critical thinking vs problem solving cpr

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Cardiopulmonary resuscitation (CPR) training strategies in the times of COVID-19: a systematic literature review comparing different training methodologies

Daniyal mansoor ali.

1 Centre of Excellence Trauma and Emergencies, Aga Khan University, Karachi, Pakistan

Butool Hisam

Natasha shaukat.

2 Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

3 Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan

Marcus Eng Hock Ong

4 Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore

5 Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore

Jonathan L. Epstein

6 Emergency Care Safety Institute, Public Safety Group, Burlington, MA USA

Eric Goralnick

7 Department of Emergency Medicine, Harvard Medical School, Boston, MA USA

Paul D. Kivela

8 Department of Emergency Medicine, University of Alabama, Birmingham, USA

Bryan McNally

9 Department of Emergency Medicine, Emory University, Atlanta, GA USA

Junaid Razzak

10 Centre of Global Emergency Care, Johns Hopkins University, Baltimore, USA

Associated Data

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Traditional, instructor led, in-person training of CPR skills has become more challenging due to COVID-19 pandemic. We compared the learning outcomes of standard in-person CPR training (ST) with alternative methods of training such as hybrid or online-only training (AT) on CPR performance, quality, and knowledge among laypersons with no previous CPR training.

We searched PubMed and Google Scholar for relevant articles from January 1995 to May 2020. Covidence was used to review articles by two independent researchers. Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess quality of the manuscripts.

Of the 978 articles screened, twenty met the final inclusion criteria. All included studies had an experimental design and moderate to strong global quality rating. The trainees in ST group performed better on calling 911, time to initiate chest compressions, hand placement and chest compression depth. Trainees in AT group performed better in assessing scene safety, calling for help, response time including initiating first rescue breathing, adequate ventilation volume, compression rates, shorter hands-off time, confidence, willingness to perform CPR, ability to follow CPR algorithm, and equivalent or better knowledge retention than standard teaching methodology.

AT methods of CPR training provide an effective alternative to the standard in-person CPR for large scale public training.

Sudden Cardiac Death (SCD) refers to an unexpected death from cardiac arrest [ 1 ]. Worldwide, SCD is the most common cause of death accounting for 17 million deaths every year or 25% of all global mortality [ 1 ]. Out-of-hospital cardiac arrest (OHCA) is a global health issue with incidence reported as 40.6 per 100,000 person-years in Europe, 47.3 in North America, 45.9 in Asia, and 51.1 in Australia [ 2 – 5 ].

Decreasing the time to initiation of CPR is crucial for improving outcomes in cases of cardiac arrest [ 6 , 7 ]. This is where the role of the bystander – any layrescuer (non-medical professional) who witnesses a medical emergency – comes into play [ 8 ]. In fact, bystander CPR before arrival of EMS is independently associated with up to a threefold increase in survival [ 9 ]. Various attempts have been made to increase the number of people trained in CPR and therefore improve bystander CPR rates, including organization of mass CPR training events. These attempts, particularly when backed by effective legislation mandating CPR training, result in significantly more laypersons trained in CPR as demonstrated by efforts led in Norway [ 10 , 11 ], Singapore [ 12 ], and Denmark [ 13 ].

CPR has traditionally been taught face to face using a mannikin as a proxy for a patient. In 2015, the American Heart Association introduced the concept of blended learning that involved the use of online videos and simulated Voice Assisted Mannikins to replace instructors. CPR self-instruction through video- and/or computer-based modules paired with hands-on practice may be an effective alternative to instructor-led courses and such technologies can be utilized more easily to facilitate safe and effective learning [ 14 , 15 ]. This has become particularly relevant now that the COVID-19 pandemic, where wide spread restrictions on in-class training and potential risk of virus spread during face-to-face sessions, has caused organizations to reconsider how trainings are allowed to be conducted [ 16 , 17 ].

The aim of this systematic review is to compare the learning outcomes between standard instructor-led classroom-based CPR training with the alternative training methods among laypersons.

Study design

A research question was identified using the PICO strategy (Population (P): laypersons not trained in CPR, Intervention (I): alternative CPR training methodologies, Comparison (C): standard CPR training methodology, Outcome (O): CPR knowledge, quality, and skill performance). After establishing the research domain, inclusion and exclusion criteria were established to identify and select relevant articles. After assessing the quality of the studies included, data was extracted, organized, summarized, and charted accordingly. The results were analyzed and reported. The primary research question guiding this review is: “What are the differences in CPR knowledge, skill performance, and quality in laypersons receiving alternative CPR training when compared to standard training methodology?”

