Critical Thinking Skills for Healthcare

Stephanie McKendry, Stephanie Mckendry

• Publisher: Routledge
• Year: 2015
• Print ISBN: 9781138787513
• eBook ISBN: 9781317660330
• Topic: Medicine
• Subtopic: Health Care Delivery

Thinking critically is an essential skill, both for students and for the modern, evidence-based, healthcare practitioner. You need to be able to find, understand and evaluate the evidence that underpins your assignments, clinical decision making and practice. The good news is that you use all of these skills in everyday life. You don't believe every advert you see or respond to every spam email. It's just a question of taking these critical skills and having the confidence to apply them to your academic work. This book will help you do just that. It will enable you to:

- recognise your existing ability to be a critical thinker

- spot logical flaws and inconsistencies in arguments

- consider health issues from multiple perspectives, weighing up the strengths and weaknesses of a case

- build a convincing argument in assessments

- develop a range of critical skills for successful study and healthcare practice.

Critical Thinking Skills for Healthcare is an essential resource for all health professionals in training.

Chapter 1
Taking a critical approach in everyday life

Overview of chapter

This chapter should help you consider the critical thinking skills you already have, as well as clarifying where you require further development. Beginning with an audit of your current abilities, it will focus on how you have used critical skills in your everyday life. Finally, it will demonstrate how you can use popular issues and the media to begin honing your skills and your ability to identify flaws and logical problems.

Learning outcomes

By the end of this chapter, you should be able to:

• assess your current critical thinking skills;
• recognise ways in which you use critical thinking in your everyday life;
• notice logical problems in popular issues and debates.

Rating your current abilities

How do you rate yourself as a critical thinker? Have you ever thought about it before? Do you consider yourself to be rational? Do you tend to win arguments or debates? Can you convince others of the correctness of your point of view?

Presumably, since you are reading this book, it is something you are aware of and hoping to develop. But why is that?

• Because you feel you already have some of the skills but you would like to refine and improve them?
• Because your lecturers continually emphasise the importance of taking a critical approach?
• Because it is regularly mentioned in the feedback you receive?
• Because you don’t really understand what people are talking about when they suggest the need to be critical?

Please do not worry if you have the latter motive – you are unclear exactly what criticality is and how to demonstrate it. This is very common, mainly because it is extremely difficult to define, even for lecturers. Often, people are able to determine whether a piece of writing is critical or not, but find it much more difficult to explain why it is critical, what it is doing that takes it beyond mere description. In the next chapter, we will examine exactly what is meant by critical thinking in academic work.

Maybe none of these reasons resonates with you or sums up why you have picked up this book. It is important to reflect upon why you have chosen to develop your critical skills, however. The more honest and detailed your reasoning is, the more likely you are to stay motivated and, thus, make a genuine difference to the way you approach your degree work.

That ‘hmmm feeling’

Before beginning a full evaluation of your critical thinking skills, it is worth noting that, in general, there is a piece of critical thinking at which we all tend to be reasonably good. Most people can sense when there is a logical flaw, inconsistency or plain error in an argument. It is almost as if something does not ‘feel right’. There is a sense of unease, an inkling there is a problem, a scepticism or reluctance to accept whatever is being presented. Maybe even a gut instinct. I call that the ‘hmmm feeling’ – the thing that makes you stop and become uneasy. This is a good thing! Learn to recognise it and pay attention to it. Go with that gut instinct.

The most obvious place you will come across this ‘hmmm feeling’ is when listening to advertisements, political debates or anything else that is trying to convince you to buy/believe/vote for something. You are also likely to have encountered it in your degree studies. Maybe you have been reluctant to accept the value of a particular model or you have finished reading a paper and felt there is definitely something wrong with it. You should take confidence from the fact that you have perceived a potential critical problem.

Unfortunately, that is the relatively easy bit. It is more challenging to understand and define what the problem actually is. You require developed critical skills to pick apart an argument, understand its structure and the evidence it is using (or failing to provide) to substantiate its points. It is only then that you can fully evaluate it, write about its flaws in an assessment, potentially dismiss it or, perhaps, offer a counterargument. This book is designed to help you reach this second, more advanced stage.

From now on, start to notice when you have that ‘hmmm feeling’ and, what’s more, begin to question what is causing it.

Activity: evaluating your critical skills

Use the following table to reflect on your current critical thinking skills. You are likely to be stronger in some areas than others. What do you most need to develop? Can you think of examples when you have demonstrated this element of critical thinking in the past? Can you think of a way of working on it? Later chapters of this book will provide you with insights, activities and advice on these different aspects of critical thinking but you may well be able to devise supplementary ways of improving.

