinking and its impact on the two dimensions of critical thinking (i.e., attitudinal tendency and cognitive skills)?

How are the disparities between the study conclusions impacted by various moderating variables if the impacts of various experimental designs in the included studies are heterogeneous?

This research followed the strict procedures (e.g., database searching, identification, screening, eligibility, merging, duplicate removal, and analysis of included studies) of Cooper’s ( 2010 ) proposed meta-analysis approach for examining quantitative data from various separate studies that are all focused on the same research topic. The relevant empirical research that appeared in worldwide educational periodicals within the 21st century was subjected to this meta-analysis using Rev-Man 5.4. The consistency of the data extracted separately by two researchers was tested using Cohen’s kappa coefficient, and a publication bias test and a heterogeneity test were run on the sample data to ascertain the quality of this meta-analysis.

Data sources and search strategies

There were three stages to the data collection process for this meta-analysis, as shown in Fig. 1 , which shows the number of articles included and eliminated during the selection process based on the statement and study eligibility criteria.

This flowchart shows the number of records identified, included and excluded in the article.

First, the databases used to systematically search for relevant articles were the journal papers of the Web of Science Core Collection and the Chinese Core source journal, as well as the Chinese Social Science Citation Index (CSSCI) source journal papers included in CNKI. These databases were selected because they are credible platforms that are sources of scholarly and peer-reviewed information with advanced search tools and contain literature relevant to the subject of our topic from reliable researchers and experts. The search string with the Boolean operator used in the Web of Science was “TS = (((“critical thinking” or “ct” and “pretest” or “posttest”) or (“critical thinking” or “ct” and “control group” or “quasi experiment” or “experiment”)) and (“collaboration” or “collaborative learning” or “CSCL”) and (“problem solving” or “problem-based learning” or “PBL”))”. The research area was “Education Educational Research”, and the search period was “January 1, 2000, to December 30, 2021”. A total of 412 papers were obtained. The search string with the Boolean operator used in the CNKI was “SU = (‘critical thinking’*‘collaboration’ + ‘critical thinking’*‘collaborative learning’ + ‘critical thinking’*‘CSCL’ + ‘critical thinking’*‘problem solving’ + ‘critical thinking’*‘problem-based learning’ + ‘critical thinking’*‘PBL’ + ‘critical thinking’*‘problem oriented’) AND FT = (‘experiment’ + ‘quasi experiment’ + ‘pretest’ + ‘posttest’ + ‘empirical study’)” (translated into Chinese when searching). A total of 56 studies were found throughout the search period of “January 2000 to December 2021”. From the databases, all duplicates and retractions were eliminated before exporting the references into Endnote, a program for managing bibliographic references. In all, 466 studies were found.

Second, the studies that matched the inclusion and exclusion criteria for the meta-analysis were chosen by two researchers after they had reviewed the abstracts and titles of the gathered articles, yielding a total of 126 studies.

Third, two researchers thoroughly reviewed each included article’s whole text in accordance with the inclusion and exclusion criteria. Meanwhile, a snowball search was performed using the references and citations of the included articles to ensure complete coverage of the articles. Ultimately, 36 articles were kept.

Two researchers worked together to carry out this entire process, and a consensus rate of almost 94.7% was reached after discussion and negotiation to clarify any emerging differences.

Eligibility criteria

Since not all the retrieved studies matched the criteria for this meta-analysis, eligibility criteria for both inclusion and exclusion were developed as follows:

The publication language of the included studies was limited to English and Chinese, and the full text could be obtained. Articles that did not meet the publication language and articles not published between 2000 and 2021 were excluded.

The research design of the included studies must be empirical and quantitative studies that can assess the effect of collaborative problem-solving on the development of critical thinking. Articles that could not identify the causal mechanisms by which collaborative problem-solving affects critical thinking, such as review articles and theoretical articles, were excluded.

The research method of the included studies must feature a randomized control experiment or a quasi-experiment, or a natural experiment, which have a higher degree of internal validity with strong experimental designs and can all plausibly provide evidence that critical thinking and collaborative problem-solving are causally related. Articles with non-experimental research methods, such as purely correlational or observational studies, were excluded.

The participants of the included studies were only students in school, including K-12 students and college students. Articles in which the participants were non-school students, such as social workers or adult learners, were excluded.

The research results of the included studies must mention definite signs that may be utilized to gauge critical thinking’s impact (e.g., sample size, mean value, or standard deviation). Articles that lacked specific measurement indicators for critical thinking and could not calculate the effect size were excluded.

Data coding design

In order to perform a meta-analysis, it is necessary to collect the most important information from the articles, codify that information’s properties, and convert descriptive data into quantitative data. Therefore, this study designed a data coding template (see Table 1 ). Ultimately, 16 coding fields were retained.

The designed data-coding template consisted of three pieces of information. Basic information about the papers was included in the descriptive information: the publishing year, author, serial number, and title of the paper.

