4/16/2013 1 Promoting & Assessing Competency in Critical, Thinking, Self‐Assessment & Life‐long Learning Bill Hendricson University of Texas Health Science Center at San Antonio; Dental School (210) 567‐0436 [email protected]27 Components of General Dentistry Professional Role, Thinking, Demeanor, Values (N = 12; 44%) Patient Care / Clinical Skills (N=15; 56%) Std Role, Demeanor, Values (12) Assessment 2‐09 Use critical thinking in patient care, inquiry and research 2‐10 Use self‐assessment to develop competency 2‐14 Apply biomedical science knowledge in patient care 2‐15 Apply behavioral sciences & patient‐centered approaches to promote, improve & maintain oral health 2‐16 • Manage a diverse patient population • Skills for multicultural work environment (CC) 2‐17 2‐18 • Practice Mgmt: regulatory, principles • Health care delivery models • Function as oral health care team leader 2‐19 IPE: Collaborate with other health care team members 2‐20 Apply ethical decision‐making & professional responsibility 2‐21 EBP: Access, critically appraise, apply, communicate 2‐22 Provide oral health care to patients in all life stages 2‐24 Assess Tx needs of patients with special needs
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4/16/2013
1
Promoting & Assessing Competency in Critical, Thinking, Self‐Assessment
& Life‐long Learning
Bill HendricsonUniversity of Texas Health Science Centerat San Antonio; Dental School(210) 567‐[email protected]
27 Components of General Dentistry
Professional Role, Thinking, Demeanor, Values
(N = 12; 44%)
Patient Care / Clinical Skills
(N=15; 56%)
Std Role, Demeanor, Values (12) Assessment
2‐09 Use critical thinking in patient care, inquiry and research
2‐10 Use self‐assessment to develop competency
2‐14 Apply biomedical science knowledge in patient care
2‐15 Apply behavioral sciences & patient‐centered approaches to promote, improve & maintain oral health
2‐16 • Manage a diverse patient population• Skills for multicultural work environment (CC)
2‐172‐18
• Practice Mgmt: regulatory, principles• Health care delivery models• Function as oral health care team leader
2‐19 IPE: Collaborate with other health care team members
2‐20 Apply ethical decision‐making & professional responsibility
Facione PA. Critical Thinking: What Is It and Why It Counts; 2009 Update. Milbrae, CA: Insight Assessment. www.insightassessment.com
Facione PA, Facione N. Thinking & Reasoning in Human Decision Making: Method of Argument & Heuristic Analysis. Millbrae, CA: California Academic Press, 2007.
Hendricson, ADEA Commission on Change & Innovation: Educational strategies associated with development of problem‐solving, critical thinking, and self‐directed learning. J Dent Educ 2007; 70: 925‐936.
King & Kitchner. Developing Reflective Judgment: Understanding & Promoting Intellectual Growth & Critical Thinking in Adolescents & Adults. Jossey‐Bass.1994.
Parkes. Teaching Critical Appraisal Skills in Health Care Settings. Cochrane
Database of Systematic Reviews. 2001 (3). Art. No.: CD001270.
American Philosophical Association
Critical Thinking: A Statement of Expert Consensus for
Purposes of Educational Assessment and Instruction
ERIC Doc. No. ED 315‐423. (1990, 2004)
Workshop Agenda1. 2013 CODA standards 2‐9 & 2‐10
2. What are the cognitive components of CT?
3. What learning strategies promote CT, SA, SDL & LLL?
4. How can we assess competence for CT, SA & SDL?
5. Assess readiness for 2013 CODA standards for CT, SA, SDL & LLL
2013 CODA Standards 2 – 09 Critical ThinkingGraduates must be competent in the use of critical thinking & problem‐solving including their use in comprehensivecare of patients, scientific inquiry & research methodology.
CODA 2 – 10 Self‐Assessment Graduates must demonstrate the ability to self‐assess,including development of professional values & capacitiesassociated with self‐directed, life‐long learning.
Workshop Agenda1. 2013 CODA standards 2‐9 & 2‐10
2. What are the cognitive components of CT?
3. What learning strategies promote critical thinking, SA, SDL, LLL?
4. How can we assess competence for CT, SA & SDL?
5. Assess readiness for 2013 CODA standards related to CT, SA, SDL & LLL
What is Critical Thinking?CT is a rational response to questions that cannot be
answered definitively and for which all relevant
information may not be available.
Joanne Gainen Kurfiss. Critical Thinking: Theory, Research, Practice and Possibilities, ASHE‐ERIC Higher Education Report 2, Washington DC, 1988.
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Facione PA. Critical Thinking: What Is It and Why It Counts; 2009 Update. Milbrae, CA: Insight Assessment. www.insightassessment.com
Interpretation
• Comprehend & explain meaning, significance or consequences of experiences, data, events, problems, beliefs, rules, procedures & criteria
Analysis
Evaluation
Inference
Explanation
Identify relationships, similarities and differences among concepts, data, events, opinions, problems (recognize patterns)
Assess credibility of statements, assess logical strength of claims, theories & positions; make best option judgments
Deduce reasons for events & outcomes; predict consequence of potential actions; develop hypotheses to determine reasons
Coherent communication of one’s own critical thinking process
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Does student have effective self‐regulation?
