six critical thinking guidelines

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How to think effectively: Six stages of critical thinking

Credit: Elder / Paul

• Researchers propose six levels of critical thinkers: Unreflective thinkers, Challenged thinkers, Beginning thinkers, Practicing thinkers, Advanced thinkers, and Master thinkers.
• The framework comes from educational psychologists Linda Elder and Richard Paul.
• Teaching critical thinking skills is a crucial challenge in our times.

The coronavirus has not only decimated our populations, its spread has also attacked the very nature of truth and stoked inherent tensions between many different groups of people, both at local and international levels. Spawning widespread conspiracy theories and obfuscation by governments, the virus has also been a vivid demonstration of the need for teaching critical thinking skills necessary to survive in the 21st century. The stage theory of critical thinking development, devised by psychologists Linda Elder and Richard Paul , can help us gauge the sophistication of our current mental approaches and provides a roadmap to the thinking of others.

The researchers identified six predictable levels of critical thinkers, from ones lower in depth and effort to the advanced mind-masters, who are always steps ahead.

As the scientists write , moving up on this pyramid of thinking “is dependent upon a necessary level of commitment on the part of an individual to develop as a critical thinker.” Using your mind more effectively is not automatic and “is unlikely to take place “subconsciously.” In other words – you have to put in the work and keep doing it, or you’ll lose the faculty.

Here’s how the stages of intellectual development break down:

Unreflective thinker

These are people who don’t reflect about thinking and the effect it has on their lives. As such, they form opinions and make decisions based on prejudices and misconceptions while their thinking doesn’t improve.

Unreflective thinkers lack crucial skills that would allow them to parse their thought processes. They also do not apply standards like accuracy, relevance, precision, and logic in a consistent fashion.

How many such people are out there? You probably can guess based on social media comments. As Elder and Paul write , “it is perfectly possible for students to graduate from high school, or even college, and still be largely unreflective thinkers.”

Challenged thinker

This next level up thinker has awareness of the importance of thinking on their existence and knows that deficiencies in thinking can bring about major issues. As the psychologists explain, to solve a problem, you must first admit you have one.

People at this intellectual stage begin to understand that “high quality thinking requires deliberate reflective thinking about thinking”, and can acknowledge that their own mental processes might have many flaws. They might not be able to identify all the flaws, however.

A challenged thinker may have a sense that solid thinking involves navigating assumptions, inferences, and points of view, but only on an initial level. They may also be able to spot some instances of their own self-deception. The true difficulty for thinkers of this category is in not “believing that their thinking is better than it actually is, making it more difficult to recognize the problems inherent in poor thinking,” explain the researchers.

Thinkers at this level can go beyond the nascent intellectual humility and actively look to take control of their thinking across areas of their lives. They know that their own thinking can have blind spots and other problems and take steps to address those, but in a limited capacity.

Beginning thinker

Beginning thinkers place more value in reason, becoming self-aware in their thoughts. They may also be able to start looking at the concepts and biases underlying their ideas. Additionally, such thinkers develop higher internal standards of clarity, accuracy and logic, realizing that their ego plays a key role in their decisions.

Another big aspect that differentiates this stronger thinker – some ability to take criticism of their mental approach, even though they still have work to do and might lack clear enough solutions to the issues they spot.

Practicing thinker

This more experienced kind of thinker not only appreciates their own deficiencies, but has skills to deal with them. A thinker of this level will practice better thinking habits and will analyze their mental processes with regularity.

While they might be able to express their mind’s strengths and weaknesses, as a negative, practicing thinkers might still not have a systematic way of gaining insight into their thoughts and can fall prey to egocentric and self-deceptive reasoning.

How do you get to this stage? An important trait to gain, say the psychologists, is “intellectual perseverance.” This quality can provide “the impetus for developing a realistic plan for systematic practice (with a view to taking greater command of one’s thinking).”

“We must teach in such a way that students come to understand the power in knowing that whenever humans reason, they have no choice but to use certain predictable structures of thought: that thinking is inevitably driven by the questions, that we seek answers to questions for some purpose, that to answer questions, we need information, that to use information we must interpret it (i.e., by making inferences), and that our inferences, in turn, are based on assumptions, and have implications, all of which involves ideas or concepts within some point of view,” explain Elder and Paul.

One doesn’t typically get to this stage until college and beyond, estimate the scientists. This higher-level thinker would have strong habits that would allow them to analyze their thinking with insight about different areas of life. They would be fair-minded and able to spot the prejudicial aspects in the points of view of others and their own understanding.

While they’d have a good handle on the role of their ego in the idea flow, such thinkers might still not be able to grasp all the influences that affect their mentality.

Advanced thinker

The advanced thinker is at ease with self-critique and does so systematically, looking to improve. Among key traits required for this level are “intellectual insight” to develop new thought habits, “ intellectual integrity” to “recognize areas of inconsistency and contradiction in one’s life,” intellectual empathy ” to put oneself in the place of others in order to genuinely understand them, and the “ intellectual courage” to confront ideas and beliefs they don’t necessarily believe in and have negative emotions towards.

Master thinker

This is the super-thinker, the one who is totally in control of how they process information and make decisions. Such people constantly seek to improve their thought skills, and through experience “regularly raise their thinking to the level of conscious realization.”

A master thinker achieves great insights into deep mental levels, strongly committed to being fair and gaining control over their own egocentrism.

Such a high-level thinker also exhibits superior practical knowledge and insight, always re-examining their assumptions for weaknesses, logic, and biases.

And, of course, a master thinker wouldn’t get upset with being intellectually confronted and spends a considerable amount of time analyzing their own responses.

“Why is this so important? Precisely because the human mind, left to its own, pursues that which is immediately easy, that which is comfortable, and that which serves its selfish interests. At the same time, it naturally resists that which is difficult to understand, that which involves complexity, that which requires entering the thinking and predicaments of others,” write the researchers.

So how do you become a master thinker? The psychologists think most students will never get there. But a lifetime of practicing the best intellectual traits can get you to that point when “people of good sense seek out master thinkers, for they recognize and value the ability of master thinkers to think through complex issues with judgment and insight.”

The significance of critical thinking in our daily lives, especially in these confusing times, so rife with quick and often-misleading information, cannot be overstated. The decisions we make today can truly be life and death.

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6 Steps to better critical thinking

Rationale’s interface has been designed to provide a path for critical thinking. From gathering research, to weighing up evidence to formulating a judgement, Rationale will assist you.

Take a look at these 6 critical thinking steps with examples to demonstrate the path to better outcomes.

Step 1: ORGANISE INFORMATION We have no difficulty in locating information. The key is that the information is selected and structured appropriately. With Rationale’s grouping maps you can drag information from the web onto your workspace via the scratchpad and include colour, hyperlinks and images. The structured, pyramid like maps provide a guide for students to structure the information in such a way that reveals the connections between the main topic and its various themes or categories.

Step 2: STRUCTURE REASONING Many people provide opinions but rarely provide supporting reasons for their view. Rationale’s reasoning maps encourage people to support their responses and to consider different opinions. It uses colour conventions to display reasoning – green for reasons, red for objections and orange for rebuttals. It also includes indicator or connecting words so that the relationship between statements is clearly understood.

Step 3: CONSIDER EVIDENCE A test of a solid argument is how good the evidence is that underpins the claims. Rationale’s basis boxes provide a means to identify the basis upon which a statement is given. The icons provide a visual guide as to the range of research utilised and the strength of the evidence that is provided.

Step 4: IDENTIFY ASSUMPTIONS We often talk about analysing arguments. This can mean a few things including looking at the logical structure of the argument to ensure it is valid or well formed and also identifying assumptions or co premises. For those who require higher levels of analysis, Rationale provides the analysis map format to show the relationships between main premises and co premises.

Step 5: EVALUATE ARGUMENTS Once arguments for and against an issue have been logically structured, they need to be evaluated. Rationale provides a visual guide for the evaluation of claims and evidence – the stronger the colour, the stronger the argument while icons designate acceptable or rejected claims. While learning this process of evaluating arguments, the colour and icons provide immediate undertanding and communication of the conclusion.

Step 6: COMMUNICATE CONCLUSION Presenting ideas orally or in writing is crucial and is often the distinguishing feature between good results and average ones. Rationale has essay and letter writing templates to build skills and confidence. Templates provide instruction and generation of prose. When exported, there is a structured essay plan with detailed instructions to assist understanding of clear and systematic prose.

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• Paul-Elder Critical Thinking Framework

Critical thinking is that mode of thinking – about any subject, content, or problem — in which the thinker improves the quality of his or her thinking by skillfully taking charge of the structures inherent in thinking and imposing intellectual standards upon them. (Paul and Elder, 2001). The Paul-Elder framework has three components:

• The elements of thought (reasoning)
• The  intellectual standards that should be applied to the elements of reasoning
• The intellectual traits associated with a cultivated critical thinker that result from the consistent and disciplined application of the intellectual standards to the elements of thought

According to Paul and Elder (1997), there are two essential dimensions of thinking that students need to master in order to learn how to upgrade their thinking. They need to be able to identify the "parts" of their thinking, and they need to be able to assess their use of these parts of thinking.

Elements of Thought (reasoning)

The "parts" or elements of thinking are as follows:

• All reasoning has a purpose
• All reasoning is an attempt to figure something out, to settle some question, to solve some problem
• All reasoning is based on assumptions
• All reasoning is done from some point of view
• All reasoning is based on data, information and evidence
• All reasoning is expressed through, and shaped by, concepts and ideas
• All reasoning contains inferences or interpretations by which we draw conclusions and give meaning to data
• All reasoning leads somewhere or has implications and consequences

Universal Intellectual Standards

The intellectual standards that are to these elements are used to determine the quality of reasoning. Good critical thinking requires having a command of these standards. According to Paul and Elder (1997 ,2006), the ultimate goal is for the standards of reasoning to become infused in all thinking so as to become the guide to better and better reasoning. The intellectual standards include:

Intellectual Traits

Consistent application of the standards of thinking to the elements of thinking result in the development of intellectual traits of:

• Intellectual Humility
• Intellectual Courage
• Intellectual Empathy
• Intellectual Autonomy
• Intellectual Integrity
• Intellectual Perseverance
• Confidence in Reason
• Fair-mindedness

Characteristics of a Well-Cultivated Critical Thinker

Habitual utilization of the intellectual traits produce a well-cultivated critical thinker who is able to:

• Raise vital questions and problems, formulating them clearly and precisely
• Gather and assess relevant information, using abstract ideas to interpret it effectively
• Come to well-reasoned conclusions and solutions, testing them against relevant criteria and standards;
• Think open-mindedly within alternative systems of thought, recognizing and assessing, as need be, their assumptions, implications, and practical consequences; and
• Communicate effectively with others in figuring out solutions to complex problems

Paul, R. and Elder, L. (2010). The Miniature Guide to Critical Thinking Concepts and Tools. Dillon Beach: Foundation for Critical Thinking Press.

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Critical Thinking Is About Asking Better Questions

• John Coleman

Six practices to sharpen your inquiry.

Critical thinking is the ability to analyze and effectively break down an issue in order to make a decision or find a solution. At the heart of critical thinking is the ability to formulate deep, different, and effective questions. For effective questioning, start by holding your hypotheses loosely. Be willing to fundamentally reconsider your initial conclusions — and do so without defensiveness. Second, listen more than you talk through active listening. Third, leave your queries open-ended, and avoid yes-or-no questions. Fourth, consider the counterintuitive to avoid falling into groupthink. Fifth, take the time to stew in a problem, rather than making decisions unnecessarily quickly. Last, ask thoughtful, even difficult, follow-ups.

Are you tackling a new and difficult problem at work? Recently promoted and trying to both understand your new role and bring a fresh perspective? Or are you new to the workforce and seeking ways to meaningfully contribute alongside your more experienced colleagues? If so, critical thinking — the ability to analyze and effectively break down an issue in order to make a decision or find a solution — will be core to your success. And at the heart of critical thinking is the ability to formulate deep, different, and effective questions.

• JC John Coleman is the author of the HBR Guide to Crafting Your Purpose . Subscribe to his free newsletter, On Purpose , or contact him at johnwilliamcoleman.com . johnwcoleman

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Critical thinking and problem-solving, jump to: , what is critical thinking, characteristics of critical thinking, why teach critical thinking.

• Teaching Strategies to Help Promote Critical Thinking Skills

References and Resources

When examining the vast literature on critical thinking, various definitions of critical thinking emerge. Here are some samples:

• "Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action" (Scriven, 1996).
• "Most formal definitions characterize critical thinking as the intentional application of rational, higher order thinking skills, such as analysis, synthesis, problem recognition and problem solving, inference, and evaluation" (Angelo, 1995, p. 6).
• "Critical thinking is thinking that assesses itself" (Center for Critical Thinking, 1996b).
• "Critical thinking is the ability to think about one's thinking in such a way as 1. To recognize its strengths and weaknesses and, as a result, 2. To recast the thinking in improved form" (Center for Critical Thinking, 1996c).

Perhaps the simplest definition is offered by Beyer (1995) : "Critical thinking... means making reasoned judgments" (p. 8). Basically, Beyer sees critical thinking as using criteria to judge the quality of something, from cooking to a conclusion of a research paper. In essence, critical thinking is a disciplined manner of thought that a person uses to assess the validity of something (statements, news stories, arguments, research, etc.).

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Wade (1995) identifies eight characteristics of critical thinking. Critical thinking involves asking questions, defining a problem, examining evidence, analyzing assumptions and biases, avoiding emotional reasoning, avoiding oversimplification, considering other interpretations, and tolerating ambiguity. Dealing with ambiguity is also seen by Strohm & Baukus (1995) as an essential part of critical thinking, "Ambiguity and doubt serve a critical-thinking function and are a necessary and even a productive part of the process" (p. 56).

Another characteristic of critical thinking identified by many sources is metacognition. Metacognition is thinking about one's own thinking. More specifically, "metacognition is being aware of one's thinking as one performs specific tasks and then using this awareness to control what one is doing" (Jones & Ratcliff, 1993, p. 10 ).

In the book, Critical Thinking, Beyer elaborately explains what he sees as essential aspects of critical thinking. These are:

• Dispositions: Critical thinkers are skeptical, open-minded, value fair-mindedness, respect evidence and reasoning, respect clarity and precision, look at different points of view, and will change positions when reason leads them to do so.
• Criteria: To think critically, must apply criteria. Need to have conditions that must be met for something to be judged as believable. Although the argument can be made that each subject area has different criteria, some standards apply to all subjects. "... an assertion must... be based on relevant, accurate facts; based on credible sources; precise; unbiased; free from logical fallacies; logically consistent; and strongly reasoned" (p. 12).
• Argument: Is a statement or proposition with supporting evidence. Critical thinking involves identifying, evaluating, and constructing arguments.
• Reasoning: The ability to infer a conclusion from one or multiple premises. To do so requires examining logical relationships among statements or data.
• Point of View: The way one views the world, which shapes one's construction of meaning. In a search for understanding, critical thinkers view phenomena from many different points of view.
• Procedures for Applying Criteria: Other types of thinking use a general procedure. Critical thinking makes use of many procedures. These procedures include asking questions, making judgments, and identifying assumptions.

