Can One Learn to Think Critically? – A Philosophical Exploration

Abstract

Within nursing, critical thinking is a required skill that educators strive to foster in their students' development for use in complex healthcare settings. Hence the numerous studies published measuring critical thinking as a terminal outcome of education. However, an important comparison between different philosophical underpinnings such as person, truth and the nature of nursing, and how one defines and utilizes critical thinking in practice, has been absent from discussions about critical thinking and learning. When one views critical thinking with varying philosophical lenses, important questions are raised and discussion is expanded. These questions illuminate different perspectives of critical thinking and attempt to explore whether critical thinking can be learned in nursing. The implications of taking a single philosophical viewpoint and a pluralistic approach to understanding critical thinking and learning are explored.

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The Open Nursing Journal, 2011, 5, 45-51 45
1874-4346/11 2011 Bentham Open
Open Access
Can One Learn to Think Critically? – A Philosophical Exploration
Christy Raymond-Seniuk*,1,2 and Joanne Profetto-McGrath1
1University of Alberta, Canada
2Grant MacEwan University, Canada
Abstract: Within nursing, critical thinking is a required skill that educators strive to foster in their students’ development
for use in complex healthcare settings. Hence the numerous studies published measuring critical thinking as a terminal
outcome of education. However, an important comparison between different philosophical underpinnings such as person,
truth and the nature of nursing, and how one defines and utilizes critical thinking in practice, has been absent from
discussions about critical thinking and learning. When one views critical thinking with varying philosophical lenses,
important questions are raised and discussion is expanded. These questions illuminate different perspectives of critical
thinking and attempt to explore whether critical thinking can be learned in nursing. The implications of taking a single
philosophical viewpoint and a pluralistic approach to understanding critical thinking and learning are explored.
Keywords: Critical thinking, learning, nursing, nursing education, philosophy.
Critical thinking in nursing is complex and described by
a mosaic of different definitions. These various definitions
have led to confusion about what critical thinking entails [1].
In nursing education, critical thinking is a key objective
and/or desired outcome for almost every nursing course and
is an aspect of knowledge-based nursing practice evident in
Canadian provincial standards [2]. A strong emphasis on the
need to develop critical thinking is evident in nursing
education despite the lack of an agreed upon definition to
guide teaching practice. The variety of critical thinking
definitions has also made measurement of students’ critical
thinking more difficult [3]. To this end, research has been
inconclusive as to whether critical thinking results from
nursing educational experiences and has called into question
whether critical thinking can be learned [4]. Due to the
presence of inconclusive literature, a different approach to
conceptualizing critical thinking is warranted. Many
literature reviews have examined critical thinking and the
related definitions and measurement, however none have
offered a new lens from which to view similar conclusions
[5, 6]. More specifically, the philosophical underpinnings
upon which critical thinking is based should be explored to
determine whether critical thinking is a result of nursing
education. By using a philosophical inquiry approach, how
critical thinking is conceptualized and operationalized in
nursing education can be more thoroughly examined.
In this article, we offer a discussion related to the
philosophical issue of whether nursing students can learn to
think critically. Prompting the need for this exploration was
a review of the critical thinking literature in nursing. Articles
written in English and published from 2000-2010 focusing
on critical thinking in nursing were examined. From those
articles, the issues of defining and measuring critical
thinking in nursing education were evident. Seminal works
that contribute to a definition of critical thinking were
*Address correspondence to this author at the University of Alberta,
Canada; Tel: 780-497-5714; E-mail: craymond@ualberta.ca
included, as well as articles more specifically related to
measurement of critical thinking in nursing education.
Narrative articles were also incorporated to represent the
current perspectives on critical thinking in a nursing context.
Limits to the literature reviewed for this paper include the
exclusion of non-English written articles, anecdotal articles
describing methods to enhance critical thinking in nursing,
critical thinking research articles outside nursing, and other
formats of literature including dissertations and unpublished
works. This paper is meant as a starting point to spark
additional discourse examining concepts, such as critical
thinking, using a philosophical approach.
