On completion of this chapter, you should be able to:
• Identify the qualities of a critical thinker.
• Identify the assumptions, ethics, and values in written works.
• Discern fallacies in arguments.
• Control psychologic impediments to sound reasoning.
• Recognize the effects of authors’ background beliefs on reasoning.
All health care providers must be able to make logical decisions and wise choices; it goes without saying. The care of the patient demands that good judgment is exercised in the selection of technical factors for quality imaging and in other patient care tasks. You will be responsible for giving the physician a radiograph that is diagnostically sound and for providing safe care to the patient while performing the examination.
As a professional, you will be making vital decisions regarding your own career. You will need to make choices regarding the route you follow in the profession to meet your own personal needs and goals.
Many definitions have been given for critical thinking. One definition calls it emancipatory learning. Emancipation means freedom from restraint or influence. Things that restrain or influence people can be personal, institutional, or environmental. Personal beliefs, rules and regulations of institutions, and physical environments can all work to prevent people from seeing new directions and gaining understanding and control of their own lives and of the world around them. Emancipatory learning means that learners become aware of the forces that have created the circumstances of their lives and take action to change them.
Another definition for critical thinking focuses on the use of morality and virtues, making wise judgments about aspects of our lives, and recognizing the impact these judgments will have on others. Some stress the importance of recognizing reality in the context of cultural elements and the process of trying to create order in a changing world.
Creating order in a changing world will be a challenge for us all. Never in our history have changes occurred with such rapidity. Global information and communication exchange, worldwide exchange of goods and services, and, most importantly, an exchange of ideas affect our world. Geographic boundaries are becoming blurred, as are the cultures and traditions of separate groups. Learning how to live and work in this changing world makes critical thinking more important than ever.
Although the wording of the definitions of critical thinking may differ, they are all made on the assumption that a set of values exists. Each definition assumes that these values are universal; for example, life is better than death, wellness is better than illness, happiness is better than sadness, pleasure is better than pain, and hope is better than despair. Therefore, when we speak of making wise judgments, we have to agree on a set of values. These values are not unique to a specific culture or religion nor are they characteristic of a specific nation or state. They are universal except in rare aberrations of individuals, cult groups, and other deviants.
The assumption that you have accepted these values is a fair conclusion because you have chosen to be a health care provider. We may disagree on the specifics of behaviors that will best accomplish the preservation of these values, but if we disagree on the values, then further discussion is no longer needed. When we speak of making wise decisions, we are judging decisions made within the framework of a value system that is universally understood. It is equated with logical reasoning abilities and reflective judgment.
Critical thinkers are valued for their ability to look at a situation from a variety of perspectives. They are able to discern the best possible way to react to a situation, making them ideally suited for work in the health care profession. Box 3-1 summarizes the characteristics that a critical thinker needs to possess.
One of the first traits that one observes in critical thinkers is the presence of heart as well as mind. The definitions regarding critical thinking are reflective of human values and can thus be expected of critical thinkers. Such a thinker will be able to balance compassion with realism.
The critical thinker must also be analytical, which means finding evidence in unclear and confusing situations. Being alert to the consequences of accepting a course of action and being able to defend that position are both important. Rushing into a plan without examining the ramifications of hastened actions can be dangerous.
Rational thinkers recognize reality; they can discern what is factual and true from what is opinion or misinformation. Seeking truth and making every effort to be honest with yourself is an important characteristic. To accomplish this, we must recognize the difference between what is true and what we wish were true. Making this distinction is more difficult than it may appear on the surface. Recognizing the laws of physics or mathematics as factual is simple enough; however, when the discussions involve government, religion, evolution, or other similar topics, facts become blurred and clouded with emotion. The truth is often elusive, and the evidence is less convincing. Nonetheless, critical thinkers will seek to make rational judgments and act responsibly.
Open-mindedness is an important quality and necessary in the field of patient care. Disagreements are not uncommon, but a heated confrontation can be diffused by the willingness of the critical thinker to listen and understand, which is especially important in dealing with patients. Attempting to understand a patient’s point of view will leave him or her feeling more secure that his or her health care provider actually cares. Dealing with diversity while remaining true to your values is often complicated, but patience and compromise can lead to a solution.
Patience and organization will allow time for the critical thinker to gather evidence, test ideas, and systematically work through tough problems and complex questions. Rash judgments are less likely to be made when time is taken to internalize or ponder the question. During this time, ideas can be tested to ensure that a logical and just decision can be made or an appropriate action can be taken. The critical thinker will resist the desire to reach a solution before all the facts are in.
An inquisitive nature will lead the critical thinker to seek knowledge from many sources. This quality is found in all effective learners. The need to learn, to gather information, and to use that information wisely is a sign of growth and maturity.
In light of these qualities of a critical thinker previously mentioned, it becomes obvious that becoming a critical thinker is a process. Unlike a characteristic you are born with, critical thinking is developed throughout life by the experiences you encounter.
Religious training, attitudes of society, cultural traditions, and teachings of our parents and school teachers form our background beliefs. These beliefs are the stabilizing forces that guide us and the glue that holds our society together. Often, they are the most deeply ingrained beliefs and thus the most intensely defended. Times occur, however, when these beliefs may be challenged by a conflicting value. If a physician must choose between performing an abortion to save a mother’s life and defending his religious convictions that forbid it, to which does his obligation belong? Although no clear-cut answer to this question or others like it can usually be found, examining one’s views and beliefs while keeping in mind the reality of the situation enables the critical thinker to choose the best solution.
