Presentation on theme: "استدلال برنامه آموزشی تم طولی ، حل مسأله وتصمیم گیری(تفکر نقاد) دانشجویان پزشکی دانشگاه تهران مهر 91 گروه تفکر نقاد وپزشکی مبتنی بر شواهد ترم سوم کارگاه."— Presentation transcript:
1استدلال برنامه آموزشی تم طولی ، حل مسأله وتصمیم گیری(تفکر نقاد) دانشجویان پزشکی دانشگاه تهران مهر 91 گروه تفکر نقاد وپزشکی مبتنی بر شواهد ترم سوم کارگاه دوم
2رئوس مطالب: بقیه پیچ و مهره های تفکر رئوس مطالب: بقیه پیچ و مهره های تفکراستانداردهاوضوح صحت دقت اهمیتارتباط کفایتمنطقي بودن انصاف وسعت نظر عمقمولفه هازمینههدف استنتاج/ادعاپرسش/مسئله مفاهيمديدگاه سرانجاماطلاعات پیش فرضهاويژگی های ذهنیتواضع عقلی پشتکار عقلیاستقلال عقلی اطمينان به استدلالدرستی عقلی همدلی عقلیشهامت عقلی منصف بودنباید در موارد زيربكار رودچنان كه ميآموزيم اين خصا يص را پرورش ميدهيم
3The key to clarification is concrete, specific examples. وضوحآیا می توانی آنچه را گفتی شرح دهی؟آیا می توانی منظور خود را از طریق مثال روشن کنی؟آیا می توانی مثالی ارائه دهی یا نه ؟The key to clarification is concrete, specific examples.
4In philosophy unclear proposition is not worth to evaluate. Accuracy ClarityClarity is a gateway standard. If a statement is unclear, we cannot determine whether it is accurate or relevant. In fact, we cannot tell anything about it because we don't yet know what it is saying.Example: EBMIn philosophy unclear proposition is not worth to evaluate.AccuracyPrecisionRelevanceDepthBreadthExample: some philosophers (positivists) believe that only things which can be measure empirically are meaningfulExample: some philosophers (logical positivists) believe that only things which can be measure empirically or evaluate analytically are meaningfulSo ethical propositions are meaningless so could not be assessLogicalnessFor example, the question "What can be doneabout the education system in America?" is unclear.SignificanceFairness
5Clarity Accuracy Precision Relevance Depth Breadth Logicalness To adequately address the question, we would need a clearer understanding of what the person asking the question is considering the "problem" to be.This question, because of its increased clarity, provides a better guide to thinking. It lays out in a more definitive way the intellectual task at hand.AccuracyPrecisionRelevanceA clearer question might be, "What can educators do to ensure that students learn the skills and abilities that help them function successfully on the job and in their daily decision making?"DepthBreadthLogicalnessSignificanceFairness
7Clarity Accuracy Precision Relevance Depth Breadth Logicalness ClearnessIs the thinking clear?Is this clear in my mind?Am I saying this clearly?Definition: Your thinking is clear when it's easily understood' when it’s free from the likelihood of misunderstanding, when it‘s readily apparent what follows from it.Related terms: understandable, plainOpposites: Your thinking is ,unclear when it is obscure ambiguous, confused, easily misunderstood or you don't see what follows from it.AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
8Clarity Accuracy Precision Relevance Depth Breadth Logicalness CONVERTING UNCLEAR THOUGHTS TO CLEAR THOUGHTSCan you convert an unclear thought to one that is clear?Suppose you are engaged in a discussion about welfare and one person says, "Let's face it-welfare is corrupt!" What does this mean? What could it mean?It could mean, "The very idea of giving people goods and services they have not personally earned is equivalent to stealing money from those who have earned it" (a moral claim).Or it could mean, "The welfare laws have so many loophole (escape) that people are receiving money and services that were not envisioned when the laws were initially formulated" (a legal claim).Or it could mean, "The people who receive welfare so often lie and cheat to falsify the documents they submit that they should be thrown in jail" (a claim about the ethical character of the recipients). AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
9Clarity Accuracy Precision Relevance Depth Breadth Logicalness Clearness Is Context Dependentwhat is clear in one context is not necessarily clear in another' OneAudienceDiscipline or subject matterStage of thinkingAccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
10Clarity Accuracy Precision Relevance Depth Breadth Logicalness Clearness Is Context Dependentwhat is clear in one context is not necessarily clear in another' One the following page I discuss three important contexts where you may have to adjust your standard of clearness: audience, discipline or subject matter, and stage of thinkingLogicalnessSignificanceFairness
11صحت چطور می توانم آن را بررسی کنم؟ چطور می توانم از صحت آن مطمئن شوم؟ چطور می توانم از صحت آن مطمئن شوم؟چطور می توانم در موردش تحقیق کرده یا آن راامتحان کنم؟متفکر انتقادی بدبینی متعادلی درباره توصیفات عمومی ـ درباره چیستی و صحت موضوع ـ دارد.
