Is all the focus on Critical Thinking "much ado about nothing"?

Why spend all the energy outlining the critical thinking that occurs in each of the Nutrition Care Process steps?

The answer is fairly straightforward.  The critical thinking is one of the key skills that the dietitian contributes to the process!

It is the ability to USE all that unique body of dietetics knowledge that dietitians have learned in their formal education process to gather and assess data, identify problems that need to be addressed,  to select the most important and appropriate interventions in collaboration with the patient/client and healthcare team, make recommendations to clients and healthcare team members, and guide problem solving when situations arise that need additional thought.

When the first article was published in 2003, the term Critical Thinking was formally defined, elaborated, and included in the terms defined in the article. (1)   While it had been used prior to this in educational standards, it had not been formally defined for dietetics.

The 2003 article went further and stated:

"Critical thinking integrates facts, informed opinions, active listening and observations.  It is also a reasoning process in which ideas are produced and evaluated"

"The use of critical thinking provides a unique strength that dietetics professionals bring to the Nutrition Care Process.  Further characteristics of critical thinking include the ability to do the following:

• conceptualize
• think rationally
• think creatively
• be inquiring and
• think autonomously."

It was felt to be so important, that when each of the steps of the nutrition care process  was elaborated in the articles accompanying the Nutrition Care Process and Model, a separate section was devoted to further delineating the critical thinking of the dietitian in each of the steps. (1,2)

In the 2012 standards for dietetics education programs it is mentioned 8 times, usually in relationship to problem solving  (3) For example:  "Critical thinking is the careful attainment and interpretation of information to reach a valid conclusion" (3)  In the formal definitions  critical thinking is defined as "The ability to draw conclusions about issues where there are no clear-cut answers by analyzing, synthesizing and evaluation facts, informed opinions and observations".

The practice paper on nutrition assessment also echoes the importance of critical thinking. (4)  Additional work has been published on critical thinking as it applies to dietetics topics. (5)

Bottom line:  Critical thinking is an important contribution throughout the steps in the Nutrition Care Process that is provided by the dietitian and significantly affects the outcome of the nutrition care process cycle(s).

1.         Lacey K, Pritchett E. Nutrition Care Process and Model: ADA adopts road map to quality care and outcomes management. J Am Diet Assoc. Aug 2003;103(8):1061-1072.

2.         Nutrition care process and modelpart I: the 2008 update. J Am Diet Assoc. Jul 2008;108(7):1113-1117.

3.         ACEND Accreditation Standards for Dietetics Education Programs:  Available at http://www.eatright.org/ACEND/content.aspx?id=57.  Accessed Sep 2, 2014.

4.         Critical Thinking Skills in Nutrition Assessment..  Available at: http://www.eatright.org/Members/content.aspx?id=6442478892

5.        Trostler, N, Myers, E.  Review of critical thinking.  Making decisions to either measure or estimate Resting Metabolic Rate Requirements (RMR).  Top Clin Nutr.  2008:25(4):278-292.