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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