What Is It?“Critical thinking is the identification andevaluation of evidence to guide decision making. A critical thinker uses broad in-depth analysis of evidence to make decisions and communicate her/ his beliefs clearly and accurately.” The Critical Thinking Co.
Hierarchy of Knowledge Bloom’s Taxonomy, 1956• Knowledge: What is the most common cause of...?• Understand: If you see this, what must you consider…?• Application: In this patient, what is causing…?• Analysis, synthesis, evaluation: critical thinking?
TT Chazin Group Knowledge he Chazin Group he• Content learned in a conceptual framework: – How do the facts fit together? – What are the underlying mechanisms? – What do you do when the patterns break down?• Judge the credibility of the sources: – From primary sources (Google it…) – Primary sources: • Study design • Appropriate population • Statistics• Secondary sources: – Textbooks – Review articles• Evidence-based medicine
TT Chazin Group Knowledge he Chazin Group he• Bias and cognitive dispositions to respond: – Availability bias - probability assigned based on ease of recall of specific examples; and – Confirmation bias - selectively accepting or ignoring data.
TT Chazin Group he Chazin Group he Skills• Formulate hypotheses• Make logical connections between ideas• Utilize of data• Identify assumptions
TT Chazin Group he Chazin Group he Attitude• Have an open mind - willingness to consider alternative explanations• Be aware of your own cognitive processes: what type of reasoning was I using? (meta-cognition)• Reflection - how did we go wrong? Where did we make a mistake?
Importance to Medicine“…few physicians spend much time thinking about such a fundamental medical activity as thinking. Logic is as important tophysicians as water is to fish. It surrounds us all and we swim in it every day." Suzanne Fletcher Professor of Ambulatory Care & Prevention Harvard Medical School & Harvard Pilgrim Medical Care
TT What Group he Chazin Makes he Chazin Group a Critical Thinker?• Analysis: Critical thinking can be defined as an Analysis approach to ideas from the standpoint of deliberate consideration. (from VirutalSalt.com)• Attention: Pay attention to the claims made all Attention around you.• Awareness: have the ability to look around Awareness and consider all the thoughts provided, rather than remaining fixed on your own limited views.• Independent Judgment: the ability to form Judgment independent judgments, based on good evidence.
TT What Group he Chazin Makes he Chazin Group a Critical Thinker?• Critical thinkers are by nature SKEPTICAL. They approach text with the same skepticism and suspicion as spoken comments.• Critical thinkers are ACTIVE, not passive. They ask questions & analyze. They consciously apply tactics and strategies to uncover meanings and confirm understanding.• Critical thinkers don’t take an egotistical view of the world. They’re OPEN to new ideas/ perspectives. They’re willing to challenge their beliefs and consider competing evidence.
TTPassive (Non-Critical) he Chazin Group he Chazin Group Thinkers• Take a SIMPLISTIC view of the world.• They see things in black and white, as either-or, rather than recognizing a variety of possible understanding.• They see questions as YES/NO with no subtleties.• They fail to see linkages & complexities.• They fail to recognize related items.
A Comparisonwww.chinesenursing.org/openAccess/sn331/html/doc/cyber- M1_students.pdf
“Shades of grey wherever I go. The more I find out, the less That I know. Black and white is how it should be. But shades of grey are the Colors I see.” Billy Joel
FindTT Chazin Group he Chazin Group he Assumptions• Inferences Versus Assumptions: – INFERENCE: A conclusion you come to, based on something else that is true/you believe to be true. (Ex. There will be layoffs in my dept. because there were layoffs in another dept.) – ASSUMPTION: Part of your belief system. Something you dont question. Your mind takes for granted that your assumption is true. (Doctors think they know EVERYTHING.) – Your beliefs (assumptions) cause you to come to conclusions (inferences). Your inferences then cause you to act accordingly.
FindTT Chazin Group he Chazin Group he Assumptions•Question your assumptions as a path tosubstantiating them.•Most statements or assertions are basedon assumptions.•Sometimes assumptions are implicit, sothey’re much harder to find.
