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PubMed2002

Measuring change in students' critical thinking ability: implications for health care education.

The purpose of this study was to determine the change in critical thinking (CT) dispositions and skills among physical therapy students over academic and clinical portions of a year and to determine correlates of change in CT abilities. Twenty-eight middle-year physical therapy students participated (26 women and 2 men; mean age, 22 years). Participants completed a descriptive survey at the beginning of the study. They also completed the California Critical Thinking Disposition Inventory (CCTDI) and the California Critical Thinking Skills Test (CCTST) before the academic year, after the academic year, and after their clinical placements. A one-way repeated measures analysis of variance was conducted on the subscales and total scores of the CCTDI and CCTST. Multiple regression was used to determine the correlations between the descriptive variables and change in total CCTDI and CCTST scores. Statistically significant improvements in all subscales and both total scores were obtained over the year. Greatest improvements on the CCTDI were observed for truth-seeking (p < 0.001) and CT self-confidence (p < 0.001). Greatest improvement on the CCTST was noted for deduction (p < 0.001). Changes in skills were more modest than changes in dispositions. None of the descriptive variables were correlated with change in total score on the CCTDI. Age was negatively associated with change on the CCTST. Although both instruments detected change over the year, more change was detected by the CCTDI; it also took less time to complete. The CCTDI can be used to monitor individual change and to evaluate the effectiveness of a program in enhancing CT ability. Although this study was conducted with physical therapy students, it should be of interest to educators in other health care disciplines because CT ability is a fundamental component of clinical reasoning.

Adult↗

PubMed2003

Electroencephalographic activities during wakefulness and sleep in the frontal cortex of healthy older people: links with "thinking".

STUDY OBJECTIVE: Separate studies have shown for the frontal cortex that: i) sleep electroencephalogram (EEG) activity less than 1 Hz may be linked to waking recovery, and ii) waking frontal theta activity may reflect "cortical workload." We explored the potential linkage between (i) and (ii) in relation to specific waking theta frequencies and 0.5-Hz to 1.0-Hz activity in sleep. DESIGN: A correlational study SETTING: Laboratory-based waking EEGs under different (eyes-closed) contrived "thinking" conditions (mostly localized to the left frontal area), and night sleep EEGs at home. PARTICIPANTS: Twelve right-handed, healthy, good-sleeping, older adults (mean age, 67.3 years) MEASUREMENT & RESULTS: EEGs comprised 4 bipolar derivations (Fp1-F3; Fp2-F4; O1-P3; O2-P4). Power in the 7-8-Hz bin was the only waking frequency significantly (positively) correlated with power in the 0.5- to 1.0-Hz bin during the first NREM period and only for the left frontal EEG. Interestingly, 7- to 8-Hz power immediately after lights out at bedtime, and before the appearance of EEG sleepiness, showed an even higher positive correlation with 0.5- to 1.0-Hz power during sleep. This wake-sleep EEG link was confirmed in another sample of 8 similar participants. Waking frontal 7- to 8-Hz EEG may not be typical theta, but "kappa" activity, believed to be associated with thinking CONCLUSIONS: Within limits of the EEG, and for the left frontal area, waking thinking may be reflected by putative cortical reorganization during the first NREM period.

Aged↗

PubMed2006

Educational strategies associated with development of problem-solving, critical thinking, and self-directed learning.

This article was developed for the Commission on Change and Innovation in Dental Education (CCI), established by the American Dental Education Association. CCI was created because numerous organizations within organized dentistry and the educational community have initiated studies or proposed modifications to the process of dental education, often working to achieve positive and desirable goals but without coordination or communication. The fundamental mission of CCI is to serve as a focal meeting place where dental educators and administrators, representatives from organized dentistry, the dental licensure community, the Commission on Dental Accreditation, the ADA Council on Dental Education and Licensure, and the Joint Commission on National Dental Examinations can meet and coordinate efforts to improve dental education and the nation's oral health. One of the objectives of the CCI is to provide guidance to dental schools related to curriculum design. In pursuit of that objective, this article summarizes the evidence related to this question: What are educational best practices for helping dental students acquire the capacity to function as an entry-level general dentist or to be a better candidate to begin advanced studies? Three issues are addressed, with special emphasis on the third: 1) What constitutes expertise, and when does an individual become an expert? 2) What are the differences between novice and expert thinking? and 3) What educational best practices can help our students acquire mental capacities associated with expert function, including critical thinking and self-directed learning? The purpose of this review is to provide a benchmark that faculty and academic planners can use to assess the degree to which their curricula include learning experiences associated with development of problem-solving, critical thinking, self-directed learning, and other cognitive skills necessary for dental school graduates to ultimately become expert performers as they develop professionally in the years after graduation.