The variable information for the experimental design had three variables: the independent variable (instruction method), the dependent variable (critical thinking), and the moderating variable (learning stage, teaching type, intervention duration, learning scaffold, group size, measuring tool, and subject area). Depending on the topic of this study, the intervention strategy, as the independent variable, was coded into collaborative and non-collaborative problem-solving. The dependent variable, critical thinking, was coded as a cognitive skill and an attitudinal tendency. And seven moderating variables were created by grouping and combining the experimental design variables discovered within the 36 studies (see Table 1 ), where learning stages were encoded as higher education, high school, middle school, and primary school or lower; teaching types were encoded as mixed courses, integrated courses, and independent courses; intervention durations were encoded as 0–1 weeks, 1–4 weeks, 4–12 weeks, and more than 12 weeks; group sizes were encoded as 2–3 persons, 4–6 persons, 7–10 persons, and more than 10 persons; learning scaffolds were encoded as teacher-supported learning scaffold, technique-supported learning scaffold, and resource-supported learning scaffold; measuring tools were encoded as standardized measurement tools (e.g., WGCTA, CCTT, CCTST, and CCTDI) and self-adapting measurement tools (e.g., modified or made by researchers); and subject areas were encoded according to the specific subjects used in the 36 included studies.

The data information contained three metrics for measuring critical thinking: sample size, average value, and standard deviation. It is vital to remember that studies with various experimental designs frequently adopt various formulas to determine the effect size. And this paper used Morris’ proposed standardized mean difference (SMD) calculation formula ( 2008 , p. 369; see Supplementary Table S3 ).

Procedure for extracting and coding data

According to the data coding template (see Table 1 ), the 36 papers’ information was retrieved by two researchers, who then entered them into Excel (see Supplementary Table S1 ). The results of each study were extracted separately in the data extraction procedure if an article contained numerous studies on critical thinking, or if a study assessed different critical thinking dimensions. For instance, Tiwari et al. ( 2010 ) used four time points, which were viewed as numerous different studies, to examine the outcomes of critical thinking, and Chen ( 2013 ) included the two outcome variables of attitudinal tendency and cognitive skills, which were regarded as two studies. After discussion and negotiation during data extraction, the two researchers’ consistency test coefficients were roughly 93.27%. Supplementary Table S2 details the key characteristics of the 36 included articles with 79 effect quantities, including descriptive information (e.g., the publishing year, author, serial number, and title of the paper), variable information (e.g., independent variables, dependent variables, and moderating variables), and data information (e.g., mean values, standard deviations, and sample size). Following that, testing for publication bias and heterogeneity was done on the sample data using the Rev-Man 5.4 software, and then the test results were used to conduct a meta-analysis.

Publication bias test

When the sample of studies included in a meta-analysis does not accurately reflect the general status of research on the relevant subject, publication bias is said to be exhibited in this research. The reliability and accuracy of the meta-analysis may be impacted by publication bias. Due to this, the meta-analysis needs to check the sample data for publication bias (Stewart et al., 2006 ). A popular method to check for publication bias is the funnel plot; and it is unlikely that there will be publishing bias when the data are equally dispersed on either side of the average effect size and targeted within the higher region. The data are equally dispersed within the higher portion of the efficient zone, consistent with the funnel plot connected with this analysis (see Fig. 2 ), indicating that publication bias is unlikely in this situation.

This funnel plot shows the result of publication bias of 79 effect quantities across 36 studies.

Heterogeneity test

To select the appropriate effect models for the meta-analysis, one might use the results of a heterogeneity test on the data effect sizes. In a meta-analysis, it is common practice to gauge the degree of data heterogeneity using the I 2 value, and I 2  ≥ 50% is typically understood to denote medium-high heterogeneity, which calls for the adoption of a random effect model; if not, a fixed effect model ought to be applied (Lipsey and Wilson, 2001 ). The findings of the heterogeneity test in this paper (see Table 2 ) revealed that I 2 was 86% and displayed significant heterogeneity ( P  < 0.01). To ensure accuracy and reliability, the overall effect size ought to be calculated utilizing the random effect model.

The analysis of the overall effect size

This meta-analysis utilized a random effect model to examine 79 effect quantities from 36 studies after eliminating heterogeneity. In accordance with Cohen’s criterion (Cohen, 1992 ), it is abundantly clear from the analysis results, which are shown in the forest plot of the overall effect (see Fig. 3 ), that the cumulative impact size of cooperative problem-solving is 0.82, which is statistically significant ( z  = 12.78, P  < 0.01, 95% CI [0.69, 0.95]), and can encourage learners to practice critical thinking.

This forest plot shows the analysis result of the overall effect size across 36 studies.

