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Critical Thinking in Clinical Practice Improving the Quality of Judgments and Decisions pdf

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  • Critical Thinking in Clinical Practice: Improving the Quality of Judgments and Decisions

    • Contents

    • Preface

    • PART I: LAY OF THE LAND

      • Chapter 1: The Need for Critical Thinking in Clinical Practice

        • THE IMPORTANCE OF THINKING CRITICALLY ABOUT DECISIONS

        • HALLMARKS OF CRITICAL THINKING

        • BARRIERS TO MAKING SOUND JUDGMENTS

        • CLINICAL REASONING AS A TEACHABLE SKILL

        • THE COSTS AND BENEFITS OF CRITICAL THINKING

        • HOW SKEPTICAL SHOULD CLINICIANS BE?

        • SUMMARY

      • Chapter 2: Sources of Influence on Decisions That Clinicians Make

        • CHANGING VIEWS OF PROBLEMS AND THEIR PREVALENCE

        • POLITICAL, ECONOMIC, AND SOCIAL INFLUENCES ON PROBLEM DEFINITIONS AND PROPOSED REMEDIES

        • THE INFLUENCE OF AGENCY VARIABLES

        • TECHNOLOGY DEVELOPMENT

        • THE INTERACTION BETWEEN CLIENTS AND CLINICIANS

        • PSYCHOLOGICAL FACTORS THAT INFLUENCE CLINICAL JUDGMENTS

        • SUMMARY

      • Chapter 3: Reasons and Reasoning: The Heart of Making Decisions

        • VIEWS OF INTELLECTUAL COMPETENCE

        • REASONS

        • SOME HELPFUL DISTINCTIONS

        • ARGUMENTS

        • ANALYZING ARGUMENTS

        • KINDS OF ARGUMENTS

        • EXPLANATIONS

        • INDIVIDUAL AND CULTURAL DIFFERENCES

        • SUMMARY

      • Chapter 4: Different Views of Knowledge and How to Get It: Exploring Your Personal Epistemology

        • DIFFERENT VIEWS OF KNOWLEDGE AND HOW (OR IF) IT CAN BE GAINED

        • EVALUATING KNOWLEDGE CLAIMS

        • AVOIDING HARMING IN THE NAME OF HELPING

        • QUESTIONABLE CRITERIA

        • SCIENCE AND SCIENTIFIC CRITERIA

        • THE DIFFERENCE BETWEEN SCIENCE AND PSEUDOSCIENCE

        • ANTISCIENCE

        • QUACKERY

        • PROPAGANDA

        • FRAUD

        • KNOWLEDGE VALUED IN EVIDENCE-BASED PRACTICE

        • KNOWLEDGE VALUED IN AUTHORITY-BASED PRACTICE

        • CRITICAL APPRAISAL OF PRACTICES AND POLICIES AS AN ETHICAL OBLIGATION

        • THE BURDEN OF KNOWLEDGE

        • SUMMARY

        • GLOSSARY

    • PART II: COMMON SOURCES OF ERROR

      • Chapter 5: The Influence of Language and Persuasion Strategies

        • THE INFLUENCE OF LANGUAGE

        • FALLACIES RELATED TO LANGUAGE

        • THE INFLUENCE OF SOCIAL PSYCHOLOGICAL PERSUASION STRATEGIES

        • SUMMARY

      • Chapter 6: Formal and Informal Fallacies: Mistakes in Thinking and How to Avoid Them

        • FALSE EVEN THOUGH VALID

        • IRRELEVANT APPEALS

        • EVADING THE FACTS

        • OVERLOOKING THE FACTS

        • DISTORTING FACTS/POSITIONS

        • DIVERSIONS

        • THE USE OF CONFUSION

        • SUMMARY

        • A CATALOG OF FAULTY INFERENCES

      • Chapter 7: Classification, Pseudoauthority, and Focusing on Pathology

        • FALLACIES RELATED TO CLASSIFICATION

        • APPEALS TO PSEUDOAUTHORITY

        • FALLACIES RELATED TO A PATHOLOGICAL SET

        • THE RULE OF OPTIMISM

        • SUMMARY

    • PART III: DECISION AIDS

      • Chapter 8: Content and Procedural Knowledge

        • IS KNOWLEDGE IMPORTANT IN THE INTERPERSONAL HELPING PROFESSIONS?

