Critical thinking in action: decision-making in medical school graduates

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Research and Development in Higher Education: Enhancing Higher Education, Theory and Scholarship Vol. 30

July, 2007, 651 pages
Published by
Geoffrey Crisp & Margaret Hicks
0 908557 72 8

The aim of this study was to investigate the possible relationship between critical thinking ability and decision-making in recent medical school graduates during their emergency medicine intern rotation. In this qualitative study, five interns completed an emergency medicine trauma case study; and a test of critical thinking ability. Scores on these tests were compared for relationship. Secondly, three of these interns, and five emergency medicine consultants, participated in individual 30 minute semi-structured interviews in which subjects talked through the reasoning used to address the case, using a “think aloud” protocol. Novice/expert differences were identified.

Interns scored well on the test of critical thinking ability, but although they responded well to the basic facts of the trauma case, they missed important ancillary features that were identified by consultants. Differences in pattern recognition were evident between consultants (experts) and interns (novices); and in the use of metacognition. Interns' responses demonstrated the action of biases such as anchoring, Sutton's slip, representativeness restraint, search satisficing and premature closure.

Research in disciplines other than medicine is clear on the point that the explicit, contextualised teaching of critical thinking skills, cognitive debiasing and decision-making heuristics improves decision outcomes. In the light of the importance of the reduction of preventable error for patient safety, it is suggested that such a curriculum be utilised in medical education.

Keywords: critical thinking; assessment; medical education

Critical thinking in action: decision-making in medical school graduates

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Macpherson, K.