|Year : 2020 | Volume
| Issue : 2 | Page : 115-118
Critical thinking skills among the oral medicine postgraduate students of Tamilnadu and Puducherry - A pilot study
Sarvathikari Ramasamy1, NG Mogeshvaar1, GK Divyapriya2
1 Division of Oral Medicine and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
2 Division of Public Health Dentistry, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
|Date of Submission||06-Mar-2020|
|Date of Decision||09-Apr-2020|
|Date of Acceptance||25-Apr-2020|
|Date of Web Publication||27-Jun-2020|
Dr. Sarvathikari Ramasamy
Division of Oral medicine and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, Tamil Nadu
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Critical thinking is the mental process of active and skillful perception, analysis, synthesis and evaluation of collected information through observation, experience, and communication that leads to a decision for action. Critical thinking applies to dentists in the process of solving the clinical conditions of patients and making crucial decisions for diagnosis and intervention. Aim: To assess the critical thinking skills (CTS) among oral medicine postgraduate students of dental colleges in Tamilnadu and Puducherry. Methodology: A convenience sampling method was used. The clinical scenario-based validated self-designed structured questionnaire was administered. The questionnaire was prepared using Google forms and the link was sent through WhatsApp among Oral Medicine postgraduate students. Descriptive statistics and Chi-square test were used for statistical analysis. A P value of less than 0.05 was considered to be significant. Results: A total of 49 responses were obtained. The participants who obtained the score >5 were considered to be high-level critical thinkers and those who obtained a score ≤5 were considered to be low-level critical thinkers. High-level critical thinkers among first, second, and third year postgraduates are 2 (12.5), 7 (43.8), and 7 (43.8). Similarly, low-level critical thinkers are 12 (36.4), 10 (30.3), and 11 (33.3) respectively. The association between the years of course and critical thinking skills were not statistically significant. Conclusion: The subjects with higher critical thinking score were less among oral medicine postgraduate students. Therefore, it is essential to pay more attention to improving critical thinking in clinical practice.
Keywords: Critical thinking, critical thinking skills, dental, postgraduate students
|How to cite this article:|
Ramasamy S, Mogeshvaar N G, Divyapriya G K. Critical thinking skills among the oral medicine postgraduate students of Tamilnadu and Puducherry - A pilot study. J Indian Acad Oral Med Radiol 2020;32:115-8
|How to cite this URL:|
Ramasamy S, Mogeshvaar N G, Divyapriya G K. Critical thinking skills among the oral medicine postgraduate students of Tamilnadu and Puducherry - A pilot study. J Indian Acad Oral Med Radiol [serial online] 2020 [cited 2020 Oct 1];32:115-8. Available from: http://www.jiaomr.in/text.asp?2020/32/2/115/288136
| Introduction|| |
The constantly changing and emerging trends within the health care system require healthcare professionals to acquire critical thinking skills to meet challenging expectations and new priorities. Critical thinking (CT) is generally defined as a process of purposeful, interactive reasoning, criticism, and judgment about what we believe and do. The ideal critical thinker is habitually inquisitive, well-informed, trustful of reason, open-minded, flexible, fair minded in evaluation, honest in facing personal biases, prudent in making judgments, willing to reconsider, clear about issues, orderly in complex matters, diligent in seeking relevant information, reasonable in the selection of criteria, focused in inquiry, and persistent in seeking results which are as precise as the subject and the circumstances of inquiry permit. Williams et. al., noted that the clinical reasoning process involves critical thinking in the form of information analysis, inductive, deductive reasoning, and developing treatment plans based on available information.
In the 21st century, students must think their way through abstract problems, work in teams, distinguish good information from bad, and be multilingual and globally/environmentally sensitive so that they can be more effective in their disciplines. This applies to dental students also who are expected to take effective decisions in both well- and ill-defined conditions to handle treatment planning and medical emergencies. It has been reported that critical thinking should be fostered at the grass root level among the students which will promote better decision making when they eventually practice. Thus, dental students are in need to improve their competency to prove quality dental care. A literature search revealed there is a paucity of information related to critical thinking skills among dental students. Hence, this survey is undertaken to assess the critical thinking skills among oral medicine postgraduate students.
| Methodology|| |
A pilot study was undertaken to assess the critical thinking abilities of Oral Medicine postgraduate students by using the convenience sampling method. The sampling frame comprised all oral medicine postgraduate students affiliated to the Tamilnadu Dr. M.G.R. medical university and other deemed universities of Tamilnadu and Puducherry. The subjects who were accessible through WhatsApp and those who gave consent were included in the study. Of the total 133 postgraduates, only 90 were reachable through WhatsApp. A structured proforma was prepared in Google forms which consisted of two sections. The first section comprised of informed consent and data related to name, age, gender, year of course, and college name. The second section includes the self-designed, structured, and scenario-based CT questionnaire [Annexure 1] which consists of 10 items given under five subscales namely inference, assumption, deduction, interpreting information, and argument skills. Each subscale has two items and the questions were framed in both open and close-ended types. The reliability of the questionnaire was assessed using kappa statistics. The kappa coefficient score was 0.88. The content validity ratio was 0.61 indicating satisfactory results and face validity of the questionnaire was done by expert opinions. The questionnaire link was sent via WhatsApp to the study subjects.