Oliver & Utermohlen (1995) see students as too often being passive receptors of information. Through technology, the amount of information available today is massive. This information explosion is likely to continue in the future. Students need a guide to weed through the information and not just passively accept it. Students need to "develop and effectively apply critical thinking skills to their academic studies, to the complex problems that they will face, and to the critical choices they will be forced to make as a result of the information explosion and other rapid technological changes" (Oliver & Utermohlen, p. 1 ).

As mentioned in the section, Characteristics of Critical Thinking , critical thinking involves questioning. It is important to teach students how to ask good questions, to think critically, in order to continue the advancement of the very fields we are teaching. "Every field stays alive only to the extent that fresh questions are generated and taken seriously" (Center for Critical Thinking, 1996a ).

Beyer sees the teaching of critical thinking as important to the very state of our nation. He argues that to live successfully in a democracy, people must be able to think critically in order to make sound decisions about personal and civic affairs. If students learn to think critically, then they can use good thinking as the guide by which they live their lives.

Teaching Strategies to Help Promote Critical Thinking

The 1995, Volume 22, issue 1, of the journal, Teaching of Psychology , is devoted to the teaching critical thinking. Most of the strategies included in this section come from the various articles that compose this issue.

• CATS (Classroom Assessment Techniques): Angelo stresses the use of ongoing classroom assessment as a way to monitor and facilitate students' critical thinking. An example of a CAT is to ask students to write a "Minute Paper" responding to questions such as "What was the most important thing you learned in today's class? What question related to this session remains uppermost in your mind?" The teacher selects some of the papers and prepares responses for the next class meeting.
• Cooperative Learning Strategies: Cooper (1995) argues that putting students in group learning situations is the best way to foster critical thinking. "In properly structured cooperative learning environments, students perform more of the active, critical thinking with continuous support and feedback from other students and the teacher" (p. 8).
• Case Study /Discussion Method: McDade (1995) describes this method as the teacher presenting a case (or story) to the class without a conclusion. Using prepared questions, the teacher then leads students through a discussion, allowing students to construct a conclusion for the case.
• Using Questions: King (1995) identifies ways of using questions in the classroom:
• Reciprocal Peer Questioning: Following lecture, the teacher displays a list of question stems (such as, "What are the strengths and weaknesses of...). Students must write questions about the lecture material. In small groups, the students ask each other the questions. Then, the whole class discusses some of the questions from each small group.
• Reader's Questions: Require students to write questions on assigned reading and turn them in at the beginning of class. Select a few of the questions as the impetus for class discussion.
• Conference Style Learning: The teacher does not "teach" the class in the sense of lecturing. The teacher is a facilitator of a conference. Students must thoroughly read all required material before class. Assigned readings should be in the zone of proximal development. That is, readings should be able to be understood by students, but also challenging. The class consists of the students asking questions of each other and discussing these questions. The teacher does not remain passive, but rather, helps "direct and mold discussions by posing strategic questions and helping students build on each others' ideas" (Underwood & Wald, 1995, p. 18 ).
• Use Writing Assignments: Wade sees the use of writing as fundamental to developing critical thinking skills. "With written assignments, an instructor can encourage the development of dialectic reasoning by requiring students to argue both [or more] sides of an issue" (p. 24).
• Written dialogues: Give students written dialogues to analyze. In small groups, students must identify the different viewpoints of each participant in the dialogue. Must look for biases, presence or exclusion of important evidence, alternative interpretations, misstatement of facts, and errors in reasoning. Each group must decide which view is the most reasonable. After coming to a conclusion, each group acts out their dialogue and explains their analysis of it.
• Spontaneous Group Dialogue: One group of students are assigned roles to play in a discussion (such as leader, information giver, opinion seeker, and disagreer). Four observer groups are formed with the functions of determining what roles are being played by whom, identifying biases and errors in thinking, evaluating reasoning skills, and examining ethical implications of the content.
• Ambiguity: Strohm & Baukus advocate producing much ambiguity in the classroom. Don't give students clear cut material. Give them conflicting information that they must think their way through.
• Angelo, T. A. (1995). Beginning the dialogue: Thoughts on promoting critical thinking: Classroom assessment for critical thinking. Teaching of Psychology, 22(1), 6-7.
• Beyer, B. K. (1995). Critical thinking. Bloomington, IN: Phi Delta Kappa Educational Foundation.
• Center for Critical Thinking (1996a). The role of questions in thinking, teaching, and learning. [On-line]. Available HTTP: http://www.criticalthinking.org/University/univlibrary/library.nclk
• Center for Critical Thinking (1996b). Structures for student self-assessment. [On-line]. Available HTTP: http://www.criticalthinking.org/University/univclass/trc.nclk
• Center for Critical Thinking (1996c). Three definitions of critical thinking [On-line]. Available HTTP: http://www.criticalthinking.org/University/univlibrary/library.nclk
• Cooper, J. L. (1995). Cooperative learning and critical thinking. Teaching of Psychology, 22(1), 7-8.
• Jones, E. A. & Ratcliff, G. (1993). Critical thinking skills for college students. National Center on Postsecondary Teaching, Learning, and Assessment, University Park, PA. (Eric Document Reproduction Services No. ED 358 772)
• King, A. (1995). Designing the instructional process to enhance critical thinking across the curriculum: Inquiring minds really do want to know: Using questioning to teach critical thinking. Teaching of Psychology, 22 (1) , 13-17.
• McDade, S. A. (1995). Case study pedagogy to advance critical thinking. Teaching Psychology, 22(1), 9-10.
• Oliver, H. & Utermohlen, R. (1995). An innovative teaching strategy: Using critical thinking to give students a guide to the future.(Eric Document Reproduction Services No. 389 702)
• Robertson, J. F. & Rane-Szostak, D. (1996). Using dialogues to develop critical thinking skills: A practical approach. Journal of Adolescent & Adult Literacy, 39(7), 552-556.
• Scriven, M. & Paul, R. (1996). Defining critical thinking: A draft statement for the National Council for Excellence in Critical Thinking. [On-line]. Available HTTP: http://www.criticalthinking.org/University/univlibrary/library.nclk
• Strohm, S. M., & Baukus, R. A. (1995). Strategies for fostering critical thinking skills. Journalism and Mass Communication Educator, 50 (1), 55-62.
• Underwood, M. K., & Wald, R. L. (1995). Conference-style learning: A method for fostering critical thinking with heart. Teaching Psychology, 22(1), 17-21.
• Wade, C. (1995). Using writing to develop and assess critical thinking. Teaching of Psychology, 22(1), 24-28.

Other Reading

• Bean, J. C. (1996). Engaging ideas: The professor's guide to integrating writing, critical thinking, & active learning in the classroom. Jossey-Bass.
• Bernstein, D. A. (1995). A negotiation model for teaching critical thinking. Teaching of Psychology, 22(1), 22-24.
• Carlson, E. R. (1995). Evaluating the credibility of sources. A missing link in the teaching of critical thinking. Teaching of Psychology, 22(1), 39-41.
• Facione, P. A., Sanchez, C. A., Facione, N. C., & Gainen, J. (1995). The disposition toward critical thinking. The Journal of General Education, 44(1), 1-25.
• Halpern, D. F., & Nummedal, S. G. (1995). Closing thoughts about helping students improve how they think. Teaching of Psychology, 22(1), 82-83.
• Isbell, D. (1995). Teaching writing and research as inseparable: A faculty-librarian teaching team. Reference Services Review, 23(4), 51-62.
• Jones, J. M. & Safrit, R. D. (1994). Developing critical thinking skills in adult learners through innovative distance learning. Paper presented at the International Conference on the practice of adult education and social development. Jinan, China. (Eric Document Reproduction Services No. ED 373 159)
• Sanchez, M. A. (1995). Using critical-thinking principles as a guide to college-level instruction. Teaching of Psychology, 22(1), 72-74.
• Spicer, K. L. & Hanks, W. E. (1995). Multiple measures of critical thinking skills and predisposition in assessment of critical thinking. Paper presented at the annual meeting of the Speech Communication Association, San Antonio, TX. (Eric Document Reproduction Services No. ED 391 185)
• Terenzini, P. T., Springer, L., Pascarella, E. T., & Nora, A. (1995). Influences affecting the development of students' critical thinking skills. Research in Higher Education, 36(1), 23-39.

On the Internet

• Carr, K. S. (1990). How can we teach critical thinking. Eric Digest. [On-line]. Available HTTP: http://ericps.ed.uiuc.edu/eece/pubs/digests/1990/carr90.html
• The Center for Critical Thinking (1996). Home Page. Available HTTP: http://www.criticalthinking.org/University/
• Ennis, Bob (No date). Critical thinking. [On-line], April 4, 1997. Available HTTP: http://www.cof.orst.edu/cof/teach/for442/ct.htm
• Montclair State University (1995). Curriculum resource center. Critical thinking resources: An annotated bibliography. [On-line]. Available HTTP: http://www.montclair.edu/Pages/CRC/Bibliographies/CriticalThinking.html
• No author, No date. Critical Thinking is ... [On-line], April 4, 1997. Available HTTP: http://library.usask.ca/ustudy/critical/
• Sheridan, Marcia (No date). Internet education topics hotlink page. [On-line], April 4, 1997. Available HTTP: http://sun1.iusb.edu/~msherida/topics/critical.html

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The Ultimate Guide To Critical Thinking

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Table Of Contents

The basic process of critical thinking, improving your critical thinking skills, critical thinking and social media, critical thinking and the mainstream media, critical thinking and improving mental health, critical thinking in everyday life.

Critical thinking is the foundation of rationality and independent thought.

Developing this vital skill allows a person to not only see the world through clearer eyes, but to reach reasonable conclusions and make better decisions in their life .

It is one’s ability to think objectively without the influence of one’s own biases, prejudices, personal feelings, or opinions and come to a conclusion solely on factual, objective information.

A critical thinker is someone who can draw logical connections between actions and reactions, troubleshoot and systematically solve problems, and detect common mistakes in the reasoning of arguments – including their own.

The critical thinker is a person who is more easily able to understand themselves and their motivations for feeling and believing the things that they do.

They are also willing and able to entertain and understand multiple perspectives of an argument before making their own decisions.

Many people mistake critical thinking for the collection of knowledge. A degree does not necessarily mean that the person is a good critical thinker, though many people credit college education with developing their critical thinking skills.

A critical thinker is more agile. They tend to use the knowledge they possess to identify weaknesses in their reasoning and seek out new information that will allow them to make a more informed decision.

They are typically not afraid to ask questions or change their opinions when presented with new information.

Another common misconception is that critical thinking means to be overly skeptical or critical of what other people are saying or doing. Though it can be used to tear through weak arguments or bad reasoning, it can also be used to help persuade and build in a more positive direction.

Critical thinking is a valuable tool for personal or professional success because it helps us make sounder decisions from a rational place rather than acting on how we feel.

There are those – often artists and creative types – who feel deeply that placing rules and restrictions on one’s thinking limits their ability to be creative. That isn’t necessarily so.

In fact, critical thinking pairs well with creative thinking when trying to build a large or long-term project. If it is not well ordered and organized, a project or idea can be broken to pieces from the stress when it finally reaches a real world application.

The guidelines and rules of critical thinking can serve to guide our thoughts. If we know, by virtue of the knowledge that we have, that some facet of a project won’t work out, we can deduce that we need a better solution rather than relying on what we know or seeking a shortcut.

That leads a creator down different roads that they may not have previously considered before.

People perceive and think of the world in different ways. The following steps present the basic process of critical thinking, but should really only be used as a guideline and a place to start developing or improving on those skills.

Analysis and problem solving is best done in a methodical way, so you can develop a habit to build on and hone further.

It can also help you identify any weaker points in your thinking so you can work on developing those further too.

1. Identification and clarification.

Identification and clarification of the problem or subject gives us our place to start. You can’t solve a problem or scrutinize information unless you identify what you are trying to accomplish.

Examples of identification and clarification may include:

– Is this news headline or article biased? The news and media, particularly opinion-editorials, will often be written from a perspective that is not neutral.

– Is this factoid presented in a way that is meant to evoke emotion? Advertisers and influencers may write or speak in such a way as to evoke an emotional reaction to influence the way you think about what you are viewing.

– Is this social media meme honestly representing the subject matter? Almost everything shared around on social media will have some emotional bias to it, often purposefully put there to play on fear or anger.

– Is this problem that I’m looking at the actual problem or is it something else? The problem in front of you isn’t always the actual problem. The low morale in a workplace may not be because the job is bad, but because management is bad. Things aren’t always what they seem on the surface.

2. Investigation and research.

Once you’ve identified what you’re actually looking for, it’s time to research and investigate the components of the thing that you are scrutinizing. How do you go about that?

– Identify the source. Ideally, you want to track the piece of information back to where it came from to see how it originated.

Is it just a problem that developed? Is it a piece of information that’s been carefully crafted by a think-tank or marketing firm with an agenda? Does anyone stand to gain anything by you or other people believing it?

In regard to personal interactions, it’s always worthwhile to double-check on their claims. Trust, but verify.

– Look for third-party information on the claim. Ideally, you want to look for neutral, unbiased third-party information about the claim.

Where can you find that? Articles from the Associated Press, Reuters, and the BBC are a good start. Websites that are from .gov and .edu domains are usually valid.

The blogs of attorneys and doctors can be valuable as well, because reputation is so important in their respective fields so they tend to scrutinize what represents them well.

Legitimate online journals and Google Scholar can be used to find studies for further information.

Any language that includes emotional appeals in the writing or material is not likely to be a good source.

3. Identify bias, either personal or external.

Identifying outside bias is much easier than identifying personal bias.

A person really needs to be in tune with who they are, what they believe, and why they believe it to be able to identify their own bias in their perceptions of a piece of information or a problem.

Again, we come back to emotions. How do you feel about the piece of information or problem? Does it invoke anger? Sadness? Excitement? Hopefulness? Why does it invoke those emotions? And are those emotions causing you to not see the other angles of the situation?

Emotion is a quick, easy way to tell that you may be influenced by your own beliefs rather than objective facts.

Of course, there are some things that we are so raw about that it is impossible to be completely objective, and that’s okay.

Just being aware of the bias and striving to not use it as a basis of your examination, judgment, and decision making will give you a much greater edge in your critical thinking.

