CRITICAL THINKING AND PROBLEM SOLVING SKILLS Nancy Lemelin

CRITICAL THINKING AND PROBLEM SOLVING SKILLS Nancy Lemelin MLT Educator, Cegep de l’Outaouais, Gatineau QC Simulation and Clinical Placement National Discussion - Teleconference Series April 24, 2017

Objectives for Today’s Presentation � Brief introduction about this presentation – a teacher’s perspective � Some background information about our school program and what brought on the search for better ways to prepare students for the clinical workplace � Information about critical thinking: what exactly is it and how can we teach it to our students � Future projects for critical thinking and simulation at the Cegep.

Today’s Medical Laboratory Work in the medical laboratory has undergone a significant change – especially when it comes to technology: high tech equipment, LIS… Putting a « Do not use» Post-it on the broken down equipment doesn’t cut it anymore. MLT’s can sometimes be considered modern day mechanics with very complex instruments. Troubleshooting and problem solving is no longer left up to the laboratory managers. The workplace needs employees who can analyze a situation and make informed decisions - they need problem-solvers. Lets not forget that MLTs are part of a healthcare team – exceptional communication and interpersonal skills are needed more than ever, especially with the current workplace situation for MLTs. We can teach all of these concepts on paper, but does the student really know how to apply this knowledge when you factor in the work environment and the stress ?

A Little Background Information…. o The MLT program at the Cegep is fairly new (only 5 years old) o We are a 3 year program o Our final semester is 19 weeks of clinical placement - 4 weeks in microbiology, immunohematology, biochemistry - 3 weeks in pathology o There are 2 groups of students who have graduated so far (approx. 14 -16 students in each group) o This year’s group started in January and will be done at the end of May. o Considering our short clinical rotations, we have been searching for better ways to prepare students for their placements before they leave their school environment.

Program evaluation Ongoing program evaluations have provided us with valuable information for curriculum improvement. Surveys were sent to preceptors/employers and students who have graduated from the program. Employer’s survey: So far so good, but students and new employees need to improve stress management and critical thinking skills: communication, prioritizing, technical troubleshooting… Student comments: When everything goes well in the lab, the workflow is easy. Unfortunately, this doesn’t happen very often. It would be nice to have more ”troubleshooting” scenarios at school to help us learn how to deal with day to day problems in the workplace.

Teaching for a Medical Laboratory Science Program I’m a Medical Laboratory Technologist by profession. When I started teaching for the MLT program at the Cegep, I thought to myself “ This my field of expertise – how hard can it be ? ” I quickly learned there is a difference between knowing and teaching. As an educator, I have been exploring different ways to teach the competencies necessary for MLTs, but what about the other criteria in the Medical Laboratory Technologist profile: - Autonomy Communication skills Stress management Problem solving Organizational skills… “Critical thinking”

What is Critical Thinking ? When I first started in my quest to define CT, I was overwhelmed with the vast amount of literature that exists on the subject. Out of all the definitions I’ve read, this is my own compilation that I feel is the most inclusive, yet easy to understand: “Critical thinking is a deliberate thought process. It is an objective analysis of facts to form a judgment, solve a problem or a make an informed decision. ” Being the analytical person that I am, I created a list of skills related to critical thinking that I feel relate to the medical laboratory: - Logical reasoning Problem solving Objective judgment Decision making

Characteristics of a Critical Thinker - Precise Specific Analytical Logical Thorough Consistent Accurate Reflective To become a “critical thinker”, a persons actions need to become habits: we must work with confidence, be organized and modify/adapt ones actions to accommodate various situation. When I thought about all these conditions, I realized I was teaching good techniques and a large amount of theory and book knowledge, but was I bringing my students to this type of complex learning level ?

