Table 2. IHC competences.

Goal To enable people to make good decisions * about which claims to believe about the effects of things they can do for their health, the health of others or for other reasons, and about what to do to achieve their goals. Competences To achieve this goal, people should be able to: 1.     Recognise when a claim has an untrustworthy basis by:        a)    recognising claims about the effects of treatments        b)    questioning the basis for treatment claims        c)    thinking carefully about treatment claims before believing them        d)    recognising when a treatment claim is relevant and important, and warrants reflection 2.     Recognise when evidence used to support a treatment claim is trustworthy or untrustworthy by:        a)    recognising the assumptions, evidence and reasoning behind treatment claims        b)    recognising unfair treatment comparisons        c)    recognising unreliable summaries of treatment comparisons        d)    recognising when a statistical model and its assumptions are used to support a treatment claim        e)    recognising misleading ways of presenting treatment effects        f)    understanding how systematic errors (the risk of bias), random errors (the play of chance), and the relevance               (applicability) of treatment comparisons can affect the degree of confidence in estimates of treatment effects        g)    understanding the extent to which evidence does or does not support a treatment claim 3.     Make well-informed decisions about treatments by:        a)    being aware of cognitive biases when making decisions        b)    clarifying and understanding the problem, options, and goals when making a decision        c)    recognising when decisions have irreversible consequences        d)    judging the relevance of evidence used to inform decisions about treatments        e)    weighing the advantages and disadvantages of treatments, taking into account the size of treatment effects, how               important each outcome is, the costs, and the certainty of the evidence        f)    communicating with others about the advantages and disadvantages of treatments 4.     Reflect on people’s competences and dispositions by:        a)    monitoring how they decide which treatment claims to believe and what to do        b)    monitoring how people adjust the processes they use to decide what to believe and do to fit the relevance, importance,               and nature of different types of treatment claims and choices        c)    being aware of when people are making treatment claims themselves

*A good decision is one that makes effective use of the information available to the decision maker at the time the decision is made. A good outcome is one that the decision maker likes. The aim of thinking critically about treatments is to increase the probability of good outcomes (and true conclusions), but many other factors affect outcomes aside from critical thinking ³⁶.