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Critical thinking in healthcare and education

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• Peer review
• Jonathan M Sharples , professor 1 ,
• Andrew D Oxman , research director 2 ,
• Kamal R Mahtani , clinical lecturer 3 ,
• Iain Chalmers , coordinator 4 ,
• Sandy Oliver , professor 1 ,
• Kevan Collins , chief executive 5 ,
• Astrid Austvoll-Dahlgren , senior researcher 2 ,
• Tammy Hoffmann , professor 6
• 1 EPPI-Centre, UCL Department of Social Science, London, UK
• 2 Global Health Unit, Norwegian Institute of Public Health, Oslo, Norway
• 3 Centre for Evidence-Based Medicine, Oxford University, Oxford, UK
• 4 James Lind Initiative, Oxford, UK
• 5 Education Endowment Foundation, London, UK
• 6 Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia
• Correspondence to: J M Sharples Jonathan.Sharples{at}eefoundation.org.uk

Critical thinking is just one skill crucial to evidence based practice in healthcare and education, write Jonathan Sharples and colleagues , who see exciting opportunities for cross sector collaboration

Imagine you are a primary care doctor. A patient comes into your office with acute, atypical chest pain. Immediately you consider the patient’s sex and age, and you begin to think about what questions to ask and what diagnoses and diagnostic tests to consider. You will also need to think about what treatments to consider and how to communicate with the patient and potentially with the patient’s family and other healthcare providers. Some of what you do will be done reflexively, with little explicit thought, but caring for most patients also requires you to think critically about what you are going to do.

Critical thinking, the ability to think clearly and rationally about what to do or what to believe, is essential for the practice of medicine. Few doctors are likely to argue with this. Yet, until recently, the UK regulator the General Medical Council and similar bodies in North America did not mention “critical thinking” anywhere in their standards for licensing and accreditation, 1 and critical thinking is not explicitly taught or assessed in most education programmes for health professionals. 2

Moreover, although more than 2800 articles indexed by PubMed have “critical thinking” in the title or abstract, most are about nursing. We argue that it is important for clinicians and patients to learn to think critically and that the teaching and learning of these skills should be considered explicitly. Given the shared interest in critical thinking with broader education, we also highlight why healthcare and education professionals and researchers need to work together to enable people to think critically about the health choices they make throughout life.

Essential skills for doctors and patients

Critical thinking …

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Why Critical Thinking Is Important (& How to Improve It)

Last updated May 1, 2023. Edited and medically reviewed by Patrick Alban, DC . Written by Deane Alban .

By improving the quality of your thoughts and your decisions, better critical thinking skills can bring about a big positive change in your life. Learn how.

The quality of your life largely depends on the quality of the decisions you make.

Amazingly, the average person makes roughly 35,000 conscious decisions every day! 

Imagine how much better your life would be if there were a way to make better decisions, day in and day out?

Well, there is and you do it by boosting a skill called critical thinking .

Learning to master critical thinking can have a profoundly positive impact on nearly every aspect of your life.

What Exactly Is Critical Thinking?

The first documented account of critical thinking is the teachings of Socrates as recorded by Plato. 

Over time, the definition of critical thinking has evolved.

Most definitions of critical thinking are fairly complex and best understood by philosophy majors or psychologists.

For example, the Foundation for Critical Thinking , a nonprofit think tank, offers this definition:

“Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action.”

If that makes your head spin, here are some definitions that you may relate to more easily.

Critical thinking is “reasonable, reflective thinking that is focused on deciding what to believe or do.”

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Or, a catchy way of defining critical thinking is “deciding what’s true and what you should do.”

But my favorite uber-simple definition is that critical thinking is simply “thinking about thinking.”

6 Major Benefits of Good Critical Thinking Skills

Whether or not you think critically can make the difference between success and failure in just about every area of your life.

Our human brains are imperfect and prone to irrationality, distortions, prejudices, and cognitive biases .

Cognitive biases are systematic patterns of irrational thinking.

While the number of cognitive biases varies depending on the source, Wikipedia, for example, lists nearly 200 of them ! 

Some of the most well-known cognitive biases include:

• catastrophic thinking
• confirmation bias
• fear of missing out (FOMO)

Critical thinking will help you move past the limitations of irrational thinking.

Here are some of the most important ways critical thinking can impact your life.

1. Critical Thinking Is a Key to Career Success

There are many professions where critical thinking is an absolute must.

Lawyers, analysts, accountants, doctors, engineers, reporters, and scientists of all kinds must apply critical thinking frequently.

But critical thinking is a skill set that is becoming increasingly valuable in a growing number of professions.

Critical thinking can help you in any profession where you must:

• analyze information
• systematically solve problems
• generate innovative solutions
• plan strategically
• think creatively
• present your work or ideas to others in a way that can be readily understood

And, as we enter the fourth industrial revolution , critical thinking has become one of the most sought-after skills.

According to the World Economic Forum , critical thinking and complex problem-solving are the two top in-demand skills that employers look for. 

Critical thinking is considered a soft or enterprise skill — a core attribute required to succeed in the workplace . 

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According to The University of Arizona, other soft skills include : 

• interpersonal skills
• communication skills
• digital literacy

Critical thinking can help you develop the rest of these soft skills.

Developing your critical thinking can help you land a job since many employers will ask you interview questions or even give you a test to determine how well you can think critically.

It can also help you continually succeed in your career, since being a critical thinker is a powerful predictor of long-term success.

2. Critical Thinkers Make Better Decisions

Every day you make thousands of decisions.

Most of them are made by your subconscious , are not very important, and don’t require much thought, such as what to wear or what to have for lunch. 

But the most important decisions you make can be hard and require a lot of thought, such as when or if you should change jobs, relocate to a new city, buy a house, get married, or have kids.

At work, you may have to make decisions that can alter the course of your career or the lives of others.

Critical thinking helps you cope with everyday problems as they arise.

It promotes independent thinking and strengthens your inner “BS detector.”

It helps you make sense of the glut of data and information available, making you a smarter consumer who is less likely to fall for advertising hype, peer pressure, or scams.

3. Critical Thinking Can Make You Happier

Knowing and understanding yourself is an underappreciated path to happiness. 

We’ve already shown how your quality of life largely depends on the quality of your decisions, but equally as important is the quality of your thoughts.

Critical thinking is an excellent tool to help you better understand yourself and to learn to master your thoughts.

You can use critical thinking to free yourself from cognitive biases, negative thinking , and limiting beliefs that are holding you back in any area of your life.

Critical thinking can help you assess your strengths and weaknesses so that you know what you have to offer others and where you could use improvement.

Critical thinking will enable you to better express your thoughts, ideas, and beliefs.

Better communication helps others to understand you better, resulting in less frustration for both of you.

Critical thinking fosters creativity and out-of-the-box thinking that can be applied to any area of your life.

It gives you a process you can rely on, making decisions less stressful.

4. Critical Thinking Ensures That Your Opinions Are Well-Informed

We have access to more information than ever before .

Astoundingly, more data has been created in the past two years than in the entire previous history of mankind. 

Critical thinking can help you sort through the noise.

American politician, sociologist, and diplomat Daniel Patrick Moynihan once remarked , “You are entitled to your opinion. But you are not entitled to your own facts.” 

Critical thinking ensures your opinions are well-informed and based on the best available facts.

You’ll get a boost in confidence when you see that those around you trust your well-considered opinions.

5. Critical Thinking Improves Relationships

You might be concerned that critical thinking will turn you into a Spock-like character who is not very good at relationships.

But, in fact, the opposite is true.

Employing critical thinking makes you more open-minded and better able to understand others’ points of view.

Critical thinkers are more empathetic and in a better position to get along with different kinds of people.

Critical thinking keeps you from jumping to conclusions.

You can be counted on to be the voice of reason when arguments get heated.

You’ll be better able to detect when others:

• are being disingenuous
• don’t have your best interests at heart
• try to take advantage of or manipulate you

6. Critical Thinking Makes You a Better, More Informed Citizen

“An educated citizenry is a vital requisite for our survival as a free people.”

This quote has been incorrectly attributed to Thomas Jefferson , but regardless of the source, these words of wisdom are more relevant than ever. 

Critical thinkers are able to see both sides of any issue and are more likely to generate bipartisan solutions.

They are less likely to be swayed by propaganda or get swept up in mass hysteria.

They are in a better position to spot fake news when they see it.

5 Steps to Improve Your Critical Thinking Skills

Some people already have well-developed critical thinking skills.

These people are analytical, inquisitive, and open to new ideas.

And, even though they are confident in their own opinions, they seek the truth, even if it proves their existing ideas to be wrong.

They are able to connect the dots between ideas and detect inconsistencies in others’ thinking.

But regardless of the state of your critical thinking skills today, it’s a skill set you can develop.

While there are many techniques for thinking rationally, here’s a classic 5-step critical thinking process . 

How to Improve Your Critical Thinking Skills

Clearly define your question or problem.

This step is so important that Albert Einstein famously quipped:

“If I had an hour to solve a problem, I’d spend 55 minutes thinking about the problem and 5 minutes thinking about solutions.”

Gather Information to Help You Weigh the Options

Consider only the most useful and reliable information from the most reputable sources.

Disregard the rest.

Apply the Information and Ask Critical Questions

Scrutinize all information carefully with a skeptic’s eye.

Not sure what questions to ask?

You can’t go wrong starting with the “5 Ws” that any good investigator asks: Who? What? Where? When? Why?

Then finish by asking “How?”

You’ll find more thought-provoking questions on this Critical Thinking Skills Cheatsheet .

Consider the Implications

Look for potential unintended consequences.

Do a thought experiment about how your solution could play out in both the short term and the long run.

Explore the Full Spectrum of Viewpoints

Examine why others are drawn to differing points of view.

This will help you objectively evaluate your own viewpoint.

You may find critical thinkers who take an opposing view and this can help you find gaps in your own logic.

Watch the Video

This TED-Ed video on YouTube elaborates on the five steps to improve your critical thinking.

Recommended: Upgrading brain health is key to making your brain work better.

• Improve your mental clarity and focus.
• Boost your memory and your ability to learn.
• Increase your capacity to think critically, solve problems, and make decisions.

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Critical Thinking in Nursing: Tips to Develop the Skill

4 min read • February, 09 2024

Critical thinking in nursing helps caregivers make decisions that lead to optimal patient care. In school, educators and clinical instructors introduced you to critical-thinking examples in nursing. These educators encouraged using learning tools for assessment, diagnosis, planning, implementation, and evaluation.

Nurturing these invaluable skills continues once you begin practicing. Critical thinking is essential to providing quality patient care and should continue to grow throughout your nursing career until it becomes second nature. 

What Is Critical Thinking in Nursing?

Critical thinking in nursing involves identifying a problem, determining the best solution, and implementing an effective method to resolve the issue using clinical decision-making skills.

Reflection comes next. Carefully consider whether your actions led to the right solution or if there may have been a better course of action.

Remember, there's no one-size-fits-all treatment method — you must determine what's best for each patient.

How Is Critical Thinking Important for Nurses? 

As a patient's primary contact, a nurse is typically the first to notice changes in their status. One example of critical thinking in nursing is interpreting these changes with an open mind. Make impartial decisions based on evidence rather than opinions. By applying critical-thinking skills to anticipate and understand your patients' needs, you can positively impact their quality of care and outcomes.

Elements of Critical Thinking in Nursing

To assess situations and make informed decisions, nurses must integrate these specific elements into their practice:

• Clinical judgment. Prioritize a patient's care needs and make adjustments as changes occur. Gather the necessary information and determine what nursing intervention is needed. Keep in mind that there may be multiple options. Use your critical-thinking skills to interpret and understand the importance of test results and the patient’s clinical presentation, including their vital signs. Then prioritize interventions and anticipate potential complications. 
• Patient safety. Recognize deviations from the norm and take action to prevent harm to the patient. Suppose you don't think a change in a patient's medication is appropriate for their treatment. Before giving the medication, question the physician's rationale for the modification to avoid a potential error. 
• Communication and collaboration. Ask relevant questions and actively listen to others while avoiding judgment. Promoting a collaborative environment may lead to improved patient outcomes and interdisciplinary communication. 
• Problem-solving skills. Practicing your problem-solving skills can improve your critical-thinking skills. Analyze the problem, consider alternate solutions, and implement the most appropriate one. Besides assessing patient conditions, you can apply these skills to other challenges, such as staffing issues . 

How to Develop and Apply Critical-Thinking Skills in Nursing

Critical-thinking skills develop as you gain experience and advance in your career. The ability to predict and respond to nursing challenges increases as you expand your knowledge and encounter real-life patient care scenarios outside of what you learned from a textbook. 

Here are five ways to nurture your critical-thinking skills:

• Be a lifelong learner. Continuous learning through educational courses and professional development lets you stay current with evidence-based practice . That knowledge helps you make informed decisions in stressful moments.  
• Practice reflection. Allow time each day to reflect on successes and areas for improvement. This self-awareness can help identify your strengths, weaknesses, and personal biases to guide your decision-making.
• Open your mind. Don't assume you're right. Ask for opinions and consider the viewpoints of other nurses, mentors , and interdisciplinary team members.
• Use critical-thinking tools. Structure your thinking by incorporating nursing process steps or a SWOT analysis (strengths, weaknesses, opportunities, and threats) to organize information, evaluate options, and identify underlying issues.
• Be curious. Challenge assumptions by asking questions to ensure current care methods are valid, relevant, and supported by evidence-based practice .

Critical thinking in nursing is invaluable for safe, effective, patient-centered care. You can successfully navigate challenges in the ever-changing health care environment by continually developing and applying these skills.

Images sourced from Getty Images

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Cultivating Critical Thinking in Healthcare

Published: 06 January 2019

Critical thinking skills have been linked to improved patient outcomes, better quality patient care and improved safety outcomes in healthcare (Jacob et al. 2017).

Given this, it's necessary for educators in healthcare to stimulate and lead further dialogue about how these skills are taught , assessed and integrated into the design and development of staff and nurse education and training programs (Papp et al. 2014).

So, what exactly is critical thinking and how can healthcare educators cultivate it amongst their staff?

What is Critical Thinking?

In general terms, ‘ critical thinking ’ is often used, and perhaps confused, with problem-solving and clinical decision-making skills .

In practice, however, problem-solving tends to focus on the identification and resolution of a problem, whilst critical thinking goes beyond this to incorporate asking skilled questions and critiquing solutions .

Several formal definitions of critical thinking can be found in literature, but in the view of Kahlke and Eva (2018), most of these definitions have limitations. That said, Papp et al. (2014) offer a useful starting point, suggesting that critical thinking is:

‘The ability to apply higher order cognitive skills and the disposition to be deliberate about thinking that leads to action that is logical and appropriate.’

The Foundation for Critical Thinking (2017) expands on this and suggests that:

‘Critical thinking is that mode of thinking, about any subject, content, or problem, in which the thinker improves the quality of his or her thinking by skillfully analysing, assessing, and reconstructing it.’

They go on to suggest that critical thinking is:

• Self-directed
• Self-disciplined
• Self-monitored
• Self-corrective.

Key Qualities and Characteristics of a Critical Thinker

Given that critical thinking is a process that encompasses conceptualisation , application , analysis , synthesis , evaluation and reflection , what qualities should be expected from a critical thinker?

In answering this question, Fortepiani (2018) suggests that critical thinkers should be able to:

• Formulate clear and precise questions
• Gather, assess and interpret relevant information
• Reach relevant well-reasoned conclusions and solutions
• Think open-mindedly, recognising their own assumptions
• Communicate effectively with others on solutions to complex problems.

