why critical thinking and problem solving skills important to medical technologist

12 Medical Laboratory Technologist Skills: Definition and Examples

Medical laboratory technologists play an important role in the healthcare industry. They are responsible for performing various laboratory tests and procedures. There are 12 essential skills that every medical laboratory technologist should possess. These include: 1. Communication 2. Critical thinking 3. Detail oriented 4. Organizational 5. Time management 6. Interpersonal 7. Technical 8. Computer 9. Math 10. Science 11. Reading 12. Writing

Medical Laboratory Technologist Skills

Communication, problem-solving, critical thinking, organization, time management, detail-oriented, multitasking, stress management, flexibility.

Communication is a critical skill for medical laboratory technologists, who must be able to effectively communicate with physicians, other healthcare providers, and patients. They need to be able to explain test results and answer questions from patients and other providers. They also need to be able to work effectively as part of a team.

Teamwork is the ability to work together toward a common goal. It is an important skill for medical laboratory technologists because they often work in teams to complete tasks and projects. Teamwork can help to increase efficiency and productivity, and it can also help to build morale and camaraderie among team members.

Problem-solving is a skill that is essential for medical laboratory technologists. They need to be able to identify problems and then find solutions to them. This skill is important because it helps them to keep the laboratory running smoothly and efficiently.

Critical thinking is the ability to analyze a situation and make an informed decision. It is an important skill for medical laboratory technologists because they often have to make decisions based on limited information. They need to be able to weigh the pros and cons of each option and make the best decision for the patient.

The ability to organize one's thoughts and ideas in a clear and concise manner is critical for any medical laboratory technologist. This skill is important because it allows the technologist to communicate effectively with other members of the healthcare team, as well as keep accurate records of patient results.

Time management is the ability to use your time efficiently and effectively. As a medical laboratory technologist, you will often be working with tight deadlines and it is important to be able to manage your time well in order to complete your work on time.

A detail-oriented medical laboratory technologist is able to pay attention to small details in order to accurately collect and analyze samples. This skill is important in order to ensure that the results of tests are accurate.

Accuracy is the ability to consistently produce results that are free from error. This skill is important for medical laboratory technologists because it ensures that the results of laboratory tests are reliable.

Efficiency is the ability to produce desired results with a minimum of effort, time, or waste. In the medical laboratory, efficiency is important because it allows technologists to produce accurate results quickly and with minimal errors.

The ability to multitask is an important skill for medical laboratory technologists because they often have to perform several tasks at the same time. This might include taking samples from patients, running tests on those samples, and keeping track of results. Being able to multitask effectively can help ensure that all tasks are completed accurately and in a timely manner.

The ability to manage stress is an important skill for medical laboratory technologists. They often work in fast-paced environments and must be able to handle multiple tasks at once. Stress management can help them stay focused and efficient in their work.

The ability to be flexible is important for medical laboratory technologists because they often have to work with a variety of different patients, each with their own unique set of needs. They also have to be able to adapt to changes in technology and methods.

How to improve medical laboratory technologist skills

Medical laboratory technologists are responsible for performing a variety of tests on patient samples and providing accurate results. They must have a strong knowledge of laboratory procedures and be able to operate complex equipment. In order to maintain the highest level of accuracy and precision, medical laboratory technologists must continually update their skills and knowledge.

There are many ways for medical laboratory technologists to improve their skills. One way is to participate in continuing education courses offered by professional organizations such as the American Society for Clinical Laboratory Science (ASCLS) or the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS). These courses keep technologists up-to-date on new procedures, techniques, and regulations.

In addition to taking courses, medical laboratory technologists can also attend conferences and seminars. These events provide an opportunity to network with other professionals and learn about the latest advances in the field. Many conferences offer continuing education credits that can be applied towards license renewal.

Another way to improve skills is to become certified in a specialty area. The ASCLS offers certification exams in several areas, including medical microbiology, immunology, and molecular diagnostics. Specialty certification can demonstrate expertise in a particular area and make technologists more marketable to employers.

Finally, medical laboratory technologists can stay current on new developments by reading professional journals and articles. The ASCLS website provides links to several online journals that focus on clinical laboratory science. Reading these publications can help technologists keep up with new technologies, procedures, and research findings.

How to highlight medical laboratory technologist skills

In order to highlight your skills as a Medical Laboratory Technologist, you should first identify what your strongest skills are. Once you have identified your strongest skills, you can then begin to market yourself as a Medical Laboratory Technologist. You can do this by writing a resume that highlights your skills and experience, and by networking with other Medical Laboratory Technologists. You can also join professional organizations, such as the American Society for Clinical Laboratory Science, which can help you to meet other Medical Laboratory Technologists and to stay up-to-date on the latest industry news.

On a resume

As a medical laboratory technologist, you will be responsible for performing tests on patient samples and providing accurate results. It is important to highlight your skills and experience in your resume so that potential employers can see that you are qualified for the position. Include your educational background, including any degrees or certification in medical laboratory technology. List any relevant work experience, including your roles and responsibilities in each position. Be sure to include any special training or skills that you have in your field. Highlight your attention to detail and accuracy, as these are essential qualities for a medical laboratory technologist. Emphasize your ability to work independently and follow instructions carefully. Show that you are able to handle sensitive information with discretion and maintain confidentiality. Make sure to list any professional memberships or associations that you belong to, as this will show potential employers that you are up-to-date on the latest developments in your field. Finally, include any awards or recognition that you have received for your work as a medical laboratory technologist.

In a cover letter

In your cover letter, be sure to highlight your skills as a Medical Laboratory Technologist. Include your experience working with various laboratory equipment and instruments, as well as your knowledge of laboratory procedures and techniques. Also mention your ability to collect and analyze specimens, and to prepare reports detailing your findings. Finally, emphasize your commitment to accuracy and precision in all aspects of your work.

During an interview

In order to highlight your skills as a medical laboratory technologist during an interview, you should be sure to emphasize your experience working with various laboratory equipment and your knowledge of different laboratory procedures. You should also highlight your ability to maintain accurate records and your attention to detail. Additionally, be sure to emphasize your interpersonal skills and your ability to work well with others, as this is an important aspect of the job.

Related Career Skills

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Cultivating Critical Thinking in Healthcare

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Critical thinking skills have been linked to improved patient outcomes, better quality patient care and improved safety outcomes in healthcare. Given this, it's necessary for educators in healthcare to stimulate and lead further dialogue about how these skills are taught, assessed and integrated into the design and development of staff and nurse education and training programs. So, what exactly is critical thinking and how can healthcare educators cultivate it amongst their staff?

