Development of critical thinking skills in human anatomy and physiology.

Application-of-knowledge skills are highly valued in clinical medicine, as indicated by recent changes to licensure and entrance exams for nursing and physician programs (i.e., the NCLEX and MCAT). Such emphasis should be both welcomed and supported by approaches to teaching human anatomy and physiology that emphasize critical thinking skills built upon logic, reasoning, and judgment. The argument for development of these skills is not simply philosophical. Rather, such emphasis is strongly supported by a 2016 Johns Hopkins study (Makary MA, Daniel M. BMJ 353: i2139, 2016) that estimates that medical errors are now the third leading cause of death in the United States! Active learning techniques known to require critical thinking skills are often supplemental to standard expository lecturing or other avenues of imparting content knowledge (reading, videos, etc.). We propose that all content dissemination can and should provide for the development of critical thinking skills, preparing students for active learning techniques requiring this ability. This can be accomplished by establishing an intellectual framework for understanding the adaptive benefits of anatomical or physiological traits. Additionally, explanations conveying the causality of mechanistic sequences result in learning content within intuitive functional groups rather than as isolated phenomena, the latter often accomplished mainly through memorization as opposed to real understanding. Here, we provide a template for lecture development based upon these principles as well as a specific example from human anatomy and physiology. Our hope is to provide a model for how students should think about all physiology, making comprehensive coverage of content (an impossible task!) much less important.NEW & NOTEWORTHY Critical thinking skills are essential to the effective performance of many careers, particularly those involving health care. To aid the development of these skills in physiology, the formation of logical cognitive frameworks needs to be supported via instruction that emphasizes the context of physiological functions (the "why") as well as the causality of their sequential actions. Within such frameworks, students become capable of cognitive reasoning required to reach intuitive conclusions after system perturbations.