4. Inference and conclusion.

Data and information does not always come with a clean, foregone conclusion attached to it. Most of the time, you will need to draw your own conclusions from the information that is available.

The more valid information you can gather before drawing your conclusion, the more likely it is that your conclusion will land in the general area of correct. Particular details may change the overall perspective of a piece of data.

As an example, let’s say a business produces 1,000 widgets in the course of a production run. You can’t infer if that is a lot of widgets or not.

Maybe they need to produce a million for their order, in which case it’s not that many widgets. Maybe they had machinery that broke down where they were only able to produce half of their widget capacity for the production run.

It may be a lot, it may not be. New factual information and details will change your perspective on the business’s widget production.

5. Determining relevance of information.

There is a lot of information out there. The internet is packed with over 1 billion websites where you can find a plethora of information on just about everything.

Too much information can be a serious problem. The internet is also polluted with a lot of biased and misinformation.

Even if your information is factually correct, it doesn’t necessarily mean that it is relevant to whatever data, information, or situation you are trying to analyze. It may turn out that there are only a handful of data points that are important to the situation.

Let’s build a bit more on the widget example. Is 1,000 widgets an efficient production run for the company? The business has 30 employees. But wait, how many employees are actually responsible for producing the widgets?

What about management? Accounting? Marketing? Research and Development? It doesn’t matter if the company has 30 employees if only 5 of them are producing the necessary widgets.

The number of total employees is irrelevant information, though factually correct, while the quantity that are producing the widgets is relevant.

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1. Ask more relevant questions. Far too often we force ourselves into a narrow path of thinking based on the information that is given to us.

However, there are times when that path would be much broader if we only had a greater perspective of the overall situation.

Asking more relevant questions allows you to gather more information, discern what is important and not, and allows you to make more informed decisions.

2. Question your basic assumptions. Do you just know a certain thing to be true? What do you believe in as an adamant truth? Something you believe in wholeheartedly?

Question it. Look into the counterarguments from experts and other people about those assumptions.

Can you adequately justify what you believe past how you feel or what you believe? Can you shore up those adamant beliefs with facts and truth?

3. Identify your personal biases and prejudices. What do you hate? What upsets you? What makes you angry, sad, or afraid?

Identifying these emotional points in yourself can help you when you are confronted with those situations, because sometimes our emotions do not line up with the reality that we are perceiving. This is particularly true with opinion-editorials, social media, and the news.

4. Examine other conclusions. There are a lot of people in the world who have already blazed trails that you may be trying to walk down. You don’t need to blaze the trail again if you have a goal you are pursuing and need to find your way.

By all means, incorporate your own ideas and pick your own path, but do research about how other people accomplished similar goals.

It can provide additional inspiration thanks to an outside perspective that you may not have otherwise considered. Also, be certain to explore how they reached their ultimate conclusion and destination.

5. Understand that no one can think critically all of the time. Even the most stalwart of critical thinkers is going to have momentary lapses of judgment or understanding.

You’re not going to maintain a veneer of perfection in your critical thinking. No one does or can. It’s just impossible.

That’s why it is always a good idea to not only double check your own sources, but those of other people, even if they are someone you admire for their perspective or critical thinking skills.

Mistakes happen. Trust, but verify.

6. Don’t lose yourself in the research and thoughts of others. In doing your research, you do want to make sure that you are thinking for yourself .

If something seems off or doesn’t line up with your own experience, it’s worth making a note of it and exploring it further. You may find that you have knowledge of your own that changes context or perspective that can give you additional clarity.

Don’t get so caught up in the work that you forget about your own knowledge and experience.

7. Practice continued curiosity in more things. Curiosity is a fundamental part of critical thinking. It’s the reason we examine the ‘why’ of a bit of knowledge or experience.

Make curiosity and wonder a regular part of your existence. If something seems interesting to you, do some research on it.

Better yet, even if something doesn’t seem interesting to you, do some additional research on it. That will help you build a broad perspective and body of knowledge to draw from.

8. Never assume you’re right. In assuming that you are right about a particular thing, you miss out on the opportunity to learn something new from someone who might have a different perspective or information you have not considered.

It’s okay to be confident in what you know, but it is worthwhile to listen to additional perspectives for more facts and context that you may not possess.

People who assume they are right rarely take the time to really listen to other people, instead defaulting to what they think they know and closing themselves off.

Social media is a pervasive part of the everyday lives of many people. Nearly 3 billion people around the world are using social media as a means to connect, share information and news, and exchange ideas every day.

The problem with that is that people with similar ideas tend to flock together. The algorithms that social media websites utilize look at your interests, what you are commenting about, what you are liking and sharing, and serve you up more information about the things that you like.

That can be good in finding things that are relevant to your interest, but it can be bad if all you’re doing is shouting into an echo chamber.

You can very quickly find yourself being presented with news and information that is crafted and tailored specifically to people with your interests and perspectives.

On the one hand, it can be a good thing to be around other people with similar interests. On the other, it can reinforce negative and incorrect perceptions about the world, fanning the flames of ignorance, anxiety, fear, and anger.

Social media is a fantastic tool for keeping in touch and seeking out new information, but one must be careful to treat everything they read with skepticism.

People with an agenda may craft emotional appeals or create content that is slanted to evoke an impulsive emotional reaction out of the viewer.

Misinformation spreads like wildfire because it’s often emotional speculation, which resonates with people and causes them to hit those like and share buttons.

A good rule of thumb is to check the veracity and accuracy of any story or claim that evokes an emotional reaction out of you.

Angry? Disgusted? Scared? Research it. Someone with an agenda likely crafted it that way to capitalize on your emotions and use them against you.

The critical examination of these feelings and their sources can bring a lot more peace and calmness to your life.

The internet, blogging, and social media has forced mainstream media into a questionable place.

The internet and social media move at a tremendous pace. Old school mainstream media and news sources did not.

It used to be that there were only one or two new bulletins a day. It gave the news plenty of time to research stories, dig up the truth, eliminate fabrications or misconceptions, and present a fairly unbiased story.

Now, the mainstream media needs to compete with the instant gratification for information that the internet provides. Consumers of news information are going to go where they can access it immediately.

As a result, you have social media or comment sections on news sites blowing up about events that have happened, or that are currently in progress, before anyone has had any time to actually confirm what the truth is.

Many news organizations have also introduced entertainment factors into their shows, particularly with pundits and personality hosts who are able to generate an audience and draw a crowd.

Far too many people are equating the skewed opinions of their favorite hosts or pundits with what is factual, because they rely on emotional appeal to connect and maintain a relationship with their audience.

None of it should be taken at face value because it’s impossible to know just how truthful and honest that source of information is without taking the time to research their claims. Instead, use their information to guide your own research and reading.

A good indicator that you’re being influenced is the use of weasel words and speculative questioning. “Could this be happening…?” “What exactly is going on here…?” “This circumstance may be occurring…” “What don’t they want you to know?”

Good news reporting is direct, factual, and unemotional.

Improving one’s critical thinking can serve as an effective tool to help improve one’s emotional and mental health.

There are many mental health issues that stem from emotions that are either allowed to run uncontrolled or are running out of control on their own.

This is not to suggest that all emotions are controllable or that a person can just think themselves to mental wellness. That’s not how it usually works.

However, there are times when a person can lessen the effects of mental or emotional unwellness with the help of critical thinking.

Consider a person with anxiety. The news and social media are chock full of fearful information, often that is written or presented in such a way to capitalize on the emotion of the consumer.

That person with anxiety may make their own anxiety worse by constantly keeping themselves embroiled in the drama and half-truths that are rife throughout media sources.

There’s always something to be fearful of, because fear and insecurity keeps people tuning in for more information about things that may or may not affect them.

In a similar way, there are many people with depression who find solace in dark humor, sad music, or depression related memes and content.

The more depressing and sad things a person exposes themselves to, the more it is going to drag down their own mood and perceptions of the world, which in turn fuels and makes the depression worse.

It is well-known and accepted that social media can negatively impact mental health in particular situations.

However, it is also a way for people to solidly connect with one another that may otherwise have a hard time finding like-minded people. It’s not all negative, but it’s not all positive either.

Critical thinking is a powerful tool that can help a person greatly in their pursuit of peace, happiness, and a calm life, but it is not a natural skill.

Few people are inherently blessed with critical thinking capabilities, while others need to practice and train their mind to embrace the related concepts.

Adding it to your mental toolbox can help you avoid certain pitfalls of life and not be unnecessarily disturbed by what goes on in the world.

It doesn’t matter what kind of person you are. Critical thinking is good and beneficial for everyone.

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About The Author

Jack Nollan is a mental health writer of 10 years who pairs lived experience with evidence-based information to provide perspectives from the side of the mental health consumer. Jack has lived with Bipolar Disorder and Bipolar-depression for almost 30 years. With hands-on experience as the facilitator of a mental health support group, Jack has a firm grasp of the wide range of struggles people face when their mind is not in the healthiest of places. Jack is an activist who is passionate about helping disadvantaged people find a better path.

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• What Is Critical Thinking? | Definition & Examples

What Is Critical Thinking? | Definition & Examples

Published on May 30, 2022 by Eoghan Ryan . Revised on May 31, 2023.

Critical thinking is the ability to effectively analyze information and form a judgment .

To think critically, you must be aware of your own biases and assumptions when encountering information, and apply consistent standards when evaluating sources .

Critical thinking skills help you to:

• Identify credible sources
• Evaluate and respond to arguments
• Assess alternative viewpoints
• Test hypotheses against relevant criteria

Table of contents

Why is critical thinking important, critical thinking examples, how to think critically, other interesting articles, frequently asked questions about critical thinking.

Critical thinking is important for making judgments about sources of information and forming your own arguments. It emphasizes a rational, objective, and self-aware approach that can help you to identify credible sources and strengthen your conclusions.

Critical thinking is important in all disciplines and throughout all stages of the research process . The types of evidence used in the sciences and in the humanities may differ, but critical thinking skills are relevant to both.

In academic writing , critical thinking can help you to determine whether a source:

• Is free from research bias
• Provides evidence to support its research findings
• Considers alternative viewpoints

Outside of academia, critical thinking goes hand in hand with information literacy to help you form opinions rationally and engage independently and critically with popular media.

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Critical thinking can help you to identify reliable sources of information that you can cite in your research paper . It can also guide your own research methods and inform your own arguments.

Outside of academia, critical thinking can help you to be aware of both your own and others’ biases and assumptions.

Academic examples

However, when you compare the findings of the study with other current research, you determine that the results seem improbable. You analyze the paper again, consulting the sources it cites.

You notice that the research was funded by the pharmaceutical company that created the treatment. Because of this, you view its results skeptically and determine that more independent research is necessary to confirm or refute them. Example: Poor critical thinking in an academic context You’re researching a paper on the impact wireless technology has had on developing countries that previously did not have large-scale communications infrastructure. You read an article that seems to confirm your hypothesis: the impact is mainly positive. Rather than evaluating the research methodology, you accept the findings uncritically.

Nonacademic examples

However, you decide to compare this review article with consumer reviews on a different site. You find that these reviews are not as positive. Some customers have had problems installing the alarm, and some have noted that it activates for no apparent reason.

You revisit the original review article. You notice that the words “sponsored content” appear in small print under the article title. Based on this, you conclude that the review is advertising and is therefore not an unbiased source. Example: Poor critical thinking in a nonacademic context You support a candidate in an upcoming election. You visit an online news site affiliated with their political party and read an article that criticizes their opponent. The article claims that the opponent is inexperienced in politics. You accept this without evidence, because it fits your preconceptions about the opponent.

There is no single way to think critically. How you engage with information will depend on the type of source you’re using and the information you need.

However, you can engage with sources in a systematic and critical way by asking certain questions when you encounter information. Like the CRAAP test , these questions focus on the currency , relevance , authority , accuracy , and purpose of a source of information.

When encountering information, ask:

• Who is the author? Are they an expert in their field?
• What do they say? Is their argument clear? Can you summarize it?
• When did they say this? Is the source current?
• Where is the information published? Is it an academic article? Is it peer-reviewed ?
• Why did the author publish it? What is their motivation?
• How do they make their argument? Is it backed up by evidence? Does it rely on opinion, speculation, or appeals to emotion ? Do they address alternative arguments?

Critical thinking also involves being aware of your own biases, not only those of others. When you make an argument or draw your own conclusions, you can ask similar questions about your own writing:

• Am I only considering evidence that supports my preconceptions?
• Is my argument expressed clearly and backed up with credible sources?
• Would I be convinced by this argument coming from someone else?

If you want to know more about ChatGPT, AI tools , citation , and plagiarism , make sure to check out some of our other articles with explanations and examples.

• ChatGPT vs human editor
• ChatGPT citations
• Is ChatGPT trustworthy?
• Using ChatGPT for your studies
• What is ChatGPT?
• Chicago style
• Paraphrasing

 Plagiarism

• Types of plagiarism
• Self-plagiarism
• Avoiding plagiarism
• Academic integrity
• Consequences of plagiarism
• Common knowledge

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Critical thinking refers to the ability to evaluate information and to be aware of biases or assumptions, including your own.

Like information literacy , it involves evaluating arguments, identifying and solving problems in an objective and systematic way, and clearly communicating your ideas.

Critical thinking skills include the ability to:

You can assess information and arguments critically by asking certain questions about the source. You can use the CRAAP test , focusing on the currency , relevance , authority , accuracy , and purpose of a source of information.

Ask questions such as:

• Who is the author? Are they an expert?
• How do they make their argument? Is it backed up by evidence?

A credible source should pass the CRAAP test  and follow these guidelines:

• The information should be up to date and current.
• The author and publication should be a trusted authority on the subject you are researching.
• The sources the author cited should be easy to find, clear, and unbiased.
• For a web source, the URL and layout should signify that it is trustworthy.

Information literacy refers to a broad range of skills, including the ability to find, evaluate, and use sources of information effectively.

Being information literate means that you:

• Know how to find credible sources
• Use relevant sources to inform your research
• Understand what constitutes plagiarism
• Know how to cite your sources correctly

Confirmation bias is the tendency to search, interpret, and recall information in a way that aligns with our pre-existing values, opinions, or beliefs. It refers to the ability to recollect information best when it amplifies what we already believe. Relatedly, we tend to forget information that contradicts our opinions.

Although selective recall is a component of confirmation bias, it should not be confused with recall bias.

On the other hand, recall bias refers to the differences in the ability between study participants to recall past events when self-reporting is used. This difference in accuracy or completeness of recollection is not related to beliefs or opinions. Rather, recall bias relates to other factors, such as the length of the recall period, age, and the characteristics of the disease under investigation.

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Critical thinking is the one skillset you can't afford not to master

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What is critical thinking?

5 characteristics of critical thinking, what are critical thinking skills, and why are they important, 6 key critical thinking skills, critical thinking example in real-life, 13 ways to start thinking critically.