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Critical Thinking Skills of Allied Health Science Students: A Structured Inquiry

by Marcia Y. Sharp, EdD, RHIA; Rebecca B. Reynolds, EdD, RHIA, FAHIMA; and Keisha N. Brooks, MS, CT(ASCP)

This study examines the critical thinking skills of health informatics and allied health students. The Health Sciences Reasoning Test was utilized to investigate the critical thinking skills of 57 graduating seniors in the class of 2011 at a university in the southeastern United States. Results indicate that 64.9 percent of the participants had weak critical thinking skills, 31.6 percent of the participants had moderate critical thinking skills, and 3.5 percent of the participants had strong critical thinking skills. Baccalaureate participants’ critical thinking skills were lower than master’s and entry-level master’s participants. Entry-level master’s students scored higher than master’s level students. This research adds to the body of literature surrounding the critical thinking skills of allied health students and provides new information to deans, administrators, and educators that may be useful when evaluating students’ critical thinking skills. As accrediting agencies and policymakers continue to raise the bar and place more accountability on higher education institutions, it is important that attention remain on graduating students who can think critically. The results of the study will help to establish a foundation for allied health science programs to determine the level of critical thinking skills that their graduates possess. Results of the study can provide a starting point for faculty to make changes in the curriculum to improve students’ critical thinking skills.

Introduction

Critical thinking is a major educational outcome required of higher education institutions. Today, more than ever, educational programs are challenged to develop students’ critical thinking skills. In light of the shifting scope of practice in various healthcare settings, allied health professionals must be capable of adapting to these ever-changing demands. Because of the demands placed on healthcare institutions to deliver quality patient care in an interdisciplinary environment, the development of critical thinking skills among allied health students is essential.

Every day allied health professionals must gather, analyze, and process information to make sound, logical decisions. Often the decisions are complex and require multiple levels of decision making. Regardless of the magnitude of the decisions to be made, it is essential that allied health students have the clinical reasoning and critical thinking skills to make good decisions. But do these students have critical thinking skills and the abilities to apply those skills in many different contexts? Can deans, program directors, and department chairs at colleges and universities be assured that they are graduating students who can think critically in complex situations? As accrediting agencies and policy makers continue to raise the bar and place more accountability on higher education institutions, it is important that attention remain on graduating students who can think critically. It is up to us, as educators, to ensure that we are teaching, evaluating, and assessing students’ critical thinking skills.

Much research on critical thinking has been conducted, examining strategies used to integrate critical thinking into the curriculum, single courses on critical thinking, and the use of concept maps as critical thinking techniques. 1–5 A few studies among allied health professions such as dental hygiene, occupational therapy, and physical therapy have been conducted, assessing the critical thinking skills of students. Each discipline conducted studies with only students from that field; no studies that had an interdisciplinary approach were found. The researcher did not find any studies that included health informatics and information management (HIIM) professionals, medical laboratory technicians, or cytotechnologists. As the healthcare industry moves away from silos in treating patients to a more interdisciplinary team approach, so should higher education institutions move toward an interdisciplinary approach in teaching and research. This study is an attempt to include students from different disciplines, such as dental hygiene, medical technology, HIIM, and cytotechnology, and add to the body of knowledge by assessing the critical thinking skills of students enrolled in these allied health programs collectively. Rather than looking at a single discipline, this study aimed to determine whether there are differences in the critical thinking skills of students in various allied health programs.

The primary purpose of this study was to determine the critical thinking skill level of allied health students at a university in the southeastern United States, as measured by the Health Sciences Reasoning Test (HSRT). The questions the investigators sought to answer were as follows:

• What is the critical thinking skill level of allied health students at this university (strong, moderate, or weak)?
• Are there differences in critical thinking skills based on the allied health students’ programs?
• Are there differences in critical thinking skills between programs taught at different academic levels (baccalaureate, entry-level master’s, and master’s)?

Background/Literature Review

The following excerpt outlines the history of critical thinking:

Although the principles of Critical Thinking underpin much of Western philosophy, it did not come to the forefront as a specific concept until the late Nineteenth Century. Philosophical discussion of critical inquiry surfaced in the 1870’s in the United States, when Charles Sanders Peirce, who believed that logic is the scientific method that will lead to truth, originated the concept of pragmatism. Pragmatism stresses the relation of theory to practice (or what Paulo Freire called “praxis,” meaning reflection and action upon the world in order to change it). . . . John Dewey, [the noted educator] who argued for a model of critical thinking based on a theory of knowing that is continuous[,] . . . adopted Peirce’s notion of meaning, and focused on the connection that thinking has with experience, doing, and the consequences of action. Dewey subscribed to the philosophical school known as pragmatism, and described his approach to inquiry as “reflective thinking,” to distinguish it from ordinary thinking. 6

Various sources have defined and explained critical thinking as follows:

• Critical thinking is the process by which one penetrates beyond the surface of a problem, recognizes how the problem can be solved, and possesses the content knowledge needed to solve the problem. 7
• “Critical thinking is reflective reasoning about beliefs and actions. It is a way of deciding whether a claim is always true, sometimes true, partly true, or false. . . . Critical thinking clarifies goals, examines assumptions, discerns hidden values, evaluates evidence, accomplishes actions, and assesses conclusions.” 8
• “It is a part of formal education and is increasingly significant as students progress through university to graduate education. . . . Critical thinking is considered important in the academic fields because it enables one to analyze, evaluate, explain, and restructure [one’s] thinking, thereby decreasing the risk of adopting, acting on, or thinking with, a false belief.” 9

Although no single definition of critical thinking exists, much research has been conducted on critical thinking. The critical thinking research in the higher education arena has been broad and extensive, while research on the allied health professions lags behind. The results of this study will help to establish a foundation for allied health programs to determine the level of critical thinking skills their graduates possess. This study can inform deans, program directors, and department chairs, as well as faculty, on the extent to which critical thinking is demonstrated in their program’s graduates. Results of the study can provide a foundation for faculty to make changes in the curriculum to improve students’ critical thinking skills.

Critical thinking is not only essential but an expectation of healthcare professionals. “Critical thinking is increasingly being recognized as the cognitive engine driving the processes of knowledge development and professional judgment in a wide variety of professional practice fields.” 10 The depth and breadth of information that healthcare practitioners are expected to master is voluminous. The two major disciplines in healthcare are medicine and nursing. Some studies related to critical thinking exist within the medicine discipline, but most studies have been conducted in nursing.

