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The The POWERPOWER of of Thinking Thinking CRITICALLYCRITICALLY

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In the next 3 hours…In the next 3 hours…

This Morning’s Agenda

What Is It? Characteristics of Critical Thinkers Characteristics of Non-Critical Thinkers Famous Quotes How to Think Critically

What Is Critical Thinking?What Is Critical Thinking?

What Is It?

“Critical thinking is the identification andevaluation of evidence to guide decision

making. A critical thinker uses broadin-depth analysis of evidence to make

decisions and communicate her/his beliefs clearly and accurately.”

The CriticalThe CriticalThinking Co. Thinking Co.

What Is It?

What Is It?

““Life is a tragedy for those Life is a tragedy for those who feel, and a comedy for who feel, and a comedy for

those who think." those who think."  

Jean dela Bruyere

“Thought is great and swift and free, the light of the

world, and the chief glory of man.”

Principles of Social Reconstruction.

BertrandRussell

“Many people would die sooner than think; in fact,

they do.”BertrandRussell

““Most people don't take the time to think. I made an international reputation for myself by deciding

to think twice a week." ."  

George Bernard Shaw

““Think, think, think. It will hurt like hell at first, but you'll

get used to it." "  

Barbara Castle

““just the facts, ma’am." just the facts, ma’am."  

““Always question Always question authority.“authority.“

 

Why?

Critical Thinking Is Critical Thinking Is NOT NOT Clinical ReasoningClinical Reasoning

It’s NOT Clinical Reasoning

www.chinesenursing.org/openAccess/sn331/html/doc/cyber-M1_students.pdfwww.chinesenursing.org/openAccess/sn331/html/doc/cyber-M1_students.pdf

It’s NOT Clinical Reasoning

It’s NOT Clinical Reasoning

Hierarchy of Knowledge

• 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?

Bloom’s Taxonomy, 1956

The KSA Model

• Are there specific:– KnowledgeKnowledge/factsfacts– SkillsSkills– Attitudes …that must be

acquired, in order for the learner to become a critical thinker?

• 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

The Chazin Group The Chazin GroupKnowledge

• 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.

The Chazin Group The Chazin GroupKnowledge

• Formulate hypotheses• Make logical connections between ideas• Utilize of data• Identify assumptions

The Chazin Group The Chazin GroupSkills

• 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?

The Chazin Group The Chazin GroupAttitude

Importance to Medicine““…few physicians spend much time thinking about such a fundamental medical activity

as thinking. Logic is as important to physicians as water is to fish. It surrounds

us all and we swim in it every day.""  

Suzanne FletcherProfessor of Ambulatory Care & Prevention

Harvard Medical School &Harvard Pilgrim Medical Care

Characteristics of Critical Characteristics of Critical ThinkersThinkers

• AnalysisAnalysis: Critical thinking can be defined as an approach to ideas from the standpoint of deliberate consideration. (from VirutalSalt.com)

• AttentionAttention: Pay attention to the claims made all around you.

• AwarenessAwareness: have the ability to look around and consider all the thoughts provided, rather than remaining fixed on your own limited views.

• Independent JudgmentIndependent Judgment: the ability to form independent judgments, based on good evidence.

The Chazin Group The Chazin GroupWhat Makes 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.

The Chazin Group The Chazin GroupWhat Makes a Critical Thinker?

Characteristics ofCharacteristics ofNon-Critical ThinkersNon-Critical Thinkers

• Take a SIMPLISTICSIMPLISTIC 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.

The Chazin Group The Chazin GroupPassive (Non-Critical) Thinkers

A Comparison

www.chinesenursing.org/openAccess/sn331/html/doc/cyber-M1_students.pdfwww.chinesenursing.org/openAccess/sn331/html/doc/cyber-M1_students.pdf

““Shades of grey wherever I go.Shades of grey wherever I go.The more I find out, the lessThe more I find out, the less

That I know.That I know.Black and white is how itBlack and white is how it

should be.should be.But shades of grey are theBut shades of grey are the

Colors I see.”Colors I see.”

Billy Joel

http://www.youtube.com/watch?v=iksqQHy6vEA

How to Think CRITICALLY

• 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 don't 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.

The Chazin Group The Chazin GroupFind Assumptions

The Chazin Group The Chazin GroupFind Assumptions

•Question your assumptions as a path to substantiating them.•Most statements or assertions are based on assumptions.•Sometimes assumptions are implicit, so they’re much harder to find.

• 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.”

The Chazin Group The Chazin GroupTrends, Evidence, Exceptions

• 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?)

The Chazin Group The Chazin GroupBe Skeptical of Surveys

• 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.

The Chazin Group The Chazin GroupLook for CAUSE & EFFECT

• 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.”

The Chazin Group The Chazin GroupDON’T Defer to Authority

• 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.

The Chazin Group The Chazin GroupBeware of GROUP Think

• Trust your own intuition based on:– your schooling;– on-the-job training;– Past work experience; and– your certifications.

The Chazin Group The Chazin GroupTrust YOUR Instincts

• 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.

The Chazin Group The Chazin GroupObserving Can Change a Situation

• 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".

The Chazin Group The Chazin GroupFind Meaningful Statements

• 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.

The Chazin Group The Chazin GroupDeconstruct Elements

• 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.

The Chazin Group The Chazin GroupUse a SWOT Analysis

•Specific•Measurable•Achievable•Relevant•Timed

The Chazin Group The Chazin GroupCreate SMART Objectives

• 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.

The Chazin Group The Chazin GroupUse Statistics

1, 5, 5, 5, 13, 50, 74, 1001, 5, 5, 5, 13, 50, 74, 100

• 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.

The Chazin Group The Chazin GroupWhat’s NOT There?

"Problems cannot be solved by thinking within the framework in

which they were created.”

Think OUTSIDE the Box

• Have someone take a position on a controversial issue (Euthanasia, evolutionEuthanasia, 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.

The Chazin Group The Chazin GroupThe Socratic Method