critical thinking skills are necessary for the competent medical imaging professional

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• Published: 24 May 2023

Embracing critical thinking to enhance our practice

• Luis Martí-Bonmatí   ORCID: orcid.org/0000-0002-8234-010X 1  

Insights into Imaging volume  14 , Article number:  97 ( 2023 ) Cite this article

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Miguel de Cervantes, the great Spanish writer, once wrote that those “who read much and walk much, go far and know much" [ 1 ]. The same is true in medicine; reading and gathering experience are the main pillars on which one should develop the knowledge of solving clinical problems in the ever-changing field of healthcare. If properly done, these newly acquired skills will continuously enhance our critical thinking strategies with which we try to identify the best possible improvements in the clinical pathway of radiology. As gaps in knowledge are always present, medicine is rooted in consolidated knowledge based on validated scientific studies and clinical experience reproducibility and accuracy [ 2 ]. This represents our best approach to evidence-based decisions. Medical knowledge must be well-established before it can be considered as the basis for decision making and patients guidance in daily practice.

The practice of critical thinking helps us understand the disease manifestations and the related processes and actions that might be relevant to prevent, diagnose and treat diseases. To critically appraise the way we perform evidence-based practice, we must combine best quality research with clinical expertise. This link between exploration and practice will allow radiologists and related disciplines to impact the way medicine is practiced.

These concepts are the cornerstones of Insights into Imaging , and it is my privilege as editor-in-chief to describe in this editorial how the journal, and each author, can contribute quality through critical thinking, and hence improve the way we practice radiology by re-shaping our understandings.

It is universally recognized that, in medical imaging, strong levels of evidence are needed to assess the results of the different possible actions and to guide decisions (i.e., to demonstrate a sufficient causal relationship between a specific diagnostic criterion and a disease grading, or a given radiological intervention versus another option in a given condition) toward the most effective or safe outcome considering the benefit of patients and value-based healthcare pathways. Consequently, solid levels of evidence are required to assess the results of different possible actions derived from imaging findings. And, in doing so, we continuously generate more data in our diagnostic and therapeutic activities, whether they are processes or outcomes. This new information will then be transformed into new evidence, real world evidence. In this way, the observed relationship between action and outcome generates causality course actions that will improve our understanding of the best clinical pathways, eliminating the many confounding thoughts that we unconsciously carry during the process of learning and implementing our clinical practice.

Socratic inquiry and Skepticism as foundation. Critical thinking can be understood as the process of analyzing and questioning existing and established knowledge with the intention of improving it. Previous knowledge, either eminence- or evidence-based, should continuously be critically reconsidered and reevaluated for the benefit of the patients, as knowledge is always changing in Precision Medicine. In the real world of medical imaging, this critical thinking must be focused on the evaluation of the effectiveness and clinical impact of all those processes in which images are involved, from the acquisition with different modalities to the processing of the data, from the biological correlation of radiomics as an image biomarker to the therapeutic orientation, and finally in image-guided interventional treatments. Developing critical thinking helps to improve any medical discipline by asking ourselves how to establish better and more precise processes based on existing accumulated evidence, how to recognize and control the biases when approaching a clinical problem, and how to adapt the new clinical information in service of the best solutions. Socratic inquiry and a skeptic attitude can be used to consolidate the best knowledge and construct new associations to be more efficient and to approach excellence in our daily work. Critical thinking is therefore necessary to improve both clinical practice and research in radiology, avoiding disruptive uncertainties and wrong assumptions.

These “questioning and solving” skills require learning, practice, and experience [ 3 ], but mainly a recognition of the many uncertainties we do have despite the important scientific advances. Precisely, a good example of the importance of critical thinking is its contribution to Precision Medicine through medical imaging data and information. In daily practice, we should ask ourselves why should we accept a reliable diagnostic method that fails 15% of the time, or an appropriate treatment that is not effective in almost 25% of patients? As scientists, we can improve these clinical decisions in the daily practice. Artificial intelligence (AI) solutions integrating different imaging, clinical, molecular, and genetic data as inputs are being implemented as a suitable pathway to solve clinical problems. The design and methodology of these AI algorithms must allow for their explainability and critical thinking evaluation before they are implemented in clinical practice [ 4 ].

In summary, critical thinking develops evidence-based knowledge, provides continuous improvements, and avoids spurious technical and clinical misconceptions. Insights into Imaging is dedicated to manuscripts with a clear critical approach, focusing on excellence in clinical practice, evidence-based knowledge and causal reasoning in radiology. Science is based on long-lived critiques and authors are encouraged to systematically identify, analyze, and solve problems by identifying inconsistencies and correcting errors.

