• Edward Krupat, Jared M Sprague, Daniel Wolpaw, Paul Haidet, David Hatem, and Bridget O'Brien.
• Center for Evaluation, Harvard Medical School, Boston, Massachusetts 02115, USA. ed_krupat@hms.harvard.edu
• Med Educ. 2011 Jun 1;45(6):625-35.

ObjectivesThe objectives of this study were to determine the extent to which clinician-educators agree on definitions of critical thinking and to determine whether their descriptions of critical thinking in clinical practice are consistent with these definitions.MethodsNinety-seven medical educators at five medical schools were surveyed. Respondents were asked to define critical thinking, to describe a clinical scenario in which critical thinking would be important, and to state the actions of a clinician in that situation who was thinking critically and those of another who was not. Qualitative content analysis was conducted to identify patterns and themes.ResultsThe definitions mostly described critical thinking as a process or an ability; a minority of respondents described it as a personal disposition. In the scenarios, however, the majority of the actions manifesting an absence of critical thinking resulted from heuristic thinking and a lack of cognitive effort, consistent with a dispositional approach, rather than a lack of ability to analyse or synthesise.ConclusionsIf we are to foster critical thinking among medical students, we must reconcile the way it is defined with the manner in which clinician-educators describe critical thinking--and its absence--in action. Such a reconciliation would include consideration of clinicians' sensitivity to complexity and their inclination to exert cognitive effort, in addition to their ability to master material and process information.© Blackwell Publishing Ltd 2011.

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