All of these qualities are important, however, good communication skills are generally considered to be the bedrock of critical thinking. Why? Because they help to create a dialogue that invites questions, reflections and an open-minded approach, as well as generating a positive learning environment needed to support all forms of communication.

Lippincott Solutions (2018) outlines a broad spectrum of characteristics attributed to strong critical thinkers. They include:

• Inquisitiveness with regard to a wide range of issues
• A concern to become and remain well-informed
• Alertness to opportunities to use critical thinking
• Self-confidence in one’s own abilities to reason
• Open mindedness regarding divergent world views
• Flexibility in considering alternatives and opinions
• Understanding the opinions of other people
• Fair-mindedness in appraising reasoning
• Honesty in facing one’s own biases, prejudices, stereotypes or egocentric tendencies
• A willingness to reconsider and revise views where honest reflection suggests that change is warranted.

Papp et al. (2014) also helpfully suggest that the following five milestones can be used as a guide to help develop competency in critical thinking:

Stage 1: Unreflective Thinker

At this stage, the unreflective thinker can’t examine their own actions and cognitive processes and is unaware of different approaches to thinking.

Stage 2: Beginning Critical Thinker

Here, the learner begins to think critically and starts to recognise cognitive differences in other people. However, external motivation  is needed to sustain reflection on the learners’ own thought processes.

Stage 3: Practicing Critical Thinker

By now, the learner is familiar with their own thinking processes and makes a conscious effort to practice critical thinking.

Stage 4: Advanced Critical Thinker

As an advanced critical thinker, the learner is able to identify different cognitive processes and consciously uses critical thinking skills.

Stage 5: Accomplished Critical Thinker

At this stage, the skilled critical thinker can take charge of their thinking and habitually monitors, revises and rethinks approaches for continual improvement of their cognitive strategies.

Facilitating Critical Thinking in Healthcare

A common challenge for many educators and facilitators in healthcare is encouraging students to move away from passive learning towards active learning situations that require critical thinking skills.

Just as there are similarities among the definitions of critical thinking across subject areas and levels, there are also several generally recognised hallmarks of teaching for critical thinking . These include:

• Promoting interaction among students as they learn
• Asking open ended questions that do not assume one right answer
• Allowing sufficient time to reflect on the questions asked or problems posed
• Teaching for transfer - helping learners to see how a newly acquired skill can apply to other situations and experiences.

(Lippincott Solutions 2018)

Snyder and Snyder (2008) also make the point that it’s helpful for educators and facilitators to be aware of any initial resistance that learners may have and try to guide them through the process. They should aim to create a learning environment where learners can feel comfortable thinking through an answer rather than simply having an answer given to them.

Examples include using peer coaching techniques , mentoring or preceptorship to engage students in active learning and critical thinking skills, or integrating project-based learning activities that require students to apply their knowledge in a realistic healthcare environment.

Carvalhoa et al. (2017) also advocate problem-based learning as a widely used and successful way of stimulating critical thinking skills in the learner. This view is echoed by Tsui-Mei (2015), who notes that critical thinking, systematic analysis and curiosity significantly improve after practice-based learning .

Integrating Critical Thinking Skills Into Curriculum Design

Most educators agree that critical thinking can’t easily be developed if the program curriculum is not designed to support it. This means that a deep understanding of the nature and value of critical thinking skills needs to be present from the outset of the curriculum design process , and not just bolted on as an afterthought.

In the view of Fortepiani (2018), critical thinking skills can be summarised by the statement that 'thinking is driven by questions', which means that teaching materials need to be designed in such a way as to encourage students to expand their learning by asking questions that generate further questions and stimulate the thinking process. Ideal questions are those that:

• Embrace complexity
• Challenge assumptions and points of view
• Question the source of information
• Explore variable interpretations and potential implications of information.

To put it another way, asking questions with limiting, thought-stopping answers inhibits the development of critical thinking. This means that educators must ideally be critical thinkers themselves .

Drawing these threads together, The Foundation for Critical Thinking (2017) offers us a simple reminder that even though it’s human nature to be ‘thinking’ most of the time, most thoughts, if not guided and structured, tend to be biased, distorted, partial, uninformed or even prejudiced.

They also note that the quality of work depends precisely on the quality of the practitioners’ thought processes. Given that practitioners are being asked to meet the challenge of ever more complex care, the importance of cultivating critical thinking skills, alongside advanced problem-solving skills , seems to be taking on new importance.

Additional Resources

• The Emotionally Intelligent Nurse | Ausmed Article
• Refining Competency-Based Assessment | Ausmed Article
• Socratic Questioning in Healthcare | Ausmed Article
• Carvalhoa, D P S R P et al. 2017, 'Strategies Used for the Promotion of Critical Thinking in Nursing Undergraduate Education: A Systematic Review', Nurse Education Today , vol. 57, pp. 103-10, viewed 7 December 2018, https://www.sciencedirect.com/science/article/abs/pii/S0260691717301715
• Fortepiani, L A 2017, 'Critical Thinking or Traditional Teaching For Health Professionals', PECOP Blog , 16 January, viewed 7 December 2018, https://blog.lifescitrc.org/pecop/2017/01/16/critical-thinking-or-traditional-teaching-for-health-professions/
• Jacob, E, Duffield, C & Jacob, D 2017, 'A Protocol For the Development of a Critical Thinking Assessment Tool for Nurses Using a Delphi Technique', Journal of Advanced Nursing, vol. 73, no. 8, pp. 1982-1988, viewed 7 December 2018, https://onlinelibrary.wiley.com/doi/10.1111/jan.13306
• Kahlke, R & Eva, K 2018, 'Constructing Critical Thinking in Health Professional Education', Perspectives on Medical Education , vol. 7, no. 3, pp. 156-165, viewed 7 December 2018, https://link.springer.com/article/10.1007/s40037-018-0415-z
• Lippincott Solutions 2018, 'Turning New Nurses Into Critical Thinkers', Lippincott Solutions , viewed 10 December 2018, https://www.wolterskluwer.com/en/expert-insights/turning-new-nurses-into-critical-thinkers
• Papp, K K 2014, 'Milestones of Critical Thinking: A Developmental Model for Medicine and Nursing', Academic Medicine , vol. 89, no. 5, pp. 715-720, https://journals.lww.com/academicmedicine/Fulltext/2014/05000/Milestones_of_Critical_Thinking___A_Developmental.14.aspx
• Snyder, L G & Snyder, M J 2008, 'Teaching Critical Thinking and Problem Solving Skills', The Delta Pi Epsilon Journal , vol. L, no. 2, pp. 90-99, viewed 7 December 2018, https://dme.childrenshospital.org/wp-content/uploads/2019/02/Optional-_Teaching-Critical-Thinking-and-Problem-Solving-Skills.pdf
• The Foundation for Critical Thinking 2017, Defining Critical Thinking , The Foundation for Critical Thinking, viewed 7 December 2018, https://www.criticalthinking.org/pages/our-conception-of-critical-thinking/411
• Tsui-Mei, H, Lee-Chun, H & Chen-Ju MSN, K 2015, 'How Mental Health Nurses Improve Their Critical Thinking Through Problem-Based Learning', Journal for Nurses in Professional Development , vol. 31, no. 3, pp. 170-175, viewed 7 December 2018, https://journals.lww.com/jnsdonline/Abstract/2015/05000/How_Mental_Health_Nurses_Improve_Their_Critical.8.aspx

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Critical Thinking in Medicine and Health

• First Online: 01 March 2020

Cite this chapter

• Louise Cummings 2  

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1 Citations

This chapter addresses why there is a need for experts and lay people to think critically about medicine and health. It will be argued that illogical, misleading, and contradictory information in medicine and health can have pernicious consequences, including patient harm and poor compliance with health recommendations. Our cognitive resources are our only bulwark to the misinformation and faulty logic that exists in medicine and health. One resource in particular—reasoning—can counter the flawed thinking that pervades many medical and health issues. This chapter examines how concepts such as reasoning, logic and argument must be conceptualised somewhat differently (namely, in non-deductive terms) to accommodate the rationality of the informal fallacies. It also addresses the relevance of the informal fallacies to medicine and health and considers how these apparently defective arguments are a source of new analytical possibilities in both domains.

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Chapter Summary

Medicine and health have tended to be overlooked in the critical thinking literature . And yet robust critical thinking skills are needed to evaluate the large number and range of health messages that we are exposed to on a daily basis.

An ability to think critically helps us to make better personal health choices and to uncover biases and errors in health messages and other information. An ability to think critically allows us to make informed decisions about medical treatments and is vital to efforts to reduce medical diagnostic errors.

A key element in critical thinking is the ability to distinguish strong or valid reasoning from weak or invalid reasoning. When an argument is weak or invalid, it is called a ‘fallacy’ or a ‘fallacious argument’.

The informal fallacies are so-called on account of the presence of epistemic and dialectical flaws that cannot be captured by formal logic . They have been discussed by many generations of philosophers and logicians , beginning with Aristotle .

Historically, philosophers and logicians have taken a pejorative view of the informal fallacies. Much of the criticism of these arguments is related to a latent deductivism in logic , the notion that arguments should be evaluated according to deductive standards of validity and soundness . Against deductive standards and norms, many reasonable arguments are judged to be fallacies.

Developments in logic , particularly the teaching of logic, forced a reconsideration of the prominence afforded to deductive logic in the evaluation of arguments. New criteria based on presumptive reasoning and plausible argument started to emerge. Against this backdrop, non-fallacious variants of most of the informal fallacies began to be described for the first time.

Today, some argument analysts characterize non-fallacious variants of the informal fallacies in terms of cognitive heuristics . During reasoning , these heuristics function as mental shortcuts, allowing us to bypass knowledge and come to judgement about complex health problems.

Suggestions for Further Reading

Sharples, J. M., Oxman, A. D., Mahtani, K. R., Chalmers, I., Oliver, S., Collins, K., Austvoll-Dahlgren, A., & Hoffmann, T. (2017). Critical thinking in healthcare and education. British Medical Journal, 357 : j2234. https://doi.org/10.1136/bmj.j2234 .

The authors examine the role of critical thinking in medicine and healthcare, arguing that critical thinking skills are essential for doctors and patients. They describe an international project that involves collaboration between education and health. Its aim is to develop a curriculum and learning resources for critical thinking about any action that is claimed to improve health.

Hitchcock, D. (2017). On reasoning and argument: Essays in informal logic and on critical thinking . Cham: Switzerland: Springer.

This collection of essays provides more advanced reading on several of the topics addressed in this chapter, including the fallacies, informal logic , and the teaching of critical thinking . Chapter 25 considers if fallacies have a place in the teaching of critical thinking and reasoning skills.

Hansen, H. V., & Pinto, R. C. (Eds.). (1995). Fallacies: Classical and contemporary readings . University Park: The Pennsylvania State University Press.

This edited collection of 24 chapters contains historical selections on the fallacies, contemporary theory and criticism, and analyses of specific fallacies. It also examines fallacies and teaching. There are chapters on four of the fallacies that will be examined in this book: appeal to force; appeal to ignorance ; appeal to authority; and post hoc ergo propter hoc .

Diagnostic errors are a significant cause of death and serious injury in patients. Many of these errors are related to cognitive factors. Trowbridge ( 2008 ) has devised twelve tips to familiarize medical students and physician trainees with the cognitive underpinnings of diagnostic errors. One of these tips is to explicitly describe heuristics and how they affect clinical reasoning . These heuristics include the following:

Representativeness —a patient’s presentation is compared to a ‘typical’ case of specific diagnoses.

Availability —physicians arrive at a diagnosis based on what is easily accessible in their minds, rather than what is actually most probable.

Anchoring —physicians may settle on a diagnosis early in the diagnostic process and subsequently become ‘anchored’ in that diagnosis.

Confirmation bias —as a result of anchoring, physicians may discount information discordant with the original diagnosis and accept only that which supports the diagnosis.

Using the above information, identify any heuristics and biases that occur in the following scenarios:

Scenario 1: A 60-year-old man has epigastric pain and nausea. He is sitting forward clutching his abdomen. He has a history of several bouts of alcoholic pancreatitis. He states that he felt similar during these bouts to what he is currently feeling. The patient states that he has had no alcohol in many years. He has normal blood levels of pancreatic enzymes. He is given a diagnosis of acute pancreatitis. It is eventually discovered that he has had acute myocardial infarction.

Scenario 2: A 20-year-old, healthy man presents with sudden onset of severe, sharp chest pain and back pain. Based on these symptoms, he is suspected of having a dissecting thoracic aortic aneurysm. (In an aortic dissection, there is a separation of the layers within the wall of the aorta, the large blood vessel branching off the heart.) He is eventually diagnosed with pleuritis (inflammation of the pleura, the thin, transparent, two-layered membrane that covers the lungs).

Many of the logical terms that were introduced in this chapter also have non-logical uses in everyday language. Below are several examples of the use of these terms. For each example, indicate if the word in italics has a logical or a non - logical meaning or use:

University ‘safe spaces’ are a dangerous fallacy —they do not exist in the real world ( The Telegraph , 13 February 2017).

The MRI findings beg the question as to whether a careful ultrasound examination might have yielded some of the same information on haemorrhages ( British Medical Journal: Fetal & Neonatal , 2011).

The youth justice system is a slippery slope of failure ( The Sydney Morning Herald , 26 July 2016).

The EU countered with its own gastronomic analogy , saying that “cherry picking” the best bits of the EU would not be tolerated ( BBC News , 28 July 2017).

As Ebola spreads, so have several fallacies ( The New York Times , 23 October 2014).

Removing the statue of Confederacy Army General Robert E. Lee no more puts us on a slippery slope towards ousting far more nuanced figures from the public square than building the statue in the first place put us on a slippery slope toward, say, putting up statues of Hitler outside of Holocaust museums or of Ho Chi Minh at Vietnam War memorials ( Chicago Tribune , 16 August 2017).

We can expand the analogy a bit and think of a culture as something akin to a society’s immune system—it works best when it is exposed to as many foreign bodies as possible ( New Zealand Herald , 4 May 2010).

The Josh Norman Bowl begs the question : What’s an elite cornerback worth? ( The Washington Post , 17 December 2016).

The intuition behind these analogies is simple: As a homeowner, I generally have the right to exclude whoever I want from my property. I don’t even have to have a good justification for the exclusion. I can choose to bar you from my home for virtually any reason I want, or even just no reason at all. Similarly, a nation has the right to bar foreigners from its land for almost any reason it wants, or perhaps even no reason at all ( The Washington Post , 6 August 2017).

Legalising assisted suicide is a slippery slope toward widespread killing of the sick, Members of Parliament and peers were told yesterday ( Mail Online , 9 July 2014).

In the Special Topic ‘What’s in a name?’, an example of a question-begging argument from the author’s recent personal experience was used. How would you reconstruct the argument in this case to illustrate the presence of a fallacy?

On 9 July 2017, the effect of coconut oil on health was also discussed in an article in The Guardian entitled ‘Coconut oil: Are the health benefits a big fat lie?’ The following extract is taken from that article. (a) What type of reasoning is the author using in this extract? In your response, you should reconstruct the argument by presenting its premises and conclusion . Also, is this argument valid or fallacious in this particular context?

When it comes to superfoods, coconut oil presses all the buttons: it’s natural, it’s enticingly exotic, it’s surrounded by health claims and at up to £8 for a 500 ml pot at Tesco, it’s suitably pricey. But where this latest superfood differs from benign rivals such as blueberries, goji berries, kale and avocado is that a diet rich in coconut oil may actually be bad for us.