To foster this, Insights into Imaging welcomes critical thinking papers and will incorporate a new “Critical Relevance Statement” in all their publications, where authors are asked to summarize in one sentence the question they are trying to answer and the improvement they are providing to the issue at hand.

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De Cervantes M (1986) The adventures of don Quixote de la Mancha. New York, Farrar, Straus, Giroux

Martí-Bonmatí L (2021) Evidence levels in radiology: the insights into imaging approach. Insights Imaging 12(1):45. https://doi.org/10.1186/s13244-021-00995-7

Article   PubMed   PubMed Central   Google Scholar  

Ho YR, Chen BY, Li CM (2023) Thinking more wisely: using the Socratic method to develop critical thinking skills amongst healthcare students. BMC Med Educ 23(1):173. https://doi.org/10.1186/s12909-023-04134-2

Cerdá-Alberich L, Solana J, Mallol P et al (2023) MAIC-10 brief quality checklist for publications using artificial intelligence and medical images. Insights Imaging 14(1):11. https://doi.org/10.1186/s13244-022-01355-9

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Martí-Bonmatí, L. Embracing critical thinking to enhance our practice. Insights Imaging 14 , 97 (2023). https://doi.org/10.1186/s13244-023-01435-4

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• Critical thinking
• Precision medicine
• Reproducibility
• Causal inference

Goals, SLO, and Technical Standards

Goals and student learning outcomes, goal 1: students will demonstrate clinical competency..

• SLO 1.1: Apply knowledge of anatomy, positioning, and radiographic techniques to accurately image anatomical structures.
• SLO 1.2: Evaluate images for diagnostic information.
• SLO 1.3: Apply knowledge of radiation protections to minimize patient dose.

Goal 2: Students will develop and apply effective critical thinking skills.

• SLO 2.1: Determine proper exposure factors to achieve optimum images of anatomical structures.
• SLO 2.2: Work in an ethical, legal, safe, and effective manner in diagnostic imaging.
• SLO 2.3: Develop lifelong learning habits that reflect professional development.

Goal 3: Student will demonstrate effective verbal and written communication skills. 

• SLO 3.1: Provide patient care essentials to radiologic sciences.
• SLO 3.2: Communicate effectively to serve the needs of the community and other health care providers.

Technical Standards

The abilities and skills which students must possess in order to complete the training associated with the Northern Virginia Community College (NOVA) Health Sciences and Nursing Programs are referred to as Technical Standards. These Technical Standards are a group of minimal physical and cognitive abilities as well as sufficient mental and emotional stability to confirm that students are able to complete the entire course of study, participate fully in all aspects of training, and be deployable as competent Health Sciences and Nursing students, with or without reasonable accommodation.

The NOVA Health Sciences & Nursing programs have the ethical responsibility for the safety of patients with whom students will come in contact, and to the public to assure that its students can become fully competent Health Sciences & Nursing professionals. Thus, it is important that persons admitted to our programs possess the intelligence, integrity, compassion, humanitarian concern, and physical and emotional capacity necessary to practice Health Sciences & Nursing skills. Students must verify that they meet these Technical Standards at the time of matriculation to our programs and maintain them during their training. Students are obligated to alert the Program Director of their Health Sciences & Nursing program of any change in their ability to fulfill the technical standards. Students who do not meet the Technical Standards are at risk for dismissal from the program.

The Radiography Program at Northern Virginia Community College adopts its Standards from the Standards approved by the American Society of Radiologic Technologists. These Technical Standards are reviewed annually by the NOVA Radiography Program Advisory Board.

Technical Standard 1: Observation

Students must be able to observe demonstrations and participate in physical examination sessions, clinical skills workshops, and observe the difference between normal versus pathological states.

Technical Standard 2: Hearing

• Students must have a normal or corrected ability sufficient to interpret verbal communication from patients and the health care team members, and to monitor and assess patient health needs.
• Students must have the ability to hear and respond to monitored alarms, emergency signals, and cries for help.
• Students must have the ability to hear telephone interactions.
• Students must have the ability to hear audible stethoscope signals during blood pressure screenings.
• Students must have the ability to hear patients speaking from a 20-foot distance.

Technical Standard 3: Visual

• Students must have normal or corrected visual acuity sufficient for observation and patient assessment, equipment operations, and departmental protocols.
• Students must have the visual acuity to read, write, and assess the patient and the environment.
• Students must have the ability to read emergency monitor data.
• Students must be able to observe patient conditions and needs from a distance of 20 feet.
• Students must be able to identify and distinguish between colors.
• Students must be able to read radiation exposure readings on x-ray equipment.
• Students must be able to view radiographic images and medical reports.
• Students must be able to read departmental protocols for imaging procedures, radiographic examinations, and physician orders.
• Students must be able to correctly direct the central ray to the anatomical part being imaged and align the image receptor.

