Hypocognition and evidence-based medicine

The Safe Care Framework™: A practical tool for critical thinking

Safe, effective and ethical clinical decision-making in nursing depends on critical thinking, yet there is no consensus on the educational strategies that are most effective in developing and refining this foundational skill. A qualitative inquiry among graduating Bachelor of Science in Nursing students sought to determine whether one such educational strategy, an operationalized critical thinking framework, would assist nursing students to better understand acute care patients' complex profiles. The Safe Care Framework™, consisting of the 'Concept Map Template' and the 'Priority Setting Tool Template', was developed using a constructivist pedagogical approach. The framework illustrates and operationalizes the systematic critical thinking processes that expert nurses use to provide safe, comprehensive care. Thematic analysis of qualitative survey results revealed the following three main themes; (1) greater organization and understanding of patient data; (2) guiding of assessments and priorities of care; (3) better communication with others, and several subthemes. Thus, the Safe Care Framework™ may be a practical operational tool that can support novice nurses in developing critical thinking skills. This framework adds to the literature on innovative pedagogy for nurse educators.

Interpreting a randomized trial report: evidence-based practice for the clinician

The purpose of this article is to present a structured approach to help the reader with the objective interpretation of published randomized clinical trials. This process will promote an organized and critical appraisal of scientific evidence, which we believe to be an essential step prior to the introduction of published scientific findings into clinical practice. The reason to personally scrutinize and critically assess published reports is that the process of peer review is by no means perfect and methodological flaws can be uncovered, even in articles published in prestigious journals. The article elaborates on the substance of the consolidated standards of reporting trials (CONSORT) statements intended to facilitate the complete reporting of trials and aid in their critical assessment. The structure of the CONSORT guidelines was used as a basis for specific commentary, including cautions for the clinical interpretation, implications and impact of published randomized trial reports.