In addition, this study examined two distinct dimensions of critical thinking to better understand the precise contributions that collaborative problem-solving makes to the growth of critical thinking. The findings (see Table 3 ) indicate that collaborative problem-solving improves cognitive skills (ES = 0.70) and attitudinal tendency (ES = 1.17), with significant intergroup differences (chi 2  = 7.95, P  < 0.01). Although collaborative problem-solving improves both dimensions of critical thinking, it is essential to point out that the improvements in students’ attitudinal tendency are much more pronounced and have a significant comprehensive effect (ES = 1.17, z  = 7.62, P  < 0.01, 95% CI [0.87, 1.47]), whereas gains in learners’ cognitive skill are slightly improved and are just above average. (ES = 0.70, z  = 11.55, P  < 0.01, 95% CI [0.58, 0.82]).

The analysis of moderator effect size

The whole forest plot’s 79 effect quantities underwent a two-tailed test, which revealed significant heterogeneity ( I 2  = 86%, z  = 12.78, P  < 0.01), indicating differences between various effect sizes that may have been influenced by moderating factors other than sampling error. Therefore, exploring possible moderating factors that might produce considerable heterogeneity was done using subgroup analysis, such as the learning stage, learning scaffold, teaching type, group size, duration of the intervention, measuring tool, and the subject area included in the 36 experimental designs, in order to further explore the key factors that influence critical thinking. The findings (see Table 4 ) indicate that various moderating factors have advantageous effects on critical thinking. In this situation, the subject area (chi 2  = 13.36, P  < 0.05), group size (chi 2  = 8.77, P  < 0.05), intervention duration (chi 2  = 12.18, P  < 0.01), learning scaffold (chi 2  = 9.03, P  < 0.01), and teaching type (chi 2  = 7.20, P  < 0.05) are all significant moderators that can be applied to support the cultivation of critical thinking. However, since the learning stage and the measuring tools did not significantly differ among intergroup (chi 2  = 3.15, P  = 0.21 > 0.05, and chi 2  = 0.08, P  = 0.78 > 0.05), we are unable to explain why these two factors are crucial in supporting the cultivation of critical thinking in the context of collaborative problem-solving. These are the precise outcomes, as follows:

Various learning stages influenced critical thinking positively, without significant intergroup differences (chi 2  = 3.15, P  = 0.21 > 0.05). High school was first on the list of effect sizes (ES = 1.36, P  < 0.01), then higher education (ES = 0.78, P  < 0.01), and middle school (ES = 0.73, P  < 0.01). These results show that, despite the learning stage’s beneficial influence on cultivating learners’ critical thinking, we are unable to explain why it is essential for cultivating critical thinking in the context of collaborative problem-solving.

Different teaching types had varying degrees of positive impact on critical thinking, with significant intergroup differences (chi 2  = 7.20, P  < 0.05). The effect size was ranked as follows: mixed courses (ES = 1.34, P  < 0.01), integrated courses (ES = 0.81, P  < 0.01), and independent courses (ES = 0.27, P  < 0.01). These results indicate that the most effective approach to cultivate critical thinking utilizing collaborative problem solving is through the teaching type of mixed courses.

Various intervention durations significantly improved critical thinking, and there were significant intergroup differences (chi 2  = 12.18, P  < 0.01). The effect sizes related to this variable showed a tendency to increase with longer intervention durations. The improvement in critical thinking reached a significant level (ES = 0.85, P  < 0.01) after more than 12 weeks of training. These findings indicate that the intervention duration and critical thinking’s impact are positively correlated, with a longer intervention duration having a greater effect.

Different learning scaffolds influenced critical thinking positively, with significant intergroup differences (chi 2  = 9.03, P  < 0.01). The resource-supported learning scaffold (ES = 0.69, P  < 0.01) acquired a medium-to-higher level of impact, the technique-supported learning scaffold (ES = 0.63, P  < 0.01) also attained a medium-to-higher level of impact, and the teacher-supported learning scaffold (ES = 0.92, P  < 0.01) displayed a high level of significant impact. These results show that the learning scaffold with teacher support has the greatest impact on cultivating critical thinking.

Various group sizes influenced critical thinking positively, and the intergroup differences were statistically significant (chi 2  = 8.77, P  < 0.05). Critical thinking showed a general declining trend with increasing group size. The overall effect size of 2–3 people in this situation was the biggest (ES = 0.99, P  < 0.01), and when the group size was greater than 7 people, the improvement in critical thinking was at the lower-middle level (ES < 0.5, P  < 0.01). These results show that the impact on critical thinking is positively connected with group size, and as group size grows, so does the overall impact.

Various measuring tools influenced critical thinking positively, with significant intergroup differences (chi 2  = 0.08, P  = 0.78 > 0.05). In this situation, the self-adapting measurement tools obtained an upper-medium level of effect (ES = 0.78), whereas the complete effect size of the standardized measurement tools was the largest, achieving a significant level of effect (ES = 0.84, P  < 0.01). These results show that, despite the beneficial influence of the measuring tool on cultivating critical thinking, we are unable to explain why it is crucial in fostering the growth of critical thinking by utilizing the approach of collaborative problem-solving.