Whether you’re aiming to improve your performance at work or simply trying to live a more fulfilling life , you’ll need a variety of hard and soft skills to move the needle. Some skills come naturally to some people, while others need to develop them actively.

One of these skills is critical thinking. But critical thinking itself is made up of several types of skills that contribute to solving problems more effectively.

Let’s explore the different types of critical thinking skills and how you can start improving them to level up your career.

Critical thinking is the ability to analyze facts objectively and form a judgment. It is a form of emotional intelligence .

Someone with critical thinking skills can think clearly and rationally when the situation demands it. It allows them to perform problem-solving and decision-making more effectively. 

As a result, you can look further than what you see at face value. You’re able to analyze what you see from a situation and gain some insight that goes further than what’s obvious to anyone from the outside.

Critical thinking also requires being able to understand the logical connection between two or more ideas or concepts. For example, a team working on a company’s pricing strategy needs to think critically about several concepts. 

Both the marketing and sales teams must work together. They need to analyze how to maximize sales. But they need to do so while also meeting profit goals. It’s important to understand the logical connection between sales strategy and marketing logistics. It’s the only way to get a good outcome.

Critical thinking is different from creative thinking . Creative thinking is the ability to generate brand new, innovative ideas. On the other hand, critical thinking requires you to carefully and logically analyze what information is given to you. Both are important to maximize results in any given situation.

What defines critical thinking? How does it affect the decision-making process? Here are five characteristics that make up the ability to think critically.

1. Dispositions

Critical thinkers have specific traits that allow them to think the way they do. Some people are predisposed to these traits, while others need to develop them actively.

Some of these dispositions include:

• Open-mindedness
• Respecting evidence and reasoning
• Being able to consider different perspectives and points of view: in other words, having cognitive flexibility
• Not being stuck in one position
• Clarity and precision

2. Argument

Good critical thinkers need to make solid arguments. 

An argument is making a statement aided by supporting evidence. It’s important to use well thought-out arguments when you’re in a constructive conflict . When analyzing a situation critically, you’ll need to make several arguments in your own mind to come to a judgment. 

3. Reasoning

In addition to arguments, critical thinking also requires inferring conclusions. From the facts and arguments presented to you, you need to use reasoning skills to come to a logical conclusion. 

This conclusion will determine the best course of action to take.

4. Criteria

Critical thinking is sometimes a matter of discerning truth from fiction. Not all facts presented to you may have the same level of truth. Certain conditions need to be met for something to be considered believable, and a critical thinker needs to be able to understand that.

5. Metacognition

Metacognition is the ability to think about your own thinking. Critical thinkers should be able to analyze their thoughts so that they can judge whether or not they’ve thought everything through. This helps them come up with better hypotheses.

The critical thinking skills definition is: soft skills that help you in the critical thinking process. Developing these skills can improve your ability to think critically.

Critical thinking skills are considered one of many durable skills in the workplace . Many of these are soft skills that are also useful in other situations.

According to research by America Succeeds, critical thinking is in the top five most requested durable skills in job postings. Those top five durable skills get requested 2.6x more often than the top five hard skills. This goes to show that soft skills like critical thinking skills are in demand in the workplace.

Critical thinking skills are important for several reasons. These include helping you work independently and solve problems . Not all positions require ongoing critical thinking. But, those skills definitely matter to anyone who wants to uplevel their career. And even the most easygoing positions require at least some level of critical thinking skills.

For example, working as an accountant can be straightforward in most cases. But it may require critical thinking skills. For instance, what if certain expenses aren’t easily distributed in simple categories? Without critical thinking skills, an accountant will struggle to work independently and solve problems on their own.

Critical thinking abilities also matter in everyday life. Having a foundation for critical thinking can help you analyze several possible solutions for problems that pop up in the home. It can also help you:

• Analyze different viewpoints
• Come up with the best solution for complex problems
• Become a better learner

The key critical thinking skills are identifying biases, inference, research, identification, curiosity, and judging relevance.

Let’s explore these six critical thinking skills you should learn and why they’re so important to the critical thinking process.

1. Identifying biases

This critical thinking skill is necessary for metacognition, which is the fifth characteristic of critical thinking. It involves knowing when others have a cognitive bias and when you have one yourself.

Biases can influence how someone understands the facts presented to them. But when you’re aware of those biases, you can question yourself on those biases and consider other points of view.

Identifying biases is especially important for people who make hiring decisions. That’s because biases against groups of minorities can lead to inequalities in the workplace when not identified. 

For example, imagine a hiring manager comparing two resumes. Their gut feeling could guide them to discount one of the resumes due to a bias against the opposite gender. But let’s say this hiring manager realizes they have this bias. They can then question themselves on whether or not this bias is influencing their judgment. 

2. Inference

Inference is the ability to draw conclusions based on the information you have. Without inference, it can be difficult to take action once you’ve analyzed the facts presented to you. Processing information is key to coming up with a reasoned judgment.

For example, let’s go back to the accountant struggling to assign the correct category to a business expense. They can analyze other similar situations and infer the most logical category based on that information.

3. Research

Before you analyze facts and infer a conclusion, you need to find out what those facts are. Researching skills allow you to discover facts and figures to make an argument.

Not all situations will have the required information available to you. Researching skills are necessary to dig into a situation and gather the information you need to think critically.

Some situations don’t require further research. For example, a first responder who arrives on the scene of an automobile accident won’t perform further research. They’ll have to analyze what they see in front of them and decide which injuries are the most urgent to care for. 

On the other hand, someone performing a market analysis will need to research competitors and gather information before coming up with an opinion. 

4. Identification

Identification is different from inference and research. It involves being able to identify a problem but also what’s influencing that problem.

In short, identification is necessary for someone to realize that they need to think critically about something. Without proper identification skills, it will be difficult for someone to know when it’s time to analyze a situation. 

For example, let’s say you’re entering numbers in a spreadsheet. The numbers aren’t coming out as they usually do. Without identification skills, you could easily keep going without realizing there’s an issue. But when you identify what’s going on, you can see that something is broken in the spreadsheet’s formula.

Only once you identify the fact that the formula is broken can you start analyzing what’s going on to solve the issue.

5. Curiosity

Don’t be afraid to question everything and explore what you’re curious about. That’s because intellectual curiosity is a valuable skill, especially when it comes to critical thinking.

One way to practice curiosity is to adopt a beginner’s mindset . When you come into every situation with the mindset of a beginner, you’re able to keep an open mind. You’ll be able to perceive things you may not have noticed when keeping your mind closed.

6. Judging relevance

Not all information is equally pertinent. In order to make a critical judgment, it’s important to be able to judge the relevance of the information you have.

Take, for instance, basic online researching skills. You have access to a plethora of information on virtually every topic imaginable. But performing online research requires you to constantly judge the relevance of what you see. 

Without judging relevance, you’d spend too much time on details that don’t matter as much for the final desired outcome. But when you’re able to discern what’s most pertinent, you can give that information more weight as you’re thinking critically.

So what would critical thinking skills look like in a real-life situation?

Let’s imagine you’re working in software quality assurance (QA) as a team lead. But every time your team needs to enter bug regression, everyone gets bottlenecked because you must manually populate the spreadsheet used for the regression. While you do this task, your team cannot be productive without you.

This process happens once a week and easily wastes half an hour for each team member.

First, you must identify what’s going on. The team gets bottlenecked because only you, as the team lead, can access the information required to fill in the regression spreadsheet.

Next, you can research information. You can inquire to higher-ups about the reason why only you have access to this information. You can also speak to other teams about what potential solutions they’ve come up with to solve this problem.

Once you’ve done your research, it’s time to analyze the information and judge relevance. Some teams have solutions that don’t apply to you, so that information isn’t relevant anymore. 

Figure out if there are any personal biases before you analyze your information. 

For example, it’s possible that you don’t get along with one of the other team leads. As a result, you could discount the information they’ve given you. But by identifying this bias, you can look past your personal opinion of this person and see how valuable their solution is.

Based on what you’ve analyzed, it’s time to brainstorm and come up with a solution. You realize that creating a simple, automated script will save your team’s time. And it will do so without consuming too many resources from the engineering department.

Next, present your solution to your manager. Explain how you came to this conclusion. 

Now, let’s say your spreadsheet automation solution is approved. It’s important to go back and analyze what happens after implementing the solution. But only do this once the spreadsheet has been in place for long enough to gather plenty of information. 

Here’s an example. You could realize that the solution did solve the bottleneck. But, the script also slows down the spreadsheet and makes it difficult to work with. This would require you to go back to the drawing board and start the process all over again.

Want to start improving your own critical thinking skill sets? Here’s how you can improve critical thinking skills using 13 techniques:

• Play games that require critical thinking skills
• Ask more questions, even basic ones
• Question your assumptions
• Develop your technical skills so that you can identify problems more easily
• Find ways to solve more problems (at work and at home)
• Become aware of your mental processes, like the availability heuristic
• Think for yourself: don’t adopt other people’s opinions without questioning them first
• Seek out diversity of thought
• Start developing foresight
• Try active listening
• Weigh the consequences of different actions before you act
• Seek a mentor who can help you develop these skills
• Get professional coaching

How to improve your critical thinking skills 

Critical thinking skills aren’t always easy to develop. But it’s much easier to start thinking critically when you have someone to work with. Try a custom BetterUp demo to see how a coach can help you develop your critical thinking skills today.

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Maggie Wooll, MBA

Maggie Wooll is a researcher, author, and speaker focused on the evolving future of work. Formerly the lead researcher at the Deloitte Center for the Edge, she holds a Bachelor of Science in Education from Princeton University and an MBA from the University of Virginia Darden School of Business. Maggie is passionate about creating better work and greater opportunities for all.

How to develop critical thinking skills

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3 Core Critical Thinking Skills Every Thinker Should Have

Critically thinking about critical thinking skills..

Posted March 13, 2020 | Reviewed by Ekua Hagan

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I recently received an email from an educator friend, asking me to briefly describe the skills necessary for critical thinking. They were happy to fill in the blanks themselves from outside reading but wanted to know what specific skills they should focus on teaching their students. I took this as a good opportunity to dedicate a post here to such discussion, in order to provide my friend and any other interested parties with an overview.

To understand critical thinking skills and how they factor into critical thinking, one first needs a definition of the latter. Critical thinking (CT) is a metacognitive process, consisting of a number of skills and dispositions, that when used through self-regulatory reflective judgment, increases the chances of producing a logical conclusion to an argument or solution to a problem (Dwyer, 2017; Dwyer, Hogan & Stewart, 2014). On the surface, this definition clarifies two issues. First, critical thinking is metacognitive—simply, it requires the individual to think about thinking; second, its main components are reflective judgment, dispositions, and skills.

Below the surface, this description requires clarification; hence the impetus for this entry—what is meant by reflective judgment, disposition towards CT, and CT skills? Reflective judgment (i.e. an individuals' understanding of the nature, limits, and certainty of knowing and how this can affect their judgments [King & Kitchener, 1994]) and disposition towards CT (i.e. an inclination, tendency or willingness to perform a given thinking skill [Dwyer, 2017; Facione, Facione & Giancarlo, 1997; Ku, 2009; Norris, 1992; Siegel, 1999; Valenzuela, Nieto & Saiz, 2011]) have both already been covered in my posts; so, consistent with the aim of this piece, let’s discuss CT skills.

CT skills allow individuals to transcend lower-order, memorization-based learning strategies to gain a more complex understanding of the information or problems they encounter (Halpern, 2014). Though debate is ongoing over the definition of CT, one list stands out as a reasonable consensus conceptualization of CT skills. In 1988, a committee of 46 experts in the field of CT gathered to discuss CT conceptualisations, resulting in the Delphi Report; within which was overwhelmingly agreement (i.e. 95% consensus) that analysis , evaluation and inference were the core skills necessary for CT (Facione, 1990). Indeed, over 30 years later, these three CT skills remain the most commonly cited.

1. Analysis

Analysis is a core CT skill used to identify and examine the structure of an argument, the propositions within an argument and the role they play (e.g. the main conclusion, the premises and reasons provided to support the conclusion, objections to the conclusion and inferential relationships among propositions), as well as the sources of the propositions (e.g. personal experience, common belief, and research).

When it comes to analysing the basis for a standpoint, the structure of the argument can be extracted for subsequent evaluation (e.g. from dialogue and text). This can be accomplished through looking for propositions that either support or refute the central claim or other reasons and objections. Through analysis, the argument’s hierarchical structure begins to appear. Notably, argument mapping can aid the visual representation of this hierarchical structure and is supported by research as having positive effects on critical thinking (Butchart et al., 2009; Dwyer, 2011; Dwyer, Hogan & Stewart, 2012; van Gelder, Bisset & Cumming, 2004).

2. Evaluation

Evaluation is a core CT skill that is used in the assessment of propositions and claims (identified through the previous analysis ) with respect to their credibility; relevance; balance, bias (and potential omissions); as well as the logical strength amongst propositions (i.e. the strength of the inferential relationships). Such assessment allows for informed judgment regarding the overall strength or weakness of an argument (Dwyer, 2017; Facione, 1990). If an argument (or its propositions) is not credible, relevant, logical, and unbiased, you should consider excluding it or discussing its weaknesses as an objection.

Evaluating the credibility of claims and arguments involves progressing beyond merely identifying the source of propositions in an argument, to actually examining the "trustworthiness" of those identified sources (e.g. personal experiences, common beliefs/opinions, expert/authority opinion and scientific evidence). This is particularly important because some sources are more credible than others. Evaluation also implies deep consideration of the relevance of claims within an argument, which is accomplished by assessing the contextual relevance of claims and premises—that is, the pertinence or applicability of one proposition to another.

With respect to balance, bias (and potential omissions), it's important to consider the "slant" of an argument—if it seems imbalanced in favour of one line of thinking, then it’s quite possible that the argument has omitted key, opposing points that should also be considered. Imbalance may also imply some level of bias in the argument—another factor that should also be assessed.

However, just because an argument is balanced does not mean that it isn’t biased. It may very well be the case that the "opposing views" presented have been "cherry-picked" because they are easily disputed (akin to building a strawman ); thus, making supporting reasons appear stronger than they may actually be—and this is just one example of how a balanced argument may, in fact, be biased. The take-home message regarding balance, bias, and potential omissions should be that, in any argument, you should construct an understanding of the author or speaker’s motivations and consider how these might influence the structure and contents of the argument.

Finally, evaluating the logical strength of an argument is accomplished through monitoring both the logical relationships amongst propositions and the claims they infer. Assessment of logical strength can actually be aided through subsequent inference, as a means of double-checking the logical strength. For example, this can be checked by asking whether or not a particular proposition can actually be inferred based on the propositions that precede it. A useful means of developing this sub-skill is through practicing syllogistic reasoning .

