Critical Thinking Activities for Nursing Students (That Are Not Quizzes)

Search for critical thinking activities for nursing students and you will find a lot of “nursing games”: crosswords, quizzes and flashcards. They are fine for recall. Critical thinking is something else. It is deciding what matters in front of you, under time pressure, and checking whether you were right.

Here are activities that train that, roughly in order from low-tech to high-fidelity. Each maps to a step in the NCSBN Clinical Judgment Measurement Model (CJMM), which describes six cognitive skills: recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action and evaluate outcomes.

1. The “what changed?” handover

Give students two sets of observations for the same patient, four hours apart. Ask them to name the single change that worries them most, and why. This trains cue recognition and analysis without any equipment.

2. Rank the patients

Give a group four short patient summaries and one nurse. Who do you see first? Acuity, the ABCs and Maslow’s hierarchy all help with prioritisation, and Open RN notes that acuity tools have limits, so students should defend their ranking out loud. It builds the prioritise-hypotheses step. Our explainer on high acuity is a useful primer.

3. Think-aloud case

One student works through a paper case while speaking every thought. Peers note which cues were missed. Swap and repeat.

4. Unfolding case with a twist

Release a case in stages. At stage three, the patient gets worse despite the “right” intervention. Students must evaluate the outcome and change course, which is the step most often skipped in practice.

5. Screen-based or VR simulation first, manikin second

A 2022 crossover study of nursing students compared the order of virtual and high-fidelity manikin simulation. Doing virtual simulation first led to significantly higher reflective thinking and self-confidence scores than doing it second. The study was small and used screen-based simulation, but it supports a practical idea: rehearse the thinking virtually, then do the hands-on work.

6. Repeat a VR scenario until the debrief is clean

In a responsive simulation the patient deteriorates if you hesitate. Run a case such as acute asthma, read the scored debrief, then run it again and try to fix one thing. Repetition with feedback is where VR beats a once-a-semester manikin session.

7. Structured debrief, every time

The INACSL debriefing standard says all simulation-based activities must include a planned debriefing process. Use the six CJMM steps as the debrief structure: what did you notice, what did you think it was, what did you prioritise, what did you do, and how did you know it worked?

Try it

Students can join the waitlist for free practice scenarios on our students page, including a deteriorating patient case. Educators can see the full Firsthand XR library on the nursing education page.