title: A multi-site study of strategies to teach critical thinking: 'why do you think that?'.
abstract: BACKGROUND
  Critical thinking (CT) is a fundamental skill for clinicians. It plays an essential role in clinical decision making, which has implications for diagnostic accuracy, appropriate management and, ultimately, patient outcomes. Many theoretical frameworks have conceptualised CT and its related constructs. Nevertheless, it is unclear how this topic is taught by faculty staff who teach health professionals.
  
  
  METHODS
  The purpose of this multi-site qualitative study was to characterise the instructional strategies of faculty members actively teaching CT. We used semi-structured interviews to answer the following questions: (i) What approaches do faculty staff recognised by peers as good teachers in CT use to teach CT? (ii) How explicit is this teaching? We used snowball recruitment at eight participating institutions to identify faculty staff considered to be local experts in teaching CT. Forty-four eligible faculty members agreed to participate in semi-structured interviews, which were recorded and transcribed. We used the framework method to analyse the qualitative data.
  
  
  RESULTS
  We organised the findings into themes of what faulty staff teach to learners (habits of mind, such as higher-order thinking and metacognition), how they teach (guiding principles of clinical relevance and perspective shifting, and concrete strategies such as questioning and group interaction) and why they teach CT (to produce the best possible health outcomes for patients).
  
  
  CONCLUSIONS
  This work has practical recommendations for the individual faculty member. Promoting higher-level cognition, asking questions that probe the learner's understanding and linking discussions to the clinical context are some of the approaches that can be incorporated immediately.
authors.affiliation: Carl J. Shapiro Institute for Education and Research, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.|Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.|Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Grace C
authors.initials: GC
authors.lastname: Huang
authors.affiliation: Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Lindell
authors.affiliation: Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, Florida, USA.
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Jaffe
authors.affiliation: Carl J. Shapiro Institute for Education and Research, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.|Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.|Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Sullivan
mesh_terms: D005180:Faculty, Medical; D005181:Faculty, Nursing; D006282:Health Personnel / Q000193:education*; D006801:Humans; D036301:Qualitative Research; D013663:Teaching / Q000379:methods*; D013850:Thinking