Search strategies

We searched PubMed or Medical Literature Analysis and Retrieval System Online (Medline), and Google Scholar for relevant articles from January 1995 to May 2020. Medical subject headings (MeSH) were searched using Boolean operators “ OR/AND ”. The search terms were: (“hands-only CPR” OR “cardiopulmonary resuscitation” OR “CPR”) AND (“teaching methodologies” OR “training methods”) AND (“medical students” OR “bystanders” OR “laypersons” OR “health-care workers” OR “school children” OR “physicians” OR “nurses” OR “paramedical staff” OR “technicians”).

Inclusion and exclusion criteria

We included studies which compared two or more CPR training methodologies targeting laypersons with no previous CPR training. Studies describing a single methodology with no comparison group were excluded as were the case reports, case series, and non-English articles.

Identification and selection of studies

The studies were selected after two stages of screening. Two researchers (DMA and BH) independently, extracted data. In stage 1, we screened the article titles and abstracts and those which matched the inclusion criteria were selected for full text review. In the final stage, we reviewed full texts of the articles and determined their inclusion in this review. Any conflicts between researchers during the article screening process was resolved by the senior researcher (JR). Data was organized using a simple database on Microsoft Excel. Figure  1 presents a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram showing the process of searching and selecting the research articles.

PRISMA Flow diagram for database search of studies

Data extraction from included studies

After article selection, we extracted and recorded data in a data extraction form in an excel spreadsheet. The domains in the data extraction form were: year and country of publication, intervention tested, study design, sample size, study population, presence of prior training, outcome measures, and key findings.

Quality assessment of studies

The quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool [ 18 ]. Two researchers (DMA and BH) reviewed each study using EPHPP. The results of the quality assessment are summarized in Table  2 . No studies were excluded on the basis of quality assessment, as this quantitative evidence synthesis aimed to include all articles relevant to our review question.

Results of quality assessment of included studies using the Effective Public Health Practice Project (EPHPP) tool

Summarizing the findings

We summarized our findings into the following research domains: standard instructor-led classroom-based CPR training, non-standard face to face CPR training, hybrid CPR training, and online CPR training.

Definition of terms

The definitions of commonly used terminologies in this article are detailed in Table  1 .

Definitions of training methodologies employed to train participants

Studies’ characteristics

A total of 978 articles were retrieved from PubMed and Google Scholar. Four hundred and twenty duplicate articles were excluded. Out of the remaining 558 articles, 537 articles were either not comparing different teaching methodologies, were case reports or case series, or were written in a language other than English, and no English translation was available and therefore were excluded. Among the remaining 21 articles, 1 articles did not have available full texts. Twenty full-text articles were reviewed and included in this study. Out of these twenty articles, ten had a moderate global rating, while ten had a strong global rating based on Effective Public Health Practice Project (EPHPP) Quality Assessment Tool (Table ​ (Table2 2 ) .

Research domains

Among the twenty studies included in this review, eleven compared online CPR training with the standard training, six studies compared non-standard face to face CPR training with the standard training, and three studies compared the standard CPR training with hybrid training methodologies. Among the included studies, fourteen studies were randomized controlled trials, two had an interventional study design, two were cluster randomized controlled trials, and two studies had a case-control study design. The study population comprised of school children, laypersons, medical students, and nursing students. The details of individual studies are summarized in Table  3 .

Summarized findings of included CPR training methodology research articles

Characteristics of different CPR training methodologies

The CPR training methodologies were divided into two broad categories including standard instructor-led classroom-based CPR training and alternative CPR training. The alternative CPR teaching methodology was further classified as non-standard face to face CPR training, hybrid CPR training, and online CPR training. The comparison of content, duration, mode of delivery, standard of content, and measured outcomes between different training methodologies are detailed in Fig.  2 and Table  4 . Significant difference was noted between the duration of the teaching methods. The studies reported a longer duration of standard CPR training (20 min to 6 h) when compared to non-standard face to face (45 min to 3 h), hybrid (4 min to 1.5 h), and online CPR training methods (1 min to 1.5 h). Moreover, variability was also noted in the standard of content taught between different training methods and within each training method as well. Although “Einlebenretten” (“save one life”) educational framework [ 20 ] and European Resuscitation Council (ERC) 2010 guidelines [ 21 , 34 ] were the two contents similar between standard and non-standard face to face CPR training, the standard training group also used contents from ERC 2005 guidelines [ 34 ], American Heart Association (AHA) Heartsaver Citizen CPR course [ 27 , 28 , 31 , 38 ], AHA 2010 guidelines [ 25 ], National Safety Council Adult CPR training program [ 29 ], HeartCode BLS course [ 33 ], Dutch Resuscitation Council course [ 37 ], and Danish Red Cross course [ 36 ]. Although the computer-based HeartCode BLS course [ 33 ] and National Center for Early Defibrillation course [ 27 ] were similar between hybrid and online CPR training methodology, the standard of content was also adopted from other sources in these instructional methods. The hybrid teaching methodology had contents from Japanese Red Cross Society [ 25 ] and AHA 2010 guidelines [ 25 ], while online training method adopted content from National Safety Council Adult CPR training program [ 29 ] and TrygFonden foundation [ 36 ]. The content (CPR, ventilation, and breathing) and outcomes measured (CPR performance, quality, knowledge, attitude, self-confidence, and willingness to perform CPR) were similar between the training methodologies.

