Issue link: https://www.massageandbodyworkdigital.com/i/1358392
we can derive that critical thinking involves increasing self-awareness with the intention of getting better at what we do. Here is another defi nition from the Foundation for Critical Thinking: "Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, refl ection, reasoning, or communication, as a guide to belief and action." 1 To paraphrase this somewhat ponderous statement, I'd say critical thinking is the conscientious processing of reliable information, which may come from many sources, to inform choices. Another defi nition I like is: "Critical thinking is not a matter of accumulating information. A person with a good memory and who knows a lot of facts is not necessarily good at critical thinking. A critical thinker is able to deduce consequences from what they know, and they know how to make use of information to solve problems, and to seek relevant sources of information to inform themselves." 2 Other experts' defi nitions of critical thinking follow similar themes, with varying points of emphasis on the quality of thinking, the importance of creative problem-solving, and the value of independence and autonomy. Underpinning all critical thinking and critical refl ection is curiosity. —Pam Fitch From all these defi nitions, I propose that critical thinking for massage therapists requires three primary skills. We need to be able to: • Evaluate information for relevance, trustworthiness, and completeness. • Independently use that information to make plans and take action. • Evaluate the effectiveness of that action to make adjustments for next time. These skills are complex and challenging. When massage therapists perform them successfully, we are able to make compassionate clinical decisions that lead to safe, effective, and evidence-informed care (sound familiar?). These skills apply in any practice setting, from an outpatient chemotherapy unit to a cruise ship spa. In this model, evidence- informed practice is a key element of critical thinking. EVIDENCEINFORMED PRACTICE Evidence-informed practice is a term with a specifi c meaning. It means making clinical decisions by balancing three different sources of infl uence: client values, practitioner expertise, and research. • Client values must provide our framework of priorities as we consider options in the clinical application of our work. What does this person need? What do they want? What do they want to avoid? What are their values and hopes for this interaction? • Practitioner expertise is what you bring into the session room with your education, your experiences, your observations of this client and others, and whatever other fi lters you carry with you. What have you learned in your previous work? How able are you to identify all the variables that must go into your decision-making process? Do you have the expertise this client needs, or is it necessary to obtain a new set of skills or refer them to another provider? • Research can refer to what researchers have studied about any specifi c massage therapy question. It can also include what you've read in trustworthy textbooks or articles, what you learn from trusted peers and authorities, and what comes to you through other means of communication. Of course, it is your job to determine whether these sources of information are reliable and applicable. When we blend these three elements together—client values, practitioner expertise, and research—we can be confi dent we are bringing our best to the table. This is the essence of best practices, and it is inextricably a part of critical thinking. CRITICALTHINKING STEPS I have compiled a list of possible steps to take toward critical thinking in clinical decision-making. They are the product of much reading, trial and error (oh look—that's critical thinking!), and consultation with other people in the fi eld. Critical thinking is the ability to think about the client presentation in a way that breaks it down into manageable parts, and to do that across different settings and with different client populations. —Tracy Walton I offer these steps with the hope they might be helpful—not so much in terms of making the "right" clinical L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 57 The three elements of evidence-informed practice (EIP).