The collected data were organized, tabulated, and subjected to statistical analysis by R software. Descriptive statistics were generated in terms of percentages. Chi-square test was used to associate the critical thinking skills and year of postgraduation. The significance level was set at P ≤ 0.05.
| Results|| |
Of the 49 subjects who responded, 14 were the firstyear, 17 were the second-year and 18 were the third-year postgraduate students. The responses for four subscales (inference, assumption, deduction, and interpreting information) were categorized as not correct (if no right answer), partially correct (if one right answer), and correct (if both answers are correct). Similarly, the responses for argument subscale (open ended type) were categorized into strong and weak arguments based on expert opinions.
[Table 1] shows the distribution of study subjects based on the responses for critical thinking subscales and the year of course. Of 49 subjects, only 2 (4.1%) in the first year, 7 (14.3%) in the second year, and 7 (14.3%) in the third year accurately answered for inference-based questions. Among the 18 third-year postgraduates, the majority of the students (20.4%) rightly answered for assumption-based questions whereas very few students from first year and second year were able to provide correct answers. Similarly, a very less number of students from the first year (4.1), secondyear (12.2%), thirdyear (8.2%) answered correctly for deduction-based questions. The majority of students from the first, second, and third year, (24.5%), 14 (28.6%), and 13 (26.5%), respectively, were not able to precisely interpret the information provided. [Table 2] describes the number of students who strongly argued for the given case scenarios: first year - 4.1%; second year - 10.2%; and thirdyear - 16.3%.
|Table 1: The association between the components of critical thinking skills and the year of study among first, second and third year oral medicine postgraduates|
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|Table 2: The association between argument skills and the year of study among first, second and third year oral medicine postgraduates|
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The participants who scored >5 were considered as high-level critical thinkers and those who scored ≤5 were considered as a low-level critical thinker. As shown in [Table 3], high-level critical thinkers among the first, second, and thirdyear postgraduates were 2 (12.5), 7 (43.8), and 7 (43.8). Similarly, low-level critical thinkers are 12 (36.4), 10 (30.3), and 11 (33.3), respectively. The association between the year of the course and critical thinking skills was not statistically significant (P- value was 0.223).
|Table 3: The association between year of study and overall critical thinking score among first, second and third year oral medicine postgraduates|
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| Discussion|| |
Critical thinking is neither discipline specific nor knowledge specific skill; rather, it is a complex high-order thought process that involves reflection, doubt, curiosity, and challenge. Critical thinking and its measurement are gaining attention as dental education attempts to better define student educational outcomes and respective measures. As oral medicine specialists play a key role in the initial screening and diagnosis of patients attending dental colleges and hospitals, they must be competent in the use of critical thinking and problem solving, including their use in the comprehensive care of patients, scientific inquiry and to provide evidence-based patient care. In this context, a cross-sectional survey was conducted to assess critical thinking skills among oral medicine postgraduate students.
There are several critical thinking skill inventories and measures like Watson–Glaser Critical Thinking Appraisal (WGCTA), Cornell Critical thinking test, California Critical Thinking Disposition iInventory, and so on. Of these, Watson–Glaser Critical Thinking Appraisal (WGCTA) is the most commonly used critical thinking test that assesses the participants' skills in five subscales: inference, recognition of assumptions, deduction, interpretation, and evaluation of arguments. However, it is important to point out that all these measures are of questionable utility for dental educators because their content is general rather than dental education specific. Hence, considering these limitations, a self-designed structured questionnaire is prepared based on WGCTA subscales and it is tested for validation.
The results of the present study indicates that only very few students were able to answer precisely for critical thinking questions. There was no association found between the years of course and overall critical thinking score. This finding is important as it reflects the need for critical thinking competency among oral medicine postgraduate students. However, a study done in Iran indicated a significant difference between the years of education for the total CT score among medical and dental students. This contrary finding could be due to the use of the WGCTA questionnaire in their study which failed to include profession-related CT components like the interpretation of patients' test results. A study done by Pardamean concluded that dental students showed no continuous and significant incremental improvement in overall critical thinking skill scores during problem-based learning dental education. Similarly, a study done to compare the CT skills of freshmen and senior nursing students and findings of this study showed that the mean critical thinking scores of freshmen and senior nursing students were at a low level. Using the WGCTA, Scott and Market found that the correlation between critical thinking scores and Grade Point Average (GPA) for medical students in the first two years was not significant.
