• David Ross, Michelle Morros, and Efrem Violato.
• Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
• Fam Med. 2020 Oct 1; 52 (9): 635-641.

Background And ObjectivesCritical thinking (CT) skills are an important aspect of clinical reasoning and diagnosis. The goals of this study were to (1) examine levels of CT skills of practicing family physicians, (2) compare the CT skills of practicing family physicians to family medicine residents, and (3) identify individual variables and practice characteristics predictive of CT skills. .MethodsWe used a population-based, cross-sectional design to compare practicing and resident family physicians and examine the predictors of CT skills in practicing family physicians. Sixty-two practicing family physicians were recruited across Canada. We used data from 59 family medicine residents at a single institution in Canada. We used the California Critical Thinking Skills Test (CCTST) to measure CT skills. We analyzed data using descriptive and univariate analysis, multivariate analysis of variance, and hierarchical multiple linear regression. CT skills were further examined in follow-up analysis using polynomial regression.ResultsResidents performed better than practicing physicians on nearly all aspects of CT (P<.005). Age was the strongest predictor of CT skills in practicing physicians (P<.005); CT skills declined with age as a quadratic function (P<.005).ConclusionsAs a group, practicing family physicians exhibited lower scores on the CCTST compared to family medicine residents. CT skills showed a decline with age, accelerating after approximately age 60 years. The results of the study have implications for continuing education and assessment of physicians' clinical skills. Further research is required to better understand what other predictors may be important for CT skills of practicing family physicians.

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