decision making and critical thinking are examples of what dimension of health

Let's change the way we see health

The 8 Dimensions of Health

The 8 dimensions of health represents a view of health.

in which many factors contribute to one's overall wellness and well-being. In the past, health had been defined as relating to the physical body in terms of the presence or lack of pain, illness, disease. Today, the concept of health has grown to include more than the condition of one's physical body and the absence of disease. The 8 Dimensions of Health acknowledge that beyond the body, the quality of one's mental state, interactions with others, regular living and work environments, career pursuits, hobbies and other stimulating areas of personal interest and expression, financial stability, and system of beliefs and values all have a role in determining well-being. This belief states that each of these factors can influence one's overall health, and that these factors are not isolated from each other. Instead, any combination of these factors can be connected at any given point in time.

Building Blocks of Health

Physical Health

Physical health refers directly to the body and its condition. One's physical health is influenced by nutrition and diet, physical activity, sexual activity, sleep, and medical conditions. The state of physical health is often visible through one's outward appearance, but can also relate to the internal systems of the body as they are affected by disease, illness, injury, stress, and weight maintenance.

Mental Health

Mental health relates directly to emotions, and includes coping mechanisms, self-evaluation, and temperament. The ability to react well to change and to maintain a positive mindset has a direct impact on mental health. Mental health conditions occur internally and can be determined through psychological evaluation, and may or may not be outwardly visible to others.

Intellectual Health

Intellectual health refers to activities that stimulate the mind and includes many forms of personal expression. Aspects of intellectual health include learning and using life skills such as critical thinking, decision-making, organization, and problem-solving. These skills can be applied to a variety of creative pursuits, often for the purpose of expressing oneself.

Social Health

Social health is impacted by interactions and relationships with others. The quality of these interactions and relationships are largely affected by social skills including assertiveness, behavior, communication, empathy, kindness, listening, and patience. These relationships can have varying levels of importance and serve as a system of support.

Environmental Health

Environmental health frequently refers to the condition of the earth and atmosphere. The availability of resources, cleanliness of air and water, climate conditions, and management of waste all contribute to the earth's environment. Environmental health also refers to one's personal surroundings that include home, community, work, and other living conditions.

Financial Health

Financial health relates directly to money and resources one has at their disposal. Education and occupation play a significant role in one's finances by impacting the ability to earn money. Planning and maintaining a budget, saving for the future, making investments, limiting unnecessary expenses to avoid debt, and living within one's means also affect financial health.

decision making and critical thinking are examples of what dimension of health

Spiritual Health

Spiritual health is often tied to faith and religiousness, though one can be spiritual without being religious. Spirituality relates directly to the beliefs, morals, principles, and values that govern one's everyday life. Skills such as mindfulness and self-awareness play a role in spirituality, and can anchor one's sense of well-being and inner peace.

Occupational Health

Occupational health is the pursuit of a job or career that provides one with a sense of fulfillment and personal enrichment. The ability to be productive can be influenced by a variety of conditions in the workplace including demands and expectations, the nature of the work, the layout and organization of the work space, safety, and the structure of the business.

Developing Clinical Reasoning Capabilities

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Joy Higgs 5

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This chapter addresses five questions: What is clinical reasoning as a metapractice? What are key elements of context in clinical reasoning and professional decision-making and what impact do they have on these practices? How can we categorize the main clinical reasoning and decision-making approaches? How can the learning and teaching of clinical reasoning and health care decision-making be facilitated and pursued? At the end of the chapter readers are invited to reflect on how the contents of the chapter have stimulated thoughts about their own reasoning practices and capabilities and their clinical reasoning development strategies.

Clinical reasoning
Learning approaches
Capabilities

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Faculty of Health Sciences and Medicine, Bond University, Manchester, UK

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Higgs, J. (2020). Developing Clinical Reasoning Capabilities. In: Nestel, D., Reedy, G., McKenna, L., Gough, S. (eds) Clinical Education for the Health Professions. Springer, Singapore. https://doi.org/10.1007/978-981-13-6106-7_103-1

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DOI : https://doi.org/10.1007/978-981-13-6106-7_103-1

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Decision-making

Decision-making is a fundamental aspect of daily life, influenced by various factors including mental health. Mental health conditions such as anxiety, depression, or impulsivity can significantly impact decision-making processes, leading to altered perceptions, biases, and potentially risky choices.

What Is Decision-making?

Decision-making is the cognitive process through which individuals select a course of action among several alternatives 1 Hicks Patrick, J., Steele, J. C., & Spencer, S. M. (2013). Decision making processes and outcomes. Journal of aging research , 2013 , 367208. https://doi.org/10.1155/2013/367208 . It involves evaluating information, weighing various options, and ultimately making a choice that best aligns with one’s goals, preferences, and values.

Decision-making is a fundamental aspect of human cognition, occurring in both conscious and unconscious levels 2 Elwyn, G., Price, A., Franco, J. V. A., & Gulbrandsen, P. (2023). The limits of shared decision making. BMJ evidence-based medicine , 28 (4), 218–221. https://doi.org/10.1136/bmjebm-2022-112089 , influencing behaviors ranging from mundane daily activities to significant life-changing decisions. Whether it’s choosing what to eat for breakfast, determining which route to take to work, or making complex financial investments, decision-making permeates virtually every aspect of daily life.

What Influences Decision-making?

The symptoms of good or poor decision-making are often influenced by several factors 3 Ricou, M., & Marina, S. (2020). Decision Making and Ethical Reasoning in Psychology. Psychology in Russia: State of Art, 13(1), 2–10. https://doi.org/10.11621/pir.2020.0101 :

Cognitive biases: An individual’s mental set that affects decision-making by skewing judgment.
Emotions: Feelings that influence choices by coloring perceptions and preferences.
Personal values: Core beliefs guiding decisions toward options that align with individual principles.
Available information: Data accessible to influence decision evaluation and selection.
Past experiences: Previous encounters shaping current decision-making patterns.
Risk perception: Assessment of potential outcomes’ likelihood and impact on decisions.
Time constraints: Limits on decision-making duration impacting depth of analysis.
Social-cultural pressures: Shared societal beliefs and norms influencing decision-making behaviors.

Spotting Good Decision-Making: Symptoms

Research 4 Ricou, M., & Marina, S. (2020). Decision Making and Ethical Reasoning in Psychology. Psychology in Russia: State of Art, 13(1), 2–10. https://doi.org/10.11621/pir.2020.0101 claims that good decision-making:

Considers diverse perspectives.
Weighs potential outcomes and risks.
Incorporates relevant information.
Adapts to changing circumstances.
Reflects on past experiences.
Aligns with personal values.
Acknowledges and manages emotions.
Shows flexibility and openness.
Demonstrates critical thinking skills.
Leads to positive outcomes and growth.

Symptoms Of Poor Decision-making

As opposed to good decision-making, the symptoms of poor decision-making entail 5 Hicks Patrick, J., Steele, J. C., & Spencer, S. M. (2013). Decision making processes and outcomes. Journal of aging research , 2013 , 367208. https://doi.org/10.1155/2013/367208 :

Ignorance of relevant information
Failure to consider consequences
A rigid adherence to initial plans
Constant negative outcomes
Emotion- or bias-driven
Disregarded feedback or alternative viewpoints
Impulsivity or recklessness
Inconsistency or indecisiveness
Repetition of past mistakes
Conflict or dissatisfaction

Causes Of Poor Decision-making

The common 6 Turner, S., D’Lima, D., Hudson, E., Morris, S., Sheringham, J., Swart, N., & Fulop, N. J. (2017). Evidence use in decision-making on introducing innovations: a systematic scoping review with stakeholder feedback. Implementation Science, 12(1). https://doi.org/10.1186/s13012-017-0669-6 causes of poor decision-making include:

Cognitive biases can lead to poor decision-making by skewing our perception and judgment.
Emotional influences may cloud rational thinking, causing decisions based on feelings rather than logic.
Lack of relevant information can hinder the ability to make informed choices.
Pressure from social or environmental factors can push individuals to make decisions that may not align with their best interests.
Impaired judgment due to fatigue or stress can result in suboptimal decision-making.
Overconfidence or under-confidence can lead to decisions that are not well-considered.
Limited consideration of consequences may result in decisions made without fully understanding the potential outcomes.
Inadequate problem-solving skills can contribute to making decisions that are not well thought out.
Failure to learn from past mistakes can lead to repeated poor decisions.
External distractions or disruptions can interfere with the decision-making process, leading to less effective choices.

How Does Mental Health Affect Decision-making?

Effective decision-making cultivates feelings of empowerment and accomplishment 7 Yamauchi, Y., Shiga, T., Shikino, K., Uechi, T., Koyama, Y., Shimozawa, N., Hiraoka, E., Funakoshi, H., Mizobe, M., Imaizumi, T., & Ikusaka, M. (2019). Influence of psychiatric or social backgrounds on clinical decision making: a randomized, controlled multi-centre study. BMC medical education , 19 (1), 461. https://doi.org/10.1186/s12909-019-1897-z , bolstering individuals’ sense of control and self-confidence. By aligning choices with personal values and goals, decision-making fosters authenticity and enhances overall well-being. Moreover, the development of problem-solving skills through decision-making promotes resilience and adaptability, reducing stress associated with uncertainty and challenges.

Conversely, decision-making challenges such as indecision or regret can lead to feelings of helplessness and anxiety, impairing mental well-being. Additionally, conflicts arising from decisions and cognitive overload from processing excessive information can contribute to stress and strain on mental resources, impacting overall mental health negatively.

How Does Mental Disorder Affect Decision-making?

Mental disorders 8 Sanders Thompson V. L. (2013). Making decisions in a complex information environment: evidential preference and information we trust. BMC medical informatics and decision making , 13 Suppl 3 (Suppl 3), S7. https://doi.org/10.1186/1472-6947-13-S3-S7 affect decision-making in several ways:

Depression: Decreased motivation and energy levels hinder decision-making.
Anxiety disorders: Excessive worry or indecision due to heightened anxiety.
Bipolar disorder: Fluctuating between impulsive and indecisive phases.
OCD: Obsessive thoughts and compulsions interfere with rational choices.
PTSD: Hyperarousal or avoidance impacting decision-making.
Substance use disorders: Impaired judgment leading to risky decisions.
Schizophrenia: Disorganized thinking affects decision-making abilities.
ADHD: Impulsivity and distractibility influencing choices.
BPD: Emotional instability leading to impulsive actions or avoidance.

How To Improve Decision-making Skills: Tips And Strategies

Consider the following tips 9 Alaseeri, R., Rajab, A., & Banakhar, M. (2021). Do Personal Differences and Organizational Factors Influence Nurses’ Decision Making? A Qualitative Study. Nursing reports (Pavia, Italy) , 11 (3), 714–727. https://doi.org/10.3390/nursrep11030067 on how to improve decision-making skills:

Practice mindfulness to enhance self-awareness.
Gather relevant information before making decisions.
Consider potential consequences and risks.
Seek input from trusted sources or mentors.
Break complex decisions into manageable steps.
Learn from past experiences and mistakes.
Cultivate critical thinking and problem-solving skills.
Manage emotions and reduce impulsivity.
Set clear goals and priorities.
Trust your intuition while remaining open to feedback.

At A Glance

Decision-making is fundamental, influencing daily actions to major life choices.
Factors like biases, emotions, and experiences shape decision quality.
Effective decision-making empowers, enhances adaptability, and problem-solving skills.
Mental health conditions can impair decision-making, leading to indecision or impulsivity.
Improving decision-making involves mindfulness, gathering information, and managing emotions.
Recognizing the link between decision-making and mental health emphasizes the need for resilience strategies.

Frequently Asked Questions (FAQs)

1. is being indecisive a mental health issue.

Indecisiveness can be a symptom of various mental health issues, but it’s not always indicative of a specific disorder on its own.

2. When Does Decision-making Become A Complex Issue?

Decision-making becomes complex when there are multiple options with significant consequences, unclear outcomes, or conflicting priorities.

3. Which Mental Functioning Is Concerned With Making Decisions?

Decision-making primarily involves cognitive functioning, including processes like judgment, reasoning, and problem-solving.

4. How Does Emotional Self-control Affect Decision-making?

Emotional self-control can positively influence decision-making by helping individuals regulate impulsive reactions and consider long-term consequences more effectively.

References:

1 Hicks Patrick, J., Steele, J. C., & Spencer, S. M. (2013). Decision making processes and outcomes. Journal of aging research , 2013 , 367208. https://doi.org/10.1155/2013/367208
2 Elwyn, G., Price, A., Franco, J. V. A., & Gulbrandsen, P. (2023). The limits of shared decision making. BMJ evidence-based medicine , 28 (4), 218–221. https://doi.org/10.1136/bmjebm-2022-112089
3 Ricou, M., & Marina, S. (2020). Decision Making and Ethical Reasoning in Psychology. Psychology in Russia: State of Art, 13(1), 2–10. https://doi.org/10.11621/pir.2020.0101
4 Ricou, M., & Marina, S. (2020). Decision Making and Ethical Reasoning in Psychology. Psychology in Russia: State of Art, 13(1), 2–10. https://doi.org/10.11621/pir.2020.0101
5 Hicks Patrick, J., Steele, J. C., & Spencer, S. M. (2013). Decision making processes and outcomes. Journal of aging research , 2013 , 367208. https://doi.org/10.1155/2013/367208
6 Turner, S., D’Lima, D., Hudson, E., Morris, S., Sheringham, J., Swart, N., & Fulop, N. J. (2017). Evidence use in decision-making on introducing innovations: a systematic scoping review with stakeholder feedback. Implementation Science, 12(1). https://doi.org/10.1186/s13012-017-0669-6
7 Yamauchi, Y., Shiga, T., Shikino, K., Uechi, T., Koyama, Y., Shimozawa, N., Hiraoka, E., Funakoshi, H., Mizobe, M., Imaizumi, T., & Ikusaka, M. (2019). Influence of psychiatric or social backgrounds on clinical decision making: a randomized, controlled multi-centre study. BMC medical education , 19 (1), 461. https://doi.org/10.1186/s12909-019-1897-z
8 Sanders Thompson V. L. (2013). Making decisions in a complex information environment: evidential preference and information we trust. BMC medical informatics and decision making , 13 Suppl 3 (Suppl 3), S7. https://doi.org/10.1186/1472-6947-13-S3-S7
9 Alaseeri, R., Rajab, A., & Banakhar, M. (2021). Do Personal Differences and Organizational Factors Influence Nurses’ Decision Making? A Qualitative Study. Nursing reports (Pavia, Italy) , 11 (3), 714–727. https://doi.org/10.3390/nursrep11030067

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Abrasive Personality
Academic Problems And Skills
Actor-Observer Bias
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Critical Thinking and Decision-Making Skills