The article in The Guardian also makes extensive use of expert opinion. Two such opinions are shown below. (b) What three linguistic devices does the author use to confer expertise or authority on the individuals who advance these opinions?

Christine Williams, professor of human nutrition at the University of Reading, states: “There is very limited evidence of beneficial health effects of this oil”.

Tom Sanders, emeritus professor of nutrition and dietetics at King’s College London, says: “It is a poor source of vitamin E compared with other vegetable oils”.

The author of the article in The Guardian went on to summarize the findings of a study by two researchers that was published in the British Nutrition Foundation’s Nutrition Bulletin. The author’s summary included the following statement: There is no good evidence that coconut oil helps boost mental performance or prevent Alzheimer’s disease . (c) In what type of informal fallacy might this statement be a premise ?

Scenario 1: An anchoring error has occurred in which the patient is given a diagnosis of acute pancreatitis early in the diagnostic process. The clinician becomes anchored in this diagnosis, with the result that he overlooks two pieces of information that would have allowed this diagnosis to be disconfirmed—the fact that the patient has reported no alcohol use in many years and the presence of normal blood levels of pancreatic enzymes. By dismissing this information, the clinician is also showing a confirmation bias —he attends only to information that confirms his original diagnosis.

Scenario 2: A representativeness error has occurred. The patient’s presentation is typical of aortic dissection. However, this condition can be dismissed in favour of conditions like pleuritis or pneumothorax on account of the fact that aortic dissection is exceptionally rare in 20-year-olds.

(2) (a) non-logical; (b) non-logical; (c) non-logical; (d) non-logical; (e) non-logical; (f) logical; (g) logical; (h) non-logical; (i) logical; (j) logical

(3) The fallacy can be illustrated as follows. The head of department asks the question ‘Why did so many of these students get ‘A’ grades’? He receives the reply ‘Because they did very well’. But someone might reasonably ask ‘How do we know that they did very well?’ To which the reply is ‘Because so many students got ‘A’ grades’. The reasoning can be reconstructed in diagram form as follows:

The author is using an analogical argument , which has the following form:

P1: Blueberries, goji berries, kale, avocado and coconut oil are natural, exotic, pricey and surrounded by health claims.

P2: Blueberries, goji berries, kale and avocado have health benefits.

C: Coconut oil has health benefits.

This is a false analogy , or a fallacious analogical argument , because coconut oil does not share with these other superfoods the property or attribute < has health benefits >.

The author uses academic rank, field of specialization, and university affiliation to confer authority or expertise on individuals who advance expert opinions.

This statement could be a premise in an argument from ignorance .

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Cummings, L. (2020). Critical Thinking in Medicine and Health. In: Fallacies in Medicine and Health. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-28513-5_1

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BRIEF RESEARCH REPORT article

How do critical thinking ability and critical thinking disposition relate to the mental health of university students.

• School of Education, Huazhong University of Science and Technology, Wuhan, China

Theories of psychotherapy suggest that human mental problems associate with deficiencies in critical thinking. However, it currently remains unclear whether both critical thinking skill and critical thinking disposition relate to individual differences in mental health. This study explored whether and how the critical thinking ability and critical thinking disposition of university students associate with individual differences in mental health in considering impulsivity that has been revealed to be closely related to both critical thinking and mental health. Regression and structural equation modeling analyses based on a Chinese university student sample ( N = 314, 198 females, M age = 18.65) revealed that critical thinking skill and disposition explained a unique variance of mental health after controlling for impulsivity. Furthermore, the relationship between critical thinking and mental health was mediated by motor impulsivity (acting on the spur of the moment) and non-planning impulsivity (making decisions without careful forethought). These findings provide a preliminary account of how human critical thinking associate with mental health. Practically, developing mental health promotion programs for university students is suggested to pay special attention to cultivating their critical thinking dispositions and enhancing their control over impulsive behavior.

Introduction

Although there is no consistent definition of critical thinking (CT), it is usually described as “purposeful, self-regulatory judgment that results in interpretation, analysis, evaluation, and inference, as well as explanations of the evidential, conceptual, methodological, criteriological, or contextual considerations that judgment is based upon” ( Facione, 1990 , p. 2). This suggests that CT is a combination of skills and dispositions. The skill aspect mainly refers to higher-order cognitive skills such as inference, analysis, and evaluation, while the disposition aspect represents one's consistent motivation and willingness to use CT skills ( Dwyer, 2017 ). An increasing number of studies have indicated that CT plays crucial roles in the activities of university students such as their academic performance (e.g., Ghanizadeh, 2017 ; Ren et al., 2020 ), professional work (e.g., Barry et al., 2020 ), and even the ability to cope with life events (e.g., Butler et al., 2017 ). An area that has received less attention is how critical thinking relates to impulsivity and mental health. This study aimed to clarify the relationship between CT (which included both CT skill and CT disposition), impulsivity, and mental health among university students.

Relationship Between Critical Thinking and Mental Health

Associating critical thinking with mental health is not without reason, since theories of psychotherapy have long stressed a linkage between mental problems and dysfunctional thinking ( Gilbert, 2003 ; Gambrill, 2005 ; Cuijpers, 2019 ). Proponents of cognitive behavioral therapy suggest that the interpretation by people of a situation affects their emotional, behavioral, and physiological reactions. Those with mental problems are inclined to bias or heuristic thinking and are more likely to misinterpret neutral or even positive situations ( Hollon and Beck, 2013 ). Therefore, a main goal of cognitive behavioral therapy is to overcome biased thinking and change maladaptive beliefs via cognitive modification skills such as objective understanding of one's cognitive distortions, analyzing evidence for and against one's automatic thinking, or testing the effect of an alternative way of thinking. Achieving these therapeutic goals requires the involvement of critical thinking, such as the willingness and ability to critically analyze one's thoughts and evaluate evidence and arguments independently of one's prior beliefs. In addition to theoretical underpinnings, characteristics of university students also suggest a relationship between CT and mental health. University students are a risky population in terms of mental health. They face many normative transitions (e.g., social and romantic relationships, important exams, financial pressures), which are stressful ( Duffy et al., 2019 ). In particular, the risk increases when students experience academic failure ( Lee et al., 2008 ; Mamun et al., 2021 ). Hong et al. (2010) found that the stress in Chinese college students was primarily related to academic, personal, and negative life events. However, university students are also a population with many resources to work on. Critical thinking can be considered one of the important resources that students are able to use ( Stupple et al., 2017 ). Both CT skills and CT disposition are valuable qualities for college students to possess ( Facione, 1990 ). There is evidence showing that students with a higher level of CT are more successful in terms of academic performance ( Ghanizadeh, 2017 ; Ren et al., 2020 ), and that they are better at coping with stressful events ( Butler et al., 2017 ). This suggests that that students with higher CT are less likely to suffer from mental problems.

Empirical research has reported an association between CT and mental health among college students ( Suliman and Halabi, 2007 ; Kargar et al., 2013 ; Yoshinori and Marcus, 2013 ; Chen and Hwang, 2020 ; Ugwuozor et al., 2021 ). Most of these studies focused on the relationship between CT disposition and mental health. For example, Suliman and Halabi (2007) reported that the CT disposition of nursing students was positively correlated with their self-esteem, but was negatively correlated with their state anxiety. There is also a research study demonstrating that CT disposition influenced the intensity of worry in college students either by increasing their responsibility to continue thinking or by enhancing the detached awareness of negative thoughts ( Yoshinori and Marcus, 2013 ). Regarding the relationship between CT ability and mental health, although there has been no direct evidence, there were educational programs examining the effect of teaching CT skills on the mental health of adolescents ( Kargar et al., 2013 ). The results showed that teaching CT skills decreased somatic symptoms, anxiety, depression, and insomnia in adolescents. Another recent CT skill intervention also found a significant reduction in mental stress among university students, suggesting an association between CT skills and mental health ( Ugwuozor et al., 2021 ).

The above research provides preliminary evidence in favor of the relationship between CT and mental health, in line with theories of CT and psychotherapy. However, previous studies have focused solely on the disposition aspect of CT, and its link with mental health. The ability aspect of CT has been largely overlooked in examining its relationship with mental health. Moreover, although the link between CT and mental health has been reported, it remains unknown how CT (including skill and disposition) is associated with mental health.

Impulsivity as a Potential Mediator Between Critical Thinking and Mental Health

One important factor suggested by previous research in accounting for the relationship between CT and mental health is impulsivity. Impulsivity is recognized as a pattern of action without regard to consequences. Patton et al. (1995) proposed that impulsivity is a multi-faceted construct that consists of three behavioral factors, namely, non-planning impulsiveness, referring to making a decision without careful forethought; motor impulsiveness, referring to acting on the spur of the moment; and attentional impulsiveness, referring to one's inability to focus on the task at hand. Impulsivity is prominent in clinical problems associated with psychiatric disorders ( Fortgang et al., 2016 ). A number of mental problems are associated with increased impulsivity that is likely to aggravate clinical illnesses ( Leclair et al., 2020 ). Moreover, a lack of CT is correlated with poor impulse control ( Franco et al., 2017 ). Applications of CT may reduce impulsive behaviors caused by heuristic and biased thinking when one makes a decision ( West et al., 2008 ). For example, Gregory (1991) suggested that CT skills enhance the ability of children to anticipate the health or safety consequences of a decision. Given this, those with high levels of CT are expected to take a rigorous attitude about the consequences of actions and are less likely to engage in impulsive behaviors, which may place them at a low risk of suffering mental problems. To the knowledge of the authors, no study has empirically tested whether impulsivity accounts for the relationship between CT and mental health.

This study examined whether CT skill and disposition are related to the mental health of university students; and if yes, how the relationship works. First, we examined the simultaneous effects of CT ability and CT disposition on mental health. Second, we further tested whether impulsivity mediated the effects of CT on mental health. To achieve the goals, we collected data on CT ability, CT disposition, mental health, and impulsivity from a sample of university students. The results are expected to shed light on the mechanism of the association between CT and mental health.

Participants and Procedure

A total of 314 university students (116 men) with an average age of 18.65 years ( SD = 0.67) participated in this study. They were recruited by advertisements from a local university in central China and majoring in statistics and mathematical finance. The study protocol was approved by the Human Subjects Review Committee of the Huazhong University of Science and Technology. Each participant signed a written informed consent describing the study purpose, procedure, and right of free. All the measures were administered in a computer room. The participants were tested in groups of 20–30 by two research assistants. The researchers and research assistants had no formal connections with the participants. The testing included two sections with an interval of 10 min, so that the participants had an opportunity to take a break. In the first section, the participants completed the syllogistic reasoning problems with belief bias (SRPBB), the Chinese version of the California Critical Thinking Skills Test (CCSTS-CV), and the Chinese Critical Thinking Disposition Inventory (CCTDI), respectively. In the second session, they completed the Barrett Impulsivity Scale (BIS-11), Depression Anxiety Stress Scale-21 (DASS-21), and University Personality Inventory (UPI) in the given order.

Measures of Critical Thinking Ability

The Chinese version of the California Critical Thinking Skills Test was employed to measure CT skills ( Lin, 2018 ). The CCTST is currently the most cited tool for measuring CT skills and includes analysis, assessment, deduction, inductive reasoning, and inference reasoning. The Chinese version included 34 multiple choice items. The dependent variable was the number of correctly answered items. The internal consistency (Cronbach's α) of the CCTST is 0.56 ( Jacobs, 1995 ). The test–retest reliability of CCTST-CV is 0.63 ( p < 0.01) ( Luo and Yang, 2002 ), and correlations between scores of the subscales and the total score are larger than 0.5 ( Lin, 2018 ), supporting the construct validity of the scale. In this study among the university students, the internal consistency (Cronbach's α) of the CCTST-CV was 0.5.

The second critical thinking test employed in this study was adapted from the belief bias paradigm ( Li et al., 2021 ). This task paradigm measures the ability to evaluate evidence and arguments independently of one's prior beliefs ( West et al., 2008 ), which is a strongly emphasized skill in CT literature. The current test included 20 syllogistic reasoning problems in which the logical conclusion was inconsistent with one's prior knowledge (e.g., “Premise 1: All fruits are sweet. Premise 2: Bananas are not sweet. Conclusion: Bananas are not fruits.” valid conclusion). In addition, four non-conflict items were included as the neutral condition in order to avoid a habitual response from the participants. They were instructed to suppose that all the premises are true and to decide whether the conclusion logically follows from the given premises. The measure showed good internal consistency (Cronbach's α = 0.83) in a Chinese sample ( Li et al., 2021 ). In this study, the internal consistency (Cronbach's α) of the SRPBB was 0.94.

Measures of Critical Thinking Disposition

The Chinese Critical Thinking Disposition Inventory was employed to measure CT disposition ( Peng et al., 2004 ). This scale has been developed in line with the conceptual framework of the California critical thinking disposition inventory. We measured five CT dispositions: truth-seeking (one's objectivity with findings even if this requires changing one's preconceived opinions, e.g., a person inclined toward being truth-seeking might disagree with “I believe what I want to believe.”), inquisitiveness (one's intellectual curiosity. e.g., “No matter what the topic, I am eager to know more about it”), analyticity (the tendency to use reasoning and evidence to solve problems, e.g., “It bothers me when people rely on weak arguments to defend good ideas”), systematically (the disposition of being organized and orderly in inquiry, e.g., “I always focus on the question before I attempt to answer it”), and CT self-confidence (the trust one places in one's own reasoning processes, e.g., “I appreciate my ability to think precisely”). Each disposition aspect contained 10 items, which the participants rated on a 6-point Likert-type scale. This measure has shown high internal consistency (overall Cronbach's α = 0.9) ( Peng et al., 2004 ). In this study, the CCTDI scale was assessed at Cronbach's α = 0.89, indicating good reliability.

Measure of Impulsivity

The well-known Barrett Impulsivity Scale ( Patton et al., 1995 ) was employed to assess three facets of impulsivity: non-planning impulsivity (e.g., “I plan tasks carefully”); motor impulsivity (e.g., “I act on the spur of the moment”); attentional impulsivity (e.g., “I concentrate easily”). The scale includes 30 statements, and each statement is rated on a 5-point scale. The subscales of non-planning impulsivity and attentional impulsivity were reversely scored. The BIS-11 has good internal consistency (Cronbach's α = 0.81, Velotti et al., 2016 ). This study showed that the Cronbach's α of the BIS-11 was 0.83.

Measures of Mental Health

The Depression Anxiety Stress Scale-21 was used to assess mental health problems such as depression (e.g., “I feel that life is meaningless”), anxiety (e.g., “I find myself getting agitated”), and stress (e.g., “I find it difficult to relax”). Each dimension included seven items, which the participants were asked to rate on a 4-point scale. The Chinese version of the DASS-21 has displayed a satisfactory factor structure and internal consistency (Cronbach's α = 0.92, Wang et al., 2016 ). In this study, the internal consistency (Cronbach's α) of the DASS-21 was 0.94.

The University Personality Inventory that has been commonly used to screen for mental problems of college students ( Yoshida et al., 1998 ) was also used for measuring mental health. The 56 symptom-items assessed whether an individual has experienced the described symptom during the past year (e.g., “a lack of interest in anything”). The UPI showed good internal consistency (Cronbach's α = 0.92) in a Chinese sample ( Zhang et al., 2015 ). This study showed that the Cronbach's α of the UPI was 0.85.

