Cognitive Dissonance

We all wish that students came into our classrooms with their critical thinking caps firmly in place, but that rarely happens. Many students have experienced a traditional education where they passively memorized what the instructor told them. They may have learned to only answer questions when they were sure they knew the answer. These students may appear adverse to educational experiences that ask them to question, analyse and/or be creative because it is unfamiliar and they might not know the answer. Medical students have been very invested in knowing the right answer all of their lives, and asking them to examine ambiguity and multiple viewpoints can be very unnerving.

Creating an environment where their traditional thinking doesn't work will help them start moving forward into higher order thinking. You can create this Cognitive Dissonance by:

Tapping into the student's creative brain by using puzzles, illusions and brainstorming in a way that provides no risk to the students. Ten minutes spent on an activity of this kind will prepare students for actively involving themselves in seeing the world differently.

Ex. How many uses can you find for a paper cup?
This example of uncritical brainstorming demonstrates very effectively how silly ideas lead to new ways of understanding a problem or challenge. It is also useful for demonstrating how non-judgemental thinking is crucial in the initial phase of critical thinking.

drinking utensil, break when nervous, flower pot, lamp shade,
ice cream holder, garbage can, prop window open, coin dispenser, display an object, puppet, drawing board, trowel, dog toy, sifter, throw liquids etc.
How many people do you see?

There are at least 10 and the most frequently missed is the baby in the woman's arms.

This image could inspire a discussion about the problems with observation.
Seeing the world as others see it. Another step in analyzing a situation and a crucial aspect of empathy, this technique can be taught through the use of the following:

  1. role plays where a student takes on a role very different from their own
  2. successfully arguing a case from a viewpoint that isn't their own
  3. guest speakers, site visits, patient home visits
  4. examining theories from the point of view of stakeholders
This image could be used in a discussion about our perception of disabilities such as dyslexia. Nature of Reading
Using the 5WHY technique. Repeatedly asking "why?" until the student reaches a nebulous core where there are no more answers, helps students examine their assumptions about the root cause of issues. Why do you become frustrated with the patient's non-compliance?
Why do you think they should follow your advice?
Why might the patient distrust your experience?
Why is it important to not assume what the patient is thinking?
Why might the patient be reluctant to tell you about not being able to afford medication? etc.
Using higher order thinking techniques throughout the course such as:

  1. Compass Points
  2. Thinking Diamond

Although not true examples of cognitive dissonance, these two techniques give concrete learners a process for approaching critical thinking in a more systematic way that might fit their learning style.
Compass Points examines a theory from four points CompassPoints
Thinking Diamond compares creative solutions to compromise solutions Thinking Diamond

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