TT Chazin GroupEvidence, he Trends, he Chazin Group Exceptions• There are many different ways to measure variables, so absolute figures may not be that relevant.• In science, it is the EXCEPTION that disproves the RULE.• The Scottish philosopher David Hulme noted: "A wise man proportions his belief to the evidence.”
Be SkepticalTT Chazin Group he Chazin Group he of Surveys• Always ask: “Who is funding the project” because EVERONE has an AGENDA.• How are the questions worded/posed?• How are those being questioned selected and the context in which the questions are put to them?• How is the statistical analysis carried out and the statistics interpreted?• How are the findings presented/reported (or misreported?)
he Look forTT Chazin Group he Chazin Group CAUSE & EFFECT• Correlation does not necessarily mean causation .• Because two variables often occur together, doesn’t mean that one actually causes the other.• The concept of causation is extremely complex.
TT Chazin Group Defer he DON’T he Chazin Group to Authority• Albert Einstein once remarked: "Foolish faith in authority is the worst enemy of truth."• Study the evidence and make an independent judgment, based on the balance of the available evidence.• Confirm the credibility of sources and credentials of “experts.”
BewareTT Chazin Group he Chazin Group he of GROUP Think• The Emperor’s new clothes.• You can be seduced by this esp. if you are a member of a close-knit group of people where there is a strong sense of loyalty to the group.• The Independent Evaluation Office of the IMF identified groupthink as a major factor in its official report on why the IMF did not foresee the international financial crisis of ‘07-’09.
TT ChazinTrust he Chazin Group he Group YOUR Instincts• Trust your own intuition based on: – your schooling; – on-the-job training; – Past work experience; and – your certifications.
TT Chazin Group Can Observing he Chazin Group he Change a Situation• A situation occurs in experiments to test the efficacy of drugs or medical treatments known as the placebo response. A placebo (sugar or a tonic containing nothing medicinal) is used with a control group of patients to compare with another group taking the drug or treatment being tested. Researchers have found that frequently a placebo has a positive effect because the person taking it believes it will cure them.
he Find Group he Chazin MeaningfulTT Chazin Group Statements• Often politicians, businessmen, administrators make statements which are meaningless: – “I think that if we tried harder we could possibly do somewhat better." – "Some improvements in performance might be expected in the fullness of time.” – A much more meaningful sentence would be: "We will reduce recorded crimes of violence by 10% before the next election" or "If we increase our capital expenditure by 5% annually for the next three years, we should achieve a 25% increase in revenues by the end of the decade".
DeconstructTT Chazin Group he Chazin Group he Elements• In a paper or speech, look at the arguments, the evidence, the structure, and the presentation.• In a novel, consider the plot, the characterization and the language.• In a film, think about the script, the acting, the direction, the cinematography, and the music.
TT ChazinUse a he Chazin Group he Group SWOT Analysis• SWOT analysis is a strategic planning method used to evaluate the Strengths, Weaknesses, Opportunities, and Threats involved in a project or situation.• Strengths and weaknesses are internal to the hospital.• Opportunities and threats are external.
TT Chazin Group SMART he Create he Chazin Group Objectives• Specific• Measurable• Achievable• Relevant• Timed
UseTT Chazin Group he Chazin Group he Statistics• A statistic without any content is MEANINGLESS.• Averages can be misleading.• Medians and modes often work better than the mean.• Consider how the data points in a set are distributed.• The PARETO Principle. 1, 5, 5, 5, 13, 50, 74, 100
he ChazinWhat’sTT Chazin Group he Group NOT There?• When asked to respond to material most people limit their comments to what is requested.• What ISN’T there is just as important. You might want to ask: “Why are certain arguments missing?” “Why have certain sources not been used?• What about patient medical histories, prior treatments, allergies, past surgeries?• A clinical trial or hospital annual report will put the most favorable ‘spin on activities and may not mention the financial difficulties or threats.
Think OUTSIDE the Box "Problems cannot be solved bythinking within the framework in which they were created.”
TT Chazin The Socratic he Chazin Group he Group Method• Have someone take a position on a controversial issue (Euthanasia, evolution) evolution• Have someone else ask a question to make that person explain themselves.• Ask a follow up question to exploit a potential weakness of the answer to the first question.• Keep going to you either establish or disprove the person’s argument.
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