Chapter 4 Critical Thinking and Decision-Making Skills Betsy Frank http://evolve.elsevier.com/Huber/leadership/ In an era of changing reimbursements, value based purchasing, and expanded roles for nursing in the health care delivery system, critical thinking and decision making are important skills for nurses caring for patients and for nurse leaders and managers. Both the American Nurses Association’s (2009) and American Association of Nurse Executives’ (2005) standards for practice for nurse administrators and executives support the fact that in a fast-paced health care delivery environment, staff nurses, leaders, and managers must be able to analyze and synthesize a large array of information, use critical thinking and decision making skills to deliver effective day to day patient care, and solve complex problems that occur in complex health care delivery systems (see Figure 4-1 ). Furthermore, the Magnet Hospital initiative and the Institute of Medicine’s ( Committee on the Robert Wood Johnson Foundation, 2011 ) Future of Nursing report highlight the need for nurses to be able to be fully involved and even take the lead in decision making from the unit level to the larger health care delivery system. FIGURE 4-1 Differences and interactions among critical thinking, problem solving, and decision making. Nurses are a cadre of knowledge workers within the health care system. As such, they need information, resources, and support from their environment. In fact, the nurse manager’s expertise in critical thinking and shared decision making are essential for creating healthy work environments where quality and effective care can be delivered ( Kramer et al., 2010 ; Zori et al., 2010 ). Critical thinking and decision-making competences include analytical skills as well as intuition. Just as intuition is part of expert clinical practice ( Benner, 1984 ), intuition plays an important role in developing managerial and leadership expertise (Shirey, 2007). DEFINITIONS Critical thinking can be defined as a set of cognitive skills including “interpretation, analysis, evaluation, inference, explanation, and self-regulation” ( Facione, 2007 , p. 1). Using these skills, nurses in direct patient care and leaders and managers can reflect analytically, reconceptualize events, and avoid the tendency to make decisions and problem solve hastily or on the basis of inadequate information. Facione also pointed out that critical thinking is not only a skill but also a disposition that is grounded in a strong ethical component. Critical thinking in nursing can be defined as “purposeful, informed, outcomes focused thinking…[that] applies logic, intuition, creativity and is grounded in specific knowledge, skills, and experience” ( Alfaro-LeFevre, 2009 , p. 7). Alfaro-LeFevre noted that outcomes-focused thinking helps to prevent, control, and solve problems. Tanner (2000) noted that critical thinking is much more than just the five steps of the nursing process. Problem solving involves moving from an undesirable to a desirable state ( Chambers, 2009 ). Problem solving occurs in a variety of nursing contexts, including direct client care, team-level leadership, and systems-level leadership. Nurses and nurse managers are challenged to move from step-by-step problem-solving techniques to incorporating creative thinking, which involves considering the context when meeting current and future challenges in health care delivery ( Chambers, 2009 ; Rubenfeld & Scheffer, 2006 ). Decision making is the process of making choices that will provide maximum benefit ( Drummond, 2001 ). Decision making can also be defined as a behavior exhibited in selecting and implementing a course of action from alternative courses of action for dealing with a situation or problem. It may or may not be the result of an immediate problem. Critical thinking and effective decision making are the foundation of effective problem solving. If problems require urgent action, then decisions must be made rapidly; if solutions do not need to be identified immediately, decision making can occur in a more deliberative way. Because problems change over time, decisions made at one point in time may need to be changed ( Choo, 2006 ). For example, decisions about how to staff a unit when a nurse calls in sick have to be made immediately. However, if a unit is chronically short-staffed, a decision regarding long-term solutions will have to be made. The process of selecting one course of action from alternatives forms the basic core of the definition of decision making. Choo (2006) noted that all decisions are bounded by cognitive and mental limits, how much information is processed, and values and assumptions. In other words, no matter the decision-making process, all decisions are limited by a variety of known and unknown factors. In a chaotic health care delivery environment, where regulations and standards of care are always changing, any decision may cause an unanticipated future problem. BACKGROUND Critical Thinking Critical thinking is both an attitude toward handling issues and a reasoning process. Critical thinking is not synonymous with problem solving and decision making ( Figure 4-1 ), but it is the foundation for effective decision making that helps to solve problems ( Fioratou et al., 2011 ). Figure 4-2 illustrates the way obstacles such as poor judgment or biased thinking create detours to good judgment and effective decision making. Critical thinking helps overcome these obstacles. Critical thinking skills may not come naturally. The nurse who is a critical thinker has to be open-minded and have the ability to reflect on present and past actions and to analyze complex information. Nurses who are critical thinkers also have a keen awareness of their surroundings ( Fioratou et al., 2011 ). FIGURE 4-2 Decision-making maze. Critical thinking is a skill that is developed for clarity of thought and improvement in decision-making effectiveness. The roots of the concept of critical thinking can be traced to Socrates, who developed a method of questioning as a way of thinking more clearly and with greater logical consistency. He demonstrated that people often cannot rationally justify confident claims to knowledge. Confused meanings, inadequate evidence, or self-contradictory beliefs may lie below the surface of rhetoric. Therefore it is important to ask deep questions and probe into thinking sequences, seek evidence, closely examine reasoning and assumptions, analyze basic concepts, and trace out implications. Other thinkers, such as Plato, Aristotle, Thomas Aquinas, Francis Bacon, and Descartes, emphasized the importance of systematic critical thinking and the need for a systematic disciplining of the mind to guide it in clarity and precision of thinking. In the early 1900s, Dewey equated critical thinking with reflective thought ( The Critical Thinking Community, 2008 ). Critical thinking, then, is characterized by thinking that has a purpose, is systematic, considers alternative viewpoints, occurs within a frame of reference, and is grounded in information ( The Critical Thinking Community, 2008 ). Questioning is implicit in the critical thinking process. The following are some of the questions to be asked when thinking critically about a problem or issue ( Elder & Paul, n.d. ): • What is the question being asked? • Is this the right question? • Is there another question that must be answered first? • What information is needed? • Given the information, what conclusions are justified? • Are there alternative viewpoints? No matter what questions are asked, critical thinkers need to know the “why” of the thinking, the mode of reasoning (inductive or deductive), what the source and accuracy of the information is, what the underlying assumptions and concepts are, and what might be the outcome of the thinking ( The Critical Thinking Community, 2008 ). Critical Thinking in Nursing Nurses in clinical practice continually make judgments and decisions based on the assessment and diagnosis of client needs and practice problems or situations. Clinical judgment is a complex skill grounded in critical thinking. Clinical judgment results in nursing actions directed toward achieving health outcomes ( Alfaro-LeFevre, 2009 ). Scheffer and Rubenfeld (2000) have stated that habits of the mind that are characteristic of critical thinking by nurses include confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, open-mindedness, perseverance, and reflection. Emphasizing the value of expert experience and holistic judgment ability, Benner (2003) cautioned that clinical judgments must not rely too heavily on technology and that the economic incentives to use technology must not come at the expense of human critical thinking and reasoning in individual cases. Critical thinkers have been distinguished from traditional thinkers in nursing. A traditional thinker, thought to be the norm in nursing, preserves status quo. Critical thinkers go beyond the step-by-step processes outlined in the nursing process and traditional problem solving. A critical thinker challenges and questions the norm and considers in the context of decision making potential unintended consequences. Unlike traditional thinkers, critical thinkers are creative in their thinking and anticipate the consequences of their thinking ( Rubenfeld & Scheffer, 2006 ). Creativity is necessary to deal with the complex twenty-first century health care delivery environment. Nurse leaders and managers have an obligation to create care delivery climates that promote critical thinking, which leads to innovative solutions to problems within the system of care ( Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine; Institute of Medicine, 2011 ; Porter-O’Grady, 2011 ). Such a climate encourages deep reflection, especially so that nurses feel safe to learn from mistakes, and encourages nurses to ask questions and consider a variety of viewpoints and alternative solutions to problems. What specific strategies can be used to promote a climate in which critical thinking is fostered? First and foremost, the nurse manager/leader, in the role of mentor, coach, or preceptor, should encourage questions such as “Is what you are doing or proposing based on sound evidence?” ( Ignatavicius, 2008 ). However, Snowden and Boone (2007) cautioned that “best practice, by definition is past practice” (p. 71). Therefore use of best practices needs to be examined carefully in order to use them appropriately. Staff nurses and managers must use critical thinking skills in order to determine the appropriateness of implementing recommended practice protocols. As managers, allowing staff and self “think time” is essential for reflection and is a key component of critical thinking ( Zori & Morrison, 2009 ). Nurse managers’ critical thinking abilities promotes a positive practice environment which can lead to better patient outcomes ( Zori, Nosek, & Musil, 2010 ). Coaching new and experienced nurses to develop expertise in clinical judgment is critically important. Many new nurses, in particular, need to further develop their critical thinking skills ( Fero et al., 2008 ; Forneris & Peden-McAlpine, 2009 ). In addition to having preceptors and others ask questions of new nurses, nurse managers and leaders can use other strategies to enhance critical thinking in nursing staff. Developing concept maps is another useful strategy to promote critical thinking. Although typically used in prelicensure programs ( Ellermann et al., 2006 ), nurse managers can encourage their preceptors to use concept maps with orientees ( Toofany, 2008 ). Developing concept maps in concert with others further develops a nurse’s critical thinking through the process of dialogue. Simulations also promote critical thinking or “thinking like a nurse” ( Tanner, 2006 ). According to Tanner, simulations can promote clinical reasoning, which leads to making conclusions in the form of clinical judgments and, thus, effective problem solving. The use of human patient simulators is well known in educational settings. Simulators may also be useful in orienting new graduates to the acute care setting ( Leigh, 2011 ). Pulman and colleagues (2009) have reported on the use of simulators to promote critical thinking role development in inter-professional environments. Decision Making Decision making is the essence of leadership and management. It is what leaders and managers are expected to do ( Keynes, 2008 ). Thus decisions are visible outcomes of the leadership and management process. The effectiveness of decision making is one criterion for evaluating a leader or manager. Yet staff nurses and nurse managers and leaders must make decisions in uncertain and complex environments ( Clancy & Delaney, 2005 ). Within a climate of uncertainty and complexity, nurse managers and leaders must also understand that all decision making involves high-stakes risk taking ( Clancy & Delaney, 2005 ; Keynes, 2008 ). If poor decisions are made, progress can be impeded, resources wasted, harm caused, and a career adversely affected. The results of poor decisions may be subtle and not appear until years later. Take, for instance, a decision to reduce expenses by decreasing the ratio of registered nurses to nurses’ aides. There may be a short-term cost savings, but if not implemented appropriately, this tactic may result in the gradual erosion of patient care over time (Kane et al., 2007). Unintended effects may include higher turnover of experienced nurses, increased adverse events such as medication errors, decreased staff morale, and lower patient satisfaction scores. The long-term outcome of this decision may actually result in increased expenses not reduced expenses. Thus it is vital for nurses to understand decision making and explore styles and strategies to enhance decision-making skills. Decision making, like traditional problem solving, has been traditionally thought of as a process with identifiable steps yet influenced by the context and by whether there is an intuitive grasp of the situation. However, Effken and colleagues (2010) stated that decision making is much more. Expert decision making is a constructive process in which the outcomes are not preplanned or simply pulled out of a memory bank. Instead, expert decision-making activities are creative, innovative, and adapted to uncertainty and the context of the current problem, using learning from prior experience (p. 189). Nurses make decisions in personal, clinical, and organizational situations and under conditions of certainty, uncertainty, and risk. Various decision-making models and strategies exist. Nurses’ control over decision making may vary as to amount of control and where in the process they can influence decisions. Although decision-making is more than a step-by-step process as noted by Effken and colleagues (2010) , awareness of the components, process, and strategies of decision making contributes to effectiveness in nursing leadership and management decision making. The basic elements of decision making, which enhances day to day activities, contributes to strategic planning and solves problems can be summarized into the following two parts: (1) identifying the goal for decision-making, and (2) making the decision. According to Guo (2008, p. 120) , the steps of the decision-making process can be illustrated as follows, using DECIDE: • D efine the problem and determine why anything should be done about it and explore what could be happening. • E stablish desirable criteria for what you want to accomplish. What should stay the same and what can be done to avoid future problems? • C onsider all possible alternative choices that will accomplish the desired goal or criteria for problem solution. • I dentify the best choice or alternative based on experience, intuition, experimentation. • D evelop and implement an action plan for problem solution. • E valuate decision through monitoring, troubleshooting, and feedback. Notice how these steps are analogous to the traditional problem-solving process or nursing process well-known by nurses and nurse managers. Thus decision making is used to solve problems. However, decision making is more than just problem solving. Decision making may also be the result of opportunities, challenges, or more long-term leadership initiatives as opposed to being triggered by an immediate problem. In any case, the processes are virtually the same, but their purposes may be slightly different. Nurse managers use decision making in managing resources and the environment of care delivery. Decision making involves an evaluation of the effectiveness of the outcomes that result from the decision-making process itself. Whether nurse managers are the sole decision makers or facilitate group decision making, all the factors that influence the problem-solving process also impact how decisions are made: who owns the problem that will result in a decision, what is the context of the decision to be made, and what lenses or perspectives influence the decision to be made? For example, the chief executive officer may frame issues as a competitive struggle not unlike a sports event. The marketing staff may interpret problems as military battles that need to be won. Nurse executives may view concerns from a care or family frame that emphasizes collaboration and working together. Learning and understanding which analogies and perspectives offer the best view of a problem or issue are vital to effective decision making. It may be necessary for nurse managers to expand their frame of reference and be willing to consider even the most outlandish ideas. Obviously, it is important to begin the goal definition phase with staff members who are closest to the issue. That includes staff nurses in concert with their managers. Often, decisions can originate within the confines of the shared governance system that may be in place within an organization ( Dunbar et al., 2007 ). It is wise, also, to consider adding individuals who have no connection with the issue whatsoever. Often it is these “unconnected” staff members who bring new decision frames to the meeting and have the most unbiased view of the problem. One of the core competencies for all health professionals is working in interprofessional teams ( Interprofessional Education Collaborative Expert Panel, 2011 ). Therefore using interprofessional teams for problem solving and decision making can be assumed to be more effective than working in disciplinary silos. No matter who is involved in the decision-making process, the basic steps to arrive at a decision to resolve problems remain the same. One critical aspect to note, however, is that in making decisions, nurse managers must have situational awareness ( Sharma & Ivancevic, 2010 ). That is, decision makers must always consider the context in which the outcome of the decision is to occur. A decision that leads to a desired outcome on one patient care unit may lead to undesirable outcomes on another unit because the patient care environment and personnel are different. DECISION OUTCOMES When looking at outcomes, one critical aspect of decision making is to determine the desired outcome. The desired outcome may vary, according to Guo (2008) , from an ideal or short-term resolution to covering up a situation. What is desired may be (1) for a problem to go away forever, (2) to make sure that all involved in this problem are satisfied with the solution and gain some benefit from it, or (3) to obtain an ideal solution. Sometimes a quick decision is desired, and researching different aspects of the problem or allowing for participation in decision making is not appropriate. For example, in disaster management, the nurse leader will use predetermined procedures for determining roles of the various personnel involved (Coyle et al., 2007). Desired decisions can be categorized into two end points: minimal and optimal. A minimal decision results in an outcome that is sufficient, satisfies basic requirements, and minimally meets desired objectives. This is sometimes called a “satisficing” decision . An optimizing decision includes comparing all possible solutions with desired objectives and then selecting the optimal solution that best meets objectives ( Choo, 2006 ; Guo, 2008 ). In addition to these two strategies, Layman (2011) drawing from Etzioni (1986) , discussed two other strategies: mixed scanning and incrementalism. Incrementalism is slow progress toward an optimal course of action. Mixed scanning combines the stringent rationalism of optimizing with the “muddling through” approach of incrementalism to form substrategies. Optimizing has the goal of selecting the course of action with the highest payoff (maximization). Limitations of time, money, or people may prevent the decision maker from selecting the more deliberative and slower process of optimizing. Still, the decision maker needs to focus on techniques that will enhance effectiveness in decision-making situations. Barriers to effective decision making exist and, once identified, can lead to going back through the decision-making process. Flaws in thinking can create hidden traps in decision making. These are common psychological tendencies that create barriers or biases in cognitive reflection and appraisal. Six common distortions are as follows ( Hammond et al., 1998 ; 2006 ): 1. Anchoring trap: When a decision is being considered, the mind gives a disproportionate weight to the first information it receives. Past events, trends, and numbers outweigh current and future realities. All individuals have preconceived notions and biases that influence decisions in a variety of ways. For instance the Institute of Medicine (IOM, 2001) endorsed the use of c omputerized p hysician o rder e ntry (CPOE) as one solution to reduce medication errors. Furthermore, The Centers for Medicare and Medicaid Services has set forth meaningful use criteria for implementation of CPOE as well as electronic health records (EHR). Despite incentive payments for implementing EHR ( HFMA P & P Board, 2012 ), the financial costs involved, human-factor errors and work-flow issues can hamper successful implementation ( Campbell et al., 2006 ). 2. Status-quo trap: Decision makers display a strong bias toward alternatives that perpetuate the status quo. In the face or rapid change in the environment, past practices that exhibit any sense of permanence provide managers with a feeling of security. 3. Sunk-cost trap: Past decisions become sunk costs, and new choices are often made in a way that justifies past choices. This may result in becoming trapped by an escalation of commitment. Because of rapid, ongoing advances in medical technology, managers are frequently pressured to replace existing equipment before it is fully depreciated. If the new equipment provides a higher level of quality at a lower cost, the sunk cost of the existing equipment is irrelevant to the decision-making process. However, managers may delay purchasing new equipment and forgo subsequent savings because the equipment has yet to reach the end of its useful life. 4. Confirming-evidence trap: Kahneman and colleagues (2011) noted that decision makers also fall into the trap of confirmation bias where contradictory data are ignored. This bias leads people to seek out information that supports an existing instinct or point of view while avoiding contradictory evidence. A typical example is favoring new technology over less glamorous alternatives. A decision maker may become so enamored by technological solutions (and slick vendor demonstrations) that he or she may unconsciously decide in favor of these systems even though strong evidence supports implementing less costly solutions first. 5. Framing trap: The way a problem is initially framed profoundly influences the choices made. Different framing of the same problem can lead to different decision responses. A decision frame can be viewed as a window into the varied reasons a problem exists. As implied by the word frame , individuals may perceive problems only within the boundaries of their own frame. The human resources director may perceive a staffing shortage as a compensation problem, the chief financial officer as an insurance reimbursement issue, the director of education as a training issue, and the chief nursing officer as a work environment problem. Obviously all these issues may contribute, in part, to the problem; however, each person, in looking through his or her individual frame, sees only that portion with which he or she is most familiar ( Layman, 2011 ). 6. Estimating and forecasting traps: People make estimates or forecasts about uncertain events, but their minds are not calibrated for making estimates in the face of uncertainty. The notion that experience is the parent of wisdom suggests that mature managers, over the course of their careers, learn from their mistakes. It is reasonable to assume that the knowledge gained from a manager’s failed projects would be applied to future decisions. Whether right or wrong, humans tend to take credit for successful projects and find ways to blame external factors on failed ones. Unfortunately, this form of overconfidence often results in overly optimistic projections in project planning. This optimism is usually buried in the analysis done before ranking alternatives and recommendations. Conversely, excessive cautiousness or prudence may also result in faulty decisions. This is called aversion bias ( Kahneman et al., 2011 ). Dramatic events may overly influence decisions because of recall and memory, exaggerating the probability of rare but catastrophic occurrences. It is important that managers objectively examine project planning assumptions in the decision-making process to ensure accurate projections. Because misperceptions, biases, and flaws in thinking can influence choices, actions related to awareness, testing, and mental discipline can be employed to ferret out errors in thinking before the stage of decision making ( Hammond et al., 1998 ). Data-driven decision making is important ( Dexter et al., 2011 ; Lamont, 2010 ; Mick, 2011 ). The electronic health record can be mined for valuable data, upon which fiscal, human resource, and patient care decisions can be made. However, the data derived can be overwhelming and cause decision makers to make less than optimal decisions. Shared decision making can help ameliorate decision traps ( Kahneman et al., 2011 ) because dissent within the group may help those accountable for the decision to prevent errors that are “motivated by self-interest” (p. 54). More alternatives can be generated by a group and more data can be gathered upon which to base the decision, rather than just using data that is more readily apparent. DECISION-MAKING SITUATIONS The situations in which decisions are made may be personal, clinical, or organizational ( Figure 4-3 ). Personal decision making is a familiar part of everyday life. Personal decisions range from multiple small daily choices to time management and career or life choices. FIGURE 4-3 Decision-making situations. Clinical decision making in nursing relates to quality of care and competency issues. According to Tanner (2006) , decision making in the clinical arena is called clinical judgment . In nursing, as with all health professions, clinical judgments should be patient-centered, use available evidence from research and other sources, and use available informatics tools (IOM, 2003). These crucial judgments should take place within the context of interprofessional collaboration. Within a hospital or other health care agency, a social network forms that is interprofessional ( Tan et al., 2005 ). This social network has to collaborate for positive change within the organization and to make clinical decisions of the highest quality. Nurses manage care and make decisions under conditions of certainty, uncertainty, and risk. For example, if research has shown that, under prescribed conditions, the selection of a specific nursing intervention is highly likely to produce a certain outcome, then the nurse in that situation faces a condition of relative certainty. An example would be the prevention of decubitus ulcers by frequent repositioning. If little knowledge is available or if the specific situation is more complex or variant from the usual, then the nurse faces uncertainty. Risk situations occur when a threat of harm to patients exists. Conditions of risk occur commonly relative to the administration of medications, crisis events, infection control, invasive procedures, and the use of technology in nursing practice. Furthermore, these conditions also apply to the administration of nursing care delivery, in which decision making is a critical function. Conditions of uncertainty and complexity are common in nursing care management. Over time, the complexity of health care processes has increased as a natural outgrowth of innovation and new technology. With computerized integration of billing, physician ordering, results of diagnostic tests, information about medications and their actions and side effects, and critical pathways and computerized charting, complexity increases more. Trying to integrate so many data points in care delivery can overwhelm the care provider who is making clinical judgments. As a result, subtle failures in any part of the information system can go unnoticed and have catastrophic outcomes. For example, if the computer system in the emergency room cannot “talk” to the system in the operating room, then errors in care management, such as giving cephalexin to patient who has an allergy can occur. If a provider fails to input critical information, such as a medication that a patient is taking, a fatal drug interaction could occur when another provider prescribes a new medication. Ready access to the Internet and online library sources can further create complexity in the decision-making process as care providers have access to more information upon which to make decisions. Readily accessible information related to evidence-based practice and information gleaned from human resources records and clinical systems can overwhelm nurse managers and leaders. Nurse leaders are coming to understand that innovation and new technology are the driving forces behind the discovery of new knowledge and improvements in patient care. Overlapping, unclear, and changing roles for nurses as a result of new technology and services create complex decision-making situations and impact the quality of care delivered (IOM, 2003). In addition, workflow interruptions can inhibit critical thinking, particularly in a chaotic environment ( Cornell et al., 2011 ; Sitterding et al., 2012 ). ADMINISTRATIVE AND ORGANIZATIONAL DECISION MAKING According to Choo (2006) , organizations use information to “make decisions that commit resources and capabilities to purposeful action” (p. 1). Nurse managers, for example, make staffing decisions and thus commit financial resources for the purpose of delivering patient care. Hospital administrators may decide to add additional services to keep up with external forces. These decisions subsequently have financial implications related to reimbursement, staffing, and the like. Etzioni (1989) noted that the traditional model for business decisions was rationalism. However, he further asserted that as information flow became more complex and faster-paced, a new decision-making model based on the use of partial information that has not been fully analyzed had begun to evolve. He called this model “humble decision making.” This approach arises in response to the need to make a decision when the amount of data exceeds the time available to analyze it. For instance, predicting the outcome of clinical and administrative decisions in health care is problematic because such processes are collectively defined as c omplex a daptive s ystems (CASs). A CAS is characterized by groups of individuals who act in unpredictable, nonlinear (not cause and effect) ways, such that one person’s actions affect all the others ( Holden, 2005 ). In CASs, humans do behave in unpredictable ways ( Tan et al., 2005 ). Critical thinking can help all health care personnel to examine these complex systems, wherein groups solve problems through complex, continually altering interactions between the environment and all involved in the decision making ( Fioratou et al., 2011 ). Situations within the environment constantly change and decision makers need to reframe their thinking as they broaden their awareness of the context of their decisions ( Sharma & Ivancevic, 2010 ). Having situation awareness is a must ( Fioratou et al., 2011 ; Sitterding et al., 2012 ). Decision makers need to make every effort to forecast unanticipated consequences of their decisions. For example if staffing is cut, what adverse events might occur (Kane et al., 2007)? Decision making is also influenced by the manager’s leadership style. A democratic/collaborative style of leadership and decision making works best in a complex adaptive system, such as a hospital, which is characterized by a large array of social relationships that can have an economic impact on an organization. Staff nurses who are not engaged in shared decision making may experience less job satisfaction and subsequently may leave an organization, leading to loss of expertise in patient care ( Gromley, 2011 ). However, the full array of leadership styles may at some time be used in the decision-making process. Vroom and Yetton (1973) proposed a classic managerial decision-making model that identified five managerial decision styles on a continuum from minimal subordinate involvement to delegation. Their model uses a contingency approach, which assumes that situational variables and personal attributes of the leader influence leader behavior and thus can affect organizational effectiveness. To diagnose the situation, the decision maker examines the following seven problem attributes: 1. The importance of the quality of the decision 2. Whether there is sufficient information/expertise 3. The amount of structure to the problem 4. The extent to which acceptance/commitment of followers is critical to implementation 5. The probability that an autocratic decision will be accepted 6. The motivation of followers to achieve organizational goals 7. The extent to which conflict over preferred solutions is likely

