Abstract

PurposeImproving physicians’ critical thinking abilities could have meaningful impacts on various aspects of routine medical practice, such as choosing treatment plans, making an accurate diagnosis, and reducing medical errors. The present study aimed to measure the effects of a curriculum integrating critical thinking on medical students’ skills at Tehran University of Medical Sciences, Iran.MethodsA 1-group pre-test, post-test quasi-experimental design was used to assess medical students’ critical thinking abilities as they progressed from the first week of medical school to middle of the third year of the undergraduate medical curriculum. Fifty-six participants completed the California Critical Thinking Skills Test twice from 2016 to 2019.ResultsMedical students were asked to complete the California Critical Thinking Skills Test the week before their first educational session. The post-test was conducted 6 weeks after the 2 and half-year program. Out of 91 medical students with a mean age of 20±2.8 years who initially participated in the study, 56 completed both the pre- and post-tests. The response rate of this study was 61.5%. The analysis subscale showed the largest change. Significant changes were found in the analysis (P=0.03), evaluation (P=0.04), and inductive reasoning (P<0.0001) subscales, but not in the inference (P=0.28), and deductive reasoning (P=0.42) subscales. There was no significant difference according to gender (P=0.77).ConclusionThe findings of this study show that a critical thinking program had a substantial effect on medical students’ analysis, inductive reasoning, and evaluation skills, but negligible effects on their inference and deductive reasoning scores.

Highlights

  • Critical thinking is described as the ability to pose a discriminating question in order to search for better ideas or to find better solutions [1]

  • The research questions were as follows: first, is there a significant change in the medical students’ critical thinking abilities as they progress from the first week of medical school to the third year of the undergraduate medical curriculum?; second, which critical thinking skills improve as students progress through the curriculum; and third, are there differences according to gender in critical www.jeehp.org thinking before and after the program?

  • Interpretation The results of this study suggest that medical students have a meaningful ability to acquire critical thinking skills and that their critical thinking skills improve after delivery of direct instruction, despite relatively low scores in some critical thinking subscales

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Summary

Introduction

Background Critical thinking is described as the ability to pose a discriminating question in order to search for better ideas or to find better solutions [1]. Critical thinking ability is strongly correlated with clinical competence and academic success [3]. Evidence shows that clinical clerkships and other forms of clinical experience provide the opportunity to enhance critical thinking through observation of more senior clinicians and gaining experience, but the impact of such experiences is insufficient [4]. Medical schools are placing a major priority on assessing critical thinking, improving this ability using specialized teaching techniques, and providing sufficient educational opportunities [5]. The inadequacy of these methods has led to curricular reforms in an attempt to add critical thinking to all levels of education. Medical school instructors should be well versed in models of argument and should regularly encourage their students to engage in discussions during daily rounds, morbidity and mortality conferences, and any other teaching sites

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