Different subject areas had a greater impact on critical thinking, and the intergroup differences were statistically significant (chi 2  = 13.36, P  < 0.05). Mathematics had the greatest overall impact, achieving a significant level of effect (ES = 1.68, P  < 0.01), followed by science (ES = 1.25, P  < 0.01) and medical science (ES = 0.87, P  < 0.01), both of which also achieved a significant level of effect. Programming technology was the least effective (ES = 0.39, P  < 0.01), only having a medium-low degree of effect compared to education (ES = 0.72, P  < 0.01) and other fields (such as language, art, and social sciences) (ES = 0.58, P  < 0.01). These results suggest that scientific fields (e.g., mathematics, science) may be the most effective subject areas for cultivating critical thinking utilizing the approach of collaborative problem-solving.

The effectiveness of collaborative problem solving with regard to teaching critical thinking

According to this meta-analysis, using collaborative problem-solving as an intervention strategy in critical thinking teaching has a considerable amount of impact on cultivating learners’ critical thinking as a whole and has a favorable promotional effect on the two dimensions of critical thinking. According to certain studies, collaborative problem solving, the most frequently used critical thinking teaching strategy in curriculum instruction can considerably enhance students’ critical thinking (e.g., Liang et al., 2017 ; Liu et al., 2020 ; Cindy, 2004 ). This meta-analysis provides convergent data support for the above research views. Thus, the findings of this meta-analysis not only effectively address the first research query regarding the overall effect of cultivating critical thinking and its impact on the two dimensions of critical thinking (i.e., attitudinal tendency and cognitive skills) utilizing the approach of collaborative problem-solving, but also enhance our confidence in cultivating critical thinking by using collaborative problem-solving intervention approach in the context of classroom teaching.

Furthermore, the associated improvements in attitudinal tendency are much stronger, but the corresponding improvements in cognitive skill are only marginally better. According to certain studies, cognitive skill differs from the attitudinal tendency in classroom instruction; the cultivation and development of the former as a key ability is a process of gradual accumulation, while the latter as an attitude is affected by the context of the teaching situation (e.g., a novel and exciting teaching approach, challenging and rewarding tasks) (Halpern, 2001 ; Wei and Hong, 2022 ). Collaborative problem-solving as a teaching approach is exciting and interesting, as well as rewarding and challenging; because it takes the learners as the focus and examines problems with poor structure in real situations, and it can inspire students to fully realize their potential for problem-solving, which will significantly improve their attitudinal tendency toward solving problems (Liu et al., 2020 ). Similar to how collaborative problem-solving influences attitudinal tendency, attitudinal tendency impacts cognitive skill when attempting to solve a problem (Liu et al., 2020 ; Zhang et al., 2022 ), and stronger attitudinal tendencies are associated with improved learning achievement and cognitive ability in students (Sison, 2008 ; Zhang et al., 2022 ). It can be seen that the two specific dimensions of critical thinking as well as critical thinking as a whole are affected by collaborative problem-solving, and this study illuminates the nuanced links between cognitive skills and attitudinal tendencies with regard to these two dimensions of critical thinking. To fully develop students’ capacity for critical thinking, future empirical research should pay closer attention to cognitive skills.

The moderating effects of collaborative problem solving with regard to teaching critical thinking

In order to further explore the key factors that influence critical thinking, exploring possible moderating effects that might produce considerable heterogeneity was done using subgroup analysis. The findings show that the moderating factors, such as the teaching type, learning stage, group size, learning scaffold, duration of the intervention, measuring tool, and the subject area included in the 36 experimental designs, could all support the cultivation of collaborative problem-solving in critical thinking. Among them, the effect size differences between the learning stage and measuring tool are not significant, which does not explain why these two factors are crucial in supporting the cultivation of critical thinking utilizing the approach of collaborative problem-solving.

In terms of the learning stage, various learning stages influenced critical thinking positively without significant intergroup differences, indicating that we are unable to explain why it is crucial in fostering the growth of critical thinking.

Although high education accounts for 70.89% of all empirical studies performed by researchers, high school may be the appropriate learning stage to foster students’ critical thinking by utilizing the approach of collaborative problem-solving since it has the largest overall effect size. This phenomenon may be related to student’s cognitive development, which needs to be further studied in follow-up research.

With regard to teaching type, mixed course teaching may be the best teaching method to cultivate students’ critical thinking. Relevant studies have shown that in the actual teaching process if students are trained in thinking methods alone, the methods they learn are isolated and divorced from subject knowledge, which is not conducive to their transfer of thinking methods; therefore, if students’ thinking is trained only in subject teaching without systematic method training, it is challenging to apply to real-world circumstances (Ruggiero, 2012 ; Hu and Liu, 2015 ). Teaching critical thinking as mixed course teaching in parallel to other subject teachings can achieve the best effect on learners’ critical thinking, and explicit critical thinking instruction is more effective than less explicit critical thinking instruction (Bensley and Spero, 2014 ).