Although there is some evidences that CT skills increase over time,, we found that the CT ability among dental postgraduate students in the present study was weak overall which may lead to difficulties while discriminating between clinical statements in real situations of work environments. Onwueguzie identified a mutual relationship between CT and research skills. Therefore, encouraging students to participate in research projects may be another way of improving their CT skills. We also recommend the dental faculty to adopt new teaching strategies such as group discussion using case reports, problem solving, critiquing the scientific literature to promote the components of CT in their students.
The limitations of our study are its small sample size due to the low response rate in online survey thereby affecting the external validation of the results. Also, we tested our study subjects only once with a limited parameter. Longitudinal studies including more samples and different parameters in the future will help to generalize the results.
| Conclusion|| |
Our study results conclude that no significant difference exists among the first, second, and third -year postgraduate students on CT skill. Oral Medicine postgraduate students with higher critical thinking score were less; hence, it is necessary to improve their critical thinking skills through revising the dental curriculum by implementing new teaching strategies like case-based discussions, engaging the students in debate, argument mapping, thinking aloud seminar session, critical appraisal of journal articles, and thereby preparing them to maintain a cutting edge, evidence-based practice.
Ethical clearance was obtained from the Institutional Review Board of Rajah Muthiah Dental College and Hospital, Chidambaram (Ethical committee approval number IHEC 581/2019).
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Khosravani S, Manoochehri H, Memarian R. Developing critical thinking skills in nursing students by group dynamics. Internet J Adv Nurs Pract 2005;7:1-4.
Black BP. Professional nursing: Concepts and challenges.7th
ed. St. Louis, Missouri: Elseveir; 2019. p. 240.
Williams KB, Glasnapp DR, Tilliss TS, Osborn J, Wilkins K, Mitchell S, et al
. Predictive validity of critical thinking skills for initial clinical dental hygiene performance. J Dent Educ 2003;67:1180-92.
Zayapragassarazan Z, Menon V, Kar SS, Batmanabane G. Understanding critical thinking to create better doctors. Journal of Advances in medical education and research 2016;1:9-13.
Johnsen DC, Lipp MJ, Finkelstein MW, Cunningham-Ford MA. Guiding dental student learning and assessing performance in critical thinking with analysis of emerging strategies. J Dent Educ 2012;76:1548-58.
Hendricson WD, Andrieu SC, Chadwick DG, Chmar JE, Cole JR, George MC, et al
. Educational strategies associated with development of problem-solving, critical thinking, and self-directed learning. J Dent Educ 2006;70:925-36.
Commission on Dental Accreditation. Accreditation standards for dental education programs. Chicago: American Dental Association, 2010. Available from: www.ada.org/sections/educationAndCareers/pdfs/predoc_2013.pdf. [Last accessed on 2020 Feb 14].
BeharHorenstein LS. Critical thinking skills toolbox. Available from: www.adea.org/adeacci/Resources/Critical-Thinking-Skills-Toolkit/Pages/default.aspx. [Last accessed on 2020 Feb 25].
Mahmoodabad SS, Nadrian H, Nahangi H. Critical thinking ability and its associated factors among preclinical students in Yazd Shaheed Sadoughi University of Medical Sciences (Iran). Med J Islam Repub Iran 2012;26:50-7.
Pardamean B. Measuring change in critical thinking skills of dental students educated in a PBL curriculum. J Dent Educ 2012;76:443-53.
Azizi-Fini I, Hajibagheri A, Adib-Hajbaghery M. Critical thinking skills in nursing students: A comparison between freshmen and senior students. Nurs Midwifery Stud 2015;4:e25721.
Scott JN, Markert RJ. Relationship between critical thinking skills and success in preclinical courses. Acad Med 1994;69:920-4.
Angel BF, Duffey M, Belyea M. An evidence-based project for evaluating strategies to improve knowledge acquisition and critical-thinking performance in nursing students. J Nurs Educ 2000;39:219-28.
Pepa CA, Brown JM, Alverson EM. A comparison of critical thinking abilities between accelerated and traditional baccalaureate nursing students. J Nurs Educ 1997;36:46-8.
Onwuegbuzie AJ. Critical thinking skills: A comparison of doctoral-and master's-level students. Coll Stud J 2001;35:477-81.
[Table 1], [Table 2], [Table 3]