Strategies for Retention: Building Critical Thinking Skills for Student Success

Nurse and doctor talking together at a desk

As a nurse educator, I consistently strive to use teaching strategies to promote cognitive thinking skills that stimulate a higher level of critical analysis and reasoning from my RN to BSN students. When teachers only transmit information, student learning is never guaranteed. Faculty must plan for ways that students can engage in participatory and collaborative learning activities that foster critical thinking and effective clinical problem-solving skills.

Before discussing several classroom approaches, it is important to review the components of critical thinking. Those involved in academia are aware of the extensive research and literature on this subject by Dr. Peter Facione. According to Facione, critical thinking involves examining ideas, formulating questions, recognizing assumptions, analyzing arguments, drawing conclusions, reflecting upon outcomes, and using deductive reasoning in decision-making (as cited in Rowles & Russo, 2009). I have found several approaches that have proven to be successful in both online and onsite modalities. These include the use of case studies, structured debates, reflective journaling, and socratic questioning.

The use of healthcare scenarios in the form of case studies allows for interactive problem-solving and reflection on previous learning experiences. I have found that this teaching strategy works best in small groups. Students share various responses from individual perspectives and past experiences, learning from one another. Together, they weigh options, analyze, and apply learned concepts to real-life or simulated situations to create optimal approaches and responses. The use of interprofessional communication can be particularly effective when various professions are assigned among the small group members. Case studies must be relevant and reinforce complex concepts that students can recall and apply in a non-threatening classroom environment. I find this approach particularly useful when nursing students learn cultural sensitivity and spiritual interventions for care.

I have found that critical thinking is enhanced when students are able to discuss the pros and cons, interpret outcomes, and analyze consequences within a structured debate. Students may be assigned readings that support their designated side of an argument prior to the class discussion. They learn to explore constraints, benefits, “if-then” thinking, and potential outcomes related to their assigned view. This develops analytical skills and the ability to recognize complex sides of a selected issue. I often use this method when evaluating the use of electronic healthcare records.

When students are asked to reflect upon newly gained knowledge and how it relates to their professional role, their learning becomes more meaningful and satisfying. We ask students to journal about their learning in relation to stated outcomes on a weekly basis in our onsite program. We have also utilized weekly learning logs and asked students to recall concepts discussed within the course and how they could be applied to their professional practice. Teachers may tailor the learning log questions in order to identify content that should be strengthened or eliminated in a course.

Socratic questioning is defined as “probing questioning to analyze an individual’s thinking” (Rowles & Russo, 2009, p. 253). I find that when thought-provoking questions are asked, individuals explore the usefulness and application of the knowledge presented. Faculty encourage critical analysis by challenging students to draw conclusions about information gleaned from scholarly sources. I have used some of the following questions during class discussions and when providing feedback on written assignments:

  • How does this impact patient outcomes?
  • Why is this necessary or important to our profession?
  • How have you seen this implemented?
  • What is your support for this conclusion?
  • How does this relate to the assigned topic?
  • What are the consequences of this assumption?

This type of inquiry not only challenges students to use clear verbal and written communication; but also encourages them to probe their assumptions, reasons, viewpoints, perspectives, and the implications/consequences of shared information.

In conclusion, faculty play an important role in promoting critical thinking skills among students. Teaching strategies must be carefully and intentionally planned to assist students in developing this complex process for managing information and guiding professional practice.


Rowles, C. J., & Russo, B. L. (2009). Strategies to promote clinical thinking and active learning. In D. M. Billings & J. A. Halstead (Eds.), Teaching in nursing: A guide for faculty. (3rd ed., pp. 238-261). St. Louis, MO: Saunders Elsevier.


Editor’s note: Jean has written four blog posts that are a part of a series on strategies for retention. The two below were originally published on Advance for Nurses. Here are links to the full articles.

Strategies for Retention: Building Community and Enhancing Confidence in the New Adult Student (Begins on pg. 19) Instructors play an important role in building an environment where students can learn effectively. Establishing community and setting boundaries for how things operate at the school and in the classroom (both online and in a physical room), help students learn to trust the instructors and one another.

Strategies for Retention: Equipping the Adult Student with Tools for Academic Success Creating a positive learning environment is vital to foster learning in any academic setting. Students need to learn skills for resolving conflict and to communicate in a learning setting that can foster their overall success in the program and when they start working in their chosen profession.

The third blog post, “Strategies for Retention: Providing Timely and Useful Feedback on Student Work,” was published on this blog and can be read at the link here.


About the Author
Jean M. Short MSN, RN,

Jean M. Short MSN, RN

Jean M. Short MSN, RN, has a Master’s of Science in Nursing Degree from Indiana University. She has 25 years of experience in the area of neonatal nursing and served in various leadership roles and as a clinical educator at St. Vincent Women’s Hospital in Indianapolis, IN. She has held the title of Assistant Professor in the School of Nursing at Indiana Wesleyan University for the past eleven years. Her areas of expertise include curriculum development, leadership, and project management. She is the course lead for the introductory course in the RN to BSN program, and teaches both online and onsite nursing students. Jeannie and her husband currently reside in Lebanon Ohio.