In terms of the intervention duration, with longer intervention times, the overall effect size shows an upward tendency. Thus, the intervention duration and critical thinking’s impact are positively correlated. Critical thinking, as a key competency for students in the 21st century, is difficult to get a meaningful improvement in a brief intervention duration. Instead, it could be developed over a lengthy period of time through consistent teaching and the progressive accumulation of knowledge (Halpern, 2001 ; Hu and Liu, 2015 ). Therefore, future empirical studies ought to take these restrictions into account throughout a longer period of critical thinking instruction.

With regard to group size, a group size of 2–3 persons has the highest effect size, and the comprehensive effect size decreases with increasing group size in general. This outcome is in line with some research findings; as an example, a group composed of two to four members is most appropriate for collaborative learning (Schellens and Valcke, 2006 ). However, the meta-analysis results also indicate that once the group size exceeds 7 people, small groups cannot produce better interaction and performance than large groups. This may be because the learning scaffolds of technique support, resource support, and teacher support improve the frequency and effectiveness of interaction among group members, and a collaborative group with more members may increase the diversity of views, which is helpful to cultivate critical thinking utilizing the approach of collaborative problem-solving.

With regard to the learning scaffold, the three different kinds of learning scaffolds can all enhance critical thinking. Among them, the teacher-supported learning scaffold has the largest overall effect size, demonstrating the interdependence of effective learning scaffolds and collaborative problem-solving. This outcome is in line with some research findings; as an example, a successful strategy is to encourage learners to collaborate, come up with solutions, and develop critical thinking skills by using learning scaffolds (Reiser, 2004 ; Xu et al., 2022 ); learning scaffolds can lower task complexity and unpleasant feelings while also enticing students to engage in learning activities (Wood et al., 2006 ); learning scaffolds are designed to assist students in using learning approaches more successfully to adapt the collaborative problem-solving process, and the teacher-supported learning scaffolds have the greatest influence on critical thinking in this process because they are more targeted, informative, and timely (Xu et al., 2022 ).

With respect to the measuring tool, despite the fact that standardized measurement tools (such as the WGCTA, CCTT, and CCTST) have been acknowledged as trustworthy and effective by worldwide experts, only 54.43% of the research included in this meta-analysis adopted them for assessment, and the results indicated no intergroup differences. These results suggest that not all teaching circumstances are appropriate for measuring critical thinking using standardized measurement tools. “The measuring tools for measuring thinking ability have limits in assessing learners in educational situations and should be adapted appropriately to accurately assess the changes in learners’ critical thinking.”, according to Simpson and Courtney ( 2002 , p. 91). As a result, in order to more fully and precisely gauge how learners’ critical thinking has evolved, we must properly modify standardized measuring tools based on collaborative problem-solving learning contexts.

With regard to the subject area, the comprehensive effect size of science departments (e.g., mathematics, science, medical science) is larger than that of language arts and social sciences. Some recent international education reforms have noted that critical thinking is a basic part of scientific literacy. Students with scientific literacy can prove the rationality of their judgment according to accurate evidence and reasonable standards when they face challenges or poorly structured problems (Kyndt et al., 2013 ), which makes critical thinking crucial for developing scientific understanding and applying this understanding to practical problem solving for problems related to science, technology, and society (Yore et al., 2007 ).

Suggestions for critical thinking teaching

Other than those stated in the discussion above, the following suggestions are offered for critical thinking instruction utilizing the approach of collaborative problem-solving.

First, teachers should put a special emphasis on the two core elements, which are collaboration and problem-solving, to design real problems based on collaborative situations. This meta-analysis provides evidence to support the view that collaborative problem-solving has a strong synergistic effect on promoting students’ critical thinking. Asking questions about real situations and allowing learners to take part in critical discussions on real problems during class instruction are key ways to teach critical thinking rather than simply reading speculative articles without practice (Mulnix, 2012 ). Furthermore, the improvement of students’ critical thinking is realized through cognitive conflict with other learners in the problem situation (Yang et al., 2008 ). Consequently, it is essential for teachers to put a special emphasis on the two core elements, which are collaboration and problem-solving, and design real problems and encourage students to discuss, negotiate, and argue based on collaborative problem-solving situations.

Second, teachers should design and implement mixed courses to cultivate learners’ critical thinking, utilizing the approach of collaborative problem-solving. Critical thinking can be taught through curriculum instruction (Kuncel, 2011 ; Leng and Lu, 2020 ), with the goal of cultivating learners’ critical thinking for flexible transfer and application in real problem-solving situations. This meta-analysis shows that mixed course teaching has a highly substantial impact on the cultivation and promotion of learners’ critical thinking. Therefore, teachers should design and implement mixed course teaching with real collaborative problem-solving situations in combination with the knowledge content of specific disciplines in conventional teaching, teach methods and strategies of critical thinking based on poorly structured problems to help students master critical thinking, and provide practical activities in which students can interact with each other to develop knowledge construction and critical thinking utilizing the approach of collaborative problem-solving.