Comparison of the mode of delivery of different CPR training methodologies

A comparison between the characteristics of different CPR training methodologies

a The content, skills taught, and outcomes measured were similar between standard and alternative CPR trainings

Comparison of outcomes between different training methodologies

The studies assessed three main outcomes after CPR training which included CPR skill performance, CPR quality, and CPR knowledge. The difference in each outcome was compared between the standard instructor-led classroom-based CPR training and alternative (non-standard face to face, hybrid, and online) CPR training methodologies. The detailed description of these differences is illustrated in Table  5 .

Comparison between standard CPR training versus non-standard face to face, hybrid, and online CPR teaching methodologies

Standard versus non-standard face to face CPR training

The non-standard face to face CPR training included simplified (hands-only) CPR, peer-based CPR training, Jigsaw model CPR training, flowchart-supplemented CPR training, and a multi-staged approach to CPR training. Out of the twenty studies, five randomized controlled trials and one prospective case-control study fell under this domain. Two studies compared CPR performance and one study compared CPR quality. More than one outcome was measured by three studies in which one study compared CPR performance and quality, one study compared CPR quality and knowledge, and one study compared CPR performance and knowledge between the instructional methods.

In CPR performance, no statistically significant difference was noted between the peer-led (41.0%, N  = 466), jigsaw model group, and the standard instructor-led group (40.3%, N  = 471) [ 20 , 21 ]. Moreover, willingness to perform CPR was also similar between the peer-led (64.7%) and standard instructor-led group (55.2%, p  = 0.202) [ 24 ]. However, flowchart supplemented group (7 ± 2) was more confident in performing CPR than the instructor-led group (7 ± 2 vs. 5 ± 2, p  = 0.0009) [ 22 ].

In CPR quality, the simplified CPR group performed better on CPR algorithm ( p  < 0.01), had higher number and adequate chest compressions ( p <  0.01), and shorter hands-off time ( p  < 0.001) when compared with the standard training group [ 19 ]. Although the flowchart-supplemented group showed shorter hands-off time (147 ± 30s vs. 169 ± 55 s, p  = 0.024), the time to chest compression was longer (60 ± 24 s vs. 23 ± 18 s, p  < 0.0001) as compared to the instructor-led group [ 22 ]. The staged CPR group had better “shout for help” ( p =  0.02 to p <  0.01) and more adequate compressions ( p  = 0.05 to p  = 0.04) when compared to standard training [ 23 ].

Although better CPR knowledge retention was seen in the multi-staged approach CPR training when compared to the standard group [ 23 ], no difference in retention was seen between peer-assisted (61.76 ± 17.80) and professional instructor groups (60.78 ± 39.77, p  = 0.848) [ 24 ].

Standard versus hybrid CPR training

The hybrid CPR training included a kiosk group, an interactive computer training group plus an instructor-led training group, and a video learning group followed by hands-on CPR training. Three studies fell under this domain. One study compared CPR quality, while one study compared CPR performance and quality and one study compared CPR performance and knowledge between the instructional methods.

In CPR performance, although the kiosk group outperformed the instructor-led group on hand placement (+ 4.9), they scored lower on compression depth (− 5.6) [ 26 ]. Moreover, for all outcome measures, mean scores were higher in the interactive-computer training group plus instructor-led practice group when compared to the instructor-led group [ 27 ].

In terms of CPR quality, no significant difference was noted in time to first chest compression (33 s vs. 31 s, U = 1171, p  = 0.73) and number of total chest compressions (101.5 vs. 104, U = 1083, p  = 0.75) between the instructor-led group and flipped learning group [ 25 ]. Furthermore, the kiosk group and the instructor-led group had similar total scores after training [ 26 ].

Lastly, use of a computer program resulted in higher knowledge retention (80%) as compared to the instructor-led group (75%) two days after training [ 27 ].

