Clinical journal: a tool to foster critical thinking for advanced levels of competence.

Rapid changes in the health care system and the challenge of meeting complex patient care needs require that nurses function at the competent, or higher, levels of expertise. Advanced levels of competence are facilitated through development and application of critical thinking abilities. Journal writing is a tool that can be used by CNSs and other nurses to improve basic thinking abilities and application of critical thinking for clinical decision making. Guidelines are presented for writing this type of clinical journal and for providing feedback to others.