Third, teachers should be more trained in critical thinking, particularly preservice teachers, and they also should be conscious of the ways in which teachers’ support for learning scaffolds can promote critical thinking. The learning scaffold supported by teachers had the greatest impact on learners’ critical thinking, in addition to being more directive, targeted, and timely (Wood et al., 2006 ). Critical thinking can only be effectively taught when teachers recognize the significance of critical thinking for students’ growth and use the proper approaches while designing instructional activities (Forawi, 2016 ). Therefore, with the intention of enabling teachers to create learning scaffolds to cultivate learners’ critical thinking utilizing the approach of collaborative problem solving, it is essential to concentrate on the teacher-supported learning scaffolds and enhance the instruction for teaching critical thinking to teachers, especially preservice teachers.

Implications and limitations

There are certain limitations in this meta-analysis, but future research can correct them. First, the search languages were restricted to English and Chinese, so it is possible that pertinent studies that were written in other languages were overlooked, resulting in an inadequate number of articles for review. Second, these data provided by the included studies are partially missing, such as whether teachers were trained in the theory and practice of critical thinking, the average age and gender of learners, and the differences in critical thinking among learners of various ages and genders. Third, as is typical for review articles, more studies were released while this meta-analysis was being done; therefore, it had a time limit. With the development of relevant research, future studies focusing on these issues are highly relevant and needed.

Conclusions

The subject of the magnitude of collaborative problem-solving’s impact on fostering students’ critical thinking, which received scant attention from other studies, was successfully addressed by this study. The question of the effectiveness of collaborative problem-solving in promoting students’ critical thinking was addressed in this study, which addressed a topic that had gotten little attention in earlier research. The following conclusions can be made:

Regarding the results obtained, collaborative problem solving is an effective teaching approach to foster learners’ critical thinking, with a significant overall effect size (ES = 0.82, z  = 12.78, P  < 0.01, 95% CI [0.69, 0.95]). With respect to the dimensions of critical thinking, collaborative problem-solving can significantly and effectively improve students’ attitudinal tendency, and the comprehensive effect is significant (ES = 1.17, z  = 7.62, P  < 0.01, 95% CI [0.87, 1.47]); nevertheless, it falls short in terms of improving students’ cognitive skills, having only an upper-middle impact (ES = 0.70, z  = 11.55, P  < 0.01, 95% CI [0.58, 0.82]).

As demonstrated by both the results and the discussion, there are varying degrees of beneficial effects on students’ critical thinking from all seven moderating factors, which were found across 36 studies. In this context, the teaching type (chi 2  = 7.20, P  < 0.05), intervention duration (chi 2  = 12.18, P  < 0.01), subject area (chi 2  = 13.36, P  < 0.05), group size (chi 2  = 8.77, P  < 0.05), and learning scaffold (chi 2  = 9.03, P  < 0.01) all have a positive impact on critical thinking, and they can be viewed as important moderating factors that affect how critical thinking develops. Since the learning stage (chi 2  = 3.15, P  = 0.21 > 0.05) and measuring tools (chi 2  = 0.08, P  = 0.78 > 0.05) did not demonstrate any significant intergroup differences, we are unable to explain why these two factors are crucial in supporting the cultivation of critical thinking in the context of collaborative problem-solving.

Data availability

All data generated or analyzed during this study are included within the article and its supplementary information files, and the supplementary information files are available in the Dataverse repository: https://doi.org/10.7910/DVN/IPFJO6 .

Bensley DA, Spero RA (2014) Improving critical thinking skills and meta-cognitive monitoring through direct infusion. Think Skills Creat 12:55–68. https://doi.org/10.1016/j.tsc.2014.02.001

Article   Google Scholar  

Castle A (2009) Defining and assessing critical thinking skills for student radiographers. Radiography 15(1):70–76. https://doi.org/10.1016/j.radi.2007.10.007

Chen XD (2013) An empirical study on the influence of PBL teaching model on critical thinking ability of non-English majors. J PLA Foreign Lang College 36 (04):68–72

Google Scholar  

Cohen A (1992) Antecedents of organizational commitment across occupational groups: a meta-analysis. J Organ Behav. https://doi.org/10.1002/job.4030130602

Cooper H (2010) Research synthesis and meta-analysis: a step-by-step approach, 4th edn. Sage, London, England

Cindy HS (2004) Problem-based learning: what and how do students learn? Educ Psychol Rev 51(1):31–39

Duch BJ, Gron SD, Allen DE (2001) The power of problem-based learning: a practical “how to” for teaching undergraduate courses in any discipline. Stylus Educ Sci 2:190–198

Ennis RH (1989) Critical thinking and subject specificity: clarification and needed research. Educ Res 18(3):4–10. https://doi.org/10.3102/0013189x018003004

Facione PA (1990) Critical thinking: a statement of expert consensus for purposes of educational assessment and instruction. Research findings and recommendations. Eric document reproduction service. https://eric.ed.gov/?id=ed315423

Facione PA, Facione NC (1992) The California Critical Thinking Dispositions Inventory (CCTDI) and the CCTDI test manual. California Academic Press, Millbrae, CA