Standard versus online CPR training

The online CPR training methodology included video self-instruction, interactive computerized module with video, mobile phone video clips, a computer-based course with Voice Advisory Mannequin (VAM), and virtual reality CPR training. Eleven studies fell under this domain. Five studies compared CPR performance, two studies compared CPR quality, and one study compared CPR knowledge between the instructional methods. More than one outcome was compared by three studies in which, two studies compared CPR performance and knowledge while one study compared CPR quality and knowledge between instructional methods.

In CPR performance, video self-instruction group had superior overall performance scores with only 19% non-competent trainees as compared to 43% non-competent trainees in the instructor-led group [ 28 ]. Moreover, another study also reported similar findings in which, 40% of the video self-instruction group were competent when compared to only 16% competency in the instructor-led group [ 31 ]. The group which received video-based training also had more accurate airway opening ( p  < 0.001), breathing check ( p <  0.001), first rescue breathing ( p  = 0.004), hand positioning ( p =  0.004), and higher confidence and willingness to perform CPR at 3 months when compared to the instructor-led group [ 32 ]. Furthermore, another study showed that the video-based group performed better scene safety (95.2% vs. 76.1%, p <  0.05), call for help (97.6% vs. 76.1%, p <  0.05), and had shorter response to compression time (35 ± 9 s vs. 54 ± 14 s, p <  0.001) as compared to the standard instructor-based group [ 35 ]. A study in United States showed higher overall performance (60% vs. 42%), appropriate responsiveness assessment (90% vs. 72%), adequate ventilation volume (61% vs. 40%), and correct hand placement (80% vs. 68%) in the video group as compared to instructor-led training [ 38 ]. However, one study reported lower compression depth scores (− 9.9) [ 26 ] while another study had lower scores in calling 911 (71% vs. 82%) [ 38 ] in the video group as compared to the instructor-led group. Voice Advisory Mannequin (VAM) feedback was another methodology adopted for online training in one of the studies and those participants trained using this method had more correct hand position (73% vs. 37%, p  = 0.014) and better compression rate (124 vs 135, p  = 0.089) than the instructor-led group [ 34 ]. A study in Netherlands compared standard instructor-led training with Virtual Reality (VR) CPR teaching methodology. Although the VR group had better chest compression rates (114/min vs. 109/min) and proportion of compressions with full release (98% vs. 88%, p  = 0.002), the instructor-led group had higher overall scores (12 vs. 10, p <  0.001), better chest compression depth (57 mm vs. 49 mm), adequate chest compression fraction (67% vs. 61%, p <  0.001), higher proportion of participants fulfilling depth (75% vs. 51%, p <  0.001), and rate requirements (63% vs. 50%, p =  0.01) [ 37 ].

In CPR quality, the instructor-led training group had better quality of CPR compressions (location, rate, depth, and release) as compared to the computer-based training group [ 29 ]. Moreover, the chest compression depth was also better in the instructor-led group when compared to the group trained using brief videos [ 30 ]. Although the VAM feedback group showed similar compression rates, they had more compressions with adequate depth and hand placement, and had more ventilations with adequate volume than the instructor-led group [ 33 ].

Although some studies showed no significant difference in the CPR-related knowledge scores between the instructional methods [ 29 , 31 ], other studies highlighted significant differences. A study in Denmark highlighted that after 3 months, although the DVD-based group had better average inflation volume (844 ml vs. 524 ml, p  = 0.006) and chest compression depth (45 mm vs. 39 mm, p  = 0.005), the instructor-led group was superior in assessment of breathing (91% vs. 72%) [ 36 ]. At 2 months post-training, another study illustrated that although the video group had higher scores in overall performance (44% vs. 30%), assessing responsiveness (77% vs. 60%), ventilation volume (41% vs. 36%), and correct hand placement (64% vs. 59%), the instructor-led group scored higher in calling 911 (74% vs. 53%) [ 38 ].

This is a comprehensive systematic review that compares CPR performance, quality, and knowledge between different teaching methodologies including standard instructor-led, non-standard face to face, hybrid, and online CPR trainings. This review includes 20 studies and 5961 participants and illustrates significant differences in both the characteristics and the outcomes between the instructional methodologies.

All the included articles had an experimental study design and had a moderate or strong global rating based on our quality assessment tool. Our results suggested that the standard instructor-led CPR training had a longer duration (20 min to 6 h) as compared to alternative CPR trainings (1 min to 3 h). Moreover, the standard of content also varied significantly between the instructional methods. Interestingly, our review also showed variability in the content within the standard instructor-led CPR training methodology in which the teaching material was adopted from multiple sources including “Einlebenretten” (“save one life”) educational framework [ 20 ], European Resuscitation Council (ERC) 2005 and 2010 guidelines [ 21 , 34 ], American Heart Association (AHA) Heartsaver Citizen CPR course [ 27 , 28 , 31 , 38 ], AHA 2010 guidelines [ 25 ], National Safety Council Adult CPR training program [ 29 ], HeartCode BLS course [ 33 ], Dutch Resuscitation Council course [ 37 ], and Danish Red Cross course [ 36 ].

