What does critical thinking mean to you in the courses you teach?

1. What does critical thinking mean to you in the courses you teach?

2. Thinking Achievement Critical Confidence To Develop Ability Course Skills Redesign of Knowledge Wayne LaMorte School of Public Health

3. The Problem “Everyone thinks. It is our nature to do so. But much of our thinking, left to itself, is biased, distorted, partial, uninformed, or downright prejudiced. Yet, the quality of our life and that of what we produce, make, or build depends precisely on the quality of our thought. Shoddy thinking is costly, both in money and in quality of life. Excellence in thought, however, must be systematically cultivated.” From CriticalThinking.org

4. What is critical thinking?

5. [Creation] Evaluation Synthesis Analysis Application Comprehension Knowledge Bloom’s Hierarchy of Intellectual Behaviors in the Cognitive Domain

6. A Taxonomy of Significant Learning

7. A Critical Thinker: • Raises vital questions and problems, formulating them clearly and precisely • Gathers and assesses relevant information, using abstract ideas to interpret it effectively • Comes to well-reasoned conclusions and solutions, testing them against relevant criteria and standards • Thinks open-mindedly within alternative systems of thought, recognizing and assessing, as needs be, their assumptions, implications, and practical consequences • Communicates effectively with others in figuring out solutions to complex problems From CriticalThinking.org

8. Relevant Questions for Critical Thinkers: • What is the most fundamental issue here? • From what point of view should I approach this problem? • Does it make sense for me to assume this? • From these data may I infer this? • What is implied in this graph? • What is the fundamental concept here? • Is this consistent with that? • What makes this question complex? • How could I check the accuracy of these data? • If this is so, what else is implied? • Is this a credible source of information? • Are there alternative ways of thinking about this? Thinking outside the box. Lateral thinking. Adapted from CriticalThinking.org

9. For My Students: Foundational Skills & a Structured Approach to Problem Solving • Evaluate information in a structured way in order to • identify valid causal associations. • Evaluate efficacy (programs, treatments, interventions). • Weigh risks and benefits. • Make accurate predictions, e.g., who is at high risk? • Cultivate a habit of thinking & reading critically. • Distinguish validity from fallacy. • Make evidence-based decisions.

10. Critical Thinking Skills Question Define Don’t just accept; be inquisitive. Formulate testable questions. Synthesize Collect accurate data. Organize it to facilitate thinking and comparisons. Develop clear definitions of outcomes & possible determinants (causes) . Test the hypothesis. How strong is the association? How precise is it? Evaluate the role of random error, bias, & confounding. Critically review the body of evidence. Are the criteria for making a judgment of causality met? Conceptualize Can one infer that findings in the study group apply to the source population? Infer What are the options for testing the hypothesis? Feasibility? Advantages? Limitations? Examine Analyze

11. How do we promote critical thinking?

12. Definition of a Lecture: A talk on some subject to an audience or class. Also: A long or tiresome scolding.“I recall once saying that when I had given the same lecture several times I couldn't help feeling that they really ought to know it by now.” — J. E. Littlewood (1885-1977) Bakst Auditorium, 2007 Laurentius de Voltolina, late 1300s

13. I SAID I TAUGHT HIM. I DIDN’T SAY HE LEARNED IT I DON’T HEAR HIM WHISTLING I TAUGHT STRIPE HOW TO WHISTLE Teaching vs. Learning Cartoon by Bud Blake

14. 10 problem sets;

15. Assigned Reading Lecture Assigned Reading Homework (Active Learning) Exam

16. Certainly we need: • Engagement • Active Learning • Progressive Challenges • Feedback • Fewer bulleted slides (…oops)

17. Concrete Experience ‘Concrete experiences' provide a basis for 'observations and reflections'. Kolb's Experiential Learning Model These 'observations and reflections' are assimilated… Reflective Observation Active Experimentation …which can be 'actively tested,' in turn creating new experiences. … and distilled into 'abstract concepts' producing new implications for action… Abstract Conceptualization

18. Direct experience Recall experience Class exper. (lab) Lecture e.g. Passive Lecture Field work, lab Case Studies Homework, project Lecture e.g. Rhetorical ? Discussion Brainstorm Journal Critique Paper Model building Concrete Experience Reflective Observation Active Experimentation Abstract Conceptualization

19. Progressive Refinements to the Course • Examples were updated, emphasizing current problems in public health. • Lectures broken up with: • Problem sets • Clicker questions • Discussion • Homework was automated to provide immediate detailed feedback on problems. • Analysis and interpretation of raw data was added.

