1. Display as participants enter and explain that this training was developed and created based on industry and educator input in conjunction with the Health Workforce Initiative Statewide Advisory Committee, California Community Colleges Chancellor’s Office, and Workforce and Economic Development Program. This is just one soft skills module of the comprehensive training package: “Hi-Touch Healthcare: The Critical 6 Soft Skills.”
Hi-Touch Healthcare

2. Critical Thinking and Sound Judgment

3. What to Expect in this Presentation
Activity: What Is The Answer?
Definition of Critical Thinking
Types of Critical Thinking
Activity: Doesn’t Belong
Qualities of Critical and Uncritical Thinkers
Critical Thinking Steps
Activity: Prove It!
Activity: Same and Different
Activity: Dare Dare
Barriers to Critical Thinking
Quickly preview the session.

4. Importance of Communication and Soft Skills
Communication is “the skill that can possibly have the greatest impact on effective healthcare delivery. It really is the key to clinical governance and demands as much attention, respect and sustaining as other seemingly ‘harder’ targets. However, often the mere mention of the importance of communication causes less than positive reactions in healthcare professionals.”
(Jelphs, 2006, senior fellow at the
Health Services Management
Centre at the University of Birmingham)
Explain that dismissing the value of learning about how to be a more competent communicator is not peculiar to the healthcare field, but a result of the “hindsight bias” or the “I already knew that” phenomenon. The hindsight bias is a phenomenon in which people overestimate their prior knowledge. To demonstrate the concept ask the participants if they have watched TV shows such as Jeopardy, Are You Smarter Than a 5th Grader and/or Who Wants to Be a Millionaire. Remind them of the context in which music is playing while the question or answer is displayed WITHOUT the answer to the question, but when the answer is provided everyone comments, “I knew that.” The reality is that they did not know the answer, but seeing the answer rang true to their personal experience which resulted in an overestimation of their prior knowledge. Because we have been communicating our whole lives and we have communication competencies, it is easy for us to hear information about effective communication and think “I already know that,” but it is important not to fall prey to the hindsight bias or to discount the value of enhancing one’s communication competencies.

5. What’s The Answer
Two slides will be shown and each slide will have a question.
Silently figure out the answer for each and do not share your answer with others.
(See detailed procedures on page 5 of the Trainer Manual.)
Goal: This activity provides an opportunity to use critical thinking to determine an answer to a mathematical calculation. This activity serves as an introduction to critical thinking and how it differs from traditional thinking.
Materials Needed: (quantities vary by group size)
Critical Thinking PowerPoint slides 5– 9
Procedures:
Instruct participants that they will be shown two slides with a question on each slide. Participants should figure out the answer for each question and not share their answers with other participants.
Show slide 6.
Slide 6 is “ =”
Leave slide 6 up for about 10 seconds.
Show slide 7.
Slide 7 is “A bat and ball cost $ The bat costs one more dollar more than the ball. How much does the ball cost? What is the answer?”
Leave slide 7 up for about 15 seconds.
Advance to slide 8. Allow participants to share their answers. Most participants should get the first one correct. There are likely to be multiple answers for the second question. Allow participants to explain how they arrived at their answers. Encourage them to share their method of critical thinking.
Advance to slide 9. Figuring out the first problem required simple addition to arrive at the correct answer. The answer to the second problem required critical thinking because it was more than just adding two numbers together. The problem required figuring out a number and then performing a mathematical calculation. This is an example of beginning critical thinking.
This exercise illustrates basic critical thinking and while it does not directly relate to healthcare, this type of basic critical thinking is the foundation of more abstract types of interpretation and problem solving.

6. =
Display this slide for about 10 seconds. Then advance to the next slide.
What is the answer?

7. A bat and ball cost $1.10. The bat costs one dollar more than the ball. How much does the ball cost?
Display this slide for about 15 seconds.
Advance to next slide.
What is the answer?

8. What Is The Answer?
Allow participants to share their answers. Most participants should get the first one correct. There are likely to be multiple answers for the second question. Allow participants to explain how they arrived at their answers. Encourage them to share their method of critical thinking.

