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Teaching Clinical Reasoning and Critical Thinking: From Cognitive Theory to Practical Application
Jeremy B Richards1, Margaret M Hayes1, Richard M Schwartzstein1
1Center for Education, Shapiro Institute for Education and Research, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
Chest
|May 26, 2020
Summary
This study explores cognitive psychology principles to enhance clinical reasoning and critical thinking education in the Intensive Care Unit (ICU). It offers practical teaching strategies for trainees to improve diagnostic skills.
Area of Science:
- Medical Education
- Cognitive Psychology
- Critical Thinking
Background:
- Teaching clinical reasoning in the Intensive Care Unit (ICU) presents significant challenges due to time pressures and complexity.
- Clinical reasoning involves identifying, prioritizing data, and forming/testing hypotheses, closely linked to critical thinking skills like analysis and self-reflection.
Purpose of the Study:
- To review how cognitive psychological principles inform strategies for teaching clinical reasoning in the ICU.
- To identify teaching interventions that foster clinical reasoning and critical thinking in medical trainees.
Main Methods:
- Review of literature on teaching clinical reasoning, grounded in cognitive psychological theories.
- Discussion of System 1 (intuitive) and System 2 (analytical) thinking frameworks.
- Analysis of internal and external factors impacting trainee clinical reasoning.
Main Results:
- Understanding cognitive pathways (System 1 vs. System 2) aids in identifying and addressing reasoning patterns.
- Environmental factors significantly influence trainees' clinical reasoning and critical thinking development.
- Specific teaching strategies, including the 'one-minute preceptor' and concept mapping, are effective.
Conclusions:
- Cognitive psychology provides a valuable framework for improving clinical reasoning and critical thinking education.
- Targeted teaching interventions can enhance trainees' ability to apply critical thinking in complex clinical environments like the ICU.
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