2 Critical Thinking and Evidence-Based Practice 23
those requiring immediate action (Greenwood, Sullivan, Spence, & McDonald,
2000). Furthermore, the ability to think critically is an essential competency for
EBP teams when evaluating the cumulative body of evidence for its potential ap-
plicability to particular patient-care situations.
Educators can use diverse approaches to structure orientation and training for
newly hired nurses, whether experienced or newly graduated. Multiple orienta-
tion models can be found in the literature. Educators using the Benner novice-
to-expert model may ask: “At what stage would teaching critical thinking and
the importance of evidence-based practice be appropriate?” and “When would
introducing such skills yield results and benefits for the new nurse/orientee?”
The literature suggests that teaching critical thinking and acquiring these skills is
best done following the novice stage of development because in the novice stage,
nurses are still mastering tasks and procedures. Analysis and reflection, which
are critical thinking skills needed for EBP, develop with experience. Other criti-
cal thinking skills, however, may increase inquisitiveness, questioning of practice,
and inquiry into the best way to apply new knowledge. Encouraging nurses to
ask questions allows them to approach their day-to-day care with a clear under-
standing and a view to improvement.
Critical Thinking and the PET Process
Applying evidence in practice requires a number of steps. The role of critical
thinking in each phase of the PET process is described in this section.
Critical Thinking in Posing the Practice Question
In the PET process, the EBP team first defines the scope of the problem by con-
sidering the entire situation, including the background and environment relevant
to the phenomenon of interest. During this activity, interprofessional team mem-
bers apply intellectual habits such as confidence, creativity, flexibility, inquisitive-
ness, intellectual integrity, and open-mindedness. Posing an answerable practice
question determines what information to seek and which direction to search.
Creating a well-built question often can be more challenging than actually an-
swering the question (Stillwell, Fineout-Overholt, Melnyk, & Williamson, 2010).