        • DIFFERENCES BETWEEN NOVICES AND EXPERTS

        • WHAT COMPETENCIES CONTRIBUTE TO SUCCESS?

        • HOW SHOULD WE ASSESS PROFESSIONAL COMPETENCE?

        • TO KEEP UP-TO-DATE OR NOT

        • DECIDING WHAT INFORMATION TO SEEK AND WHERE TO SEEK IT

        • ACTIVE VERSUS PASSIVE LEARNING

        • REMEMBERING WHAT WE READ

        • PROBLEM-BASED LEARNING

        • BECOMING A LIFELONG LEARNER

        • THE INFLUENCE OF PROFESSIONAL EDUCATION PROGRAMS

        • SUMMARY

      • Chapter 9: Taking Advantage of Research on Judgment, Problem Solving, and Decision Making

        • PROBLEM SOLVING IS UNCERTAIN

        • SITUATIONS CHANGE

        • STRUCTURING PROBLEMS IS A CRITICAL PHASE

        • OUR GOALS AND CONFLICTS AMONG THEM INFLUENCE OUR SUCCESS

        • OUR AFFECTIVE REACTIONS INFLUENCE DECISIONS

        • TASK DEMANDS INFLUENCE DECISIONS

        • SITUATION AWARENESS IS VITAL

        • CONFIRMATION BIASES ABOUND: PARTIALITY IN THE USE OF EVIDENCE

        • WE USE SIMPLIFYING STRATEGIES (HEURISTICS)

        • AVAILABILITY

        • REPRESENTATIVE THINKING: MISUSE OF RESEMBLANCE CRITERIA

        • MEMORY AS RECONSTRUCTIVE

        • MANY INFLUENCES LIE OUTSIDE OUR AWARENESS

        • THERE ARE DIFFERENT DECISION-MAKING STYLES

        • CREATIVITY AND INTUITION PLAY AN IMPORTANT ROLE

        • DOMAIN-SPECIFIC KNOWLEDGE AND SKILLS ARE IMPORTANT

        • WE TEND TO MAKE CERTAIN KINDS OF ERRORS

        • WE CAN LEARN THROUGH OUR MISTAKES

        • FAILURES ARE INEVITABLE

        • PERSPECTIVE MAKES A DIFFERENCE: SELF VERSUS OTHERS

        • THERE ARE CULTURAL DIFFERENCES

        • SELF-IMPOSED BARRIERS

        • WE CAN LEARN TO BECOME BETTER DECISION MAKERS

        • SUMMARY

      • Chapter 10: Evidence-Based Practice: A Philosophy and Process for Thinking Ethically and Critically about Decisions

        • ORIGINS OF EVIDENCE-BASED DECISION MAKING

        • HALLMARKS AND IMPLICATIONS OF THE PHILOSOPHY OF EVIDENCE-BASED PRACTICE AND CARE

        • ALTERNATIVES TO EVIDENCE-BASED PRACTICE

        • OBJECTIONS TO EVIDENCE-BASED PRACTICE, AND COUNTERARGUMENTS

        • CONTROVERSIES REGARDING EVIDENCE

        • SUMMARY

      • Chapter 11: Posing Questions and Searching for Answers

        • POSING WELL-STRUCTURED, ANSWERABLE QUESTIONS RELATED TO PRACTICE DECISIONS

        • SEARCHING EFFECTIVELY AND EFFICIENTLY FOR PRACTICE-AND POLICY-RELATED RESEARCH FINDINGS

        • CRITICALLY APPRAISING WHAT YOU FIND

        • USING CLINICAL EXPERTISE TO INTEGRATE EXTERNAL RESEARCH FINDINGS WITH OTHER RELEVANT INFORMATION AND APPLYING THE FINDINGS

        • EVALUATING AND LEARNING FROM WHAT HAPPENS

        • EVALUATING YOUR SKILLS IN EVIDENCE-BASED PRACTICE

        • THE QUESTION OF MOTIVATION

        • SUMMARY

      • Chapter 12: Critical Appraisal of Practice-Related Research: The Need for Skepticism

