Critical thinking is one of the most important skills required to be possessed by any medical student for providing quality health care. With the introduction of a new competency-based medical education curriculum that focuses on the desired and observable ability of Indian medical graduates in real-life situations, inculcating critical thinking skills in the medical graduate is the need of the hour. With the changing expectations of society from the doctor, there is a need to focus more on this higher-order thinking skill which can serve as an essential attribute of any medical professional. It may serve as an important avenue for medical students to deal with any ill-defined medical emergencies and evolve with the best judgment for the clinical situation and solve the clinical problem. It is considered to be key competency to be cultivated and assessed in any medical school.
What is Critical Thinking and why it is Needed?
Critical thinking is a high-level thinking process that can be used in conceptual learning for students.[1] It is defined as the ability to identify and analyze problems as well as seek and evaluate relevant information to reach an appropriate conclusion.[2] Thus, critical thinking enables medical students to assess their needs for learning and comprehend their perspectives. This may aid in enhancing their problem-solving ability and making effective clinical decisions during their routine clinical encounter in the future.
In a medical college, during the budding years of medical students, they need to identify their own learning needs and take control of them as self-directed learners. This approach inculcates problem-solving ability and critical thinking skills in the students, which is considered to be the strong determinant for any good medical practitioner.
Strategies and Tools to Promote and Assess the Critical Thinking Skills of Medical Students
The various strategies and tools to promote and assess the critical thinking skills of medical students include:
Problem-based learning
It is an innovative teaching methodology that provides students with real-life scenarios to motivate them to seek out a deeper understanding of the given topic. In this, students learn to monitor their own learning process directing them toward building up on existing conceptual knowledge frameworks.[3] It is a student-centered learning method, in which the students work collaboratively as a team to find a solution to the given problem by digging deeper into the concepts. Different questions pertaining to the given problem and exploration of the topic occur during the session itself. This strategy of teaching inculcates a wide range of skills like problem-solving abilities and communication in addition to critical thinking skills.
Case-based learning
It is an effective tool that promotes active learning by linking theory to practice. It utilizes the clinical case scenario which is reflective of real-life experiences. Advanced study is required by the students before the discussion of the cases with their peers.[4] It encourages critical thinking by directing the learners toward the pavement of lifelong learner.[5]
Think, pair, and share strategy
It is one of the forms of cooperative learning strategy, where students are actively involved in group discussions.[6] They critically analyze the given question at an individual level and then practice sharing with their peers to achieve a pertinent solution to the given question and to further share that with a larger group.
Flipped classroom teaching
With an aim to address the higher-order skills and active involvement of students inside the classroom, this model of teaching was introduced in 2007.[7] The term “flipping” refers to providing the students with the resource material in advance before the classroom and utilizing the classroom time for active learning, fostering problem-solving skills, and enhancing their critical thinking skills.[8] It is considered a reverse of traditional teaching methodology which promotes the passive learning rather than active learning of the students.
Reflective writing
It is the process of creating a new insight in which experiences are recollected, critically analyzed, and then transformed into words in the form of writing.[9] It may strengthen and promote the development of critical thinking skills of medical students.[10]
Script concordance test
The script concordance test (SCT) is an innovative tool to assess the clinical and critical reasoning skills of medical students. It is based on the script theory which assumes that the clinician has a network of knowledge called scripts to make judgments for the clinical encounter they have in their routine practice. These scripts are imbibed by any medical student during their evolving stage from novice to expert in a medical college. As the career advances, these are further refined depending on their exposure to the clinical practice. In this test, trainees are exposed to ill-defined case vignettes which are pertaining to diagnostic, therapeutic, or investigative problems, for which there is no definitive answer. This serves as a very effective tool in probing into the critical thinking skills of medical students. The answers given by the trainees are then compared with the answers given by the panel of experts, and the final scoring is done.[11] Thus, this tool compares the judgment skills of the trainees with the reference panel and measures the degree of concordance between both.
An original study about the use of SCT in medical training is being published in this issue, and the article will give more insights to the readers.
In this era of the 21st century, with an effort to tackle the recent trends and challenges in the medical field, there needs to be more emphasis on drifting the students from lower-order thinking skills to higher-order thinking skills. This helps the medical students to analyze the information critically and then apply that to the existing information. Critical thinking skill is considered a cornerstone for teaching and training medical students so as to maintain clinical competence and medical professionalism.
References
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