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Teaching Critical Thinking as a Public Health Initiative

Tim Caulfield—a Law Professor at the University of Alberta and the author of Is Gwyneth Paltrow Wrong About Everything? —wants to help us get better at fighting misinformation about health.

This past Monday, Caulfield came to the Petrie-Flom Center’s Health Policy Workshop and spoke to an audience of Harvard Law students, affiliates from throughout Harvard University, and academics and community members from the Boston area.

During his fascinating and dynamic presentation, Caulfield covered a lot of ground. He discussed political polarization on Twitter, the profit-maximizing machinations (or self-delusion) of celebrities pedaling bunk health products, and evidence that false claims spread faster than true ones. All that may leave one feeling pessimistic and Caulfield would likely sympathize with your pessimism. Yet, the presentation also contained reasons to have hope.

Caulfield discussed the ways using narratives can make connections and fight misinformation, the power of consumers to initiate complaint-driven efforts to enforce truth in advertising law, and empirical research that suggests that the relevant critical thinking skills to help people make well-informed, rational decisions about their health can be taught.

This last point about teaching critical thinking stuck out to me.

I’ve just now spoke about “well-informed” and “rational” decisions. What counts as “well-informed” and “rational” will, of course, differ depending on one’s perspective and values. And it’s important that we keep this in mind when assessing the quality of the decision-making and discourse of a large population.

Yet even with these caveats in place, I take it that there are still some objective value claims we can make about some health-based decisions people make.

For example, getting your children vaccinated for measles, mumps, and rubella is a good decision , while purchasing a jade egg from Gwyneth Paltrow to put in your vagina is not (or at least not good for your health).

And if we can be doing things to help teach people how to make better, more-informed decisions about their health, for those of us interested in promoting health in the general population, this seems like an important avenue to pursue.

The study Caulfield cited was from a 2017 publication in which researchers found that primary school children (ages 10-12) in Uganda who were given nine 80-minute lessons in which they were taught about “12 concepts essential to assessing claims about treatment effects and making informed health choices” scored an average of 20 points higher than students who did not receive the instruction on a test meant to examine students’ ability to make informed, health-based decisions.

This is a hopeful finding.

In a society where people are already concerned about the population’s lack of critical thinking skills , evidence that such skills can be taught, and that they can be used to help people make better-informed decisions about their health, provides us with plenty of reason to fight for the teaching of critical thinking skills.

People are already calling for the teaching of critical thinking skills to counteract other societal issues, and courses like “ Calling Bullshit: Data Reasoning in a Digital World ” have begun cropping up online. Those of us concerned with fighting for improvements in health outcomes ought to rally behind these efforts.

If teaching critical thinking can lead to better decision-making about health, we should start treating the teaching of critical thinking as an important public health initiative.

One thought to “Teaching Critical Thinking as a Public Health Initiative”

“…an average of 20 points higher…” What percentage is that? And yes! Critical thinking NEEDS to be a skill that is REQUIRED to be taught in all high schools! I’d be willing to pay more in taxes to fund this.

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5.3: Using Critical Thinking Skills- Decision Making and Problem Solving

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Introduction

In previous lessons, you learned about characteristics of critical thinkers and information literacy. In this module, you will learn how to put those skills into action through the important processes of decision making and problem solving.

As with the process of developing information literacy, asking questions is an important part of decision making and problem solving. Thinking is born of questions. Questions wake us up. Questions alert us to hidden assumptions. Questions promote curiosity and create new distinctions. Questions open up options that otherwise go unexplored. Besides, teachers love questions.

