1. RET 1024 Introduction to Respiratory Therapy Module 6.0 Critical Thinking In Respiratory Care Based on Shelley C. Mishoe’s Critical Thinking and Problem-Based Learning in Respiratory Care, as presented in Respiratory Care Principles and Practice, W.B. Saunders Company, 2002

2. Critical Thinking In Respiratory Care For all medical professionals, information processing and decision making are at the core of clinical practice

3. Critical Thinking In Respiratory Care To be an effective practitioner and a vital, functioning member or today’s health care team, respiratory therapists need more than just a knowledge base

5. Critical Thinking In Respiratory Care Respiratory practitioners must become better thinkers, with the critical thinking skills and traits necessary to make appropriate clinical decisions

6. Critical Thinking In Respiratory Care Common Definition of Critical Thinking  Cognitive problem solving  Dressel and Mayhew, 1954  Thinking in order to believe or do  Ennis, 1962  Logical reasoning  Hallet, 1984  Rational and purposeful attempt to use thought to move toward a future goal  Halpern, 1989

7. Critical Thinking In Respiratory Care Common Definition of Critical Thinking  Discipline-specific knowledge, skill and attitudes to solve real problems  McPeck, 1990  An understanding of and an ability to formulate, analyze, and assess the elements of thought  Paul, 1993  Logical reasoning, problem solving and reflection  Mishoe, 1995

8. Critical Thinking In Respiratory Care Essential Skills for Critical Thinking in Practice:  Prioritization  Anticipation  Troubleshooting  Communication  Negotiation  Decision Making  Reflection

9. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Prioritization  The ability to arrange work according to the importance of the task  “Organized Think” - Prioritizing work that is already scheduled  “Rapid Think” – Prioritizing work that unexpected Example: STAT blood gas – Code Blue in ICU – Patient Transport – Asthmatic in ED

10. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Prioritization  Respiratory therapists must quickly prioritize responsibilities and tasks and must communicate quickly and effectively with others (e.g., nurses, physicians, other RTs) so that all patients receive optimal care – patient lives may depend it

11. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Anticipation  The ability to think ahead and envision possible problems  “Future Think” – The ability to see the big picture RTs anticipate when they …  Modify respiratory care  Expect a new patient  Plan ahead for equipment needs  Prepare what they intend to discuss with physicians  Notice subtle changes in their patient’s condition that may indicate problems

12. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Troubleshooting  The ability to locate, correct, and process technical problems  “Technical Think” RTs should be able to …  Learn and introduce new equipment  Adapt new technology for particular needs  Correct equipment malfunctions or breakdowns

13. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Communication  Critical thinking in practice is very much dependent on communication with others as a primary means to give and receive information necessary for patient care; poor communication leads to poor critical thinking  “People Think”

14. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Communication  Poor communication skills result in the inability to …  Gather the appropriate information to interpret, analyze, evaluate, infer, judge, or explain  Share information with other members of the healthcare team  Educate patients and their families  Reassure or explain care to patient’s  Mentor respiratory therapy students and other new clinicians

15. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Negotiation  Is the initiation of discussion to influence others  “Shared Think”  Teamwork  Use of influence  Making recommendations for patient care  Contacting physicians to discuss a patient

16. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Negotiation  Practitioners must negotiate for what they believe is best for a given situation in practice  Negotiation does not necessarily mean conflict, confrontation, or difficulty  If practitioners cannot negotiate, then their patients have only limited access to their expertise, including their cognitive critical- thinking skills

17. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Negotiation  Effective negotiators  Good communication skills  Good judgment/decision-making skills  Are able to explain how they came to their conclusions and suggestions  Often phrase their suggestions as questions

18. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Negotiation  Physicians have final authority regarding medical orders and patient-care decisions  Respiratory therapists should understand that they have a responsibility to make appropriate recommendations regarding respiratory care but should also realize their limitations

19. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Decision Making  The ability to reach a conclusion  “Personal Think”  Reviewing evidence against and in favor of a position  Not ignoring disconfirming evidence  Recognizing errors or mistakes in thinking  Willingness to reconsider a position when presented with conflicting alternatives in practice

20. Critical Thinking In Respiratory Care Essential Skills for CT in Practice  Reflection  The ability to think about thinking  “Inward Think” – Introspective  “Past Think” – Retrospective  Reflecting on work, patients, decisions, and the profession  Exploring assumptions, opinions, biases, and decisions  Learning from mistakes and problems; handling the pain or errors

21. Critical Thinking In Respiratory Care Characteristics of Critical Thinkers  Critical thinkers demonstrate common affective qualities – characteristics  Inquisitiveness  A concern to be well-informed  Alertness to opportunities to use critical thinking  Trust in the process of reasoning inquiry  Self-confidence in one’s own ability to reason

22. Critical Thinking In Respiratory Care Characteristics of Critical Thinkers  Critical thinkers demonstrate common affective qualities – characteristics  Open-mindedness  Honesty  Prudence in suspension of judgment  Willingness to reconsider

23. Critical Thinking In Respiratory Care Characteristics of Critical Thinkers Respiratory therapists are challenged not only to foster the development of their own critical thinking skills but also to develop the dispositions of others in their personal and professional lives

24.  “Prioritization” is defined as which of the following? a.The ability to arrange work according to the importance of the task b.The ability to think ahead and envision possible problems c.The ability to locate, correct, and process technical problems d.None of the above

25.  “Anticipation” is defined as which of the following? a.The ability to arrange work according to the importance of the task b.The ability to think ahead and envision possible problems c.The ability to locate, correct, and process technical problems d.None of the above

26.  “Troubleshooting” is defined as which of the following? a.The ability to arrange work according to the importance of the task b.The ability to think ahead and envision possible problems c.The ability to locate, correct, and process technical problems d.None of the above

27.  Which of the following is true regarding poor communication? a.Leads to poor critical thinking b.Results in the inability to do gather the appropriate information c.Results in the inability to share information with other members of the healthcare team and/or patients and family members d.Results in the inability to mentor respiratory therapy students and other new clinicians e.All of the above

28.  “Negotiation” is defined as which of the following? a.Is the initiation of discussion to influence others b.The ability to reach a conclusion c.The ability to think about thinking d.None of the above

29.  Which of the following statements is not true regarding “Negotiation”? a.Practitioners must negotiate for what they believe is best for a given situation in practice b.Negotiation, unfortunately, always involves some degree of conflict, confrontation, or difficulty c.If practitioners cannot negotiate, then their patients have only limited access to their expertise, including their cognitive critical-thinking skills d.An important point to remember when negotiating is that physicians have final authority regarding medical orders and patient-care decisions

30.  It is essential that effective negotiators possess good communication skills and are able to explain how they came to their conclusions and suggestions.  True  False

31.  It is also essential that effective negotiators possess good judgment/decision-making skills and often phrase their suggestions as questions.  True  False

32.  “Decision Making” is defined as which of the following? a.Is the initiation of discussion to influence others b.The ability to reach a conclusion c.The ability to think about thinking d.None of the above

33.  “Reflection” is defined as which of the following? a.Is the initiation of discussion to influence others b.The ability to reach a conclusion c.The ability to think about thinking d.None of the above

34.  Which is true regarding “Critical Thinkers” a.Demonstrate inquisitiveness and are concerned with being well-informed. b.Demonstrate the characteristics of honesty and open-mindedness c.Demonstrate characteristics of prudence in suspension of judgment and willingness to reconsider d.All of the above “Critical Thinkers” demonstrate inquisitiveness and are concerned with being well-informed. 1.True 2.False

35.  Respiratory therapists are challenged not only to foster the development of their own critical thinking skills but also to develop the dispositions of others in their personal and professional lives  True  False