Clinical Competence↗

PubMed1990

[Primary and secondary process thinking in normal probands, neurotic and borderline patients].

In the present paper normals, neurotics and borderline patients were compared with respect to primary and secondary process thinking. The Holtzman Inkblot Technique was used to assess the different modes of functioning. As it was expected, normals had more indicators of the most severe levels of primary process thinking than neurotics, but less than borderline patients. On the other hand it could be demonstrated that in normals the reality testing ability and synthetic functioning were not impaired compared to neurotics. In the contrary, the normals exceeded the neurotics concerning indicators of abstractive abilities. The results are discussed with regard to the hypothesis of a continuum of normal and deviant thinking and with regard to the concept of adaptive regression in the service of the ego.

Borderline Personality Disorder↗

PubMed1990

Critical thinking in the nursing curriculum.

In increasing the emphasis on critical thinking in the nursing curriculum, there is concern that it will become another unit of content competing with other units that must be included somewhere in the curriculum. Critical thinking is much more than this. It is a combination of an attitude of inquiry, supported by a knowledge base and enhanced by skill in application. Critical thinking is an approach to inquiry where both students and faculty examine clinical and professional issues and search for more effective answers. Unfortunately, there is no simple, magic "how to" formula to guide faculty in developing these skills among nursing students.

Clinical Competence↗

PubMed1987

Schizophrenic thinking and neuroleptic dosage.

Three groups (N = 60) of schizophrenics (with varying levels of chronicity and drug dosages) were administered the Whitaker Index of Schizophrenic Thinking, the Mini-Mental State, and the Self-Conscious Scale. The results indicated that no differences existed between the chronic and acute groups on the dependent measures. Furthermore, no significant differences emerged between 21 of the acute patients who were discharged and 9 patients of the acute group who were not discharged (follow-up). No significant differences on any of the dependent measures were observed when subjects were grouped according to level of schizophrenic thinking and of neuroleptic dose. Also, no relationship between neuroleptic drug dosage and thinking for any of the three groups was observed.

Acute Disease↗

PubMed1977

[Relationship between thinking activity and typologic characteristics of personality (material from a study of schizophrenic patients and their relatives)].

The paper presents an analysis of relationships between the expressivity of the change in thinking selectivity and premorbid personality characteristics of schizophrenic patients (242 patients) and the types of personality anomalies in the relatives of the probands with schizophrenia (203 patients). The authors reveal correlation of the expressiveness of the above-mentioned thinking anomaly with definite types of personality anomalies (sthenic, hyperthymic and mosaic schizoids). The circle of the marked personality types according to the analyzed indices are limited both from representatives of the normal population and representatives of other personality types ("model", "deficient", cycloids). The obtained data permit to consider the studied thinking anomaly in the system of typological peculiarities of mental activity.

Cyclothymic Disorder↗

PubMed1995

Do current educational programs address critical thinking in nurse anesthesia?

Critical thinking skills are vital in any of the nursing and medical specialties. These skills can be taught using adult teaching methods and should be incorporated into all courses in the educational process. Unfortunately, some nurse anesthesia programs fail to adequately address critical thinking or the use of these skills. They often teach using rigidly structured models. This descriptive study surveyed nurse anesthesia students (n = 197) and faculty members (n = 128) from 32 schools of nurse anesthesia. It was undertaken to determine the effect of using adult education principles on student satisfaction. Participants completed a survey that was designed by the investigator to determine individual perceptions of the program's teaching style, personal teaching and learning style preference, and, in the case of the students, satisfaction. Results of this study suggest that anesthesia students are more satisfied if they are approached as adult learners. Critical thinking, a vital component of nurse anesthesia practice, is also reinforced by these same teaching methods.

Adult↗

PubMedDate not supplied

Parental thinking: assessment and applications in nursing.

Recent research indicates that knowledge of what a parent thinks may be more valuable information than observations of what a parent does. Therefore, maternal-child nurses should have a sound knowledge about not only specific behaviors that promote good parenting but also parental thinking, or the ideas parents hold about child rearing and child development. The authors present the importance of the nursing role in assessment of parental thinking, utilization of an appropriate framework for these assessments, and the considerations of nursing interventions that build on such assessments.

Attitude to Health↗

PubMed1993

[Semantic information. Internal language. Thinking].