Technical Standard 4: Communication

• Students must be able to communicate effectively and sensitively with patients, their families, and members of the health team. Students must be able to communicate effectively with patients from different social and cultural backgrounds, as well as develop an effective professional rapport with patients and co-workers.
• Students must be able to record examination and diagnostic results clearly, accurately, and efficiently.
• Students must be able to communicate effectively in English with patients, family, and other healthcare professionals in a variety of patient settings.
• Students must have adequate verbal, non-verbal, and written communication skills to exchange ideas, detailed information, and instructions accurately.
• Students must have the ability to read, comprehend, and write legibly in the English language.
• Students must have sufficient hearing to assess a patient's needs, follow instructions, communicate with other healthcare workers, and perceive, interpret, and respond to various equipment signals.

Technical Standard 5: Motor Function

• Students must possess the capacity to perform physical examinations and diagnostic maneuvers. They must be able to respond to emergency situations promptly and provide general and emergency care. They must possess adequate sensory function and motor coordination to fulfill minimum competency objectives for inspection, palpation, percussion, and auscultation necessary to perform a physical examination. They must possess sufficient postural control, neuromuscular control, and eye-to-hand coordination in order to utilize standard medical / surgical instruments to participate in the inpatient and outpatient setting and other clinical activities.
• Students must be able to raise objects from a low to high position.
• Students must be able to push, pull, or transfer heavy objects weighing between 25 and 50 lbs.
• Students must be able to walk rapidly for a prolonged period of time while carrying up to 25 lbs.
• Students must have the physical stamina to stand and walk for 8 hours or more in a clinical setting.
• Students must have the ability to stand on both legs, move from room to room, and maneuver in small spaces.
• Students must be able to work with arms fully extended overhead.
• Students must be able to bend downward and forward by bending at the spine or waist.
• Students must have the manual dexterity, mobility, and strength to perform CPR.
• Students must be able to seize, hold, grasp, and turn with their hands.
• Students must be able to complete finite tasks with their

Technical Standard 6: Intellectual-Conceptual, Integrative, and Quantitative Abilities

• Students must be able to learn through a variety of modalities including, but not limited to, classroom instruction, small group, collaborative team activities, individual study, preparation and presentation of reports, and use computer technology. Students must have the mental capacity to assimilate and learn a large amount of complex, technical, and detailed information in order to formulate diagnostic and therapeutic plans.
• Students must have the ability to deal with abstract and concrete variable issues, define problems, collect data, establish facts, and draw valid conclusions.
• Students must have the ability to interpret instructions furnished in oral, written, or schedule form.

Technical Standard 7: Behavioral and Social Attributes

• Students must have the emotional stability to function effectively under stress and to adapt to an environment that may change rapidly, without warning, and/or in unpredictable ways.
• Students must accept responsibility for learning, exercising good judgment, and promptly completing all responsibilities attendant to the diagnosis and care of patients.
• Students must be able to work effectively, respectfully, and professionally as part of the healthcare team, and to interact with patients, their families, and healthcare personnel in a courteous, professional, and respectful manner.
• Students must be able to contribute to collaborative, constructive learning environments; accept constructive feedback from others, and take personal responsibility for making appropriate positive changes.
• Students must be able to interact purposefully and effectively with individuals and or groups from a range of social, cultural, emotional, and intellectual backgrounds. Students must be able to function safely and effectively during high-stress environments.
• Students must be able to maintain a work pace appropriate to a given workload.

Technical Standard 8: Ethical and Legal Standards

Students must be able to understand the basis and content of both general and medical ethics. The student must possess attributes that include compassion, empathy, altruism, integrity, responsibility, and tolerance. Students must be able to recognize limitations in their knowledge, skills, and abilities and to seek appropriate assistance with their identified limitations. Students whose performance is impaired by abuse of alcohol or other substances are not suitable candidates for admission, promotion, or graduation. In addition, should the student be convicted of any felony offense while in the Allied Health & Nursing Programs, they agree to immediately notify the program as to the nature of the conviction. Failure to disclose prior or new offenses can lead to disciplinary action that may include dismissal.

Technical Standard 9: Critical Thinking

• Students must have critical thinking ability sufficient for clinical judgment; synthesize information from written material and apply knowledge to clinical situations.
• Students must be able to respond to emergencies promptly and provide general and emergency care.
• Students must be able to make rapid decisions under pressure.
• Students must be able to handle multiple priorities in stressful situations.
• Students must be able to identify cause-effect relationships in clinical situations.
• Students must be able to develop an order of multiple imaging exams.