The instructional methods were compared on the basis of CPR performance, quality, and knowledge which were the three primary outcomes of the studies. In CPR performance, when compared to the standard instructor-led CPR training, the non-standard face to face CPR trained group were although more confident in performing CPR [ 22 ], similar performance was seen in the peer-led [ 20 , 24 ] and the jigsaw model groups [ 21 ]. Although the hybrid CPR training methodology led to higher overall performance scores including better hand placement, the instructor-led methodology outperformed on the chest compression depth scores [ 26 , 27 ]. When compared to standard CPR training, online instructional methodology not only resulted in a higher percentage of competent trainees [ 28 , 31 ], but it also resulted in more performance of scene safety, assessing responsiveness, calling for help, accurate airway opening, breathing check, first rescue breathing, adequate ventilation volume, shorter response to compression time, hand positioning, better compression rates, and higher confidence and willingness to perform CPR [ 32 , 34 , 35 , 38 ]. However, instructor-led trainings had higher compression depth scores and higher scores in calling 911 when compared to online CPR training [ 26 , 38 ]. With regards to CPR quality, the non-standard face to face CPR training methodology outperformed in the CPR algorithm, had higher “shout for help” rates, had better rate and quality of compressions, and had shorter hands-off time when compared with the standard training [ 19 , 22 , 23 ]. However, instructor-led groups took less time to start chest compressions [ 22 ]. The hybrid training groups and the instructor-led groups showed no statistically significant difference in the total obtained scores regarding CPR quality [ 25 , 26 ]. When compared to standard CPR training, online instructional methods showed better hand position, better chest compression rates, shorter hands-off time, and more frequency of calling for help [ 29 , 30 , 39 ]. However, correct hand placement and adequate depth of chest compression was better in the instructor-led group [ 26 , 30 ]. Lastly, when compared to standard CPR training, alternative instructional methods either had similar [ 24 , 29 , 31 ] or better knowledge retention [ 23 , 27 , 36 , 38 ].

The results of our study can be explained by certain determining factors. Due to access to better technology and readily available training material nowadays, numerous alternative training methodologies are being tested and compared with the standard training to assess their efficacy. This constant testing and repetition of training results in constant improvement in these alternate training methodologies resulting in better outcomes among participants. However, the quality of CPR, particularly the adequacy of chest compressions, is still better among instructor-led group as technology to effectively monitor chest compression depth remotely is not widely available currently.

Our systematic review has certain implications. First, since the studies included in this review had a moderate or strong global rating, comparisons made between standard and alternative CPR instructional methods can be used for future trainings. Secondly, standard CPR training is resource intensive driven by availability of instructors and therefore has limited scalability. This is especially true in low resource settings where creating an organizational structure and large cadre of instructors to deliver courses may take longer times and require more resources. Our study highlights the feasibility of utilizing instructional technologies and also recognizes the shortcomings of using technology-only solutions. Thirdly, “standard” CPR training had significant variability in both the duration and the standard of content among different studies. It is important to create standards so that future methodologies can be measured and further innovative solutions can be developed. Given the risk of infection spread due to pandemics such as COVID-19, we believe that alternative to face-to-face teaching methodologies have significant promise and can be implemented safely and effectively to increase the rate and effectiveness of bystander CPR and in turn save more lives by strengthening the first component of the chain of survival. Future alternatives to face-to-face instruction including possibly remote monitoring of students may improve correct hand placement and adequate depth of chest compression.

Limitations of the study

This article has some limitations. Most of the studies included in this review were conducted in developed countries and therefore, effective adaptability of alternate training methods in the local setting cannot be ascertained. Moreover, no study looked at CPR performance during an actual cardiac arrest event and none of the conducted studies measured the impact of different teaching methodologies on a population level. Furthermore, potential bias towards a particular CPR teaching methodology among trainers cannot be ruled out. Lastly, since no uniformity existed in the duration and content of standard CPR training, the outcomes cannot be compared with alternate training methods concretely enough.

This review outlines that alternative CPR training methodologies are as effective or even possibly better when compared to standard in-person classroom CPR training in CPR performance and knowledge acquisition. However, effective CPR quality still largely depends on some in-person training. Due to promising results seen in alternate training methodologies and non-uniformity seen in standard instructional techniques, these instructional methods can be adopted as an alternative, particularly during this time of the COVID-19 pandemic. Moreover, future research should aim to develop uniformity in standard CPR training methodology, which will make comparison with alternative CPR instructional techniques more plausible.

