Critical thinking and nursing scripts: the case for the development of both

It is argued that contemporary nursing education's emphasis on the consciou s development of nurses' critical reasoning skills fails to take account of the complexity of both human cognition and clinical nursing practice. Huma n cognition centrally includes unconscious or tacit processes and clinical nursing practice is typified by the simultaneous presentation of clinical a nd non-clinical cues and competing clinical goals. Contemporary emphases on conscious critical thinking are largely consistent with the differing theo retical frameworks which have informed the study of nurses' clinical reason ing in the last 30 years, most of which permit the use of simulated case st udy. These frameworks, that is, decision theory, information processing and skills acquisition theory, are described and their limitations highlighted . In addition, an alternative theoretical framework, that of schema or scri pt theory, which does take account elf the complexities of cognition and pr actice, is discussed. Its implications for nursing practice and education a re also outlined.