12انواع دروغ من دروغ میگویم و تو نمیدانی من دروغ میگویم و تو هم میدانی من دروغ میگویممن دروغ میگویم و تو هم میدانی و من هم میدانم که تو میدانی ولی باز میگویم!
13Clarity Accuracy Precision Relevance Depth Breadth Logicalness RECOGNIZING INACCURATE STATEMENTSCan You identify a Statement that You heard recently that Was clear but inaccurate?you will find an abundance of examples in everyday statements that people often make in praise or criticism.People in general have a tendency to make two kinds of inaccurate statements:false positives about the people they personally like (these would be untrue positive statements about people they like) andfalse negatives about the people they personally dislike (untrue negative thing, about people they don't like).AccuracyPrecisionRelevanceDepthBreadthPolitically motivated statements tend to follow a similar Pattern.See if You can think of an example of an Inaccurate statement from You, recent experience. Write out or orally explain Your answerLogicalnessSignificanceFairness
14Clarity Accuracy Precision Relevance Depth Breadth Logicalness Is the thinking accurate?Are the statements accurate, true?Definition: Aristotle gave one of the clearest definitions of the term true:To say of what is that it is , or of what is not that it is not , is true .We could define accuracy in much the same way:My thinking and my words are accurate when they describe the way things actually are.Related terms: true, well established, confirmed.Opposite: my thinking and my words are inaccurate when they are not in accord with the way things in fact are. Notice that can be inaccurate or false even if I believe they are in accord with reality.AccuracyPrecisionRelevanceDepthBreadthWhat matters for accuracy is not whether I believe a claim, but whether that claim actually fits the way things in fact are.Related terms: true, well established, confirmed, corroborated, well authenticatedLogicalnessSignificanceFairness
15Clarity Accuracy Precision Relevance Depth Breadth Logicalness Impediments: What's Difficult About Being Accurate and Recognizing What's AccurateIt is often hard to be open to the accuracy of things we hear, especially if what we hear is threatening to us.lnertia. lt is more comfortable to keep the beliefs we have than to change them, even when we get evidence that our beliefs are not accurate.Wishful thinking and denial. We often let our desires or our fears influence our assessments of what's accurate.The desire to win the lottery blinds us to the fact that we have no realistic chance to win it.People often blind themselves to their own alcoholism and the alcoholism of those they are closest to.AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
16” ما حق نداریم از تئوری هایمان دگم بسازیم و به آیه های کتاب سیاسی مان ایمان مذهبی پیدا کنیم. بر ما فرض است که چیزی را که درست انگاشته ایم، در فضایی آزاد از تعصبات شرم آور قشری و در جوی سرشار از فرزانگی، با چیزهایی که دیگران درست انگاشته اند به محک بزنیم تا اگر ما در اشتباه افتاده ایم، دیگران چراغ راهمان شوند و اگر دیگران به راه خطا می روند، ما از لغزش شان مانع شویم...