We begin this discussion with a brief overview of what is
known about critical thinking in nursing education, more
specifically the definitions available in nursing and the
predominant results from measurement efforts. Given the
more general nature of the nursing education critical thinking
literature, a philosophical look at the feasibility of learning
critical thinking in nursing is then offered. Using the broader
philosophical perspectives of person, knowledge, truth and
the nature of nursing, various positions outlining whether a
nursing based definition of critical thinking is compatible
with learning, are analyzed and discussed. We conclude with
suggestions as to how the discipline should proceed, and the
potential implications of not examining the philosophical
implications associated with learning critical thinking in
nursing.
OVERVIEW OF CRITICAL THINKING: DEFINITIONS
AND MEASUREMENT IN NURSING EDUCATION
The multiple definitions of critical thinking highlight
various interpretations of what ‘thinking critically’ is
believed to be. These definitions also vary depending on the
discipline. For example, the most cited non-nursing critical
thinking definitions evident in the literature are those by
Facione [7], Brookfield [8], and Paul [9]. Scheffer and
Rubenfeld [10], and Alfaro-Lefevre [11] offer the most
commonly cited nursing specific critical thinking definitions

46 The Open Nursing Journal, 2011, Volume 5 Raymond-Seniuk and Profetto-McGrath
in published literature. Each are included and discussed
below.
Facione’s [7] critical thinking definition emerged from
his work with the American Philosophical Association
(APA), which led to the creation of the Delphi consensus
statement. This definition states:
We understand critical thinking to be purposeful, self-
regulatory judgment that results in interpretation, analysis,
evaluation, and inference, as well as explanation of the
evidential, conceptual, methodological, criteriological, or
contextual considerations upon which that judgment is
based… The ideal critical thinker is habitually inquisitive,
well-informed, trustful of reason, open-minded, flexible,
fair-minded in evaluation, honest in facing personal biases,
prudent in making judgments, willing to reconsider, clear
about issues, orderly in complex matters, diligent in seeking
relevant information, reasonable in the selection of criteria,
focused in inquiry, and persistent in seeking results which
are as precise as the subject and the circumstances of inquiry
permit (p. 4).
Facione’s critical thinking definition includes both skills
and dispositions and served as the basis for the development
of the California Critical Thinking Skills Test (CCTST) and
the California Critical Thinking Disposition Inventory
(CCTDI). Bo th tools are commonly used to measure critical
thinking in various populations, including nursing students
and educators.
Brookfield [8] is also cited for his definition and
description of critical thinking. It includes: a) identifying and
challenging assumptions; b) challenging the importance of
context; c) imagining and exploring alternatives; and d)
engaging in reflective skepticism. These components
illustrate Brookfield’s view of critical thinking as a process
with both emotive and rational aspects. Similar to
Brookfield, Dewey [12] asserted that reflection resulted from
some disbelief in thought. The dissonance in one’s thinking
then triggers a careful consideration of one’s beliefs in order
to re-establish beliefs based on knowledge. Similarly,
Brookfield identified that reflective skepticism is initiated by
imaging and exploring alternatives to problems and
situations.
Another critical thinking definition frequently cited in the
literature is by Paul [9]. Similar to Facione [7], Paul defines
critical thinking including cognitive aspects, more
specifically perfections of thought. Paul stated:
Critical thinking is self-disciplined, self-directed thinking
that exemplifies the perfections of thinking appropriate to a
particular mode or domain of thought. It comes in two forms.
If disciplined to serve the interests of a particular individual
or group, to the exclusion of other relevant persons and
groups, it is sophistic or weak-sense critical thinking. If
disciplined to take into account the interests of diverse
persons or groups, it is fair-minded or strong-sense critical
thinking (p. 10).
The definitions by Facione [7], Brookfield [8], and Paul
[9] are non-nursing definitions. Scheffer and Rubenfeld [10]
also used a Delphi technique to generate a nursing based
definition of critical thinking. This definition will be used as
a reference point for this discussion and it states:
Critical thinking in nursing is an essential component of
professional accountability and quality nursing care. Critical
thinkers exhibit these habits of mind: confidence, contextual
perspective, creativity, flexibility, inquisitiveness, intellect-
ual integrity, intuition, open-mindedness, perseverance, and
reflection. Critical thinkers in nursing practice the cognitive
skills of analyzing, applying standards, discriminating,
information seeking, logical reasoning, predicting and
transforming knowledge (p.357).
