Critical thinking in clinical medicine: what is it?

被引:19
作者
Gupta, Mona [1 ,2 ]
Upshur, Ross [3 ]
机构
[1] Univ Montreal, Dept Psychiat, Montreal, PQ H3C 3J7, Canada
[2] Univ Montreal Hosp Ctr, Montreal, PQ, Canada
[3] Univ Toronto, Dept Family & Community Med, Toronto, ON M5S 1A1, Canada
关键词
courage; critical appraisal; critical reasoning; critical thinking; epistemic virtues; virtue theory;
D O I
10.1111/j.1365-2753.2012.01897.x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
100404 [儿少卫生与妇幼保健学];
摘要
In this paper, we explore the recent emphasis, in various medical contexts, of the term critical or the notion of being critical. We identify various definitions of being critical and note that they differ strikingly. What are these different uses of the term trying to capture that is important in clinical medicine and medical education? We have analysed these qualities as responsibilist, epistemic virtues. We believe that a virtues approach is best able to make sense of the non-cognitive elements of being critical, such as the honesty and courage to question claims in the face of persuasion, authority or social pressure. Medical educators and professional bodies seem to agree that being critical is important and desirable. Yet, it is unclear how this quality can be optimally fostered and balanced with the constraints that act upon individual practitioners in the context of institutional medicine including professional standards and the demands of the doctorpatient relationship. Other constraints such as authoritarianism, intimidation and financial pressures may act against the expression of being critical or even the cultivation of critical thinking. The issue of the constraints on critical thinking and the potential hazards it entails will require further consideration by those who encourage being critical in medicine.
引用
收藏
页码:938 / 944
页数:7
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