        • COMMON MYTHS THAT HINDER CRITICAL APPRAISAL

        • THE QUESTION OF BIAS

        • QUESTIONS TO ASK ABOUT RESEARCH

        • LEVELS OF EVIDENCE

        • QUESTIONS ABOUT EFFECTIVENESS, HARM, AND PREVENTION

        • SYSTEMATIC REVIEWS AND META-ANALYSES

        • QUESTIONS ABOUT PREVALENCE AND INCIDENCE (FREQUENCY AND RATE)

        • QUESTIONS ABOUT CAUSES

        • QUESTIONS ABOUT DIAGNOSIS AND SCREENING

        • QUESTIONS CONCERNING PROGNOSIS, RISK, AND PROTECTIVE FACTORS (PREDICTION)

        • QUESTIONS ABOUT PRACTICE GUIDELINES

        • CONTROVERSIAL ISSUES

        • OBSTACLES

        • SUMMARY

    • PART IV: APPLYING CRITICAL THINKING SKILLS TO CLINICAL DECISIONS

      • Chapter 13: Making Decisions about Data Collection

        • FACTORS THAT INFLUENCE WHAT CLINICIANS SEE AND REPORT

        • DIFFERENT KINDS OF EVIDENCE

        • NOT FOR RESEARCHERS ALONE: CONCERNS ABOUT RELIABILITY AND VALIDITY

        • QUESTIONABLE ASSESSMENT METHODS

        • SOURCES OF DATA

        • WEIGHING THE VALUE OF DATA

        • RECORDING AND STORING INFORMATION

        • SUMMARY

      • Chapter 14: Discovering Causes of Clients’ Problems: Common Biases

        • DIFFERENT PRACTICE PERSPECTIVES EMPHASIZE DIFFERENT CAUSES

        • ASSESSING COVARIATIONS

        • CAUSAL ANALYSIS

        • SOURCES OF ERROR

        • A DISPOSITIONAL BIAS

        • USE AND MISUSE OF INTUITION

        • IMPROVING THE ACCURACY OF CAUSAL ASSUMPTIONS

        • SUMMARY

      • Chapter 15: Predictions about Clients and Treatment Effectiveness: Improving the Odds

        • CASE WORKER’S REPORT

        • ACTUARIAL VERSUS CLINICAL JUDGMENT

        • PREDICTION, CHOICE, AND PROBABILITY

        • CHALLENGES IN ASSESSING RISK

        • USING TEST RESULTS

        • OVERVIEW OF SOURCES OF ERROR

        • INCREASING THE ACCURACY OF PREDICTIONS

        • SUMMARY

      • Chapter 16: Enhancing the Quality of Case Conferences, Team Meetings, and Organizational Culture

        • CHARACTERISTICS OF CASE CONFERENCES THAT DECREASE THE QUALITY OF DECISIONS

        • CHEAP SHOTS

        • WHY IS THE QUALITY OF DISCUSSION IN CASE CONFERENCES OFTEN POOR?

        • DENUNCIATIONS AND PITCHES

        • AN EXAMPLE OF A CASE CONFERENCE

        • ENHANCING THE QUALITY OF CASE CONFERENCES AND TEAM MEETINGS

        • THE INFLUENCE OF ORGANIZATION CULTURE AND CLIMATE

        • SUMMARY

    • PART V: THE FUTURE

      • Chapter 17: Overcoming Personal Obstacles to Critical Thinking

        • ENCOURAGE VALUES COMPATIBLE WITH ETHICAL OBLIGATIONS TO CLIENTS

        • CHANGE A PREFERENCE FOR MYSTERY TO ONE FOR BEING WELL INFORMED

        • OFFER CLIENTS THE SAME QUALITY OF SERVICES YOU WOULD LIKE

        • REVIEW COMPROMISES AND RECOGNIZE SIGNS OF DEPLETION

        • INCREASE EFFECTIVE REACTIONS TO UNCERTAINTY AND AMBIGUITY

        • ACQUIRE FACILITATING VIEWS ABOUT KNOWLEDGE AND HOW TO GET IT

        • IMPROVE SELF-MANAGEMENT SKILLS

        • INCREASE RELATIONSHIP SKILLS

        • DECREASE UNREALISTIC EXPECTATIONS

        • AVOID SELF-HANDICAPPING REACTIONS AND DEVELOP POSITIVE ALTERNATIVES

        • WHAT ABOUT SELF-EFFICACY AND SELF-ESTEEM?

