Commentary

How Critical Is Critical Thinking?

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Simulation. The best predictor of future performance is practicing in a simulated situation. Today’s sophisticated computer-based simulations of clinical problems can test a wide range of competencies.

If we require NP and PA students to learn critical thinking, then how do we assess it? How can we know that our students have acquired this important skill?

Several standardized tests are available to assess critical thinking skills. The California Critical Thinking Skills Test (CCTST) is a challenging, discipline-neutral measure of actual cognitive skills used in critical thinking. The standardized and validated 34-item multiple-choice test targets the core skills considered essential in a college education. An older but frequently used test is the Watson-Glaser Critical Thinking Appraisal. It too is a multiple-choice tool with text-based questions; however, it uses a more limited response format than the CCTST.

No consensus exists, however, concerning the best test. And an individual’s results on one test cannot be assumed to indicate what he or she would score on a different test.

Discipline-specific national board examinations are another option for assessing critical thinking. Today’s computerized multiple-choice tests comprise questions that assess basic medical and surgical knowledge. Some testing of reasoning skills should be required of these high-stakes examinations.

NPs and PAs need to analyze, evaluate, and synthesize information from many sources in order to make appropriate decisions about a patient’s diagnosis and treatment plan. A lack of critical thinking can be dangerous—and perhaps even fatal.

I invite your responses on best practices for teaching and assessing critical thinking. Please e-mail me at PAeditor@qhc.com.

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