A systematic review on critical thinking in medical education

Enhancing medical students critical thinking skills through ChatGPT: An empirical study with medical students

STUDY PURPOSE

This study aims to assess the effectiveness of ChatGPT in critical thinking skills among medical students.

METHODS

This cross-sectional survey study recruited 392 medical students from three public universities in Saudi Arabia. Participants completed an online questionnaire assessing perceptions of ChatGPT's impact on critical thinking skills. Data were analyzed using SPSS, employing descriptive statistics, t-tests, analysis of variance, and Cronbach's alpha to evaluate reliability.

RESULTS

Significant gender-based differences were found in perceptions of ChatGPT's efficacy, particularly in generating diverse perspectives (P = 0.0407*) and encouraging questioning (P = 0.0277*). Reflective practice perceptions varied significantly by age (P = 0.0302*), while academic backgrounds yielded significant differences across all factors assessed (P < 0.0001*). Overall, 92.6% believed integrating ChatGPT would benefit critical thinking skills. Most participants (N = 174) strongly agreed that ChatGPT improved critical thinking.

CONCLUSION

Integrating ChatGPT into medical education could offer valuable opportunities for fostering critical thinking abilities, albeit with the need for addressing associated challenges and ensuring inclusivity.

Local experience of laboratory activities in a BS physical therapy course: integrating sEMG and kinematics technology with active learning across six cohorts

Introduction

Integrating technology and active learning methods into Laboratory activities would be a transformative educational experience to familiarize physical therapy (PT) students with STEM backgrounds and STEM-based new technologies. However, PT students struggle with technology and feel comfortable memorizing under expositive lectures. Thus, we described the difficulties, uncertainties, and advances observed by faculties on students and the perceptions about learning, satisfaction, and grades of students after implementing laboratory activities in a PT undergraduate course, which integrated surface-electromyography (sEMG) and kinematic technology combined with active learning methods.

Methods

Six cohorts of PT students (n = 482) of a second-year PT course were included. The course had expositive lectures and seven laboratory activities. Students interpreted the evidence and addressed different motor control problems related to daily life movements. The difficulties, uncertainties, and advances observed by faculties on students, as well as the students' perceptions about learning, satisfaction with the course activities, and grades of students, were described.

Results

The number of students indicating that the methodology was "always" or "almost always," promoting creative, analytical, or critical thinking was 70.5% [61.0-88.0%]. Satisfaction with the whole course was 97.0% [93.0-98.0%]. Laboratory grades were linearly associated to course grades with a regression coefficient of 0.53 and 0.43 R-squared (p < 0.001).

Conclusion

Integrating sEMG and kinematics technology with active learning into laboratory activities enhances students' engagement and understanding of human movement. This approach holds promises to improve teaching-learning processes, which were observed consistently across the cohorts of students.

Medical students' awareness of overdiagnosis and implications for preventing overdiagnosis

Overdiagnosis is a growing health issue, yet our understanding of medical students' exposure to this concept within medical education is limited. Our aim was to explore students' experience of diagnostic learning to identify how overdiagnosis may be understood by students. During in-person and online semi-structured interviews throughout 2021, we explored the education experience of twelve Western Sydney University medical students in years 3-5. Through inductive thematic analysis we identified four themes. These themes encompassed student commitment to learning about diagnosis, lack of certainty surrounding diagnosis and emotional factors of medical care, overdiagnosis as seen through the lens of high and low-value care during clinical placements and student-identified missed learning opportunities related to overdiagnosis. This study found that medical students develop inherent knowledge of overdiagnosis through an interplay of personal factors, medical school curriculum and the setting in which their training takes place. Our findings allow insight for future improvement of medical curriculum to produce exceptional medical graduates.

Emotional intelligence is more important than the learning environment in improving critical thinking

PURPOSE

To examine the association of critical thinking (CT) and emotional intelligence (EI) versus CT and learning environment (LE) in order to investigate which has the greatest influence EI or LE.

