I will respond to how I am interpreting to the (cor)relation between critical thinking (CT) and perception of competence among nurses. A nurse with the ability to use CT and show that ability comes across as competent because s/he will quickly and almost simultaneously (not necessarily sequentially) have a differential diagnosis-type approach to problem-solving. S/he may do this in the past (in trying to discern what caused the patient's problem), the present (what is currently causing the patient's problem), and the future (what complications may arise).

You might see/hear this nurse only approach a few possibilities but if asked, s/he will immediately come up why these are plausible and others were thrown out. S/he will also listen and be open to other thoughts without being threatened by them, which adds to the perception of competence rather than depleting it.

The use of patterns and/or trajectories reflect CT in the realm of physiology in nursing in critical care, for instance, and the nurse who uses those with ease is often perceived as competent by her/his colleagues.

Thank you for your answer Ms/ Mary

I have another perspective on the difference between Critical Thinking and Perceived competence.

Critical thinking requires being able to identify positive outcome goals and then anticipate treatment affects that will achieve those goals. Positive outcomes are the goal in any care setting. Perceived competence could be as simple as getting through a shift with all tasks completed and may or may not contribute to positive out come of the patient. Critical thinking is outcome driven and competence is task driven.

Thank you Ms Melissa

I got your point and it is very important

really thank you but my question now how i will measure critical thinking and how i measure the competency to get out the relation or to emphasize your opinion

This would be a difficult measurement but measuring outcomes ei, patient LOS, nosocomial infections, skin condition, adverse patient events such as falls, DVTs, and any other nursing care indicators could be used as measurement.

measurement of a nurse that has CT is very easy . just stand at the nursing station and watch. you will soon see whom other nurses go to for problem solving . the CT nurse usually has no "specialness" in her demeanor and no long alphabet labels after her name but his/her peers can readily tell you whom they would go to in a crisis situation. the CT nurse is most often a bedside nurse but can easily assume the charge nurse role if warranted or neccessary . the perception of competance directly correlates to getting the job done. when the pt codes it doesnt matter whom is percieved to be comptetant the idea is to ACT.

Thank you Ms. Kelly but he question is what is the tool can be used to measure the CT among nurses? & also what is the tool can be used to measure the competency level ?

Our CNS administers annual testing of each nurse for clinical competancy . However I assure you the nurses who pass these evals are not necessarily percieved by their peers to be competant . As for a tool to measure CT I would suggest a questionarre asking nurses on a unit whom they would ask for help in solving issues.

Well again, a tool that measures positive outcomes would be helpful. Which nurse has the most positive outcomes in regard to nursing indicators? Nursing indicators would include LOS, NI rate, DVT, readmission rate, discharge patient education, etc. You really would have to narrow your criteria for nursing outcome indicators and then pull your data from past records.

Thank you Thank you Ms Melissa