TY - JOUR
T1 - Critical thinking in critical care
T2 - Five strategies to improve teaching and learning in the intensive care unit
AU - Hayes, Margaret M.
AU - Chatterjee, Souvik
AU - Schwartzstein, Richard M.
N1 - Publisher Copyright:
© 2017 by the American Thoracic Society.
PY - 2017/4
Y1 - 2017/4
N2 - Critical thinking, the capacity to be deliberate about thinking, is increasingly the focus of undergraduate medical education, but is not commonly addressed in graduate medical education. Without critical thinking, physicians, and particularly residents, are prone to cognitive errors, which can lead to diagnostic errors, especially in a high-stakes environment such as the intensive care unit. Although challenging, critical thinking skills can be taught. At this time, there is a paucity of data to support an educational gold standard for teaching critical thinking, but we believe that five strategies, routed in cognitive theory and our personal teaching experiences, provide an effective framework to teach critical thinking in the intensive care unit. The five strategies are: Make the thinking process explicit by helping learners understand that the brain uses two cognitive processes: Type 1, an intuitive pattern-recognizing process, and type 2, an analytic process; discuss cognitive biases, such as premature closure, and teach residents to minimize biases by expressing uncertainty and keeping differentials broad; model and teach inductive reasoning by utilizing concept and mechanism maps and explicitly teach how this reasoning differs from the more commonly used hypothetico-deductive reasoning; use questions to stimulate critical thinking: "how" or "why" questions can be used to coach trainees and to uncover their thought processes; and assess and provide feedback on learner's critical thinking.We believe these five strategies provide practical approaches for teaching critical thinking in the intensive care unit.
AB - Critical thinking, the capacity to be deliberate about thinking, is increasingly the focus of undergraduate medical education, but is not commonly addressed in graduate medical education. Without critical thinking, physicians, and particularly residents, are prone to cognitive errors, which can lead to diagnostic errors, especially in a high-stakes environment such as the intensive care unit. Although challenging, critical thinking skills can be taught. At this time, there is a paucity of data to support an educational gold standard for teaching critical thinking, but we believe that five strategies, routed in cognitive theory and our personal teaching experiences, provide an effective framework to teach critical thinking in the intensive care unit. The five strategies are: Make the thinking process explicit by helping learners understand that the brain uses two cognitive processes: Type 1, an intuitive pattern-recognizing process, and type 2, an analytic process; discuss cognitive biases, such as premature closure, and teach residents to minimize biases by expressing uncertainty and keeping differentials broad; model and teach inductive reasoning by utilizing concept and mechanism maps and explicitly teach how this reasoning differs from the more commonly used hypothetico-deductive reasoning; use questions to stimulate critical thinking: "how" or "why" questions can be used to coach trainees and to uncover their thought processes; and assess and provide feedback on learner's critical thinking.We believe these five strategies provide practical approaches for teaching critical thinking in the intensive care unit.
KW - Cognitive errors
KW - Critical care
KW - Critical thinking
KW - Medical education
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U2 - 10.1513/AnnalsATS.201612-1009AS
DO - 10.1513/AnnalsATS.201612-1009AS
M3 - Article
C2 - 28157389
AN - SCOPUS:85017222412
SN - 2325-6621
VL - 14
SP - 569
EP - 575
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 4
ER -