        • EXAMINE RATIONALIZATIONS/EXCUSES

        • EXCUSES AND SELF-DECEPTION

        • SUMMARY

      • Chapter 18: Maintaining Critical Thinking Skills

        • GENERALIZING AND MAINTAINING CRITICAL THINKING SKILLS

        • REVIEW PREFERRED PRACTICE THEORIES

        • TAKE OCCASIONAL TIME-OUTS TO REFLECT ON YOUR WORK

        • SUMMARY

    • Author Index

    • Subject Index

    • About the Author

Nội dung

Critical Thinking in Clinical Practice Improving the Quality of Judgments and Decisions Second Edition Eileen Gambrill John Wiley & Sons, Inc. [...]... are pertinent to critical thinking and evidence-based practice in clinical practice and to draw these together in a format that makes sense to clinicians and that can be used to enhance the quality of practice It does not attempt to offer incisive reviews of the many fields that are touched on here as they relate to clinical decision making The teaching of thinking is as old as philosophy itself, and entire... shown in Exhibit 1.5 Critical thinking involves using related knowledge and skills in everyday life and acting on the results (Paul, 1993) It requires flexibility and a keen interest in discovering mistakes in our thinking Truth (accuracy) is valued over “winning” or social approval Values and attitudes related to critical thinking include openmindedness, an interest in and respect 14 Lay of the Land... Progress and increases in critical thinking in clinical practice include the invention of the systematic review and the process and philosophy of evidence-based practice and policy in medicine and health care and its spread to other professions (Gambrill, 2006; Gibbs, 2003; Gray, 2001a; Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000) There has been greater attention to pseudoscience and fads in the. .. fragmentary, and theory must be used to fill in the gaps Other errors result from ignorance on the part of individual clinicians— The Need for Critical Thinking in Clinical Practice 9 Exhibit 1.4 Examples of Types of Errors in Medicine Diagnostic Error or delay in diagnosis Failure to employ indicated tests Use of outmoded tests of therapy Failure to act on results of monitoring or testing Treatment Error in the. .. Internet is Preface xi both a source of accurate information and bogus claims and quackery It is perhaps this very growth and the absurdity of some of the claims and the revelations of fraud and the play of special interests that do not match those of clients (e.g., harming in the name of helping) that has resulted in the greater attention to propaganda, harm, and fraud in the helping professions—including... analysis, and fairminded versus deceptive practices Both value transparency (honesty) concerning what is done to what effect, including candid description of lack of knowledge (uncertainty and ignorance) Consider the statement by the editor of the British Medical Journal: The Need for Critical Thinking in Clinical Practice 13 The history of medicine is mostly a history of ineffective and often dangerous... illustrated by use of the term “evidence-based” without the substance (e.g., misrepresenting the philosophy and evolving technology of EBP, in ated claims of effectiveness, and not involving clients as informed participants; Gambrill, 2003a) RELATED VALUES, ATTITUDES, AND STYLES Critical thinking is independent thinking thinking for yourself Critical thinkers question what others view as self-evident They ask:... decision-making processes in case conferences provided a supplement to studies of clinical decision making by individuals Research and theory in the area of teaching people how to think more critically were also of value WHAT’S NEW AND WHAT’S NOT OVER THE PAST 15 YEARS The past years since the publication of the first edition are a fascinating mix of progress and challenges These are described in this book... well as the funders of the Hutto Patterson Chair in Child and Family Studies I extend a special note of appreciation to Sharon Ikami for her word-processing support and consistent warmth and good will And, warm thanks to Gail Bigelow for her support and encouragement PA R T I LAY OF THE LAND CHAPTER 1 The Need for Critical Thinking in Clinical Practice D ecision making is at the heart of clinical practice. .. result in misleading clients because of premature acceptance of faulty assumptions Reasoning is at the heart of clinical decision making—forming hypotheses about presenting concerns, gathering data to evaluate the accuracy of different views, offering arguments for assumptions, and evaluating the quality of these arguments Chapter 3 provides an overview of different kinds of reasons (for example, hot and . Progress and in- creases in critical thinking in clinical practice include the invention of the sys- tematic review and the process and philosophy of evidence-based practice and policy in medicine and. w2 h6" alt="" Critical Thinking in Clinical Practice

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