MATERIALS AND METHODS

A cross-sectional study was conducted with 340 s-year healthcare university students in two nursing and one medical schools from three universities in Greece, between October and December 2020. Critical Thinking Disposition Scale, Dundee Ready Education Environment Measure, and Trait Emotional Intelligence Questionnaire-Short Form were administered. Hierarchical multiple linear regression analysis, with five steps, was used to compare the associations of CT and EI to CT and LE.

RESULTS

Participants' mean age (years) was 20.9 (6.6 SD); 82.6% female; 86.8% studying nursing. Students mean scores were moderate to high for CT disposition (44.7 ± 4.68). The general characteristics (age, gender, and school) were not significantly associated with CT (p > 0.05). However, CT was positively associated with LE (UCB = 0.064 & p < 0.001) and EI (UCB = 1.522 & p < 0.001). Moreover, CT seems to be associated in a higher degree (R² change adj = 0.036 & p < 0.001) with emotional intelligence (UCB = 1.522) than with learning environment (UCB = 0.064).

CONCLUSIONS

Our findings suggest a different more optimal pathway for educators to improve the CT of their students through EI and not with LE as believed till now. By focusing on improving EI, educators may help their students become critical thinkers, who will provide better quality of care.

Evaluating and comparing critical thinking skills of residents of Tehran University of Medical Sciences

BACKGROUND

Today's complexities and diversity in the clinical setting have revealed the need to pay attention to strengthening critical thinking (CT) skills. The present study aimed to evaluate and compare CT skills in the residents of the Tehran University of Medical Sciences.

METHODS

This is a cross-sectional study. The study's statistical population included 284 residents in orthopedic, internal medicine, and surgery groups studying in the PGY1 to PGY4 years of residency. The data collection tool was the California Critical Thinking Skills Test (CCTST) form B. The collected data were entered into SPSS-16 software and analyzed using descriptive (mean and standard deviation) and inferential (one-way ANOVA) statistics. The significant level in all tests was considered at P < 0.05.

RESULTS

189 out of 284 residents completed and returned the questionnaire, and the response rate was 66%. The mean CT skill score of residents (M = 13.81, SD = 3.52) was lower than the optimal level (M = 17.1 SD = 5.0). Comparing the mean CT skill scores of the residents separately for the residency year revealed a significant decrease in CT scores in the 4 years. A significant difference was found between the CT skill scores in the three groups (internal medicine, general surgery, and orthopedic surgery).

CONCLUSION

The CT skills of the residents of Tehran University of Medical Sciences were generally below the optimal level. The CT score of the residents show an increase in PGY2, but a decrease in PGY3 and PGY4. Due to the emphasis of accreditation institutions, the World Federation for Medical Education, and other international educational institutions on the importance of critical thinking, it is recommended to pay more attention to the factors related to the promotion and development of CT skills in residency programs.

Effects of a curriculum integrating critical thinking on medical students’ critical thinking ability in Iran: a quasi-experimental study

PURPOSE

Improving 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.

METHODS

A 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.

RESULTS

Medical 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).

CONCLUSION

The 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.

A Systematic Review of Critical Thinking Instruments for Use in Dental Education

Critical thinking is widely recognized as an essential competency in dental education, but there is little agreement on how it should be assessed. The aim of this systematic review was to determine the availability of instruments that could be used to measure critical thinking in dental students and to evaluate psychometric evidence to support their use. In January 2017, an electronic search of both the medical and education literature was performed on nine databases. The search included both keyword and Medical Subject Heading terms for critical thinking, higher education/health sciences education, measurement/assessment, and reproducibility of results. The grey literature was included in the search. The search produced 2,977 unique records. From the title and abstract review, 183 articles were selected for further review, which resulted in 36 articles for data extraction. Ten of these studies sought to evaluate psychometric properties of the instruments used and were subjected to quality assessment. Seven assessment instruments were identified. Of these, three instruments that have not been widely used nor tested in health professions students showed evidence of psychometric strength and appeared to have potential for use in dental education. Further research should focus on the three critical thinking instruments with strong psychometric evidence, with the aim of establishing validity and reliability in the context of dental education.