Acknowledgements

We thank Covidence systematic review software for its assistance in the research article screening process.

Abbreviations

Authors’ contributions.

DMA and BH contributed in the study design, data collection, data analysis, data interpretation, and writing of the manuscript. NS, NB, MO, JLE, EG, PK, and BM contributed in data analysis, data interpretation, and writing of the manuscript. JR contributed in the study design, data analysis, data interpretation, and writing of the manuscript and provided overall supervision. All authors read and approved the final manuscript.

Availability of data and materials

Declarations.

Not applicable.

The authors declare that they have no competing interest.

Publisher’s Note

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Contributor Information

Daniyal Mansoor Ali, Email: [email protected] .

Butool Hisam, Email: [email protected] .

Natasha Shaukat, Email: [email protected] .

Noor Baig, Email: [email protected] .

Jonathan L. Epstein, Email: [email protected] .

Eric Goralnick, Email: UDE.DRAVRAH.HWB@KCINLAROGE .

Paul D. Kivela, Email: ude.cmbau@alevikp .

Bryan McNally, Email: ude.yrome@llancmb .

Junaid Razzak, Email: [email protected] .

Crucial Skills®

A blog by crucial learning, crucial conversations for accountability.

Dear Crucial Skills,

Could you please help me understand the practical use of the crucial accountability skill “CPR” for front-line supervisors on a manufacturing floor? It seems somewhat abstract to them when dealing with specific violations and our progressive discipline procedure.

Signed, Real World

Dear Real World,

I’d love to help.

CPR is a skill we cover in Crucial Accountability that helps you hold the right conversation. The reason most of us have the same conversations over and over with others is because we talk about the wrong thing!

For example, on a manufacturing floor, let’s say you have an agreement with someone upstream in the process to get you fifty parts per hour. Four or five times a day they fail to deliver and you find yourself having to nag, threaten, or bribe them—or you sit and twiddle your thumbs and slow down the whole production process.

So what’s the problem here? The mistake you’re making is that you’re holding the wrong conversation. CPR identifies three levels of conversation we occasionally need to have:

1. C stands for Content. This is the immediate pain or problem you’re dealing with. In this situation, the content issue is the missed commitment for fifty parts this hour.

We tend to stay at the content level long after the problem is no longer about content. One way to tell if you’re having the wrong conversation is if your level of frustration or emotion is out of proportion to the issue. So if you find yourself shouting at the party in question, “Where are my %^@* parts?!”—this could be a sign you’re holding the wrong conversation. Your real issue is not the fifty parts you’re owed. Your real issue is a level deeper.

2. P stands for Pattern. This is the conversation you need to hold if your real concern is the pattern of you not regularly receiving promised parts.

When people have pattern concerns, they usually fail to raise the pattern issue but talk instead about the content—the most recent instance or concern.

For example, you say to your teammate, “This is the third time today you didn’t get me the parts—where are they?”

And he responds, “We’ve had three power surges in the past hour that have caused us to throw away three full lots. There’s nothing I can do about sunspots that are messing with our transformers!”

Can you see what just happened? Your teammate dragged you into dealing with the special circumstances that resulted in the most recent failure. You could have avoided this by raising your concern simply as a pattern issue rather than one recent instance of problems.

If you need to hold a pattern conversation, do not wait for a specific instance of the issue to arise. Proactively schedule a time to talk only about the pattern.

Now, let’s say you’ve held a pattern conversation and reached some new agreements. Then the other person fails to perform again. You now need to raise the third level.

3. R stands for Relationship. When after repeated failed commitments you conclude the real problem is not the pattern of missed commitments, but something deeper, you move to relationship.

For example, if you’ve decided you no longer trust the other person to keep agreements, that’s a relationship issue. If you decide the other person isn’t competent to keep the commitments, that also calls for renegotiating the relationship.

A crucial confrontation at the relationship level may call for escalation to a superior. If you want to be loyal and direct, let the other person know before it reaches the relationship level that this is the next step. This must never be threatening but must be said in respectful, sincere tone that communicates your intentions to keep your own commitments.

CPR is at the heart of progressive discipline. Good managers hold content conversations immediately when single problems emerge. They also document problems that require progressive discipline.

When the problem becomes a pattern, they document it as a pattern—and detail the data that makes the pattern evident. Furthermore, they communicate clearly to the employee that if the pattern continues, the employee is signaling that he or she is unwilling or unable to keep the agreement—and this necessitates a more comprehensive solution such as reduction of responsibilities, docked pay, dismissal, etc. Effective supervisors never communicate these future consequences as threats. They are respectful, direct and private. They also help the other person understand that these steps will only be taken if his or her actions put the interests and needs of others in jeopardy.

