Kritik provides a structure for team-based problem-solving strategies:

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One approach to using team-based problem-solving strategies in the classroom would be to simply confront the students with the problem and let them proceed by a process of trial and error. This approach has the merit of allowing students to discover useful strategies that are personal and therefore directly applicable to each individual student. However, students will vary widely in their ability to generate productive strategies intuitively. It will be time consuming for all, frustrating for many, and completely ineffective for a few. More insidiously, it may allow some students to develop flawed strategies that are reinforced by temporary successes leading only to tears and malpractice suits down the road. A superior plan is to provide an established framework for systematic, logical thought that students can then explore and adapt to their own abilities. The following represents one possible framework amenable to the medical school classroom. This scheme is an adaptation of the traditional scientific method using elements of the principles taught by Paul and Elder (2003). It fits the clinical setting because it is designed to accommodate the variations that exist when a situation cannot be controlled to meet the rigors imposed by scientific investigation. It consists of seven steps:

THE ROLES OF THE INSTRUCTOR AND STUDENTS

As mentioned earlier, TBL is an excellent pedagogical method for implementation of critical thinking strategies. The emphasis placed on student-focused education and group interaction provides an opportunity for directed practice in problem solving (Michaelsen, Knight, & Fink, 2002, 2004). Furthermore, in this learning model the professor’s and students’ roles have been drastically altered. Instead of using preparation time to carefully script elaborate presentations and fabricate slides, the instructor must spend that time making decisions about what the students will do. The following are some of the obvious tasks to be accomplished before class begins:

• Make responsible content decisions. Few professors are at risk of including too little. The more common practice is to include excessive detail that, while interesting to the professor, often obscures the truly important concepts and leaves inadequate time for students to process and apply the foundational information.
• Decide how students will ultimately be evaluated on that content and the application thereof. Design exam items now to guide one’s thinking through the rest of the pedagogical plan. This is the time to ensure that there is a good match between the objectives of the course and the assessment on the final exam. If the goal is to foster critical thinking skills in a clinical setting through TBL practices, traditional multiple-choice items that primarily require recall of factual information will not suffice. The more difficult task of designing exam items that require analytical reasoning will be required.
• Choose appropriate reading assignments. These must be sufficient to prepare students well on the necessary content. However, if the assignment is too lengthy with irrelevant detail, students will become discouraged and/or decide that the reading assignments are not really important.
• Build meaningful RATs that focus less on factual recall and more on conceptual understanding.
• Identify clinical applications (problems) relevant to the content topic.
• Anticipate both high- and low-quality solutions to the application and prepare authentic patient outcomes for each.