The above definition by Scheffer and Rubenfeld [10]
situates critical thinking as an integral part of nursing
practice and asserts that both skills and dispositions are
required by nurses to think critically. The obvious difference
in this definition is the emphasis on intuition, contextual
perspective, and creativity as part of how critical thinking is
defined in nursing. These more feminine concepts highlight
the difference between definitions created from within
nursing compared to those more cognitively emphasized and
created from outside nursing.
Another nursing definition frequently cited in critical
thinking literature is authored by Alfaro-Lefevre [11]. She
stated:
Critical thinking and clinical judgment in nursing is: a)
purposeful, informed, outcome-focused (results oriented)
thinking, b) carefully identifies key problems, issues and
risks, c) is based on principles of nursing process, problem
solving and the scientific method, d) applies logic, intuition,
and creativity, e) is driven by patient, family, and community
needs, f) calls for strategies that make the most of the human
potential and, g) requires constant reevaluating self-
correcting, and striving to improve (p. 7). This definition
offers a comprehensive description of elements comprising
critical thinking from a nursing perspective. It is evident that
Alfaro-Lefevre infers a strong link between critical thinking
and clinical judgment, which is not evident in other
definitions.
Given the various definitions and perspectives, critical
thinking is not consistently defined [3, 1] and is “not one,
monolithic thing” [13, p. 216]. Therefore, the diversity of
critical thinking definitions and perspectives is
understandable, yet remains problematic for some [14]. Not
having a clear conceptualization of what it means to think
critically within or outside of nursing is challenging and
requires reexamination why and how critical thinking is
being operationalized within the discipline.
In nursing critical thinking is often employed as a goal of
education, to promote quality nursing care, and positive
patient outcomes. Interestingly, the application of this
concept as a desirable educational outcome was determined
by educational institutions and the academic community to
ensure nursing graduates and practicing nurses have the
necessary ‘skills’ to deal with the acuity and complex nature
of nursing practice. Moreover, critical thinking is mainly
conceived as a cognitive process to assist nurses in managing
their expanding knowledge base and to foster the application
of knowledge into practice [5]. However, the underlying
philosophical implications of critical thinking and whether it
can be learned as a cognitive skill or otherwise, has not been
explored or discussed in recent literature.

Critical Thinking The Open Nursing Journal, 2011, Volume 5 47
The predominantly cognitive nature of critical thinking
definitions, such as those proposed by Facione [7] and Paul
[9] are evident. More specifically, a chiasm of difference has
been created between the more cognitive definitions and
those definitions emphasizing more feminine aspects, such
as those emanating from nursing. For example, critical
thinking has been equated with reflection, problem solving,
decision-making, clinical judgment and practical reasoning
in nursing [15], whereas others believe that critical thinking
is a set of more defined thinking skills such as analysis,
evaluation, inference, as well as inductive and deductive
reasoning [7]. As a result, it appears many authors use
critical thinking as a blanket statement to capture its fluid
and non-linear nature.
Looking at our reference definition for this discussion,
the components of the critical thinking definition offered by
Scheffer and Rubenfeld [10] are inclusive of both skills and
dispositions. The generalizability of these skills and
dispositions; that is, can critical thinking skills and
dispositions be transferred to different contexts, is not clear.
Generally there is no consensus as to whether critical
thinking is contextually specific to nursing. Forneris [16]
describes how different philosophers address context but
limited discussion occurs whether critical thinking is
transferable. Based on Scheffer and Rubenfeld’s definition,
critical thinking will manifest differently in varying
situations and contexts, which makes the task of
conceptualizing and operationalizing critical thinking more
difficult. In addition to various definitive aspects of critical
thinking, the varying philosophical beliefs concerning the
nature of the individual responsible for the thinking process
also impacts whether one believes critical thinking can be
learned. Yet without a fundamental discipline specific
definition of critical thinking, it is difficult to measure
educational outcomes.
Another problematic aspect of trying to clearly
understand critical thinking and its place in nursing
education results from attempts to measure it. Measuremen t
of critical thinking in nursing has yielded inconclusive
findings. For example, some studies identify significant
increases in students’ critical thinking following the
completion of a nursing education program [17-21]. Yet,
other studies reported insignificant increases in critical
thinking and unexplained decreases that occurred at certain
points in students’ nursing programs [22-26]. These
contradictory findings require further exploration and
understanding to better design and complete future research
in this area.