I hope these brief illustrations help. You’re asking a profoundly important management question and deserve to have all the help you need!

Best wishes, Joseph

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Joseph Grenny

Author and cofounder.

“If I haven’t challenged you, I haven’t helped you.”

Joseph Grenny is a New York Times bestselling author, keynote speaker, and leading social scientist for business performance. His work has been translated into twenty-eight languages, is available in thirty-six countries, and has generated results for more than half of the Forbes Global 2000. Invite Joseph to speak at your next event.

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10 thoughts on “Using CPR”

Hi Real Word and Joseph! Thank you for your discussion. It’s always comforting to see that there are so many similarities in issues along such a large spectrum of working environments. I want to explore the end of Joseph’s response where documentation of a pattern was noted and prompt direct explanations of how learning contracts or discipline contracts fall in place and work out to in the end or, hopefully, growth and evolution of an employee. As a health practitioner, I know first hand how people would rather hear the truth immediately than sit and wonder if they are serious trouble or not. Someone would rather hear the news that they have terminal cancer than to have the information withheld to save a face to face awkwardness for the messenger. Time allows the beginning of moving past the initial denial and anger phases of grief toward acceptance and moving on toward healthy self growth. Similarly, but not as high stakes perhaps, is having a serious and prompt conversation with a nurse about why mistakes are happening. You will never know what someone is going through and what may inevitably be bleeding into their work from home, or worse what is happening within the work environment in the way of bullying, gossip or abuse until you open up a conversation. Opening up a conversation about patterns could lead to the initiation of a person recognizing a pattern themselves. Maybe they don’t know they are doing it. So many managers I’ve had live in silence until one day, in your review, you are hit in the face with a load of criticisms you wish you knew earlier.

I think crucial conversation is a skill and art for life. It is not theory and or some academic exercise but a necessary tool for all human beings. It has a potential to change the world.

I think this is easier said than done, what happens when this is a personal relationship there is not superior to escalate to?

I think that in some conversations it is very difficult to find the right words to achieve the result we would like to achieve

Reading some of the previous comments to the Joseph’s text, I think that at the beginning we should think “that it is really difficult sometimes to find the right words”, but to find the right words, first we have to exercise how communication skills. Once we do that it is really easy to talk to anyone without threatening or offending the person/s.

I think I’ve been stuck on content all my life..

This is so enlightening and am so glad to have been a part of the crucial conversation training. I have actually been having these type of conversations in the past but not necessarily following the CPR process at all times. Now I know better, and will be more intentional about having crucial conversations. Thanks

Thank you for the examples here! It is easy to get stuck on content sometimes. I feel like the other levels, especially relationship are harder partly do to more vulnerability.

Hello Joseph, I am deeply inspired by your work. Every company should bring you as a note speaker to start the conversation about crucial conversations and bring awareness. I used to work with HiCue Speakers a speaking agency in Colombia South America https://hicuespeakers.com/en

I find CPR to be an incredible tool to understand where the conversation needs to begin. I am confused however because in this example “This is the third time today you didn’t get me the parts—where are they?” It sounds to me like a pattern question as it is talking about the “third time” the issue happens. Can you share an example of a pattern question and more examples of relationship questions. But I assume these will be provided as I take the course. Thank you for your incredible work and I will read your books and your material as I believe communication skills are the most critical to grow and improve in every aspect of my life. Thank you.

I believe that CPR is an important tool for everyone in a leadership to have. This is something positive with positive results. It raises the conversation to another level.

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Critical Thinking and Decision-Making  - What is Critical Thinking?

Critical thinking and decision-making  -, what is critical thinking, critical thinking and decision-making what is critical thinking.

Critical Thinking and Decision-Making: What is Critical Thinking?

Lesson 1: what is critical thinking, what is critical thinking.

Critical thinking is a term that gets thrown around a lot. You've probably heard it used often throughout the years whether it was in school, at work, or in everyday conversation. But when you stop to think about it, what exactly is critical thinking and how do you do it ?

Watch the video below to learn more about critical thinking.

Simply put, critical thinking is the act of deliberately analyzing information so that you can make better judgements and decisions . It involves using things like logic, reasoning, and creativity, to draw conclusions and generally understand things better.

This may sound like a pretty broad definition, and that's because critical thinking is a broad skill that can be applied to so many different situations. You can use it to prepare for a job interview, manage your time better, make decisions about purchasing things, and so much more.

The process

As humans, we are constantly thinking . It's something we can't turn off. But not all of it is critical thinking. No one thinks critically 100% of the time... that would be pretty exhausting! Instead, it's an intentional process , something that we consciously use when we're presented with difficult problems or important decisions.