Semantic information has reached an objective condition after a lengthy history of semantic inquiries that instrumental neurophysiological devices--such as event-related potentials, electroencephalographic spectral analysis, regional brain circulation, PET scan, deep brain electrodes, and other--have made easier. In turn, internal language, as screened according to Vigotsky's perspective, is considered a product of semantic information circulation understood as neurosemae interconnection. Finally, in normal adults, thinking processes are assumed to be made up by both sensoperceptive information (proprioceptive information included) and semantic information. Thus, an "extraverbal thinking" can be distinguished, whose activity is hardly describable in healthy adults but should be considered as a condition of non-educated deaf persons, and a "verbal thinking", or internal language, made up by semantic information.

Humans↗

PubMed1996

Critical thinking for outcomes-based practice.

Critical thinking is a vital component in managing patient-related outcomes at the staff level. It involves making observations and then asking "why?" Critical thinkers explore connections between current events and other events, stretching the boundaries of the situation. This allows the critical thinker to make new associations, challenge the status quo, find subtle patterns, and arrive at new formulations to old issues. Although nurses are most often traditional thinkers, it is possible to develop or refine their critical thinking skills through participation in learning situations that focus on exploring new approaches to thinking.

Clinical Competence↗

PubMedDate not supplied

The relationship between critical thinking and self-concept in staff nurses and the influence of these characteristics on nursing practice.

Thirty-five nurse managers were interviewed, and 100 staff nurses were tested using the California Critical Thinking Skills Test (CCTST) and the Tennessee Self-Concept Scale (TSCS) to determine if a relationship existed between critical thinking and self-concept. Correlations (Pearson r) showed no statistically significant relationship (r = 0.1097, P > 0.05). Comparison of the results of the California Critical Thinking Skills Test between groups with differing levels of nursing education indicated that scores for nurses with a baccalaureate were statistically and significantly higher than the scores of nurses with an associate/diploma degree (ANOVA F = 3.03, P = 0.03). Implications for nursing education and practice are discussed.

Adult↗

PubMed1989

Pain control and rational thinking. Implications for rheumatoid arthritis.

In this study, we examined the factor structure of the Coping Strategies Questionnaire and studied the relevance of the coping process to health status in rheumatoid arthritis patients. The 2 factors of the questionnaire that were analyzed were Coping Attempts and Pain Control and Rational Thinking. The Pain Control and Rational Thinking factor was related to pain and psychological status, even after demographic variables and disease severity were statistically controlled. In addition, increases in Pain Control and Rational Thinking scores were related to improvements in pain, psychological status, and health status. Implications for the psychological care of rheumatoid arthritis patients are discussed.

Adaptation, Psychological↗

PubMed1995

Positive thinking: an unfair burden for cancer patients?

This presentation challenges the purveyors of the importance of "positive thinking" in the cure of cancer. Psychological support should allow the patient to come to terms with his or her situation in a way that works for that individual within a caring and realistic environment. In no way should psychological support add an extra burden to an already devastated patient. By forcing "positive mental attitude", health-care professionals are not allowing patients to face reality. Promoters of the "cure" that comes with positive thinking are quoted, as well as authors who question the promoters' intent and outcome. It is felt that "positive thinking" may be appropriate as one of many successful coping strategies. To attribute more to it or, worse, to insist that patients believe in its power to cure may be courting emotional disaster.

Humans↗

PubMed2004

Eight-dimensional methodology for innovative thinking about the case and ethics of the Mount Graham, Large Binocular Telescope project.

This paper introduces the Eight Dimensional Methodology for Innovative Thinking (the Eight Dimensional Methodology), for innovative problem solving, as a unified approach to case analysis that builds on comprehensive problem solving knowledge from industry, business, marketing, math, science, engineering, technology, arts, and daily life. It is designed to stimulate innovation by quickly generating unique "out of the box" unexpected and high quality solutions. It gives new insights and thinking strategies to solve everyday problems faced in the workplace, by helping decision makers to see otherwise obscure alternatives and solutions. Daniel Raviv, the engineer who developed the Eight Dimensional Methodology, and paper co-author, technology ethicist Rosalyn Berne, suggest that this tool can be especially useful in identifying solutions and alternatives for particular problems of engineering, and for the ethical challenges which arise with them. First, the Eight Dimensional Methodology helps to elucidate how what may appear to be a basic engineering problem also has ethical dimensions. In addition, it offers to the engineer a methodology for penetrating and seeing new dimensions of those problems. To demonstrate the effectiveness of the Eight Dimensional Methodology as an analytical tool for thinking about ethical challenges to engineering, the paper presents the case of the construction of the Large Binocular Telescope (LBT) on Mount Graham in Arizona. Analysis of the case offers to decision makers the use of the Eight Dimensional Methodology in considering alternative solutions for how they can proceed in their goals of exploring space. It then follows that same process through the second stage of exploring the ethics of each of those different solutions. The LBT project pools resources from an international partnership of universities and research institutes for the construction and maintenance of a highly sophisticated, powerful new telescope. It will soon mark the erection of the world's largest and most powerful optical telescope, designed to see fine detail otherwise visible only from space. It also represents a controversial engineering project that is being undertaken on land considered to be sacred by the local, native Apache people. As presented, the case features the University of Virginia, and its challenges in consideration of whether and how to join the LBT project consortium.

