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PubMed1977

Primary process thinking in the same children at two developmental levels.

Analysis of primary process thinking of the same children at kindergarten level and at grade four revealed that amount of primary process thinking was relatively constant with development, contrary to predictions based on psychoanalytic theory. However, the two facets of primary process thinking, i.e., drive related ideation and formal deviations of thought follow different lines of development with the former increasing and the latter decreasing in quality and type with age.

Journal Article↗

PubMed1987

Distinguishing thinking-feeling preferences through the content analysis of natural language.

This article investigates the relationship between natural language and personality characteristics. In particular, an effort was made to determine whether "thinkers" and "feelers," as defined by Jung's typologies, differ in terms of the language they use to express themselves. First, a linguistic content analysis scale was developed. Next, 5-min verbal samples were obtained from subjects and content analyzed. Content analysis scores were correlated with subjects' self-evaluations and their scores on the Thinking-Feeling scale of the Myers-Briggs Type Indicator (MBTI). Gender differences relating to thinking-feeling preferences were also investigated. Significant correlations between content analysis and MBTI scores were obtained, suggesting that valid information regarding individual preferences for thinking versus feeling may be obtained through the analysis of natural language. Males and females differed significantly in terms of their MBTI scores and self-evaluations, but not in their content analysis scores.

Journal Article↗

PubMed2006

An illustration of whole systems thinking.

The complexity of policy-making in the NHS is such that systemic, holistic thinking is needed if the current government's plans are to be realized. This paper describes systems thinking and illustrates its value in understanding the complexity of the diabetes National Service Framework (NSF); its role in identifying problems and barriers previously not predicted; and in reaching conclusions as to how it should be implemented. The approach adopted makes use of soft systems methodology (SSM) devised by Peter Checkland. This analysis reveals issues relating to human communication, information provision and resource allocation needing to be addressed. From this, desirable and feasible changes are explored as means of achieving a more effective NSF, examining possible changes from technical, organizational, economic and cultural perspectives. As well as testing current health policies and plans, SSM can be used to test the feasibility of new health policies. This is achieved by providing a greater understanding and appreciation of what is happening in the real world and how people work. Soft systems thinking is the best approach, given the complexity of health care. It is a flexible, cost-effective solution, which should be a prerequisite before any new health policy is launched.

Communication↗

PubMed2002

Health care reform: opportunities for professional chaplains to build intentional communities of learners by integrating faith, science, quality, and systems thinking.

Albert Einstein once said, "The significant problems we face cannot be solved at the same level of thinking we were at when we created them" (www.brainyquote.com). Health care reform has brought professional chaplains to a place of chaos-a place that raises many questions about the past, present and future. This chaos presents tremendous opportunities for professional chaplains to increase their capacities in building intentional communities of learners by integrating faith, science, quality and systems thinking. Pastoral care givers must truly understand the pressures from all sides and the new emerging paradigm of integrated health care delivery. Without this understanding, we will not see the opportunities and challenges of integrating pastoral and spiritual care in the emerging structures and systems. The future of chaplaincy largely will depend on the quality of the data, quality of our conversations and our ability to thinking together through dialogue.

Health Care Reform↗

PubMed1997

Imagery: stimulating critical thinking by exploring mental models.

The use of guided imagery in the classroom or clinical setting has traditionally been directed at decreasing anxiety or increasing skill performance (Rodriguez, 1991; Stephens, 1992; Tuyn, 1994). This article describes an innovative use of imagery as a teaching strategy to unearth and possibly reframe, what Senge (1990) has identified as "mental models." The approach described differs from traditional uses of imagery related to decreasing anxiety and increasing skill performance. This approach is directed at increasing critical thinking and has offered new insights for both students and faculty. By using both guided imagery as a teaching strategy and Senge's concepts of mental models, educators can encourage students to become critical thinkers and what Senge calls "systems thinkers." Mental models are deeply ingrained, often unacknowledged, assumptions or images that individuals develop as a result of their life experiences. These images influence values, thoughts, and actions, albeit at times, unknowingly. These images, or mental models, also influence the ability to learn and translate learning into action. Lack of knowledge and awareness of one's mental models can be an obstacle to high-quality critical thinking. The concept of mental models has been best articulated by Senge (1990), who is known for his work in systems-thinking. Senge believed that new insights are rarely followed with substantive action because the new learning, at some level, conflicts with deeply held, internal images. One way to remove this gap between insight and action is to examine mental models that may prohibit both insight and action.

Education, Nursing↗

PubMed1998

IPRs revisited: using process recordings to develop nursing students' critical thinking skills.

Professional nurses must possess critical thinking skills to practice in contemporary health care systems. This paper describes the adaptation of an established strategy for helping students organize their thoughts--the interpersonal process recording (IPR)--to develop nursing students' critical thinking skills. The Critical Thinking-IPR encourages a systemic, theory-based approach to client problems, enables students to become self-directed learners, and engages student and teacher in analytic dialogue about clinical nursing problems.

Communication Barriers↗

PubMedDate not supplied

Which population-based interventions would motivate smokers to think seriously about stopping smoking?