Technical Standard 10: Environmental

• Students must have the ability to tolerate environmental
• Students must be able to tolerate risk or discomfort in clinical settings that require special safety precautions, additional safety education, and health risk monitoring, working with sharps, chemicals, and infectious diseases.
• Students may be required to wear protective clothing or gear such as masks, goggles, gloves, and lead aprons.
• Students must be able to work with chemicals and detergents.
• Students must be able to tolerate exposure to fumes and odors.
• Students must be able to work in areas that may be close and crowded.

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Critical Thinking Skills

CHAPTER 3 Critical Thinking Skills LaVerne Tolley Gurley Outline Need for Critical Thinking What Is Critical Thinking? Qualities of a Critical Thinker Factors that Hinder Critical Thinking Background Beliefs Faulty Reasoning Group Loyalty Frozen Mind-Set Emotional Baggage Becoming a Critical Thinker Humility Respect for Others Self-Awareness Honing Your Skills Conclusion Objectives On completion of this chapter, you should be able to: •  Identify the qualities of a critical thinker. •  Identify the assumptions, ethics, and values in written works. •  Discern fallacies in arguments. •  Control psychologic impediments to sound reasoning. •  Recognize the effects of authors’ background beliefs on reasoning. •  Present valid facts, evidence, and statistics. •  Evaluate advertising claims, statistics, and rhetoric. Key terms critical thinking emancipation emancipatory learning herd instinct All health care providers must be able to make logical decisions and wise choices; it goes without saying. The care of the patient demands that good judgment is exercised in the selection of technical factors for quality imaging and in other patient care tasks. You will be responsible for giving the physician a radiograph that is diagnostically sound and for providing safe care to the patient while performing the examination. Need for critical thinking As a professional, you will be making vital decisions regarding your own career. You will need to make choices regarding the route you follow in the profession to meet your own personal needs and goals. What Is Critical Thinking? Many definitions have been given for critical thinking . One definition calls it emancipatory learning. Emancipation means freedom from restraint or influence. Things that restrain or influence people can be personal, institutional, or environmental. Personal beliefs, rules and regulations of institutions, and physical environments can all work to prevent people from seeing new directions and gaining understanding and control of their own lives and of the world around them. Emancipatory learning means that learners become aware of the forces that have created the circumstances of their lives and take action to change them. Another definition for critical thinking focuses on the use of morality and virtues, making wise judgments about aspects of our lives, and recognizing the impact these judgments will have on others. Some stress the importance of recognizing reality in the context of cultural elements and the process of trying to create order in a changing world. Creating order in a changing world will be a challenge for us all. Never in our history have changes occurred with such rapidity. Global information and communication exchange, worldwide exchange of goods and services, and, most importantly, an exchange of ideas affect our world. Geographic boundaries are becoming blurred, as are the cultures and traditions of separate groups. Learning how to live and work in this changing world makes critical thinking more important than ever. Although the wording of the definitions of critical thinking may differ, they are all made on the assumption that a set of values exists. Each definition assumes that these values are universal; for example, life is better than death, wellness is better than illness, happiness is better than sadness, pleasure is better than pain, and hope is better than despair. Therefore, when we speak of making wise judgments, we have to agree on a set of values. These values are not unique to a specific culture or religion nor are they characteristic of a specific nation or state. They are universal except in rare aberrations of individuals, cult groups, and other deviants. The assumption that you have accepted these values is a fair conclusion because you have chosen to be a health care provider. We may disagree on the specifics of behaviors that will best accomplish the preservation of these values, but if we disagree on the values, then further discussion is no longer needed. When we speak of making wise decisions, we are judging decisions made within the framework of a value system that is universally understood. It is equated with logical reasoning abilities and reflective judgment. Qualities of a Critical Thinker Critical thinkers are valued for their ability to look at a situation from a variety of perspectives. They are able to discern the best possible way to react to a situation, making them ideally suited for work in the health care profession. Box 3-1 summarizes the characteristics that a critical thinker needs to possess. BOX 3-1     Characteristics of a Critical Thinker Human Analytical Rational Open-minded Systematic Inquisitive One of the first traits that one observes in critical thinkers is the presence of heart as well as mind. The definitions regarding critical thinking are reflective of human values and can thus be expected of critical thinkers. Such a thinker will be able to balance compassion with realism. The critical thinker must also be analytical, which means finding evidence in unclear and confusing situations. Being alert to the consequences of accepting a course of action and being able to defend that position are both important. Rushing into a plan without examining the ramifications of hastened actions can be dangerous. Rational thinkers recognize reality; they can discern what is factual and true from what is opinion or misinformation. Seeking truth and making every effort to be honest with yourself is an important characteristic. To accomplish this, we must recognize the difference between what is true and what we wish were true. Making this distinction is more difficult than it may appear on the surface. Recognizing the laws of physics or mathematics as factual is simple enough; however, when the discussions involve government, religion, evolution, or other similar topics, facts become blurred and clouded with emotion. The truth is often elusive, and the evidence is less convincing. Nonetheless, critical thinkers will seek to make rational judgments and act responsibly.

