A protocol for the development of a critical thinking assessment tool for nurses using a Delphi technique

Document Type

Journal Article

Publication Title

Journal of Advanced Nursing


Blackwell Publishing Ltd


School of Nursing and Midwifery




West Australian Nurses Memorial Charity


Jacob, E., Duffield, C., & Jacob, D. (2017). A protocol for the development of a critical thinking assessment tool for nurses using a Delphi technique. Journal of Advanced Nursing, 73(8), 1982-1988. https://doi.org/10.1111/jan.13306



The aim of this study was to develop an assessment tool to measure the critical thinking ability of nurses.


As an increasing number of complex patients are admitted to hospitals, the importance of nurses recognizing changes in health status and picking up on deterioration is more important. To detect early signs of complication requires critical thinking skills. Registered Nurses are expected to commence their clinical careers with the necessary critical thinking skills to ensure safe nursing practice. Currently, there is no published tool to assess critical thinking skills which is context specific to Australian nurses.


A modified Delphi study will be used for the project.


This study will develop a series of unfolding case scenarios using national health data with multiple-choice questions to assess critical thinking. Face validity of the scenarios will be determined by an expert reference group of clinical and academic nurses. A Delphi study will determine the answers to scenario questions. Panel members will be expert clinicians and educators from two states in Australia. Rasch analysis of the questionnaire will assess validity and reliability of the tool. Funding for the study and Research Ethics Committee approval were obtained in March and November 2016, respectively.


Patient outcomes and safety are directly linked to nurses’ critical thinking skills. This study will develop an assessment tool to provide a standardized method of measuring nurses’ critical thinking skills across Australia. This will provide healthcare providers with greater confidence in the critical thinking level of graduate Registered Nurses.

Why the study is needed?

  • Critical thinking is an essential skill for Registered Nurses to enable detection of changes in patients’ conditions and effectively manage changing circumstances, yet no standardized critical thinking tool is available which is context specific and relevant to Australian nurses to assess this skill.
  • Development of this assessment tool will provide a consistent method of measuring critical thinking skills with measurable outcomes for all education providers.
  • A standardized tool will enable healthcare personnel to have greater confidence that new graduate Registered Nurses will have an appropriate skill level to provide the required level of care and ensure patient safety.



Access Rights

subscription content