Critical Thinking Through Reflection & Self Assessment

Pamela L. Stamm, PharmD, CDE, BCPSAssociate Professor of Pharmacy PracticeAuburn University Harrison School of Pharmacy

Research conducted by Pamela L. Stamm and Kristen L. HelmsNovember 18, 2012

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.”

http://www.criticalthinking.org/pages/defining-critical-thinking/410

Process of actively and skillfully analyzing and evaluating information generated by reflection as a guide to belief and action.

Reflection

• “The process of analyzing and making judgments about what has happened”

• Ideally, translating this to change when needed

http://www.hawaii.edu/intlrel/pols382/Reflective%20Thinking%20-%20UH/reflection.html

Now What?

So What?

What

Overview of Course

• Problem Based Learning • Therapeutics course• Four 8 week courses divided over 2

semesters• Three facilitated sessions weekly, 3 hours

each

Overview of Course

• Students expected to solve the problem AND learn optimal drug therapy approach

• Students expected to learn about all common drugs available for treatment

• Writing products: Disease SKPs, Drug SKPs, Learning issues

Drug SKP (Standard Knowledge Parameters)

• Name, doses, dosage forms• Mechanism of action• Relevant drug chemistry• Pharmacokinetics• Safety issues• Special population concerns• Monitoring for efficacy and safety• Major counseling points• Role in treating the disease• Preferred agent in class• Application to case

Assessment Methods

• Daily and weekly facilitator grading – Completes responsibilities, Groupwork, Learning

Issue and Presentation of Learning Issues• Weekly peer feedback– Strengths, Areas for Improvement, How group can

help with this• Quizzes• Oral exam• Written exam

Reflection Objectives

Critical Thinking

Require students to make connections among self,

artifacts, and learning

Metacognitive Thinking

Require students to think of the process they used. Disciplinary

Thinking & Writing

Require students to find and arrange

information, discriminate

important from unimportant,

compare & contrast, and apply information.

Reflection Assignment

Choose drug SKP document

Complete portfolio entry• Upload SKP document• List references • List time needed to complete the SKP document• Answer questions

Course 1 Any drug

SKP

Course 2 Any drug

SKP

Course 3 Any drug

SKP

Course 4 Any drug

SKP

Reflection Scaffold (Course 1, SKP 1)

What did you find most

challenging?

What will you do differently?

How could you have been

better prepared?

Reflection Scaffold (Courses 2-4, SKPs 2-4)

How was this SKP the same?

different?

What were its strengths?

limitations?

What will you do differently?

How was this SKP the same?

different?

What were its strengths?

limitations?

How will you use this skill on rotations? As a

pharmacist?

Data Handling

• Downloaded into Excel, Microsoft 2010

• Data reviewed for completeness

• Data reviewed and categorized responses for

each question

• Categories developed as reflections were read

What was the most challenging?What will you do differently?How will you use this skill?

Results

Critical Thinking

Require students to make connections among self,

artifacts, and learning

What was most challenging? (n= 88 )

Managing the Information• Discriminating (42)• Organizing (12) • Formatting (7)• Differentiating (5)• Clinical application (4)• Managing conflicting info (3)• Summarizing (2)• Condensing (2)• Compiling (3)• Plagiarism (1)• Interpretation of data (1)

Knowing the information

Finding the information• Resource utilization & navigation

(23)

Communicating information

Overall process (6)

Miscellaneous• Time management (9)• Technology challenges (2)• Confidence (1)• Lack of an example (2)

What will you do differently? (n= 88)

Managing the information• Consider objectives (22)• Condensing (12)• Discriminating (12) • Organizing (12)• Differentiating (11)• Formatting (8)• Template (7)• Completeness (3)• Summarizing (3)• Clinical application (1)• Synthesizing (1)

Finding the information:• Resource utilization (20)

Knowing the information• Knowledge/understanding (10)

Communicating information• Clarity (2)• Enhance teaching (12)• Confidence

Overall process • Change Team Process (1)• Systematic approach (5)

Miscellaneous• Technological Challenges (1) • Time Management (9)

Challenging vs Change

Challenging

Discriminating (42) Resource utilization (23) Organizing (13) Time management (9)• Formatting (7)• Overall process (6) Differentiating (6)

• Consider objectives (22) Resource utilization (20) Discriminating (12)• Enhance teaching (12) Organizing (12)• Condensing (12) Differentiating (11)• Knowledge/understanding (10) Time management (9)

Discriminating (42) Resource utilization (23) Organizing (13) Time management (9)

• Formatting (7)

• Overall process (6) Differentiating (6)

Change

How will you use this skill?

Rotations (n=26) Pharmacist (n=27)• Resource utilization (16) • Process to follow (10) • Knowledge base (4)• Select appropriate drug (2) • Peripheral brain (1) • Discriminate (1) • Evaluate of guidelines (1) • Formulate a plan (1) • Recognize bias (1) • Self-learning skills (1)

• Resource utilization (20)• Process to follow (7)• Discriminate (6)• Efficiently answer questions (4) • RIT (1)• Special pop knowledge (1)• Understand Context (1)

How will you use this skill?

• Resource utilization (16) • Process to follow (10) • Knowledge base (4)• Select appropriate drug (2) • Peripheral brain (1) • Discriminate (1) • Evaluate of guidelines (1) • Formulate a plan (1) • Recognize bias (1) • Self-learning skills (1)

• Resource utilization (20)• Process to follow (7)• Discriminate (6)• Efficiently answer questions (4) • Role in therapy (1)• Special pop knowledge (1)• Understand Context (1)

Limitations

• Students not held accountable on assignment

• Lack of feedback (faculty or peers) on reflections– Current software does allow for feedback but not a

conversation

• Reflection may not be students’ original thoughts– Daily / weekly grading– Weekly peer assessments

Changes to assignment

• Ask, “what was most challenging?” each time

• Asking for “strengths” did not bring much insight

• Asking for similarities did not bring much insight. Mostly said, content and format was similar

Assignment Objectives

• Promote self assessment & self improvement skills– Identify strengths, limitations, and plan for change

• Develop critical, metacognitive, and disciplinary thinking – Made connections among artifacts, learning, and self– Think about the process they were using to find

information, create documents, disseminate information, and teach others

– Discriminate important from unimportant, differentiate, apply, and select

Thank you for your time and attention