Equally important to the healthcare industry, but often overlooked, are the allied health professions. Allied health professionals are “involved with the delivery of health or related services pertaining to the identification, evaluation and prevention of diseases and disorders; dietary and nutrition services; rehabilitation and health systems management, among others.” 11 Studies related to critical thinking were found in radiographic technology, occupational therapy, physical therapy, and dental hygiene professions. 12–15 The majority of these studies evaluated critical thinking skills as an outcome measure based on licensure examination scores.

Despite widespread attention to critical thinking, studies have shown that schools neither challenge students to think critically about academic subjects nor help them develop the reasoning skills needed to succeed in the 21st century. 16, 17 “On average, gains in critical thinking, complex reasoning and writing skills (i.e., general collegiate skills) during the first two years of college are either exceedingly small or empirically non-existent for a large proportion of students.” 18 In a study conducted by Arum and Roksa (2011), 19 “Forty-five percent of our students did not demonstrate any significant improvement in CLA [Collegiate Learning Assessment] performance during the first two years of college.” 20 This study reports that many college students graduate without knowing how to sift fact from opinion, make a clear written argument, or objectively review conflicting reports of a situation or event. 21

This quantitative research study is both descriptive and exploratory. Institutional review board approval was obtained from the university. A commercial survey tool, the HSRT, was used to investigate the critical thinking skills of allied health students. The instrument gathers information regarding demographic variables and an overall critical thinking score. The data were subsequently analyzed with SPSS version 19.0.

Participants

The participants in the study consisted of cytotechnology, dental hygiene, HIIM, and medical technology students graduating in the class of 2011 from an allied health college in an academic health science center in the southeastern United States. The college also includes audiology and speech language pathology, occupational therapy, and physical therapy programs. Because of the various schedules of the programs, students were selected for participation from the programs where students were available on-campus for the researcher to meet with, to increase the response rate. A total of 63 students from cytotechnology ( n = 2), dental hygiene ( n = 33), HIIM ( n = 20), and medical technology ( n = 8) constituted the research population for this survey.

Data were collected through the administration of the HSRT. The HSRT is a commercially available survey instrument, developed by Noreen and Peter Facione and designed specifically for health science professionals, workers, and students. 22 The instrument has been used in research studies attempting to predict critical thinking skills needed for professional licensure exams, disposition toward critical thinking among various allied health disciplines, and association of critical thinking skills and clinical performance. It is being used worldwide at high-ranking health science education programs to measure critical thinking skills and habits of mind in students and practicing professionals. 23 The HRST is a multiple-choice test that targets core critical thinking skills of health science professionals and health science students. It measures five subscale critical thinking areas, including analysis and interpretation, inference, evaluation and explanation, deductive reasoning, and inductive reasoning. 24 Questions invite test takers to draw inferences, make interpretations, analyze information, draw warranted inferences, identify claims and reasons, and evaluate the quality of arguments. The HSRT has an overall internal consistency value of .81 with Kuder-Richardson formula 20, and an overall .81 reliability coefficient. 25 The total score is a measure of overall critical thinking skills, and the maximum score is 33. According to the HSRT test manual, total HSRT scores of 25 or above represent strong critical thinking skills, scores ranging from 15 to 24 are considered midrange and represent competence in critical thinking skills in most situations, and scores of 14 or below represent fundamental weaknesses in critical thinking skills. 26

After training on how to administer the instrument was conducted, dates were arranged with dental hygiene and medical technology students to take the paper version of the assessment. Because the HIIM students are online students, they were given the same assessment online. The cytotechnology students were in the process of finishing clinical rotations, so the researcher decided that they should take the online assessment as well. An e-mail message that explained the study, asked for consent, and provided the instructions for accessing the HSRT was sent to the online students. To improve participation rates, the researcher sent a follow-up e-mail to online participants one week later, after the initial e-mail request. Dental hygiene and medical technology students, who were face-to-face students, completed the assessment in person on a scheduled data collection date. Completion of either assessment, paper or online, took approximately 45 to 50 minutes.

Independent variables included age, gender, grade point average (GPA), program, academic level, and educational degree the student was currently seeking. Age was defined as the student’s current age. Gender was defined as the student’s birth gender (female, male). Grade point average was the student’s overall GPA prior to being accepted to the program. This variable was self-reported and was based on a 4.00 scale. Program was defined as the current allied health program the student was enrolled in (cytotechnology, dental hygiene, HIIM, and medical technology). Academic level was defined as the highest education level obtained prior to acceptance in the current allied health program (some college hours but no degree yet, associate’s degree, bachelor’s degree, master’s degree, doctoral [terminal] degree, or other). Degree the student was currently seeking was defined as the degree that the student was currently attending school to obtain (bachelor’s degree, master’s degree, entry-level master’s degree). Entry-level master’s degree programs do not require completion of a baccalaureate degree before matriculating to the masters level. The dependent variables in the study were the HSRT total score and the five HSRT scale subscores: analysis and interpretation, inference, evaluation and explanation, deductive reasoning, and inductive reasoning.

Reliability

Cronbach’s alpha was used to assess the internal reliability or consistency of the scales that made up the total HSRT score. An internal reliability test for the five scales—analysis and interpretation, inference, evaluation and explanation, inductive reasoning, and deductive reasoning—was conducted and yielded an alpha value of .85. According to Pallant (2007), an alpha value of .70 or greater is an acceptable measure. 27

Descriptive statistics were used to describe the critical thinking skill level of allied health students overall. Analysis of variance (ANOVA) was used to determine if any differences in HSRT scores between groups of students were statistically significant ( p < .05).

  Results

This study was conducted with a sample of 63 graduating students. A total of 57 students (90 percent response rate) volunteered to take the assessments. The face-to-face sessions resulted in a 91 percent response rate from dental hygiene students and a 75 percent response rate from medical technology students. The e-mail requests asking students to take the online version of the HSRT resulted in a 100 percent response rate from the cytotechnology students and a 95 percent response rate from the HIIM students.

The critical thinking skill level of the participating students was assessed through descriptive analysis, which indicated that 64.9 percent ( n = 37) of allied health science students showed weak critical thinking skills, 31.6 percent ( n = 18) showed moderate critical thinking skills, and 3.5 percent ( n = 2) showed strong critical thinking skills (see Table 1 ).

One-way ANOVA was used to determine if there were any statistically significant differences in critical thinking skills based on allied health program. Results displayed in Table 2 indicated a statistically significant difference at the p < .05 level in critical thinking scores for the different programs, F (3, 53) = 28.708, p = .00. Post hoc analysis using the Tukey test indicated that the mean score for dental hygiene students ( M = 7.73) was significantly different from that of cytotechnology students ( M = 19.50) and HIIM students ( M =18.68). HIIM students’ mean score ( M = 18.68) was significantly different from that of dental hygiene students ( M = 7.73) and medical technology students ( M = 10.33). The mean score of medical technology students ( M = 10.33) was significantly different from that of cytotechnology students ( M = 19.50) and HIIM students ( M = 18.68).

