3.5 Min Read | Think Tank
The Curious Case of Critical Thinking in Clinical Practice
Written by Rucha Gadgil & Nirja Shah
Visual Media by Harshil Kapadia
Audio by Param Sampat
Guest Contributors: Dr. Asha Menon & Dr. Ashish Dev Gera
Share this article
Table of Contents
The important thing is not to stop questioning. Curiosity has its own reason for existing . —Albert Einstein
The world of Physiotherapy is shifting, we are moving away from the rigamarole typical exercises, modalities towards an interdisciplinary and person-centered approach. This subtle change needs to be highlighted for those who are dipping their toes in areas of clinical practice. The ones who can break the barriers of the “same set of exercises for everyone.”
What exactly do you think is causing this shift in practice?
It’s the ability to think critically, independently, and question clinical decisions to arrive at a sound conclusion. Does that mean senior physical therapists didn’t have this ability?
Treatment without firm research support gained popularity because clinicians and patients saw the results. This phenomenon is known as Scott’s parabola1 it perfectly describes the ever-changing techniques based on minimal scientific evidence and personal opinions.
Today’s generation of Physios believes in questioning typical treatment protocols being followed and trying to incorporate newer more innovative methods. But what needs to be understood is their reason behind this line of thinking. Are they clinically challenging the flaws in the methods of the past or are they simply straw-manning it? This is where critical thinking abilities must be developed and understood.
What exactly is critical thinking and why should it be given importance in our clinical practice?
The Oxford definition states, “it is the objective analysis and evaluation of an issue in order to form a judgment.”
Critical thinkers are free from cognitive, personal, and societal biases and are open-minded enough to appreciate their fallacies and faults. Clinically speaking, it involves the application of knowledge and experience to identify patient problems and to direct clinical judgments and actions that result in positive patient outcomes.
It is easy to understand the concept of critical thinking but to actually apply it in practice is where the challenge lies. For example, a physiotherapist is giving a talk at a company seminar, about certain ergonomics to follow and a blanket recommendation of exercises that the general public can do. The language used is recognized (by many) as unhelpful in that it may be interpreted in a literal sense. It is labeled by other Physios as a misrepresentative of correlation to causative links between exercise and pathology. Can you think about what the implications are here? What can be done here? Thinking critically in this scenario will mean:
We are all trying to do what’s best for our patients. If we continue to engage in pissing contests within our own profession, not only do we become our own nemesis, but we show the public that there is disunity within our profession. Simply following the above-mentioned steps instead of directly accusing the speech of misrepresenting will not only benefit our profession but also the public following it.
Critical thinking has to be accompanied by scientific evidence, clinical reasoning, and good decision-making skills.
To benefit from this reasoning, it is important to nurture the thought process that encourages questions. The need to understand the “why” and “how” behind each decision, and the ability to correlate evidence with clinical practice. But that does not mean we should second guess all our decisions or question everything that everyone is doing and find shortcomings.
Embracing that you might go astray and understanding the “why” behind each decision, even though you might take time to arrive at a conclusion.
In the words of Aristotle- It is the mark of an educated mind to be able to entertain a thought without accepting it.
In order to better understand the applications of thinking critically clinically, we invited Dr. Ashish Dev Gera and Dr. Asha Menon and the results were enlightening.
In conclusion, critical thinking is a process that is indispensable yet misunderstood to clinical practice. New paths and methods need to be forged academically to encourage critical thinking and raise our profession to peak standards.