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Critical Thinking in Health Professions Education Open Access


Other title
medical education
interprofessional education
critical thinking
nurse education
higher education
pharmacy education
health professions education
Type of item
Degree grantor
University of Alberta
Author or creator
Kahlke, Renate M
Supervisor and department
Dr Jorge Sousa, Department of Educational Policy Studies
Dr Paul Newton, Department of Educational Administration, University of Saskatchewan
Examining committee member and department
Dr Heather Kanuka, Department of Educational Policy Studies
Dr Jonathan White, Department of Surgery
Dr Claudia Ruitenberg, Department of Educational Studies, University of British Columbia
Department of Educational Policy Studies
Educational Administration and Leadership
Date accepted
Graduation date
Doctor of Philosophy
Degree level
Historically, health professions education has focused on content knowledge. However, there has been increasing recognition that there is a need to focus on the thinking processes required of future health professionals. To this end, educators in the health professions have looked to the concept of critical thinking. But what does it mean to “think critically”? Educators espouse radically different understandings of critical thinking, often with very different epistemological and theoretical roots. Differences in educators’ understandings of critical thinking are not just semantic, but result from the unique ways in which each educator makes sense of their contexts and experiences. This study asks, first, how do educators in the health professions understand critical thinking? Second, how does an educator’s unique personal and professional experiences inform their understanding of critical thinking? I engage with cultural historical activity theory (CHAT) as a theoretical perspective. Through CHAT I examine the contexts and experiences through which educators construct their understandings of critical thinking. As a methodology, I have taken a generic interpretive approach (Merriam, 2009), incorporating selected tools and techniques from constructivist grounded theory (Charmaz, 2006). I completed two semi-structured individual interviews with each of sixteen educators from four health professional programs: medicine, nursing, pharmacy, and social work. The first interview explored how each educator understands critical thinking, and how that understanding relates to their experiences. The second invited each educator to locate their understanding of critical thinking within the range of understandings generated from the first interview. Not surprisingly, I found that educators understood critical thinking in many different ways. Primarily, they saw critical thinking as 1) a rational process based in reasoning or problem solving, 2) as a humanistic approach to personal and interpersonal development, and 3) as a process of examining individual and societal assumptions, with a goal of social justice. These understandings of critical thinking are constructed through educators’ personal and professional experiences. Those experiences are embedded in the contexts in which they live and work, including: their profession, their practice context or discipline, their institutional contexts, and their personal world. These contexts are not discreet; rather they overlap and compete for priority. As a result, educators’ understandings of critical thinking are constantly shifting, and are often contradictory. Through CHAT, I see these contradictions as productive, particularly given that critical thinking is value-laden and ought to be contested if we are to produce a robust sense of what it means to be a “critical thinking” professional. Learning and change occur when meaning becomes unstable. Thus, I argue for a conceptual eclecticism that allows for multiple understandings of critical thinking, and invites a conversation about what “we” mean, and what “we” value.
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
Citation for previous publication
Kahlke, R. & White, J. (2013). Critical thinking in health sciences education: Considering “three waves.” Creative Education, 4(12A), 21-29.

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