One-way ANOVA was used to determine if there were any statistically significant differences in critical thinking skills of students in programs taught at different academic levels (baccalaureate, entry-level master’s, and master’s). The descriptive statistics are listed in Table 3 . Results depicted in Table 4 indicated a statistically significant difference at the p < .05 level in critical thinking scores for the different academic levels.

The results of the study indicated that 64.9 percent of allied health science students participating in the study had weak critical thinking skills, 31.6 percent had moderate critical thinking skills, and 3.5 percent had strong critical thinking skills. This finding is consistent with Arum and Roksa’s 2011 study, which indicated that students’ critical thinking and critical reasoning skills were relatively weak or nonexistent. 28

This study found statistically significant differences in critical thinking skills based on program type. The dental hygiene mean score ( M = 7.73) was significantly different from the cytotechnology mean score ( M = 19.50) and the HIIM mean score ( M =18.68). The HIIM mean score ( M = 18.68) was significantly different from the dental hygiene mean score ( M = 7.73) and the medical technology mean score ( M = 10.33). The medical technology mean score ( M = 10.33) was significantly different from the cytotechnology mean score ( M = 19.50) and the HIIM mean score ( M = 18.68). No other studies investigating multiple programs at once have been published to allow for comparison.

ANOVA indicated differences in critical thinking based on academic level (Table 4). Bachelor participants’ critical thinking skills were lower than those of master’s and entry-level master’s participants. Surprisingly, entry-level master’s students scored higher than master’s-level students. This finding could be a result of the small sample of entry-level master’s students. This result is consistent with findings in a nursing study that found significant differences between the development of critical thinking skills among graduates of diploma, associate, and baccalaureate educational programs. 29 The nursing study also found that students prepared at the baccalaureate level demonstrated higher levels of critical thinking ability than those at the diploma or associate level. 30 King and Kitchener (1994) also found that more formal education is a powerful predictor of critical and reflective thinking. 31

Limitations

There are several limitations to this study. First, the study is limited to one academic health science center located in the southeastern United States, which reduces the generalizability of the results. While results of this study may be typical for allied health students at this location, they may not be indicative of allied health students elsewhere in the region or in other regions of the United States. Second, participants were limited to only those students enrolled and expected to graduate in the spring of 2011, so the demographics and backgrounds of these participants may not be typical of those expected to graduate at other times. This study was also constrained by the collection of data at one point in the students’ academic careers—that is, upon exit from the students’ academic program. While the results of this study cannot be generalized to all allied health students, the study nonetheless contributes to the body of research concerning the importance of improving critical thinking skills among allied health students.

Recommendations

Recognizing the importance of critical thinking, universities and colleges are implementing critical thinking assessments and outcome measures of critical thinking throughout their academic programs. For deans and college administrators, the results of the study provide support to introduce programs to improve critical thinking skills. Several institutions, such as George Mason University, the University of Tennessee at Chattanooga, and El Paso Community College, have instituted critical thinking programs to provide an avenue for students and faculty to focus on critical thinking outcome measures. These avenues include, but are not limited to, programs such as critical thinking across the curriculum, critical thinking across the disciplines, and specific courses on critical thinking.

For program directors and department chairs in the allied health areas, the ability of students to pass national board examinations is an important outcome measure. However, equally important is the ability of allied health students to demonstrate adequate critical thinking and reasoning skills. Therefore, program directors and department chairs should assess students’ critical thinking skills upon entering, midway through, and upon exiting their respective programs and make necessary changes to ensure students are graduating with adequate critical thinking skills.

There is no “magic trick” or “quick fix” instructional model that instructors can apply in a few courses to increase critical thinking skills; rather, the careful integration of deep thinking and thought-provoking assignments by educators is essential for developing students’ critical thinking skills. Activities used to foster critical thinking skills include evaluating alternatives to a problem, identifying credible sources, organizing an essay, predicting what will happen next, defending an argument, and self-evaluating the learning process through reflective analysis.

The findings of this research suggest the need for improvements in the critical thinking skills of allied health students. Results from the study provide a foundation for faculty to be aware of the potential lack of critical thinking skills in students and to make curricular changes in an attempt to improve students’ critical thinking skills. Several remaining questions offer future research possibilities. Critical thinking research should be expanded to other allied health programs throughout the United States and include longitudinal studies to identify if critical thinking skills change during students’ academic careers. A future research study could examine other allied health disciplines to identify if a relationship between students’ critical thinking skills and pass rate on their disciplines’ national board examinations exists.

The literature that currently exists recognizes the importance of critical thinking and the evaluation of students’ critical thinking skills. When assessing the critical thinking skills of college students, one must also consider the critical thinking skills of college educators. The ability to think critically and the ability to teach critical thinking skills warrant an investigation into how the two areas can be successfully merged. The information gathered from an assessment of critical thinking skills among college educators could help inform college administrators, deans, program directors, department chairs, and faculty on how to better train educators to teach critical thinking skills to their students.

Marcia Y. Sharp, EdD, RHIA, is an associate professor in the Department of Health Informatics and Information Management at the University of Tennessee Health Science Center in Memphis, TN.

Rebecca B. Reynolds, EdD, RHIA, FAHIMA, is chair and associate professor in the Department of Health Informatics and Information Management at the University of Tennessee Health Science Center in Memphis, TN.

Keisha N. Brooks, MS, CT (ASCP), is an assistant professor of clinical laboratory sciences at the University of Tennessee Health Science Center in Memphis, TN.