We make decisions all the time, whether we realize it or not. Even avoiding decisions is a form of decision making. The student who puts off studying for a test until the last minute, for example, might really be saying, “I’ve decided this course is not important” or “I’ve decided not to give this course much time.”

Decisions are specific and lead to focused action. When we decide, we narrow down. We give up actions that are inconsistent with our decision.

In addition to decision making, critical thinking skills are important to solving problems. We encounter problems every single day, and having a solid process in place is important to solving them.

At the end of the lesson, you will learn how to put your critical thinking skills to use by reviewing an example of how critical thinking skills can help with making those everyday decisions.

Using Critical Thinking Skills: Asking Questions

Questions have practical power. Asking for directions can shave hours off a trip. Asking a librarian for help can save hours of research time. Asking how to address an instructor—by first name or formal title—can change your relationship with that person. Asking your academic advisor a question can alter your entire education. Asking people about their career plans can alter your career plans.

You can use the following strategies to develop questions for problem solving and decision making:

Ask questions that create possibilities. At any moment, you can ask a question that opens up a new possibility for someone.

Suppose a friend walks up to you and says, “People just never listen to me.” You listen carefully. Then you say, “Let me make sure I understand. Who, specifically, doesn’t listen to you? And how do you know they’re not listening?”
Another friend tells you, “I just lost my job to someone who has less experience. That should never happen.” You respond, “Wow, that’s hard. I’m sorry you lost your job. Who can help you find another job?”
A relative seeks your advice. “My mother-in-law makes me mad,” she says. “You’re having a hard time with this person,” you say. “What does she say and do when you feel mad at her? And are there times when you don’t get mad at her?”

These kinds of questions—asked with compassion and a sense of timing—can help people move from complaining about problems to solving them.

Discover new questions. Students sometimes say, “I don’t know what questions to ask.” Consider the following ways to create questions about any subject you want to study or about any

area of your life that you want to change:

Let your pen start moving. Sometimes you can access a deeper level of knowledge by taking out your pen, putting it on a piece of paper, and writing down questions—even before you know what to write. Don’t think. Just watch the pen move across the paper. Notice what appears. The results might be surprising.
Ask about what’s missing . Another way to invent useful questions is to notice what’s missing from your life and then ask how to supply it. For example, if you want to take better notes, you can write, “What’s missing is skill in note taking. How can I gain more skill in taking notes?” If you always feel rushed, you can write, “What’s missing is time. How do I create enough time in my day to actually do the things that I say I want to do?”
Pretend to be someone else. Another way to invent questions is first to think of someone you greatly respect. Then pretend you’re that person. Ask the questions you think she would ask.
What can I do when ... an instructor calls on me in class and I have no idea what to say? When a teacher doesn’t show up for class on time? When I feel overwhelmed with assignments?
How can I ... take the kind of courses that I want? Expand my career options? Become much more effective as a student, starting today?
When do I ... decide on a major? Transfer to another school? Meet with an instructor to discuss an upcoming term paper?
What else do I want to know about ... my academic plan? My career plan? My options for job hunting? My friends? My relatives? My spouse?
Who can I ask about ... my career options? My major? My love life? My values and purpose in life?

Many times you can quickly generate questions by simply asking yourself, “What else do I want to know?” Ask this question immediately after you read a paragraph in a book or listen to someone speak.

Start from the assumption that you are brilliant. Then ask questions to unlock your brilliance.

Using Critical Thinking Skills in Decision Making

As you develop your critical thinking skills, you can apply them as you make decisions. The following suggestions can help in your decision-making process:

Recognize decisions. Decisions are more than wishes or desires. There’s a world of difference between “I wish I could be a better student” and “I will take more powerful notes, read with greater retention, and review my class notes daily.” Deciding to eat fruit for dessert instead of ice cream rules out the next trip to the ice cream store.

Establish priorities. Some decisions are trivial. No matter what the outcome, your life is not affected much. Other decisions can shape your circumstances for years. Devote more time and energy to the decisions with big outcomes.

Base decisions on a life plan. The benefit of having long-term goals for our lives is that they provide a basis for many of our daily decisions. Being certain about what we want to accomplish this year and this month makes today’s choices more clear.

Balance learning styles in decision making. To make decisions more effectively, use all four modes of learning explained in a previous lesson. The key is to balance reflection with action, and thinking with experience. First, take the time to think creatively, and generate many options. Then think critically about the possible consequences of each option before choosing one. Remember, however, that thinking is no substitute for experience. Act on your chosen option, and notice what happens. If you’re not getting the results you want, then quickly return to creative thinking to invent new options.

Choose an overall strategy. Every time you make a decision, you choose a strategy—even when you’re not aware of it. Effective decision makers can articulate and choose from among several strategies. For example:

Find all of the available options, and choose one deliberately. Save this strategy for times when you have a relatively small number of options, each of which leads to noticeably different results.
Find all of the available options, and choose one randomly. This strategy can be risky. Save it for times when your options are basically similar and fairness is the main issue.
Limit the options, and then choose. When deciding which search engine to use, visit many search sites and then narrow the list down to two or three from which to choose.

Use time as an ally. Sometimes we face dilemmas—situations in which any course of action leads to undesirable consequences. In such cases, consider putting a decision on hold. Wait it out. Do nothing until the circumstances change, making one alternative clearly preferable to another.

Use intuition. Some decisions seem to make themselves. A solution pops into your mind, and you gain newfound clarity. Using intuition is not the same as forgetting about the decision or refusing to make it. Intuitive decisions usually arrive after we’ve gathered the relevant facts and faced a problem for some time.

Evaluate your decision. Hindsight is a source of insight. After you act on a decision, observe the consequences over time. Reflect on how well your decision worked and what you might have done differently.

Think of choices. This final suggestion involves some creative thinking. Consider that the word decide derives from the same roots as suicide and homicide . In the spirit of those words, a decision forever “kills” all other options. That’s kind of heavy. Instead, use the word choice , and see whether it frees up your thinking. When you choose , you express a preference for one option over others. However, those options remain live possibilities for the future. Choose for today, knowing that as you gain more wisdom and experience, you can choose again.

Using Critical Thinking Skills in Problem Solving

Think of problem solving as a process with four Ps : Define the problem , generate possibilities ,

create a plan , and perform your plan.

Step 1: Define the problem. To define a problem effectively, understand what a problem is—a mismatch between what you want and what you have. Problem solving is all about reducing the gap between these two factors.

Tell the truth about what’s present in your life right now, without shame or blame. For example: “I often get sleepy while reading my physics assignments, and after closing the book I cannot remember what I just read.”

Next, describe in detail what you want. Go for specifics: “I want to remain alert as I read about physics. I also want to accurately summarize each chapter I read.”

Remember that when we define a problem in limiting ways, our solutions merely generate new problems. As Albert Einstein said, “The world we have made is a result of the level of thinking we have done thus far. We cannot solve problems at the same level at which we created them” (Calaprice 2000).

This idea has many applications for success in school. An example is the student who struggles with note taking. The problem, she thinks, is that her notes are too sketchy. The logical solution, she decides, is to take more notes; her new goal is to write down almost everything her instructors say. No matter how fast and furiously she writes, she cannot capture all of the instructors’ comments.

Consider what happens when this student defines the problem in a new way. After more thought, she decides that her dilemma is not the quantity of her notes but their quality . She adopts a new format for taking notes, dividing her notepaper into two columns. In the right-hand column, she writes down only the main points of each lecture. In the left-hand column, she notes two or three supporting details for each point.

Over time, this student makes the joyous discovery that there are usually just three or four core ideas to remember from each lecture. She originally thought the solution was to take more notes. What really worked was taking notes in a new way.

Step 2: Generate possibilities. Now put on your creative thinking hat. Open up. Brainstorm as many possible solutions to the problem as you can. At this stage, quantity counts. As you generate possibilities, gather relevant facts. For example, when you’re faced with a dilemma about what courses to take next semester, get information on class times, locations, and instructors. If you haven’t decided which summer job offer to accept, gather information on salary, benefits, and working conditions.

Step 3: Create a plan. After rereading your problem definition and list of possible solutions, choose the solution that seems most workable. Think about specific actions that will reduce the gap between what you have and what you want. Visualize the steps you will take to make this solution a reality, and arrange them in chronological order. To make your plan even more powerful, put it in writing.

Step 4: Perform your plan. This step gets you off your chair and out into the world. Now you actually do what you have planned.

Ultimately, your skill in solving problems lies in how well you perform your plan. Through the quality of your actions, you become the architect of your own success.

When facing problems, experiment with these four Ps, and remember that the order of steps is not absolute. Also remember that any solution has the potential to create new problems. If that happens, cycle through the four Ps of problem solving again.

Critical Thinking Skills in Action: Thinking About Your Major, Part 1

One decision that troubles many students in higher education is the choice of a major. Weighing the benefits, costs, and outcomes of a possible major is an intellectual challenge. This choice is an opportunity to apply your critical thinking, decision-making, and problem-solving skills. The following suggestions will guide you through this seemingly overwhelming process.

The first step is to discover options. You can use the following suggestions to discover options for choosing your major:

Follow the fun. Perhaps you look forward to attending one of your classes and even like completing the assignments. This is a clue to your choice of major.

See whether you can find lasting patterns in the subjects and extracurricular activities that you’ve enjoyed over the years. Look for a major that allows you to continue and expand on these experiences.

Also, sit down with a stack of 3 × 5 cards and brainstorm answers to the following questions:

What do you enjoy doing most with your unscheduled time?
Imagine that you’re at a party and having a fascinating conversation. What is this conversation about?
What kind of problems do you enjoy solving—those that involve people? Products? Ideas?
What interests are revealed by your choices of reading material, television shows, and other entertainment?
What would an ideal day look like for you? Describe where you would live, who would be with you, and what you would do throughout the day. Do any of these visions suggest a possible major?

Questions like these can uncover a “fun factor” that energizes you to finish the work of completing a major.

Consider your abilities. In choosing a major, ability counts as much as interest. In addition to considering what you enjoy, think about times and places when you excelled. List the courses that you aced, the work assignments that you mastered, and the hobbies that led to rewards or recognition. Let your choice of a major reflect a discovery of your passions and potentials.

Use formal techniques for self-discovery. Explore questionnaires and inventories that are designed to correlate your interests with specific majors. Examples include the Strong Interest Inventory and the Self-Directed Search. Your academic advisor or someone in your school’s career planning office can give you more details about these and related assessments. For some fun, take several of them and meet with an advisor to interpret the results. Remember inventories can help you gain self-knowledge, and other people can offer valuable perspectives. However, what you do with all this input is entirely up to you.

Critical Thinking Skills in Action: Thinking About Your Major, Part 2

As you review the following additional suggestions of discovering options, think about what strategies you already use in your own decision-making process. Also think about what new strategies you might try in the future.

Link to long-term goals. Your choice of a major can fall into place once you determine what you want in life. Before you choose a major, back up to a bigger picture. List your core values, such as contributing to society, achieving financial security and professional recognition, enjoying good health, or making time for fun. Also write down specific goals that you want to accomplish 5 years, 10 years, or even 50 years from today.

Many students find that the prospect of getting what they want in life justifies all of the time, money, and day-to-day effort invested in going to school. Having a major gives you a powerful incentive for attending classes, taking part in discussions, reading textbooks, writing papers, and completing other assignments. When you see a clear connection between finishing school and creating the life of your dreams, the daily tasks of higher education become charged with meaning.

Ask other people. Key people in your life might have valuable suggestions about your choice of major. Ask for their ideas, and listen with an open mind. At the same time, distance yourself from any pressure to choose a major or career that fails to interest you. If you make a choice solely on the basis of the expectations of other people, you could end up with a major or even a career you don’t enjoy.

Gather information. Check your school’s catalog or website for a list of available majors. Here is a gold mine of information. Take a quick glance, and highlight all the majors that interest you. Then talk to students who have declared these majors. Also read the descriptions of courses required for these majors. Do you get excited about the chance to enroll in them? Pay attention to your gut feelings.

Also chat with instructors who teach courses in a specific major. Ask for copies of their class syllabi. Go to the bookstore and browse the required texts. Based on all of this information, write a list of prospective majors. Discuss them with an academic advisor and someone at your school’s career-planning center.

Invent a major. When choosing a major, you might not need to limit yourself to those listed in your school catalog. Many schools now have flexible programs that allow for independent study. Through such programs, you might be able to combine two existing majors or invent an entirely new one of your own.

Consider a complementary minor. You can add flexibility to your academic program by choosing a minor to complement or contrast with your major. The student who wants to be a minister could opt for a minor in English; all of those courses in composition can help in writing sermons. Or the student with a major in psychology might choose a minor in business administration, with the idea of managing a counseling service some day. An effective choice of a minor can expand your skills and career options.

Think critically about the link between your major and your career. Your career goals might have a significant impact on your choice of major.

You could pursue a rewarding career by choosing among several different majors. Even students planning to apply for law school or medical school have flexibility in their choice of majors. In addition, after graduation, many people tend to be employed in jobs that have little relationship to their major. And you might choose a career in the future that is unrelated to any currently available major.

Critical Thinking Skills in Action: Thinking About Your Major, Part 3

Once you have discovered all of your options, you can move on to the next step in the process— making a trial choice.

Make a Trial Choice

Pretend that you have to choose a major today. Based on the options for a major that you’ve already discovered, write down the first three ideas that come to mind. Review the list for a few minutes, and then choose one.

Evaluate Your Trial Choice

When you’ve made a trial choice of major, take on the role of a scientist. Treat your choice as a hypothesis, and then design a series of experiments to evaluate and test it. For example:

Schedule office meetings with instructors who teach courses in the major. Ask about required course work and career options in the field.
Discuss your trial choice with an academic advisor or career counselor.
Enroll in a course related to your possible major. Remember that introductory courses might not give you a realistic picture of the workload involved in advanced courses. Also, you might not be able to register for certain courses until you’ve actually declared a related major.
Find a volunteer experience, internship, part-time job, or service-learning experience related to the major.
Interview students who have declared the same major. Ask them in detail about their experiences and suggestions for success.
Interview people who work in a field related to the major and “shadow” them—that is, spend time with those people during their workday.
Think about whether you can complete your major given the amount of time and money that you plan to invest in higher education.
Consider whether declaring this major would require a transfer to another program or even another school.

If your “experiments” confirm your choice of major, celebrate that fact. If they result in choosing a new major, celebrate that outcome as well.

Also remember that higher education represents a safe place to test your choice of major—and to change your mind. As you sort through your options, help is always available from administrators, instructors, advisors, and peers.

Choose Again

Keep your choice of a major in perspective. There is probably no single “correct” choice. Your unique collection of skills is likely to provide the basis for majoring in several fields.

