The purpose of this section is to draw similarities in relation to the requirement for critical thinking development in both diagnostic radiography and nursing practice. Considering that the respective training programmes of nursing and radiography consist of similar pathways and expectations, critical thinking in radiography appears to be better aligned with the training and practice requirements of nursing rather than medicine.
Issues regarding critical thinking in nursing draw parallels with those personally discovered in radiography. One such issue is supported by Daly (2001) who claims that there is no single definition of critical thinking that is widely accepted in nursing literature. This is true for radiography as well. Critical thinking is an abstract concept and there is a need to define it in a discipline-specific manner so that as educators we communicate both the importance and the expectation of developing this skill, as relevant to our discipline. Furthermore, the development of critical thinking skills in nursing is a key requirement of nursing practice just as that expected in radiography practice. Jones and Morris (2007) say that critical thinking is essential for professional accountability and quality nursing practice. Similar to radiography, the necessity for critical thinking skills in nursing has grown as the requirement for autonomy has increased. The reason is that doctors are not always present to make decisions in the clinical environment. As expected within their role, a nurse or radiographer must exercise autonomy in making decisions and these decisions should be made based on experience, scientific knowledge, training, values, and ethics (Jones & Morris, 2007).
Nurses who think critically are argued to value intellectually stimulating situations and are self- confident in their own thoughts (Heaslip, 2008). Similar to radiographers, nurses have to sift through masses of information on a daily basis in order to ensure that the information has been properly utilised to make good decisions. One of the obstacles to thinking critically in practice, as mentioned by Duron et al. (2006), is when nurses are satisfied with taking a passive approach to nursing care. One important component in developing critical thinking skills is therefore to encourage active learning in students. Students need to be able to actively question practice, both in nursing and radiography, in order to seek an understanding of what they are expected to do. The integration of theory and practice forms the cornerstone of both nursing and radiography education and practice; critical thinking is therefore not an isolated part of this process (Duron, et al., 2006). Chan (2013) agrees by saying that educators believe that critical thinkers do not accept information in a cursory way but rather question, seek and examine the questions for answers and deeper meanings. He says that educators are encouraged when they see their students asking questions because this indicates that
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students are thinking critically. This might be considered as naïve given that I, as the researcher, do not believe that all students who ask questions are thinking critically. However, the act of questioning is an indication of active learning (Biggs, 2003). Active learners are more likely to develop higher order thinking skills compared with passive learners. This is discussed later in the chapter. I am therefore inclined to accept Chan’s (2013) statement on this basis.
Kaddoura (2010) asserts that critical thinking is required to deal with complex care as seen in nursing. This is essential for professional accountability and quality nursing practice (Jones & Morris, 2007). Similarly, due to the complexity of the development of the role of a radiographer, it is argued to be a key requirement for radiography. The practice of radiography and nursing are framed by similar expectations as defined by their respective professional and regulatory bodies. Their similarities lie in the expectations of best practice regarding patient care and autonomous decision-making. Their difference lies in their respective scope of practice which is discipline specific. This is where the originality of my study will add to the body of knowledge in the field of critical thinking relating to the health sciences with a specific focus on the practice of diagnostic radiography.
Furthermore, both professions use criteria in their judgment and decision-making. Both professions are boundaried by their specific parameters, protocols and practice requirements. In diagnostic radiography, for example, practice takes place within a specifically designed environment. This is highly specialised in the context of radiographic practice with the purpose of producing diagnostic radiographic images. Radiographers’ views, like nurses, have been informed by the generic meaning of critical thinking, however they work within very specific environments and decisions taken need to be made within these very specific contexts. Both disciplines have been informed by a generic set of critical thinking principles of which Bloom (1956) provided a very useful framework from which to work and is discussed later in the chapter. Bloom’s framework provided a common platform from which to build on in relation to how critical thinking develops in radiography. Hence for this study, it is assumed that a similarity between these two professional disciplines can be drawn. In view of this assumption, it is argued that relevant nursing literature can be used to support this study. Lastly, Distler (2007) offers his contribution by saying that critical thinkers in nursing exhibit confidence, creativity, flexibility, integrity, and open-mindedness while practicing their craft. These are attributes and dispositions of critical thinking that both nursing and radiography students are expected to exhibit by their respective professional and regulatory bodies.
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2.3.1. Summary
In this section, a rationale for the use of nursing literature within this study is presented. Similar to diagnostic radiography, the necessity for critical thinking skills in nursing has grown as the requirement for autonomy has increased, due to doctors, in nursing, and radiologists in radiography, not always being present. A nurse or radiographer has the autonomy to make decisions; these decisions should be made based on experience, scientific knowledge, training, values, and ethics in accordance with their respective scope of practice. Nurses are required to make decisions in the clinical environment similar to radiographers, their parameters and protocols are very specific to the context within which they practice. Both professions, therefore, share a similar requirement towards needing a discipline-specific definition of critical thinking as well as research into how critical thinking develops within both these fields. Studies used in this dissertation have been drawn largely from nursing research due to its proximity to radiography within a healthcare setting.