Kaohsiung Journal of Medical Sciences
Volume 24, Issue 7 , Pages 341-355, July 2008

Current Trends in Developing Medical Students' Critical Thinking Abilities

  • Peter H. Harasym

      Affiliations

    • Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Alberta, Canada
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Peter H. Harasym, Department of Community Health Sciences, Faculty of Medicine, University of Calgary, 2500 University Drive, N.W. Calgary, Alberta, Canada T2N 1N4
    • ,
  • Tsuen-Chiuan Tsai

      Affiliations

    • Department of Pediatrics, Taipei Medical University Municipal Wan-Fang Hospital, Taipei, Taiwan
    • ,
  • Payman Hemmati

      Affiliations

    • Center for Disease Control, Deputy Ministry for Health Affairs, Ministry of Health and Medical Education, Tehran, Iran

Received 24 January 2008; accepted 30 July 2008.

Article Outline

Health care is fallible and prone to diagnostic and management errors. The major categories of diagnostic errors include: (1) no-fault errors—the disease is present but not detected; (2) system errors—a diagnosis is delayed or missed because of the imperfection in the health care system; and (3) cognitive errors—a misdiagnosis from faulty data collection or interpretation, flawed reasoning, or incomplete knowledge. Approximately one third of patient problems are mismanaged because of diagnostic errors. Part of the solution lies in improving the diagnostic skills and critical thinking abilities of physicians as they progress through medical school and residency training. However, this task is challenging since both medical problem-solving and the learning environments are complex and not easily understood. There are many interacting variables including the motivation of the medical student (e.g. deep versus surface learning), the acquisition and evolution of declarative and conditional knowledge (e.g. reduced, dispersed, elaborated, scheme, and scripted), problem-solving strategies (e.g. procedural knowledge—guessing, hypothetical deductive, scheme inductive, and pattern recognition), curricular models (e.g. apprenticeship, discipline-based, body system-based, case-based, clinical presentation-based), teaching strategies (e.g. teaching general to specific or specific to general), the presented learning opportunities (PBL versus scheme inductive PBL), and the nature of the learning environment (e.g. modeling critical thinking and expert problem-solving). This paper elaborates on how novices differ from experts and how novices can be educated in a manner that enhances their level of expertise and diagnostic abilities as they progress through several years of medical training.

Key Words:  critical thinking , curriculum design , expertise acquisition , medical cognition , medical problem-solving

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PII: S1607-551X(08)70131-1

doi:10.1016/S1607-551X(08)70131-1

Kaohsiung Journal of Medical Sciences
Volume 24, Issue 7 , Pages 341-355, July 2008

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