17دقت می توانی صریح تر باشی؟ می توانی جزئیات بیشتری ارائه کنی؟ می توانی صریح تر باشی؟می توانی جزئیات بیشتری ارائه کنی؟می توانی دقیق تر باشی؟
18Clarity Accuracy Precision Relevance Depth Breadth Logicalness Questions focusing on making thinking more precise include:Could you give me more details?Could you be more specific?Definition: Your thinking is precise when you have been as specific and detailed as needed to reason through an issue.Related terms: when you are satisfied with speaking in generalities without getting down to specific issues.Hot example: what do you want to do to improve outpatient managementAnswer: we should do our job and you too!AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
20ClarityImpediments: What's Difficult About Being Precise ,We often overlook the need to be precise,lt takes work to be precise. lt means getting specific enough to tell exactly what we are talking about. lt's easy to settle for generalities.We are sometimes too rushed to take the time to make our reasoning precise.AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
23ارتباط این موضوع چه ارتباطی به مشکل دارد؟ چطور به مسئله ربط پیدا می کند؟در رابطه با مسئله چه کمکی به ما می کند؟
24Clarity Accuracy Precision Relevance Depth Breadth Logicalness Definition: To say something is important is to say that it matters, If you're thinking about an issue, the thinking is important when it matters in deciding that issue. The thinking is important when it's directly relevant to addressing the problem at hand.Related terms: relevant, main, central, essential, crucial, critical.Opposites: You are focusing on what is unimportant if it makes little or no difference in relation to the question you're addressing. Your thinking can focus on a minor aspect of the problem. At an extreme, your thinking can be irrelevant to the problem at hand.AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
25عمق چه فاکتورهایی در دشواری این مشکل تاثیر دارند؟ برخی پیچیدگی های این مشکل چیست؟دشواری هایی که باید به آنها بپردازیم کدامند؟Example: Let's say you are asked what should be done about the problem of drug use in America and you answer by saying, "Just say no."
26Clarity Accuracy Precision Relevance Depth Breadth Logicalness This slogan, which was for several years used to discourage children and teens from using drugs, is clear, accurate, precise, and relevant.Nevertheless, it lacks depth because it treats an extremely complex issue, the pervasive problem of drug use among people in our culture superficially.How much our children admit our reasoning?It does not addressthe history of the problem,the politics of the problem,the economics of the problem,the psychology of addiction, and so on.AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
27وسعت نظر آیا لازم است از دیدگاه دیگری به این مسئله نگاه کنیم؟ آیا می بایست نقطه نظر دیگری را نیز لحاظ کنیم؟آیا لازم است این مسئله را به شیوه های دیگری بررسی کنیم؟
28Humans are frequently guilty of narrow-mindedness for many reasons: ClarityHumans are frequently guilty of narrow-mindedness for many reasons:limited education,innate sociocentrism,natural selfishness,self-deception,and intellectual arrogance.Points of view that significantly disagree with our own often threaten us. It's much easier to ignore perspectives with which we disagree than to consider them.AccuracyPrecisionRelevanceDepthBreadthIt's much easier to ignore perspectives with which we disagree than to consider them, when we know at some level that to consider them would mean to be forced to reconsider our views.LogicalnessSignificanceFairness
29Clarity Accuracy Precision Relevance Depth Breadth Logicalness DiscussionDifferences between depth and breadth. Depth and breadth are aspects or sufficiency; the question is always” Is the person reasoning this out deeply enough (or broadly enough) to accomplish his or her purpose in a reasonable way?”The two standards are not always clearly distinguishable.The goal is to develop an intuitive feel for when it is important to delve (dig) more deeply into an issue, and when it is important to look at it more broadly by taking account of other related issues.AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
30Clarity Accuracy Precision Relevance Depth Breadth Logicalness Example: Imagine yourself on a path going toward a destination.Breadth says to look around you, at the forest, fields, mountains, other travelers, the impending weather. Depth asks you to look deeper: at the solidity of the path itself the state of your muscles when walking it, the strength of your desire to reach the destination, your knowledge of the human body's need for nutrition.One directs you to look around, to take a more comprehensive view of things; the other directs you to look below the surface, to see things in all their depth.AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
31Clarity Accuracy Precision Relevance Depth Breadth Logicalness Depth and theory.One fruitful way to gain depth in your thinking is to look at the theoretical underpinnings (foundation) of the question you are considering.Often we operate by a rule of thumb:Take daily multivitamins,discipline your children without shaming them,set performance quotas (share) as an important part of sales management.When these situations become problematic though, a good place to look is at the theory that underlies them:nutrition theory,child development theory, andsales management theoryAccuracyPrecisionRelevanceDepthBreadthTheories answer in far greater depth the questions of why you should or you should not follow the rule of thumb.LogicalnessSignificanceFairness
