Intended for healthcare professionals

Feature Essay

Critical thinking in healthcare and education

BMJ 2017; 357 doi: (Published 16 May 2017) Cite this as: BMJ 2017;357:j2234
  1. Jonathan M Sharples, professor1,
  2. Andrew D Oxman, research director2,
  3. Kamal R Mahtani, clinical lecturer3,
  4. Iain Chalmers, coordinator4,
  5. Sandy Oliver, professor1,
  6. Kevan Collins, chief executive5,
  7. Astrid Austvoll-Dahlgren, senior researcher2,
  8. Tammy Hoffmann, professor6
  1. 1EPPI-Centre, UCL Department of Social Science, London, UK
  2. 2Global Health Unit, Norwegian Institute of Public Health, Oslo, Norway
  3. 3Centre for Evidence-Based Medicine, Oxford University, Oxford, UK
  4. 4James Lind Initiative, Oxford, UK
  5. 5Education Endowment Foundation, London, UK
  6. 6Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia
  1. Correspondence to: J M Sharples Jonathan.Sharples{at}

Critical thinking is just one skill crucial to evidence based practice in healthcare and education, write Jonathan Sharples and colleagues, who see exciting opportunities for cross sector collaboration

Imagine you are a primary care doctor. A patient comes into your office with acute, atypical chest pain. Immediately you consider the patient’s sex and age, and you begin to think about what questions to ask and what diagnoses and diagnostic tests to consider. You will also need to think about what treatments to consider and how to communicate with the patient and potentially with the patient’s family and other healthcare providers. Some of what you do will be done reflexively, with little explicit thought, but caring for most patients also requires you to think critically about what you are going to do.

Critical thinking, the ability to think clearly and rationally about what to do or what to believe, is essential for the practice of medicine. Few doctors are likely to argue with this. Yet, until recently, the UK regulator the General Medical Council and similar bodies in North America did not mention “critical thinking” anywhere in their standards for licensing and accreditation,1 and critical thinking is not explicitly taught or assessed in most education programmes for health professionals.2

Moreover, although more than 2800 articles indexed by PubMed have “critical thinking” in the title or abstract, most are about nursing. We argue that it is important for clinicians and patients to learn to think critically and that the teaching and learning of these skills should be considered explicitly. Given the shared interest in critical thinking with broader education, we also highlight why healthcare and education professionals and researchers need to work together to enable people to think critically about the health choices they make throughout life.

Essential skills for doctors and patients

Critical thinking …

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