A framework of critical thinking skills for teaching and learning physiotherapy.

Abstract

The use of critical thinking is called for in the practise of physiotherapy and has been cited as a learning outcome in the design of the physiotherapy curriculum. Further, the South African Draft White Paper on Higher Education (July,1997) is committed to endow graduates with skills that build the foundation for lifelong learning and included in such skills is that of critical thinking. Although welcomed by the profession, the introduction of critical thinking within the programmes may be premature because of the lack of debate and subsequent understanding about the critical thinking skills necessary for the practise of physiotherapy. Hence critical thinking remains implicit within the context of physiotherapy. Physiotherapy educators are assessing the skill implicitly within the process of clinical reasoning and decision making, without articulating what critical thinking really is, in the context of physiotherapy clinical reasoning. Further one needs to identify the repertoire of component skills that one should possess, in order to be an accomplished critical thinker. Data obtained from interviews with level co-ordinators, and an examination of the course plans within one department at one institution, provided an insight into how critical thinking is understood within the profession. Further, it identified if, and how, critical thinking was currently incorporated into the physiotherapy curriculum. In an attempt to develop a deeper understanding and a guiding framework for critical thinking in Physiotherapy, a workshop was conducted amongst qualified physiotherapists. They were required to model the clinical reasoning and decision making processes that they employ in the clinical area, in the process of working through the clinical problem that was presented. The data that emerged was qualitatively analysed and categorised. This was for the purpose of generating meaning, and for the development of a framework of critical thinking skills, that may be used in conjunction with the process of clinical reasoning to enhance one's clinical judgement. Critical factors emerged from analysis of the data. These included the preponderance of the product over the process method for teaching and assessing, the implicit nature of teaching and assessing for critical thinking in physiotherapy, and the similarities and differences in perception and conception about the meaning of critical thinking and its associated skills. The findings of this study contribute to the understanding and development of critical thinking within the specific context of physiotherapy and inform the development of the physiotherapy curriculum towards the realisation of its intended goals.