CCIV Critical Thinking

process of intentional higher level thinking to define a problem

• utilizes info from other subjects and fields

• requires evidence based practice

• allows for informed decisions to be made (especially in a high stakes environment like health care)

define critical thinking

inductive reasoning

• predictions based on what we observe

• start with specific examples to build a generalization

• multiple observations of a similar event allow you to recognize patterns

inductive reasoning

e.g. every time I touch a pot on the stove, I get burned; therefore all pots on the stove are hot and will burn me

deductive reasoning

• predictions based on what we already know

• start with general knowledge or concepts

• draw conclusion from generalizations

deductive reasoning

e.g. when the sun goes down, it gets dark, therefore if I go outside at midnight it will be dark

fact

can be verified through investigation

inference

conclusions drawn from verified info; going beyond to make a statement about something not currently known

judgement

evaluation of facts of information that reflects values or other criteria (type of opinion)

concept

• our experiences shape our interpretations

• not necessarily wrong

• efforts should be made to clarify where misinterpretations may arise

assumption

• accepted as true but is not supported by evidence

• important to understand when may not be aligned

• socratic questioning can help determine if being made

• decision making in health care as a situation develops

• critical thinking applied in a clinical setting

• cognitive skills (learned knowledge) + metacognitive skills (reflective thinking and awareness)

define clinical reasoning

1. trial and error = multiple solutions applied systemically until one works

   1. while allowing for multiple solutions, doesn’t provide insight into why a solution works

   2. not usually a good strategy in healthcare (can’t do this to patients lol)

2. intuition = relies on hunches, instincts, feelings and suspicions to solve problems

   1. bypasses logical reasoning

   2. overtime we develop critical judgement skills (past experiences + professional knowledge

   3. variable reliability based on previous experiences

3. research = logical, systematic approach to problem solving

   1. evidence-based research is essential for solutions

   2. most thorough method of problem solving, but also most time consuming

Discuss methods of problem solving

• will encounter a variety of ways to approach each specimen types and may be asked to use methods we’ve never seen

• use critical thinking to evaluate new techniques you see and modify the techniques you know

• the CORE of our healthcare contribution is to demonstrate that the surgical procedure was complete and warranted

  • "WHY” are you grossing this specimen?

  • margins → free of disease

  • relationship of disease to tissue → dx and staging

• autopsy:

  • best opportunity to develop and utilize clinical reasoning

  • often limited hx

  • findings are systemic in nature and unique to the circumstances surrounding each case

  • takes more time to develop skills

• transition into healthcare:

  1. independence and self awareness

  2. humility and fairness

  3. integrity

  4. confidence

understand the importance of clinical reasoning to a pathologists' assistant

1. critical analysis

2. inductive and deductive reasoning

3. make valid inferences

4. differentiating facts from opinions

5. evaluating the credibility of information sources

6. clarifying concepts

7. recognizing assumptions

what are the steps of critical thinking (7)

inductive reasoning

e.g. noticing you tend to have a higher volume of GI bx on Friday for the last five weeks, you conclude most patients schedule their bx for fridays

deductive reasoning

e.g. every time you conduct an autopsy, you always practice universal precautions and wear the max PPE

inductive reasoning

e.g. each time you measure a mass to be < 1 cm, additional tissue from the margin is taken, therefore there is a higher risk of recurrence when a mass is that close

1. concept

2. concept

3. assumption

4. assumption

determine if each is concept or assumption: you find a metallic clip while sectioning a lump

1. clips are left after a bx

2. biopsies are done for suspected masses

3. the patient has breast cancer

4. the tumor has been completely removed

1. invalid

2. valid

1. invalid

2. invalid