Odds are that you’ll change your major at least once—and that you’ll change careers several times during your life. One benefit of higher education is mobility. You gain the general skills and knowledge that can help you move into a new major or career field at any time.

Viewing a major as a one-time choice that determines your entire future can raise your stress levels. Instead, look at choosing a major as the start of a continuing path that involves discovery, choice, and passionate action.

As you review this example of how you can use critical thinking to make a decision about choosing your major, think about how you will use your critical thinking to make decisions and solve problems in the future.

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Critical Thinking and Decision-Making - Decision-Making Strategies

Critical thinking and decision-making -, decision-making strategies, critical thinking and decision-making decision-making strategies.

Critical Thinking and Decision-Making: Decision-Making Strategies

Lesson 3: decision-making strategies.

/en/problem-solving-and-decision-making/why-is-it-so-hard-to-make-decisions/content/

How do you usually make decisions?

There are lots of ways to make a decision . For example, you could flip a coin. You could trust your gut and do what you think is right. Or you could avoid thinking about it at all, and just make a choice at random—for better or for worse.

That's probably OK for small decisions, but what about more important ones? It's better to think carefully about your options and consider the many paths you could take.

With the right tools, you can learn to do this objectively , so you can make decisions you feel good about. We're going to cover several strategies that can help.

Watch the video below to learn more about decision-making strategies.

Making decisions objectively

The first step to making any decision is simple: Identify the problem . As an example, say you're trying to choose between two apartments. One is cheaper but farther away from work. The other is closer—and nicer!—but much more expensive.

Which one would you choose? Depending on what you value, you probably have some idea. This initial response, the one tied to your instincts and emotions , is perfectly valid; however, you should also try to look at your options rationally .

Comparing your options

Start by comparing them. There are several ways to do this. For example, you could list all the factors that you're considering—things like price, location, and other amenities—then choose the one thing that's most important to you. With that in mind, which option comes out on top?

Creating a points system

You could go one step further and create a points system . Take that same list and turn it into a scorecard for each option.

In this example, it means the first apartment would score high on affordable rent (let's say a 10), but much lower on location . The other apartment would score about the opposite in the same categories.

Keep going down the list until you've scored every item, being as objective as you can. Then add up the totals, and see if you have a winner.

Identifying pros and cons

Looking at it another way, you could evaluate one option at a time using a list of pros and cons. It sounds simple, but sometimes it helps to write these things down.

apartment 1 - pro: cheap / con: 2-hour commute

This time, it's OK to be subjective —certain factors can and should carry more weight than others. It's how you feel about them that counts, so be honest about what these things mean to you.

Thinking about the consequences

Imagining possible outcomes might give you some perspective on the decision. Say you're thinking about adopting a dog. What do you think the consequences might be in a month? In a year? How about several years from now?

tired man with dog surrounded by tennis balls

Making decisions can be a roller coaster ride, especially when there are long-term consequences to think about. We can't see into the future, but we can try to be prepared.

Other mental tricks

At this point, it's normal to feel overwhelmed, even stuck. With so much to consider, how do you know you're making the right choice? There are a couple more techniques that can help you fire up your brain and trick it into thinking differently . Try these the next time you need a mental reset.

The two-minute diversion

Distract yourself with a two-minute activity that you find moderately difficult . Maybe you like playing mobile games, or solving math problems for fun—whatever works for you (we won't judge).

Believe it or not, you'll continue to process the decision unconsciously , according to brain imaging research by Carnegie Mellon University. This brief window of time helps you internalize important details, so you can make better, more insightful decisions.

Thinking in third person

Sometimes it helps to step outside yourself and pretend you're helping someone else . Studies show we're able to think more objectively in third person —that's why it's easier to give advice than it is to receive it.

If a friend or family member were struggling with the same decision, what questions would you ask them? What compromises would you suggest?

chat conversation - friend: "what if i bought this lol" / you: "do you know how to play? maybe wait until it's on sale"

Really think about it. Adopting a different point of view might help you see the situation in an entirely new way.

Making decisions with confidence

Making decisions isn't like taking a test. There are no right or wrong answers, per se—it just depends on the situation.

Focus on taking the time to think about your options and what you hope to achieve so you can feel confident about the choices you make. It's not as easy as flipping a coin, but it's worth the extra effort.

/en/problem-solving-and-decision-making/using-brain-teasers-to-build-critical-thinking-skills/content/

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Int J Environ Res Public Health

Strengthening Critical Health Literacy for Health Information Appraisal: An Approach from Argumentation Theory

Sara rubinelli.

1 Department of Health Sciences and Medicine, University of Lucerne, 6002 Luzern, Switzerland; [email protected] (A.O.); [email protected] (C.Z.); [email protected] (N.D.)

2 Swiss Paraplegic Research, 6207 Nottwil, Switzerland; [email protected]

Alexander Ort

Claudia zanini, maddalena fiordelli.

3 Institute of Public Health, Università della Svizzera Italiana, 6900 Lugano, Switzerland

Nicola Diviani

Associated data.

Not applicable.

The overload of health information has been a major challenge during the COVID-19 pandemic. Public health authorities play a primary role in managing this information. However, individuals have to apply critical health literacy to evaluate it. The objective of this paper is to identify targets for strengthening critical health literacy by focusing on the field of argumentation theory. This paper is based on the textual analysis of instances of health information through the lens of argumentation theory. The results show that critical health literacy benefits from: (1) understanding the concept of argument and the supporting reasons, (2) identifying the main argument schemes, and (3) the knowledge and use of the main critical questions to check the soundness of arguments. This study operationalizes the main aspects of critical health literacy. It calls for specific educational and training initiatives in the field. Moreover, it argues in favor of broadening the current educational curricula to empower individuals to engage in informed and quality decision making. Strengthening individuals’ critical health literacy involves interventions to empower in argument evaluation. For this purpose, argumentation theory has analytical and normative frameworks that can be adapted within a lay-audience education concept.

1. Introduction

The recent COVID-19 pandemic and the related mushrooming of fake news, conspiracy theories, and more general disinformation has put the so-called “infodemic” in the global spotlight. The WHO refers to infodemic as the overload of information, including mis/disinformation [ 1 ]. Due to the increased discourse around those issues, one could get the impression that the start of the COVID-19 health crisis also caused the infodemic. However, the phenomenon is not new and dates back at least two decades to the advent of the Internet in the late nineties [ 2 ]. The introduction of this new technology also led to the extensive availability of health-related information, which goes hand in hand with low-threshold accessibility to everyone with an internet connection. Regardless of the vast benefits, online health information—because of its uncontrollable nature—also has the potential to have detrimental effects on citizens and society as a whole. For example, citizens, especially those with a limited ability to distinguish between good and bad information, could take crucial health-related decisions based on wrong or incomplete information, consequently putting themselves and others at risk of suboptimal health outcomes [ 3 ]. A concrete example in the context of the COVID-19 pandemic is the abundance of fake news surrounding face masks; different sources have claimed that they do not protect from the virus or even that they are unhealthy. Such disinformation can lead to detrimental outcomes, as people following such claims are less likely or would entirely refrain from wearing a face mask, with possible dire consequences [ 4 , 5 , 6 ].

Public health authorities can play a central role in this context [ 7 ]. One possible solution to counter the respective risks would be to design systems that allow monitoring and contain the spread of mis/disinformation. Additionally, many endeavors in this direction are now ongoing at the national and international level, such as the World Health Organization’s “Call for Action: Managing the infodemic” [ 8 ]. However, due to the nature and magnitude of the phenomenon, it is unlikely to identify and control all the information available, especially online. Therefore, it is crucial to equip individuals with the necessary set of skills to understand and evaluate health information or, in other words, to distinguish between information and disinformation. This set of skills is referred to as critical health literacy [ 9 , 10 , 11 ]. Although the potential of critical health literacy is now widely recognized by researchers and policymakers, its operationalization is still in its infancy, thus hindering the development of targeted interventions [ 12 ].

This paper aims to identify targets for strengthening an individual’s critical literacy about the appraisal of health information. This objective is achieved by theorizing and illustrating some main principles for evaluating information rooted in the field of argumentation theory and by contextualizing them from a health-educational perspective.

2. Analytical Approach

Argumentation theory is conceptually and empirically well developed [ 13 ]. Specifically, “argumentation theory”, in its very essence, is the body of knowledge that deals with the study of arguments, that is, of claims supported by reasons [ 14 , 15 , 16 , 17 ]. For example, in the sentence, “these flowers are beautiful because they have beautiful colors”, “these flowers are beautiful” is the claim, and “they have beautiful colors” is the reason that supports the claim. In generalized terms, argumentation theory studies how to support claims by reasons and whether this support is sound or unsound . Still, little attention has been paid to harness its main achievements: the potential to guide and educate people in the process of appraising health information. This is unfortunate, as taking the essence of this knowledge into account, argumentation theory can provide valuable insights on how to guide people in the process of evaluation, i.e., whether a particular piece of health information contains arguments and whether these arguments are qualitatively high or poor [ 18 , 19 ]. Consequently, information containing poor-quality arguments should be questioned because, as we shall see, it could be false, irrelevant, or manipulative [ 20 ].

To fill this gap, this paper applies the approach of textual analysis to the main theoretical frameworks from argumentation theory. It analyzes examples of arguments—inspired by actual instances of dis/misinformation that actually circulated during the global COVID-19 health crisis—with the goal to pointing towards ways to identify low-quality health information. In doing so, the following sections will explain the value of the following argumentation theory concepts: the structure and purpose of arguments, argument schemes, fallacies and critical questions. Implications of the analysis will then been discussed in the context of critical health literacy.

3. Insights from Argumentation Theory

3.1. the structure and purpose of an argument.

As anticipated above, argumentation is a process of communication where the speaker supports their point of view (a claim) by means of reasons. Although among English speakers, the term “argument” often connotes “quarrel”, its technical meaning, at the basis of argumentation theory, indicates the process and act of discussing with reasoning for or against a claim. For instance, the claim “people should wear masks” might be supported by the reasons “because it is a key measure for suppressing the transmission of COVID-19 (reason 1) and for saving lives (reason 2)”.

Key insight 1: People should be made aware of the concept of argument and that the acceptance of a claim derives from the approval of the supporting reasons that, as such, need to be verified and evaluated.

People make and present claims and arguments because they want to convince an audience to think or act in a certain way. A health promotion institute can present arguments to convince people to wash their hands frequently during the day. However, due to vested interests, one might try to convince an audience that COVID-19 is like the flu and provide their reasons for this (for instance, that “he/she is an expert and knows about that”).

Although, as we shall see below, reasons can be false, wrong, or misleading, the fact that a speaker provides them to support their claim is an important way to verify the quality of the claim itself [ 21 ]. Indeed, if someone says “Don’t wear a mask” without saying why the claim is weak in the sense that the rationale behind it is unclear. If the speaker says, “Don’t wear a mask (claim) because COVID-19 is no worse than the flu (reason 1) and masks are even hazardous as they impair breathing (reason 2)”, reasons 1 and 2 offer grounds for verifying the claims and for deciding whether one should believe in it. Then, of course, the reasons provided are not sound. However, to carry out this evaluation, the concept of arguments has to be clear in people’s minds, as well as the supporting reasons and the need to check their quality. In the discussion section of this paper, we shall highlight how this presupposes the daily work of health institutions in presenting and discussing evidence so that people have quality sources to evaluate the reasons behind claims.

A primary skill in the context of critical health literacy and information appraisal is to check whether or not the claims put forward present reasons and, subsequently, whether or not these are valid and supported. Indeed, in the current world of influencers and opinion leaders, it is not unusual that people believe in claims that are unsupported simply because they trust the speaker. The Elaboration Likelihood Model [ 22 ] shows that, indeed, people might appraise information and arguments within a peripheral perspective, focused on aspects that do not point to the goodness of a claim. To agree that “masks kill” simply because the person who says this receives trust within a particular community is a pitfall in critical thinking skills. Additionally, evaluating the soundness of argumentation based on trust in the speaker and without paying proper attention to the actual content of what he/she says is problematic: It is an evaluation based on a peripheral cue and, thus, potentially misleading. Even if the claim comes from a famous health professional, it is still unsupported due to a lack of substantiating scientific data. Moreover, the experience of a person, even if they are perceived as an expert, is not sufficient to substantiate a general claim. Especially if, such as in this case, there is scientific evidence supporting the use of masks during the pandemic.

3.2. Argument Schemes

The literature on argumentation theory has identified argument schemes as central components of an argument structure, which is crucial for evaluating argument strength. Specifically, an argument scheme is a template that indicates a specific connection between the claim and the supporting reason/s. Each argument scheme has a name [ 23 ].

Key insight 2: People should be able to recognize the most essential argument schemes to evaluate the arguments themselves.

According to pragma-dialectics, among the most potent approaches to the study of argumentation, a threefold typology of arguments exists [ 24 ], which we exemplify below through suboptimal information about COVID-19. Starting from an analysis of the argument schemes, we will then show how it is possible to identify why this information is of low quality.

The first argument scheme is named symptomatic argumentation , which poses that a claim can be supported by citing in its reasons a particular sign, symptom, or distinguishing mark of what is claimed. For example, in the following argument:

“This person is right about COVID-19 because he is a doctor.”

The fact that this person is a doctor is presented as a sign of the quality of what he says about COVID-19.

Y is true of X,

because : Z is true of X

and : Z is symptomatic of Y.

This person (X) is right about COVID-19 (Y).

because: This person (X) is a doctor (Z).

and: Being a doctor is a sign of knowing about health conditions, resulting in true health-related statements.

Figure 1 below shows the example in a visual chart:

An external file that holds a picture, illustration, etc.
Object name is ijerph-18-06764-g001.jpg

Example of symptomatic argumentation.

The second type of argument schemes is based on a comparison relation , meaning that a claim is supported by showing that something similar occurs elsewhere. Therefore, people should also accept it for resemblance. For example, in the following argument:

“The COVID-19 vaccine is dangerous because past vaccines have also been found to be dangerous.”

Here, the comparison with other vaccines is a reason for supporting the danger of the COVID-19 vaccine.

Y is appropriate for Y,

because : Y is appropriate for Z

and : Z is comparable to X.

The COVID-19 vaccine (X) is dangerous (Y)

because: past vaccines (Z) are dangerous (Y)

and: past vaccines (Z) are comparable to the COVID-19 vaccine (X).

Figure 2 below shows the example in a visual chart.

An external file that holds a picture, illustration, etc.
Object name is ijerph-18-06764-g002.jpg

Example of argument based on a comparison relation.

The third type of argument scheme is based on a causal relation , where the claim is supported by making a causal connection between itself and its grounding reason. For example, in the following argument:

“Some people contracted COVID-19 because they used 5G technologies.”

and : Z leads to Y.

