Critical Thinking and Decision Making Arnuparp Lekhakula Faculty of Medicine Prince of Songkla University Hat 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 Skills IDEAL (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 อริยสัจ 4 ทุกข์ สมุทัย นิโรธ มรรค

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-Making SQEJA 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