• Kurfiss, J. Critical Thinking Theory, Research, Practice, and Possibilities (ASHE-ERIC Higher Education Report No. 2). Washington, DC: Association for the Study of Higher Education, 1988.
• Halpern, D. F. “Students Need Reality Checks.” Education Digest 63 (1997): 24–26.
• Irvine, L. M. “Can Concept Mapping Be Used to Promote Meaningful Learning in Nurse Education?” Journal of Advanced Nursing 21 (1995): 1175–79.
• Baugh, N. G., and K. G. Mellott. “Clinical Concept Mapping as Preparation for Student Nurses’ Clinical Experiences.” Journal of Nurse Education 23 (1998): 35–41.
• Clayton, L. H. “Concept Mapping: An Effective, Active Teaching-Learning Method.” Nursing Education Perspectives 27, no. 4 (2006): 197–203.
• Damji, S., M. Dell’Anno, M. McGrath, and J. Warden. “What Is Critical Thinking and How Can It Be Promoted by Adult Educators?” December 2001. Available at http://fcis.oise.utoronto.ca/~daniel_sc/faqs/qa10.html.
• Willingham, D. T. “Critical Thinking: Why Is It So Hard to Teach?” American Educator 31, no. 2 (2007): 8–19.
• Wikipedia. “Critical Thinking.” Available at en.wikipedia.org/wiki/Critical_thinking(accessed April 1, 2013).
• Facione, N. C., and P. A. Facione. “Externalizing the Critical Thinking in Knowledge Development and Clinical Judgment.” Nursing Outlook 44 (1996): 129–36.
• Association of Schools of Allied Health Professions. “Allied Health Professionals.” Avaliable at http://www.asahp.org/definition.htm .
• Bartlett, D. J., and P. D. Cox. “Measuring Change in Students’ Critical Thinking Ability: Implications for Healthcare Education.” Journal of Allied Health 31 (2002): 64–69.
• Velde, B., P. P. Wittman, and P. Vos. “Development of Critical Thinking in Occupational Therapy Students.” Occupational Therapy International 13, no. 1 (2006): 49–60.
• Williams, K. B., C. Schmidt, T. S. Tilliss, K. Wilkins, and D. R. Glasnapp. “Predictive Validity of Critical Thinking Skills and Disposition for the National Board Dental Hygiene Examination: A Preliminary Investigation.” Journal of Dental Education 70 (2006): 536–44.
• Zettergren, K. K., and R. Beckett. “Changes in Critical Thinking Scores: An Examination of One Group of Physical Therapy Students.” Journal of Physical Therapy Education 18, no. 2 (2004): 73–79.
• Halpern, D. F. “Students Need Reality Checks.”
• Arum, Richard, and Josipa Roksa. Academically Adrift: Limited Learning on College Campuses . Chicago, IL: University of Chicago Press, 2011.
• Learning in Higher Education. “Core Findings.” Social Science Research Council. 2011. Avaliable at http://highered.ssrc.org/?page_id=33 .
• Arum, Richard, and Josipa Roksa. Academically Adrift: Limited Learning on College Campuses .
• Insight Assessment. “Health Sciences Reasoning Test (HSRT).” Available at http://www.insightassessment.com/Products/Critical-Thinking-Skills-Tests/Health-Sciences-Reasoning-Test-HSRT/(language)/eng-US.Facione, Noreen C., and Peter A. Facione. The Health Sciences Reasoning Test . Millbrae,CA: California Academic Press, 2005.
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• Pallant, J. SPSS Survival Manual: A Step-by-Step Guide to Data Analysis Using SPSS Version 15 . 3rd ed. Berkshire, England: Open University Press, 2007.
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Laboratory Critical Thinking

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Laboratory Critical Thinking By Scott Warner

From Nursing to the Lab The dictionary defines critical thinking as “disciplined thinking that is clear, rational, open-minded, and informed by evidence.”[1] Critical thinking has been emphasized in nursing training and clinical practice for over fifty years. There are many definitions in this context, but the American Association of Colleges of Nurses says it “underlies independent and interdependent decision making.”[2] Thus, it is an intelligent approach to unstructured, independent problem solving.

Jennifer Olin, BSN, RN blogs that critical thinking includes being rational, reflective, inquisitive, creative and fair. She writes, “The thinking process that guides nursing practice must be organized, purposeful and disciplined because nursing decisions often profoundly affect their patients’ lives.”[3] As she points out, the autonomy of nursing necessitates this kind of thinking.

A similar autonomy mandates critical thinking on the bench. For example, in a blood bank, a technologist may need to troubleshoot weak reactions when the need for blood is urgent; in chemistry, a sequence of delta checks may suggest a method failure; and in microbiology, consulting with the physician will determine if an organism is reported as a possible contaminant or probable pathogen. These and other novel situations are unique to laboratory medicine, difficult to script in advance, and often need to be solved on the fly using critical thinking skills.

Boost Your Career There are degrees of autonomy in any laboratory. Many decisions are predefined in writing, from how many times to attempt collecting a blood sample to troubleshooting quality control failure. Novel situations are often handled by supervisors. But critical thinking is necessary at all levels of an organization and applicable in many situations. They also enhance your brand and boost your career.

As Time reported last year, a lack of soft skills for new college graduates is leaving many jobs unfilled. These include communication, interpersonal, creativity and critical thinking skills. According to one survey, technical and computer-related proficiency rank much farther down the list of what employers value.[4] Developing your critical thinking skills early improves your marketability when competing with experience.

Despite this, colleges and schools don’t adequately challenge students to think critically. One study concluded among allied health programs that 64.9 percent of students had weak critical thinking skills; less than four percent had strong skills.[5] The technical details of laboratory medicine add to this challenge. Thus, each technologist must develop critical thinking skills on the job.

Core Skills Critical thinking is about acquiring, understanding and applying knowledge to analyze and solve problems. All laboratory professionals can do this, but understanding basic steps can help enhance these core skills:[6]

– Knowledge – identification and recall of information on a subject (who, what, where, etc.).

– Comprehension – the ability to organize, interpret, and paraphrase knowledge.

– Application – using the knowledge to solve problems, especially in novel situations.

– Analysis – connecting or separating pieces of information to determine its significance.

Abnormal cell identification in hematology is a good example of when critical thinking skills are necessary. Knowledge includes cellular morphology and clinical context, and a technologist needs to be able to recall this knowledge in a way that fits the clinical setting. This comprehension is used when performing a manual differential count, and the final results are analyzed and reported to best help the physician and patient. Critical thinkers are able to describe abnormal cells that cannot be easily identified (e.g. large mononuclear cell with agranular cytoplasm) using knowledge of cellular anatomy where appropriate.

The best critical thinkers continuously learn new knowledge to be applied. They know the value of getting it right over being right. This sometimes difficult process can lead to over-analysis of a situation, however, leading to decision paralysis, but good critical thinkers learn how to avoid getting too bogged down in details. A good example of this is troubleshooting quality control results. It’s easy to ignore other factors, such as temperature, storage and water quality, which can affect method performance.

Finally, critical thinkers turn their skills upon themselves, asking, “Have I considered everything?” and “Am I being impartial enough?” Everyone makes mistakes, including critical thinkers. A common mistake is confirmation bias, a tendency to look for information or make conclusions that confirm one’s preconceptions. This and other cognitive biases can cause judgement errors. Good critical thinkers are aware of these tendencies and constantly strive to correct themselves.