Statistical Analyses

We first performed analyses to detect outliers. Any observation exceeding three standard deviations from the means was replaced with a value that was three standard deviations. This procedure affected no more than 5‰ of observations. Hierarchical regression analysis was conducted to determine the extent to which facets of critical thinking were related to mental health. In addition, structural equation modeling with Amos 22.0 was performed to assess the latent relationship between CT, impulsivity, and mental health.

Descriptive Statistics and Bivariate Correlations

Table 1 presents descriptive statistics and bivariate correlations of all the variables. CT disposition such as truth-seeking, systematicity, self-confidence, and inquisitiveness was significantly correlated with DASS-21 and UPI, but neither CCTST-CV nor SRPBB was related to DASS-21 and UPI. Subscales of BIS-11 were positively correlated with DASS-21 and UPI, but were negatively associated with CT dispositions.

Table 1 . Descriptive results and correlations between all measured variables ( N = 314).

Regression Analyses

Hierarchical regression analyses were conducted to examine the effects of CT skill and disposition on mental health. Before conducting the analyses, scores in DASS-21 and UPI were reversed so that high scores reflected high levels of mental health. Table 2 presents the results of hierarchical regression. In model 1, the sum of the Z-score of DASS-21 and UPI served as the dependent variable. Scores in the CT ability tests and scores in the five dimensions of CCTDI served as predictors. CT skill and disposition explained 13% of the variance in mental health. CT skills did not significantly predict mental health. Two dimensions of dispositions (truth seeking and systematicity) exerted significantly positive effects on mental health. Model 2 examined whether CT predicted mental health after controlling for impulsivity. The model containing only impulsivity scores (see model-2 step 1 in Table 2 ) explained 15% of the variance in mental health. Non-planning impulsivity and motor impulsivity showed significantly negative effects on mental health. The CT variables on the second step explained a significantly unique variance (6%) of CT (see model-2 step 2). This suggests that CT skill and disposition together explained the unique variance in mental health after controlling for impulsivity. 1

Table 2 . Hierarchical regression models predicting mental health from critical thinking skills, critical thinking dispositions, and impulsivity ( N = 314).

Structural equation modeling was performed to examine whether impulsivity mediated the relationship between CT disposition (CT ability was not included since it did not significantly predict mental health) and mental health. Since the regression results showed that only motor impulsivity and non-planning impulsivity significantly predicted mental health, we examined two mediation models with either motor impulsivity or non-planning impulsivity as the hypothesized mediator. The item scores in the motor impulsivity subscale were randomly divided into two indicators of motor impulsivity, as were the scores in the non-planning subscale. Scores of DASS-21 and UPI served as indicators of mental health and dimensions of CCTDI as indicators of CT disposition. In addition, a bootstrapping procedure with 5,000 resamples was established to test for direct and indirect effects. Amos 22.0 was used for the above analyses.

The mediation model that included motor impulsivity (see Figure 1 ) showed an acceptable fit, χ ( 23 ) 2 = 64.71, RMSEA = 0.076, CFI = 0.96, GFI = 0.96, NNFI = 0.93, SRMR = 0.073. Mediation analyses indicated that the 95% boot confidence intervals of the indirect effect and the direct effect were (0.07, 0.26) and (−0.08, 0.32), respectively. As Hayes (2009) indicates, an effect is significant if zero is not between the lower and upper bounds in the 95% confidence interval. Accordingly, the indirect effect between CT disposition and mental health was significant, while the direct effect was not significant. Thus, motor impulsivity completely mediated the relationship between CT disposition and mental health.

Figure 1 . Illustration of the mediation model: Motor impulsivity as mediator variable between critical thinking dispositions and mental health. CTD-l = Truth seeking; CTD-2 = Analyticity; CTD-3 = Systematically; CTD-4 = Self-confidence; CTD-5 = Inquisitiveness. MI-I and MI-2 were sub-scores of motor impulsivity. Solid line represents significant links and dotted line non-significant links. ** p < 0.01.

The mediation model, which included non-planning impulsivity (see Figure 2 ), also showed an acceptable fit to the data, χ ( 23 ) 2 = 52.75, RMSEA = 0.064, CFI = 0.97, GFI = 0.97, NNFI = 0.95, SRMR = 0.06. The 95% boot confidence intervals of the indirect effect and the direct effect were (0.05, 0.33) and (−0.04, 0.38), respectively, indicating that non-planning impulsivity completely mediated the relationship between CT disposition and mental health.

Figure 2 . Illustration of the mediation model: Non-planning impulsivity asmediator variable between critical thinking dispositions and mental health. CTD-l = Truth seeking; CTD-2 = Analyticity; CTD-3 = Systematically; CTD-4 = Self-confidence; CTD-5 = Inquisitiveness. NI-I and NI-2 were sub-scores of Non-planning impulsivity. Solid line represents significant links and dotted line non-significant links. ** p < 0.01.

This study examined how critical thinking skill and disposition are related to mental health. Theories of psychotherapy suggest that human mental problems are in part due to a lack of CT. However, empirical evidence for the hypothesized relationship between CT and mental health is relatively scarce. This study explored whether and how CT ability and disposition are associated with mental health. The results, based on a university student sample, indicated that CT skill and disposition explained a unique variance in mental health. Furthermore, the effect of CT disposition on mental health was mediated by motor impulsivity and non-planning impulsivity. The finding that CT exerted a significant effect on mental health was in accordance with previous studies reporting negative correlations between CT disposition and mental disorders such as anxiety ( Suliman and Halabi, 2007 ). One reason lies in the assumption that CT disposition is usually referred to as personality traits or habits of mind that are a remarkable predictor of mental health (e.g., Benzi et al., 2019 ). This study further found that of the five CT dispositions, only truth-seeking and systematicity were associated with individual differences in mental health. This was not surprising, since the truth-seeking items mainly assess one's inclination to crave for the best knowledge in a given context and to reflect more about additional facts, reasons, or opinions, even if this requires changing one's mind about certain issues. The systematicity items target one's disposition to approach problems in an orderly and focused way. Individuals with high levels of truth-seeking and systematicity are more likely to adopt a comprehensive, reflective, and controlled way of thinking, which is what cognitive therapy aims to achieve by shifting from an automatic mode of processing to a more reflective and controlled mode.

Another important finding was that motor impulsivity and non-planning impulsivity mediated the effect of CT disposition on mental health. The reason may be that people lacking CT have less willingness to enter into a systematically analyzing process or deliberative decision-making process, resulting in more frequently rash behaviors or unplanned actions without regard for consequences ( Billieux et al., 2010 ; Franco et al., 2017 ). Such responses can potentially have tangible negative consequences (e.g., conflict, aggression, addiction) that may lead to social maladjustment that is regarded as a symptom of mental illness. On the contrary, critical thinkers have a sense of deliberativeness and consider alternate consequences before acting, and this thinking-before-acting mode would logically lead to a decrease in impulsivity, which then decreases the likelihood of problematic behaviors and negative moods.

It should be noted that although the raw correlation between attentional impulsivity and mental health was significant, regression analyses with the three dimensions of impulsivity as predictors showed that attentional impulsivity no longer exerted a significant effect on mental effect after controlling for the other impulsivity dimensions. The insignificance of this effect suggests that the significant raw correlation between attentional impulsivity and mental health was due to the variance it shared with the other impulsivity dimensions (especially with the non-planning dimension, which showed a moderately high correlation with attentional impulsivity, r = 0.67).

Some limitations of this study need to be mentioned. First, the sample involved in this study is considered as a limited sample pool, since all the participants are university students enrolled in statistics and mathematical finance, limiting the generalization of the findings. Future studies are recommended to recruit a more representative sample of university students. A study on generalization to a clinical sample is also recommended. Second, as this study was cross-sectional in nature, caution must be taken in interpreting the findings as causal. Further studies using longitudinal, controlled designs are needed to assess the effectiveness of CT intervention on mental health.

In spite of the limitations mentioned above, the findings of this study have some implications for research and practice intervention. The result that CT contributed to individual differences in mental health provides empirical support for the theory of cognitive behavioral therapy, which focuses on changing irrational thoughts. The mediating role of impulsivity between CT and mental health gives a preliminary account of the mechanism of how CT is associated with mental health. Practically, although there is evidence that CT disposition of students improves because of teaching or training interventions (e.g., Profetto-Mcgrath, 2005 ; Sanja and Krstivoje, 2015 ; Chan, 2019 ), the results showing that two CT disposition dimensions, namely, truth-seeking and systematicity, are related to mental health further suggest that special attention should be paid to cultivating these specific CT dispositions so as to enhance the control of students over impulsive behaviors in their mental health promotions.

Conclusions

This study revealed that two CT dispositions, truth-seeking and systematicity, were associated with individual differences in mental health. Furthermore, the relationship between critical thinking and mental health was mediated by motor impulsivity and non-planning impulsivity. These findings provide a preliminary account of how human critical thinking is associated with mental health. Practically, developing mental health promotion programs for university students is suggested to pay special attention to cultivating their critical thinking dispositions (especially truth-seeking and systematicity) and enhancing the control of individuals over impulsive behaviors.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics Statement

The studies involving human participants were reviewed and approved by HUST Critical Thinking Research Center (Grant No. 2018CT012). The patients/participants provided their written informed consent to participate in this study.

Author Contributions

XR designed the study and revised the manuscript. ZL collected data and wrote the manuscript. SL assisted in analyzing the data. SS assisted in re-drafting and editing the manuscript. All the authors contributed to the article and approved the submitted version.

This work was supported by the Social Science Foundation of China (grant number: BBA200034).

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: mental health, critical thinking ability, critical thinking disposition, impulsivity, depression

Citation: Liu Z, Li S, Shang S and Ren X (2021) How Do Critical Thinking Ability and Critical Thinking Disposition Relate to the Mental Health of University Students? Front. Psychol. 12:704229. doi: 10.3389/fpsyg.2021.704229

Received: 04 May 2021; Accepted: 21 July 2021; Published: 19 August 2021.

Reviewed by:

Copyright © 2021 Liu, Li, Shang and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Xuezhu Ren, renxz@hust.edu.cn

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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The Science Behind Critical Thinking and Its Role in Mental Health

In the journey towards understanding and improving mental health, one cannot overlook the influence of a powerful cognitive tool known as critical thinking..

Here we will delve into the science underpinning critical thinking and shed light on its role in bolstering mental health. 

Exploring the Foundations of Critical Thinking 

The term 'critical thinking' encompasses a broad set of cognitive skills and dispositions aimed at objective analysis and evaluation of information. It involves thinking in a clear, logical, and reflective manner to make reasoned judgements. Critical thinking is not merely being critical in the negative sense, but rather, it's about engaging with information critically - questioning, analysing, and evaluating - to reach a sound, unbiased conclusion. 

The science behind critical thinking is rooted in various cognitive processes, including perception, memory, attention, and problem-solving. It involves the prefrontal cortex, the part of the brain associated with complex cognitive behaviour, decision-making, and social behaviour. A strong capacity for critical thinking implies that these cognitive processes and brain regions are functioning optimally. 

Critical Thinking and Mental Health: The Connection

The relationship between critical thinking and mental health is more intertwined than it might initially appear. Many mental health issues can be traced back to negative or distorted thinking patterns. These unhelpful thinking styles can lead to emotional distress and behavioural problems. It's here that critical thinking comes into play, as it equips individuals with the ability to identify, analyse, and ultimately challenge these negative thought patterns.

The Interplay of Perception and Critical Thinking 

Perception, the process of interpreting the information that we receive through our senses, plays a significant role in critical thinking. It shapes our understanding of the world around us and influences our reactions to various situations. However, perception can sometimes be biased or distorted, leading to misunderstandings or misconceptions. 

Critical thinking allows us to scrutinise our perceptions and question their accuracy. It encourages us to seek evidence and consider alternative perspectives, leading to a more accurate and comprehensive understanding of our experiences. This process can have a profound impact on our mental health, as it helps to challenge distorted perceptions that can fuel negative emotions or unhealthy behaviours.

Memory's Role in Critical Thinking

Memory, another key cognitive process, also intersects with critical thinking. Our memories of past experiences can shape our current thoughts, feelings, and behaviours. However, memories are not always accurate representations of reality. They can be influenced by our current mood, biases, and beliefs, leading to distorted recollections.

Critical thinking can help us evaluate our memories objectively. It prompts us to question the accuracy of our recollections and consider the influence of external factors. This reflective approach can prevent us from basing our beliefs or behaviours on distorted memories, thereby enhancing our mental health.

Attention and Its Influence on Critical Thinking

Attention, the cognitive process of selectively concentrating on one aspect while ignoring others, is crucial for critical thinking. It enables us to focus on relevant information and ignore irrelevant distractions. However, attention can be biased towards negative information, especially in individuals with mental health issues such as anxiety or depression.

Critical thinking skills can aid in managing attentional biases. It involves questioning why we are focusing on certain aspects and ignoring others, considering the impact of this focus, and making a conscious effort to direct our attention in a more balanced manner. This approach can reduce negative bias, improve emotional well-being, and enhance overall mental health. 

Problem-Solving: A Crucial Component of Critical Thinking

Problem-solving is an integral part of critical thinking. It involves identifying problems, generating potential solutions, and evaluating these solutions to make an informed decision. Individuals with strong problem-solving skills are often good critical thinkers, as they can analyse situations objectively, consider various solutions, and make reasoned decisions based on evidence. In the context of mental health, problem-solving skills can help manage stress, navigate life's challenges, and improve overall well-being. 

Cognitive Biases and Critical Thinking 

Cognitive biases, systematic errors in thinking that influence our judgements and decisions, can impede critical thinking. They can lead to distorted perceptions, irrational beliefs, and poor decision-making, which can negatively impact mental health. Common cognitive biases include confirmation bias, where we focus on information that confirms our pre-existing beliefs, and negativity bias, where we pay more attention to negative information.

Critical thinking can help us recognise and overcome these cognitive biases. It encourages us to question our biases, seek diverse perspectives, and make decisions based on objective evidence rather than biased perceptions. By mitigating the impact of cognitive biases, critical thinking can promote healthier thought patterns, better decision-making, and improved mental health.

The Impact of Critical Thinking on Emotional Intelligence 

Emotional intelligence, the ability to understand, use, and manage our own emotions in positive ways, can be enhanced through critical thinking. By critically analysing our emotional responses, we can gain insights into our emotional patterns, understand the triggers for certain emotions, and develop effective strategies to manage these emotions. This understanding can lead to improved emotional regulation, better interpersonal relationships, and enhanced mental health.

Critical Thinking and Resilience

Critical thinking also plays a significant role in building resilience, the ability to bounce back from adversity. Resilient individuals use critical thinking to understand the nature of the adversity, explore various coping strategies, and make informed decisions to overcome the challenge. This ability not only helps manage the immediate adversity but also fosters mental strength, which can safeguard against future challenges.

In conclusion, the science behind critical thinking and its role in mental health is a fascinating and integral area of exploration. By enhancing our cognitive processes, helping us navigate our emotions, and bolstering our resilience, critical thinking serves as a powerful tool for mental health.

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If you are struggling with mental health issues or feeling overwhelmed, we invite you to reach out to us for support. We are here to listen, guide, and empower you towards a healthier and happier life. Don't let mental health challenges hold you back from living your best life. Contact us today to schedule an appointment and take the first step towards better mental health.

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Sound critical thinking skills can help clinicians avoid cognitive biases and diagnostic errors. This article describes three critical thinking skills essential to effective clinical care – clinical reasoning, evidence-informed decision-making, and systems thinking – and approaches to develop these skills during clinician training.