3. Inference

Similar to other educational concepts like synthesis (e.g., see Bloom et al., 1956; Dwyer, 2011; 2017), the final core CT skill, inference , involves the “gathering” of credible, relevant and logical evidence based on the previous analysis and evaluation, for the purpose of drawing a reasonable conclusion (Dwyer, 2017; Facione, 1990). Drawing a conclusion always implies some act of synthesis (i.e. the ability to put parts of information together to form a new whole; see Dwyer, 2011). However, inference is a unique form of synthesis in that it involves the formulation of a set of conclusions derived from a series of arguments or a body of evidence. This inference may imply accepting a conclusion pointed to by an author in light of the evidence they present, or "conjecturing an alternative," equally logical, conclusion or argument based on the available evidence (Facione, 1990). The ability to infer a conclusion in this manner can be completed through formal logic strategies, informal logic strategies (or both) in order to derive intermediate conclusions, as well as central claims.

Another important aspect of inference involves the querying of available evidence, for example, by recognising the need for additional information, gathering it and judging the plausibility of utilising such information for the purpose of drawing a conclusion. Notably, in the context of querying evidence and conjecturing alternative conclusions, inference overlaps with evaluation to a certain degree in that both skills are used to judge the relevance and acceptability of a claim or argument. Furthermore, after inferring a conclusion, the resulting argument should be re-evaluated to ensure that it is reasonable to draw the conclusion that was derived.

Overall, the application of critical thinking skills is a process—one must analyse, evaluate and then infer; and this process can be repeated to ensure that a reasonable conclusion has been drawn. In an effort to simplify the description of this process, for the past few years, I’ve used the analogy of picking apples for baking . We begin by picking apples from a tree. Consider the tree as an analogy, in its own right, for an argument, which is often hierarchically structured like a tree-diagram. By picking apples, I mean identifying propositions and the role they play (i.e. analysis). Once we pick an apple, we evaluate it—we make sure it isn’t rotten (i.e. lacks credibility, is biased) and is suitable for baking (i.e. relevant and logically strong). Finally, we infer— we gather the apples in a basket and bring them home and group them together based on some rationale for construction— maybe four for a pie, three for a crumble and another four for a tart. By the end of the process, we have baked some apple-based goods, or developed a conclusion, solution or decision through critical thinking.

Of course, there is more to critical thinking than the application of skills—a critical thinker must also have the disposition to think critically and engage reflective judgment. However, without the appropriate skills—analysis, evaluation, and inference, it is not likely that CT will be applied. For example, though one might be willing to use CT skills and engage reflective judgment, they may not know how to do so. Conversely, though one might be aware of which CT skills to use in a given context and may have the capacity to perform well when using these skills, they may not be disposed to use them (Valenzuela, Nieto & Saiz, 2011). Though the core CT skills of analysis, evaluation, and inference are not the only important aspects of CT, they are essential for its application.

Bloom, B.S. (1956). Taxonomy of educational objectives: The classification of educational goals. Handbook 1: Cognitive domain. New York: McKay.

Butchart, S., Bigelow, J., Oppy, G., Korb, K., & Gold, I. (2009). Improving critical thinking using web-based argument mapping exercises with automated feedback. Australasian Journal of Educational Technology, 25, 2, 268-291.

Dwyer, C.P. (2011). The evaluation of argument mapping as a learning tool. Doctoral Thesis. National University of Ireland, Galway.

Dwyer, C.P. (2017). Critical thinking: Conceptual perspectives and practical guidelines.Cambridge, UK: Cambridge University Press.

Dwyer, C.P., Hogan, M.J., & Stewart, I. (2012). An evaluation of argument mapping as a method of enhancing critical thinking performance in e-learning environments. Metacognition and Learning, 7, 219-244.

Dwyer, C. P., Hogan, M. J., & Stewart, I. (2014). An integrated critical thinking framework for the 21st century. Thinking Skills & Creativity, 12, 43–52.

Facione, P.A. (1990). The Delphi report: Committee on pre-college philosophy. Millbrae, CA: California Academic Press.

Facione, P.A., Facione, N.C., & Giancarlo, C.A. (1997). Setting expectations for student learning: New directions for higher education. Millbrae: California Academic Press.

Halpern, D.F. (2014). Thought & knowledge: An introduction to critical thinking (5th Ed.). UK: Psychology Press.

King, P. M., & Kitchener, K. S. (1994). Developing reflective judgment: Understanding and promoting intellectual growth and critical thinking in adolescents and adults. San Francisco: Jossey Bass.

Ku, K.Y.L. (2009). Assessing students’ critical thinking performance: Urging for measurements using multi-response format. Thinking Skills and Creativity, 4, 1, 70- 76.

Norris, S. P. (Ed.). (1992). The generalizability of critical thinking: Multiple perspectives on an educational ideal. New York: Teachers College Press.

Siegel, H. (1999). What (good) are thinking dispositions? Educational Theory, 49, 2, 207-221.

Valenzuela, J., Nieto, A.M., & Saiz, C. (2011). Critical thinking motivational scale: A contribution to the study of relationship between critical thinking and motivation. Journal of Research in Educational Psychology, 9, 2, 823-848.

van Gelder, T.J., Bissett, M., & Cumming, G. (2004). Enhancing expertise in informal reasoning. Canadian Journal of Experimental Psychology 58, 142-52.

Christopher Dwyer, Ph.D., is a lecturer at the Technological University of the Shannon in Athlone, Ireland.

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Critical Thinking Skills Toolbox

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• Introduction

Overview of Critical Thinking Skills

• Teaching Observations
• Avenues for Research
• CTS Tools for Faculty and Student Assessment
• Critical Thinking and Assessment
• Conclusions
• Bibliography
• Helpful Links
• Appendix A. Author's Impressions of Vignettes

What is Critical Thinking?

Many researchers, including Facione, Simpson and Courtneay, Banning, Brookfield, Ornstein and Hunkins, Sternberg, Ennis, and Lipman, have defined critical thinking (CT). Researchers debate whether critical thinking can be learned or if it's a developmental process regulated by motivations, dispositions, and personality traits. Despite differences of opinion, many researchers agree that critical thinking is "Purposeful, self-regulatory judgment which results in interpretation, analysis, evaluation, and inference, as well as explanation of the evidential, conceptual, methodological, criteriological or contextual considerations upon which judgment is based. 11

Critical thinking is also regarded as intellectually engaged, skillful, and responsible thinking that facilitates good judgment because it requires the application of assumptions, knowledge, competence, and the ability to challenge one's own thinking. Critical thinking requires the use of self-correction and monitoring to judge the rationality of thinking as well as reflexivity. When using critical thinking, individuals step back and reflect on the quality of that thinking. Simpson and Courtneay point out that critical thinking processes require active argumentation, initiative, reasoning, envisioning and analyzing complex alternatives, and making contingency-related value judgment. 12

According to Banning, critical thinking involves scrutinizing, differentiating, and appraising information as well as reflecting on information to make judgments that will inform clinical decisions. 13  Brookfield asserts that identifying and challenging assumptions and analyzing assumptions for validity are essential to critical thinking skills. He also suggested that because critical thinkers possess curiosity and skepticism, they are more likely to be motivated to provide solutions that resolve contradictions. 14

Others such as Ornstein and Hunkins suggest that critical thinking and thinking skills refer to problem-solving and other related behaviors. 15  For a number of years, dental educators thought teaching problem-solving skills was akin to teaching critical thinking skills. While teaching problem-solving skills is important to the process of learning how to use critical thinking skills, in the absence of other learning activities it may not be enough.

Sternberg, Ennis, and Lipman assert that critical thinking skills are not a fixed entity but a form of intelligence that can be taught. 16-19  The ability to develop critical thinking skills may be likened to Piaget's concrete and formal operations. If students have not yet reached the formal operations stage, their ability to use critical thinking skills may be limited by an inability to handle abstract ideas. It is important to remember that Piaget's stages of cognitive development are also linked to intellectual potential and environmental experiences. If the learning environment is crucial to the development of critical thinking skills, what instructional strategies can be used to promote critical thinking?

Sternberg asserts that critical thinking involves complex mental operations that cannot be broken into discrete styles of thinking. He claims that CT involves students' total intellectual functioning, not a narrowly defined set of skills. He postulates that there are three mental processes fostering critical thinking: meta-components, performance components, and knowledge-acquisition strategies. 20  Meta-components refer to higher-order mental processes that individuals use to plan, monitor, and evaluate what they do. Performance components refer to the actual steps taken or strategies used, while knowledge-acquisition strategies refer to the ways in which individuals relate old to new material and apply new material. Sternberg does not specify a "how" approach to teaching and learning critical thinking skills. Instead, he provides general guidelines for developing or selecting a program or curriculum that will foster CTS. Interestingly, although not surprisingly, Sternberg states that students are not adequately prepared for the problems and critical thinking tasks they will face in everyday life because they are not taught these skills in their formative years. 21  Tasks that stress right answers or truth telling or use objectively scored tests are generally removed from real-world relevance. Thus, it is particularly important that all aspects of dental educational curriculum stress real-world practice, the importance of oral health care, and the relationship of overall oral health care to systemic health by teaching students how to use critical thinking skills.

Lipman, like Sternberg, does not specify a "how to" approach. However, he makes clear distinctions between ordinary thinking and critical thinking. He explains that ordinary thinking is simplistic thinking because it does not rely upon the use of standards or criteria. Examples of ordinary thinking are guessing, believing, and supposing. Lipman describes critical thinking as a complex process based on standards of objectivity, utility, or consistency in which students can reflect upon the certainty of their thinking because critical thinking is self-correcting. 22  In order words, students can defend their thinking with evidence. Ennis asserts that to help students develop critical thinking skills, teachers must understand the cognitive processes that constitute critical thinking and use instructional activities that will develop these processes. He recommends instructors teach students how to define and clarify information, ask appropriate questions to clarify or challenge statements or beliefs, judge the credibility of sources, and solve problems by predicting probable outcomes through logic or deduction. Ennis also suggests that critical thinkers demonstrate particular attributes. Critical thinkers tend to:

Critical thinkers use these skills appropriately and usually without prompting. They are generally predisposed to think critically and to evaluate the outcome of their thought processes. 24

Instructional Strategies and Critical Thinking

Researchers have asserted that how educators teach has a direct influence on what is learned. 25  Thus, the instructional strategies selected must be appropriate to the desired outcomes. For example, strategies of inquiry are contingent upon the problem being investigated and the targeted concepts, so it is essential that they be integrated with the associated processes of inquiry in order for students to see how new knowledge evolves. 26  Researchers have also recommended eliminating superfluous activities and repetitious content and expanding learner-centered active forms of experiences to promote critical thinking skills. 27  If the goal is for students to use critical thinking skills, then the following opportunities should constitute the majority of learning activities:

     a) Engaging in problem-based learning      b) Analyzing case-based scenarios      c) Engaging in debates, role-play, argument mapping, thinking aloud, and simulation among others 28  

The benefit of engaging students in learning experiences that utilize critical thinking skills is the public nature of their thinking. When students engage in CTS, they have an opportunity to examine tacitly held knowledge of one another, make knowledge and think explicitly, respond to questions and comments, and clarify their thinking processes. 29

Several researchers stated the types of instructional strategies that may be used to promote students' critical thinking skills. Weerts suggested that working in groups might reduce students' stress while trying to answer difficult questions. She points out that working together may result in better answers than working alone. 30  Many dental educators might eschew the notion of using groups. However, it is important to acknowledge that even in classes of 80 to 100 dental students, groups of six to eight students could be developed to facilitate learning and inquiry. These groups could be responsible for answering questions about readings by being called upon randomly during class time. For example, instructors can consider writing three to four focus questions that accompany the readings to guide student comprehension. Instructors could also tell students that they should to be able to answer those questions in class. In this way, students can be held responsible for learning some of this discrete information before class. Rather than having the instructor feel responsible for "telling" students what they should know, the instructor can elicit the key concepts from students. Class time can then be used to present a case where the concept is illustrated, and students can work in groups to analyze how that concept is operationalized rather than receiving discrete knowledge through a lecture. Weerts also suggests that student groups can work together and develop critical thinking skills by:

     Identifying issues      Gathering authoritative sources      Identifying potential treatments      Presenting competing points of view      Weighing modalities in light of the presenting case and then agreeing upon the treatment plan 31  

To ensure that students are developing appropriate skills, the instructor and students can use a Likert scale to rate each other on the following criteria:

     Accuracy and relevancy of supporting evidence      Credibility of authoritative knowledge      Depth and breadth of thought      Clarity and soundness of responses

Hendricson et al. suggest several active learning strategies that can be used to develop students' critical thinking skills.

Van Gelder concurs with Hendricson et al. that critical thinking must be deliberately practiced with the intent to improve performance; however, he states that CT is hard and human beings are not naturally critical. 33  Shermer agrees and describes human beings as "pattern-seeking, story-telling animals ... [who] like things to make sense, and the kinds of sense we grasp most easily are simple familiar patterns or narratives" (p. 42). 34  This penchant for the familiar affects how curriculum is designed and implemented.

As a type of thinking that eschews the uncritical acceptance of information, critical thinking should be a deliberate part of the curriculum. Moreover, exposing students to good examples is insufficient to developing critical thinking skills. Students must demonstrate the ability to transfer critical thinking skills from one situation to another. As Kuhn writes:

"The best approach . . . may be to work from both ends at once-from a bottom-up anchoring in the regular practice [of what is being taught] so that skills are exercised, strengthened and consolidated as well as from a top-down fostering of understanding and intellectual values that play a major role in whether these skills will be used." (p. 24). 35

Kuhn's point has implications for teaching critical thinking skills in the basic science courses as well. Even though students are heavily immersed in learning a tremendous amount of information, they should still be presented with critical thinking learning experiences that embed concepts in actual practice-based scenarios. 36

Argument mapping

Van Gelder suggests that students' critical thinking skills improve faster when instruction is based upon argument mapping. He asserts that when arguments are presented in diagrammatic form, students are more capable of following critical thinking procedures. Because argument maps are visual and more transparent, they make the core operations of critical thinking more straightforward. Van Gelder cautions, however, that belief preservation is a human tendency. He states that individuals tend to make evidence secondary to beliefs. Thus, critical thinking runs counter to human tendencies. Humans tend to seek evidence that supports beliefs and ignore evidence that goes against beliefs. Ideally, critical thinkers will recognize this, put extra effort into searching for evidence that contradicts their own beliefs and cultivate a willingness to change when evidence to the contrary begins to mount. 37

To apply argument mapping to clinical reasoning, consider Case #1.

