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Improving Students’ Patient Care Management Using the Thinker’s Guide to Clinical Reasoning

Course Number: 551

The Intellectual Standards

Another challenge to overcome in analyzing self-thought is to hold it against the intellectual standards. The Paul-Elder model has nine standards to use to judge reasoning abilities and apply to the Elements of Thought. Explicit use of these standards will render thinking that is clearer, more accurate, on a deeper level and more relevant. These intellectual standards include clarity, accuracy, precision, relevance, depth, breadth, logic, significance and fairness.2-6 The interactive tool on the previous page introduces the Intellectual Standards. A description of each Intellectual Standard provides a more in-depth look at the standards.

Clarity prompts identification and resolution of any type of confusion that an individual may have, thus enabling communication reflecting that they truly understand the nuances of the concept or central question at hand. For example, students want their professors to be explicit and very clear in the directions they give for assignments. If the assignment is ambiguous and leaves the students with many questions, the student needs to seek clarity and check their assumptions.

Accuracy is concerned with the truth or correctness of what is said, read or learned. It eliminates any distortion there may be regarding the truth. As dental professionals, we must convey accurate information to our patients so the patients can decide the treatment option that is best for them.

Relevance is about whether something relates directly to the problem at hand or any questions to be answered. If issues or information are not directly related to the central question, the original purpose or objective can be lost. For example, there is no reason to talk about the possibility of getting pregnancy gingivitis if your patient is male. This information is irrelevant to the oral health of a male patient.

Logic asks us to ensure everything fits together, or makes sense, to allow the bigger picture to materialize. If there seems to be a missing part of the whole and conclusions do not flow “logically,” then an individual probably needs to gather more information and other points of view to allow a full picture of the concept or central question they are pursuing. For example, dental professionals gain information about a patient’s oral health through various assessments completed during the appointment. All of this information should add up to give you a complete picture of the patient’s oral health status.

Precision goes hand in hand with logic. All of the pieces of the puzzle and the necessary details are needed to solve the problem or answer the central question. Oral health instructions need to be precise and not generic. The dental professional should tailor the message to the level of detail needed for the patient based on the information gathered throughout the appointment.

Fairness is associated with considering alternative points of view regarding the issue at hand. Considering only one point of view is self-serving or one sided. For oral health education efforts to be effective, a dental professional needs to consider the patient’s perspective in addition to their own viewpoint and best practices.

Depth and Breadth are two standards that are commonly confused and used interchangeably. Depth of thought considers all of the complexities and difficulties of an issue whereas breadth incorporates thinking about all of the necessary contexts of the issue at hand. Depth is “deepness” of thought whereas breadth is “width” of thought.

Significance, or importance, is the last intellectual standard. A dental professional needs to strive for non-trivial thinking in their interactions. Healthcare providers need to determine what information is and is not significant. Once they determine what is significant, they can prioritize the significant pieces of information to provide the best, individualized treatment for their patients.2-6

The poster below, developed by the University of Louisville’s Ideas to Action team, provides pertinent questions that correspond with the intellectual standards (Table 4).13

Intellectual Standards

Table 4. Intellectual Standards.

These nine intellectual standards are tools that dental professionals can use in their interactions with patients, students, and colleagues.2 Using these intellectual standards allows dental professionals and educators to check the quality of their thinking and allows them to be the best they can be.