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Critical Thinking Skills in Health Care Professional Students: A Systematic Review

Brudvig, Tracy J. PT, DPT, PhD, OCS; Dirkes, Angelique PT, DPT, MS; Dutta, Priyanka PT, MS; Rane, Kalpita PT, MS

Tracy Brudvig is a clinical associate professor in the Department of Physical Therapy in the MGH Institute of Health Professions, 36 1st Avenue, Boston, MA 02129 ( [email protected] ). Please address all correspondence to Tracy Brudvig.

Angelique Dirkes is a clinical instructor in the Department of Physical Therapy in the MGH Institute of Health Professions, Boston, Massachusetts.

Priyanka Dutta was a student in the Master of Science in Physical Therapy program at the MGH Institute of Health Professions, Boston, Massachusetts, when this study was conducted.

Kalpita Rane was a student in the Master of Science in Physical Therapy program at the MGH Institute of Health Professions, Boston, Massachusetts, when this study was conducted.

The authors declare no conflict of interest. Received January 8, 2012, and accepted August 19, 2012.

Background and Purpose. 

The purpose of this systematic review is to determine if critical-thinking skills in health care professional students change as a result of participating in a health care professional education program, and to assess the quality of the evidence evaluating this change.

Method/Model Description and Evaluation. 

The study design was a systematic review. Six electronic databases were searched. Articles were graded using the Evaluation Guidelines for Rating the Quality of an Intervention Study.

Outcomes. 

Eighteen articles were identified as meeting the inclusion criteria. Ten articles were identified in nursing, 5 in physical therapy and occupational therapy, 2 in pharmacy, and 1 in medicine. The scores on the Evaluation Guidelines for Rating the Quality of an Intervention Study ranged from 17 to 26 out of 48. The intraclass correlation of the 2 raters on the Evaluation Guidelines for Rating the Quality of an Intervention Study was 0.87. Eight studies in nursing, 2 studies in physical therapy, 1 study each in occupational therapy, pharmacy, and medicine showed statistically significant change in criticalthinking skills.

Discussion and Conclusion. 

The evidence measuring the acquisition of criticalthinking skills in the fields of physical therapy, occupational therapy, pharmacy, and medicine is scarce. In nursing, although the majority of the studies support the acquisition of critical- thinking skills, none of the studies established appropriate sample size and statistical power analysis, and the cross-sectional studies did not perform group matching beyond sex and age. In physical therapy, the results are mixed and the studies lack adequate statistical power. In occupational therapy, pharmacy, and medicine, the studies that showed a statistically significant increase in critical-thinking skills had relatively small sample sizes and weak statistical power. There is a need for additional welldesigned studies looking at the acquisition of critical-thinking skills in all health care fields.

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• What Is Critical Thinking? | Definition & Examples

What Is Critical Thinking? | Definition & Examples

Published on May 30, 2022 by Eoghan Ryan . Revised on May 31, 2023.

Critical thinking is the ability to effectively analyze information and form a judgment .

To think critically, you must be aware of your own biases and assumptions when encountering information, and apply consistent standards when evaluating sources .

Critical thinking skills help you to:

• Identify credible sources
• Evaluate and respond to arguments
• Assess alternative viewpoints
• Test hypotheses against relevant criteria

Table of contents

Why is critical thinking important, critical thinking examples, how to think critically, other interesting articles, frequently asked questions about critical thinking.

Critical thinking is important for making judgments about sources of information and forming your own arguments. It emphasizes a rational, objective, and self-aware approach that can help you to identify credible sources and strengthen your conclusions.

Critical thinking is important in all disciplines and throughout all stages of the research process . The types of evidence used in the sciences and in the humanities may differ, but critical thinking skills are relevant to both.

In academic writing , critical thinking can help you to determine whether a source:

• Is free from research bias
• Provides evidence to support its research findings
• Considers alternative viewpoints

Outside of academia, critical thinking goes hand in hand with information literacy to help you form opinions rationally and engage independently and critically with popular media.

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Critical thinking can help you to identify reliable sources of information that you can cite in your research paper . It can also guide your own research methods and inform your own arguments.

Outside of academia, critical thinking can help you to be aware of both your own and others’ biases and assumptions.

Academic examples

However, when you compare the findings of the study with other current research, you determine that the results seem improbable. You analyze the paper again, consulting the sources it cites.

You notice that the research was funded by the pharmaceutical company that created the treatment. Because of this, you view its results skeptically and determine that more independent research is necessary to confirm or refute them. Example: Poor critical thinking in an academic context You’re researching a paper on the impact wireless technology has had on developing countries that previously did not have large-scale communications infrastructure. You read an article that seems to confirm your hypothesis: the impact is mainly positive. Rather than evaluating the research methodology, you accept the findings uncritically.

Nonacademic examples

However, you decide to compare this review article with consumer reviews on a different site. You find that these reviews are not as positive. Some customers have had problems installing the alarm, and some have noted that it activates for no apparent reason.

You revisit the original review article. You notice that the words “sponsored content” appear in small print under the article title. Based on this, you conclude that the review is advertising and is therefore not an unbiased source. Example: Poor critical thinking in a nonacademic context You support a candidate in an upcoming election. You visit an online news site affiliated with their political party and read an article that criticizes their opponent. The article claims that the opponent is inexperienced in politics. You accept this without evidence, because it fits your preconceptions about the opponent.

There is no single way to think critically. How you engage with information will depend on the type of source you’re using and the information you need.

However, you can engage with sources in a systematic and critical way by asking certain questions when you encounter information. Like the CRAAP test , these questions focus on the currency , relevance , authority , accuracy , and purpose of a source of information.

When encountering information, ask:

• Who is the author? Are they an expert in their field?
• What do they say? Is their argument clear? Can you summarize it?
• When did they say this? Is the source current?
• Where is the information published? Is it an academic article? Is it peer-reviewed ?
• Why did the author publish it? What is their motivation?
• How do they make their argument? Is it backed up by evidence? Does it rely on opinion, speculation, or appeals to emotion ? Do they address alternative arguments?

Critical thinking also involves being aware of your own biases, not only those of others. When you make an argument or draw your own conclusions, you can ask similar questions about your own writing:

• Am I only considering evidence that supports my preconceptions?
• Is my argument expressed clearly and backed up with credible sources?
• Would I be convinced by this argument coming from someone else?

If you want to know more about ChatGPT, AI tools , citation , and plagiarism , make sure to check out some of our other articles with explanations and examples.

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Critical thinking refers to the ability to evaluate information and to be aware of biases or assumptions, including your own.

Like information literacy , it involves evaluating arguments, identifying and solving problems in an objective and systematic way, and clearly communicating your ideas.

Critical thinking skills include the ability to:

You can assess information and arguments critically by asking certain questions about the source. You can use the CRAAP test , focusing on the currency , relevance , authority , accuracy , and purpose of a source of information.

Ask questions such as:

• Who is the author? Are they an expert?
• How do they make their argument? Is it backed up by evidence?

A credible source should pass the CRAAP test  and follow these guidelines:

• The information should be up to date and current.
• The author and publication should be a trusted authority on the subject you are researching.
• The sources the author cited should be easy to find, clear, and unbiased.
• For a web source, the URL and layout should signify that it is trustworthy.

Information literacy refers to a broad range of skills, including the ability to find, evaluate, and use sources of information effectively.

Being information literate means that you:

• Know how to find credible sources
• Use relevant sources to inform your research
• Understand what constitutes plagiarism
• Know how to cite your sources correctly

Confirmation bias is the tendency to search, interpret, and recall information in a way that aligns with our pre-existing values, opinions, or beliefs. It refers to the ability to recollect information best when it amplifies what we already believe. Relatedly, we tend to forget information that contradicts our opinions.

Although selective recall is a component of confirmation bias, it should not be confused with recall bias.

On the other hand, recall bias refers to the differences in the ability between study participants to recall past events when self-reporting is used. This difference in accuracy or completeness of recollection is not related to beliefs or opinions. Rather, recall bias relates to other factors, such as the length of the recall period, age, and the characteristics of the disease under investigation.

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Think Critically Before Thinking Critically

The source of information is often as important as the information itself..

Posted February 11, 2020 | Reviewed by Daniel Lyons M.A.

This post is by Jeffrey A. Greene and Brian M. Cartiff of the University of North Carolina at Chapel Hill.

The Internet’s superabundance of information (Lankshear et al., 2000) has led to a “data smog” (Shenk, 1998) of mis- and dis-information (Wardle, 2019). This vast proliferation of dangerous information is particularly concerning given more and more people are primarily getting their news online (Fedeli & Matsa, 2018).

To help people cut through the smog, policy-makers, educators, and parents have called for a greater focus on teaching critical thinking in schools. But what is critical thinking, and can we really expect people to engage in such thinking consistently and successfully across the many topics they encounter every day? In short, the answer is no.

Concerns about people’s critical thinking, or lack thereof, extend back to the time of Plato and his stories of Socrates as the gadfly of the Athenian state and marketplace, stinging and questioning people to make them aware of their lazy and complacent thought processes. In the early 20th century, the pragmatic philosopher John Dewey pointed out that American schools were not helping students learn how to think deeply and reflectively about ideas; instead, he argued they overemphasized specific content knowledge.

Dewey claimed that the major aim of schools should be to teach critical thinking, which he defined as the “active, persistent, and careful consideration of any belief or supposed form of knowledge in the light of the grounds that support it and the further conclusions to which it tends” (Dewey, 1933, p. 9). Modern scholars including Paul (1992), Facione (1990), and Ennis (1991, 1996) have argued that critical thinking involves dispositions such as being open-minded and intellectually flexible (i.e., being willing to look at ideas from multiple perspectives) and skills such as being able to reflect on ideas and one’s own biases.

Other definitions of critical thinking focus on the “ability to engage in purposeful, self-regulatory judgment” necessary for problem-solving, reasoning, and conceptual understanding (Abrami et al., 2008, p. 1102). Regardless of the definition used, researchers have shown that people struggle to learn how to think critically, particularly when they are taught those skills outside of an academic discipline or setting, such as in “general critical thinking” courses (Abrami et al., 2015; Willingham, 2007).

Why is critical thinking so difficult for people to do well? Perhaps it is because critically evaluating information requires a tremendous amount of prior knowledge and a disposition for questioning the data and oneself, neither of which is easy to acquire. Even relatively knowledgeable people can struggle to think critically. Medical students are prone to start diagnosing themselves with the illnesses they are learning about (i.e., medical student disease; Hunter et al., 1964; Woods et al., 1966). With extensive training and experience, medical students gain knowledge to appropriately contextualize and interpret symptoms and other related health information; that is, they learn to think critically about the evidence to make appropriate diagnoses.

Similarly, the proliferation of medical information sites like WebMD has led people to diagnose themselves in ways similar to medical students (Starcevic & Berle, 2013). However, research has shown that online symptom checkers are accurate only about one-third of the time (Semigran et al., 2015), leading doctors and scholars to recommend that most people avoid using the Internet for researching illness-related information altogether (Doherty-Torstrick et al., 2016). Thus, expecting people to think critically about medical or technical, scientific information is unrealistic because most people are not medical experts; they do not have the appropriate training nor the necessary vast amounts of specific, medical knowledge.

The modern world requires critical thinking about a large variety of topics, ranging from biology (e.g., vaccines) to political science (e.g., constitutional procedures) to psychology (e.g., confirmation bias ). Yet, research has shown that it is difficult to become an expert in even one area, let alone many (Collins, 2014; Ericsson et al., 2018). So, how can we help people successfully deal with all the information they encounter, and often seek out, online and elsewhere?

The answer lies in redefining critical thinking. Good critical thinkers know when they have the disciplinary knowledge necessary to directly evaluate reasoning and evidence (i.e., first-order reasoning; Chinn & Duncan, 2018). Likewise, good critical thinkers have the self-knowledge and metacognitive skills to know when they do not possess the necessary knowledge, skills, or training to directly evaluate the evidence, and instead should shift to determining which experts or sources to believe about the topic (i.e., second-order reasoning; Chinn & Duncan, 2018).

Thus, good critical thinking sometimes requires only first-order reasoning but more often needs both the metacognitive skills to determine when second-order reasoning is required instead (Barzilai & Chinn, 2018), as well as the skills to determine reliable sources (Brante & Strømsø, 2018; Greene, 2016). Second-order reasoning skills can be taught and learned. As but one example, the Stanford History Education Group has developed a Civic Online Reasoning website with tools and curricula.

In sum, many modern scholars, employers, policymakers, and educators (e.g., Tsui, 2002) agree with Dewey that critical thinking should be a “fundamental aim and an overriding ideal of education” (Bailin & Siegel, 2003, p. 188). However, the “data smog” created by the vast amounts of often contradictory information found on the Internet calls for new views of what critical thinking involves. If people happen to have the disciplinary expertise, background knowledge, and skills to competently evaluate information and evidence about a particular topic, then they can engage first-order reasoning, which includes enacting the dispositions and cognitive skills that many critical thinking scholars have discussed in the past.

At the same time, when people do not possess such knowledge and skills, which describes most of us much of the time, apt critical thinking would involve realizing the need to switch to second-order reasoning: comparing and evaluating the sources of the information using these same dispositions and skills (Barzilai & Chinn, 2018; Wineburg & McGrew, 2017). Thus, people should think critically about thinking critically, and in many cases, evaluate the sources of information rather than the information itself.

Abrami, P. C., Bernard, R. M., Borokhovski, E., Waddington, D. I., Wade, C. A., & Persson, T. (2015). Strategies for teaching students to think critically: A meta-analysis. Review of Educational Research, 85 (2), 275-314. https://doi.org/10.3102/0034654314551063

Bailin, S., & Siegel, H. (2003). Critical thinking. In N. Blake, P. Smeyers, R. Smith, & P. Standish (Eds.), The Blackwell guide to the philosophy of education (pp. 181–193). Oxford, UK: Blackwell.

Barzilai, S., & Chinn, C. A. (2018). On the goals of epistemic education: Promoting apt epistemic performance. Journal of the Learning Sciences, 27 (3), 353–389. doi:10.1080/10508406.2017.1392968

Brante, E. W., & Strømsø, H. I. (2018). Sourcing in text comprehension: A review of interventions targeting sourcing skills. Educational Psychology Review, 30 (3), 773-799.

Chinn, C. A., & Duncan, R. G. (2018). What is the value of general knowledge of scientific reasoning? In K. Engelmann, F. Fischer, J. Osborne, & C. A. Chinn (Eds.), Scientific reasoning and argumentation: The role of domain-specific and domain-general knowledge (pp. 460-478). New York, NY: Routledge.

Collins, H. (2014). Are we all scientific experts now? Cambridge, UK: Polity.

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Doherty-Torstrick, E. R., Walton, K. E., & Fallon, B. A. (2016). Cyberchondria: Parsing health anxiety from online behavior. Psychosomatics, 57 (4), 390–400. https://doi.org/10/ggcm5z

Ennis, R. H. (1991). Critical thinking: A streamlined conception. Teaching Philosophy, 14 (1), 5-24. https://doi.org/10.5840/teachphil19911412

Ennis, R. H. (1996). Critical thinking dispositions: Their nature and assessability. Informal Logic, 18 (2-3), 165-182. https://doi.org/10.22329/il.v18i2.2378

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Fedeli, S., & Matsa, K. E. (2018, July 17). Use of mobile devices for news continues to grow, outpacing desktops and laptops. Retrieved from https://www.pewresearch.org/fact-tank/2018/07/17/use-of-mobile-devices-…

Greene, J. A. (2016). Interacting epistemic systems within and beyond the classroom. In J. A. Greene, W. A. Sandoval, & I. Bråten (Eds.). Handbook of epistemic cognition (pp. 265-278). New York: Routledge.