33Clarity Accuracy Precision Relevance Depth Breadth Logicalness Impediments: What's Difficult About Reasoning Deeply Enough and Broadly Enoughlt is difficult to live with the ambiguity and uncertainty that attend reasonable thinking about so many complex problems. We would like thing to be simpler more clear-cut.All or-nothing answers give us a feeling of control over complex problems. Even the illusion of control is sometimes comforting.Often you may not realize that there are complexities to an issue, In fact, one of the things we learn directly from disciplines is the amount of complexity there is to a seemingly simple issue.example: compare traditional and classic medicineAccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
34منطقی بودن آیا این موارد معقول به نظر می رسند؟ آیا این موارد معقول به نظر می رسند؟آیا پاراگراف اول با پاراگراف آخر همخوانی دارد؟آیا حرفهایت از شواهد ناشی می شوند؟
35Clarity Accuracy Precision Relevance Depth Breadth Logicalness Example: Say that you know a person who has had a heart attack, and her doctors have told her she must be careful what she eats, to avoid problems in the future. Yet she concludes that what she eats really doesn't matter. Given the evidence, her conclusion is illogical. It doesn't make sense.Example:Our practitioners do not know common problems, but they should be at high level ground roundsTo increase rank of health, medical education is very important, but its rank is very low,Thinking is very important, but our education is based on recallAccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
36اهمیت آیا این مهم ترین مشکل برای بررسی است؟ آیا این مهم ترین مشکل برای بررسی است؟آیا این ایده مرکزی است که باید رویش تمرکز کرد؟کدام یک از این حقایق اهمیت بیشتری دارد؟گرچه ایده های مربوط زیادی وجود دارند، اما همگی آنها اهمیت یکسانی ندارند.
37Clarity Accuracy Precision Relevance Depth Breadth Logicalness Too often we fail in our thinking because we do not recognize that, though many ideas may be relevant to an issue, it does not follow that all are equally important.Example:In college, few students focus on important questions such as, "What does it mean to be an educated person? What do I need to do to become educated?“Instead, students tend to ask questions such as, "What do I need to do to get an 'A' in this course? How many pages does this paper have to be? What do I have to do to satisfy this professor?"AccuracyPrecisionRelevanceDepthBreadthWhen we reason through issues, we want to concentrate on the most important information (questions) in our reasoning and take into account the most important ideas or concepts.LogicalnessSignificanceFairness
38Clarity Accuracy Precision Relevance Depth Breadth Logicalness FOCUSING ON SIGNIFICANCE IN THINKINGThink about your life, about the way you spend your time in terms of the amount of time you spend on significant versus trivial things. As you do so write the answers to these questions: What is the most important goal or purpose you should focus on at this point in your life? Why is this purpose important? How much time do you spend focused on it? What are the most trivial or superficial things you spend time focused on (things such as your appearance, impressing your friends, chatting about insignificant things at parties, and the like)? What can you do to reduce the amount of time you spend on the trivial and increase the amount of time you spend on the significant?AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairness
39Clarity Accuracy Precision Relevance Depth Breadth Logicalness Has this been reasoned out sufficiently?Have reasoned this out enough to decide the issue reasonably?Definition: Your thinking about a question or an issue is sufficient when you have reasoned it out thoroughly enough for the purpose at hand. when it is adequate for what is needed when you've taken account of all necessary factors.Related terms: adequate, enough, complete, comprehensive, thorough0pposites: when there are other essential factors for you to address before you decide this issue.AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificance0pposites: Your thinking is insufficient when you have left out crucial considerations, when you have not reasoned the issue out enough to meet the needs of the situationFairnessSufficiency
41Clarity Accuracy Precision Relevance Depth Breadth Logicalness Impediments: What's Difficult About Reasoning Through Something Sufficientlyjumping to conclusions (biased jumper)a tendency to reason through unimportant issues too much and through important issues too littlesticking with pre-established views that seem sufficient because we have not examined alternatives.unreasonable standards (such as perfectionism) of what counts as enoughlack of relevant background knowledge is imply for getting to ask, “is this sufficient?“ is it enough?'‘Medical stuffs have a very limited knowledge about human!AccuracyPrecisionRelevanceDepthBreadthLogicalnessSignificanceFairnessSufficiency