9. First Answer: 11 Second answer: five cents
80% of all college students get the wrong answer on number 2.
Second question - Must be “one dollar more”
$ $.05 = $1.10
Figuring out the answer to the first question is simply adding and coming up with the right answer. The answer to the second one took critical thinking; the answer required more steps than just adding two numbers together. It required figuring out a number and then performing a mathematical calculation. This is an example of the beginning critical thinking.
This exercise is basic critical thinking and while it does not directly relate to healthcare, it is basic critical thinking which are important skills to develop in healthcare.

10. What is Critical Thinking?
Not being content with the first solution
Knowing, understanding, analyzing, synthesizing, applying, and evaluating
Read between the lines
Use logic
Use reason not emotion
Critical thinking is commonly called problem solving.
Critical thinking is not being content with the first solution to a problem, but thinking more deeply about the issue.
Critical thinking is a series of steps, knowing, understanding, analyzing, synthesizing, applying, and evaluating the problem.
Critical thinking is looking for what is implied in a question rather just accepting what is stated.
Critical thinking is actively applying logic and reason.
Critical thinking is not letting reason be clouded by emotions.

11. Critical Thinking Defined
“Critical thinking is the ability to recognize problems and raise questions, gather evidence to support answers and solutions, evaluate alternative solutions, and communicate effectively with others to implement solutions for the best possible outcomes.”
-The Sentinel Watch Nursing, 2011
After reading the quote, discuss why participants think critical thinking is essential to healthcare in terms of assuring the best possible patient outcomes.

12. Four types of thinking of Critical Thinking
Abstract Thinking
Creative Thinking
Systematic Thinking
Communicative Thinking
Critical Thinking
Explain - critical thinking can be divided into four aspects:
Abstract thinking – thinking past what your sense tell you and diving deep into the issue or problem
Creative thinking – thinking outside the box, using innovation and imagination
Systematic thinking – using logic and organizing thoughts into logical steps
Communicative thinking – being precise and using effective communication skills when sharing ideas with others.

13. Doesn’t Belong Activity
Letters will appear on the next slide
Independently decide which letter does not belong with the other letters
(See detailed procedures on page 6 of the Trainer Manual.)
Goal: This activity provides an opportunity for participants to attempt critical thinking in a safe environment.
Materials Needed:
Power Point slides 13 – 14
 Procedures:
Instruct participants to look at the letters on slide 14 and determine which letter in the diagram doesn’t belong.
Advance to slide 14 and allow participants a minute or so to determine which letter doesn’t belong with the rest.
Allow various participants to explain their answers.
Then give the correct answer. The correct answer is the letter “t.”
Most individuals don’t even see the “t” because it is out of place. It is bigger, thinner, and in a different color and font than all of the other letters.
Explain that this is an example of critical thinking because the situation required thinking outside the box. It required creative thinking. The answer was something unexpected and was not predictable.
In healthcare we are continually looking for answers that are hidden in plain site or are not obvious. This exercise is an introduction to out of the box type of critical thinking.

14. Doesn’t Belong Activityk m q w
Which letter in this diagram does not belong?
Allow various participants to explain their answers. Then give the correct answer. The correct answer is the letter “t”. Most individuals don’t even see it because it is out of place. It is bigger, thinner, and a different color and font than all the other letters.
In healthcare we are continually looking for answers that are hidden in plain site or are not obvious. This exercise is an introduction to out of the box critical thinking.

15. Qualities of Uncritical thinkers
Pretend
Annoyed
Impatient
First impressions
Own opinions
Thinking gives them a headache
Uncritical thinkers pretend to know more than they really do.
Uncritical thinkers are annoyed by problems.
Uncritical thinkers are impatient and often jump at the first suggested solution.
Uncritical thinkers focus on their own opinions and look for those that share those opinions.
Uncritical thinkers claim that trying to find a solution gives them a headache and are easily frustrated.