Meta ‐ Cognition:– Accurately monitor performance & behavior
– Identify problems
– Self‐correct
– Seek assistance / support
Maki, et al. Relationship between comprehension and metacomprehension ability. Psychonomic Bulletin & Review. 1994; 1: 126 – 129.
Marsh, et al. Multifaceted academic self‐concept: its hierarchical structure and relation to academic achievement. J Educational Psych.1988; 80: 366‐380.
“Ignorance more often begets confidence than
does knowledge.”Charles Darwin
9 – 6 – 3 Rule of Thumb
Hartman HJ. Metacognition in Learning and Instruction: Theory, Research and Practice. Dordrecht: Kluwer Academic Publishers. 2001.
Workshop Agenda1. 2013 CODA standard 2‐9 & 2‐10
2. What are the cognitive components of CT?
3. What learning strategies promote critical thinking, SA, SDL & LLL?
4. How can we assess competence for CT, SA & SDL?
5. Assess readiness for 2013 CODA standards related to CT, SA, SDL & LLL
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“IDEALS” Model6 Questions for Effective Thinking
• Identify problem. What’s the real question we’re facing?
• Define context. What circumstances frame this problem?
• Enumerate choices. What are our most plausible options?
• Analyze options.What is our best course of action, all things considered?
• List reasons explicitly. Why are we making this choice?
• Self‐assess & correct. Let’s review. What was missed?
Facione. Thinking & Reasoning in Human Decision Making. Millbrae, CA: California Academic Press, 2007.
Getting Good at CT• Talk/Write: Students ….
• describe problem etiology
• analyze alternative approaches
• explain rationales for plans
• predict outcomes & explain “why”
• defend their ideas under questioning, and
• evaluate the merits of ideas
• Listen to experts’ reasoning as they “talk through”
approaches to analyzing problems (mental modeling)
• Compare their own data search steps, evidence found & decisions to experts who work same cases
TLC
Hendricson, et al. Educational strategies associated with development of problem‐solving, critical thinking, and self‐directed learning. J Dent Educ. 2006. 70(9):925‐936.
Workshop Agenda1. 2013 CODA standard 2‐9
2. What are the cognitive components of CT?
3. What learning strategies are must likely to promote development of critical thinking, SA & SDL/LLL?
4. How can we assess competence for CT, SA & SDL?
5. Assess readiness for 2013 CODA predoc standards related to CT, SA & SDL
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“Validated” Measures of CT• California Critical Thinking Skills Test
• California Critical Thinking Disposition Inventory
• Health Sciences Reasoning Test (HSRT)
• Cambridge Thinking Skills Assessment
• Cornell Critical Thinking Test
• Ennis‐Weir Critical Thinking Essay Test
• Watson‐Glaser Critical Thinking Appraisal
• Test of Everyday Reasoning Skills
Limitation:
Tests measure reasoning for well‐structured problems; health care
providers assess ill‐defined and evolving problems.
Critical Thinking Self‐Directed Learning
Case presentations with EBD RRR = Research, wRite & Report
Dx / TxP Simulation Peer teaching: Conduct a seminar for classmates
CPR (Case Prompted Review) –oral exam format
CATs = Critical Appraised Topic
OSCE (case analysis stations)
CATs = Critical Appraised Topic
Strong Assessments for CT & SDL
Hendricson, Andrieu, Chadwick, Chmar, Cole, George, et al. Educational Strategies Associated with Development of Problem‐Solving, Critical Thinking & Self‐Directed Learning. J Dent Educ. 2006; 70(9): 925‐936.
• Analysis: assess scenario & make decisions: Dx, etiology –pathophys, first action (written, computer, face to face)
• Decision: for a scenario depicting a problem, make a decision
• Recognize or interpret: radiographs, images, lesions
• Patient assess stations
• Case present stations
• Ethical dilemma
• Rapport
• Knowledge (case)
• Self‐assessment (coupled)
• Critical error
• EBP
OSCE Stations Requiring Critical Thinking
Evidence of CT Competency @ UTHSCSA D1: Issues in oral health presentations (RRR)
D2TxP simulations (4)Critical appraisal cases in EBP courseEBP final exam (EBP simulation)Mentored CAT project (Critically Appraised Topic)
D3Dx/TxP assessment on monthly progress evaluationEBP OSCEEBP rotation: case analysis presentationsCase Presentations (3); with CAT/EBP
D4Case presentations in group practices Dx/TxP competency examOutcomes of care competency examsMock WREB: Patient Assessment & TxP
Faculty appraisal on daily feedback
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Evaluation of Students’ Capacity for Self‐Assessment
• Appraisal by clinical faculty ??• Component of CPR• Portfolio analysis essays• Component of case presentation• Outcomes of care “comp”• Progress essay (end‐of‐semester)• Learning plan based on SA
• participation in Research or Teaching Honor Programs
• # students presenting abstracts at DS research events
• # students presenting abstracts at national meetings
• # students participating in specialty meetings
• participation in ASDA & other student organizations
• attendance at scientific seminars at DS
• collaboration with faculty on research projects
• student‐initiated activities / programs
Indirect, predictive, measurements
2‐14: Apply biomedical science knowledge in patient care