“评判性的”不是指“急于发现问题”，而是指 “仔细地、正确地判断能力”； “思维”是指有思想、 有反思、有回忆、有设S 计M发h M明U、有想象和有推理。10
评判性思维（critical thinking）
Definitions
▪ Kozier et al（2000）: ▪ Critical thinking: “a purposeful mental activity in which ideas are produced and evaluated, plans made, and desired conclusions determined.”
▪ 70年代开始运用于教学 本质是反思能力和建设性批判精神
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评判性思维（critical thinking）
History
▪ 80年代初，被引入护理 护护理理科科学学的的理理论论基基础础和和哲哲学学基基础础
▪ 1992年，美国护理联盟（the National
League for Nursing，NLN）把评判
Aimless thinking
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Purposefully Initiatively Dialectically Dynamically Critically
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评判性思0世纪30年代德国法兰克福学派创立 一种批判理论和思维方式
how to make clinical decisions?
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Significance of Nursing Thinking
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思维的类型
思维形态
动作思维 形象思维（直观思维） 抽象思维（逻辑思维）
思维探索答案方向
求异思维（发散思维） 求同思维（聚合思维）
思维是否具有新颖性、独创性
“一个有目的的、产生思想并对其进行评价，制定 计划和确定理想结论的智力活动过程。”
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评判性思维（critical thinking）
Definitions
▪ Alfaro-LeFevre(1999) : ▪ Entails purposeful ,outcome-directed (results-oriented)
▪ ①必须是有目的的、结果导向的思维；②受患者、家庭、社
区需要的驱动；③以护理程序和科学方法原则为基础；④需要
性❖One of the core competencies 思❖维O列ne入of评th审e护hSo理tM学thoM院pUi的cs必须标准。 8
评判性思维（critical thinking）
Definitions
▪ Bandman(1988):“the rational examination of ideas, inferences, assumptions, principles, arguments, conclusions, issues, statements, beliefs, and actions. ”
“对思想、推理、假设、原则、争议、结论、问题、
说明、信念和行动的理性检验。”
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评判性思维（critical thinking）
Definitions
▪ Kozier et al（2000）: ▪ Critical: not “eager to find fault” but “capable of judging carefully and accurately.” ▪ Thinking: to have an opinion, to reflect on, to call to mind, to devise by thinking, to form a mental picture of (image), to reason.
第七章 评判性思维和护理临床决策
Critical Thinking and Decision-making in Nursing
Nursing School of Second MilitarSy MM heMdiUcal University 1
Main Topics:
➢Why and which thinking is important
to nurse?
➢What is the definition and components
of critical thinking and why it is
important?
➢How to improve the nurses’ critical
thinking ability?
➢ What’s clinical decision making and
再生性思维 创造性思维
Everybody thinks all the day and all the time.
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Scenario ：It’s Tuesday. You’re on the way to classroom and these thoughts are going though your mind: “I have so much to do…anatomy(解 剖) test on Wednesday, Physiology(生理学) paper due on Thursday.……I really wanted to get a hair cut.……Do I really have to shop tomorrow?……Hey, what an interesting looking man that is on the corner.……I’m starving……What can I eat?”
thinking. ▪ Is driven by patient, family, and community needs. ▪ Is based on principles of nursing process and scientific
method. ▪ Requires knowledge, skills and experience.