Thinking critically about critical thinking: ability, disposition or both?

Krupat, Edward; Sprague, Jared; Wolpaw, Daniel R.; Haidet, Paul; Hatem, David S.; O’Brien, Bridget

doi:10.1111/j.1365-2923.2010.03910.x

Cited by 76 publications

(80 citation statements)

References 30 publications

(49 reference statements)

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“…It is also a prerequisite of the analytical approach to diagnostic reasoning 23 . Critical thinking is widely acknowledged to be an ideal characteristic of doctors, yet understanding of what it entails varies amongst medical school faculty members 24 . Positive correlations have been shown between validated critical thinking test scores and Medical College Admission Test (MCAT) performance and pre‐clinical course grades 25,26 …”

Section: Introductionmentioning

confidence: 99%

Video‐based cases disrupt deep critical thinking in problem‐based learning

Roy

McMahon

2012

Medical Education

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CONTEXT Video is a popular tool in problembased learning (PBL), although its production requires resources and time. Few studies have examined the impact of the use of video in PBL upon cognitive processes and critical thinking. Those that have done focused on cases involving physical signs, where video has natural advantages.OBJECTIVES This study aimed to investigate preferences for video-or text-based cases and the effects of each format upon medical students' deep thinking in PBL. Tutorials were based on material portraying interviews with patients with conditions that include psychosocial elements but no physical signs.METHODS Four tutorial groups of students in a Year 2 endocrine and reproductive pathophysiology course participated in a crossover study using one video-based and one text-based case. Transcripts of tutorials were coded for depth of thinking by a blinded coder. A generalised estimating equation model was used to adjust for potential differences among groups, cases, and tutor participation. The distribution of cognitive activity within the crossover groups and the adjusted odds ratios (ORs) for deep versus superficial thinking were calculated. A prior cohort of 165 students and 18 tutors completed a survey of learning preferences. RESULTSOf 5224 student utterances, the majority referred to problem exploration (2622, 50%) and description (1479, 28%). Overall, the odds of deep thinking versus superficial thinking were significantly lower using video-based cases compared with textbased cases ( CONCLUSIONS Students and their tutors prefer video-based cases in PBL. However, compared with text-based material, the use of video-based material that refers to cases without dynamic physical signs is associated with a reduction in deep thinking.technology enhanced learning

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Section: Introductionmentioning

confidence: 99%

Video‐based cases disrupt deep critical thinking in problem‐based learning

Roy

McMahon

2012

Medical Education

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“…This effect may become more pronounced when working under stress and in environments with high demands for cognitive resources, as in a medical context [34]. High demands are placed on the WM of medical physicians practicing in their own language [35–39], and those practicing in a second language may have the added burden of using WM capacity for translation processes. This in turn reduces the available WM capacity allocated to medical tasks and problem solving.…”

Section: Introductionmentioning

confidence: 99%

A preliminary investigation to explore the cognitive resources of physicians experiencing difficulty in training

Patterson¹,

Cousans

Coyne

et al. 2017

BMC Med Educ

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BackgroundTreating patients is complex, and research shows that there are differences in cognitive resources between physicians who experience difficulties, and those who do not. It is possible that differences in some cognitive resources could explain the difficulties faced by some physicians. In this study, we explore differences in cognitive resources between different groups of physicians (that is, between native (UK) physicians and International Medical Graduates (IMG); those who continue with training versus those who were subsequently removed from the training programme); and also between physicians experiencing difficulties compared with the general population.MethodsA secondary evaluation was conducted on an anonymised dataset provided by the East Midlands Professional Support Unit (PSU). One hundred and twenty one postgraduate trainee physicians took part in an Educational Psychology assessment through PSU. Referrals to the PSU were mainly on the basis of problems with exam progression and difficulties in communication skills, organisation and confidence. Cognitive resources were assessed using the Wechsler Adult Intelligence Scale (WAIS-IV). Physicians were categorised into three PSU outcomes: ‘Continued in training’, ‘Removed from training’ and ‘Active’ (currently accessing the PSU).ResultsUsing a one-sample Z test, we compared the referred physician sample to a UK general population sample on the WAIS-IV and found the referred sample significantly higher in Verbal Comprehension (VCI; z = 8.78) and significantly lower in Working Memory (WMI; z = −4.59). In addition, the native sample were significantly higher in Verbal Comprehension than the UK general population sample (VCI; native physicians: z = 9.95, p < .001, d = 1.25), whilst there was a lesser effect for the difference between the IMG sample and the UK general population (z = 2.13, p = .03, d = 0.29). Findings also showed a significant difference in VCI scores between those physicians who were ‘Removed from training’ and those who ‘Continued in training’.ConclusionsOur results suggest it is important to understand the cognitive resources of physicians to provide a more focussed explanation of those who experience difficulties in training. This will help to implement more targeted interventions to help physicians develop compensatory strategies.

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“…4 The nonanalytic approach is more common, accounting for 80% of clinical reasoning and is based on pattern (or illness script) recognition, and the use of heuristics. 5 This allows for the rapid diagnosis of clinical presentations that match preformed illness scripts. When such matches are not apparent, clinicians must transition to a more deliberate hypothesis-driven model for diagnosis.…”

Section: What Is Knownmentioning

confidence: 99%

Teaching and Assessing Critical Reasoning Through the Use of Entrustment

Iobst¹,

Trowbridge²,

Philibert³

2013

Journal of Graduate Medical Education

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Problems with clinical reasoning (wrong, delayed, or missed diagnosis and/or treatment) make up a sizable portion of preventable adverse outcomes.1,2 In 1 review of diagnostic errors, 75% were at least in part due to cognitive errors.3 Of 320 cognitive factors identified in 74 cases, 45 were due to faulty data gathering and 264 resulted from errors in problem representation and clinical reasoning.

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Thinking critically about critical thinking: ability, disposition or both?

Cited by 76 publications

References 30 publications

Video‐based cases disrupt deep critical thinking in problem‐based learning

Video‐based cases disrupt deep critical thinking in problem‐based learning

A preliminary investigation to explore the cognitive resources of physicians experiencing difficulty in training

Teaching and Assessing Critical Reasoning Through the Use of Entrustment

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