scientific-thinking

Thinking and Reasoning Skills

Elias Sukardi

Types of thinking

General & critical thinking

Scientific reasoning

Clinical diagnostic reasoning

Thinking Skill

What is thinking?’?

Broadening the sweep of perception for an exploration of past experience

(Edward de Bono)

Common errors

Partialism Time-scale Egocentricity Arrogance & conceit

Initial judgment Adversary thinking Ego-involvement

Magnitude error Extremes

Critical Thinking

Two dimensions of critical thinking

Cognitive components

Affective components

The paradigm of critical thinking

Interpretation Analysis

Evaluation

Inference

Self- regulation

Explanation

Attitude

5

1 2

3

4

6

Cognitive components

Affective dispositions toward critical thinking

Inquisitive

Systematic

Judicious

Analytical

TruthseekingOpenminded

Confident in Reasoning

The affective components

The nature of scientific reasoning & inference

Two types of scientific reasoning

Deductive reasoning (Deduction)

(Logics: logical reasoning)

Inductive reasoning (Induction)

Deductive reasoning

General

Specifics

Inductive reasoning

General

Specifics

Inductive Inference

Observation of particular instances

General conclusion

Proof versus Evidence

Outcome of a deductive conclusion: Proof

Outcome of an inductive conclusion: Evidence (in the legal sense: 'testimony')

Karl Popper's Falsification Theory

A theory is the result of an inductive reasoning

Renin-Angiotensin Theory

Renin Angiotensinogen

Angiotensin 1 ACE Angiotensin 2 Receptor

Vasoconstriction, fluid retention

Hypertension

Problems of inductive Inference

• David Hume’s problem: Uniformity of nature

• Concept of probability

David Hume's Problem

Uniformity of nature

Probability and Induction

Clinical diagnostic reasoning

• Clinical decision making

• Clinical judgment

• Clinical problem solving

Clinical scenario (Vignette)

• A 57-year-old woman presenting with history of hypertension, chest pressure, light-headedness. In the clinic her blood pressure was 83/50 mm Hg and heart rate was 110 beats per minute, loud crescendo systolic murmur at right upper sternal border. She smoke 5 cigarettes daily for 30 years. She was on lisinopril 5 mg daily. No clinically significant family history.

The reasoning processes that follow

Hypertension, chest pressure, light-headedness Benign to life-threatening emergency Acute coronary syndrome, aortic dissection, pulmonary

embolism, esophageal rupture, myocarditis or pericarditis, penumothorax.

Non-cardiac disorders include gastroesophageal reflux disease, peptic ulcer disease, costochondritis, herpes zoster, pleuritis, panic attack. But no hypotension.

Loud crescendo systolic murmur: bicuspid aortic valve with stenosis, hypertrophic cardiomyopathy, pulmonic-valve stenosis. New murmur: mechanical complication, such as ventricular septal rupture, papillary-muscle rupture causing mitral regurgitation.

Loud crescendo systolic murmur: old murmur: bicuspid aortic valve with stenosis, hypertrophic cardiomyopathy, pulmonic-valve stenosis. New murmur: mechanical complication, such as ventricular septal rupture, papillary-muscle rupture causing mitral regurgitation.

ECG Echocardiagraphy

Definitive diagnosis: Apical ballooning syndrome

Summary points

General thinking skills

Critical thinking

Scientific reasoning: deduction & induction

Problems of deductive & inductive reasoning

Clinical diagnostic reasoning

Summary points

General thinking skills

Critical thinking

Scientific reasoning: deduction & induction

Problems of deductive & inductive reasoning

Clinical diagnostic reasoning