A clear link between nursing education and critical
thinking has not been established despite prominent calls for
the necessity of critical thinking in nurses and the proof of
critically thinking graduates. Ferguson and Day [27] purport
that many scholars believe critical thinking is not necessarily
a direct outcome of nursing education. Inconsistent and
mixed results are evident in many studies examining the
critical thinking skills and abilities of students at various
points in their nursing education programs. This
inconsistency speaks to the need for additional exploration
into critical thinking as an outcome of nursing education
programs and the potential creation of a nursing specific
critical thinking measure [1, 4, 26]. There has been no
nursing specific critical thinking measure created to date and
given the varied nature of definitions and measurement
results, a deeper examination of critical thinking from
various perspectives is warranted. By using the concepts of
person, truth and nature of nursing, the potential of learning
critical thinking is investigated.
THE CONCEPT OF PERSON AND CRI TICAL
THINKIN G
Critical thinking is usually associated with skills and
abilities demonstrated at the individual level. As individuals
we are unique in personalities and abilities. One
philosophical perspective purports that man is a rational and
autonomous being [28]. However, it would appear that what
makes us similar and different is at the heart of whether one
can learn to think critically. More specifically, if individuals
are similar, then some aspects of the processes of thinking
critically must be similar in order to clearly identify and
label such skills and dispositions found in general
definitions. These similarities provide a common foundation
from which core thinking skills can be defined, taught and
hopefully measured. Conversely, the differences in each
individual showcase the autonomous and personal nature of
applying critical thinking skills in various contexts. Critical
thinking may in fact be the application of common cognitive
abilities in tandem with each individual’s own adaptation
and application. We therefore propose that it is through
understanding both similarities and differences between
individuals that students’ critical thinking can be fostered.
Different philosophical perspectives on the nature of being
offer an interesting starting point to understand whether
critical thinking can be learned.
From a reductionist perspective, humans are essentially
similar biological beings with brain power regulated by
chemicals. Cognitive activity is supported by evidence and
as human beings we have more similarities than differences.
However, any differences are usually explained by physical
changes and validated by science. The assumptions
underlying a reductionist perspective on being are that
science explains all intellectual activity by reducing each
step to a simple, empirically proven brain state [29]. Overall,
a reductionist perspective is not compatible with the
definition of critical thinking offered by Scheffer and
Rubenfeld [10]. More specifically there is a lack of
consideration for individuals’ non-physical attributes in
reductionism that does not resonate with a nursing definition
of critical thinking. Furthermore, a reductionist viewpoint
does not account for the relational properties human beings
exhibit within a larger social context. Although some
cognitive processes, such as logic and rational thought can
be explained by scientific evidence, the main essence of
individuality related critical thinking and the reliance on the
specific context of nursing is not explained through
reductionist principles. Moreover, a linear scientific
viewpoint fails to consider the critical thinking process and
the overall goals of nursing. One could not learn anything
contextually based or meaning driven (part of thinking
critically in nursing) if critical thinking was viewed using
this perspective. Although learning of cognitive behavioral
skills would be feasible using a reductionist lens, it is unclear
whether the less tangible critical thinking skills and

48 The Open Nursing Journal, 2011, Volume 5 Raymond-Seniuk and Profetto-McGrath
dispositions could be learned or even valued from this
perspective.
Another perspective on ‘person’ is based on the work of
Merleau-Ponty and follows a dualistic approach. Dualism
espouses that mind and body are seamlessly connected and
that sensory perceptions and motor skills are inseparable
[29]. The unified being would then focus on the relationship
between oneself and the world, ultimately becoming part of
that environment. From a dualistic perspective, each human
being experiences the world differently, without similarities
to other individuals. Critical thinking in nursing, as defined
by Scheffer and Rubenfeld [10], appears incongruent with
this perspective. The main reason for this incongruency is
the dualistic tendency to focus on one individual’s
experiences without considering similarities of those
experiences to other individuals. Since critical thinking as
defined by Scheffer and Rubenfeld predicts and transforms
knowledge as one aspect of quality nursing care, it is
suggestive of a relational process. Critical thinking based on
a dualistic perspective would be so personalized that the
overall goal of nursing, doing good for others, would be lost.
Individuals could not learn critical thinking from this
perspective because they might not consider undertaking
similar processes and actions not driven from their own
interpretation.