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Bachelor of Science in Radiologic Science

General Overview

For specific information regarding the curriculum concentrations, visit: Diagnostic & Interventional Radiology (DIR) or Diagnostic Medical Sonography (DMS) .

Radiologic Science is the health profession concerned with disease diagnosis, injury assessment, and interventional procedures. Medical imaging studies have been a cornerstone in medical diagnosis for decades; however, technological advances and the addition of new imaging modalities now place medical imaging among the most dynamic, expanding and high demand fields in clinical medicine.

Clinical practice includes: general radiography such as orthopedics, pediatrics and mammography, vascular imaging, cardiac catheterization studies, computerized tomography, magnetic resonance imaging, and sonography. Medical imaging professionals are employed in medical centers, community and private hospitals, clinics, and physicians’ offices.

Upon completion of the program, graduates receive the Bachelor of Science degree and may be eligible to take the national certification examination administered by the American Registry of Radiologic Technologists (ARRT) or the American Registry of Diagnostic Medical Songraphers (ARDMS).

The radiologic science program prepares students to practice competently, safely, and effectively as medical imaging professionals in diverse health care environments with awareness of global health issues. The academic and clinical foundation in the curriculum develops graduates with professional flexibility and adaptability to assume prominent roles and responsibilities after graduation in both career and scholarly pursuits.

• Develop competent, safe, and effective medical imaging professionals.
• Support development of skills necessary to practice in diverse health care environments and to acquire prominent roles in radiologic science.
• Program curriculum, teaching methods, and philosophy promote development of integrative, critical thinking, and communication skills to include written, oral, and electronic discourse.
• Graduates successfully pursue scholarly activities such as contributions to the profession and post-baccalaureate education.
• Encourage global awareness of cultural and health care perspectives.

For further information please contact:

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Medical Student Guide For Critical Thinking

Critical thinking is an essential cognitive skill for every individual but is a crucial component for healthcare professionals such as doctors, nurses and dentists. It is a skill that should be developed and trained, not just during your career as a doctor, but before that when you are still a medical student.

To be more effective in their studies, students must think their way through abstract problems, work in teams and separate high quality from low quality information. These are the same qualities that today's medical students are supposed to possess regardless of whether they graduate in the UK or study medicine in Europe .

In both well-defined and ill-defined medical emergencies, doctors are expected to make competent decisions. Critical thinking can help medical students and doctors achieve improved productivity, better clinical decision making, higher grades and much more.

This article will explain why critical thinking is a must for people in the medical field.

Definition of Critical Thinking

You can find a variety of definitions of Critical Thinking (CT). It is a term that goes back to the Ancient Greek philosopher Socrates and his teaching practice and vision. Critical thinking and its meaning have changed over the years, but at its core always will be the pursuit of proper judgment.

We can agree on one thing. Critical thinkers question every idea, assumption, and possibility rather than accepting them at once.

The most basic definition of CT is provided by Beyer (1995):

"Critical thinking means making reasoned judgements."

In other words, it is the ability to think logically about what to do and/or believe. It also includes the ability to think critically and independently. CT is the process of identifying, analysing, and then making decisions about a particular topic, advice, opinion or challenge that we are facing.

Steps to critical thinking

There is no universal standard for becoming a critical thinker. It is more like a unique journey for each individual. But as a medical student, you have already so much going on in your academic and personal life. This is why we created a list with 6 steps that will help you develop the necessary skills for critical thinking.

1. Determine the issue or question

The first step is to answer the following questions:

• What is the problem?
• Why is it important?
• Why do we need to find a solution?
• Who is involved?

By answering them, you will define the situation and acquire a deeper understanding of the problem and of any factors that may impact it.

Only after you have a clear picture of the issue and people involved can you start to dive deeper into the problem and search for a solution.

2. Research

Nowadays, we are flooded with information. We have an unlimited source of knowledge – the Internet.

