2 Critical Thinking and Evidence-Based Practice 21
Nursing Expertise, Intellectual Competence, and
Evidence-Based Practice
In her landmark book From Novice to Expert: Excellence and Power in Clini-
cal Nursing Practice, Benner (2001) models the stages of development of clinical
expertise in nurses. Progressing from novice to expert, nurses learn to link techni-
cal expertise with intuitive expertise. That is, to manage patient-care situations,
nurses refine their critical thinking skills to integrate experience with acquired
knowledge.
Nursing, in particular, requires specific cognitive skills for excellence in practice;
developing these is an essential aspect of their nursing education (Taylor-Seehafer,
Abel, Tyler, & Sonstein, 2004). Cognitive skills include:
■■ Divergent thinking: Analyzing a variety of opinions
■■ Reasoning: Differentiating between fact and conjecture
■■ Reflection: Deliberating and identifying multidimensional processes
■■ Creativity: Considering multiple solutions
■■ Clarification: Noting similarities, differences, and assumptions
■■ Basic support: Evaluating credibility of sources of information
Beyond the requisite nursing knowledge and skills, practitioners must have the
necessary attitudes, attributes, and habits of mind to use this knowledge appro-
priately and to complement these skills effectively (Profetto-McGrath, 2005).
One approach to defining these dispositions is based on the proposition that
certain intellectual virtues are valuable to the critical thinker (Foundation for
Critical Thinking, 1996). In another approach, habits of the mind are identi-
fied as exhibited by critical thinkers (Scheffer & Rubenfeld, 2000). These two
complementary disposition sets are outlined in Table 2.2. When participating in
EBP projects, the team members should be aware of these intellectual virtues and
habits to avoid the pitfalls of vague, fragmented, or closed-minded thinking.
