Critical thinking stations

There is no right or wrong answer when you are answering a critical thinking question. Many of these questions contain an ethical component, and the idea is to minimize the negative outcome for anyone involved in the ethical dilemma presented to you. Be consistent in your response even if the interviewer tries to sway your opinion by adding new information partway through your answer. On the other hand, if the new information has a great impact one way or the other, clearly state your justification for changing your opinion. For health-related admission interviews, answers should always be patient-focused. Health care is about objectivity, best health care, and best outcomes from a medical standpoint, not what a person can contribute to society.

Identify the issues in the question, make sure you understand exactly what is being asked, and address the issue(s) raised. Endeavour to provide unbiased and neutral solutions. Rather than start with the outcome you best subscribe to, lead the interviewer to the conclusion with your evidence-based reasoning. Wherever possible, try to back up your claims with proof (e.g., items in the news, journal articles, and other research from valid and verifiable sources).

Choose three to four of these perspectives and evaluate the situation. Avoid having your argument seem one sided. Ensure that you are evaluating both pros and cons for the different PESTLE perspectives. In addition, know regulations and your own ethical considerations — what is the scope of your authority and extent of your obligation?

If you are unprepared to answer the question, ask the interviewer to clarify the question and/or to provide some probing or leading questions. If that is not possible, attempt to address the part(s) of the question for which you have some knowledge. Responses to ethical questions can be fairly long. Towards the end of your response, use phrases such as “in conclusion” or “in summary” or “as a final recommendation” or “given the above, I believe” to indicate that you are concluding your response.

For example, “In some countries there is presumed consent for organ donation (it is assumed that you wish to donate your viable organs unless you opt out). Canada has the opposite system where you must sign up to be an organ donor. Do you think we should have presumed consent in Canada? Discuss this issue with the interviewer.”

Critical thinking format

When possible, show empathy and compassion when working through the PESTLE model (or another model of choice):

1. Summarize the question in your own words
2. Identify missing information (state what you don’t know or that you need to gather more information), assumptions that you need to make, and/or key issues
3. State your framework to list the options you will consider: (e.g., “I will look at this situation from an economic, social and ethical perspective”). It is also possible to look at it from each person’s perspective (e.g., student, faculty, society).
   
   

   With the PESTLE model: Focus on three to four perspectives and have pros/cons for each.

   In most cases pros/cons should be patient-centered, student-centered, client-centered, etc. Also show who else will be affected by the situation, don’t just focus on the people listed in the situation (if the situation is about a child think about how it will affect their parent(s), siblings, teachers, school, educational system, etc.).

   P: Political pros/cons: government interventions/taxes/policies can influence health & education

   E: Economic pros/cons: save/spend time and money

   S: Social pros/cons: cultural aspects, health consciousness, population growth, age distribution, career attributes

   T: Technological pros/cons: R&D activity, automation, changes and innovation

   L: Legal pros/cons: legal implications

   E: Ethical pros/cons: ethical dilemmas OR Environmental pros/cons: weather, climate change, tourism, farming

4. Synthesize and incorporate information from another source (personal perspective, something you read online or learned in a course)
5. Initiative (action you might take e.g., education, prevention, contact others to gather more information, look beyond the people involved in this situation)
6. Summarize: provide an assessment on how one side outweighs the other and your view of a feasible option
7. Make sure the question is answered

Other models for critical thinking and ethical decision making:

Other models to address ethical questions are ABCDE of Medical Ethics (Levine, 1994) and CARVE (Gampel):

ABCDE

• Autonomy
• Beneficence (what can be done for the patient)
• Confidentiality
• Do no harm
• Equality (justice)

CARVE

• Consequences
• Autonomy
• Rights
• Values
• Equality