Trying to find the missing link Defining CT gave me a better understanding of what type of teaching methods were needed in our school curriculum. The classroom needed to be a student centered learning environment. One important fact that I realized while teaching my students: As medical laboratory professionals, when there is a problem, we are used to “working it out" – we have a process that becomes natural to us when problem solving. Personally, I sometimes forget that my students need to learn this thinking process so they can become better and more comfortable with situations that demand critical thinking. I also realized that I was teaching mostly school skills and not enough work skills.

What’s the difference between school skills and work skills ? School Skills Work Skills - - Completing worksheets Collecting information to write reports Studying for tests Preparing protocols and lab reports Problem solving Logical thinking Independent thinking Organizational skills Students need school skills to gain the knowledge necessary for competencies, but how can we also teach them to use this knowledge and apply it to work skills ? By using immersive and experiential learning techniques

What are the methods that we can use to teach CT ? � Problem-based learning � Case-based learning � Team-based learning and… �Simulation All of these methods are used in a student centered learning approach. They help teach the student to recognize a problem and then use a systematic process to find a solution or make an objective decision. If we think about Bloom’s learning pyramid – we tend to learn and comprehend 90% of what we both say and do – students need to be the center of attention. Simulation is a great tool for this type of learning.

A few words about learning and memory To make learning last, the information that we give our students must have meaning. Creating a meaningful context for new learning is a critical factor in developing long-term adhesion of new information to a student’s memory. If students aren’t asked to apply their learning to actual situations, they do not develop the skills needed in the workplace. Simulation allows us to create authentic situations that provides the student with workplace context. It provides the student with a safe environment where he can develop is CT skills.

Simulation Advantages - High-risk activities within a safe environment Allows students to learn from errors Learners have a greater understanding about the consequences of their actions Students are actively participating in their learning Simulation is knowledge (CT) in action: problem solving, decision making… SIM gives learners feedback Disadvantages - SIM can be expensive Not everything can be simulated SIM can’t always recreate real-life situations SIM requires a great amount of preparation

Where is CT needed ? After evaluating the curriculum and compiling survey information, there were 3 main aspects that seemed to stand out in our program when it came to CT : 1. People issues (co-workers, nurses, physicians. . . ) 2. Pre analytical/specimen troubleshooting (specimen rejection, interference factors…) 3. Technology/analysis (equipment malfunction, QC, result interpretation…) In all three of these categories, students need to learn how to: - Identify the problem - Collect and interpret the appropriate data/information - Find solutions to solve problems/make decisions Every time we have to make a decision, the process we go through involves CT. With practice, this process can become automatic.

Projects to increase CT skills in our curriculum at the Cegep Communication and interpersonal skills - laboratory ethics - Short term project Create a series of short videos with various ethical and communication issues Online questionnaires and Discussion groups Online platform (Moodle) – students will have access throughout the 3 year program - Information will also be used in the classroom (PBL and case studies) - The goal is to give students the necessary tools to deal with professional and ethical issues in the workplace.

Projects to increase CT skills in our curriculum at the Cegep “Troubleshooting” in the lab - Mainly during the third year of the program – before clinical placements. - Some of the practical labs will be used for simulation. - Scenarios will be created to give students the opportunity to practice in a simulated workplace environment. There will be situations integrated into the scenario that demands critical thinking skills such as: � � specimen troubleshooting equipment malfunction QC troubleshooting communication/interpersonal skills

Projects to increase CT skills in our curriculum at the Cegep Interdisciplinary SIM - Larger project with other programs – Nursing, Paramedics, Respiratory. Mainly with Nursing Possibility of medical clinic Project still in development.

References � Theses and Dissertations: Short, D. M. J “Enhancing Critical Thinking in Clinical Laboratory Students: A multimodal Model, Virginia Commonwealth University � Web site: Critical Thinking; Paul, R. and Elder, L. , The Miniature Guide to Critical Thinking: Concepts and Tools – Foundation for Critical Thinking. � Simulation training web site; simulatedtraining. wordpress. com � Mc. Cain, T. , Teaching for Tomorrow: Teaching Content and Problem Solving Skills, Corwin press, 96 pages.