Arizona↗

PubMed2004

Cognitive bias in back pain patients attending osteopathy: testing the enmeshment model in reference to future thinking.

BACKGROUND: Depressive symptoms are common in chronic pain. Previous research has found differences in information-processing biases in depressed pain patients and depressed people without pain. The schema enmeshment model of pain (SEMP) has been proposed to explain chronic pain patients' information-processing biases. Negative future thinking is common in depression but has not been explored in relation to chronic pain and information-processing models. OBJECTIVES: The study aimed to test the SEMP with reference to future thinking. METHODS: An information-processing paradigm compared endorsement and recall bias between depressed and non-depressed chronic low back pain patients and control participants. Twenty-five depressed and 35 non-depressed chronic low back pain patients and 25 control participants (student osteopaths) were recruited from an osteopathy practice. Participants were asked to endorse positive and negative ill-health, depression-related, and neutral (control) adjectives, encoded in reference to either current or future time-frame. Incidental recall of the adjectives was then tested. RESULTS: While the expected hypothesis of a recall bias by depressed pain patients towards ill-health stimuli in the current condition was confirmed, the recall bias was not present in the future condition. Additionally, patterns of endorsement and recall bias differed. DISCUSSION: Results extend understanding of future thinking in chronic pain within the context of the SEMP.

Adult↗

PubMed2005

Dimensions of catastrophic thinking associated with pain experience and disability in patients with neuropathic pain conditions.

The objective of the present study was to examine the relative contributions of different dimensions of catastrophic thinking (i.e. rumination, magnification, helplessness) to the pain experience and disability associated with neuropathic pain. Eighty patients with diabetic neuropathy, post-herpetic neuralgia, post-surgical or post-traumatic neuropathic pain who had volunteered for participation in a clinical trial formed the basis of the present analyses. Spontaneous pain was assessed with the sensory and affective subscales of the McGill Pain Questionnaire. Pinprick hyperalgesia and dynamic tactile allodynia were used as measures of evoked pain. Consistent with previous research, individuals who scored higher on a measure of catastrophic thinking (Pain Catastrophizing Scale; PCS) also rated their pain as more intense, and rated themselves to be more disabled due to their pain. Follow up analyses revealed that the PCS was significantly correlated with the affective subscale of the MPQ but not with the sensory subscale. The helplessness subscale of the PCS was the only dimension of catastrophizing to contribute significant unique variance to the prediction of pain. The PCS was not significantly correlated with measures of evoked pain. Catastrophizing predicted pain-related disability over and above the variance accounted for by pain severity. The findings are discussed in terms of mechanisms linking catastrophic thinking to pain experience. Treatment implications are addressed.

Adaptation, Psychological↗

PubMed2003

Thinking of the future and past: the roles of the frontal pole and the medial temporal lobes.

Human lesion data have indicated that the frontal polar area might be critically involved in having an insight into one's future. Retrospective memory mediated by medial temporal lobes and related structures, on the other hand, could be used to extract one's future prospects efficiently. In the present study, we investigated the roles of these two brain structures in thinking of the future and past by using positron emission tomography (PET) and a naturalistic task setting. We measured regional cerebral blood flow (rCBF) in healthy subjects while they were talking about their future prospects or past experiences, with regard to two different temporal windows (in years or days). Many areas in the frontal and the medial temporal lobes were activated during the future and past tasks compared with a control task requiring semantic retrieval. Among these, areas in anteromedial frontal pole showed greater activation during the future tasks than during the past tasks, showing significant effect of temporal distance from the present. Most areas in the medial temporal lobes showed greater or equivalent level of activations during the future tasks compared with the past tasks. The present results suggest that thinking of the future is closely related to retrospective memory, but that specific areas in the frontal pole and the medial temporal lobes are more involved with thinking of the future than that of the past.

Adult↗