Hunter, R. C. A., Lohrenz, J. G., & Schwartzman, A. E. (1964). Nosophobia and hypochondriasis in medical students. The Journal of Nervous and Mental Disease, 139 (2), 147-152. https://doi.org/10.1097/00005053-196408000-00008

Lankshear, C., Peters, M., & Knobel, M. (2000). Information, knowledge and learning: Some issues facing epistemology and education in a digital age. Journal of the Philosophy of Education, 34 (1), 17–39. https://doi.org/10/bkn52d

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Semigran, H. L., Linder, J. A., Gidengil, C., & Mehrotra, A. (2015). Evaluation of symptom checkers for self diagnosis and triage: Audit study. The BMJ , h3480. https://doi.org/10/gb3sw7

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Tsui, L. (2002). Fostering critical thinking through effective pedagogy: Evidence from four institutional case studies. Journal of Higher Education, 73 (6), 740–763. https://doi.org/10.1080/00221546.2002.11777179

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Communication Sciences and Disorders Dissertations

Critical thinking in public health: an exploration of skills used by public health practitioners and taught by instructors.

Martha Elizabeth Alexander Follow

Date of Award

Fall 12-18-2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Educational Psychology and Special Education

First Advisor

Nannette Commander, Ph.D.

Second Advisor

Jodi Kaufmann, Ph.D.

Third Advisor

Daphne Greenberg, Ph.D.

Fourth Advisor

Ann Cale Kruger, Ph.D.

Critical thinking is crucial in public health due to the increasingly complex challenges faced by this field, including disease prevention, illness management, economic forces, and changes in the health system. Although there is a lack of consensus about how practitioners and educators view critical thinking, such skills are essential to the functions of applying theories and scientific research to public health interventions (Rabinowitz, 2012). The purpose of this research was to examine the relationship between critical thinking skills used by public health practitioners and critical thinking skills taught to graduate students in schools/programs of public health. Through interviews with public health practitioners and instructors twelve distinct critical thinking skills were identified. Findings of this study indicate that many critical thinking skills used by practitioners are aligned with those taught in courses, such as analysis, identification and assessment of a problem, information seeking, questioning, and reflection. This study also identified conceptualizing, evaluating, interpreting, predicting, reasoning, and synthesizing as critical thinking skills that may not be receiving the explicit attention deserved in both the workplace and the classroom. A high percentage of practitioners identified explaining as a critical thinking skill often used in the field, while few instructors reported teaching this skill. The results of this study have important implications for informing public health curricula and workforce development programs about critical thinking. Further, this research serves as a model for other professions to explore the relationship between critical thinking skills used by practitioners and those taught in higher education.

https://doi.org/10.57709/6494807

Recommended Citation

Alexander, Martha Elizabeth, "Critical Thinking in Public Health: An Exploration of Skills Used by Public Health Practitioners and Taught by Instructors." Dissertation, Georgia State University, 2014. doi: https://doi.org/10.57709/6494807

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Constructing critical thinking in health professional education

Affiliations.

• 1 Centre for Health Education Scholarship, University of British Columbia, Vancouver, Canada. [email protected].
• 2 Centre for Health Education Scholarship, University of British Columbia, Vancouver, Canada.
• PMID: 29619664
• PMCID: PMC6002289
• DOI: 10.1007/s40037-018-0415-z

Introduction: Calls for enabling 'critical thinking' are ubiquitous in health professional education. However, there is little agreement in the literature or in practice as to what this term means and efforts to generate a universal definition have found limited traction. Moreover, the variability observed might suggest that multiplicity has value that the quest for universal definitions has failed to capture. In this study, we sought to map the multiple conceptions of critical thinking in circulation in health professional education to understand the relationships and tensions between them.

Methods: We used an inductive, qualitative approach to explore conceptions of critical thinking with educators from four health professions: medicine, nursing, pharmacy, and social work. Four participants from each profession participated in two individual in-depth semi-structured interviews, the latter of which induced reflection on a visual depiction of results generated from the first set of interviews.

Results: Three main conceptions of critical thinking were identified: biomedical, humanist, and social justice-oriented critical thinking. 'Biomedical critical thinking' was the dominant conception. While each conception had distinct features, the particular conceptions of critical thinking espoused by individual participants were not stable within or between interviews.

Discussion: Multiple conceptions of critical thinking likely offer educators the ability to express diverse beliefs about what 'good thinking' means in variable contexts. The findings suggest that any single definition of critical thinking in the health professions will be inherently contentious and, we argue, should be. Such debates, when made visible to educators and trainees, can be highly productive.

Keywords: Clinical reasoning; Critical thinking; Health professions education.

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Conflict of interest statement

R. Kahlke and K. Eva declare that they have no competing interests.

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• Facione PA. Critical thinking: a statement of expert consensus for purposes of educational assessment and instruction. Millbrae: California Academic Press; 1990.
• Black B. Critical thinking—a definition and taxonomy for Cambridge Assessment: supporting validity arguments about critical thinking assessments administered by Cambridge Assessment. 34th IAEA Annual Conference; 09.9.2008; Cambridge; 2008.
• Fischer SC, Spiker VA, Riedel SL. Critical thinking training for army officers volume two: a model of critical thinking. Arlington: US Army Research Institute; 2009.
• Ennis RH. Critical thinking: a streamlined conception. In: Davies M, Barnett R, editors. The Palgrave handbook of critical thinking in higher education. New York: Palgrave MacMillan; 2015. pp. 31–47.

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More From Forbes

10 elements of critical thinking – and how to develop them.

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creative idea.Concept of idea and innovation

My 6/7/24 post here – “Your Three Most Important Career Skills” – focused on the importance – and paucity – of critical thinking, critical listening, and critical reading.

Predictably, it prompted much reader response, mostly asking for elaboration.

What Comprises Critical Thinking

1. open-mindedness.

Malcolm Forbes postulated, “The role of education is to replace an empty mind with an open one.” Critical thinking needs receptivity to new ideas and perspectives, and willingness to reconsider one’s beliefs or opinions – no matter how fundamental – when new evidence or arguments arise.

2. Curiosity

“I’m not necessarily smarter than anyone else,” explained Albert Einstein. “I’m infinitely more curious.” He had a natural inclination – from early childhood – to ask questions, seek information, and explore various viewpoints. His favorite question: “What if…?”

Best High-Yield Savings Accounts Of 2024

Best 5% interest savings accounts of 2024, 3. mental stamina.

Critical thinking is difficult, rigorous, almost always takes time and patience, and can be exhausting. That’s OK, but you should never let a conclusion be the place where you got tired of thinking. Push on.

4. Analysis

Analysis breaks down complex information into smaller parts, to understand its components and how they relate. It’s our left brain at work: linear, logical, methodical, sequential, rational, and objective. It engages in deductive thinking. Computers also do this.

5. Interpretation and Inference

Interpretation makes meaning out of data, relying not just on the brain, but also on experience. It’s our transcendental right brain having fun: creative, intuitive, random, holistic, and playful. It engages in inductive thinking, which today’s computers can’t do, but which A.I. is trying. Through inference, we make sensible deductions based on available information; reach reasonable, workable conclusions; and assess the viability of those conclusions.

6. Evaluation

What’s it worth? To make better decisions, we must accurately assess the credibility, relevance, and significance of information, arguments, and/or evidence.

7. Articulation

“If you can’t explain something to a six-year-old,” declared Albert Einstein, “you probably don’t understand it yourself.” Critical intake and critical output are one and the same.

8. Problem-solving

Both sides of our brains solve problems, just differently. Critical thinking is about the ability to do both with equal aplomb.

9. Self-Accountability and Reflection

Bertrand Russell advised, "In all affairs it's a healthy thing now and then to hang a question mark on the things you’ve long taken for granted." In this case – our own thinking processes, biases, and assumptions – “now and then” should mean “always and ever.”

10. Metacognition

Avid self-awareness of one's own thinking processes, cognitive strategies, and sphere of awareness can insure ongoing improvement of critical skills.

Developing Your Critical Thinking

1. think creatively.

“Curiosity is the key to creativity,” said Akio Morita, founder of Sony. Cultivate your creativity by exploring the unknown and the ambiguous. Welcome different perspectives, alternative solutions, and new thinking. Always be looking for the spark. Listen to the new guy.

2. Ask Questions

Nothing starts until there is a question – or better, multiple questions. Cultivate a curious mindset by asking probing questions. Question assumptions, biases, and implications. Nothing is off the table.

3. Seek Diverse Perspectives

Diversity is much more than demographics. “Diversity,” explained Malcolm Forbes, “is the art of thinking independently together.” Welcome a variety of viewpoints and opinions, especially those different from your own. Engage in active discussions with people who hold different beliefs. Constantly challenge what you know or believe.

4. Evaluate Information

Learn to critically – and objectively – evaluate the credibility, relevance, and reliability of sources of information. Today’s chaotic media circus, further manipulated by special interests, elevates this challenge.

5. Practice Analytical Thinking

As analytical thinking is more orderly than creative thinking, it can be practiced every day. Good idea.

6. Develop Logical Reasoning Skills

Practice deductive and inductive reasoning to draw logical conclusions from what you already have. But remember, logic and creativity are often at odds.

Things look different in the rear-view mirror, and a day (or more) later.

8. Learn Different Problem-Solving Techniques

Different problems can be solved different ways. Conversely, many problems can be solved many ways.

9. Learn Active Listening

Identify the barriers to active listening – presuppositions, for example – and eliminate them. Fast.

10. Read. Read. Read!

Reading is the most proactive and stimulating way of taking in the world, not by clicking on little blue links, but by real reading: wide, deep, and time-consuming reading, which has a positive effect on thinking. Great leaders are great readers. This we know.

None of this happens in a day, but starting it happens any day.

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• Mental Health

Are There Mental Health Benefits of Video Games?

There are many misconceptions about video games and the impact they have on mental health. The truth is that video games have many benefits, including developing complex problem-solving skills and promoting social interaction through online gaming. Video games can be a great way to stimulate your mind and improve your mental health. 

Benefits of Video Games

Playing video games has numerous benefits for your mental health. Video games can help you relieve stress and get your mind going. Some benefits include: 

Mental stimulation. Video games often make you think. When you play video games, almost every part of your brain is working to help you achieve higher-level thinking. Depending on the complexity of the game, you may have to think, strategize, and analyze quickly. Playing video games works with deeper parts of your brain that improve development and critical thinking skills.

Feeling accomplished. In the game, you have goals and objectives to reach. Once you achieve them, they bring you a lot of satisfaction, which improves your overall well-being. This sense of achievement is heightened when you play games that give you trophies or badges for certain goals. Trying to get more achievements gives you something to work toward. 

Mental health recovery. Regardless of the type, playing games can help with trauma recovery. Video games can act as distractions from pain and psychological trauma. Video games can also help people who are dealing with mental disorders like anxiety, depression, attention deficit hyperactivity disorder (ADHD) , and post-traumatic stress disorder (PTSD).

Social interaction. Multiplayer and online games are good for virtual social interaction. In fast-paced game settings, you’ll need to learn who to trust and who to leave behind within the game. Multiplayer games encourage cooperation. It’s also a low-stakes environment for you to test out talking to and fostering relationships with new people. 

Emotional resilience. When you fail in a game or in other situations, it can be frustrating. Video games help people learn how to cope with failure and keep trying. This is an important tool for children to learn and use as they get older. 

Despite what people may think, playing video games boosts your mood and has lasting effects. Whether you’re using gaming to spend time with your friends or to release some stress, it's a great option. 

Playing for Your Well-Being

Playing video games has been linked to improved moods and mental health benefits. It might seem natural to think that violent video games like first-person shooters aren’t good for your mental health. However, all video games can be beneficial for different reasons.

Try strategic video games. Role-playing and other strategic games can help strengthen problem-solving skills. There’s little research that says violent video games are bad for your mental health. Almost any game that encourages decision-making and critical thinking is beneficial for your mental health. 

Set limits. Though video games themselves aren’t bad for your mental health, becoming addicted to them can be. Spending too much time gaming can lead to isolation. You may also not want to be around people in the real world. When you start to feel yourself using video games as an escape, you might need to slow down.

If you can’t stop playing video games on your own, you can contact a mental health professional .  

Play with friends. Make game time fun by playing with friends. There are online communities you can join for your favorite games. Moderate gaming time with friends can help with socialization, relaxation, and managing stress. 

Limits of Video Games as a Mood Booster

Video games stop being good for you when you play an excessive amount. More than 10 hours per week is considered “excessive.” In these cases, you may:

• Have anxious feelings
• Be unable to sleep
• Not want to be in social settings

Another troubling sign is using video games to escape real life. As noted above, this type of behavior can lead to video game addiction, which then leads to other negative behaviors. Too much gaming can become a problem, but in moderation, it can do great things for your mental health.

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Here’s how you can improve your health by stopping negativity and embracing optimism

Prince Bhojwani sits on Charlies Bunion mountain along the Appalachian Trail in Great Smoky Mountains National Park in Tennessee on April 17, 2022. (Nita Bhojwani via AP)

Hayami Koga, a postdoctoral research fellow at the Harvard Center for Population and Development Studies, poses for a portrait in Cambridge, Mass., on May 23, 2023. (Kaoru Gleissner via AP)

This cover image released by Avery Books shows “Practical Optimism: The Art, Science, and Practice of Exceptional Well-Being” by Sue Varma, MD. (Avery via AP)

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Prince Bhojwani never thought of himself as a negative person, until three trips to the hospital in one month forced him to reconsider.

Before May 2018, he was a healthy but chronically worried start-up founder who regularly did 20-mile (32-kilometer) bike rides. When he suddenly became barely able to walk, with blurry vision and spiking blood pressure, emergency room doctors suspected a stroke, but couldn’t pinpoint the cause of his illness.

A close friend, however — “one of the most optimistic people I know,” he said — pointed out Bhojwani often lacked faith that things would work out, and suggested that had pushed him to burn out.

“I started looking at the world very differently, literally the next day,” said Bhojwani, who lives in New York City. He started meditating and taking a moment every morning to feel grateful to be alive. He also found purpose by co-founding a nonprofit, Asana Voices, a South Asian advocacy organization.

In the years since, he hasn’t had any similar health crises, despite working longer hours. He credits his newfound positive outlook.

“After there was a life-changing event, it kind of forced me to become optimistic,” he said. “I can’t even imagine living life the way I did back then.”

Optimism in itself is hardly a cure-all, but numerous studies over the decades have demonstrated a link between a positive outlook and good health outcomes.

A longer, healthier life?

This article is part of AP’s Be Well coverage, focusing on wellness, fitness, diet and mental health. Read more Be Well.

Experts say a standard for measuring someone’s relative optimism has long been the 10-question Life Orientation Test-Revised , published in 1994. (Sample question: On a scale of 1 to 5, respondents are asked how strongly they agree with the statement, “In uncertain times, I usually expect the best”?)

Generally, optimism is defined as the “expectation that good things will happen, or believing the future will be favorable because we can control important outcomes,” said Hayami Koga, a postdoctoral research fellow at the Harvard Center for Population and Development Studies.

She was the lead author on a 2022 study that found optimism associated with longer life spans and a greater chance of living past 90. In another study, published in May in JAMA Psychiatry, she and other researchers said optimists generally maintained better physical functioning as they aged . They looked at 5,930 postmenopausal women over a 6-year period.