Faulty reasoning occurs when biased or false information is stated as fact. Often, this is the aim of advertising. Frequently, celebrities and famous athletes are used as spokespeople for a certain product or service. The logic here is that an endorsement by a public figure will lend credibility to the advertiser’s claims that the product is the best. In this case, the ultimate goal is persuading you to buy the product.
If your only evidence of the worth of the information is because of an “authority” endorsement, it is time to examine the information more critically. Even statistics can be used to persuade. We reason that statistics are accurate and unquestionable. However, the interpretation of the statistics may be faulty. Statistics must be examined from several aspects such as sample size, evidence of bias, nature of the information, and even how recently the information was gathered. Some statistics, such as those regarding spousal abuse or rape, are by their very nature hard to obtain, because most incidences go unreported. Statistics are also used to predict the future, with the assumption that what happened in the past will be repeated in the future. This assumption may or may not be true. Although some statistics may be suspect, we should not dismiss using them altogether, but it does mean we must critically examine them and understand their limitations.
The natural cohesiveness in a social group is called the herd instinct. In such groups, a desire to gain status within the group exists. Generally, all members follow a predetermined set of acceptable behaviors. Success in everyday life depends to a great extent on being accepted by your social group, a concept that is learned early in life. This instinct keeps us loyal to the group; consequently, we tend to behave in ways that will enhance our status and make us feel comfortable within the group. At a more primitive level, instinct makes us aware that our survival depends on the survival of the group. Believing what others in the group believe and defending these beliefs without examining or testing them are natural.
For the most part, loyalty is beneficial to the preservation of the group, but when horrifying acts are committed by mobs or street gangs, loyalty becomes disastrous. In recognizing the natural tendency to group loyalty, we must also realize that this loyalty tends to make us see everything in terms of our own social group. This view may hinder our ability to make just and logical decisions. Unfortunately, creative ideas can be stifled in a group environment.
Individuals with frozen minds reach frozen solutions. This argument is centered in maintaining the status quo. They find the status quo comfortable because they think, often times rightly so, that they have the consensus and support of the group. Early in childhood, we learn to go along with the group and base our actions on group approval. Maintaining the status quo is so deeply ingrained in some people that no amount of evidence will change their minds. It takes courage to recognize this mind-set within ourselves, and it takes discipline to weigh the evidence and create a better solution.
Almost all of us have issues they feel strongly about and will defend vigorously. Emotions run high in the discussions of these issues, and sometimes logic is abandoned. The key to keeping your emotions in check is to identify the issues that cause you discomfort or ire when discussions run counter to your opinion. Some issues to which many have emotional ties are abortion, gun control, the death penalty, censorship—the list goes on and on.
When you have identified the issue that causes you to feel anger or discomfort, it helps to seek out information on both sides of the argument. Learn why those whose position runs counter to yours believe the way they do and on what basis their opinions rest. Make an effort to talk to people whose opinions differ from your own, and read articles on the subject in newspapers, magazines, and books. Understanding both sides of an issue will help sharpen your skills in critical thinking. Developing a greater understanding in no way means that you should change your opinions to conform to the views of others, but it does mean that you can more calmly weigh the evidence so that logic, rather than emotion, determines your actions.
The first step in becoming a critical thinker is to take a humble approach and be open to learning. It is acceptable, even admirable, to admit that you are not sure or that you need more information. You are living at a time when people are pressured to give quick answers; to examine or consider other points of view is often criticized. Short, quick answers are easy to come by when speaking of things that are certain, such as a mathematical answer. For example, you do not need to seek other points of view to determine that the square root of 144 is 12. Such a factual answer leaves no element of doubt. Answers to other questions are more difficult because of uncertainty or the presence of doubt. In cases in which a consensus is widely held in your group, giving up your belief and accepting another view can be difficult. Take, for example, the commonly held belief that more money spent on education will result in higher test scores and therefore a better education. Reflecting on this statement reveals two beliefs that need to be further examined. First, we should question whether money alone is the answer, or whether how it is used makes the difference. Second, we should examine the belief that higher scores mean better education. Could higher scores merely be the result of lowering the level of difficulty of the examinations? These two examples, one of certainty, and the other of widely held beliefs, make it necessary to distinguish truths and certainties from beliefs and opinions.
Another stage in becoming a critical thinker is learning to respect the opinions of others. To live peacefully in a diverse society, we must be tolerant of many different cultures and traditions. Just as geographic lines have been blurring, cultural and traditional lines have also been blurring. At times, this creates a dilemma because tradition is mingled with religion and is a part of every civilized society. Logic and wisdom will, at this point, be needed.
Recognize the things that make you glad, the things that make you sad, and the things that make you mad. Although this is a simplistic way of examining your personality, it is a start. As you grow and develop in your critical thinking ability, the issues that bring forth an emotional response will become more evident, and you will be able to deal with them more effectively. When you are aware of your own standards and ethical values, you can make objective decisions and act responsibly.
It takes practice to become proficient in activities such as sports, music, and dance. Practice will also help you develop your skills in critical thinking. As issues arise, consciously and deliberately examine them from several points of view, and weigh the evidence on the most reliable and convincing basis. This will enable you to resist making instant judgments and taking rash actions.
Critical thinking is a term used to describe thinking based on a universal value system. Characteristics of critical thinkers are compassion, patience, respect for others’ opinions, open-mindedness, and the ability to be analytical. As a health care provider, you will be confronted with many issues requiring logical judgment and rational action. Critical thinkers will be aware of their values and know the reason and consequences of the actions taken.
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