Before choosing which medical schools to apply to, most applicants researched their desired schools online. Some of the areas you might have researched include:

• If the degree is recognised worldwide
• Tuition fees
• Living costs
• Entry requirements
• Competition for entry
• Number of exams
• Programme style

Having done the research, you were able to make an informed decision about your medical future based on the gathered information. Our list may be a little different to yours but that's okay. You know what factors are most important and relevant to you as a person.

The process you followed when choosing which medical school to apply to also applies to step 2 of critical thinking. As a medical student and doctor, you will face situations when you have to compare different arguments and opinions about an issue. Independent research is the key to the right clinical decisions. Medical and dentistry students have to be especially careful when learning from online sources. You shouldn't believe everything you read and take it as the absolute truth. So, here is what you need to do when facing a medical/study argument:

• Gather relevant information from all available reputable sources
• Pay attention to the salient points
• Evaluate the quality of the information and the level of evidence (is it just an opinion, or is it based upon a clinical trial?)

Once you have all the information needed, you can start the process of analysing it. It’s helpful to write down the strong and weak points of the various recommendations  and identify the most evidence-based approach.

Here is an example of a comparison between two online course platforms , which shows their respective strengths and weaknesses.

When recommendations or conclusions are contradictory, you will need to make a judgement call on which point of view has the strongest level of evidence to back it up. You should leave aside your feelings and analyse the problem from every angle possible. In the end, you should aim to make your decision based on the available evidence, not assumptions or bias.

4. Be careful about confirmation bias

It is in our nature to want to confirm our existing ideas rather than challenge them. You should try your best to strive for objectivity while evaluating information.

Often, you may find yourself reading articles that support your ideas, but why not broaden your horizons by learning about the other viewpoint?

By doing so, you will have the opportunity to get closer to the truth and may even find unexpected support and evidence for your conclusion.

Curiosity will keep you on the right path. However, if you find yourself searching for information or confirmation that aligns only with your opinion, then it’s important to take a step back. Take a short break, acknowledge your bias, clear your mind and start researching all over.

5. Synthesis

As we have already mentioned a couple of times, medical students are preoccupied with their studies. Therefore, you have to learn how to synthesise information. This is where you take information from multiple sources and bring the information together. Learning how to do this effectively will save you time and help you make better decisions faster.

You will have already located and evaluated your sources in the previous steps. You now have to organise the data into a logical argument that backs up your position on the problem under consideration.

6. Make a decision

Once you have gathered and evaluated all the available evidence, your last step  is to make a logical and well-reasoned conclusion.

By following this process you will ensure that whatever decision you make can be backed up if challenged

Why is critical thinking so important for medical students?

The first and most important reason for mastering critical thinking is that it will help you to avoid medical and clinical errors during your studies and future medical career.

Another good reason is that you will be able to identify better alternative options for diagnoses and treatments. You will be able to find the best solution for the patient as a whole which may be different to generic advice specific to the disease.

Furthermore, thinking critically as a medical student will boost your confidence and improve your knowledge and understanding of subjects.

In conclusion, critical thinking is a skill that can be learned and improved.  It will encourage you to be the best version of yourself and teach you to take responsibility for your actions.

Critical thinking has become an essential for future health care professionals and you will find it an invaluable skill throughout your career.

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Inculcating Critical Thinking Skills in Medical Students: Ways and Means

Mandeep kaur.

Department of Pharmacology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India

Rajiv Mahajan

Critical thinking is one of the most important skills required to be possessed by any medical student for providing quality health care. With the introduction of a new competency-based medical education curriculum that focuses on the desired and observable ability of Indian medical graduates in real-life situations, inculcating critical thinking skills in the medical graduate is the need of the hour. With the changing expectations of society from the doctor, there is a need to focus more on this higher-order thinking skill which can serve as an essential attribute of any medical professional. It may serve as an important avenue for medical students to deal with any ill-defined medical emergencies and evolve with the best judgment for the clinical situation and solve the clinical problem. It is considered to be key competency to be cultivated and assessed in any medical school.

What is Critical Thinking and why it is Needed?

Critical thinking is a high-level thinking process that can be used in conceptual learning for students.[ 1 ] It is defined as the ability to identify and analyze problems as well as seek and evaluate relevant information to reach an appropriate conclusion.[ 2 ] Thus, critical thinking enables medical students to assess their needs for learning and comprehend their perspectives. This may aid in enhancing their problem-solving ability and making effective clinical decisions during their routine clinical encounter in the future.

In a medical college, during the budding years of medical students, they need to identify their own learning needs and take control of them as self-directed learners. This approach inculcates problem-solving ability and critical thinking skills in the students, which is considered to be the strong determinant for any good medical practitioner.

