Education Leadership Conference

Critical-thinking researcher Eileen Gambrill, PhD, advocated using realistic hypotheticals to teach clinical decision-making at the 2004 Education Leadership Conference. Specifically, students can profit from group-based work on the process of making a decision, rather than the decision itself, she said.

One benefit of this strategy is that students have the opportunity to practice dealing with the factors that often complicate decisions, such as limited information and time pressure, noted Gambrill, the Hutto Patterson Professor of Social Welfare at the University of California, Berkeley. And in those groups, uncertainty over the path to take should be acceptable, she added.

"One of the uphill battles in this is being able to say 'I don't know,'" Gambrill said.

In particular, Gambrill suggested that clinical decision-making classes:

  • Focus on specific examples. Hypothetical scenarios allow future clinicians to practice thinking through complex problems. Additionally, working through specific cases keeps students focused on the kinds of problems they may encounter in their future practice, she said.

  • Break students into small groups. Students working together can profit from the knowledge of their classmates and learn to consider and contend with alternative viewpoints.

  • Use tutors. Leaders, perhaps older graduate students, can be on hand to keep groups focused and answer questions.

  • Avoid lecturing. At the crux of clinical decisions is the ability to apply knowledge--and this skill is best learned and practiced, not simply talked about, Gambrill concluded.