Case #1-Differing Views on Patient Treatment

A 60-year-old woman has internal resorption of the left maxillary lateral incisor. Radiographic exams reveal that saving the tooth is questionable. The student dentist recommends to Professor Marlin that the patient receive a fixed partial denture (FPD). Marlin confers with Professor James, and James recommends a removable partial denture (RPD).

• The students are instructed to use argument mapping to explain the phenomenon.
• Next, students are asked to write about the contradictions that differentiate viewpoints about FPD and RPD and to write about the counterarguments.
• 3. Finally, students are to identify their treatment decisions and provide evidence that supports or justifies their assertions.

Think-aloud seminar

Lee and Ryan-Wenger recommend the use of the "think-aloud seminar" as a teaching tool. Students are presented with a case and asked relevant questions regarding symptoms and presenting signs. Using this approach, students can exclude underlying pathologies based upon the presentation. This process of excluding potential diagnoses aids students' critical thinking by encouraging them to openly verbalize the rationales behind their opinions. 38

Wong and Chung used simulation to develop diagnostic reasoning skills among nursing students. Students were asked to consider the etiological factors, presenting symptoms, and clinical signs of a patient who presented with a particular condition. As they examined the underlying patholophysiology, the CTS they developed were "assessing duration" and "frequency of symptoms and additional triggers." They also were expected to review their understanding of the possible pathophysiological significance. The next set of CTS they focused on was "considering the pros and cons of treatments" and "drug actions and the possible side effects on the patient." Finally they explored the efficacy of the outcomes. CTS developed in this phase were "determining the success of the treatment," "determining complications," "considering the time it took to resolve the clinical signs and symptoms," and "considering reasons for the development of symptoms." 39

Other strategies

Other strategies that can promote critical thinking include particular behaviors, especially asking questions.

Table 3. Strategies that Promote Critical Thinking

Asking particular types of questions also promotes critical thinking.

  Table 4. Questions that Promote Critical Thinking

Also, Facione and Facione (1996) recommend that students begin analyzing their own thinking. For example, "If you were teaching a colleague about this situation, how would you lead him or her through the issues?" 41

Logical Fallacies

While faculty strive to develop students' abilities to use critical thinking, it is also important to communicate the logical fallacies students may demonstrate in their writing or speaking. Engel provides an overview that illustrates the common fallacies. 42 Three common types of fallacies are shown in Table 5.

Table 5. Common Logical Fallacies (Adapted from Engel, 1990)

Allowing Time for Reflection

Teaching students how to use critical thinking skills shifts teaching from a model that largely ignores thinking to an approach that renders it pervasive 43 When content is didactically taught, it is treated as static and students are unlikely to question or think it through. They tend to rely on rote memorization without grasping the logic, supporting evidence and application of what they are trying to memorize. Students who learn through a critical thinking process truly learn content. At every level, students need to learn how to:

Ask questions precisely, define contexts and purposes, pursue relevant information, analyze key concepts, derive sound inferences, generate good reasons, recognize questionable assumptions, trace important implications, and think empathetically within different points of view (p. 20). 44

Critical thinking is difficult and requires overt practice using a variety of learning activities across the dental curriculum. It is also important to recognize the role that reflection plays in its development. Students need time to think about what they are learning and reflect upon that information. However, what they are learning must have an impact on their feelings in order for critical thinking to occur.

Emotions and Critical Thinking 

The role of emotion in learning to use critical thinking skills is yet another area that necessitates research inquiry. As Zull suggests, if we want students to retain concepts we must allow them to put things into their own words, verbally and in writing. 45  Give students time to think before speaking and better construct ideas in their own words. Processing information takes time; stating one's thinking correctly also takes time. If a student cannot do this alone, we can give him or her the opportunity to discuss questions with others. Giving students time to reflect is giving them time to make connections.

Zull explains the process that takes place within the brain. First, the sensory cortex receives sensory input or concrete experiences. Next, the back integrative cortex tries to create meaning and images during the human process of reflection. The frontal integrative cortex is responsible for short-term memory and problem solving, making decisions and language, and making judgments and evaluations. This activity is akin to how learners handle abstractions-manipulating images and language to create new mental arrangements. The motor cortex triggers all coordinated and voluntary muscle contractions. This matches with the action that completes the learning cycle-actively testing abstractions and converting ideas into physical actions. The brain visualizes items in small amounts and all information arrives at the same time, producing an outline of objects and features in the visual field. 46 Thus, the brain can fully see great detail and nuance. Converting ideas into images helps students learn. Images enhance recall and aid in discovery. Sometimes the best teaching is just showing the student how.

To ensure that students learn, educators need to limit the amount of information they give. Instructors should limit or condense to three or four pieces the amount of information they want students to process.

The amygdala is responsible for screening experiences. 47  If something is recognized as dangerous, the amygdale will instinctively cause the body to "freeze." When a student first encounters something new, he or she may have a somewhat negative reaction. The instructor needs to find a way for the student to move into a more positive emotional territory. 48  Making suggestions or showing examples can remind the student what he or she already knows, and then the student can hang newly acquired knowledge on that "scaffolding." The support given by the instructor allows the student some level of success. Recognizing his or her success helps the student feel more hope, interest, and curiosity. At this point, the student is able to assume more control of the learning process. Boyd (2002) concurs and states, "emotions ... constantly regulate what we experience as reality." She also points out, "The limbic system plays an important role in processing emotion and memory and therefore appears to be important in the transfer of short-term memory into long-term memory." 49  Engaging students emotionally and actively strengthens memory.

Teaching students to use CTS during instruction

There is some empirical evidence that a four-year undergraduate experience contributes to modest gains in overall CT. However, there is little scientific evidence that a single course, other than a critical thinking skills course makes a positive measurable difference. 50  Even in the case of a specific CTS course, the evidence is mixed. 51

Recent studies show that limited efforts to infuse critical thinking in instruction can lead to improved scores on the Cornell Critical Thinking Test Level Z, a test that is aimed at a sophisticated audience and measures six common critical thinking skills. 52  Allegrettti and Frederick (1995) reported pre- to post-test gains on the Cornell Z for a group of college seniors (n = 24) who took a capstone integrated psychology and philosophy course. 53  Solon (2001) found that a partial treatment group of psychology students (n = 26) improved their scores on the Cornell Z compared to a group of untreated humanities students (n = 26). The results were statistically significant (beyond .001). In 2003, Solon studied three groups to compare coursework effects and reported that the full treatment group (n = 25) significantly outscored both the partial (n = 25) and non-treatment (n = 25) groups on the Cornell Z test. 54  Solon (2007) reported that a group of introductory psychology students (n = 25) received a moderate infusion of critical thinking skills (10 hours instruction and 20 hours homework). Compared to the non-treatment group (n= 26), the experimental group significantly improved their scores on the Cornell Z test. 55  These findings suggest that even a moderate infusion of critical thinking skills instruction can result in enhanced reasoning skills without requiring a significant investment from the instructor. 56

Collins and Onwuegbuzie reported significant relationships between overall CTS and achievement in a graduate level research methodology course at the midterm (r = .34, p < .01) and final (r = .26, p < .01) stages. 57  Onwuegbuzie compared the CTS of master's and doctoral level students. He reported that doctoral level students (n = 19) obtained statistically higher overall CTS using the California Critical Thinking Skills Test than the masters' degree students (n = 101, t = -3.54, p < .01). The effect size (d = 0.92) associated with this difference was extremely large. 58

Teaching CTS requires instruction that uses higher order taxonomic skills. These skills require student demonstration or teacher usage of behaviors classified as analysis, evaluation, and creation (levels 4, 5, and 6 on Bloom's revised taxonomy). When teaching takes place at higher levels of learning, lower order behaviors such as remembering, understanding, and applying are subsumed within instruction. The following table lists behaviors common at each level of learning and examples of related dental education activities.

Table 6. Revised Bloom's Taxonomy, Sample Verbs, and Related Learning Activities 59

Making Critical Thinking Explicit

Teaching for critical thinking is a rational and intentional act. Typically, instructors cannot suddenly decide to teach CTS and develop an appropriate learning activity. An instructor must have a clear understanding of what CTS is, how it is implemented during instruction, and what strategies should be used during particular classroom and predoctoral clinical learning activities. Developing a repertoire of well-honed CTS activities appropriate to your specific discipline is advisable.

Also crucial to the teaching of CTS is an educator announcing to students he or she will teach CTS, how he or she intends to do so, and what will be required of the students as learners. It is important to have an explicit conversation with students about what CTS is, what it looks like, and how educators will model it so students can differentiate the teaching of CTS from lower level learning. Effective teaching of university-age students is characterized by collegial and collaborative processes, not instruction that is ambiguous. In ambiguous instruction, the learner does not know what to expect next or have a clear understanding of what behavioral or skill changes he or she should demonstrate as a result of teacher-student interaction. Teaching explicitly helps ensure that less re-teaching will be necessary. Both teachers and students know their responsibilities as instructors and learners.

Stages of Critical Thinking

Paul and Elder claim that individuals progress through predictable stages of unreflective, challenged, beginning, practicing, advanced, and master thinking. 60  They state that unless educators help students develop an intellectual vocabulary for discussing their thought processes and challenge them to identify the problems in their thinking, the students' cognitive processes will remain invisible to them. The implication for curriculum development: If instructors want students to develop critical thinking skills, then critical thinking must be integrated into the foundations of instruction.

It is also important to recognize that when patient care is task focused, it can obscure the bigger picture and become a barrier to the development of critical thinking skills. Individual personality, background, and position might also limit one's ability to think critically. Additionally, gender, age, religion, and socioeconomic status might influence the development of critical thinking skills. One of the biggest barriers to the development of CTS is our educational system. Although it is important to recognize these attributes as potential barriers, it is more important that dental educators establish the kind of learning environments that will foster the development of CTS.

Case #2-Why Are Mrs. Connor's Teeth Yellow?

Mrs. Connor, a 74-year-old white female, comes to your office as a new patient. She presents you with a complaint that her teeth have become yellowed and unattractive. Her husband died one year prior, and since then she has been drinking 8-10 cups of coffee daily. Her internist diagnosed anemia and high blood cholesterol. She is taking iron and Lipitor. She feels better since she began taking Lipitor, but feels her teeth are too yellow. She recently met a widower who invited her to dinner next week. She is worried about the appearance of her teeth.

• Working in groups of six, students are asked to write at least four hypotheses about why Mrs. Connor's teeth are yellow.
• Students must also determine if whiter teeth are important to the health and well being of geriatric patients.
• Students must discuss if there a relationship between the need of care and the use of dental services by older patients.
• A student group will then outline its recommendations and a rationale for the treatment plan to be presented to Mrs. Connor at her next dental appointment.

Teachers must recognize that not all students will apply critical thinking skills at the same rate they learn these skills. Thus, instructional methods and objectives need to match students' cognitive and experiential abilities while trying to stretch students to their growing edge. 61  Students' capacity for self-directed learning (SDL), which is required to implement reflective judgment, underlies many of the critical thinking skill dispositions. 62  There is evidence that the students who routinely use the "learn by doing" approach to explore problems develop more sophisticated SDL than students in lecture-based curricula. 63  The reflection element of critical thinking is considered essential to clinical judgment. 64  Tanner asserts that using the skills associated with reflective thinking prepares students for ill-structured or ambiguous problems that they are likely to encounter in clinical practice. 65

Problem-based learning (PBL) is a popular instructional strategy for promoting collaboration and reflection and negotiating different and individual constructions of knowledge. Some researchers assert that PBL is best used when problems are unsolvable or when they generate many individual constructions of knowledge that appear valid. 66  However, using only problem-based learning to teach critical thinking skills may not be enough. This instructional strategy does not necessarily equip students with the ability to analyze or critique a given situation or the information with which they are been provided. A variety of instructional strategies that give students the opportunity to think aloud, role play, prioritize alternatives, communicate conclusions effectively, simulate, or defend the logical basis of their thinking is recommended to foster students' ability to use critical thinking.

Asking students to apply their understanding of dental and medical knowledge to treatment planning and diagnosis is not an example of CTS. However, asking students to determine differential diagnoses of caries and periodontal disease among patients at various stages of lung cancer requires the ability to reason and justify particular treatment plans or demonstrate critical thinking skills. Habits of the students who demonstrate critical thinking are:

Case #3-Female with Erythroplakia

Mrs. Jacklin, a 40-year-old female, presents you with a history of SLE and erythroplakia on the left lateral border of the tongue. She states she is experiencing a burning sensation on her tongue. She asks why she is having this discomfort and what she can do to make the sore on her tongue go away. The oral exam shows that Mrs. Jacklin has poor oral hygiene and mild dry mouth (xerostomia) but is otherwise not in danger for oral health concerns.

• Working in groups of four, students are asked to locate the four most recent references on oral lesions.
• Using those resources, they are asked to write five or six reasons that the patient is experiencing a tongue lesion and determine what questions they should ask the patient about her personal and social history.
• Next, they identify questions to ask her about her medical history.
• Using the information they have acquired, they are asked to generate a list of potential treatment plans and the benefits and limitations of each plan.
• What should they tell the patient and why?

Critical thinking is not :

Critical thinking cannot be taught in a learning environment where the dental educator always lectures, tells students what ought to be undertaken during patient treatment, or shows students how to do a procedure correctly. Some habits of students who do not use critical thinking skills are:

Critical thinking skills can be developed with frequent practice and the use of ill-structured problems and situations that require the ability to recall useful knowledge quickly, use pattern recognition, discern pertinent information, think ahead, and anticipate outcomes and problems while remaining composed so that emotions do not hinder decisionmaking skills. However, it is important to recognize CTS do not develop spontaneously or with maturation. Since strong personality components underlie CT dispositions, what happens if students admitted to colleges of dentistry do not already possess these traits?

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6 Critical Thinking Skills You Need to Master Now

By Will Erstad on 01/22/2018

No matter what walk of life you come from, what industry you’re interested in pursuing or how much experience you’ve already garnered, we’ve all seen firsthand the importance of critical thinking skills. In fact, lacking such skills can truly make or break a person’s career, as the consequences of one’s inability to process and analyze information effectively can be massive.

“The ability to think critically is more important now than it has ever been,” urges Kris Potrafka , founder and CEO of Music Firsthand. “Everything is at risk if we don’t all learn to think more critically.” If people cannot think critically, he explains, they not only lessen their prospects of climbing the ladder in their respective industries, but they also become easily susceptible to things like fraud and manipulation.

With that in mind, you’re likely wondering what you can do to make sure you’re not one of those people. Developing your critical thinking skills is something that takes concentrated work. It can be best to begin by exploring the definition of critical thinking and the skills it includes—once you do, you can then venture toward the crucial question at hand: How can I improve?

This is no easy task, which is why we aimed to help break down the basic elements of critical thinking and offer suggestions on how you can hone your skills and become a better critical thinker.

What is critical thinking?

