Critical thinking

Over recent years, there has been a growth in academic critical thinking courses, initially as a supplement to more formal courses in logic. The skills associated with critical thinking, such as reflection, rational analysis and open-mindedness, are necessary to any academic endeavour and can be taught as methodological skills. They are now identified as a central aim of education in general. In schools in the UK, the 'AS' level in critical thinking has become increasingly popular (Fisher, 2001).

A cynical view may be that education in schools over recent years has left less room for individual thought. British universities are now looking at aptitude tests involving critical thinking skills to differentiate the best students at 'A' level. It may also be the case that the ideals of a liberal progressive education of the 1960s and 70s, which saw its aim as developing creative dissent rather than uncritical acceptance of orthodoxy, have now become seen as outmoded. At least critical thinking seems to be making a comeback, if only in its more regimented form as a method of learning that can be taught.

By critical thinking, I am not merely considering a technique that can be taught to improve problem solving. Maybe a better term is reflective practice, which involves a preparedness to think critically. The notion of reflection as a contribution to the improvement of practice has its origin in the work of John Dewey (1909). Doubt, perplexity and uncertainty lead to a search for possible explanations and solutions (Mamede & Schmidt, 2004). An attitude of openness means that the practitioner must tolerate the uncertainty and ambiguity required during reflection. 'Meta-reasoning' is the ability to think about one's own thinking processes and be prepared to critically assess one's own assumptions and beliefs.

Despite the development of guidelines and standards, which have been seen as being of increasing importance over recent years, professionals still need to use their judgement when undertaking their work. The National Institute for Clinical Excellence (NICE) agrees that guidelines may help healthcare professionals in their work, but that they cannot replace practitioners' knowledge and skills. Critical thinking is required to ensure that practice is open-minded, reflective and takes account of different perspectives. The route to clinical excellence is, in fact, through criticality, not reliance on managerial guidelines.

Critical thinking, then, is the art of taking charge of one's mind. If we can take charge of our own minds, the theory is that we can take charge of our lives; we can improve them, bringing them under our command and direction. Critical thinking involves getting into the habit of reflecting on our inherent and accustomed ways of thinking and leads to action in every dimension of our lives. Similarly, critical psychiatry wants to promote critical reflection on practice and research in psychiatry.

Critical thinking is not just having an impact in the field of psychiatry. For example, critical psychology (Fox & Prilleltensky, 1997) and critical social work (Adams et al, 2002) have been developed over recent years. The critical practitioner is someone who accepts uncertainty and attempts to deal with it creatively.