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Critical thinking has been identified as a key requirement for safe and competent practice for Nurse Practitioners. It has been suggested that it is the foundation for the development of clinical reasoning, diagnostic reasoning, and clinical judgement. Poorly developed critical thinking is linked to negative patient outcomes, diagnostic error, cognitive bias, and poor information processing. There is little literature that studies the teaching and learning activities that can be used in the development of critical thinking in Nurse Practitioners. The aim of this rapid review was to identify teaching and learning activities that promote critical thinking in Nurse Practitioners.
A rapid review was conducted to identify studies that examined different teaching and learning activities that promoted the development of critical thinking or any of its subthemes such as clinical reasoning, diagnostic reasoning or clinical judgement. Four databases were systematically searched: CINAHL, Medline, Embase and ERIC. The methodology used was guided by the Cochrane Rapid Review Methods Group. Eligible papers included peer-reviewed publications that evaluated the efficacy or effectiveness of teaching or learning strategies used for the development or promotion of critical thinking or its components. The included populations were faculty teaching in a Nurse Practitioner programme, Nurse Practitioners, Nurse Practitioner students or graduate level nursing students.
The search yielded 6421 article titles and abstracts. Of these, 12 were included in the final rapid review. Teaching and learning activities were divided into three themes: classroom, simulation, and written. Classroom activities included problem-based learning, unfolding case scenarios, self-explanation, and Socratic inquiry. Simulation was in the form of high fidelity using standardised patients, computer-based programmes, escape rooms and virtual reality. Written activities included concept mapping, evolving case studies and illness scripts. Study participants noted that using a combination of teaching and learning activities had the greatest impact on their development of critical thinking.
There is limited knowledge on the effects of teaching and learning strategies on the development of critical thinking in nurse practitioners. This review offers a perspective on strategies that were most impactful for student nurse practitioners in their development of the different aspects of critical thinking. Simulation activities were the most researched and using it in combination with other activities was preferred by study participants.
No patient or public contribution as this is a literature review.
To describe how implementation leadership manifests among formal and informal point of care nurse leaders during a successful evidence-based practice implementation.
A collective case study.
A conceptual framework on shared implementation leadership guided the study. Two units known for strong implementation were selected as instrumental cases from a healthcare network. Data were collected from multiple sources (2022–2023), including document review, site visits, focus group and individual interviews with formal managerial and non-managerial nurse leaders, staff nurses, interdisciplinary clinical staff and departmental leaders. The Framework Method was used to thematically analyse within-case findings, followed by cross-case comparison.
Nurse leaders in formal and informal roles engaged in collaborative processes to collectively enact leadership behaviours throughout the implementation phases. Change-, relation- and task-oriented behaviours aimed to foster staff readiness, ensure supportive presence, structure implementation activities and reinforce the use of evidence-based practices on the units. Collaborative processes fostered leaders' engagement and kept one another informed to align and synchronise their collective actions.
This study extends our understanding of implementation leadership in nursing by highlighting a shared and relational approach among diverse point of care leaders. Strengthening team-level processes is essential to enhance leadership capacity for implementation in nursing.
Given the global push for innovative, high-quality healthcare, strong leadership is needed to create conditions for implementation and practice change. This study makes visible how multiple and diverse leaders collectively support implementation.
With much focus on nurse manager roles, there is a gap in the research showing how multiple point of care leaders facilitate implementation, which this study addresses. This study can serve as a template to assist nurse leaders in their implementation efforts and to advocate for developing diverse nurse leadership roles.
The report adheres to the COnsolidated criteria for REporting Quality research (COREQ) guidelines.
This study did not include patient or public involvement in the design, conduct or reporting.
International Registered Report Identifier (IRRID): DERRI-10.2196/54681
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