Even if you want to be a better critical thinker, it’s hard to improve upon something you can’t define. Critical thinking is the analysis of an issue or situation and the facts, data or evidence related to it. Ideally, critical thinking is to be done objectively—meaning without influence from personal feelings, opinions or biases—and it focuses solely on factual information.

Critical thinking is a skill that allows you to make logical and informed decisions to the best of your ability. For example, a child who has not yet developed such skills might believe the Tooth Fairy left money under their pillow based on stories their parents told them. A critical thinker, however, can quickly conclude that the existence of such a thing is probably unlikely—even if there are a few bucks under their pillow.

6 Crucial critical thinking skills (and how you can improve them)

While there’s no universal standard for what skills are included in the critical thinking process, we’ve boiled it down to the following six. Focusing on these can put you on the path to becoming an exceptional critical thinker.

1. Identification

The first step in the critical thinking process is to identify the situation or problem as well as the factors that may influence it. Once you have a clear picture of the situation and the people, groups or factors that may be influenced, you can then begin to dive deeper into an issue and its potential solutions.

How to improve: When facing any new situation, question or scenario, stop to take a mental inventory of the state of affairs and ask the following questions:

• Who is doing what?
• What seems to be the reason for this happening?
• What are the end results, and how could they change?

2. Research

When comparing arguments about an issue, independent research ability is key. Arguments are meant to be persuasive—that means the facts and figures presented in their favor might be lacking in context or come from questionable sources. The best way to combat this is independent verification; find the source of the information and evaluate.

How to improve: It can be helpful to develop an eye for unsourced claims. Does the person posing the argument offer where they got this information from? If you ask or try to find it yourself and there’s no clear answer, that should be considered a red flag. It’s also important to know that not all sources are equally valid—take the time to learn the difference between popular and scholarly articles .

3. Identifying biases

This skill can be exceedingly difficult, as even the smartest among us can fail to recognize biases. Strong critical thinkers do their best to evaluate information objectively. Think of yourself as a judge in that you want to evaluate the claims of both sides of an argument, but you’ll also need to keep in mind the biases each side may possess.

It is equally important—and arguably more difficult—to learn how to set aside your own personal biases that may cloud your judgment. “Have the courage to debate and argue with your own thoughts and assumptions,” Potrafka encourages. “This is essential for learning to see things from different viewpoints.”

How to improve: “Challenge yourself to identify the evidence that forms your beliefs, and assess whether or not your sources are credible,” offers Ruth Wilson, director of development at Brightmont Academy .

First and foremost, you must be aware that bias exists. When evaluating information or an argument, ask yourself the following:

• Who does this benefit?
• Does the source of this information appear to have an agenda?
• Is the source overlooking, ignoring or leaving out information that doesn’t support its beliefs or claims?
• Is this source using unnecessary language to sway an audience’s perception of a fact?

4. Inference

The ability to infer and draw conclusions based on the information presented to you is another important skill for mastering critical thinking. Information doesn’t always come with a summary that spells out what it means. You’ll often need to assess the information given and draw conclusions based upon raw data.

The ability to infer allows you to extrapolate and discover potential outcomes when assessing a scenario. It is also important to note that not all inferences will be correct. For example, if you read that someone weighs 260 pounds, you might infer they are overweight or unhealthy. Other data points like height and body composition, however, may alter that conclusion.

How to improve: An inference is an educated guess, and your ability to infer correctly can be polished by making a conscious effort to gather as much information as possible before jumping to conclusions. When faced with a new scenario or situation to evaluate, first try skimming for clues—things like headlines, images and prominently featured statistics—and then make a point to ask yourself what you think is going on.

5. Determining relevance

One of the most challenging parts of thinking critically during a challenging scenario is figuring out what information is the most important for your consideration. In many scenarios, you’ll be presented with information that may seem important, but it may pan out to be only a minor data point to consider.

How to improve: The best way to get better at determining relevance is by establishing a clear direction in what you’re trying to figure out. Are you tasked with finding a solution? Should you be identifying a trend? If you figure out your end goal, you can use this to inform your judgment of what is relevant.

Even with a clear objective, however, it can still be difficult to determine what information is truly relevant. One strategy for combating this is to make a physical list of data points ranked in order of relevance. When you parse it out this way, you’ll likely end up with a list that includes a couple of obviously relevant pieces of information at the top of your list, in addition to some points at the bottom that you can likely disregard. From there, you can narrow your focus on the less clear-cut topics that reside in the middle of your list for further evaluation.

6. Curiosity

It’s incredibly easy to sit back and take everything presented to you at face value, but that can also be also a recipe for disaster when faced with a scenario that requires critical thinking. It’s true that we’re all naturally curious—just ask any parent who has faced an onslaught of “Why?” questions from their child. As we get older, it can be easier to get in the habit of keeping that impulse to ask questions at bay. But that’s not a winning approach for critical thinking.

How to improve: While it might seem like a curious mind is just something you’re born with, you can still train yourself to foster that curiosity productively. All it takes is a conscious effort to ask open-ended questions about the things you see in your everyday life, and you can then invest the time to follow up on these questions.

“Being able to ask open-ended questions is an important skill to develop—and bonus points for being able to probe,” Potrafka says.

Become a better critical thinker

Thinking critically is vital for anyone looking to have a successful college career and a fruitful professional life upon graduation. Your ability to objectively analyze and evaluate complex subjects and situations will always be useful. Unlock your potential by practicing and refining the six critical thinking skills above.

Most professionals credit their time in college as having been crucial in the development of their critical thinking abilities. If you’re looking to improve your skills in a way that can impact your life and career moving forward, higher education is a fantastic venue through which to achieve that. For some of the surefire signs you’re ready to take the next step in your education, visit our article, “ 6 Signs You’re Ready to Be a College Student .”

RELATED ARTICLES:

• How To Build Your Management Skills
• 6 Common Concerns of Adult Learners (And Why They Shouldn’t Worry)
• I Hate My Job … What Should I Do?

EDITOR’S NOTE: This article was originally published in December 2012. It has since been updated.

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About the author

Will Erstad

Will is a Sr. Content Specialist at Collegis Education. He researches and writes student-focused articles on a variety of topics for Rasmussen University. He is passionate about learning and enjoys writing engaging content to help current and future students on their path to a rewarding education.

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Choosing Wisely in clinical practice: Embracing critical thinking, striving for safer care

Ludovico furlan.

1 Department of Clinical Sciences and Community Health, University of Milan, Milan Italy

2 Department of Internal Medicine, General Medicine Unit, IRCCS Ca’ Granda Foundation, Ospedale Maggiore Policlinico, Milan Italy

Pietro Di Francesco

Giorgio costantino.

3 Department of Anaesthesia—Intensive Care Unit, Emergency Department and Emergency Medicine Unit, IRCCS Ca’ Granda Foundation Ospedale Maggiore Policlinico, Milan Italy

Nicola Montano

In recent years, the Choosing Wisely and Less is More campaigns have gained growing attention in the medical scientific community. Several projects have been launched to facilitate confrontation among patients and physicians, to achieve better and harmless patient‐centered care. Such initiatives have paved the way to a new “way of thinking.” Embracing such a philosophy goes through a cognitive process that takes into account several issues. Medicine is a highly inaccurate science and physicians should deal with uncertainty. Evidence from the literature should not be accepted as it is but rather be translated into practice by medical practitioners who select treatment options for specific cases based on the best research, patient preferences, and individual patient characteristics. A wise choice requires active effort into minimizing the chance that potential biases may affect our clinical decisions. Potential harms and all consequences (both direct and indirect) of prescribing tests, procedures, or medications should be carefully evaluated, as well as patients’ needs and preferences. Through such a cognitive process, a patient management shift is needed, moving from being centered on establishing a diagnosis towards finding the best management strategy for the right patient at the right time. Finally, while “thinking wisely,” physicians should also “act wisely,” being among the leading actors in facing upcoming healthcare challenges related to environmental issues and social discrepancies.

Content List – This is an article from the symposium: “When is too much too much and too little too little: Scientific evidence of limited workup”.

Clinical vignette

A 43‐year‐old woman with scleroderma was admitted to the Emergency Department (ED) complaining of fever and abdominal pain in the left upper quadrant. The attending physician performed an abdominal ultrasound examination that was negative. Blood exams showed significantly elevated C‐reactive protein so a urinary tract infection was suspected. Intravenous ciprofloxacin treatment was started. After 24 h, the patient felt much better, she had no pain nor fever and was discharged with the indication to continue oral antibiotic therapy. The next day, the patient returned to the ED complaining of pain at the forearm where the peripheral vein access had been placed. Superficial phlebitis was noticed and the physician in charge decided to perform a bedside ultrasound that showed thrombosis of the antecubital vein. Treatment with fondaparinux for a week was started. The patient was discharged in good clinical conditions; however, the following day, the patient was admitted again to the ED for a severe headache. The head computed tomography scan showed a cerebral hemorrhage, and she was transferred to the neurosurgery ward.

As shown by this simple but dramatic clinical case, even the most trivial and innocent medical decision may have catastrophic consequences. This is the reason why any intervention we perform (treatment or test) must be preceded by relevant clinical questions. Looking back at our case: (a) was the peripheral venous access necessary? (b) Was the ultrasound examination appropriate? (c) Was the consultation with the thrombosis specialist needed? (d) Was anticoagulant therapy appropriate? No single step of the diagnostic strategy was absolutely incorrect, but a cascade of small clinical decisions snowballed into dramatic and unexpected consequences.

The rationale

The call for action inspired by Brody in 2010 [ 1 ] led to the creation of the Choosing Wisely (CW) campaign, an initiative of the American Board of Internal Medicine Foundation (ABIM) launched in 2012 that was immediately followed by the seminal article by Grady and Redberg, “Less is More” [ 2 ], calling for a shift from the traditional paradigm “more care is better” towards care tailored to the patient's needs.

The main mission of this campaign was the promotion of conversations between clinicians and patients by helping patients to choose care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm and truly necessary. This was pursued through the publication of hundreds of “top 5 lists,” created by medical societies from 25 different countries, listing unnecessary or overused medical procedures, tests, or treatments, all based on recent evidence and good medical practice. Several studies testing the efficacy of the campaign in reducing medical waste and side effects have been performed or are ongoing [ 3 , 4 , 5 ].

However, in our opinion, CW represents an even broader and general concept expanding the borders of healthcare and medical decisions to include a new “way of thinking” that is more respectful not only of patients but of all economic and environmental resources. To choose wisely is to choose consciously and conscientiously. We would like to propose here a “medical” revisitation of the Cartesian philosophical concept “ Cogito ergo sum” (I think, therefore I am), which would sound, rephrasing St Augustine, like “Dubito, ergo sum [medicus]” (I doubt, therefore I am [a physician]).

Constantly enlarging healthcare systems, where the number of actors involved and the complexity of the relationships between them keeps increasing, tends to generate automated and impersonal clinical decisions. We wish for physicians to reacquire a central role in patient management, tailoring choices to their specific patients and involving them in the decisional process.

In the present review, we will discuss the fundamental issues hindering our capabilities to choose wisely, such as the difficulty in dealing with uncertainty, the fear of making errors, and the pitfalls of the evidence‐based approach, and we will discuss a possible roadmap to help modify our way of thinking and to overcome what is holding us back from doing so (Fig.  1 ).

Clinical reasoning—no single choice of performing tests or initiating treatment should be made without considering all the factors involved. Each test serves the purpose of increasing or reducing our probability of a diagnosis to help us choose, together with our patients, whether starting treatment could be beneficial.

Factors at play

Uncertainty.

Medicine is a highly inaccurate scientific field compared to other disciplines such as engineering or computer science [ 6 ]. The most accurate tests we use during a diagnostic workup boasts of a sensitivity and sensibility that is lower than 90%, leaving a great margin of error even when no human effort is involved [ 7 , 8 ]. Similarly, the most effective therapies for commonly encountered illnesses do not assure treatment success, even when given promptly [ 9 ].

The minimization of uncertainty in clinical decision making has become central to biomedical research over the past 50 years, driving the development of evidence‐based medicine (EBM), with millions of articles published every year.

However, the more knowledge is accumulated the more we perceive the differences in each clinical condition presented, in the underlying mechanisms and mostly, in each patient we meet [ 10 ]. The more we know, the more we understand how little of what we know is actually applicable to every single case. The concept seems obvious as this is one of the better‐known postulations of Western philosophy, as expressed by the Socratic motto “I know that I know nothing” [ 11 ], but in our hypertechnological and specialistic era, sometimes we tend to forget about this concept and dismiss it.

The feeling that an outcome can be predicted leads to a sense of security that is, unfortunately, often based on wrong assumptions. As William Osler said, “medicine is a science of uncertainty and an art of probability.” Uncertainty can make the physicians uncomfortable and communicating uncertainty to patients can feel like letting them down and not being able to predict what is happening to them. While it can be true that patients feel safer and more satisfied knowing their doctor is certain about the evolution of their condition [ 12 ], being able to communicate uncertainty can, in the long term, lead to an improvement in the patient–doctor relationship and trust [ 13 ].

Embracing uncertainty does not represent a rejection of EBM but instead supports its best use. As soon as we accept the hindrance that precludes us to be 100% accurate in our predictions, we can start implementing this type of thinking into practical skills of evaluating a situation and describing it to our patients. The probability of a response to therapy can be expressed as a numerical range with a qualitative estimate rather than a single number. For most diagnostic tests, we should emphasize that the result can only increase or diminish the probability of a diagnosis based on the likelihood ratio of the test, and cannot provide a definitive answer [ 14 , 15 , 16 ]. Thus, to better engage our patients, shared decision making, using the best available evidence as a tool, should be implemented [ 17 ], as when faced with hard choices, our patients may feel that their physician will be with them, no matter what the future holds.

Evidence‐based medicine

Not all clinical research is good research [ 6 ]. EBM aims for the idea that healthcare professionals should make conscientious, explicit, and judicious use of current best evidence in their everyday practice. EBM uses systematic reviews of the medical literature to evaluate the best evidence on specific clinical topics. This is the first and easiest to apply step, called “evidence synthesis.”

Selecting treatments and procedures based on updated evidence strikes as the best to provide the best care available for a patient. This can be held only if the supporting scientific evidence is of good quality and extrinsically applicable to the patients we are currently treating. Blindly applying results of clinical trials can be extremely dangerous, and therefore even guidelines should be considered critically and not as an unquestionable Bible.

The amount of weakly designed studies, skewered analysis, and straight‐up false data that gets published each year is astounding. Some of these studies present data that lacks credibility so blatantly that they earned the name “zombie trials” [ 18 ]. Moreover, even if millions of papers get published every year, the publication record is only a small part of the unpublished research data existent, with an abundance of inconclusive or controversial results, never to be shared [ 19 ].