20. Independent Analysis of a Large Dataset

21. Video

22. Data Set With > 3,000 Subjects

23. “EpiTools”: an Excel file with a series of statistical tools An invitation to explore: what if….?

24. Results • All 120 students successful mastered the raw data analyses. • Course evaluations: • 98% of students strongly agreed (78%) or agreed (20%) that “I acquired new information (facts and concepts I understand) in this course.” • 93% of students strongly agreed (78%) or agreed (15%) that “I acquired new skills (things I can do) in this course.” • Overall, 89% of respondents said the degree of difficulty of the course was “about right,” 6% said it was “too hard,” and 2% said it was “too easy.” • Students now report that they use these skills for other courses and projects and in their part time jobs.

25. The Next Phase (still in progress)

26. A Self-Directed Guide to Designing Courses for Significant Learning L. Dee Fink, PhD Director, Instructional Development Program University of Oklahoma Author of: Creating Significant Learning Experiences: An Integrated Approach to Designing College Courses

27. Key Components of Integrated Course Design Significant Learning Learning Goals Teaching & Learning Activities Feedback & Assessment Active Learning Educative Assessment Situational Factors (120 students; beginners; breakout rooms for only one class) From L. Dee Fink

28. Example of a Course that is Not Integrated ‘The teacher says the learning goals are to (a) “learn all the important content” and (b) “learn how to think critically about the subject.” But, it is a straight lecture course (this is the “teaching/learning activity”), so the teaching/learning activities are NOT aligned with the learning goals. Students might be able to learn the content from the lectures, but they definitely are not getting practice and feedback in learning how to think critically.’ From L. Dee Fink

29. From L. Dee Fink

30. 9 1 7 3 5 11 2 8 6 12 4 10 Surveillance; Frequency; Hypotheses; Strategies out out out out out out out out out out out out out out out out out out Measuring Association; Random Error RCT; Cohort; Case-Control Bias, Confounding Screening for Disease Critical Reading; Causal Inference

31. Reading, Videos, Skill Building, Problems, Pre-Class Quizzes (interactive web pages + progressive problems; challenging problem [post your discussion online before class]) Open Discussion of Problem Q&A Mini-Lecture Individual & Team Exercises Progressive Disclosure Exercises Reading, Videos, Skill Building, Problem Sets (interactive web pages + progressive problems; challenging problem [post your discussion online before class])

33. Inference & Causality Link to Module 1

34. A Progression from Fundamentals Skills to Increasingly Complex Problem Solving

35. An In-Class Exercise (Class #4) • A prospective cohort study was used to compare lung cancer mortality in smokers and non-smokers. • Among 20,000 non smokers there were 20 deaths from lung cancer during 5 years of study. • Among 5,000 smokers there were 100 deaths from lung cancer during the 5 year study period. • Organize this information in a 2x2 contingency table. • Calculate the cumulative incidence of death (per 1,000) due to lung cancer in smokers and non-smokers. • Calculate the relative risk; interpret it in words. • Calculate the risk difference; interpret it in words. • Calculate the attributable proportion in the exposed subjects; interpret it in words. • Calculate the population attributable fraction; interpret it in words.

36. Risk vs. Benefit – Aspirin to Prevent Heart Attacks (Class #6) Crestor to Prevent CVD Events In people with normal LDL but elevated CRP (Class #7) Crestor vs. Moderate Exercise to Prevent CVD Events (Class #7)

37. Progressive Disclosure Exercises in Class (Class #6) Link to Karachi Hand Washing RCT Link to Manson et al.: Cohort Study (Class #7)

38. One Hour Workshop Followed by Full Class Discussion (Class #14) Are policies aimed at reducing exposure to environmental tobacco smoke (secondhand exposure) evidence-based? Or are they the result of anti-tobacco zealots? Link to Assignment

39. Interactive learning modules and videos of abridged lectures can be accessed by smart phone as well. Link to class resources