OBJECTIVE: To describe what smokers say about the impact of different population-based interventions to motivate them to think seriously about stopping smoking. METHODS: A random-digit dialed cross-sectional telephone survey of adult current cigarette smokers was conducted in Erie and Niagara counties, New York, in October through November 2002. A total of 815 smokers were asked which of eight interventions would motivate them to think seriously about stopping smoking in the next 6 months. RESULTS: The offer of free nicotine patches/gum (53%) and cash incentives (49%) were the most frequently mentioned interventions that smokers said would get them to think seriously about stopping smoking. The degree of motivation to stop smoking was the most consistent and strongest predictor of how respondents answered the question about the influence of the various intervention options. CONCLUSION: Communities need to offer a wide array of interventions that are likely to appeal to different subgroups of smokers in order to have a population-wide impact on smoking behavior.

Adolescent↗

PubMed2001

Ethical thinking and stakeholders.

Modern medical practice increasingly requires us to think beyond the confines of the doctor-patient relationship to other stakeholders. Problems and issues that can be identified as being of interest to a number of people are defined as "focal entities". Stakeholders are those with an interest in the outcome of the problem or issue. The salience of stakeholders is defined by their power, legitimacy and urgency. The process of thinking about stakeholders can help to clarify our ethical thinking about matters of importance to people beyond the doctor-patient relationship.

Attitude to Health↗

PubMed1999

Innovative thinking for the improvement of medical systems.

If health care systems are not delivering the desired results, those systems must be changed in some way. Innovative thinking is sometimes needed to generate ideas for improvement. Many persons erroneously believe that innovative thinking is a special gift or that it requires an air of lightheartedness that seems inappropriate in a health care setting. Current research in the cognitive sciences has yielded methods to help individual persons and groups generate innovative ideas. These methods do not require any special gift and can be practiced in a serious way. Through a case example from a health maintenance organization, this paper shows that, given some direction, groups of health care professionals can produce useful and innovative ideas. The tools of idea generation are based on three principles: mental attention, escape, and movement. Activities that help persons pay attention to their current situations in a different way, escape their current mental patterns about the situation, and maintain movement in their thoughts support efforts to generate innovative, testable ideas for health system improvements. This paper illustrates several methods of stimulating innovative thinking and shows the ways in which they can be applied in health care.

Creativity↗

PubMed1999

Patient product availability through the use of systems thinking: developing coherent relationships.

The traditional techniques of quality improvement, such as just-in-time delivery, can only go so far in dealing with materiel management issues. A further step is necessary: the implementation of systems thinking. This type of thinking focuses on the interconnectedness of all the members that exist throughout the system. This article explains the nature of systems thinking and how it can be used in materiels management to describe and improve the availability of materiels needed.

Contract Services↗

PubMed2003

Teaching critical thinking in a developmental biology course at an American liberal arts college.

We all expect our students to learn facts and concepts, but more importantly, we want them to learn how to evaluate new information from an educated and skeptical perspective; that is, we want them to become critical thinkers. For many of us who are scientists and teachers, critical thought is either intuitive or we learned it so long ago that it is not at all obvious how to pass on the skills to our students. Explicitly discussing the logic that underlies the experimental basis of developmental biology is an easy and very successful way to teach critical thinking skills. Here, I describe some simple changes to a lecture course that turn the practice of critical thinking into the centerpiece of the learning process. My starting point is the "Evidence and Antibodies" sidelight in Gilbert's Developmental Biology (2000), which I use as an introduction to the ideas of correlation, necessity and sufficiency, and to the kinds of experiments required to gather each type of evidence: observation ("show it"), loss of function ("block it") and gain of function ("move it"). Thereafter, every experiment can be understood quickly by the class and discussed intelligently with a common vocabulary. Both verbal and written reinforcement of these ideas dramatically improve the students' ability to evaluate new information. In particular, they are able to evaluate claims about cause and effect; they become experts at distinguishing between correlation and causation. Because the intellectual techniques are so powerful and the logic so satisfying, the students come to view the critical assessment of knowledge as a fun puzzle and the rigorous thinking behind formulating a question as an exciting challenge.

Developmental Biology↗

PubMed1992

[A role of statistical thinking in clinical anesthesia practice].

The world where we practice anesthesia is composed of heterogeneic, multivariate components. Yet, these components are not known with certainty. Nevertheless, we are compelled to make a prediction and, furthermore, to make a decision to treat patients at risk. Therefore, decision making under uncertainty is one of the important issues in clinical practice. A fundamental strategy for such action would be one of statistical thinking process, which is widely applicable in many circumstances to reduce the degree of uncertainty and to construct a tool to deal with uncertainty. Here, topics relevant to statistical thinking and its pitfalls are discussed, including those related to information theory. In short, statistical thinking will, I believe, remain to be valid to make an appropriate prediction and decision in the years to come.

Anesthesiology↗

PubMed2004

Critical thinking among environmental health undergraduates and implications for the profession.

