Critical Thinking in Sciences: Thought Process is the Outcome, Learning Guide, Assessment

Background: Critical thinking (CT) is ubiquitous in the health sciences and essential for patient care, yet few prototypes give structure to relevant skill sets.  CT guidance starts with articulating the thought process of the expert for a specific skill set (the outcome), resulting in defensible alternatives (more than a “right” answer).  The outcome is reported in treatment planning, literature search and critique, caries risk assessment and evidence-based dentistry. The purposes of our research are to: 1) demonstrate three CT skill sets as outcomes: geriatric risk assessment, technology decision-making and reflections/general situation analysis; and 2) describe how skill sets connect across disciplines and curriculum years. Methods: Education literature focuses on emulating an intended activity for its validity in proactively guiding skill set design.  An emerging concept in CT guidance and direct performance assessment is the shared experience with the student in the act of CT.  Results: The educational outcomes are three tested CT skill sets, for the health (and other) sciences, that enhance a CT model and a network emulating the intended activity.  Steps in the skill set for geriatric risk: “Do we have basic data?”, “What data are important?”, “What will happen if I do nothing?”, “What is the patient risk?” based on risk factors and disease progression, “What are treatment alternatives?”, “What are specific interventions?”, “What is the communication plan?” and “Self-assess”.  Faculty agreement for assessment was over 95% on students applying steps (objective), and improved to over 90% for agreement on grasping principles (subjective).  Categories (with sub-categories) in the skill set for technology decision-making: “Evidence”, “Technology characteristics”, “Training”, “Financial”, “Company characteristics”, “Process”.  In year one, students developed their own skill sets; none in year one would have been judged competent in year two, where students were give the explicit skill set.  Steps for General Situation Analysis/Reflections: “Event: Description, Emotional response, Problem posed”, “Analysis: Assumptions, Biases, Components shaping event, Modification components, Outcome of modifying components”, “Differences between players’ assumptions”, “Ability to view from a different perspective”, “Alternative actions”.  95% of students applied the steps (objective).  Written feedback was given for this exercise. The interconnectedness and synergy of CT skill sets increased as more were developed into outcomes with assessments. Conclusions: For critical thinking the thought process is the outcome, the learning guide and the assessment instrument. The student leaves the experience with a learning/assessment framework as a skill set.  Assessment is both objective and subjective, with the level of precision needed to establish competency.   While these skill sets apply to dental students, they can be used for members of any health-care team. Model development in CT is at an early stage.