Strategies and Tools to Promote and Assess the Critical Thinking Skills of Medical Students

The various strategies and tools to promote and assess the critical thinking skills of medical students include:

Problem-based learning

It is an innovative teaching methodology that provides students with real-life scenarios to motivate them to seek out a deeper understanding of the given topic. In this, students learn to monitor their own learning process directing them toward building up on existing conceptual knowledge frameworks.[ 3 ] It is a student-centered learning method, in which the students work collaboratively as a team to find a solution to the given problem by digging deeper into the concepts. Different questions pertaining to the given problem and exploration of the topic occur during the session itself. This strategy of teaching inculcates a wide range of skills like problem-solving abilities and communication in addition to critical thinking skills.

Case-based learning

It is an effective tool that promotes active learning by linking theory to practice. It utilizes the clinical case scenario which is reflective of real-life experiences. Advanced study is required by the students before the discussion of the cases with their peers.[ 4 ] It encourages critical thinking by directing the learners toward the pavement of lifelong learner.[ 5 ]

Think, pair, and share strategy

It is one of the forms of cooperative learning strategy, where students are actively involved in group discussions.[ 6 ] They critically analyze the given question at an individual level and then practice sharing with their peers to achieve a pertinent solution to the given question and to further share that with a larger group.

Flipped classroom teaching

With an aim to address the higher-order skills and active involvement of students inside the classroom, this model of teaching was introduced in 2007.[ 7 ] The term “flipping” refers to providing the students with the resource material in advance before the classroom and utilizing the classroom time for active learning, fostering problem-solving skills, and enhancing their critical thinking skills.[ 8 ] It is considered a reverse of traditional teaching methodology which promotes the passive learning rather than active learning of the students.

Reflective writing

It is the process of creating a new insight in which experiences are recollected, critically analyzed, and then transformed into words in the form of writing.[ 9 ] It may strengthen and promote the development of critical thinking skills of medical students.[ 10 ]

Script concordance test

The script concordance test (SCT) is an innovative tool to assess the clinical and critical reasoning skills of medical students. It is based on the script theory which assumes that the clinician has a network of knowledge called scripts to make judgments for the clinical encounter they have in their routine practice. These scripts are imbibed by any medical student during their evolving stage from novice to expert in a medical college. As the career advances, these are further refined depending on their exposure to the clinical practice. In this test, trainees are exposed to ill-defined case vignettes which are pertaining to diagnostic, therapeutic, or investigative problems, for which there is no definitive answer. This serves as a very effective tool in probing into the critical thinking skills of medical students. The answers given by the trainees are then compared with the answers given by the panel of experts, and the final scoring is done.[ 11 ] Thus, this tool compares the judgment skills of the trainees with the reference panel and measures the degree of concordance between both.

An original study about the use of SCT in medical training is being published in this issue, and the article will give more insights to the readers.

In this era of the 21 st century, with an effort to tackle the recent trends and challenges in the medical field, there needs to be more emphasis on drifting the students from lower-order thinking skills to higher-order thinking skills. This helps the medical students to analyze the information critically and then apply that to the existing information. Critical thinking skill is considered a cornerstone for teaching and training medical students so as to maintain clinical competence and medical professionalism.

Important Job Skills for Radiologic Technologists

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• Skills & Keywords
• Salary & Benefits
• Letters & Emails
• Job Listings
• Job Interviews
• Cover Letters
• Career Advice
• Work-From-Home Jobs
• Internships
• Skills Radiologic Technologists Need
• Types of Radiologic Technologist Skills

Medical and Anatomical Skills

Communication skills, mechanical aptitude, more radiologic technologist skills.

• How to Make Your Skills Stand Out

A  radiologic technologist  is a healthcare worker who specializes in imaging tests like X-ray, MRI, and CT scans, performed primarily in diagnostic capacities. Some radiologic technologists will specialize in certain disciplines related to specific areas of the body, such as mammography, for example.  

What Skills Does a Radiologic Technologist Need?

Radiologic technologists will have close working relationships with the radiologists who interpret the images.

In order for doctors to be able to do their jobs, the technician has to be thorough and accurate in their imaging technique.

They’ll also be responsible for keeping patients as comfortable as possible during their tests, which can sometimes be frightening and stressful for those undergoing them. Radiologic technologists can steadily increase their income over time by developing specialties and by acquiring more experience.   

Types of Radiologic Technologist Skills 

Here’s a list of the most important skills employers look for in a radiologic technologist.

Along with learning about the technology and equipment required to be successful, a radiologic technologist will also learn a good deal about examination methods, human anatomy, safety around radiation protection, and more about the basics of caring for patients.