16. Qualities of a Critical Thinker
Limitations
Challenge
Understanding
Evidence
Other ideas
Think then act
Open-mind
A critical thinker acknowledges that s/he has personal limitations. This allows the critical thinker to keep those limitations in mind and keep them in their place
A critical thinker sees problems as exciting challenges rather than a burden or a drudgery.
Critical thinkers have understanding as their goal, not being the winner.
Critical thinkers use evidence to make decisions, not hunches or gut feelings.
Critical thinkers seek out other’s ideas and value them.
Critical thinkers think before they act.
Critical thinkers keep an open mind and don’t follow preconceived notions.

17. Steps to Critical thinking
Fact or Opinion
Comprehend
Analyze
Apply
Evaluate

18. Step 1 - Fact or Opinion Opinion – Facts –
What someone thinks is right
Subjective
Change
Facts –
Provable truths
Objective
Don’t change
The ability to differentiate between facts and opinions is the first step in critical thinking. An opinion is what someone thinks is right. Two people can have completely different opinions. Opinions are subjective. Facts are truths that can be proven. Facts don’t change from person to person.
For example:
A fact is that fall begins on September 21st.
An opinion is that fall is most beautiful season of the year.
A fact is something that can be proven with some form of evidence.
An opinion is not back by facts. Opinions often result from feelings or emotions.

19. Dr. Cross Quiz Activity
Read the statement on the handout and determine if it is fact or opinion.
(See detailed procedures on pages 7– 8 of the Trainer Manual.)
Goal – The first step in critical thinking is to be able to determine the difference between fact and opinion. This exercise will allow participants to practice and validate their stance on whether statements are fact or opinion.
Materials Needed:
A copy of the “Dr. Cross Quiz” handout for each participant (pages 9–10 of the Trainer Manual).
A writing utensil for each participant
Procedures:
1. Pass out a copy of the handout to each participant.
2. Make sure each participant has a writing utensil.
3. Have the individual read the paragraph and then determine if each statement is true, false, or can’t be determined (“?”).
4. Allow 5–10 minutes for participants to complete the handout.
5. By show of hands, ask participants:
if anyone answered “True” to all questions.
if anyone answered “False” to all of the questions.
if anyone answered “?” to all the questions.
(Trainer: Write down how many participants raised their hand for each type of answer and note that rarely will anyone answer all “?” which is the correct answer.)
Ask participants to raise their hand if they answered “True” to question #2 (write down the number), raise their hand if they answered “True” to question #4 (write down the number).
These two questions provide an opportunity to discuss gender bias.
Participants who answered “True” to question 2 inferred that the Dr. was a man and answering “True” to question 4 inferred that the nurse was a woman.
Nowhere in the paragraph are the gender of the characters identified.
Put participants into groups of 3– 4 (a minimum of 4 – 5 groups works best). Ask participants to share their answers and to make any changes if they believe they “inferred” an answer which was not provided. (In other words, factual information is NOT provided enabling a “True” answer. To reach a “True” conclusion, participants must be inferring form their previous experiences the answers).
Ask the same questions outlined in step one of the groups. Note whether or not any of the groups now have ALL “?” as their responses.
Review the Answer Key. This provides an opportunity to discuss the difference between good and bad inferences. Our brains are wired to think inferentially. We must be able to draw conclusions without questioning every step. For example, we don’t bother calling our local grocery store or gas station, or even our place of employment, before going to these establishments because we infer from past experience and that they will be open for business. However, we don’t KNOW they are open; and, once in a while, extenuating circumstances do cause the establishments to be unexpectedly closed. Make the point that in problem solving situations or situations that require interpretation, we must use critical thinking processes to determine whether or not we HAVE the facts or are drawing conclusions based on limited information and/or past experiences.

20. Step 2 - Comprehend
Understanding the issue and possible solutions is key to critical thinking.
Compare
Contrast
The best way to comprehend the situation and potential outcomes is to be able to compare and contrast solutions. When we compare and contrast things we note what is the same between things and what is different.