During a study conducted in 2000-2002, the critical-thinking dispositions of undergraduate environmental health students at Illinois State University were found to have significant shortcomings. The critical-thinking-disposition scores were comparable to those of other undergraduates throughout the United States and Canada; nevertheless, these findings have significant implications for environmental health academic programs and the profession. Environmental health professionals commonly confront "ill-structured" problems, for which critical thiking is an essential skill. In addition, the challenges faced by the profession in terms of recognition, funding, and public support require a high level of critical thinking. This paper provides a number of recommendations for academic programs and professionals.

Adolescent↗

PubMed2004

[Concept analysis and critical thinking: a complementary relationship in nursing].

The purpose of this paper is to demonstrate the relationship between the concept analysis process and critical thinking skills in nursing. Utilizing a discursive essay approach, it is argued that the concept analysis technique enhances critical thinking. The steps of the concept analysis are analyzed as to the inherent cognitive operations that represent critical reasoning processes. Reflecting on an experience with undergraduate nursing students, the technique of concept analysis is evaluated as a didactic activity that enhances critical thinking. It is concluded that both processes complement each other in the rethinking of nursing and in confronting challenging practice situations.

Education, Nursing↗

PubMedDate not supplied

Using critical thinking vignettes to evaluate student learning.

Nursing skills have traditionally been evaluated using laboratory demonstration. The reality, however, is that skill performance does not occur in isolation in the practice setting. Nurses demonstrate skills while functioning within several nursing roles. Following an examination of the relationship of educational outcomes focusing on critical thinking, communication ability, and therapeutic nursing interventions, faculty at a two-year associate degree nursing program formulated Critical Thinking Vignettes as a method of assessing student outcomes. Students role-play a nurse-client interaction using a case study prompt. Student performance outcomes in skills demonstration, communication, teaching, problem solving, critical thinking, identification of resources, and response to environmental cues are evaluated. Preliminary reliability and inter-rater reliability studies suggest that this method provides a controlled method of assessing nursing outcomes reflective of actual practice.

Clinical Competence↗

PubMed2005

Usability evaluation of a laboratory order entry system: cognitive walkthrough and think aloud combined.

Though designing physician order entry (POE) systems has been a highly discussed research topic in the last decade, it seems that engineering POE systems that truly optimise the quality and efficiency of ordering is still a challenge. This study addresses a usability evaluation of an emerging POE for the electronically ordering of laboratory tests. By applying two complementary cognitive approaches, specifically the cognitive walkthrough and think aloud method with seven potential end users of the system, we analyzed usability problems in the prototype system and their potential effect on the quality of orders in terms of efficiency and errors in ordering. The cognitive walkthrough provided a coding scheme that was used to analyse in more detail usability errors encountered during the think aloud tests with the seven end users. The analyses revealed a total of 33 usability problems, which indeed led to inefficiency, omissions in ordering and even to cancelled orders. Most of these usability problems referred to incomprehensiveness of required actions by the user and incomprehensiveness of text used in the system. Next to the discussion of the reasons for these usability problems, the surplus value of the think aloud method as supplementary to the cognitive walkthrough in evaluating physician order entry systems is outlined in this paper.

Cognition↗

PubMed2006

[On establishing comparative reference system for syndrome classification study from the thinking characteristics of syndrome differentiation dependent therapy].

To create a comparative referential system for syndrome classification study by viewing from the thinking characteristics of TCM on syndrome differentiation dependent therapy (SDDT), through analyzing the thinking process of SDDT, and the basic features of disease, syndrome and prescription, combining the basic principles of modern evidence-based medicine and feasibility of establishing integrative disease-syndrome animal model. The practice of creating a comparative referential system based on clinical efficacy of prescription was discussed around syndrome pathogenesis and its relationship with disease and prescription, which was one of the important scientific problems in TCM syndrome study. The authors hold that, it may be one of the available approaches for the present study on integration of disease with syndrome by way of insisting on the thinking pathway of stressing the characteristics of TCM and intermerging with modern scientific design; on taking the efficacy of prescription as the comparative reference system to accumulate and improve unceasingly according to the TCM method of syndrome diagnosis inferred from effect of prescription with reverse thought (i.e., to differentiate syndrome from the effect of prescription), and thus build up the syndrome diagnostic standard on the solid clinical and scientific base.

Clinical Medicine↗

PubMed2006

Access, responsibility, and funding: A systems thinking approach to universal access to oral health.

Universal access to oral health care is a justifiable demand for a number of disparate but morally sound reasons. Nevertheless, that conclusion, however reached, has not solved the problem of the lack of access. Market forces, scarcity of funding, and lack of clarity as to who is responsible for ensuring that oral care is available seem to present insurmountable difficulties. I shall argue that these are not irresolvable problems, but the resolution has to take place through the tool of systems thinking and a systemic approach to moral imagination. Taking the lead from Susan Wolf's and Linda Emanuel's work on systems thinking, and developing ideas from work on mental models and moral imagination, I shall argue that what is often missing in discussions and demands for universal access to oral health care is a morally imaginative systemic approach that takes into account the multi-perspective dynamics involved in health care today. Moral imagination may encourage sound, broad-based, more inclusive moral thinking and moral judgment without ignoring the critical roles and responsibilities each of us has as professionals, providers, payers, or patients, without which change will not take place at all.

Dental Care↗