An Approach to Teaching for Critical Thinking in Health Education

Article excerpt

Critical thinking represents a major focus of educational reform in the United States from elementary schools through colleges and universities. Differences exist in the way critical thinking is conceptualized and defined in the literature.[1-6] However, lack of consensus should not dissuade health educators from actively participating in this reform movement. Literature on critical thinking from a variety of disciplines provides strong evidence of a powerful tool for developing the minds of students. This paper considers one approach to teaching for critical thinking and the relevance of the approach to health education. Specifically, the approach to teaching for critical thinking developed by Richard Paul and colleagues at the Foundation for Critical Thinking is presented as an appropriate framework for infusing critical thinking into health education.

Development of thinking skills, and critical thinking in particular, is emerging as an important pedagogical approach for health instruction. Ubbes, Black, and Ausherman[7] described how critical and creative thinking could enhance students' understanding of health. Read[8] proposed that a cognitive-behavioral approach to health education would emphasize "learning how to learn" and "learning as expansion of one's ability to create new solutions" as well as "wrestling with new ideas." Keyser and Broadbear[9] articulated the pressing need to design health education to improve the thinking skills of students. In addition, writers of the National Health Education Standards[10] identified health-literate individuals as being critical thinkers and problem solvers. These Standards contain numerous performance indicators based on higher order thinking skills. This body of literature demonstrates a need for health educators to focus on developing the critical thinking skills of students.

Critical thinking is characterized by three interdependent traits. First, critical thinking is based on standards such as clarity, accuracy, relevance, and logic.(11) Second, these standards are applied consistently to produce thinking that is "self-correcting."(12) Also, the act of improving thinking through self-application of standards is volitional, based on the premise that the cognitive and affective domains are indissociable, or as Paul suggests, "Our basic ways of knowing are inseparable from our basic ways of being."[11,13]

Paul defined critical thinking as:

   A unique kind of purposeful thinking in which the thinker systematically
   and habitually imposes criteria and intellectual standards upon the
   thinking, taking charge of the construction of thinking, guiding the
   construction of the thinking according to the standards, (and) assessing
   the effectiveness of the thinking according to the purpose, the criteria,
   and the standards.[11]

Richard Paul, a leader in the critical thinking movement, is a philosopher at Sonoma State University in California. He serves as director of the Center for Critical Thinking and Moral Critique at that university. In concert with the Foundation for Critical Thinking, he conducts conferences and seminars on critical thinking. He authored or coauthored several articles, curriculum guides, and books that detail his perspectives on how critical thinking should be employed in schools and universities.[11,14-18] As a critical thinking theorist, his work has been widely cited and had a significant impact on the conceptualization, investigation, and implementation of critical thinking in a variety of educational settings.[19]

Paul harshly criticizes many contemporary educational practices. He contends that educational approaches such as emphasizing rote memorization, which he calls "the unending dominance of unimaginative didactic teaching," perpetuate an "anti-intellectual culture."[11] He believes, given the dramatic and inescapable change of our times and propensity of the human mind and human systems to seek stasis, that "our educational institutions, unfortunately, are totally unprepared" for the challenges that lie ahead and are "fixated on self-protection. …