(^16) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
patient care, critical thinking supplies the necessary skills and cognitive habits
needed to support EBP (Profetto-McGrath, 2005).
This chapter describes the knowledge and skills needed to foster critical thinking.
The objectives are to describe:
■■ The similarities among the nursing process, critical thinking, and EBP
■■ The differences among critical thinking, reasoning, reflection, and judg-
ment
■■ The way these skills influence evidence appraisal and decisions about ap-
plying evidence to practice
■■ The role of critical thinking in the Practice question, Evidence, and Trans-
lation (PET) process
Nursing Process, Critical Thinking, and Evidence-Based
Practice
The American Nurses Association (ANA) publication Nursing: Scope and
Standards of Practice (2004) references each step of the nursing process, from
collection of comprehensive data pertinent to the patient’s health or illness
through evaluation of the outcomes of planned interventions. It also references
integration of the best available evidence, including research findings, to guide
practice decisions.
The similarity between EBP and the nursing process is evident: Both are problem-
solving strategies. The nursing process structures practice through the following
problem-solving stages: assessment, diagnosis, outcome identification, planning,
intervention, and evaluation. Although critical thinking is generally considered
inherent in the nursing process, this has not been empirically demonstrated (Fesler-
Birch, 2005). Nevertheless, the nursing process does require certain skills that are
also necessary for critical thinking, such as seeking information and synthesizing
it (assessment), drawing conclusions from available information (diagnosis), and
transforming knowledge into a plan of action (planning). However, the concept of
critical thinking extends beyond this well-defined process.