“We know that more optimistic people are more likely to live a healthier life, with healthier habits, eating healthier, having more exercise,” Koga said.

Can I learn to be an optimist?

Some people are born more optimistic but it can definitely be learned, too, said Sue Varma, clinical assistant professor of psychiatry at New York University and author of “Practical Optimism: The Art, Science, and Practice of Exceptional Well-Being.”

Optimism training, she said, can improve life satisfaction and lessen anxiety.

“Even if you were not born with this natural disposition to anticipate favorable outcomes and see the glass as half full, there are skills that you can learn,” Varma said.

Begin by noticing how you deal with uncertainty, she said. Do you tend to worry? Assume the worst?

Try to reframe the thought in an objective manner. “Is there a silver lining? Is this a problem to be solved or a truth to be accepted?” said Varma, noting that her book builds upon the work of Martin Seligman, one of the fathers of positive psychology.

Try to envision the best possible outcome and a step-by-step path to get there. Varma asks her clients to describe the path in detail until the problem is resolved, and encourages them to bask in their success.

“Then you are already approaching your day and your life as if things have worked out,” she said. “And you tend to be more proactive, more positive, more resilient, more buoyant in the face of obstacles.”

Finding a sense of purpose also can help. Volunteering would be beneficial, but for those who can’t find the time, Varma suggested trying to remake your role at work to align better with your interests. That could be as simple as a very social person organizing outings with co-workers.

Trying to master a skill, whether a sport, a musical instrument, a language or a hobby such as knitting or chess can help prevent you from ruminating on negative possibilities.

Even with these and other interventions, it’s not easy to change your mindset, Varma noted. But practice helps.

“It’s a toolset, it’s a mindset,” she said. “I have to practice it every day in my mind.”

Albert Stumm writes about food, travel and wellness. Find his work at https://www.albertstumm.com

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Strengthening Critical Health Literacy for Health Information Appraisal: An Approach from Argumentation Theory

Sara rubinelli.

1 Department of Health Sciences and Medicine, University of Lucerne, 6002 Luzern, Switzerland; [email protected] (A.O.); [email protected] (C.Z.); [email protected] (N.D.)

2 Swiss Paraplegic Research, 6207 Nottwil, Switzerland; [email protected]

Alexander Ort

Claudia zanini, maddalena fiordelli.

3 Institute of Public Health, Università della Svizzera Italiana, 6900 Lugano, Switzerland

Nicola Diviani

Associated data.

Not applicable.

The overload of health information has been a major challenge during the COVID-19 pandemic. Public health authorities play a primary role in managing this information. However, individuals have to apply critical health literacy to evaluate it. The objective of this paper is to identify targets for strengthening critical health literacy by focusing on the field of argumentation theory. This paper is based on the textual analysis of instances of health information through the lens of argumentation theory. The results show that critical health literacy benefits from: (1) understanding the concept of argument and the supporting reasons, (2) identifying the main argument schemes, and (3) the knowledge and use of the main critical questions to check the soundness of arguments. This study operationalizes the main aspects of critical health literacy. It calls for specific educational and training initiatives in the field. Moreover, it argues in favor of broadening the current educational curricula to empower individuals to engage in informed and quality decision making. Strengthening individuals’ critical health literacy involves interventions to empower in argument evaluation. For this purpose, argumentation theory has analytical and normative frameworks that can be adapted within a lay-audience education concept.

1. Introduction

The recent COVID-19 pandemic and the related mushrooming of fake news, conspiracy theories, and more general disinformation has put the so-called “infodemic” in the global spotlight. The WHO refers to infodemic as the overload of information, including mis/disinformation [ 1 ]. Due to the increased discourse around those issues, one could get the impression that the start of the COVID-19 health crisis also caused the infodemic. However, the phenomenon is not new and dates back at least two decades to the advent of the Internet in the late nineties [ 2 ]. The introduction of this new technology also led to the extensive availability of health-related information, which goes hand in hand with low-threshold accessibility to everyone with an internet connection. Regardless of the vast benefits, online health information—because of its uncontrollable nature—also has the potential to have detrimental effects on citizens and society as a whole. For example, citizens, especially those with a limited ability to distinguish between good and bad information, could take crucial health-related decisions based on wrong or incomplete information, consequently putting themselves and others at risk of suboptimal health outcomes [ 3 ]. A concrete example in the context of the COVID-19 pandemic is the abundance of fake news surrounding face masks; different sources have claimed that they do not protect from the virus or even that they are unhealthy. Such disinformation can lead to detrimental outcomes, as people following such claims are less likely or would entirely refrain from wearing a face mask, with possible dire consequences [ 4 , 5 , 6 ].

Public health authorities can play a central role in this context [ 7 ]. One possible solution to counter the respective risks would be to design systems that allow monitoring and contain the spread of mis/disinformation. Additionally, many endeavors in this direction are now ongoing at the national and international level, such as the World Health Organization’s “Call for Action: Managing the infodemic” [ 8 ]. However, due to the nature and magnitude of the phenomenon, it is unlikely to identify and control all the information available, especially online. Therefore, it is crucial to equip individuals with the necessary set of skills to understand and evaluate health information or, in other words, to distinguish between information and disinformation. This set of skills is referred to as critical health literacy [ 9 , 10 , 11 ]. Although the potential of critical health literacy is now widely recognized by researchers and policymakers, its operationalization is still in its infancy, thus hindering the development of targeted interventions [ 12 ].

This paper aims to identify targets for strengthening an individual’s critical literacy about the appraisal of health information. This objective is achieved by theorizing and illustrating some main principles for evaluating information rooted in the field of argumentation theory and by contextualizing them from a health-educational perspective.

2. Analytical Approach

Argumentation theory is conceptually and empirically well developed [ 13 ]. Specifically, “argumentation theory”, in its very essence, is the body of knowledge that deals with the study of arguments, that is, of claims supported by reasons [ 14 , 15 , 16 , 17 ]. For example, in the sentence, “these flowers are beautiful because they have beautiful colors”, “these flowers are beautiful” is the claim, and “they have beautiful colors” is the reason that supports the claim. In generalized terms, argumentation theory studies how to support claims by reasons and whether this support is sound or unsound . Still, little attention has been paid to harness its main achievements: the potential to guide and educate people in the process of appraising health information. This is unfortunate, as taking the essence of this knowledge into account, argumentation theory can provide valuable insights on how to guide people in the process of evaluation, i.e., whether a particular piece of health information contains arguments and whether these arguments are qualitatively high or poor [ 18 , 19 ]. Consequently, information containing poor-quality arguments should be questioned because, as we shall see, it could be false, irrelevant, or manipulative [ 20 ].

To fill this gap, this paper applies the approach of textual analysis to the main theoretical frameworks from argumentation theory. It analyzes examples of arguments—inspired by actual instances of dis/misinformation that actually circulated during the global COVID-19 health crisis—with the goal to pointing towards ways to identify low-quality health information. In doing so, the following sections will explain the value of the following argumentation theory concepts: the structure and purpose of arguments, argument schemes, fallacies and critical questions. Implications of the analysis will then been discussed in the context of critical health literacy.

3. Insights from Argumentation Theory

3.1. the structure and purpose of an argument.

As anticipated above, argumentation is a process of communication where the speaker supports their point of view (a claim) by means of reasons. Although among English speakers, the term “argument” often connotes “quarrel”, its technical meaning, at the basis of argumentation theory, indicates the process and act of discussing with reasoning for or against a claim. For instance, the claim “people should wear masks” might be supported by the reasons “because it is a key measure for suppressing the transmission of COVID-19 (reason 1) and for saving lives (reason 2)”.

• Key insight 1: People should be made aware of the concept of argument and that the acceptance of a claim derives from the approval of the supporting reasons that, as such, need to be verified and evaluated.

People make and present claims and arguments because they want to convince an audience to think or act in a certain way. A health promotion institute can present arguments to convince people to wash their hands frequently during the day. However, due to vested interests, one might try to convince an audience that COVID-19 is like the flu and provide their reasons for this (for instance, that “he/she is an expert and knows about that”).

Although, as we shall see below, reasons can be false, wrong, or misleading, the fact that a speaker provides them to support their claim is an important way to verify the quality of the claim itself [ 21 ]. Indeed, if someone says “Don’t wear a mask” without saying why the claim is weak in the sense that the rationale behind it is unclear. If the speaker says, “Don’t wear a mask (claim) because COVID-19 is no worse than the flu (reason 1) and masks are even hazardous as they impair breathing (reason 2)”, reasons 1 and 2 offer grounds for verifying the claims and for deciding whether one should believe in it. Then, of course, the reasons provided are not sound. However, to carry out this evaluation, the concept of arguments has to be clear in people’s minds, as well as the supporting reasons and the need to check their quality. In the discussion section of this paper, we shall highlight how this presupposes the daily work of health institutions in presenting and discussing evidence so that people have quality sources to evaluate the reasons behind claims.

A primary skill in the context of critical health literacy and information appraisal is to check whether or not the claims put forward present reasons and, subsequently, whether or not these are valid and supported. Indeed, in the current world of influencers and opinion leaders, it is not unusual that people believe in claims that are unsupported simply because they trust the speaker. The Elaboration Likelihood Model [ 22 ] shows that, indeed, people might appraise information and arguments within a peripheral perspective, focused on aspects that do not point to the goodness of a claim. To agree that “masks kill” simply because the person who says this receives trust within a particular community is a pitfall in critical thinking skills. Additionally, evaluating the soundness of argumentation based on trust in the speaker and without paying proper attention to the actual content of what he/she says is problematic: It is an evaluation based on a peripheral cue and, thus, potentially misleading. Even if the claim comes from a famous health professional, it is still unsupported due to a lack of substantiating scientific data. Moreover, the experience of a person, even if they are perceived as an expert, is not sufficient to substantiate a general claim. Especially if, such as in this case, there is scientific evidence supporting the use of masks during the pandemic.

3.2. Argument Schemes

The literature on argumentation theory has identified argument schemes as central components of an argument structure, which is crucial for evaluating argument strength. Specifically, an argument scheme is a template that indicates a specific connection between the claim and the supporting reason/s. Each argument scheme has a name [ 23 ].

• Key insight 2: People should be able to recognize the most essential argument schemes to evaluate the arguments themselves.

According to pragma-dialectics, among the most potent approaches to the study of argumentation, a threefold typology of arguments exists [ 24 ], which we exemplify below through suboptimal information about COVID-19. Starting from an analysis of the argument schemes, we will then show how it is possible to identify why this information is of low quality.

The first argument scheme is named symptomatic argumentation , which poses that a claim can be supported by citing in its reasons a particular sign, symptom, or distinguishing mark of what is claimed. For example, in the following argument:

“This person is right about COVID-19 because he is a doctor.”

The fact that this person is a doctor is presented as a sign of the quality of what he says about COVID-19.

    Y is true of X,

      because : Z is true of X

      and : Z is symptomatic of Y.

    This person (X) is right about COVID-19 (Y).

      because: This person (X) is a doctor (Z).

      and: Being a doctor is a sign of knowing about health conditions, resulting in true health-related statements.

Figure 1 below shows the example in a visual chart:

Example of symptomatic argumentation.

The second type of argument schemes is based on a comparison relation , meaning that a claim is supported by showing that something similar occurs elsewhere. Therefore, people should also accept it for resemblance. For example, in the following argument:

“The COVID-19 vaccine is dangerous because past vaccines have also been found to be dangerous.”

Here, the comparison with other vaccines is a reason for supporting the danger of the COVID-19 vaccine.

    Y is appropriate for Y,

      because : Y is appropriate for Z

      and : Z is comparable to X.

    The COVID-19 vaccine (X) is dangerous (Y)

      because: past vaccines (Z) are dangerous (Y)

      and: past vaccines (Z) are comparable to the COVID-19 vaccine (X).

Figure 2 below shows the example in a visual chart.

Example of argument based on a comparison relation.

The third type of argument scheme is based on a causal relation , where the claim is supported by making a causal connection between itself and its grounding reason. For example, in the following argument:

“Some people contracted COVID-19 because they used 5G technologies.”

      and : Z leads to Y.

    Using 5G technologies (Z) leads to contracting COVID-19 (Y).

      because : Some people (X) contracted COVID-19 (Y)

      and : Some people (X) used 5G technologies (Z)

Figure 3 below shows the example in a visual chart.

Example of argument based on a causal relation.

Highlighting the formal structure of arguments seems to be technical. Yet, these three main types of argument schemes can be used to analyze and evaluate all types of arguments, where claims support reasons. Strengthening people’s skills in understanding and using these argument schemes is, thus, important as a base to avoid taking claims for granted or relying on peripheral cues that can be misleading.

3.3. Fallacies and Critical Questions

Identifying the structure of arguments in terms of their claims and supporting reasons is the essential step to evaluating the quality of the arguments themselves and defining whether they are of good or poor quality. When, indeed, the reasons put forward to support a claim are false, irrelevant, or, in general, not appropriate, the argument itself lacks soundness. The literature refers to these as “fallacies” that are invalid or faulty reasoning [ 25 ]. It is not always easy to recognize fallacies. Yet, the primary step is to instruct people on how to detach this type of disinformation.

• Key insight 3: People should learn to identify the structure of an argument and then verify if it is fallacious by asking critical questions.

More specifically, people can identify the weaknesses of arguments by using “critical questions”, that is, questions to test the soundness of arguments [ 26 ]. Referring to the above-mentioned reasoning:

“This person is right about COVID-19 because they are a doctor.”

Taking into account the above-introduced knowledge about argument schemes, the main critical question to ask here is: “is Z indeed symptomatic of Y?”, that is, is being a doctor indeed a sign of knowing about all health conditions and, thus, always making factual health-related statements? The unreflected answer might be, “yes, of course”. However, the framework gets shaky by taking a closer look at the claim and the specific situation. First of all, doctors are experts about specific health conditions, not about all health conditions. Moreover, they might be right in diagnosing and treating cases that they have experience in, but not where they have no clinical experience and have not conducted research, which would hold for most doctors and COVID-19. Moreover, experience is often contextualized in a specific setting. However, for generalizations regarding, for instance, the country-specific COVID-19 clinical situation, they have to rely on national data and conduct sophisticated research that goes beyond their personal opinions. Certain aspects about COVID-19 are not within the domain of general practitioners but rather lie within the field of epidemiologists, virologists, public health experts, and health economics experts. Being a medical doctor does not directly qualify to hold expertise in other areas, even if significant overlaps exist between different health-related fields. Thus, the “authority-oriented” perspective for the argument is weak when the speaker might not have any absolute authority, knowledge, or experience in what they claim.

Concerning the second example:

Here, there are different critical questions to ask. The first question relates to the grounds for claiming that “vaccines in the past were shown to be dangerous”. Is this true? What does the evidence say and prove? Further, another important question is, “what does it mean to say that a vaccine is dangerous”? Related to these questions, the list of other questions includes: does the vaccine have some side effects like any other drug? Does it have more side effects? Have these effects been proven through rigorous scientific studies? Moreover, provided that some vaccines produced side effects in the past: Is the COVID-19 vaccine comparable to them? In other words, going back to the previous argument schemes: is Z (the COVID-19 vaccine) really equivalent to X (the other vaccines)? Is X (the other vaccines) really Y (dangerous)?

Overall, arguments from analogies always work by claiming comparisons. It is, thus, essential to verify the nature of the comparison itself. In particular, whether there is a relation/correspondence between two things and, if so, in which way.

“Some people contracted COVID-19 because they were exposed to 5G radiowaves.”

