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Critical Thinking > Week 1 > Flashcards

Week 1 Flashcards

1
Q

Define Problem Solving

A
  • Working through the problem to find a solution
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2
Q

Define Clinical Reasoning

A
  • Process during which we structure meanin, goals and health management strategies based on clinical data, pt preferences and values, knowledge and professional judgement
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3
Q

Deine Clinical Judgement

A
  • Application of information based on actual observation of a pt combined with subjective and objective data that lead to a conclusion
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4
Q

Define Critical Thinking

A
  • Clarifies goals, examines assumptions, uncovers hidden values, evaluates evidence, accomplishes actions and assess conclusions
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5
Q

Define Clinical Decision Making

A
  • Complexprocessinvolvingobservation,information processing, critical thinking, evaluating evidence, applying relevant knowledge, problem solving skills, reflection and clinical judgement to select the best course of action
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6
Q

What are the three decision making theories

A
  • Normative models
  • Descriptive model
  • Prescriptive model
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7
Q

What is a Normative Model

A
  • The analysis of individual decisions, using logic, rationality, scientific evidence based decisions: eg clinical trials testing drug efficacy or ‘normal range’ SpO2 reading to minimize judgement error of physiological processes

What theory dictates people should do when making a decision

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8
Q

What is a Descriptive Model

A
  • Examines how people make decisions in reality when choosing the options available to them

What people actually do when making a decision

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9
Q

What is a Prescriptive Model

A
  • A combination of the theoretical aspect of normative theory and observations of descriptive theory. Provides a practical aid to decision making, whilst aspiring to rationality: eg. Frameworks, guidelines, algorithms designed to improve specific decision tasks

What people should/can do when making a decision

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10
Q

How do we explain decision making

A
  • Combination of experience, knowledge, expertise of others, research and available
    evidence
  • Numerous frameworks and models used to explain the process of decision making with many overlapping themes.
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11
Q

What are the two opposing conceptual frameworks underpinning decision making

A
  • The intuitive framework (also known as inductive framework (Hamm, 1988) Data is collected and leads to generation of a hypothesis
  • The analytical framework (also known as deductive framework) Hypotheses are used to predict the presence/absence of data to confirm/deny hypotheses
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12
Q

What is Intuition

A
  • Understanding without rationale’ (Benner and Tanner 1987)
  • An irrational act
  • Guessing
  • Unfounded knowledge
  • Supernatural inspiration Hunches Non-conscious process
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13
Q

What are the FIve Levels of the Benners Model and the explanations

A
  • Novice = No experience Need rules
  • Advanced Beginner = Demonstrate acceptable behaviour Principle- based
  • Competant = Same role 2-3 years Deliberate planning
  • Proficiant = Whole situations Holistic under standing
  • Expert = Intuitive grasp Deep under standing
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14
Q

What are the 6 parts of the Dreyfus skill acquisition

A

-1. Patternrecognition
2. Similarityrecognition
3. Commonsenseunderstanding 4. Skilledknow-how
5. Senseofsalience
6. Deliberativerationality


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15
Q

Explain Similarity Recognitionin the Dreyfus Model

A
  • Awareness that this patient
    reminds you of a similar patient
  • Sets up conditions for recognising dissimilarities as well
  • This is despite objective features of past & current situations
  • Helps the expert select the most relevant patients for comparison
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16
Q

Explain Common Sense Understanding in the Dreyfus Model

A
  • Basis for understanding the illness experience in contrast to knowing the disease
  • A deep grasp of the culture & language
  • Allows flexible understanding in diverse situations
  • The language of illness is a human language with emotions & lived experiences.
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17
Q

Explain Skilled know-how in the Dreyfus Model

A
  • Two kinds of knowledge
    Polanyi (1974) & Kuhn (1962)
  • ‘Knowing how’
    Practical knowledge -
    learnt through skilled practice
    Body taking over a skill e.g. how do you ride a bike?
  • ‘Knowing that’
    Theoretical knowledge
  • Tacit knowledge
    Meerabeau (1992)
    Describes the expert knowledge
    that professionals use, but find difficult to articulate
  • Technical Rationality
    Schon (1983)
    Professional knowledge underpinned by rigorous application of scientific theory & technique
18
Q

Explain Sense of salience in the Dreyfus Model

A
  • Certain events or details stand out as more or less important
  • In formal models of judgement, sense of salience is replaced by checklists
  • Innate sense of what is happening around you
  • ‘Insider’ knowledge
  • Expert appraisal allowing
    flexibility
19
Q