Market Your Skills Any laboratory is filled with opportunities to hone and test critical thinking skills to improve your marketability. Beyond education, employers want candidates who show they can apply knowledge and think critically. These “soft” skills, which also include likeability and time management, can be added to your resume as bullet points, but you also need to be ready to provide interesting examples during an interview.[7]

During an interview, for example, you may be asked “situational” questions intended to gauge how well you respond to a situation or apply knowledge.

Example: Can you give an example of how you handled a critical value when the ordering provider was not available?

These are chances to offer specific examples that highlight your critical thinking skills, showing a potential employer that you can think quickly on your feet in unusual situations — and it can make a difference when the employer has to make a hiring decision.

As Peter Facione, PhD, of Insight Assessment summarizes, “Critical thinking is skeptical without being cynical. It is open-minded without being wishy-washy. It is analytical without being nitpicky.”[8] It is also a hallmark of a laboratory professional who is able to acquire and apply knowledge in any clinical setting, ultimately using those skills to improve patient care.

Scott Warner is lab manager at Penobscot Valley Hospital, Lincoln, ME.

References:

1. Dictionary.com. the definition of critical thinking. Available at: http://dictionary.reference.com/browse/critical+thinking. Accessed September 15, 2014.

2. Benner P, Hughes R, Sutphen M. Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically. Agency for Healthcare Research and Quality (US). 2008. Available at: http: //www.ncbi.nlm.nih.gov/books/NBK2643/. Accessed September 15, 2014.

3. Olin J. 7 Characteristics of Critical Thinking | Notes from the Nurses’ Station. Notes from the Nurses’ Station. 2011. Available at: http://www.rncentral.com/blog/2011/7-characteristics-of-critical-thinking/. Accessed September 15, 2014.

4. White M. The Real Reason New College Grads Can’t Get Hired | TIME.com. TIMEcom. 2013. Available at: http://business.time.com/2013/11/10/the-real-reason-new-college-grads-cant-get-hired/. Accessed September 18, 2014.

5. Hicks J. Critical Thinking Skills of Allied Health Science Students: A Structured Inquiry | EduPerspectives. Eduperspectivesahimaorg. 2013. Available at: http://eduperspectives.ahima.org/critical-thinking-skills-of-allied-health-science-students-a-structured-inquiry/. Accessed September 18, 2014.

6. Dunn J. The 4-Step Guide To Critical Thinking Skills | Edudemic. Edudemic. 2013. Available at: http://www.edudemic.com/the-4-step-guide-to-critical-thinking-skills/. Accessed September 19, 2014.

7. Youtern.com. 5 Keys to Demonstrating Critical Soft Skills on Your Resume | The Savvy Intern by YouTern. 2014. Available at: http://www.youtern.com/thesavvyintern/index.php/2014/06/12/5-keys-to-demonstrate-critical-soft-skills-on-your-resume/. Accessed September 19, 2014.

8. Facione P. Critical Thinking: What It Is And Why It Counts. 2014:25. Available at: http://www.insightassessment.com/CT-Resources/Teaching-For-and-About-Critical-Thinking/Critical-Thinking-What-It-Is-and-Why-It-Counts/Critical-Thinking-What-It-Is-and-Why-It-Counts-PDF. Accessed September 19, 2014.

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• v.6(4); Oct-Dec 2016

Effect of training problem-solving skill on decision-making and critical thinking of personnel at medical emergencies

Mohammad heidari.

Department of Nursing, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran

Sara Shahbazi

1 Department of Nursing, Borujen Nursing Faculty, Shahrekord University of Medical Sciences, Shahrekord, Iran

Background:

The aim of this study was to determine the effect of problem-solving training on decision-making skill and critical thinking in emergency medical personnel.

Materials and Methods:

This study is an experimental study that performed in 95 emergency medical personnel in two groups of control (48) and experimental (47). Then, a short problem-solving course based on 8 sessions of 2 h during the term, was performed for the experimental group. Of data gathering was used demographic and researcher made decision-making and California critical thinking skills questionnaires. Data were analyzed using SPSS software.

The finding revealed that decision-making and critical thinking score in emergency medical personnel are low and problem-solving course, positively affected the personnel’ decision-making skill and critical thinking after the educational program ( P < 0.05).

Conclusions:

Therefore, this kind of education on problem-solving in various emergency medicine domains such as education, research, and management, is recommended.

INTRODUCTION

Having strong coping skills to reduce stress and satisfaction on the decision-making process to be creative and also having problem-solving skill is necessary in life.[ 1 ] In this way, learning should be defined “meaningful” and problem-solving skill is one of these ways.[ 2 ]

Unfortunately, traditional teaching method in universities transfers a mixture of information and concepts to individuals but leaves them alone in analyzing, prioritizing, and reorganizing emerging knowledge which requires critical thinking and will lead to effective and meaningful learning.[ 3 ] Critical thinking is considered is an essential part of clinical decision-making and professional competence of nursing staff and medical emergencies. Emphasize the need for this skill in these jobs is due to rapid change in the healthcare field and complexities of this current system,[ 4 , 5 ] which face staff working in health–care services with the special situation to render safe, decent, and high–quality services. In general, health–care staff has to use critical thinking in taking important and vital decisions inevitable.[ 6 ]

Education experts agree that critical thinking should be an integral part of any education in every level, because, it is thinking that will lead to make a decision the best possible solution with analyzing, assessing, selecting, and application and this is what is needed in the contemporary world of today.[ 5 ] Interest in the abilities of critical thinking in educational circles is not a new phenomenon, and its origin dates back to Plato's Academy.[ 7 ]

Accordingly, this skill is considered as a priority in training medical specialties.[ 8 ] However, using and expanding it by staff of medical emergencies is a necessity,[ 9 ] which causes delineating comprehensive and purposeful care plan and also increasing the probability of success in the management of victims and the scene.[ 10 , 11 ]

Furthermore, increase the number and scale of natural disasters over the past decade has caused that staff of medical emergencies, working in the field of healthcare and treatment cares in current situation, face with very complicated problems comprehensively as a result of advanced technology, ethical and cultural factors. In this regard, it is necessary that traditional methods should be replaced with decentralized emergency management systems to meet demands and attain considerable success in severe events and catastrophic disasters. Some of these techniques use decision-making skills, creative thinking, and problem-solving skill in today's world.[ 12 , 13 ]

Critical thinking skills in medical education are considered as the ultimate goal of learning and staff and personnel, who think creatively and critically, less commit false judgment and conclusion, rather, they try to concentrate on topics that are relevant to the clinical area and adopt proper decision in this respect, the issue of which can reduce gap between theoretical and clinical education to a great extent.[ 14 ]

However, making a decision is considered the most important and risky part of health–care professions. Therefore, knowing the decision making and applying useful strategies for creating this skill is essential for health–care personnel, particularly, the staff working in medical emergencies.[ 15 ] Triage is just one of complicated decision-making examples which include considering patient and other factors of the treatment system.[ 16 ]

Therefore, knowing decision-making and applying fruitful strategies for the creation of this skill is essential for healthcare workers, especially those working in medical emergencies.[ 17 ] Considering the job sensitivity of medical emergencies’ staff and significance of decision-making power and ability of solving problem in them,[ 18 ] as well as selecting and adopting accurate decision at the time of triage of patients, they (health-care workers) are in dire need of skill more than anything else to adopt proper decision.