Using 5G technologies (Z) leads to contracting COVID-19 (Y).

because : Some people (X) contracted COVID-19 (Y)

and : Some people (X) used 5G technologies (Z)

Figure 3 below shows the example in a visual chart.

An external file that holds a picture, illustration, etc.
Object name is ijerph-18-06764-g003.jpg

Example of argument based on a causal relation.

Highlighting the formal structure of arguments seems to be technical. Yet, these three main types of argument schemes can be used to analyze and evaluate all types of arguments, where claims support reasons. Strengthening people’s skills in understanding and using these argument schemes is, thus, important as a base to avoid taking claims for granted or relying on peripheral cues that can be misleading.

3.3. Fallacies and Critical Questions

Identifying the structure of arguments in terms of their claims and supporting reasons is the essential step to evaluating the quality of the arguments themselves and defining whether they are of good or poor quality. When, indeed, the reasons put forward to support a claim are false, irrelevant, or, in general, not appropriate, the argument itself lacks soundness. The literature refers to these as “fallacies” that are invalid or faulty reasoning [ 25 ]. It is not always easy to recognize fallacies. Yet, the primary step is to instruct people on how to detach this type of disinformation.

Key insight 3: People should learn to identify the structure of an argument and then verify if it is fallacious by asking critical questions.

More specifically, people can identify the weaknesses of arguments by using “critical questions”, that is, questions to test the soundness of arguments [ 26 ]. Referring to the above-mentioned reasoning:

“This person is right about COVID-19 because they are a doctor.”

Taking into account the above-introduced knowledge about argument schemes, the main critical question to ask here is: “is Z indeed symptomatic of Y?”, that is, is being a doctor indeed a sign of knowing about all health conditions and, thus, always making factual health-related statements? The unreflected answer might be, “yes, of course”. However, the framework gets shaky by taking a closer look at the claim and the specific situation. First of all, doctors are experts about specific health conditions, not about all health conditions. Moreover, they might be right in diagnosing and treating cases that they have experience in, but not where they have no clinical experience and have not conducted research, which would hold for most doctors and COVID-19. Moreover, experience is often contextualized in a specific setting. However, for generalizations regarding, for instance, the country-specific COVID-19 clinical situation, they have to rely on national data and conduct sophisticated research that goes beyond their personal opinions. Certain aspects about COVID-19 are not within the domain of general practitioners but rather lie within the field of epidemiologists, virologists, public health experts, and health economics experts. Being a medical doctor does not directly qualify to hold expertise in other areas, even if significant overlaps exist between different health-related fields. Thus, the “authority-oriented” perspective for the argument is weak when the speaker might not have any absolute authority, knowledge, or experience in what they claim.

Concerning the second example:

Here, there are different critical questions to ask. The first question relates to the grounds for claiming that “vaccines in the past were shown to be dangerous”. Is this true? What does the evidence say and prove? Further, another important question is, “what does it mean to say that a vaccine is dangerous”? Related to these questions, the list of other questions includes: does the vaccine have some side effects like any other drug? Does it have more side effects? Have these effects been proven through rigorous scientific studies? Moreover, provided that some vaccines produced side effects in the past: Is the COVID-19 vaccine comparable to them? In other words, going back to the previous argument schemes: is Z (the COVID-19 vaccine) really equivalent to X (the other vaccines)? Is X (the other vaccines) really Y (dangerous)?

Overall, arguments from analogies always work by claiming comparisons. It is, thus, essential to verify the nature of the comparison itself. In particular, whether there is a relation/correspondence between two things and, if so, in which way.

“Some people contracted COVID-19 because they were exposed to 5G radiowaves.”

The main critical question is: “does Z indeed lead to Y?”, that is: does exposure to 5G lead to COVID-19? There is no scientific evidence that supports any link between the two as such. Thus, the argument is unsound, as the proposed cause of something is unproven. This is a typical pitfall of arguments implying that “something has the inevitable result”, that “something causes something”, and that “something always occurs when …”. The foundation of these general claims has to be carefully reviewed, as making faulty causal links between events indicates flawed critical thinking, which can lead to dangerous health decision-making.

4. Discussion

This paper contributes to the field of critical health literacy. It proposes specific topics from argumentation theory that could inform the operationalization of critical health literacy and form a basis for interventions aiming at strengthening individuals’ skills in this context. This study argues that a promising way to empower people in evaluating health information is to enhance their skills in the recognition, analysis, and evaluation of arguments. Specifically, it supports the need for people:

(1) to recognize when health information is argumentative, that is, when the speaker presents a claim that they want the audience to accept, believe, or act upon;
(2) to identify whether reasons support claims, and if so, which argument scheme they implement (that is, schemes based on symptomatic relations, analogy, or causality);
(3) to ask the main critical questions to look for evidence behind the proposed reasons that can support or deny the claims’ validity (and acceptance).

These insights stemming from argumentation theory can contribute to advancing research on critical health literacy and align with existing findings in these contexts. An individual’s ability to recognize arguments and distortions in information has indeed been identified as one of the central components of critical health literacy in a recent review aiming to operationalize the concept [ 10 ]. Always keeping in mind that critical appraisal of information is complex and also involves a variety of competencies, skills, and abilities in other contexts (e.g., the ability to recognize biases in one’s thinking), this analysis based on argumentation theory provides us with concrete examples of what these distortions could look like and how to identify them. This makes our contribution a precious addition for the conceptualization and operationalization of critical health literacy. Despite its mainstream relevance in today’s information landscape, research in this domain is still in its infancy [ 12 ].

Moreover, some main considerations are needed when thinking about the applicability of our proposed approach. First, we are very well aware that argumentation theory is a technical discipline. Experts in argument analysis and evaluation need years of study to evaluate the quality of information. While we do not expect (because this would be unrealistic) that people become experts in argumentation theory, working on these aspects is a way to implement the classical tradition of “critical thinking”. Developing competencies in argumentation theory strengthens individuals as critical thinkers. Indeed, Siegel explains, “a critical thinker is a thinker who can assess claims and make judgments based on reasons, and who understands and conforms to principles governing the evaluation of the force of these arguments” [ 27 ]. Basing education and training initiatives on argumentation theory prepares individuals to become more competent in those abilities that are necessary for successful decision-making [ 28 , 29 , 30 ]. This is a way to encourage individuals to look for evidence and to ask the right questions to scrutinize claims, points of view, or what is presented as evidence.

Thus, our broader aim here is to call for concrete and specific initiatives to empower individuals in information appraisal. This is rather urgent, and there is a whole tradition of theories, models, and tools that can assist in doing this. It is a matter of thinking how to implement the study of critical thinking and argumentation theory in education and training programs, with a focus on the provisions of criteria and standards to assess the quality of information. Of course, expressing one’s opinion is a fundamental right, but the ability to evaluate information should be seen as essential to avoid suboptimal decision-making.

Second, health institutions can play a significant role in reinforcing critical health literacy. For decades, health promotion and disease prevention have been driven by an approach of telling people what is good/bad for their health (for instance, “eating fruits and vegetables is good” and “smoking is bad”) instead of empowering them to deal with the concurring information that stands out from the informational mainstream but might be more appealing, as it offers easier, less strenuous, or more rewarding alternatives. The pitfalls of this one-sided approach have become evident during the pandemic. The global COVID-19 health crisis has shown that this type of top-down approach to health styles sometimes has little impact on people. People are exposed to so much health information from different traditional and alternative sources that, as we argue, empowering critical thinking skills provides the best guidance. By following this approach, the World Health Organization is already actively working to empower governments and institutions to manage infodemics, including informational overload and dis-/misinformation [ 8 ]. Building critical health literacy and providing science education plays a significant role in this framework.

Third, this paper points to the benefits of efforts that target the educational system. Disciplines such as epistemology, philosophy of science, critical thinking, and scientific thinking can inform educational programs in different settings and different levels of education. Thus, for instance, school-based programs could entail specific sections that lay the foundations of scientific thinking and health information quality. A primary focus should be on what evidence is, how it differs from opinions, and the difference between causality and correlation. Similarly, patient education programs, instead of focusing on information provision, could be based on argumentation theory, so to provide patients with critical thinking skills that are useful in making informed decisions concerning their health.

At this stage, we also like to acknowledge one important arising limitation. This paper is conceptual. More work on the presentation of best practices of education and training is needed. Additionally, this paper focuses on argumentation theory. It should be complemented by work focusing on the so-called biases and heuristics well-developed in the cognitive sciences [ 31 ]. While we claim that the ability to evaluate health information would be an asset for individuals’ decision-making, we also have to acknowledge that this ability can be negatively impacted by the use of heuristics in critical thinking. Thus, for instance, people may evaluate information wrongly because they have a bias. For a discussion on the role of heuristics in critical thinking, we refer to a previous publication [ 32 ]. On the link between argumentation skills and heuristics, we plan to conduct further research.

5. Conclusions

This paper contributes to the operationalization of what critical health literacy entails by looking at the structure and soundness of arguments. Indeed, since false and unsupported claims in health information might pose a risk to individuals’ health, it is fundamental to equip them with the necessary means to assess the credibility and correctness of the claims that confront them. As a well-developed field of research, argumentation theory proposes several concepts and tools to assist with these challenges. Moreover, some of argumentation theory’s main aspects are the basis of current handbooks and courses in critical thinking that have entire sections dedicated to evaluating arguments. The development of argumentation skills requires knowledge and intensive training, which might be an implementational impediment on a larger scale, e.g., for whole societal groups or communities. Yet, some main concepts could inform educational interventions within public health frameworks and help disseminate a general understanding of good versus bad instances of argumentation. As a significant part of information nowadays has a persuasive nature, guiding the public understanding of argumentation and its principles is a major step toward consolidating critical literacy skills. In an information society, where freedom of speech is a crucial value, providing some normative guidance to individuals is a vital step towards empowering a free and reasonable choice about what to believe or not. Francis Bacon once said: “read not to contradict and confute; nor to believe and take for granted… but to weigh and consider.” [ 33 ] An argumentation theory-based education and training can help to achieve this goal.

Author Contributions

Conceptualization, S.R.; Methodology, S.R., N.D.; Formal Analysis, S.R., A.O., C.Z., M.F., N.D.; Original Draft Preparation, S.R.; Review and Editing, S.R., A.O., C.Z., M.F., N.D.; Supervision, S.R.; Funding Acquisition, S.R., N.D. All authors have read and agreed to the published version of the manuscript.

The work presented in this paper has been funded by a grant awarded to Sara Rubinelli and Nicola Diviani by the Swiss National Science Foundation ( www.snf.ch ; Grant No. 31CA30_196736), within the special call on Corona Virus. The funding source had no role in the conceptualization of the study, decision to publish, or preparation of the manuscript.

Institutional Review Board Statement

Informed consent statement, data availability statement, conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Global Cognition

Critical thinking in decision making.

by Winston Sieck updated September 12, 2021

Critical thinking is often talked about as a stand-alone activity. Like some other individual activities, thinking critically may just feel good. Yet, critical thinking seems most useful when it aids other cognitive processes, such as applying critical thinking in decision making.

Anne Helsdingen from the Open University of the Netherlands and her colleagues studied an interesting issue about critical thinking in decision making. They wanted to know whether teaching critical thinking skills can improve judgment and decision making in general.

Helsdingen and her team define critical thinking as reasoned thinking with a purpose. They also describe some core critical thinking skills and abilities, such as being able to:

Appreciate that your own opinions may be wrong
Accept statements as true even when they conflict with your own views
Temporarily adopt an initial position with which you disagree, and then reason from that starting point

A challenge, according to these researchers, is how to teach skills for critical thinking in decision making so that they transfer to new decision making problems. Transfer means being able to apply what you have learned to new tasks or new situations.

To tackle this problem, they start with a useful cognitive model of how decisions are made . Numerous researchers have worked with similar versions of the model of the years. One version is called “explanation-based decision making,” or the “story model.”

The idea is that people encounter situations. When they do, they recognize important parts of the situation from past experience. They then create a story (or explanation) about what’s going on and what will happen. They make decisions based on their story, and how things have turned out in similar stories past.

A problem with making decisions this way is that our stories tend to be less complete than we think – a failure of metacognition. We also overlook inconsistent details because we’re sucked in by the good story. According to Helsdingen, we might improve our intuitive approach by bringing critical thinking in the decision making process.

The researchers tested a method for including critical thinking in decision making. First, they explained the story model of decision making. Then, they prompted the learners to reflect on their story and thinking critically about it. Some of the questions they included to prompt critical thinking were:

Do you have all the necessary information?
Is there any conflict in the evidence?
The devil’s advocate tells you that your story is wrong. Make up an alternative story. Is it more plausible than the original?

The students in the study read through cases about crimes that had been committed. Their job was to decide on the priority of each case for the police. They got feedback, so they could learn what makes cases more important in police work.

Some of the students received the critical thinking skills training while making these decisions. Others did not.

How well they made these crime decisions was not the most important thing, though. The main thing was how well they would do in a different situation after learning about critical thinking in decision making. That is, would their new skills transfer?

The researchers tested for transfer by having the students make different decisions about traffic offenses. The overall results suggested that the training on how to include critical thinking in decision making was effective. The benefits did transfer to the new decision making task.

As you come across decisions that you need to make, pay some attention to the stories you are telling yourself in the process. Use some of the ideas above and other critical thinking skills to improve your story and decision. Writing is also an excellent strategy for making good decisions . It may seem like a bit of extra work at first, but with practice will become more natural for your future decisions.

Image Credit: Critical thinking asylum

Helsdingen, A., van Gog, T., & van Merriënboer, J. (2011). The effects of practice schedule and critical thinking prompts on learning and transfer of a complex judgment task. Journal of Educational Psychology, 103 (2), 383-398 DOI: 10.1037/a0022370

About Winston Sieck

Dr. Winston Sieck is a cognitive psychologist working to advance the development of thinking skills. He is founder and president of Global Cognition, and director of Thinker Academy .

Reader Interactions

January 13, 2013 at 6:36 pm

Thanks for sharing this research and the ‘story’. We are often asked whether you can learn to be a better critical thinker – I wouldn’t be teaching it if I didn’t believe it to be the case! But it helps to have research to support this belief.

Our work is focused on critical thinking in organizational, workplace settings with all sorts of employees, including managers and executives. My experience is pretty similar to that you gave in the case; in the moment, on a particular case, the ‘decision’ may not be improved.

As the researchers and you point out, the proof is in the pudding. Can people learn and apply simple critical thinking techniques, consistently and effectively, and, does this lead to better outcomes?

We find that it can be overwhelming to try to teach too much at a clip. We boil it down to simple questions, job aids, and worksheets that can help people – especially people working on teams – to establish a common vocabulary, and create an environment that reinforces critical thinking rather than viewing it as generating conflict and controversy.