Explain Deliberative Rationality in the Dreyfus Model

A
  • The expert practitioner has learnt to expect certain events & selectively attend to certain aspects of the situation
  • A means of clarifying the current perspective by considering how your interpretation of a situation would change if your perspective were changed
20
Q

Explain Pattern Recognition in the Dreyfus Model

A
  • Perceptual ability to recognise relationships without pre-specifying the components of a situation
  • Patients present patterns of responses that expert practitioners learn to recognise
  • Novices may require a list of features to identify patterns
  • Recognition of subtle variations in the pattern
21
Q

What are the two Analytical Frameworks

A
  • The Hypothetic-Deductive Framework

- Cognitive Continuum Framework

22
Q

Define the The Hypothetic-Deductive Framework

A
  1. Cue acquisition – gathering information/clinical data
  2. Hypothesis generation – Differential diagnoses
  3. Cue interpretation – diagnostic testing/observations/history to confirm/refute diagnoses
  4. Hypothesis evaluation – weighing up pros and cons, choosing evidence based interventions
23
Q

Define the Cognitive Continuum Framework

A
  • Matches cognitive tasks to the decisions and the clinicians competence
  • This is based on all theories and models have different strengths and weaknesses
  • Different decisions need different
    approaches, so joined together intuition/experimental and analytical/rational to form the cognitive continuum
24
Q

What can help the decision making process

A
  • Protocols – rigid directions….
  • Clinical Guidelines – UK Ambulance Services Clinical Practice Guidelines, NICE guidelines, UK Resuscitation Council – best practice, evidence based
  • Algorithms – developed from research evidence and patient data
  • Decision matrix – quantitative tool to rank/score options using set criteria to gain a total score – SADS score, APGAR, GCS . Can still remain subjective
25
Q

How could we become better decision makers

A
  • Maintain desirable attributes
  • Inquisitiveness
  • Be well informed
  • Stay current – CPD
  • Be open minded
  • Ask for feedback
  • Develop communication skills Use available decision matrices
26
Q

What are the factors that effect decision making

A
  • Confirmation bias
  •  Optimism bias
  •  Anchoring
- Information bias

- Selective perception

- Hindsight bias
  • Belief/behavioural bias
27
Q

Define Confirmation Bias

A
  • misinterpretation of data to suit the decision maker
28
Q

Define Optimisim Bias

A
  • being over optimistic about what will happen as a result of decision
29
Q

Define Anchoring

A
  • relying heavily on a single piece of information
30
Q

Define Information Bias

A
  • seeking too much data which ‘swamps’ the decision process
31
Q

Define Selective Perception

A
  • giving undue/higher importance to data that supports own views
32
Q

Define Hindsight Bias

A
  • using hindsight knowledge of previous events to assign higher weight to those same outcomes in future events
33
Q

Define Behavioural / Beliefs bias

A
  • making decisions whilst being influenced by underlying beliefs
34
Q

What are Lewins Leadership Styles

A
  • Autocratic (authoritarian) leaders
  • Democratic (participative) leaders
  • Laissez faire (delgative) leaders
35
Q

Define what a Autocratic Leader is, with the pros and cons of this style

A
  • Make decisions without consulting their team members
  • Useful if quick decisions are needed or team members don’t/can’t have full picture.
  • Ignores team expertise/opinion.
  • Can be demoralizing
36
Q

Define what a Democratic Leader is, with pros and cons of this style

A
  • Make final decisions, but take input from team members
  • Encourages creativity, and job satisfaction.
  • Sense of being valued.
  • Not always effective when a quick decision is required
37
Q

Define what a Laissez Faire leader is, with the pros and cons of this style

A
  • Give team members freedom in how they complete work and set own deadlines
  • Provides support with resources and advice, but otherwise don’t get too involved.
  • Autonomy can be damaging to those who do not manage their time well, or do not have knowledge/experience to work effectively
38
Q

Why do we need Clinical Leadership at Organisational Level

A
  • Adapting to change (e.g. new ways of working)
  •  Thriving from change (e.g. new roles)
  •  Coping in an ever changing environment of paramedic practice
39
Q

Why do we need clinical leadership at Individual Level

A
  • Personal development (e.g. career development, progression, financial reward)
  •  New knowledge (e.g. academic awards)
  •  New skills (e.g. skills enhancement, evidence based practice)
40
Q

Why do we need clinical leadership at Patient level

A
  • Greater responsiveness to patient needs
  •  Improved ability to meet patient needs (e.g. user groups)
  •  Increasing use of expert patients)
41
Q

Definition of Human Factors

A
  • Definition - refer to environmental, organisational and job factors, and human and individual characteristics, which influence behaviour at work in a way which can affect health and safety (Health and Safety Executive 2015)

Critical Thinking (4 decks)

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