Critical Thinking and Decision Making

Arnuparp LekhakulaFaculty of Medicine

Prince of Songkla UniversityHat Yai, Songkhla

Knowledge and Critical Thinking

“......knowledge is no more a substitute for thinking than thinking is a substitute for knowledge…There are too many brilliant academics whose brilliance in their own fields and lack of it outside those fields shows the difference between knowledge and thinking”

Knowledge and Critical Thinking

“Imagination is more important than knowledge”

Albert Einstein

Critical Thinking

• To recognize propaganda

• To analyse hidden assumptions in arguments

• To recognise deliberate deception

• To assess credibility of information

• To work through problems/decisions in the best way

Harpern, 1996

Critical Thinking• Interpretation skills

• Analysis skills

• Evaluation skills

• Inference skills

• Argument skills

• Reflection skills

• Disposition skills

Metacognition

“Until you KNOW WHAT YOU KNOW’ you do not own your knowledge, and so you do not know anything.”

Skills for Self-Directed Learning

• Self-evaluation and identification of needs

• Accurate formulation of learning issues

• Selection and use of appropriate resources

• Selection of relevant, effective educational

activities

• Identification and rapid rejection of

irrelevant material

• Critical application of new knowledge

• Evaluation of steps

Thinking as Hypothesis Testing

• Recognizing the need for and using operational definitions

• Understanding the need to isolate and control variables in order to make strong causal claims

• Checking for adequate sample size and possible bias in sampling when a generalization is made

• Being able to describe the relationship between any two variables

• Understanding the limits of correlational reasoning

Skills for Creative Thinking

• Redefine the problem and goal

• Find analogies

• List relevant terms

• Brainstorm

• Check Lists

• List Attributes

• Positive, negative, interesting

• Visualize

• Browse

Decision Making Skills

• Framing a decision in several ways to consider different sort of alternatives

• Generating alternatives• Evaluating the consequences of various

alternatives• Recognizing the bias in hindsight analysis• Using a decision making worksheet• Avoiding the entrapment bias• Seeking discomfirming evidence• Awareness of the effects of memory on decisions

Problem Solving Skills

• Restating the problem and the goal to consider different sorts of solutions

• Recognizing the critical role of persistence• Using a quality representation of a

problem• Understanding world view constraints• Selecting the best strategy for the type of

the problem• Actively seeking analogies

Problem Solving SkillsIDEAL (Bransford & Stein,1996)

Identify the problem

Define and represent the problem

Explore possible strategies

Act on the strategies

Look back and evaluate effects of activities

Problem Solving Skills

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Strategy for Facilitators of Critical Thinking

• Affirming learners’ self-worth• Listening attentively• Showing your support• Reflecting and mirroring their ideas and actions• Motivating them• Regular evaluating the process• Helping them to create social networks with like-

minded learners• Raising awareness of how to learn to be critical

thinker• Being role models for critical thinking

Hypotheticodeductive Model of Medical Problem Solving

• Information perception and interpretation

• Hypothesis generation

• Enquiry strategy and clinical skills

• Problem formulation

• Closure via diagnostic and/or therapeutic decision making

Clinical Process

• Consulting skills

• Clinical reasoning

• Clinical decision making

Consulting Skills• What seems to be the problem? Problem identification• Is that really the problem? Problem sensing• What exactly is the problem? Problem clarification• Whose problem is it? Problem acceptance• Have I got it right? Problem formulation

Clinical Reasoning

• What are the likely explanation? Diagnostic hypothesis• Where are the likely explanation? Associating to interpretations• How should I search? Diagnostic strategy• How should I correct clinical data? Data collection• How should I interpret what I’ve found? Data interpretation

Clinical Reasoning

• What other evidence do I need? Investigation and efficiency of

investigation• What else could explain the picture? Differential diagnosis• What else must I check out? Screening• What exactly is the diagnosis? Diagnosis

Clinical Decision-Making

• What could happen? Possible outcomes• What could I do about it? Management options• What can we achieve in this patient? Choosing treatment goals• What is important to the patient? Values and preferences• How do I decide exactly what to do? Making decisions

Elements of Decision-MakingSQEJA

Situation/story/scenario

Questions on which you must make a decision

Evidence

Judgment

Action

Why are Some Decisions Difficult?

• Uncertainty about what will happen

• Conflicting consequences to be balanced

• Complexity of interacting variables