The other day I was talking to a graduate class about critical thinking. This is a topic being increasingly emphasized in higher education in the U.S. right now. Leadership and accrediting bodies have recognized that a lot of content information mastered by students 1) does not stay with them for very long and 2) has only limited shelf life as new information replaces the old. One of the things that we believe is essential that students obtain from higher education, and even more from graduate education, is the ability and habit of thinking critically. As an aside, American students often compare very unfavorably with Chinese students when it comes to standardized scores for reading, science, math, and so forth. However, American students are better able to think critically because they are not cowed by the pronouncements of authority figures. They seem to be unaware of constraining lines around problem solutions, to a greater extent than Chinese youth. Unfortunately, U.S. students still may defeat this head start by being thoughtfully lazy. They are empowered to challenge conventional thinking, but few do so with much consistency, because they are preoccupied by popular culture. What is this generation coming to? Probably an age-old lament.
For many decades, we have assumed that students learn this along the way, just by spending time with academic thinkers (one hopes) and in the rarefied academic atmosphere. Some students will be exposed to formal logic taught by philosophy departments, but most institutions do not require these courses. It has become clear that colleges and universities must be intentional about instilling thinking skills. There has to be a strategic and structured method, and it has to be part of general education. Because this is fairly new, a teaching methodology is still emerging. Professors are comfortable asking students to think about a problem, a concept, a case, and so forth, but that doesn't mean we know how to teach students how to think about thinking. I did not feel very successful in the attempt mentioned above.
Critical thinking should be an essential derivative of education, and every young person should enter adult and professional life with a fully cultivated habit of challenging conventional ideas and unexamined assertions. This is specifically true in the domain of public health and health promotion, both on the professional and the consumer side. Consumers are bombarded with marketing information for products that have health consequences, such as soft drinks or health-related products such as over-the-counter drugs or food supplements. The volume and range of these products is so great that it is difficult for the public health agencies to give everyone the "right" answer. Perhaps we can give people a framework for thinking critically about products and recommendations that may have an undesirable impact on their health. We can help them discern whether a health web site is dubious or dependable, whether assertions for health value are factual or phoney. There is lots of work to do here.
The other place where critical thinking needs to be strengthened is in professional practice. The Patient Protection and Affordable Care Act (Obamacare) has a component directing the expansion of what is called "comparative effectiveness" research. This is driven by the growing awareness that a lot of health care practices are based on limited or no solid evidence that they lead to improved patient outcomes. A recent article in the Washington Post cites the example of a surgical procedure called vertebroplasty, designed to reduce chronic neck pain. According to the Post article, 79,000 procedures are done every year, at a total cost of about $1 billion. Yet, it has not been unequivocally demonstrated that these procedures work as promised.
What does this have to do with health promotion? The same problems found in clinical health care, procedures and products that may not be effective but are driven by other considerations, are also found in health promotion practice. The driving force in health promotion is usually not a profit incentive, but instead an unwillingness to break out of traditions, a belief that doing something is better than doing nothing, a lack of evaluation which might demonstrate failure, and settling for program investments that are inadequate, rather than pushing for more costly interventions that might actually have an impact.
Throughout my career, I have seen (and yes, participated in) many instances of health promotion programming that had no chance of being successful. Learning and applying lessons from these programs is painfully slow. We can do better, and a part of that is thinking more critically about what we do. Unlike clinical care, where ineffective practice may be life threatening, our laissez faire attitude about effectiveness means that the public's health doesn't improve. Comparative effectiveness needs to become a new normal. For every program dollar available, what is the most promising way to invest it? That is a critical thought.
For many decades, we have assumed that students learn this along the way, just by spending time with academic thinkers (one hopes) and in the rarefied academic atmosphere. Some students will be exposed to formal logic taught by philosophy departments, but most institutions do not require these courses. It has become clear that colleges and universities must be intentional about instilling thinking skills. There has to be a strategic and structured method, and it has to be part of general education. Because this is fairly new, a teaching methodology is still emerging. Professors are comfortable asking students to think about a problem, a concept, a case, and so forth, but that doesn't mean we know how to teach students how to think about thinking. I did not feel very successful in the attempt mentioned above.
Critical thinking should be an essential derivative of education, and every young person should enter adult and professional life with a fully cultivated habit of challenging conventional ideas and unexamined assertions. This is specifically true in the domain of public health and health promotion, both on the professional and the consumer side. Consumers are bombarded with marketing information for products that have health consequences, such as soft drinks or health-related products such as over-the-counter drugs or food supplements. The volume and range of these products is so great that it is difficult for the public health agencies to give everyone the "right" answer. Perhaps we can give people a framework for thinking critically about products and recommendations that may have an undesirable impact on their health. We can help them discern whether a health web site is dubious or dependable, whether assertions for health value are factual or phoney. There is lots of work to do here.
The other place where critical thinking needs to be strengthened is in professional practice. The Patient Protection and Affordable Care Act (Obamacare) has a component directing the expansion of what is called "comparative effectiveness" research. This is driven by the growing awareness that a lot of health care practices are based on limited or no solid evidence that they lead to improved patient outcomes. A recent article in the Washington Post cites the example of a surgical procedure called vertebroplasty, designed to reduce chronic neck pain. According to the Post article, 79,000 procedures are done every year, at a total cost of about $1 billion. Yet, it has not been unequivocally demonstrated that these procedures work as promised.
What does this have to do with health promotion? The same problems found in clinical health care, procedures and products that may not be effective but are driven by other considerations, are also found in health promotion practice. The driving force in health promotion is usually not a profit incentive, but instead an unwillingness to break out of traditions, a belief that doing something is better than doing nothing, a lack of evaluation which might demonstrate failure, and settling for program investments that are inadequate, rather than pushing for more costly interventions that might actually have an impact.
Throughout my career, I have seen (and yes, participated in) many instances of health promotion programming that had no chance of being successful. Learning and applying lessons from these programs is painfully slow. We can do better, and a part of that is thinking more critically about what we do. Unlike clinical care, where ineffective practice may be life threatening, our laissez faire attitude about effectiveness means that the public's health doesn't improve. Comparative effectiveness needs to become a new normal. For every program dollar available, what is the most promising way to invest it? That is a critical thought.
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This is specifically true in the domain of public health and health promotion, both on the professional and the consumer side. Consumers are bombarded with marketing information for products that have health consequences, such as soft drinks or health-related products such as over-the-counter drugs or food supplements.
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