February 21, 2014 at 4:02 am

I am interested in teaching critical thinking skills to Law Enforcement, specifically to a group of people age 14 to 18 who are interested in pursuing a Law Enforcement Career (The Police Explorer Program) but then later to already established officers.

A law enforcement officer (LEO) is called upon to make decisions and wield power which effect others lives, and they are often required to do this on the spot, with a limited amount of time and information available. They make these decisions every day and I am looking for ways to sharpen their skills and help them make the best decisions possible with the information they have on hand.

I couldn’t help but notice that this study happened to be centered on LEO scenarios. I was wondering if I could adapt this study to a class for young people. Any thoughts?

Also, how could I get the specifics of this study, to include the specific scenarios used?

February 21, 2014 at 9:34 am

That sounds really interesting, Eric. I contacted Anne Helsdingen on your behalf, and shared your contact information with her.

February 28, 2016 at 11:40 pm

For the last five years I have taught CT to serving LEOs, although only slowly at first; it is a sharp departure from traditional police training. While new theories come out on how to fix a profession currently under enormous pressure, many of them have been around for 10 or 20 years whereas CT has been developed over at least 25 centuries. I would be happy to share my work and experiences to to hear of others’ work too.

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41+ Critical Thinking Examples (Definition + Practices)

Critical thinking is an essential skill in our information-overloaded world, where figuring out what is fact and fiction has become increasingly challenging.

But why is critical thinking essential? Put, critical thinking empowers us to make better decisions, challenge and validate our beliefs and assumptions, and understand and interact with the world more effectively and meaningfully.

Critical thinking is like using your brain's "superpowers" to make smart choices. Whether it's picking the right insurance, deciding what to do in a job, or discussing topics in school, thinking deeply helps a lot. In the next parts, we'll share real-life examples of when this superpower comes in handy and give you some fun exercises to practice it.

Critical Thinking Process Outline

Critical thinking means thinking clearly and fairly without letting personal feelings get in the way. It's like being a detective, trying to solve a mystery by using clues and thinking hard about them.

It isn't always easy to think critically, as it can take a pretty smart person to see some of the questions that aren't being answered in a certain situation. But, we can train our brains to think more like puzzle solvers, which can help develop our critical thinking skills.

Here's what it looks like step by step:

Spotting the Problem: It's like discovering a puzzle to solve. You see that there's something you need to figure out or decide.

Collecting Clues: Now, you need to gather information. Maybe you read about it, watch a video, talk to people, or do some research. It's like getting all the pieces to solve your puzzle.

Breaking It Down: This is where you look at all your clues and try to see how they fit together. You're asking questions like: Why did this happen? What could happen next?

Checking Your Clues: You want to make sure your information is good. This means seeing if what you found out is true and if you can trust where it came from.

Making a Guess: After looking at all your clues, you think about what they mean and come up with an answer. This answer is like your best guess based on what you know.

Explaining Your Thoughts: Now, you tell others how you solved the puzzle. You explain how you thought about it and how you answered.

Checking Your Work: This is like looking back and seeing if you missed anything. Did you make any mistakes? Did you let any personal feelings get in the way? This step helps make sure your thinking is clear and fair.

And remember, you might sometimes need to go back and redo some steps if you discover something new. If you realize you missed an important clue, you might have to go back and collect more information.

Critical Thinking Methods

Just like doing push-ups or running helps our bodies get stronger, there are special exercises that help our brains think better. These brain workouts push us to think harder, look at things closely, and ask many questions.

It's not always about finding the "right" answer. Instead, it's about the journey of thinking and asking "why" or "how." Doing these exercises often helps us become better thinkers and makes us curious to know more about the world.

Now, let's look at some brain workouts to help us think better:

1. "What If" Scenarios

Imagine crazy things happening, like, "What if there was no internet for a month? What would we do?" These games help us think of new and different ideas.

Pick a hot topic. Argue one side of it and then try arguing the opposite. This makes us see different viewpoints and think deeply about a topic.

3. Analyze Visual Data

Check out charts or pictures with lots of numbers and info but no explanations. What story are they telling? This helps us get better at understanding information just by looking at it.

4. Mind Mapping

Write an idea in the center and then draw lines to related ideas. It's like making a map of your thoughts. This helps us see how everything is connected.

There's lots of mind-mapping software , but it's also nice to do this by hand.

5. Weekly Diary

Every week, write about what happened, the choices you made, and what you learned. Writing helps us think about our actions and how we can do better.

6. Evaluating Information Sources

Collect stories or articles about one topic from newspapers or blogs. Which ones are trustworthy? Which ones might be a little biased? This teaches us to be smart about where we get our info.

There are many resources to help you determine if information sources are factual or not.

7. Socratic Questioning

This way of thinking is called the Socrates Method, named after an old-time thinker from Greece. It's about asking lots of questions to understand a topic. You can do this by yourself or chat with a friend.

Start with a Big Question:

"What does 'success' mean?"

Dive Deeper with More Questions:

"Why do you think of success that way?" "Do TV shows, friends, or family make you think that?" "Does everyone think about success the same way?"

"Can someone be a winner even if they aren't rich or famous?" "Can someone feel like they didn't succeed, even if everyone else thinks they did?"

Look for Real-life Examples:

"Who is someone you think is successful? Why?" "Was there a time you felt like a winner? What happened?"

Think About Other People's Views:

"How might a person from another country think about success?" "Does the idea of success change as we grow up or as our life changes?"

Think About What It Means:

"How does your idea of success shape what you want in life?" "Are there problems with only wanting to be rich or famous?"

Look Back and Think:

"After talking about this, did your idea of success change? How?" "Did you learn something new about what success means?"

8. Six Thinking Hats

Edward de Bono came up with a cool way to solve problems by thinking in six different ways, like wearing different colored hats. You can do this independently, but it might be more effective in a group so everyone can have a different hat color. Each color has its way of thinking:

White Hat (Facts): Just the facts! Ask, "What do we know? What do we need to find out?"

Red Hat (Feelings): Talk about feelings. Ask, "How do I feel about this?"

Black Hat (Careful Thinking): Be cautious. Ask, "What could go wrong?"

Yellow Hat (Positive Thinking): Look on the bright side. Ask, "What's good about this?"

Green Hat (Creative Thinking): Think of new ideas. Ask, "What's another way to look at this?"

Blue Hat (Planning): Organize the talk. Ask, "What should we do next?"

When using this method with a group:

Explain all the hats.
Decide which hat to wear first.
Make sure everyone switches hats at the same time.
Finish with the Blue Hat to plan the next steps.

9. SWOT Analysis

SWOT Analysis is like a game plan for businesses to know where they stand and where they should go. "SWOT" stands for Strengths, Weaknesses, Opportunities, and Threats.

There are a lot of SWOT templates out there for how to do this visually, but you can also think it through. It doesn't just apply to businesses but can be a good way to decide if a project you're working on is working.

Strengths: What's working well? Ask, "What are we good at?"

Weaknesses: Where can we do better? Ask, "Where can we improve?"

Opportunities: What good things might come our way? Ask, "What chances can we grab?"

Threats: What challenges might we face? Ask, "What might make things tough for us?"

Steps to do a SWOT Analysis:

Goal: Decide what you want to find out.
Research: Learn about your business and the world around it.
Brainstorm: Get a group and think together. Talk about strengths, weaknesses, opportunities, and threats.
Pick the Most Important Points: Some things might be more urgent or important than others.
Make a Plan: Decide what to do based on your SWOT list.
Check Again Later: Things change, so look at your SWOT again after a while to update it.

Now that you have a few tools for thinking critically, let’s get into some specific examples.

Everyday Examples

Life is a series of decisions. From the moment we wake up, we're faced with choices – some trivial, like choosing a breakfast cereal, and some more significant, like buying a home or confronting an ethical dilemma at work. While it might seem that these decisions are disparate, they all benefit from the application of critical thinking.

10. Deciding to buy something

Imagine you want a new phone. Don't just buy it because the ad looks cool. Think about what you need in a phone. Look up different phones and see what people say about them. Choose the one that's the best deal for what you want.

11. Deciding what is true

There's a lot of news everywhere. Don't believe everything right away. Think about why someone might be telling you this. Check if what you're reading or watching is true. Make up your mind after you've looked into it.

12. Deciding when you’re wrong

Sometimes, friends can have disagreements. Don't just get mad right away. Try to see where they're coming from. Talk about what's going on. Find a way to fix the problem that's fair for everyone.

13. Deciding what to eat

There's always a new diet or exercise that's popular. Don't just follow it because it's trendy. Find out if it's good for you. Ask someone who knows, like a doctor. Make choices that make you feel good and stay healthy.

14. Deciding what to do today

Everyone is busy with school, chores, and hobbies. Make a list of things you need to do. Decide which ones are most important. Plan your day so you can get things done and still have fun.

15. Making Tough Choices

Sometimes, it's hard to know what's right. Think about how each choice will affect you and others. Talk to people you trust about it. Choose what feels right in your heart and is fair to others.

16. Planning for the Future

Big decisions, like where to go to school, can be tricky. Think about what you want in the future. Look at the good and bad of each choice. Talk to people who know about it. Pick what feels best for your dreams and goals.

Job Examples

17. solving problems.

Workers brainstorm ways to fix a machine quickly without making things worse when a machine breaks at a factory.

18. Decision Making

A store manager decides which products to order more of based on what's selling best.

19. Setting Goals

A team leader helps their team decide what tasks are most important to finish this month and which can wait.

20. Evaluating Ideas

At a team meeting, everyone shares ideas for a new project. The group discusses each idea's pros and cons before picking one.

21. Handling Conflict

Two workers disagree on how to do a job. Instead of arguing, they talk calmly, listen to each other, and find a solution they both like.

22. Improving Processes

A cashier thinks of a faster way to ring up items so customers don't have to wait as long.

23. Asking Questions

Before starting a big task, an employee asks for clear instructions and checks if they have the necessary tools.

24. Checking Facts

Before presenting a report, someone double-checks all their information to make sure there are no mistakes.

25. Planning for the Future

A business owner thinks about what might happen in the next few years, like new competitors or changes in what customers want, and makes plans based on those thoughts.

26. Understanding Perspectives

A team is designing a new toy. They think about what kids and parents would both like instead of just what they think is fun.

School Examples

27. researching a topic.

For a history project, a student looks up different sources to understand an event from multiple viewpoints.

28. Debating an Issue

In a class discussion, students pick sides on a topic, like school uniforms, and share reasons to support their views.

29. Evaluating Sources

While writing an essay, a student checks if the information from a website is trustworthy or might be biased.

30. Problem Solving in Math

When stuck on a tricky math problem, a student tries different methods to find the answer instead of giving up.

31. Analyzing Literature

In English class, students discuss why a character in a book made certain choices and what those decisions reveal about them.

32. Testing a Hypothesis

For a science experiment, students guess what will happen and then conduct tests to see if they're right or wrong.

33. Giving Peer Feedback

After reading a classmate's essay, a student offers suggestions for improving it.

34. Questioning Assumptions

In a geography lesson, students consider why certain countries are called "developed" and what that label means.

35. Designing a Study

For a psychology project, students plan an experiment to understand how people's memories work and think of ways to ensure accurate results.

36. Interpreting Data

In a science class, students look at charts and graphs from a study, then discuss what the information tells them and if there are any patterns.

Critical Thinking Puzzles

Not all scenarios will have a single correct answer that can be figured out by thinking critically. Sometimes we have to think critically about ethical choices or moral behaviors.

Here are some mind games and scenarios you can solve using critical thinking. You can see the solution(s) at the end of the post.

37. The Farmer, Fox, Chicken, and Grain Problem

A farmer is at a riverbank with a fox, a chicken, and a grain bag. He needs to get all three items across the river. However, his boat can only carry himself and one of the three items at a time.

Here's the challenge:

If the fox is left alone with the chicken, the fox will eat the chicken.
If the chicken is left alone with the grain, the chicken will eat the grain.

How can the farmer get all three items across the river without any item being eaten?

38. The Rope, Jar, and Pebbles Problem

You are in a room with two long ropes hanging from the ceiling. Each rope is just out of arm's reach from the other, so you can't hold onto one rope and reach the other simultaneously.

Your task is to tie the two rope ends together, but you can't move the position where they hang from the ceiling.

You are given a jar full of pebbles. How do you complete the task?

39. The Two Guards Problem

Imagine there are two doors. One door leads to certain doom, and the other leads to freedom. You don't know which is which.

In front of each door stands a guard. One guard always tells the truth. The other guard always lies. You don't know which guard is which.

You can ask only one question to one of the guards. What question should you ask to find the door that leads to freedom?

40. The Hourglass Problem

You have two hourglasses. One measures 7 minutes when turned over, and the other measures 4 minutes. Using just these hourglasses, how can you time exactly 9 minutes?

41. The Lifeboat Dilemma

Imagine you're on a ship that's sinking. You get on a lifeboat, but it's already too full and might flip over.

Nearby in the water, five people are struggling: a scientist close to finding a cure for a sickness, an old couple who've been together for a long time, a mom with three kids waiting at home, and a tired teenager who helped save others but is now in danger.

You can only save one person without making the boat flip. Who would you choose?

42. The Tech Dilemma

You work at a tech company and help make a computer program to help small businesses. You're almost ready to share it with everyone, but you find out there might be a small chance it has a problem that could show users' private info.

If you decide to fix it, you must wait two more months before sharing it. But your bosses want you to share it now. What would you do?

43. The History Mystery

Dr. Amelia is a history expert. She's studying where a group of people traveled long ago. She reads old letters and documents to learn about it. But she finds some letters that tell a different story than what most people believe.

If she says this new story is true, it could change what people learn in school and what they think about history. What should she do?

The Role of Bias in Critical Thinking

Have you ever decided you don’t like someone before you even know them? Or maybe someone shared an idea with you that you immediately loved without even knowing all the details.

This experience is called bias, which occurs when you like or dislike something or someone without a good reason or knowing why. It can also take shape in certain reactions to situations, like a habit or instinct.

Bias comes from our own experiences, what friends or family tell us, or even things we are born believing. Sometimes, bias can help us stay safe, but other times it stops us from seeing the truth.

Not all bias is bad. Bias can be a mechanism for assessing our potential safety in a new situation. If we are biased to think that anything long, thin, and curled up is a snake, we might assume the rope is something to be afraid of before we know it is just a rope.

While bias might serve us in some situations (like jumping out of the way of an actual snake before we have time to process that we need to be jumping out of the way), it often harms our ability to think critically.

How Bias Gets in the Way of Good Thinking

Selective Perception: We only notice things that match our ideas and ignore the rest.