On the other hand, moreover all these problems, staff working in medical emergencies will face unique problems which are specific to their job environment such as working with multiple staff and people in treatment team of patients and crisis–hit families, happy and sad moments, life and death, accidents and disaster.[ 19 , 20 , 21 , 22 ]

Therefore, with due observance to the said issues, the effect of training problem-solving skills on decision-making power and critical thinking of staff working in medical emergencies is the main aim of this study.

MATERIALS AND METHODS

This is an experimental study with two pre- and post–test stages, in which, effect of teaching problem-solving skill (independent variable) has been studied on decision-making skill and critical thinking of 95 staff working in medical emergencies (dependent variable). This 95 staff was divided into two groups: Experimental ( n = 47) and control ( n = 48). A sample of this study includes all staff working in medical emergencies as many as 95 persons who showed their interest to participate in this study. Purposive sampling method and size in this study were similar to the total population. In Iran, prehospital emergency medical handled by the graduate of an emergency medical technician and a bachelor and only men is graduates in this field. Moreover, there are a number of general physicians in the central dispatch who provide medical consultation for people who call emergency medical services (EMS) and also give medical advice to the technicians who treat victims at the crash scene or on the way to the hospital.[ 23 ]

Then, all personnel filled out a demographic variables’ questionnaire. In this questionnaire, it was tried to control factors affecting decision-making power and critical thinking (such as age, marital status, working experience, education, number of children, mental illness and consumption of psychotropic drugs and experience of participating in classes (emotional intelligence, stress management, yoga, problem-solving and decision-making within 6 months) in each two groups. In this regard, any significant difference was not observed between research units in both groups ( P > 0.05). decision-making and critical thinking skill of personnel was evaluated before and after the intervention.

Decision-making skill was evaluated in twenty questions using decision-making questionnaire. According to Likert Scale, each question was scored in four levels from 0.25 to 1. The minimum and maximum score in this questionnaire stood at 5 and 20, respectively. In other words, the lowest score in this questionnaire was calculated 5, whereas the highest score stood at 20. Translation and preparation stages of questionnaire were conducted.

In the same direction, face and content validity of the questionnaire was approved by five professors. The reliability of this test was obtained at 0.87 and approved using retest method in a 2-week time interval for 30 persons.

California critical thinking skills’ test is not a test only, rather, it includes various editions for measuring critical thinking skills in children, young adults, students in various academic levels and also various health, law and business professions, etc.

Questions of the questionnaire are divided into two forms. In one classification, three cognitive critical thinking skills including analyzing, evaluating, and inference are measured while in the second category, two cognitive skills of inductive reasoning and deductive reasoning are evaluated. In fact, all forms and various editions of this test are measured the five mentioned cognitive skills.[ 24 ]

The questionnaire used in this study consists of 34 four or five option questions with only one option is correct. The timeframe for completing this questionnaire was set about 45 min. Some questions should be answered with thinking and inferring a series of assumptions while some others should be answered with well–grounded assessment of a conclusion.

This questionnaire is appropriate for evaluating students’ critical thinking and also for assessment of those people who are in dire need of solving problem and making a decision.[ 25 ] Scores of questionnaire assess general skills of critical thinking. The range of test scores is between 0 and 34.[ 26 ]

In a study conducted by Khalili et al . on 405 students in Nursing at Tehran, Iran and Shahid Beheshti Universities of Medical Sciences, Persian translation of this form was studied in terms of validity and reliability. The reliability coefficient obtained in the above study, using KR-20 (62%), had a high correlation with the reliability coefficient obtained in the standardization process of this test conducted in the US (68%-70%).

Furthermore, construct validity, which has been translated as the most important validity type in tests, indicates correlation between the structure of this test and its basic theory.[ 27 ]

To control data transfer between personnel of test and control groups, personnel of the experimental group were requested not to talk with the control group at the time of research with regard to the conducted interventions.

Then, training a course of problem-solving skill was held in eight 2-h sessions during 8 weeks in the presence of personnel of experimental group, using group discussion methods, brainstorming and discussion in small four–member groups with the guidance of a pertinent professor, taking advantage of social problem-solving model as practiced by D–zurilla and gold fried. The stages of this model include:

Stage 1: General orientation

• The ability to identify problem
• Acknowledging the problem as a changeable potentially natural phenomenon
• Believed to be effective in dealing with the problem-solving framework
• High self–efficiency expectations to implement stages of model
• Accustomed to stop, think, and then making effort to solve a problem.

Stage 2: Defining and formulating the problem

• Collection of all information available
• Separation of facts is of the assumptions which require investigation
• Analysis of the problem
• Specifying the actual objectives.

Stage 3: Production of alternative solutions

• To determine wide range of possible solutions
• Ability to choose the most effective response to replies.

Stage 4: Decision-making

• Predict probable consequences of each action
• Paying due attention to the usefulness of these consequences.

Stage 5: Implementation of solution

• Execute the selected method.

Stage 6: Review

• Observing the results of execution
• Evaluation.[ 19 ]

All sessions of the training course were designed in tandem with this pattern, and one stage of this pattern was executed in each session.

In each session, so the presence of all members of the experimental group, the instructor explained the objectives of the meeting and the participants requested that their experiences in dealing with different problems on the job fit the theme of the meeting, express. Then, discuss a case study, and participation in meeting goals, training was provided to them.

To analyze data, descriptive and inferential statistics were used. In this study, data were analyzed using SPSS statistical software version 16.0 (SPSS Inc. Released 2009. PASW Statistics for Windows, Version 16.0. Chicago: SPSS Inc.) In addition, statistical t -test, Chi–square test, and paired t -test were used.