Forawi SA (2016) Standard-based science education and critical thinking. Think Skills Creat 20:52–62. https://doi.org/10.1016/j.tsc.2016.02.005

Halpern DF (2001) Assessing the effectiveness of critical thinking instruction. J Gen Educ 50(4):270–286. https://doi.org/10.2307/27797889

Hu WP, Liu J (2015) Cultivation of pupils’ thinking ability: a five-year follow-up study. Psychol Behav Res 13(05):648–654. https://doi.org/10.3969/j.issn.1672-0628.2015.05.010

Huber K (2016) Does college teach critical thinking? A meta-analysis. Rev Educ Res 86(2):431–468. https://doi.org/10.3102/0034654315605917

Kek MYCA, Huijser H (2011) The power of problem-based learning in developing critical thinking skills: preparing students for tomorrow’s digital futures in today’s classrooms. High Educ Res Dev 30(3):329–341. https://doi.org/10.1080/07294360.2010.501074

Kuncel NR (2011) Measurement and meaning of critical thinking (Research report for the NRC 21st Century Skills Workshop). National Research Council, Washington, DC

Kyndt E, Raes E, Lismont B, Timmers F, Cascallar E, Dochy F (2013) A meta-analysis of the effects of face-to-face cooperative learning. Do recent studies falsify or verify earlier findings? Educ Res Rev 10(2):133–149. https://doi.org/10.1016/j.edurev.2013.02.002

Leng J, Lu XX (2020) Is critical thinking really teachable?—A meta-analysis based on 79 experimental or quasi experimental studies. Open Educ Res 26(06):110–118. https://doi.org/10.13966/j.cnki.kfjyyj.2020.06.011

Liang YZ, Zhu K, Zhao CL (2017) An empirical study on the depth of interaction promoted by collaborative problem solving learning activities. J E-educ Res 38(10):87–92. https://doi.org/10.13811/j.cnki.eer.2017.10.014

Lipsey M, Wilson D (2001) Practical meta-analysis. International Educational and Professional, London, pp. 92–160

Liu Z, Wu W, Jiang Q (2020) A study on the influence of problem based learning on college students’ critical thinking-based on a meta-analysis of 31 studies. Explor High Educ 03:43–49

Morris SB (2008) Estimating effect sizes from pretest-posttest-control group designs. Organ Res Methods 11(2):364–386. https://doi.org/10.1177/1094428106291059

Article   ADS   Google Scholar  

Mulnix JW (2012) Thinking critically about critical thinking. Educ Philos Theory 44(5):464–479. https://doi.org/10.1111/j.1469-5812.2010.00673.x

Naber J, Wyatt TH (2014) The effect of reflective writing interventions on the critical thinking skills and dispositions of baccalaureate nursing students. Nurse Educ Today 34(1):67–72. https://doi.org/10.1016/j.nedt.2013.04.002

National Research Council (2012) Education for life and work: developing transferable knowledge and skills in the 21st century. The National Academies Press, Washington, DC

Niu L, Behar HLS, Garvan CW (2013) Do instructional interventions influence college students’ critical thinking skills? A meta-analysis. Educ Res Rev 9(12):114–128. https://doi.org/10.1016/j.edurev.2012.12.002

Peng ZM, Deng L (2017) Towards the core of education reform: cultivating critical thinking skills as the core of skills in the 21st century. Res Educ Dev 24:57–63. https://doi.org/10.14121/j.cnki.1008-3855.2017.24.011

Reiser BJ (2004) Scaffolding complex learning: the mechanisms of structuring and problematizing student work. J Learn Sci 13(3):273–304. https://doi.org/10.1207/s15327809jls1303_2

Ruggiero VR (2012) The art of thinking: a guide to critical and creative thought, 4th edn. Harper Collins College Publishers, New York

Schellens T, Valcke M (2006) Fostering knowledge construction in university students through asynchronous discussion groups. Comput Educ 46(4):349–370. https://doi.org/10.1016/j.compedu.2004.07.010

Sendag S, Odabasi HF (2009) Effects of an online problem based learning course on content knowledge acquisition and critical thinking skills. Comput Educ 53(1):132–141. https://doi.org/10.1016/j.compedu.2009.01.008

Sison R (2008) Investigating Pair Programming in a Software Engineering Course in an Asian Setting. 2008 15th Asia-Pacific Software Engineering Conference, pp. 325–331. https://doi.org/10.1109/APSEC.2008.61

Simpson E, Courtney M (2002) Critical thinking in nursing education: literature review. Mary Courtney 8(2):89–98

Stewart L, Tierney J, Burdett S (2006) Do systematic reviews based on individual patient data offer a means of circumventing biases associated with trial publications? Publication bias in meta-analysis. John Wiley and Sons Inc, New York, pp. 261–286

Tiwari A, Lai P, So M, Yuen K (2010) A comparison of the effects of problem-based learning and lecturing on the development of students’ critical thinking. Med Educ 40(6):547–554. https://doi.org/10.1111/j.1365-2929.2006.02481.x