The main critical question is: “does Z indeed lead to Y?”, that is: does exposure to 5G lead to COVID-19? There is no scientific evidence that supports any link between the two as such. Thus, the argument is unsound, as the proposed cause of something is unproven. This is a typical pitfall of arguments implying that “something has the inevitable result”, that “something causes something”, and that “something always occurs when …”. The foundation of these general claims has to be carefully reviewed, as making faulty causal links between events indicates flawed critical thinking, which can lead to dangerous health decision-making.

4. Discussion

This paper contributes to the field of critical health literacy. It proposes specific topics from argumentation theory that could inform the operationalization of critical health literacy and form a basis for interventions aiming at strengthening individuals’ skills in this context. This study argues that a promising way to empower people in evaluating health information is to enhance their skills in the recognition, analysis, and evaluation of arguments. Specifically, it supports the need for people:

• (1) to recognize when health information is argumentative, that is, when the speaker presents a claim that they want the audience to accept, believe, or act upon;
• (2) to identify whether reasons support claims, and if so, which argument scheme they implement (that is, schemes based on symptomatic relations, analogy, or causality);
• (3) to ask the main critical questions to look for evidence behind the proposed reasons that can support or deny the claims’ validity (and acceptance).

These insights stemming from argumentation theory can contribute to advancing research on critical health literacy and align with existing findings in these contexts. An individual’s ability to recognize arguments and distortions in information has indeed been identified as one of the central components of critical health literacy in a recent review aiming to operationalize the concept [ 10 ]. Always keeping in mind that critical appraisal of information is complex and also involves a variety of competencies, skills, and abilities in other contexts (e.g., the ability to recognize biases in one’s thinking), this analysis based on argumentation theory provides us with concrete examples of what these distortions could look like and how to identify them. This makes our contribution a precious addition for the conceptualization and operationalization of critical health literacy. Despite its mainstream relevance in today’s information landscape, research in this domain is still in its infancy [ 12 ].

Moreover, some main considerations are needed when thinking about the applicability of our proposed approach. First, we are very well aware that argumentation theory is a technical discipline. Experts in argument analysis and evaluation need years of study to evaluate the quality of information. While we do not expect (because this would be unrealistic) that people become experts in argumentation theory, working on these aspects is a way to implement the classical tradition of “critical thinking”. Developing competencies in argumentation theory strengthens individuals as critical thinkers. Indeed, Siegel explains, “a critical thinker is a thinker who can assess claims and make judgments based on reasons, and who understands and conforms to principles governing the evaluation of the force of these arguments” [ 27 ]. Basing education and training initiatives on argumentation theory prepares individuals to become more competent in those abilities that are necessary for successful decision-making [ 28 , 29 , 30 ]. This is a way to encourage individuals to look for evidence and to ask the right questions to scrutinize claims, points of view, or what is presented as evidence.

Thus, our broader aim here is to call for concrete and specific initiatives to empower individuals in information appraisal. This is rather urgent, and there is a whole tradition of theories, models, and tools that can assist in doing this. It is a matter of thinking how to implement the study of critical thinking and argumentation theory in education and training programs, with a focus on the provisions of criteria and standards to assess the quality of information. Of course, expressing one’s opinion is a fundamental right, but the ability to evaluate information should be seen as essential to avoid suboptimal decision-making.

Second, health institutions can play a significant role in reinforcing critical health literacy. For decades, health promotion and disease prevention have been driven by an approach of telling people what is good/bad for their health (for instance, “eating fruits and vegetables is good” and “smoking is bad”) instead of empowering them to deal with the concurring information that stands out from the informational mainstream but might be more appealing, as it offers easier, less strenuous, or more rewarding alternatives. The pitfalls of this one-sided approach have become evident during the pandemic. The global COVID-19 health crisis has shown that this type of top-down approach to health styles sometimes has little impact on people. People are exposed to so much health information from different traditional and alternative sources that, as we argue, empowering critical thinking skills provides the best guidance. By following this approach, the World Health Organization is already actively working to empower governments and institutions to manage infodemics, including informational overload and dis-/misinformation [ 8 ]. Building critical health literacy and providing science education plays a significant role in this framework.

Third, this paper points to the benefits of efforts that target the educational system. Disciplines such as epistemology, philosophy of science, critical thinking, and scientific thinking can inform educational programs in different settings and different levels of education. Thus, for instance, school-based programs could entail specific sections that lay the foundations of scientific thinking and health information quality. A primary focus should be on what evidence is, how it differs from opinions, and the difference between causality and correlation. Similarly, patient education programs, instead of focusing on information provision, could be based on argumentation theory, so to provide patients with critical thinking skills that are useful in making informed decisions concerning their health.

At this stage, we also like to acknowledge one important arising limitation. This paper is conceptual. More work on the presentation of best practices of education and training is needed. Additionally, this paper focuses on argumentation theory. It should be complemented by work focusing on the so-called biases and heuristics well-developed in the cognitive sciences [ 31 ]. While we claim that the ability to evaluate health information would be an asset for individuals’ decision-making, we also have to acknowledge that this ability can be negatively impacted by the use of heuristics in critical thinking. Thus, for instance, people may evaluate information wrongly because they have a bias. For a discussion on the role of heuristics in critical thinking, we refer to a previous publication [ 32 ]. On the link between argumentation skills and heuristics, we plan to conduct further research.

5. Conclusions

This paper contributes to the operationalization of what critical health literacy entails by looking at the structure and soundness of arguments. Indeed, since false and unsupported claims in health information might pose a risk to individuals’ health, it is fundamental to equip them with the necessary means to assess the credibility and correctness of the claims that confront them. As a well-developed field of research, argumentation theory proposes several concepts and tools to assist with these challenges. Moreover, some of argumentation theory’s main aspects are the basis of current handbooks and courses in critical thinking that have entire sections dedicated to evaluating arguments. The development of argumentation skills requires knowledge and intensive training, which might be an implementational impediment on a larger scale, e.g., for whole societal groups or communities. Yet, some main concepts could inform educational interventions within public health frameworks and help disseminate a general understanding of good versus bad instances of argumentation. As a significant part of information nowadays has a persuasive nature, guiding the public understanding of argumentation and its principles is a major step toward consolidating critical literacy skills. In an information society, where freedom of speech is a crucial value, providing some normative guidance to individuals is a vital step towards empowering a free and reasonable choice about what to believe or not. Francis Bacon once said: “read not to contradict and confute; nor to believe and take for granted… but to weigh and consider.” [ 33 ] An argumentation theory-based education and training can help to achieve this goal.

Author Contributions

Conceptualization, S.R.; Methodology, S.R., N.D.; Formal Analysis, S.R., A.O., C.Z., M.F., N.D.; Original Draft Preparation, S.R.; Review and Editing, S.R., A.O., C.Z., M.F., N.D.; Supervision, S.R.; Funding Acquisition, S.R., N.D. All authors have read and agreed to the published version of the manuscript.

The work presented in this paper has been funded by a grant awarded to Sara Rubinelli and Nicola Diviani by the Swiss National Science Foundation ( www.snf.ch ; Grant No. 31CA30_196736), within the special call on Corona Virus. The funding source had no role in the conceptualization of the study, decision to publish, or preparation of the manuscript.

Institutional Review Board Statement

Informed consent statement, data availability statement, conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

7 Reasons Your Critical Thinking Skills are Vital to Democracy

• 6 July 2023

Becca Melhuish

In a world of misinformation, disinformation , and eroding civil liberties, what’s the special ingredient to keep our democracies safe? Fortunately you don’t need to go far to find it: it’s buried just under your skull! Yes, it’s your brain—and its incredible ability to engage in the practice of critical thinking. Here are 7 important reasons why your critical thinking skills are essential for democracy.

Photo by William Felipe Seccon, Unsplash.

But what exactly is critical thinking ? Contrary to common belief, it doesn’t actually mean constantly criticising and looking for flaws. It’s more about being creative, reflective and adaptable. Most importantly, it’s about evaluating evidence to decide whether it’s accurate and relevant—and weighing up whether there’s sufficient information to even decide at all. Essentially, it’s about knowing how to ask the right questions!

And the good news is, the more we flex our critical thinking muscle—putting it to work in our engagement with decision-making at all levels—the stronger we make our democracies. Every critical thinking workout we put our brains through adds an extra layer of protection to our democratic processes—especially when we act on our thinking to call for positive change. 

As Nadya Melati , social activist and participant in our ongoing Democracy Defenders Accelerator explains in her recent Instagram post :

“The democratic system requires citizens as active participants, who contribute within the process. In order to contribute, participants are assumed to be willing and able to think critically—to be able to make a wise decision. So, an ability to think critically helps the voters think rationally about the benefits and impact of their decision for larger society.”

View this post on Instagram A post shared by Citizen OS Foundation (@citizen_os_foundation)

Inspired by her message, we’ve come up with 7 important reasons your critical thinking skills are exactly what the doctor ordered, if we want to keep our democracies in full health.

1. Weighing up arguments

The nature of discussion and debate in democracy means we’re constantly exposed to a barrage of different arguments and viewpoints, on a whole host of often complex topics. Take the topic of sustainability, for example—an issue which touches all areas of all our lives, but is full of conflicting viewpoints and vested interests trying to push for the solutions that benefit them the most.   

Thinking critically about environmental solutions —and all complex policy topics alike—means we can carefully examine conflicting perspectives, assess the credibility of information presented, and identify biases in both ourselves and others. We can then make decisions based on evidence rather than emotions or uninformed opinions. In a world filled with fallacies and biased viewpoints, critical thinking transforms us into skilled debunkers, capable of unravelling the webs of flawed reasoning. That said, it’s good to recognise that having biases is part of human nature. But while we can never fully avoid them, being aware we all have them is already a big step towards being better critical thinkers.

2. Outing fakes

While social media has brought many benefits to the world of civic engagement, its role in exposing us to a proliferation of mis- and disinformation (often referred to as “fake news”, but that’s a term with its downsides ) and poses a big threat to our democracies. If democracy relies on a well-informed citizenry, but citizens are frequently duped by falsities, lies and conspiracy theories, what then? 

Fortunately, a little critical media and information literacy goes a long way in shielding us from the potential damage. By fact-checking information and scrutinising sources, we can flag up false information, see through misleading campaign materials, and call out propaganda. And by scrutinising candidates’ policies, track records, and campaign promises, we can make sure election candidates don’t compromise with the truth. With our critical thinking hats firmly on, we’re much less likely to be fooled.

Photo by Austin Distel, Unsplash.

3. Building bridges

We’ve all heard about the “ echo chamber ” effect of social media, that’s bringing a growing polarisation of public opinion—with populations being more and more frequently split across two opposing extremes. As social media algorithms expose us predominantly to information that aligns with our own worldview, we lose touch with different perspectives and miss out on meaningful exchanges with other opinions. 

But what can be done about it? By fostering open-mindedness, empathy, and respectful dialogue, critical thinking helps us build bridges of understanding—connecting diverse perspectives to find common ground. As a result, democratic processes are more likely to work for the greater good—with  decisions made benefiting the many, not just the few.

4. Sparking discussions

What we often forget in our day to day lives, is the power of public opinion in a democracy. The attitudes and discourse of the general population lie at the heart of media and politics. And critical thinking plays a huge role in sparking public discussions—prompting us to question the status quo, debate with our peers, and raise our collective voices to call for change in society. 

When public opinion starts to shift, the media picks up on these changes, and brings them into the political spotlight. And initiatives like citizens assemblies and Opinion Festivals—such as the Citizen OS-led Indonesian Opinion Festival —give us more formal channels to turn public discussions into concrete policy change.

Participants of the Democracy Defenders Accelerator (DDA) discussing during the Bootcamp in Estonia. Photo by Meelika Hirmo.

5. Questioning authority

We all know that “power corrupts”, and a crucial role of the citizenry is to keep its elected representatives in check! A population that’s engaged in thinking critically about its government—and not just accepting their words and actions in blind faith—helps keep elected representatives accountable, and working in the interests of the people. With a critical mindset, we’re more likely to spot potential abuses of power, inconsistencies, or breaches of trust by those in office.

What’s more, to bring about progressive change, society needs people willing and able to challenge the social norms set by the authorities or wider society—highlighting social inequalities or injustices, and calling for change. Over the years, critical thinking has fuelled grassroots movements and driven positive change, in areas such as gender equality, civil rights, diversity and inclusion.

6. Protecting freedoms

Around the world, many countries are witnessing a rise in the suppression of civil liberties —with decision-making becoming increasingly autocratic, and civil society being increasingly restricted. A population devoid of critical thinking will have a hard time protecting itself against such threats, and be at risk of gliding down the slippery slope to authoritarianism! 

But all is not lost—fortunately, critical thinkers everywhere are calling out these infringements of our rights, and fighting to keep our democracies safe. With a critical mindset, we can detect threats to democratic principles, such as censorship, voter suppression, or erosion of the right to protest. Critical thinking allows citizens to recognise when their rights are being infringed upon, and take action to protect them.

7. Maintaining trust

Politics can be a messy game, with the potential of deception, broken promises, and mis- and disinformation breeding distrust in institutions and elected representatives. And when distrust runs high, disenchanted citizens can often disengage from the process—losing faith in the system entirely. At times, this can even lead to falling for conspiracy theories, which offer a simpler way of understanding the complexities of the world. 

But in the face of all this, critical thinking allows us to navigate politics with confidence! Rather than becoming disenfranchised or losing faith in the system, critical thinkers hold politicians accountable and steer public debates along evidence-based, well-reasoned lines. And what’s more, we’re able to critically analyse competing narratives and their evidence, to make sure we’re protected from the often alluring appeal of conspiracy theories .

Photo by Anna Oliinyk, Unsplash.

Bonus Track: All-round life improvements

While it’s pretty clear that critical thinking is crucial to democracy, that’s not its only charm! Embracing critical thought in our everyday lives can bring us so many other benefits. For example, it can help us become discerning shoppers—unswayed by slick marketing tactics or greenwashing attempts . By critically evaluating product claims, considering alternatives, and aligning our purchases with our values, we become more conscious consumers. 

It can also help us in weighing up financial decisions, career choices, relationship and family decisions, and much more. By getting into the habit of looking at decisions from all angles, weighing up any assumptions or biases at play , looking out for vested interests, listening attentively and empathising with others points of view, we can navigate life’s decisions more smoothly and effectively. 

So all in all, if there’s one new workout habit to jump on this Summer, it’s got to be getting your critical thinking muscles trained up and ready for whatever life may throw your way!

Level-up your critical thinking with Citizen OS

Looking for a handy tool to think through complex decisions with others? Try our free open-source Citizen OS platform for collective discussions and decision-making. It’s a secure, ad-free tool for groups with differing opinions to engage in meaningful discussions—weighing up pros and cons, backing up arguments with evidence, and voting on the best way forward. 

Got some thoughts to share on the benefits of critical thinking? We’d love to hear from you on our social media channels! Catch us on Instagram , Facebook , Twitter and LinkedIn . 

Becca Melhuish is a social purpose communications professional, running her company, Bajoom Ltd, while on her travels as a flight-free digital nomad. She has a background in environmental and social justice activism, sustainability management and environmental communications. She holds a BA in International Development from the University of Sussex, a PGCert in Behaviour Change Marketing from the University of Brighton, and a Masters in Communications, Media and Creative Industries from Sciences Po, Paris. She has a passion for sustainability, civil society, participatory democracy and the arts, and enjoys putting her design, writing and communications skills to use in supporting causes she cares about. She has been working with the Citizen OS Foundation since 2019.

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