Thinking critically about critical thinking: ability, disposition or both?


Dr Edward Krupat, Harvard Medical School, 260 Longwood Avenue, 384 MEC, Boston, Massachusetts 02115, USA. Tel: 00 1 617 432 1689; Fax: 00 1 617 432 7850; E-mail:


Medical Education 2011: 45: 625–635

Objectives  The objectives of this study were to determine the extent to which clinician-educators agree on definitions of critical thinking and to determine whether their descriptions of critical thinking in clinical practice are consistent with these definitions.

Methods  Ninety-seven medical educators at five medical schools were surveyed. Respondents were asked to define critical thinking, to describe a clinical scenario in which critical thinking would be important, and to state the actions of a clinician in that situation who was thinking critically and those of another who was not. Qualitative content analysis was conducted to identify patterns and themes.

Results  The definitions mostly described critical thinking as a process or an ability; a minority of respondents described it as a personal disposition. In the scenarios, however, the majority of the actions manifesting an absence of critical thinking resulted from heuristic thinking and a lack of cognitive effort, consistent with a dispositional approach, rather than a lack of ability to analyse or synthesise.

Conclusions  If we are to foster critical thinking among medical students, we must reconcile the way it is defined with the manner in which clinician-educators describe critical thinking – and its absence – in action. Such a reconciliation would include consideration of clinicians’ sensitivity to complexity and their inclination to exert cognitive effort, in addition to their ability to master material and process information.