Critical thinking or Common sense?

[Lithium]

Alright, I'll make this short and sweet.

In most every paramedic program and textbook, they mention that paramedics must develop a sense of 'critical thinking'. This is supposedly what seperates a medic from the general population (EMR, EMT-B, bystanders, firefighters etc etc).

My question to all of you is, is it really critical thinking, or (playing devils advocate) is that just a term coined by schools so they can teach someone how to think using common sense?

(still play devils advocate) Most of what we do in EMS, I would argue doesn't require much 'critical thinking', and usually your local protocols will be applied. (ie. a diabetic who is unresponsive with a low blood sugar ... hmmm, well, let's just get their sugar up with some D50!) Most protocols designate when you can and can't do something, how much of it you can do and how often you can do it. Again, not much thinking involved, just a matter of knowing what the 'book' says. I'll admit, this is where it comes tricky, as I do realise there are a lot of "protocol medics' out there, but that isn't what this thread is about.

To me, it seems the only patients that would seem to require critical thinking, are those who are indeed 'critical'. (about to code, circling the drain, whatever your preferred term is). These patients are the ones who require the most help, but you need to be careful what you do.

Thoughts and feelings?

peace

[becksdad]

I always took "critical thinking" to be common sense applied to knowledge gained.

[Medic2588]

While I wouldn't agree the patients in need of critical thinking are "critical" patients, I do think more paramedics need to understand critical thinking. A great book to challenge the way you think is Morgan Jones' "The Thinker's Toolkit." It explains why we think the way we do and challenges the reader to look at many of the fallacies that we use in everyday decision making.

The patients most in need of critical thinking would be those patients that we automatically assume we know what the problem is. 1+1 doesn't always equal 2 in EMS. Ever been completely blindsided during a call? If you look back at the circumstances surrounding the call, you'll probably pick up on something you might have missed because you were lulled into thinking you knew exactly what the problem was. Usually this occurs with the patients who are complaining of the same routine complaints we always see and we've been prejudiced into thinking X complaints = Y diagnosis.

Interesting topic. I would definitely suggest picking up Jones' book! And since you're on Amazon anyway, click over and pick up my books too!

Devin

[AZCEP]

Critical thinking is what you use when the protocols fail to provide an answer for your situation.

How many "62 year old male, fall between the toilet and the tub" protocols have you seen? Are you just going to grab the patient, and pull them to where you can apply a device that is in a protocol? Or will you think about how to limit pain, control the movement, and make the patient more comfortable while you are doing it?

[tniuqs]

While I wouldn't agree the patients in need of critical thinking are "critical" patients, I do think more paramedics need to understand critical thinking. A great book to challenge the way you think is Morgan Jones' "The Thinker's Toolkit." It explains why we think the way we do and challenges the reader to look at many of the fallacies that we use in everyday decision making.

The patients most in need of critical thinking would be those patients that we automatically assume we know what the problem is. 1+1 doesn't always equal 2 in EMS. Ever been completely blindsided during a call? If you look back at the circumstances surrounding the call, you'll probably pick up on something you might have missed because you were lulled into thinking you knew exactly what the problem was. Usually this occurs with the patients who are complaining of the same routine complaints we always see and we've been prejudiced into thinking X complaints = Y diagnosis.

Interesting topic. I would definitely suggest picking up Jones' book! And since you're on Amazon anyway, click over and pick up my books too!

Devin

Very interesting topic here Lithium:

So here is my .0181 (USD) cents.....Critical Thinking can not be taught persay but protocol medical treatment can as this a matter of wrote memory skills and is sequential in nature compiled by..... Critical thinkers. The protocols are just guidelines and not a cook book recipe book but in saying so they are the foundation for the educational process(s). In fact in services that I work for it is essential to myself that a "deviation from protocol" is included in the guidelines, bit of irony? You say but protocols cannot ever include all of the variables that we observe in the field, we are applied sciences not TECHs. Don't get me going here..... At the present time it is the only means to train an individual, and the bar in which to judge as well. This is an attempt taking the good with the bad to teach with a common sense approach to emergency medical care.

A perfect example would be life threating haemorrhage of lower extremity in a entrapped patient......a critical thinker may go straight to a tourniquet because if one applies direct pressure, the helper is in the damn way and delaying extrication (maybe not the best example but it is all I can think of before coffee is brewed)

I have spent many a day or rotation with students EMTs, Paramedics, RRTs and Residents in clinical critical care settings and have come to the conclusion that "Common Sense" cannot be taught, one either HAS IT or DOES NOT.... seriously.....so in following those that do not possess common sense will never ever become Critical Thinkers.

Common sense + education + experience + (good observational skills) + situational awareness + Prioritizing - ego = the Critical Thinker

[hr:8781938448]

A perfect example here is Medic2588 taking a prime opportunity to use a topic to blatantly sell his books LMFAO!

Devin shoot me the link, you have spiked my interest.....

EDITED Re Micheal-----good advice all.

[Medic2588]

That's called experience!!! 8)

Click on my profile and you can get to the link (its the website listed).

Devin

[Medic2588]

That's called experience!!! 8)

Click on my profile and you can get to the link (its the website listed).

Devin

[tniuqs]

Another fine example in educating the ADULT......repetition....

EDIT and admitting misteakes right away.....lol.

[Medic2588]

Education? Or is it good advertising? 8)

or perhaps I merely clicked the send button too many times :oops:

Devin

[Ridryder 911]

How ironic, I was going to do a post on this subject. (Actually, trying to compose an article for JEMS, on this matter). First one must understand what critical think is, and what it is not. That is where it become a problem. Some believe that many are more "born" with this and develop it better, with experience. Some educators and theorists believe it can be taught and a developed trait. This is a scientific term and yes has been proven effective.

In the field use, yes, it may be called "multitasking", or "thinking outside the box" for many possibilities and multiple disciplinary means. More than looking outside the protocols, thinking ahead such as counting the steps before entering the house, examining the patient for medical problems while on a traumatic call, managing 5 EMS units on separate calls at the same time.. etc.. Things are not "black and white" , and usually in EMS are gray... in color. As we know, nothing is simplistic in EMS.

The nursing profession has been investigating and attempting to teach and test students during the nursing program to explore this. they realize the importance of having these skills.

I feel we in EMS should as well should explore this and start recognizing the importance of this knowledge and trait. I do believe that this type of skill needs to be addressed and be tested in the classroom and as well in clinical arenas. Starting at the Basic level on... This is not to so much to discourage anyone but to point out the need of this knowledge and as well, might to be used to explore that this profession requires such.

I feel many become dissatisfied, job, and their performance in the job market and their performance. Because of inability or lack of having critical thinking skills, never are able to fulfill the job requirements. Some people are "black and white" and never are able to cope with the demands of this profession.

I believe in this so much, I wish there were practical scenarios on the NREMT exam, using critical thinking skills. As well, should be part of the clinical objectives for field, ICU, ER , etc.. clinical sites.

R/r 911