Critical Thinking Patterns: Strengths and Weaknesses upon Admission into a Doctorate of Physical Therapy Program
Purpose/Hypothesis: Critical thinking (CT) is a significant component of successful physical therapy practice. The American Physical Therapy Association has called for advances in curricular design to improve CT skills within Doctor of Physical Therapy (DPT) programs. The enhancement of CT has been correlated with improvements in diagnostic skills, increased efficiency and reduction of medical errors. Fortunately, studies have linked specific teaching and learning interventions to changes in CT, though targeting specific CT skills and monitoring change is still a curricular challenge requiring early identification of struggles. While there is evidence of CT progression for single cohorts, there is a paucity of scholarship examining shared strengths and challenges in CT among multiple DPT cohorts. This study examines shared strengths and weaknesses in CT skills for three consecutive cohorts entering into a DPT program at a Midwestern public institution. Number of Subjects: n=158 Materials and Methods: CT was quantitatively examined by the California Critical Thinking Skills Test (CCTST), a validated and reliable assessment tool. All 3 cohorts were administered the CCTST within the first two weeks of beginning DPT coursework. Sample sizes include 40, 59, and 59 for each respective cohort. Eighty-eight percent (158/180) of the overall student body entering into the DPT program during the study time period consented to participation. The CCTST is a 34-item paper test with a proctored 45-minute time limit calculating an overall CT score, percentile rank against graduate-level health science students, and domain sub-scores of Analysis, Inference, Evaluation, Induction, and Deduction. Domain sub-scores are interpreted as: Not Manifested, Moderate, or Strong, and were ranked 1, 2, or 3 respectively. Friedman’s test was used to determine presence of significant differences among the five domains. To determine differences between domains, pairwise comparisons were performed. Statistical significance was accepted at p<0.05. Results: Descriptive statistics expressed as mean±SD: Analysis (2.56±0.52), Induction (2.51±0.51), Inference (2.42±0.51), Deduction (2.23±0.48), and Evaluation (2.11±0.52). Friedman result with mixed procedure noted significance in the domain pairs of Analysis/Deduction (0.33±0.06, p<0.0001), Analysis/Evaluation (0.45±0.06, p<0.0001), Deduction/Induction (-0.28±0.06, p<0.0001), Deduction/Inference (-0.19±0.06, p=0.009), Evaluation/Induction (-0.34±0.06, p<0.0001), and Evaluation/Inference (-0.31±0.06, p<0.0001). Conclusions: Three consecutive cohorts at a single institution demonstrated shared strengths in the CT domains of Analysis and Induction, and shared challenges in the CT domains of Evaluation and Deduction. While students demonstrated average scores in the moderate to strong range for each of the five sub-domains, discernible differences in domain performance are present. Clinical Relevance: This investigation suggests that physical therapy educators wishing to address deficits in critical thinking skills should focus teaching and learning techniques on the domains of Evaluation and Deduction during early entry level training.