This study was conducted on 95 personnel of medical emergencies. 100% of participants in this study were men, and all were employed in prehospital emergency centers in Isfahan Province. It should be noted that only men are presently admitted to medical emergencies’ course. The age range of participants was between 23 and 51 years, and their mean age stood at 32.15 ± 5.21.

Of total participants, 29 (30.52%) and 66 (69.47%) persons were single and married, respectively. The minimum and maximum job experience of participants in this study stood at 1 and 29 years, respectively. The mean work experience of all participants stood at 33.6 ± 5.42. Of total participants in this study, 10 participants (10.52%) held a diploma degree, 32 participants (33.68%) with associate's degree, 50 participants (52.63%) with Bachelor's degree and three participants (3.15%) with Master's degree. Of total participants, 48 persons (50.52%) graduated in nursing, 25 persons (26.31%) in medical emergencies, nine persons (9.47%) in anesthesiology, five persons (5.26%) in operating room, and eight persons (8.42%) graduated in other fields of study.

In terms of employment status, 20 of participants (2.10%) were official crew members, whereas 54 participants (56.84%) had been employed in contracting basis, 11 of participants (11.57%) employed in contractual basis, whereas 10 participants (10.52%) had been employed as corporate manpower.

It should be noted that 60 participants (63.15%) were employed in urban emergency bases while 35 of them (36.84%) had been employed in road emergency centers.

Before intervention, mean and standard deviation of decision-making scores in experimental and control groups stood at (12.85 ± 2.57) and (11.79 ± 2.12), respectively, while total score of critical thinking in test and control groups stood at (10.42 ± 1.85) and (10.61 ± 2.12), respectively.

Given the above issue, independent t -test did not show a significant statistical difference between these means. Furthermore, Chi–square statistical test showed that there is not any significant difference between two groups of “experimental” and “control” statistically in terms of demographic variables. None of the groups, that is, “experimental” and “control” showed experience of participating in the following classes such as “yoga,” “problem solving,” “emotional intelligence,” and “stress control and management.”

The average decision-making score in whole samples before intervention stood at 11.84 ± 1.38 while critical thinking score stood at 11.03 ± 1.09, the rate of which is not acceptable.

The mean decision-making score before intervention showed no a significant difference between the two groups statistically ( P > 0.05), but the mean between two groups showed the significant difference after intervention ( P < 0.05) [ Table 1 ]. The mean score of critical thinking did not show any significant difference between the two groups before the intervention ( P > 0.05), but this mean showed a significant difference between the two groups after intervention ( P < 0.05) [ Table 2 ].

Comparing mean change of decision-making skill score before and after intervention

Comparing mean change of critical thinking scores’ difference before and after intervention

Tables ​ Tables3 3 and ​ and4 4 indicate that mean decision-making and critical thinking scores before and after intervention in “experimental” group showed a significant difference ( P < 0.05) and has increased, but it did not show any significant difference in “control” group ( P > 0.05).

Comparing mean difference of decision-making skill scores before and after intervention

Comparing mean difference of critical thinking scores before and after intervention

Any significant relationship was not observed between demographic variables with critical thinking and decision-making power ( P > 0.05).

The results of this study show the weakness of decision-making and critical thinking skill in personnel of medical emergencies and an increase of this skill with training problem-solving skill. Unfortunately, a study has not thus far been conducted with regard to the determination of decision-making skill among personnel of medical emergencies.

In a study which was conducted by Gunnarsson and Stomberg in Sweden, he examined factors affecting decision making among EMS personnel in emergency centers. In his study, he reported that various factors affect decision-making power of these personnel which includes as follows: Factors related to patient, factors related to the environment, factors related to colleagues, factors related to patients’ privacy issues, performance of team leader, staff technical know–how and knowledge and moral contradictions, etc.[ 28 ] It should be noted that these issues make decision making very difficult for these people and sometimes, would lead to unsuccessful decisions.[ 26 ]

In a study conducted by Franklin et al ., they examined the way of decision-making among staff of medical emergency and reported that method of staff's decision-making has high relationship with the mental processes, cognitive abilities, degree of sensitiveness of decision, power of cognition (judgment), solving problem, and organizational situation of their workplace. Therefore, quality decision-making training courses should be organized at higher levels by adopting better decisions. Hence, to make better decision, staff must make an educated decision at higher levels, and education in healthcare environment merely should go step further. Generally speaking, high–level training courses should be disseminated in this regard.[ 29 ]

Furthermore, results of study conducted by Dy and Purnell showed that a variety of factors effect on the complexity of decision-making process among personnel in healthcare and treatment system, the most important of which include as follows: ability and talent of individuals, level of culture, ability of patient, level of knowledge and information, method of establishing relationship, ability of solving problem, etc. To adopt the best decision, personnel should strengthen and improve the aforesaid skills among themselves.[ 30 ]

Pitt et al . also reported that promoting critical thinking skills can increase professional competency and qualifications of nurses to a great extent, the issue of which as of paramount importance for personnel working in special emergency wards.[ 31 ]

Thaiposri and Wannapiroon also studied the impact of conceptual methods in promoting critical thinking skill and enumerated problem-solving method as one of methods of strengthening and improving critical thinking skill which is a solid evidence of the said claim.[ 32 ]

Popil also showed that the critical thinking skill can be promoted using challenge methods such as case study.[ 9 ] The results a study conducted by Roberts et al . and Heidari and Ebrahimi emphasizing on decision-making skill, confirm these results.[ 33 , 34 ]

With due observance to the results of this study and given the significance which is considered for empowering associate's degree personnel of medical emergencies in terms of problem-solving skills, it can be concluded that these skills are weak among them. Hence, to attain the best decisions, providers should receive on-the-job training to foster strong problem-solving and decision-making skills that can be utilized in the field and on the front lines of Iranian emergency medicine.

CONCLUSIONS

Finally, despite the significance of decision making and its influence on the way of managing and caring victims, the results of studies conducted in Iran show the insufficient skill of personnel in decision-making and critical thinking process.

Considering the job sensitivity of staff working in medical emergencies and significance of decision-making power and ability of critical thinking in them, it can be said that giant stride can be taken in line with promoting scientific and job level of associate's degree personnel working in medical emergencies.

In general, status of this scientific course can be promoted to a great extent. Considering that this study has been conducted among students in medical emergencies, generalization of results of this study to other students is impossible, so that this study is recommended to be conducted in other academic courses with high number of students.

In other words, results of this study cannot be generalized to other students. For this reason, this study is recommended to be conducted for students of other academic courses.

Financial support and sponsorship

Conflicts of interest.

There are no conflicts of interest.