Registered clinical trials showing negative results (where the treatment tested showed no effect) are statistically less likely to be published, and even when published they usually take, on average, 1 year more to get released than trials with positive results. [ 20 , 21 ]. It was also proven that statistically significant studies may be cited more than negative studies on the same topic, increasing the bias [ 22 ].

Another critical issue is the abundance of multiple guidelines, from different societies, on the same topic, which often cites different articles and meta‐analyses supporting their recommendations, which are sometimes discordant with each other, without a clear reason to justify the discrepancies. In addition, they may be heavily influenced by “expert” dogma and only a few of the recommendations provided are based on level A evidence [ 23 , 24 , 25 , 26 ].

Therefore, although being used to establish medical (and sometimes legal) standards of care, clinical guidelines are very far from being an unbiased and unequivocal tool. It's hard to imagine an improvement in the quality of research as long as financial conflicts of interest are associated with favorable recommendations of drugs and devices in clinical guidelines, advisory committee reports, opinion pieces, and even narrative reviews [ 27 ]. The Sars‐Cov‐2 pandemic worked like a magnifying glass in showing the limits and weaknesses of our research system. In the rush for publication, thousands of dubious papers have been released, only increasing the rampant confusion and despair that sprung in physicians forced to work without evidence [ 28 , 29 , 30 ].

Plenty of resources are currently available to improve doctors' ability to use EBM correctly, starting from critically reading manuscripts, comparing them to previously available data, all the way down to designing new trials that could improve patient outcome and satisfaction [ 31 , 32 , 33 ]. Critically approaching EBM means not stopping at the first step, that is, “evidence synthesis,” but rather continuing to the second one, which is “knowledge translation.” The evidence must be translated into practice by medical practitioners who select treatment options for specific cases based on the best research, patient preferences, and individual patient characteristics [ 34 ].

Medical errors

Medical errors are listed as the number three cause of death in the United States [ 35 ] and represent a huge cost in resources and a great risk for the unwilling patient finding himself a “victim” of the error. A wise choice requires active effort into minimizing the chance of making mistakes while considering that not all of them are predictable and thus preventable. Minimizing errors related to lack of knowledge , often only recognizable in hindsight (if not spotted at all) requires experience, continuous education, and update in the light of new available research and data. On the other hand, errors linked to inattention or carelessness could be reduced by investing in better work–life balance for healthcare providers, preserving enough good sleep, avoiding toxic workplace conditions, and supporting doctors' own mental and physical wellbeing [ 36 ].

In the last 30 years, medicine has tried to adopt tools and procedures from other fields to manage risks and minimize errors. For instance, the aviation safety procedures approach is often being used as a model to build up a safer healthcare system. While intrinsic limits are preventing the achievement of the same extremely high level of safeness [ 37 ], the use of checklists, personnel's fatigue risk management, and specialization training are all examples of features shared by both realities that improved avoidance of errors when implemented. [ 38 , 39 , 40 ]. One topic that was found to be lacking in doctors’ and interns’ apprenticeship, while well established in other professional activities, is “cognitive bias avoidance training.”

Cognitive biases (CB) are predictable, systematic patterns of deviation from the norm and/or rationality in judgment. The mind is prone to fall for these various cognitive traps especially while relying on heuristics, or mental shortcuts, using what is defined as “system 1” of cognitive process (as opposed to “system 2,” representing conscious analytical thoughts) [ 41 , 42 , 43 ]. The most commonly encountered CB in medicine include the anchoring effect and the confirmation bias (that could together be summarized as prematurely falling in love with a diagnosis), the gambler's fallacy (that makes it seem unlikely something will happen again if it recently happened many times), and the base rate neglect (overestimating or underestimating pretest probability when working up a diagnosis, skewing the Bayesian reasoning) but a long list of biases have been described and each one plays a role in increasing the risk for error making [ 44 , 45 ]. Pattern recognition is essential to clinical reasoning, especially in the context of emergencies, and one is easily tempted to think that these biases don't affect him, even if he can recognize them in others.

Learning to recognize and discuss the impact of cognitive bias from the early stage of medical education could significantly help avoid the consequences and costs of these mistakes [ 46 ].

Value‐based patient‐centered approach

What is important for the patients? When making choices, our perspective could be different from the patients’ and we should consider patients’ preferences and needs. What is important for us may be of limited value for the patient. Sharing our views and involving patients in decision making that is truly based on their needs should be a milestone when choosing wisely [ 47 ].

As physicians, we tend to make a diagnosis based on a disease‐centered point of view and then provide the best available cure. This may, nevertheless, be far from coinciding with what matters to the patient, particularly when multiple chronic conditions co‐exist [ 48 ]. For instance, from the perspective of a patient with chronic heart failure, the number of days spent at home may be a more accurate outcome for evaluating the quality of the provided cures rather than the rate of hospital admission [ 49 ]. Potentially, even the most extreme medical decisions may benefit from a positive confrontation. Is there any doctor that would raise doubts on the benefits of adrenaline in cardiac arrest? In a highly debated randomized controlled trial (RCT) published in New England Journal of Medicine on the use of epinephrine in out‐of‐hospital cardiac arrest [ 50 ], the authors actively involved patients and the public in the planning and development of the trial. The study showed a benefit of epinephrine use on short‐term survival but no significant differences in survival with favorable neurologic outcomes. Interestingly, when the community was involved in defining the priority of outcomes, 95% of respondents prioritized long‐term survival with favorable neurological outcomes instead of short‐term survival. There are several resources that clinicians could use to inform their patients of the risk and benefits of treatments, tests, and procedures. In a recent meta‐analysis, patients exposed to decision aids for screening or health treatment decisions showed increased knowledge, while the accuracy of risk perceptions and congruency between informed values and care choices did not show differences in terms of health outcomes compared to controls [ 51 ]. Some patients may be keen to discuss potential therapeutic options while others prefer not to be involved in decision making [ 52 ].

Involving patients in decision making does not mean giving up responsibility but rather including personal preferences into the physician's final decision on the matter.

Clinical decisions and consequences

Each time we make a clinical decision such as prescribing a treatment or a test, we expect benefits for our patients, but we must keep in mind that with every choice we may cause harm. Most of the time, we acknowledge direct potential adverse events but hardly identify potentially indirect risks, the long term, and social consequences of our choices. Several studies indicate that patients consistently overestimate the benefits and underestimate risks of the screening procedure, tests, and treatments [ 53 ] and there is still uncertainty about how good physicians are at understanding and communicating to patients the benefits and harms of tests and procedures [ 54 , 55 ].

Each time we make a decision, we set in motion a chain of reaction of which we should be aware. Even the cheapest, low‐risk test can have tremendous consequences for patients and healthcare. In a recent study, the American College of Cardiology highlighted the importance of avoiding preoperative routine electrocardiogram (EKG) in low‐risk noncardiac surgery [ 56 ], including such recommendations among its Choosing Wisely top five list. In another study [ 57 ] on over 110,000 patients undergoing cataract surgery in the USA, 16% of those who received a preoperative EKG underwent a series of further testing that accounted for an extra cost of $565 per patient and $35 million without evidence of disease. Incidental findings account for the largest part of inappropriate testing. In a study conducted by the American College of Physicians, 90% of interviewed physicians reported a cascade of tests after incidental findings that caused significant psychological, financial, and even physical consequences for their patients [ 58 ]. Cancer screening through prostate‐specific antigen (PSA), which is now no longer advised, has been estimated to have caused between 2.9% and 88.1% of prostate cancer overdiagnosis [ 59 ]. These findings are just a tiny dot in a much bigger picture since limited data are available on the impact of overdiagnosis and overtreatment [ 59 ]. The proposed CW approach has the first downstream effect of increasing the safety of our patients, balancing the risks and benefits of each intervention at the single‐person level.

The physician should never stop asking himself: “Why am I prescribing this test/treatment to my patient? Am I fully aware of the consequences of the result on my next clinical decisions?”

Diagnosis‐ versus management‐centered approach

Providing answers to our patients is a cognitive process passing through a critical appraisal of clinical information, checking the best available evidence, and considering the external factors involved (values, available resources, environmental factors, etc.). This clinical‐reasoning process should not just focus on providing a diagnosis. As brilliantly illustrated by a recent review on the subject by Cook et al. [ 60 ], reaching a diagnosis is not the final outcome a physician should seek; it is, in fact, the successful management of the patient. Nevertheless, most of the available literature focuses on the cognitive processes that lead ultimately to a diagnosis (diagnostic reasoning). Management reasoning, that is, the process of making decisions about patients’ treatment, follow up, need for hospitalization and resource allocation, is a less explored path with multiple aspects. Cook et al. [ 60 ] pointed out the main differences between the two approaches, as summarized in Table  1 . Focusing on patient management rather than reaching a diagnosis could possibly reduce overtesting and increase patient involvement in the decision process.

Diagnosis versus management

RCT, randomized controlled trial.

A practical example of the implications of using these two approaches is the management of patients with potential pulmonary embolism (PE). Several trials found a higher‐than‐expected prevalence of PE in patients admitted for syncope or exacerbation of chronic obstructive pulmonary disease (COPD) in the ED, suggesting a possible role for algorithms dedicated to the identification of PE in these groups of patients [ 61 , 62 ]. Further studies raised doubt on this potential approach. On one side, the study by Costantino et al. [ 63 ], collecting data from real‐world scenarios, concluded that not all patients warrant a diagnostic algorithm to exclude it, and the algorithm may increase false‐positive results and overtreatment, resulting in more adverse events. On the other side, the study by Jiménez et al. [ 64 ] on exacerbating COPD found no differences in terms of major clinical outcomes when randomizing patients for either standard care or an active strategy for diagnosing PE, showing how investing more into searching for a diagnosis might not be beneficial for patients.

The physician and the community

We assume to treat every patient the same way and give everyone the same care, but is this actually happening?

Access to education, housing, food and water quality, as well as inequity in wealth distribution are among the main determinants of patients’ health and have been related to the development of several diseases. [ 65 , 66 ]. These factors must therefore be considered in the frame of preventive medicine. A conscious physician incorporates in his thinking process the needs of his community. The devastating effect of population inequities in terms of socioeconomic determinants of health was highlighted by the Sars‐Cov‐2 pandemic, with enormous differences in patient outcomes based on social status. [ 67 , 68 ]. We cannot afford anymore to ignore these discrepancies among our population of patients.

Social determinants strictly correlate with the resilience of a population in tackling health and safety challenges. In this respect, one of the biggest threats we will face in the upcoming years is the impact of climate change on global health.

The 2020 edition of the yearly Lancet Countdown report on Health and Climate Change [ 69 ] showed alarming data on the direct effects of rising temperatures, with a drastic increase in heat‐related death (+53% for people aged 65 and above in the last two decades), a rise in exposure to wildfires, aggravating heart and lung conditions [ 70 ], and the diffusion of unhealthy diets, increasing cardiovascular risk [ 71 ]. We must realize that the voice of healthcare professionals is essential in driving forward progress on climate change and realizing the health benefits of responding strongly to the issue. In this regard, we, as authors, strongly endorse the call for emergency action recently published by a large team of editors of some of the most important health journals worldwide [ 72 ].

As physicians, we must act not only as healthcare providers but also as citizens’ advocates.

How to change the way we think

Acquiring the mindset necessary to choose wisely is a learning journey where we recognize the actors in a play, share our knowledge, and act consequently. We should work to set in motion an educational process that, directly and actively, involves students, physicians, stakeholders, and the public. The discussion and acquisition of these concepts and critical thinking should start during the first years of training of medical students and trainees. Spreading these ideas to patients, and to a greater extent also to the general public, will benefit feedback and increase trust between the parts. And first and foremost, educating ourselves as physicians will allow us to transpose these conceptual cues to clinical practice, supporting more conscious and safer care.

To initiate this process, we think we should focus our educational interventions on the following issues (Table  2 ):

• rediscussing our diagnosis‐centered approach in favor of a management‐reasoning approach, including choices about treatment, follow‐up visits, further testing, and allocation of limited resources, involving patients and their personal needs in making the choice [ 70 , 73 ];
• embracing uncertainty in the healthcare profession, grasping the concept of probability of disease and threshold for treatment, and acquiring the communication skills and empathy needed to transmit these concepts to patients.
• disputing the “publish or perish” dogma, to strive for better, more reliable, patient‐centered research. We should learn and teach how to write accurately, read critically, and research conscientiously.
• accepting that anyone, with no exceptions for healthcare providers, is bound to make mistakes. We should support systems that monitor medical errors, their consequences, and near‐miss cases with the aim of developing ways to avoid the same mistake rather than punishing the actors involved [ 74 ]. This will help stop the growth of a medical class terrified of legal consequences and prone to make decisions that protect themselves from malpractice lawsuits at the expense of patient safety and resource saving [ 75 , 76 ].

Steps towards choosing wisely

These primary steps will lead to a new way of thinking that will eventually allow the physician to get an advocate role within the society, trusted by the community as observers and reporters of the population's physical and mental wellbeing. Hence, acknowledgement of social discrepancies, environmental factors, and their role on global health will then become part of the clinical reasoning and the everyday practice of the physician of tomorrow.

Conclusions

The mission of the Choosing Wisely movement is not only to raise awareness in physicians of the risks of overdiagnosis and overtreatment but also to give the opportunity to rethink the way we treat patients.

Embracing such philosophy goes through tackling of several issues, including difficulty in dealing with uncertainty and medical errors, the limits of EBM, and shifting towards patient‐centered clinical reasoning focused on management rather than on diagnosis. Physicians should regain a central role in patient management and could be leading actors in facing upcoming healthcare challenges related to environmental issues and social discrepancies.

Thinking that doing more means doing better is perhaps a comfortable, but often dangerous, momentary lapse of reason.

Conflict of interests

The authors have no conflict of interests to declare.

Author contributions

Ludovico Furlan: conceptualization; data curation; investigation; resources; writing – original draft; writing – review and editing. Pietro Di Francesco: conceptualization; data curation; investigation; resources; writing – original draft; writing – review and editing. Nicola Montano: conceptualization; investigation; project administration; resources; supervision; writing – original draft; writing – review and editing. Giorgio Costantino: conceptualization; investigation; project administration; resources; supervision; writing – original draft; writing – review and editing.

Acknowledgments

The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Open Access Funding provided by Universita degli Studi di Milano within the CRUI‐CARE Agreement. [Correction added on 11 May 2022, after first online publication: Projekt CRUI‐CARE funding statement has been added.]

Furlan L, Francesco PD, Costantino G, Montano N. Choosing Wisely in clinical practice: embracing critical thinking, striving for safer care . J Intern Med. 2022; 291 :397–407. [ PMC free article ] [ PubMed ] [ Google Scholar ]

Ludovico Furlan and Pietro Di Francesco contributed equally to this manuscript.