21. Same and Different Activity
Watermelon and Steak
Rain and Snow
Patient and Healthcare Worker
Lab test and x-ray
(Animated slide – with click, a pair of words will appear, with the next click, the next pair appears.)
(See detailed procedures on page 11 of the Trainer Manual)
Goal: To help participants practice evaluating possible outcomes to complex questions by determining points that are the same and points that are different. In critical thinking situations, evaluating the similarities and differences of possible options by what allows the best option to be chosen.
Procedures:
A pair of words will appear on the slide, one set at a time.
Participants will find and share similarities and differences within the pairs of words.
Ask the participants to discuss how determining how items are the same and different helps with critical thinking.
Point out that looking for how different things either work together or are different is a step in developing critical thinking skills.
It is important in healthcare to be able to determine how options are the same and how they are different so the correct intervention can be determined.

22. Step 3 - Analyze Breaking down How parts relate Purpose
Explain that step 3 is analyzing the parts of the issue at hand. Break the parts by how they relate to one another and to the overall structure of the issue. Organize the parts by differentiating, organizing, and attributing.

23. DOUBLE DARE Dare Dare Activity
Word puzzles will appear on the next three slides.
Independently determine what each word puzzle says.
DOUBLE
DARE
(See detailed procedures on page 12 of the Trainer Manual.)
Goal: This activity helps participants implement the steps to critical thinking discussed so far in this module. Participants are encouraged to comprehend and analyze the presented material in order to find a solution to the problem presented.
Materials Needed:
PowerPoint Slide 23– 26 of the Critical Thinking PowerPoint
Procedures:
Example word puzzle: What is Dare Dare? (It is a double dare.)
The next three slides will show word puzzles. Instruct participants to try to figure out what the word puzzle means using the steps of critical thinking discussed thus far.
Show slide 24. Display for about 30 seconds.
Ask if anyone knows what it means. The answer can either be shared by someone if the majority of the group seems to have solved the word puzzle, or the group can be given more time to ponder before allowing someone to share the answer. If no one knows the answer, then it can be given to the group.
Show slide 25. Display for about 30 seconds.
Show slide 26. Display for about 30 seconds.
After sharing the final word puzzle ask the participants how figuring out these word puzzles compares to critical thinking. Point out that finding new and unique solutions require analysis of the puzzle as distinct parts.

24. POL4ICY Dare Dare Activity Display for about 30 seconds.
Ask if anyone knows what it means. The answer can either be shared by someone if the majority of the group seems to have solved the word puzzle, or the group can be given more time to ponder before allowing someone to share the answer. If no one knows the answer, then the it can be given to the group.
Answer – foreign policy.
(Transition to the next slide which displays the second word puzzle).

25. thing AM AM Dare Dare Activity Display for about 30 seconds.
Ask if anyone knows what it means. The answer can either be shared by someone if the majority of the group seems to have solved the word puzzle, or the group can be given more time to ponder before allowing someone to share the answer. If no one knows the answer, then the it can be given to the group.
Answer – First thing in the morning.
(Transition to the next slide which displays the final word puzzle).

26. COAST Dare Dare Activity Display for about 30 seconds.
Ask if anyone knows what it means. The answer can either be shared by someone if the majority of the group seems to have solved the word puzzle, or the group can be given more time to ponder before allowing someone to share the answer. If no one knows the answer, then the it can be given to the group.
Answer – The coast is clear.
Reflect: Ask the participants how figuring out these word puzzles compares to critical thinking. Point out that finding new and unique solutions require analysis of the puzzle as distinct parts.

27. Step 4 - Apply Implementation of critical thinking
Part of critical thinking is the actual application of what was determined during critical thinking. This may seem like an obvious step, but it is part of the critical thinking process.

28. Step 5 - evaluate Step back Did that solution work?
Explain that critical thinking is a process. It is always valuable to take a step back and look at the solution that was chosen and see if it did or will create the desired outcome.

29. Barriers Two of the biggest barriers to critical thinking:
Not keeping in mind that we can be wrong or make mistakes!
Assuming that mistakes and being wrong is simply a bad thing!

30. Become a Master at Critical thinking
Practice
Practice!

31. Thank you!
Questions? Comments?