*Result*: Fostering critical thinking competence in nurses: A systematic review.
Original Publication: [Edinburgh] : Churchill Livingstone
*Further Information*
*Aim: This study aims to synthesize evidence-based learning strategies used to enhance critical thinking competence among nurses and nursing students.
Background: Critical thinking is a fundamental component of nursing practice, enabling safe decision-making, clinical judgment and evidence-based care. A range of pedagogical strategies have been used to promote critical thinking; however, the existing evidence remains fragmented and lacks consolidation.
Design: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.
Methods: Four databases (EBSCOhost, SCOPUS, ScienceDirect and ProQuest) were searched for peer-reviewed intervention studies published between 2019 and 2025. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist and findings were synthesized thematically using a narrative synthesis approach.
Results: From 166,080 records identified, twelve studies met the inclusion criteria. Studies were conducted in China (n = 6), South Korea (n = 2), USA (n = 2) and each one in Indonesia and Palestine, involving clinical nurses (n = 6) and final-year nursing students (n = 6). Four categories of learning strategies were identified: case-based learning, simulation-based learning, reflective strategies and collaborative or peer-based learning. Interventions were implemented across academic, clinical and workplace settings and commonly incorporated authentic clinical cases, simulation scenarios, structured reflection and group-based learning activities.
Conclusion: Educational strategies are most effective when instructional design aligns pedagogical approaches with theoretical frameworks, learning environments and organizational conditions to support the consistent and sustainable development of critical thinking in nursing education and practice.
(Copyright © 2026 Elsevier Ltd. All rights reserved.)*
*Declaration of Competing Interest The authors declare no conflicts of interest.*