Perioperative Nursesʼ Ability to Think Critically

Abstract

The purpose of this quantitative descriptive correlational study was to assess for presence and degree of critical thinking skills among perioperative (OR) nurses. Critical thinking has become a multidisciplinary "buzz phrase"; however, critical thinking, reflective thinking, or mental discipline was discussed among educators, as early as 1912. As nurses' roles change in response to the dynamics of managed care and an increase in use of biotechnology in health care, more is expected of nurses in terms of both psychomotor and cognitive skills. Thus, critical thinking may be central to nurses' ability to meet the care expectations of patients and the skill expectations of managers, peers, and themselves. Data collected from 1 university-affiliated medical center, 1 non-university-affiliated medical center, and 3 ambulatory surgicenters. Data were collected over a 12-month period from 2008 to 2009. Convenience sample of 92 OR nurses. The sample comprised nurses with various educational levels for entry into practice: diploma, associate, and bachelor of science in nursing degrees. Subjects' clinical experience ranged from 1 month to 40 years. Administered California Critical Thinking Disposition Inventory; Assessment of Critical Thinking Skills of Perioperative Nurses, an investigator-developed tool; and a demographic survey. Descriptive statistics, multiple regression, and step-wise regression were performed; power of 80% with a medium effect size was calculated. Aggregate (N = 92) for the dependent variable (level of critical thinking)and predictor variables (dispositions) were not significant. The group (medical center 1) indicated that as the level of critical thinking increased, the level of truth increased. Also, as the level of critical thinking increased, the level of open-mindedness decreased. In groups 2, 4, and 5 (surgicenters) coefficient indicated that none of the predictors were significant. A stepwise regression was calculated for group 3 (medical center 2) to find the best predictor model. As the level of critical thinking decreased, open-mindedness increased. Critical thinking skill may be related to organizational culture, geography, and/or specialization. Specialization competencies may act as barriers to the development of critical thinking skills. This could be highly detrimental to the anticipation of significant negative patient outcomes within an OR setting.