Tutorial: critical thinking

What is critical thinking?

• Group brainstorm session with educator scribing onto whiteboard

‘Critical thinking represents the rational thought processes that underlies problem-solving and decision-making’

Lipe & Beasley (2004)

• Developing the skills of analysing and interpreting information, and the use of rational thinking in clinical practice is important.

• Dietitians need to demonstrate an appropriate level of critical thinking in their clinical judgements to be deemed entry level competence

Important skills in critical thinking

• Interpretation• Analysis• Evaluation• Inference• Explanation• Self-regulation

Case Study• Mrs P R is a 45 year old overweight woman 4 weeks post abdominoplasty

(fleur-de-lis procedure). Prior to surgery she was in excellent health, despite her obesity. She presents as tanned, well groomed and well nourished. She has just returned from a trip to Japan where she accompanied her husband on a business trip.

• Mrs P R began to feel hot and sticky about 10 days post-operatively and was re-admitted for investigation of pyrexia. Following examination by the plastic surgeon, the abdominoplasty was found to be grossly infected. The wound was drained and then debrided. The patient’s wound remained weepy for some time; her haemoglobin and potassium concentration were low. She was given iron sulphate therapy. Her appetite was poor. She tested positive for Staphylococcus aureus. Her current weight is 75kg and she is 5ft 2in tall.

• (taken from Clinical cases in dietetics- Fred Pender)

Adopting an analytical approach to cases: a stepwise approach to problem solving

• read through all the information and clarify any unfamiliar terminology or information

• get the key information – identify significant data provided in the case• brainstorm – explore the case, identify key issues thought to contribute to solve

the case• resources – eg; CPG, reference data• plan – make a preliminary judgement about the case and devise a treatment plan• defend the judgement – confirm the initial judgement using appropriate evidence

and reference criteria• Communicate the judgement – decide on the most appropriate method to record

the solution eg; care plan, prescribed notation unless otherwise directed? (IDNT-PES)

• Reflection – consider the process and how near you got to most points given in teh commentary on the case. What issues did it raise? Put together an action plan to improve your problem-solving or case-related skills.

Outcomes

• Observations• Main issues• priorities• Conclusions• Plans

Re-cap of areas covered

Study concepts: • post-surgical trauma and infection• fluid balance• nutritional intakes and wound healing• nutritional requirements influenced by presence of

obesity and infection• anaemiaStudy context:• wound healing complicated by persistent infection• obesity

Concept map