Critical thinking: How is it taught?

Reading and learning about the importance of critical thinking was exciting and invigorating, but it left me wondering: How can I effectively promote critical thinking within OT education?

Assessment of Critical Thinking

Part of being promoting critical thinking ideally involves measuring student progress toward these skills, so I began my search by looking for assessment methods related to critical thinking. While there are some reliable assessment tools for critical thinking (e.g., California Critical Thinking Skills Test (CCTST), Watson-Glaser Critical Thinking Appraisal (WGCTA), Ennis-Weir Critical Thinking Essay Test), there are concerns about ecological validity as the assessments emphasize a holistic approach to critical thinking rather than being content-specific (e.g., OT-specific) (Morris et al., 2018). As a result, many of these assessment tools lack the sensitivity needed to measure changes in critical thinking skills within a specific subject area such as OT (Murphy & Stav, 2018). Additionally, many of the assessments rely on a multiple-choice format which seemed incompatible with my understanding of critical thinking or alternatively employ an essay format that is time intensive to evaluate.

Given these challenges, I opted to transition my focus to identifying effective teaching and learning methods for critical thinking, anticipating that these would have more immediate applications and benefits for the students in my courses.

Teaching Methods for Critical Thinking

Research suggests that educators should combine explicit instruction on critical thinking skills with a subject-specific learning activity that is designed to promote in-depth thinking and analysis (Morris et al., 2019). Explicit instruction seems to be particularly beneficial at improving student's disposition and motivation to use critical thinking skills because they understand the "why" behind classroom learning activities (Berg et al., 2019). That made sense to me, but I was still left wondering how to design OT-specific activities that embedded concepts of critical thinking. As I returned to the literature again, I discovered a variety of teaching methods that have been used in education settings across OT and related healthcare professions.

Commonly used teaching methods to improve critical thinking include:

• Concept mapping (Grice, 2016; Yue et al., 2017)

• Experiential learning (Coker, 2010)

• Problem-based learning (Scaffa & Wooster, 2004)

• Traditional and non-traditional Level I fieldwork settings (Nielsen et al., 2020)

• Guided reciprocal peer questioning (Velde et al., 2006)

• Case studies with embedded social determinants of health (Berg et al., 2019; Plack & Santasier, 2004)

Additionally, incorporating reflective prompts within these activities may further enhance critical thinking as students are challenged to reflect on their assumptions and consider new perspectives (Berg et al., 2019; Coker, 2010; Plack & Santasier, 2004).

I was familiar with some of these methods such as problem-based learning, case studies, and early fieldwork experiences. I even had a sense of accomplishment as I recalled the growth that I experienced as a result. Interestingly enough, I previously considered most of my growth to have occurred within the realm of clinical reasoning skills and not critical thinking. This was largely due to the emphasis and explicit teaching in my classes on clinical reasoning, arguably to the detriment of critical thinking. Now as an educator, I hope to teach and emphasize BOTH of these skills and the connection between them. Being a critical thinker makes you a better therapist because it supports your clinical reasoning and decision making.

What Do You Think?

I've rambled long enough for now. What do you think? Do you agree that there is a difference (yet inextricable connection) between critical thinking and clinical reasoning? Have you used any of the methods above to promote critical thinking or clinical reasoning in your classroom? Look for future posts on suggestions and instructions for using these methods in OT education.

References

Berg, C., Philipp, R., & Taff, S. D. (2019). Critical thinking and transformational learning: using case studies as narrative frameworks for threshold concepts. Journal of Occupational Therapy Education, 3(3). https://doi.org/10.26681/jote.2019.030313

Coker, P. (2010). Effects of an experiential learning program on the clinical reasoning and critical thinking skills of occupational therapy students. Journal of Allied Health, 39(4), 280-286.

Grice, K. (2016). Concept mapping as a learning tool in occupational therapy education. Occupational Therapy in Health Care, 30(3), 309-318. https://doi.org/10.3109/07380577.2015.1130886

Morris, R. J., Brockner, A. E., & Coleman, S. E. (2019). Effectiveness of two methods for teaching critical thinking to communication sciences and disorders undergraduates. Canadian Journal of Speech-Language Pathology and Audiology, 43(1), 21-34.

Morris, R. J., Gorham-Rowan, M. M., Robinson, J. H., & Scholz, K. (2018). Assessing and teaching critical thinking in communication science and disorders. Teaching and Learning in Communication Sciences & Disorders, 2(1). https://doi.org/10.30707/TLCSD2.1Morris

Murphy, L. F., & Stav, W. B. (2018). The impact of online video cases on clinical reasoning in occupational therapy education: A quantitative analysis. The Open Journal of Occupational Therapy, 6(3). https://doi.org/10.15453/2168-6408.1494

Nielsen, S., Klug, M., & Fox, L. (2020). Brief Report—Impact of nontraditional Level I fieldwork on critical thinking. American Journal of Occupational Therapy, 74, 7403345010. https://doi.org/10.5014/ajot.2020.036350

Plack, M. M., & Santasier, A. (2004). Reflective practice: A model for facilitating critical thinking skills within an integrative case study classroom experience. Journal of Physical Therapy Education, 18(1), 4-12.

Scaffa, M. E., & Wooster, D. M. (2004). Brief Report—Effects of problem-based learning on clinical reasoning in occupational therapy. American Journal of Occupational Therapy, 58, 333–336.

Velde, B. P., Wittman, P. P., & Vos, P. (2006). Development of critical thinking in occupational therapy students. Occupational Therapy International, 13(1), 49-60. https://doi.org/10.1002/oti.20

Yue, M., Zhang, M., Zhang, C., & Jin, C. (2017). The effectiveness of concept mapping on development of critical thinking in nursing education: A systematic review and meta-analysis. Nurse Education Today, 52, 87-94.