A successful radiologic technologist will be comfortable with the human body and interacting physically with patients and confident in their ability to position patients accurately on the table in order to use radiation as safely as possible.   

• Applying radio-opaque contrast media solutions
• Assessing bone density
• Assessing vital signs
• Basic life support (BLS)
• Computerized tomography
• Developing radiographic images
• Fluoroscopy
• Hysterosalpingogram procedures
• Interpreting clinical information about patients
• Knowledge of anatomy and physiology
• Operating picture archiving and communications system (PACS) 
• Performing magnetic resonance procedures
• Performing venipuncture for contrast injections
• Positioning patients
• Practicing sterile techniques
• Retrograde urethragrams
• Reviewing images for quality
• Strictly following radiology safety protocols
• Taking X-rays of various body parts

As a radiologic technologist, you’ll be responsible for several layers of communication with both patients and colleagues. Because there’s not any single or specific type of person who might need health-related imaging, you’ll be interacting with a broad and diverse crosssection of the population.

You’ll be required to explain procedures to patients. Because you’ll be encountering all sorts of patients, you’ll need to have an agile communication style so that you can communicate effectively with anyone who crosses your lab or table.

Another critical part of the job is understanding that patients might be anxious or scared.

For some, they could be enduring the most frightening possible prospect. They could be seeing you on the worst day of their life. It won’t always be so dire, but even under the best circumstances, medical diagnostic imaging is typically uncomfortable, awkward, or inconvenient for the patient.

You’ll be on the front line, standing between the patient and the answers they seek. You’ll have to manage stress (theirs, as well as your own), express compassion, and remain calm when patients become agitated or upset –– all while doing your job well.  

• Comforting distressed patients
• Compassion for patients
• Consulting with physicians
• Explaining procedures to patients
• Orienting new staff
• Remaining calm with agitated patients
• Actively listening to patient concerns
• Documenting procedures
• Conveying patient concerns to nursing staff
• Tailoring communication to different age groups
• Deciphering nonverbal cues from patients regarding pain
• Training student staff
• Social perceptiveness

In order to calibrate and maintain radiology equipment, a radiologic technologist will have to be comfortable with their technology and gear. Each machine’s model will be different, and as a result, learning and relearning new technology will be part of the job. A technologist will also have to understand how to adjust radiation exposure time and intensity.

These factors impact the health of the patient and maximize image quality. Most training courses will provide guidelines and instructions using the equipment. However, it will be up to the technologist to expand their knowledge and master the art of handling their medical imaging equipment.   

• Diagnosing equipment problems
• Repairing malfunctioning equipment
• Calibrating and maintaining radiology equipment
• Mechanical aptitude
• Evaluating new equipment and technology
• Problem solving
• Attention to detail
• Critical thinking
• Customer service
• Flexibility
• High energy
• Identifying and responding to emergency situations
• Interacting effectively with a diverse clientele
• Maintaining patient confidentiality
• Manual dexterity
• Mathematics 
• Multitasking
• Ongoing learning
• Ordering supplies
• Organizational
• Precision 
• Prioritizing workflow
• Punctuality
• Reliability
• Resolving scheduling problems
• Stress management
• Timely and accurate documentation of patient contacts
• Time management
• Transporting patients
• Verbal communication
• Working independently 
• Working quickly and accurately

How to Make Your Radiologic Technology Skills Stand Out

Use action words in your resume.

• Construct your resume with action words that correspond to the skills in this list, especially those key skills that are highlighted in the job description for your target position.
• Lead your phrases with skill words like “resolved problems with scheduling, calculated equipment settings, and comforted agitated patients.”
• List your statements in order of relevancy to the priority qualifications of your target job.
• Include resume statements that demonstrate impact and results produced. Lead with words like increased, enhanced, revamped, and improved that point to value added.

Use quantitative terms whenever possible to demonstrate the magnitude of results generated.

For example, “reduced equipment failures by 15% by instituting an aggressive maintenance schedule.”

Share Your Skills in Your Cover Letter

Incorporate statements into your  cover letter  regarding key patient care and diagnostic skills that you have applied in various roles with emphasis on skills that have led to successes and problems solved.

Make sure you touch on the requirements that employers have emphasized in their job advertisements.

Be Prepared to Discuss Your Skills in Your Interviews 

Prepare for interviews by making a list of the core skills that best equip you to excel in your target job:

• Think of examples and short stories of how you have applied these skills to generate positive results in the past.
• Describe the situations you were confronted with, the actions you took (emphasizing skills applied), and the results of your interventions.
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