Wood D, Bruner JS, Ross G (2006) The role of tutoring in problem solving. J Child Psychol Psychiatry 17(2):89–100. https://doi.org/10.1111/j.1469-7610.1976.tb00381.x

Wei T, Hong S (2022) The meaning and realization of teachable critical thinking. Educ Theory Practice 10:51–57

Xu EW, Wang W, Wang QX (2022) A meta-analysis of the effectiveness of programming teaching in promoting K-12 students’ computational thinking. Educ Inf Technol. https://doi.org/10.1007/s10639-022-11445-2

Yang YC, Newby T, Bill R (2008) Facilitating interactions through structured web-based bulletin boards: a quasi-experimental study on promoting learners’ critical thinking skills. Comput Educ 50(4):1572–1585. https://doi.org/10.1016/j.compedu.2007.04.006

Yore LD, Pimm D, Tuan HL (2007) The literacy component of mathematical and scientific literacy. Int J Sci Math Educ 5(4):559–589. https://doi.org/10.1007/s10763-007-9089-4

Zhang T, Zhang S, Gao QQ, Wang JH (2022) Research on the development of learners’ critical thinking in online peer review. Audio Visual Educ Res 6:53–60. https://doi.org/10.13811/j.cnki.eer.2022.06.08

Download references

Acknowledgements

This research was supported by the graduate scientific research and innovation project of Xinjiang Uygur Autonomous Region named “Research on in-depth learning of high school information technology courses for the cultivation of computing thinking” (No. XJ2022G190) and the independent innovation fund project for doctoral students of the College of Educational Science of Xinjiang Normal University named “Research on project-based teaching of high school information technology courses from the perspective of discipline core literacy” (No. XJNUJKYA2003).

Author information

Authors and affiliations.

College of Educational Science, Xinjiang Normal University, 830017, Urumqi, Xinjiang, China

Enwei Xu, Wei Wang & Qingxia Wang

You can also search for this author in PubMed   Google Scholar

Corresponding authors

Correspondence to Enwei Xu or Wei Wang .

Ethics declarations

Competing interests.

The authors declare no competing interests.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Additional information.

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Supplementary tables, rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ .

Reprints and permissions

About this article

Cite this article.

Xu, E., Wang, W. & Wang, Q. The effectiveness of collaborative problem solving in promoting students’ critical thinking: A meta-analysis based on empirical literature. Humanit Soc Sci Commun 10 , 16 (2023). https://doi.org/10.1057/s41599-023-01508-1

Download citation

Received : 07 August 2022

Accepted : 04 January 2023

Published : 11 January 2023

DOI : https://doi.org/10.1057/s41599-023-01508-1

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

This article is cited by

Impacts of online collaborative learning on students’ intercultural communication apprehension and intercultural communicative competence.

• Hoa Thi Hoang Chau
• Hung Phu Bui
• Quynh Thi Huong Dinh

Education and Information Technologies (2024)

Exploring the effects of digital technology on deep learning: a meta-analysis

The impacts of computer-supported collaborative learning on students’ critical thinking: a meta-analysis.

• Yoseph Gebrehiwot Tedla
• Hsiu-Ling Chen

Sustainable electricity generation and farm-grid utilization from photovoltaic aquaculture: a bibliometric analysis

• A. A. Amusa
• M. Alhassan

International Journal of Environmental Science and Technology (2024)

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

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.

Is critical thinking useful in writing?

Critical thinking can help in planning your paper and making it more concise, but it's not obvious at first. We carefully pinpointed some the questions you should ask yourself when boosting critical thinking in writing:

• What information should be included?
• Which information resources should the author look to?
• What degree of technical knowledge should the report assume its audience has?
• What is the most effective way to show information?
• How should the report be organized?
• How should it be designed?
• What tone and level of language difficulty should the document have?

Usage of critical thinking comes down not only to the outline of your paper, it also begs the question: How can we use critical thinking solving problems in our writing's topic?

Let's say, you have a Powerpoint on how critical thinking can reduce poverty in the United States. You'll primarily have to define critical thinking for the viewers, as well as use a lot of critical thinking questions and synonyms to get them to be familiar with your methods and start the thinking process behind it.

Are there any services that can help me use more critical thinking?

We understand that it's difficult to learn how to use critical thinking more effectively in just one article, but our service is here to help.

We are a team specializing in writing essays and other assignments for college students and all other types of customers who need a helping hand in its making. We cover a great range of topics, offer perfect quality work, always deliver on time and aim to leave our customers completely satisfied with what they ordered.

The ordering process is fully online, and it goes as follows:

• Select the topic and the deadline of your essay.
• Provide us with any details, requirements, statements that should be emphasized or particular parts of the essay writing process you struggle with.
• Leave the email address, where your completed order will be sent to.
• Select your prefered payment type, sit back and relax!

With lots of experience on the market, professionally degreed essay writers , online 24/7 customer support and incredibly low prices, you won't find a service offering a better deal than ours.