An alternate viewpoint is that of the dependent concept
of person where mental and physical states are thought to be
closely linked but not inseparable. From this perspective
thinking relies on a person’s physical state but would not be
driven by it [29]. As well, this perspective allows for feeling s
in addition to brain states to be involved in thinking, through
the link with the physical world. The main principle of the
dependent position focuses on the cognitive realm being
related to the physical self and the physical world. Although
it does not specifically say how the mind and body are
linked, this perspective allows for mind and body to be
somewhat independent from each other where neither the
mind nor body can claim full control of one’s actions. This
perspective embraces the role of self, inclusive of similar
physical attributes and unique mental states. Within the
nursing context, individuals from this perspective would be
able to learn critical thinking through similar cognitive
processes as others, with a unique application that would
celebrate individual differences. Scheffer and Rubenfeld’s
[10] definition of critical thinking further supports an
independent conceptualization of ‘being’ by emphasizing
individual introspection alongside application of common
standards to one’s thinking. These are evident in the included
definitive elements of reflection and intellectual standards
such as those found in Paul’s [9] critical thinking definition.
KNOWLEDGE, TRUTH, AND CRITICAL THINKING
Whenever an individual thinks, it is undoubtedly about
something. It is this ‘something’ that is important in the
domain of critical thinking in nursing. How one attains and
applies knowledge to one’s nursing practice involves critical
thinking. As well, how one views truth is an important piece
in how knowledge is utilized when thinking critically. In
order to better understand how knowledge and critical
thinking impact whether one can learn to think critically, the
received and perceived viewpoints are comp ared to Sch effer
and Rubenfeld’s [10] critical thinking definition.
Based on a received viewpoint of knowledge,
information is solely obtained through deductive methods
that verify propositions through scientific means and deem
valuable facts empirically proven [30]. This viewpoint
assumes a general stance that knowledge is value free,
objective and quantifiable. From the correspondence
perspective of truth, knowledge is proven and justifiable
until it is contested and falsified [30]. This view of the Truth
(big T versus small t) is based on one objective and removed
reality - the pursuit of one universal Truth.
When comparing a nursing critical thinking [10]
definition to the received viewpoint, some aspects related to
making rational, operational and sound judgments resonate
between them. However, the overall complexities in the
world of nursing would not be compatible with the
unbending nature of knowledge and Truth associated with
the received or correspondence viewpoint. Thus, although
individuals might be able to learn structured and logical
thinking based on empirical knowledge, incorporating
values, human situations, and personal feelings into one’s
thinking would not be supported by those in the received or
correspondence camp. Seymour, Kinn, and Sutherland [31]
argued against adopting a received or correspondence
perspective as it would narrow the reasoning strategies one
could use in critical thinking and limit the overall goal of
engaging in thinking for mere truth versus understanding. If
one adopts a received or correspondence perspective, the
important personal attributes and necessary context to
critically think in nursing would be rendered unimportant.
Based on these viewpoints of knowledge and truth, there
would be no room for an individual to learn to think
critically as these perspectives do not align with the more
feminine skills and dispositions of critical thinking as
defined in nursing. If one believes that truth emanates from a
variety of sources and ways of knowing in nursing, these
philosophical perspectives would not foster the growth of
individuals’ critical thinking since it only supports an
empirically driven reality.
The perceived view acknowledges a value laden nature
of understanding and supports knowing from multiple
means. The perceived view highlights the individual nature
of knowledge construction and emphasizes the need for
subjective, intuitive, human factors in both theoretical and
practical knowledge [30]. Similar to this viewpoint is the
pragmatic perspective on truth, and the existence of probable
truths in nursing. This viewpoint is open to numerous
understandings and thus various origins of what constitutes
truth. The goal of this perspective on truth is to not rely on
evidence as defined in the correspondence view, but to
examine observations and to respect the humanity,
subjectivity, and usefulness of claims [30]. The perceived
and pragmatic perspectives on knowledge and truth are
congruent with the multiple ways of knowing represented by
a nursing based definition of critical thinking. Based on the
critical thinking definition provided by Scheffer and
Rubenfeld [10], the personal traits of critical thinking
include intuition as do the perceived and pragmatic
viewpoints. The main goal of the perceived view for
knowledge and the pragmatic view on truth is understanding,

Critical Thinking The Open Nursing Journal, 2011, Volume 5 49
which also resonates and corresponds with the goals of
critical thinking in a nursing context. Although critical
thinking involves inductive reasoning, it also involves
deduction as evident in the received viewpo int. Thus the full
cognitive complement of skills that are involved in critical
thinking is not necessarily captured entirely with the
perceived and pragmatic perspectives.