It's like only picking red candies from a mixed bowl because you think they taste the best, but they taste the same as every other candy in the bowl. It could also be when we see all the signs that our partner is cheating on us but choose to ignore them because we are happy the way we are (or at least, we think we are).

Agreeing with Yourself: This is called “ confirmation bias ” when we only listen to ideas that match our own and seek, interpret, and remember information in a way that confirms what we already think we know or believe.

An example is when someone wants to know if it is safe to vaccinate their children but already believes that vaccines are not safe, so they only look for information supporting the idea that vaccines are bad.

Thinking We Know It All: Similar to confirmation bias, this is called “overconfidence bias.” Sometimes we think our ideas are the best and don't listen to others. This can stop us from learning.

Have you ever met someone who you consider a “know it”? Probably, they have a lot of overconfidence bias because while they may know many things accurately, they can’t know everything. Still, if they act like they do, they show overconfidence bias.

There's a weird kind of bias similar to this called the Dunning Kruger Effect, and that is when someone is bad at what they do, but they believe and act like they are the best .

Following the Crowd: This is formally called “groupthink”. It's hard to speak up with a different idea if everyone agrees. But this can lead to mistakes.

An example of this we’ve all likely seen is the cool clique in primary school. There is usually one person that is the head of the group, the “coolest kid in school”, and everyone listens to them and does what they want, even if they don’t think it’s a good idea.

How to Overcome Biases

Here are a few ways to learn to think better, free from our biases (or at least aware of them!).

Know Your Biases: Realize that everyone has biases. If we know about them, we can think better.

Listen to Different People: Talking to different kinds of people can give us new ideas.

Ask Why: Always ask yourself why you believe something. Is it true, or is it just a bias?

Understand Others: Try to think about how others feel. It helps you see things in new ways.

Keep Learning: Always be curious and open to new information.

In today's world, everything changes fast, and there's so much information everywhere. This makes critical thinking super important. It helps us distinguish between what's real and what's made up. It also helps us make good choices. But thinking this way can be tough sometimes because of biases. These are like sneaky thoughts that can trick us. The good news is we can learn to see them and think better.

There are cool tools and ways we've talked about, like the "Socratic Questioning" method and the "Six Thinking Hats." These tools help us get better at thinking. These thinking skills can also help us in school, work, and everyday life.

We’ve also looked at specific scenarios where critical thinking would be helpful, such as deciding what diet to follow and checking facts.

Thinking isn't just a skill—it's a special talent we improve over time. Working on it lets us see things more clearly and understand the world better. So, keep practicing and asking questions! It'll make you a smarter thinker and help you see the world differently.

Critical Thinking Puzzles (Solutions)

The farmer, fox, chicken, and grain problem.

The farmer first takes the chicken across the river and leaves it on the other side.
He returns to the original side and takes the fox across the river.
After leaving the fox on the other side, he returns the chicken to the starting side.
He leaves the chicken on the starting side and takes the grain bag across the river.
He leaves the grain with the fox on the other side and returns to get the chicken.
The farmer takes the chicken across, and now all three items -- the fox, the chicken, and the grain -- are safely on the other side of the river.

The Rope, Jar, and Pebbles Problem

Take one rope and tie the jar of pebbles to its end.
Swing the rope with the jar in a pendulum motion.
While the rope is swinging, grab the other rope and wait.
As the swinging rope comes back within reach due to its pendulum motion, grab it.
With both ropes within reach, untie the jar and tie the rope ends together.

The Two Guards Problem

The question is, "What would the other guard say is the door to doom?" Then choose the opposite door.

The Hourglass Problem

Start both hourglasses.
When the 4-minute hourglass runs out, turn it over.
When the 7-minute hourglass runs out, the 4-minute hourglass will have been running for 3 minutes. Turn the 7-minute hourglass over.
When the 4-minute hourglass runs out for the second time (a total of 8 minutes have passed), the 7-minute hourglass will run for 1 minute. Turn the 7-minute hourglass again for 1 minute to empty the hourglass (a total of 9 minutes passed).

The Boat and Weights Problem

Take the cat over first and leave it on the other side. Then, return and take the fish across next. When you get there, take the cat back with you. Leave the cat on the starting side and take the cat food across. Lastly, return to get the cat and bring it to the other side.

The Lifeboat Dilemma

There isn’t one correct answer to this problem. Here are some elements to consider:

Moral Principles: What values guide your decision? Is it the potential greater good for humanity (the scientist)? What is the value of long-standing love and commitment (the elderly couple)? What is the future of young children who depend on their mothers? Or the selfless bravery of the teenager?
Future Implications: Consider the future consequences of each choice. Saving the scientist might benefit millions in the future, but what moral message does it send about the value of individual lives?
Emotional vs. Logical Thinking: While it's essential to engage empathy, it's also crucial not to let emotions cloud judgment entirely. For instance, while the teenager's bravery is commendable, does it make him more deserving of a spot on the boat than the others?
Acknowledging Uncertainty: The scientist claims to be close to a significant breakthrough, but there's no certainty. How does this uncertainty factor into your decision?
Personal Bias: Recognize and challenge any personal biases, such as biases towards age, profession, or familial status.

The Tech Dilemma

Again, there isn’t one correct answer to this problem. Here are some elements to consider:

Evaluate the Risk: How severe is the potential vulnerability? Can it be easily exploited, or would it require significant expertise? Even if the circumstances are rare, what would be the consequences if the vulnerability were exploited?
Stakeholder Considerations: Different stakeholders will have different priorities. Upper management might prioritize financial projections, the marketing team might be concerned about the product's reputation, and customers might prioritize the security of their data. How do you balance these competing interests?
Short-Term vs. Long-Term Implications: While launching on time could meet immediate financial goals, consider the potential long-term damage to the company's reputation if the vulnerability is exploited. Would the short-term gains be worth the potential long-term costs?
Ethical Implications : Beyond the financial and reputational aspects, there's an ethical dimension to consider. Is it right to release a product with a known vulnerability, even if the chances of it being exploited are low?
Seek External Input: Consulting with cybersecurity experts outside your company might be beneficial. They could provide a more objective risk assessment and potential mitigation strategies.
Communication: How will you communicate the decision, whatever it may be, both internally to your team and upper management and externally to your customers and potential users?

The History Mystery

Dr. Amelia should take the following steps:

Verify the Letters: Before making any claims, she should check if the letters are actual and not fake. She can do this by seeing when and where they were written and if they match with other things from that time.
Get a Second Opinion: It's always good to have someone else look at what you've found. Dr. Amelia could show the letters to other history experts and see their thoughts.
Research More: Maybe there are more documents or letters out there that support this new story. Dr. Amelia should keep looking to see if she can find more evidence.
Share the Findings: If Dr. Amelia believes the letters are true after all her checks, she should tell others. This can be through books, talks, or articles.
Stay Open to Feedback: Some people might agree with Dr. Amelia, and others might not. She should listen to everyone and be ready to learn more or change her mind if new information arises.

Ultimately, Dr. Amelia's job is to find out the truth about history and share it. It's okay if this new truth differs from what people used to believe. History is about learning from the past, no matter the story.

Experimenter Bias (Definition + Examples)
Hasty Generalization Fallacy (31 Examples + Similar Names)
Ad Hoc Fallacy (29 Examples + Other Names)
Confirmation Bias (Examples + Definition)
Equivocation Fallacy (26 Examples + Description)

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The Peak Performance Center

The pursuit of performance excellence, knowledge dimensions and cognitive dimensions, blooms taxonomy.

In 1956, Benjamin Bloom published a classification system for categorizing cognitive skills and learning behavior known as Bloom’s Taxonomy. The classification begins at the basic level which is simple recall skills and progresses to the perceived highest level of cognitive processing. The Taxonomy defines six different levels as Knowledge, Comprehension, Application, Analysis, Synthesis, and Evaluation.

Blooms Taxonomy Revised

In 2001, a group of cognitive psychologists published a revision of Bloom’s Taxonomy. The group revised the taxonomy using verbs to label their categories rather than the nouns of the original taxonomy. These verbs describe the cognitive processes by which thinkers encounter and work with knowledge.

This revised taxonomy is a two-dimensional framework for identifying and categorizing learning outcomes with a cognitive emphasis. This version differentiates between the “knowledge” category and the other 5 levels of Bloom’s model. The other levels dealt with intellectual abilities and skills in relation to interactions with types of knowledge. They separated this out because they believe there is a significant difference between knowledge and the mental and intellectual operations performed on, or with, that knowledge. This separation identifies and creates two dimensions; Knowledge and Cognitive Processing.

The new taxonomy differentiates between “knowing what,” the content of thinking, and “knowing how,” the procedures used in solving problems.

The Knowledge Dimension is the “knowing what.” It has four categories: factual, conceptual, procedural, and metacognitive.

The Cognitive Process Dimension is the “knowing how.” This revised version like the original has six skills. They are, from simplest to most complex: remember, understand, apply, analyze, evaluate, and create.

About the Knowledge and Cognitive Dimensions

The cognitive process dimension.

The cognitive process dimension represents a continuum of cognitive complexity. The dimension contains six categories of thinking skills. The categories are on a continuum of increasing cognitive complexity, from lower order thinking skills to higher order thinking skills.

Cognitive Processes Levels

Remember – Retrieve relevant knowledge from long-term memory.

Understand – Construct meaning from instructional messages, including oral, written and graphic communication.

Apply – Carry out or use a procedure in a given situation.

Analyze – Break material into foundational parts and determine how parts relate to one another and the overall structure or purpose.

Evaluate – Make judgments based on criteria and standards.

Create – Put elements together to form a coherent whole, or reorganize elements into a new pattern or structure.

Knowledge Dimension

The knowledge dimension contains four categories on a continuum of concrete knowledge to abstract knowledge. These four types of knowledge help determine what to teach and how to teach it, or instructional content and instructional methods and activities.

Levels of Knowledge

Factual Knowledge – The basic elements learners must know to be acquainted with a discipline or solve problems.

Conceptual Knowledge – The interrelationships among the basic elements within a larger structure that enable them to function together.

Procedural Knowledge – How to do something, methods of inquiry, and criteria for using skills, algorithms, techniques, and methods.

Metacognitive Knowledge – Knowledge of cognition in general, as well as awareness and knowledge of one’s own cognition.

Bloom, B. S. (1956). Taxonomy of Educational Objectives: The Classification of Educational Goals. Handbook 1; Cognitive Domain.

Krathwohl, D. R. (2002). “A Revision of Bloom’s Taxonomy: An Overview.” Theory into Practice

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COMMENTS

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Critical thinking underlies independent and interdependent decision making. Critical thinking includes questioning, analysis, synthesis, interpretation, inference, inductive and deductive reasoning, intuition, application, and creativity 8 (p. 9). Course work or ethical experiences should provide the graduate with the knowledge and skills to:
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Analysis of the data indicated that critical thinking ability was significantly higher in older nurses and nurses with more than 5 years of experience. The findings of this study indicated that critical thinking ability, working years, position/title, and education level were the 4 significant predictors of nursing competence.
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Of course, even when involved in decision-making about their health, patients may not select the most effective treatment option. There is certainly scope for improving the quality of patient decision-making (Fowler et al. 2011). The development of robust critical thinking skills is a good place to begin this improvement.
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Furthermore, the relationship between critical thinking and mental health was mediated by motor impulsivity (acting on the spur of the moment) and non-planning impulsivity (making decisions without careful forethought). These findings provide a preliminary account of how human critical thinking associate with mental health.
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Critical thinking is connected to a broader idea of what 'good thinking'—and, by extension, the 'good professional'—looks like for each educator [ 38] within a given context or community. These observations lead one to speculate about what purpose fluidity in conceptions of critical thinking might serve.
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Definition. Clinical reasoning or professional decision-making in the health professions is a context-dependent, complex, encultured, and professional way of thinking and decision-making to guide high-quality, professionally responsible practice actions.. Contextually, clinical reasoning: Occurs within health professional practice, meaning it is governed by the purpose of enhancing health and ...
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In a society where people are already concerned about the population's lack of critical thinking skills, evidence that such skills can be taught, and that they can be used to help people make better-informed decisions about their health, provides us with plenty of reason to fight for the teaching of critical thinking skills.
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In Chapter 10 ("Clinical Decision Making and Risk Management"), Steven A. Sobelman and Jeffrey N. Younggren offer an important perspective on how understanding risk can enhance clinical management. Formal train-ing in decision making is not yet part of graduate curricula in behavioral and mental health programs.
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Informed decision making in clinical care. It is estimated that human knowledge doubles at a mind-boggling rate of every 12 hours. Before development of the internet, information was accessed through books, journals, and peer exchange. Increasingly, with the advent of the internet, machine learning, and sheer computational power, much of that ...
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Using Critical Thinking Skills in Problem Solving. Think of problem solving as a process with four Ps: Define the problem, generate possibilities, create a plan, and perform your plan. Step 1: Define the problem. To define a problem effectively, understand what a problem is—a mismatch between what you want and what you have.
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Simply put, critical thinking is the act of deliberately analyzing information so that you can make better judgements and decisions. It involves using things like logic, reasoning, and creativity, to draw conclusions and generally understand things better. This may sound like a pretty broad definition, and that's because critical thinking is a ...
PDF Chapter 6. Clinical Reasoning, Decisionmaking, and Action: Thinking
critical reflection—have been subsumed under the rubric of critical thinking. In the nursing education literature, clinical reasoning and judgment are often conflated with critical thinking.
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If the crazes of the past have faded away, we should probably view any new trends that rise up through a critical lens. Amidst this sea of health crazes, it's ultimately up to you to think critically and find the one that's effective, healthy, and right for you. Learn about why health crazes become popular and how you can use critical thinking ...
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For example, citizens, especially those with a limited ability to distinguish between good and bad information, could take crucial health-related decisions based on wrong or incomplete information, consequently putting themselves and others at risk of suboptimal health outcomes . A concrete example in the context of the COVID-19 pandemic is the ...
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There are many resources to help you determine if information sources are factual or not. 7. Socratic Questioning. This way of thinking is called the Socrates Method, named after an old-time thinker from Greece. It's about asking lots of questions to understand a topic.
Knowledge Dimensions and Cognitive Dimensions
The Knowledge Dimension is the "knowing what.". It has four categories: factual, conceptual, procedural, and metacognitive. The Cognitive Process Dimension is the "knowing how.". This revised version like the original has six skills. They are, from simplest to most complex: remember, understand, apply, analyze, evaluate, and create.
6 Main Types of Critical Thinking Skills (With Examples)
Critical thinking skills examples. There are six main skills you can develop to successfully analyze facts and situations and come up with logical conclusions: 1. Analytical thinking. Being able to properly analyze information is the most important aspect of critical thinking. This implies gathering information and interpreting it, but also ...