Critical skills in everyday life

Even if you feel that you are not particularly experienced in using critical skills in your academic work, you will have made plenty of use of them in the rest of your life (the part that isn’t all placements, assessments and tutorials). How many times have you snorted

Table 1.1 Evaluation of current critical skills

Critical skill/ability	Current self-rating (1 = weak, 5 = strong)	Evidence of use	Plan for development
Can you recognise when there is a flaw in someone else’s argument (that ‘hmmm feeling’)?		I now read the small print in adverts and evaluate the research on which they make claims
Can you break that argument down and explain why it is flawed?
Can you evaluate different kinds of research (experimental, qualitative etc.)?			Attend additional workshops at university on research methods
Do you have a method or set of questions/criteria you use to ensure you take a critical approach to everything you read?
Can you structure an argument so that you lead your reader through the points in a logical order?
Do you actually say something within your assessments (rather than simply describing the issues)?
Can you recognise when you should provide evidence to substantiate your point (data, reference to a paper ) and when you can convince your reader by the logic of your argument alone?
Do you consciously demonstrate critical thinking in your assessments?
Can you undertake reflective tasks critically - deeply questioning your actions, emotions, preconceptions and plans for the future?

derisively at a television programme or ruined your mother’s enjoyment of said show by loudly proclaiming ‘as if!’ (sorry mothers, but we do seem to get to a certain age and insist on watching the absolute worst Silent Victims’ Unit: Peterborough type programming)?

Reading between the lines

Most of us take a critical approach in life. We don’t believe every headline we read. We are aware that these sensational headings often have very little to do with the rest of the story. We know that ‘exclusives’ in weekly magazines tend to be anything but, that quotes from the ‘friends of’ or ‘sources close to’ a celebrity are likely to be entirely fictitious. We might still enjoy reading the articles and buying into the narrative. Nevertheless, for the majority of us, we can see that the purpose of the magazine is to sell copies rather than to fastidiously document the truth. In these circumstances, you have considered the motives of the people involved, read between the lines perhaps. If you are sceptical that ‘celebrity x’ is ‘desperately unhappy, alone and putting on weight again’ that is because you have made a critical analysis of the evidence and found it insufficiently convincing – the sad photograph and quotes from ‘friends’ are not enough.

Selecting from results

Many people look cautiously at the results produced by a search engine rather than simply choosing the link at the top of the page or the one highlighted in a different colour. Again, critical skills are informing those decisions. You are likely to be evaluating the information you have – the website address, name, brief text. You will be drawing on previous experience – reputations of the websites and companies, knowledge of the subject area. You are hopefully looking beneath the surface and questioning why the results are delivered in that particular order – becoming aware that sponsored links have paid to be highlighted in search results, knowing that websites manipulate metadata so they appear high up any list of results. All of these evaluations inform your decision on which link to click.

Evaluating reviews

Consider the last time you used a review site or simply read the reviews of a product whilst shopping online. You probably don’t accept every review of a hotel posted on a travel site as entirely honest or balanced. You are unlikely to decide that each comment has equal credibility. It is worth thinking about how you arrive at these conclusions – poor spelling, overly enthusiastic praise or ridiculously aggressive criticism. Sometimes, it seems that the person writing the review has completely different expectations from you (I once decided to dismiss one of the reviews written about a hotel I was thinking of visiting. The complaint was that it was far too hot by the pool in Turkey, in August! I decided it was not fair to expect the hotel owners to adjust the climate according to visitors’ requirements and thus ignored that particular review). There are well-known cases of manufacturers posing as customers to extol the virtues of their products. Or, conversely, of competitors attempting to damage reputations by posting unfavourable reviews.

With each of these everyday activities we question and consider different perspectives. We wonder what the person’s motives might be, what additional information we need to evaluate something or make a fully informed decision.

Figure 1.1 Example 1 – buying a house

Table 1.2 Activity – choosing your current course

Why did you choose this profession?
Why did you choose your particular institution?
What were your other options?
Why did you decide against them?
Why did you choose now rather than earlier or later in your life?
What sources of information did you use when deciding?
Did you conclude these sources were all of equal value?
From whom did you seek advice?
Whose advice did you find the most useful and why?

Using critical skills in decision making

You will have used critical skills when making important decisions. Or, if you failed to, you will have learned to do it next time, having landed yourself with a duff purchase.

It is not only lifelong purchases and decisions that require critical skills. Think of anything where you have had a few options from which to choose and the final decision is important to you – a new phone, a car, an outfit for a special occasion. Much of the time, you will have employed critical skills in your decision making.

Spend some time reflecting on the decision to join your particular profession. How did you make this important, even life changing, choice? What sources of information did you turn to? Answer the questions in Table 1.2.

Critical thinking in the twentieth-century, Western world

So you do currently have critical skills. They are a necessary part of modern living. If you did not judge credibility, question motives and evaluate evidence you would not have any mone...

Table of contents

• Cover
• title
• Copyright
• Dedication
• Contents
• List of figures
• List of tables
• Introduction
• 1 Taking a critical approach in everyday life
• 2 Taking a critical approach at university
• 3 Taking a critical approach to reading
• 4 Building a rational and credible argument
• 5 Taking a critical approach in assessments
• 6 Taking a critical approach in literature reviews
• 7 Taking a critical approach in dissertations
• 8 Taking a critical approach in reflection and reflective assessments
• Index