THE NATURE OF NURSING AND CRITICAL
THINKIN G
Another important aspect of this debate is how one views
the nature of nursing and whether a certain perspective
supports critical thinking and is conducive to the facilitation
of critical thinking in nursing. Thus far we have discussed
the viewpoints on how one might view the concept of
person, knowledge and truth. The concept of the nature of
nursing offers a macro layer to this discussion, where the
overall essence of nursing is brought into the equation.
Is nursing a science, an art, both or none? Nursing is
constantly evolving and increasing in complexity. One
perspective is that nursing is a science. Johnson [32]
categorized nursing from a science perspective and discussed
three distinct sub-types: basic, applied or practical. The basic
science view supports the attainment of knowledge and
Truth as the main goal of nursing [32]. This view does not
address the means for obtaining this knowledge but relies
solely on description and explanation to make
generalizations about nursing. Applied science supports the
integration of other disciplinary knowledge into nursing
through a resynthesis process [32]. Nursing integrates
knowledge from other disciplines to achieve pragmatic
outcomes and to develop a more rich and diverse knowledge
base. Nursing as an applied science does not foster nursing
built solely from knowledge created from within the
discipline but supports the ongoing development of nursing
knowledge through contributions from other disciplines.
Nursing as a practical science embraces truths as a means to
an end goal of helping others and doing good. This practical
perspective aligns science with art in nursing and uses
practical knowledge to presuppose theoretical knowledge
[32].
Based on Scheffer and Rubenfeld’s [10] critical thinking
definition, conceptualizing nursing as a practical science is
congruent with the application of scientific and theoretical
knowledge to foster the understanding and quality care of
individuals within practice. The practical science viewpoint
offers the same goal of using critical thinking to integrate
truths, which achieve higher order outcomes of quality care.
Many would argue that choosing not to use scientifically-
based knowledge created to enhance what is known about
the world, is immoral and could ultimately cause harm to
patients if ignored. Shared principles of analysis, purposeful
application, reasoning and action based on principles are
evident in both critical thinking and nursing as a practical
science. Thus, the learning of critical thinking in a practical
nursing context is justifiable and possible due to the
congruence of principles and goals. In this sense, students
learn to employ theoretical knowledge through critical
thinking to meet pragmatic outcomes.
Another perspective supposes that nursing is an art. From
this persp ective, nursing is more than just the application of
science and objective facts. It is the ability to nurse in an
artful manner that more specifically encompasses what
Johnson [33] regarded as the ability to grasp meaning,
establish meaningful connections, skillfully perform nursing
activities, rationally determine an applicable course of
action, and morally conduct his or her nursing practice (p.1).
Johnson [33] suggested that there is no consensus whether
one’s thinking is part of the art of nursing however discussed
the importance of intellectual activity in the performance of
nursing care. The importance or irrelevance of thinking as
artful practice is not addressed in many philosophical pieces
of literature despite many authors’ focus on how knowledge
is transferred, gained, applied and questioned [33, 34]. From
an artful perspective, nursing can be learned in the practice
setting and consists of behaviors and intellectual activities
that draw upon nursing knowledge applied in a practical
sense. Scientific knowledge plays a part in nursing as an art
and is used as the antecedent to action [33]. Artful nursing
actions are not considered automatic but are more grounded
in intellectualism and judged by certain established standards
[33]. If nursing is considered an art, nurses’ personal traits
include intuition, esthetic knowing, sensitivity, and an ability
to use past experiences to understand situations would
impact how that practice is enacted. In this sense, the nature
of nursing as an art is a very fertile ground from which those
who think critically can grow. This perspective also supports
the view that individuals could learn something as elusive as
critical thinking as it mirrors the ambiguity and complexity
of an artful nursing environment.
IMPLICATION FOR THE DISCIPLINE
A discipline can be defined as a branch of knowledge,
education or learning that evolves from creative thinking
about pertinent issues [35]. The discourse surrounding
critical thinking in nursing education is necessary to advance
the discipline through questioning and scholarly discussions.
