Thinking About Your Thinking

(Reprinted from the May 2019 issue of Vital Signs, the monthly scribe newsletter from AQuity Solutions.)

Do you ever think about how you think? I don’t know about you, but sometimes I don’t want to look at my thought processes too closely! Other times, I tell myself that I need a new way of looking at things, and I start challenging myself to see if I can come to different conclusions. This process is called metacognition, which is defined as awareness and understanding of one’s own thought processes. It’s also known as critical thinking.

How do good medical scribes think? They:

• Raise relevant questions

• Analyze and interpret information

• Come to reasoned conclusions

• Modify their thinking based on instruction or experience

• Communicate effectively with others

First, effective scribes ask questions of themselves and their providers throughout every encounter. The questions may simply be a matter of laterality or duration, but often the scribe can wonder why a provider is commenting on a specific symptom or condition.

Next, an effective scribe analyzes and interprets the information they receive. Patient comments and complaints can be scattered and haphazard, but the scribe can connect the underlying meanings to understand what is being said.

Third, when an effective scribe comes to reasoned conclusions, they often perform tasks and help their provider in ways that can make providers think the scribe is a mind reader. Concluding that a provider has the possibility of diabetes in mind when they ask the patient about excessive thirst, urinary frequency, and peripheral neuropathy symptoms, the scribe anticipates that a CMP and HgA1c will be ordered.

In addition, great scribes learn from experience and from being instructed by their providers or performance coaches. When a physician corrects a chart, the scribe knows how to make their next chart better. Hearing the same provider instructions for bronchitis over and over, the scribe knows how to complete subsequent charts.

Finally, the best scribes communicate effectively with their providers and their coworkers. They think about how to express themselves in clear and precise ways while exuding self-confidence and respect for others.

The late Dr. Richard Paul, Chair of the National Council for Excellence in Critical Thinking, defined critical thinking as “the art of thinking about your thinking while you are thinking, in order to make your thinking better: More clear, more accurate, or more defensible.”

What are some ways you’re exercising your critical thinking muscles? 

Anne Bean is a Medical Scribe and Scribe Training Administrator for AQuity Solutions.