By asking and attempting to answer critical questions about
critical thinking within the context of nursing, nursing’s
knowledge base develops and theoretical operationalizations
can be explored and tested. To generate and foster the
application of nursing knowledge in practice, critical
thinking is a necessary skill. As the discipline evolves
alongside societal needs, the complexity of health care,
increased use of technology, and increased patient acuity
requires nurses with well-developed critical thinking. In turn,
this requires educational nursing institutions to ensure that its
graduates have these higher order thinking skills in order to
provide quality patient care and to further the application and
questioning of important philosophical issues such as critical
thinking within the discipline. Further discussion about
whether students can learn critical thinking is at the crux of
whether nursing as a discipline should focus on this concept
as a valuable and viable outcome in nursing education. We
believe, as do others, that critical thinking can be learned to a
certain point and that fostering this skill should remain an
important aim in nursing education [5, 16, 31].
It is evident that multiple views exist related to whether
critical thinking can be learned in nursing. Not all available
views have been discussed in this paper. However, based on
the discussions focused on the concepts of person,
knowledge, truth and the nature of nursing, we believe some
are more aligned with supporting, fostering, and developing

50 The Open Nursing Journal, 2011, Volume 5 Raymond-Seniuk and Profetto-McGrath
critical thinking. It is suggested that the discipline should
support a pluralistic approach to explain and welcome a
variety of perspectives on critical thinking. As situational
contexts vary and the nature of nursing varies dependent on
the context, critical thinking can transcend these differences
and assume a variety of different forms to best suit the
situation. We believe that one perspective alone cannot
possibly explain and support critical thinking in nursing.
Thus the use of pluralism or multiple lenses and perspective
is necessary to capture the depth and breadth of the
knowledge and essence of what constitutes nursing.
Guiliano, Tyer-Voila and Lopez [36] support pluralism and
multiple ways of knowing, which translates into supporting
unity versus diversity of knowledge. Given the complexity
and diversity of nursing, it is feasible and realistic that the
philosophical perspectives within nursing are also complex
and diverse [37]. Multiple perspectives would more
effectively capture the various aspects of critical thinking
and could help explain the concept, its principles, and how
critical thinking is learned by students.
LOOKING FORWARD
Whether or not critical thinking can be learned is a
difficult topic to philosophically debate. However, this paper
has attempted to add to the discussion surrounding this
subject and foster a critical spirit of discourse. This issue
cannot be solved without further scholarly exploration to
uncover and understand the various facets of critical
thinking, beginning with a solid conceptual analysis of
critical thinking in the literature. Without further attention
and questioning, the very vagueness that is thought to plague
many definitions of critical thinking and critical thinking
research attempting to measure outcomes, will continue to
grow and lead to ambivalent operationalization of critical
thinking in nursing. This could affect our ability to measure
and gauge potential progress and perpetuate the use of the
term ‘critical thinking’ without the necessary knowledge
behind it for meaningful application. Although one could
advocate for a pluralistic approach to explain the
multifaceted nature of critical thinking and its many
applications in a nursing context, there are drawbacks to
treading this path as well. By not examining specific
perspectives further and not analyzing why some
perspectives are better suited to the current definition and
application of critical thinking, one becomes complacent in
accepting that everything has multiple meanings and
viewpoints. This perspective can fragment the nursing
profession and discipline by raising more questions than
answers. Moreover, it would cause confusion among
educators and nurses by continuing to use an elusive concept
without truly knowing whether it fits within the nursing
context. Thus, if we decide to adopt a pluralistic approach,
we should do so with caution and with the intent to foster
scholarly discussion versus agreeing to disagree without
thought. A further incentive for nursing to take a closer look
at critical thinking is that much of the literature currently
used in nursing derives from other disciplines. More needs to
be known about critical thinking in nursing and more
specifically how students learn this important skill and its
associated attributes.
The goal of this initial philosophical exploration was to
further understand critical thinking and the implications of
exploring it using different philosophical perspectives. If the
discussion ends here we are no further along from where we
started. There needs to be additional scholarly attempts to
understand critical thinking within nursing by comparing it
to various philosophical concepts and previous under-
standing. By exploring critical thinking philosophically,
multiple ways of understanding this important concept are
illuminated to better inform whether we th ink critical
thinking can be learned in nursing education.
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Received: January 10, 2011 Revised: May 18, 2011 Accepted: May 19, 2011
© Raymond-Seniuk and Profetto-McGrath; Licensee Bentham Open.
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