Improving your critical thinking

In order to become a better critical thinker, it's important to ask questions when you're presented with a problem or decision, before jumping to any conclusions. You can start with simple ones like What do I currently know? and How do I know this? These can help to give you a better idea of what you're working with and, in some cases, simplify more complex issues.  

Real-world applications

Let's take a look at how we can use critical thinking to evaluate online information . Say a friend of yours posts a news article on social media and you're drawn to its headline. If you were to use your everyday automatic thinking, you might accept it as fact and move on. But if you were thinking critically, you would first analyze the available information and ask some questions :

• What's the source of this article?
• Is the headline potentially misleading?
• What are my friend's general beliefs?
• Do their beliefs inform why they might have shared this?

After analyzing all of this information, you can draw a conclusion about whether or not you think the article is trustworthy.

Critical thinking has a wide range of real-world applications . It can help you to make better decisions, become more hireable, and generally better understand the world around you.

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Critical Thinking vs. Problem-Solving: What’s the Difference?

The risk of a fire occurring due to dirty refrigerator coils is a possibility, although it is not a common occurrence. Refrigerator coils are located on the back or bottom of the appliance and act as a heat exchange system, dissipating heat from the refrigerator. When these coils become clogged with dust, dirt and debris, the efficiency of the cooling system is reduced and the appliance has to work harder, creating more heat in the process. This could potentially lead to an increase in the temperature of the coils, resulting in a potential fire hazard. To reduce the risk of a fire, it is important to ensure that the refrigerator coils are regularly cleaned and maintained. Additionally, it is recommended to keep combustible items away from the coils, as

The Role of Critical Thinking in Problem-Solving

What is problem-solving?

You can use problem-solving techniques to find answers to problems. When you want to identify the root of problems in your personal and professional life and put a plan of action in place, you can use problem-solving techniques. Since you might use problem-solving when unforeseen events occur, it frequently necessitates the capacity to recognize the variables that shape these issues and the capacity to improvise efficient solutions. You might be able to solve problems more quickly, visualize issues more clearly, and carry out research more successfully if you develop this skill.

What is critical thinking?

It’s a habit to critically evaluate your own thought process and look for ways to make it better. Analyzing your thoughts will help you think more quickly, organize your thoughts more intuitively, and become more conscious of your biases. When you think critically, you can examine arguments, consider the evidence that backs them up, and decide logically whether the arguments are valid. You can commit to the process of lifelong learning, consider the perspectives of peers more frequently, and be more honest about your errors if you develop critical thinking as a long-term habit.

Critical thinking vs. problem-solving

You can overcome obstacles by using both critical thinking and problem-solving techniques, but each has a different goal and set of techniques. Here are some differences between the two skills:

Critical thinking

In contrast to problem-solving, which is a set of tactics focused on finding solutions, this is a way of thinking. Learning new skills, such as problem-solving, is made simpler because critical thinking strengthens your reasoning. Enhancing your critical thinking skills can also help you gain a better understanding of who you are, including your values, learning preferences, and strongest skills. Critical thinking comprises five steps, which are :

Problem-solving

Unlike critical thinking, which you practice continuously to hone your thinking skills, problem-solving is a set of techniques you use to find solutions that actually work. It can be used to deal with problems as they arise or to plan ahead and create solutions before a problem even arises. Enhancing your problem-solving abilities can help you think more creatively and analytically, as well as make you a more valuable team member. Four steps make up problem-solving, and they are listed below:

Is problem-solving another name for critical thinking?

Examples of Critical Thinking A triage nurse evaluates the current cases and determines the sequence of care for the patients. A plumber assesses the materials that would be most appropriate for a specific job. An attorney examines the evidence and develops a plan to win the case or determines whether to reach a settlement outside of court.

What is the difference between critical thinking and problem-solving in nursing?

Critical thinking can also be called ‘problem solving. No additional effort is required to think critically. To use critical thinking abilities, you need to be informed about more than just the facts.

What are the five critical thinking skills?

Critical thinking abilities have been associated with better patient outcomes, better patient care quality, and better safety outcomes. Critical thinking entails asking insightful questions and evaluating solutions, whereas problem-solving typically focuses on the identification and solution of a problem.

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American Red Cross (ARC) Basic Life Support (BLS)

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The American Red Cross Basic Life Support - BLS course is designed toward those who work in the healthcare field, such as nurses, dentist, pharmacists and EMTs. Although, anyone may take this course. Topics covered will be geared toward those in a healthcare environment and includes situations for adults, children and infants which include the following:

• Critical Thinking and Problem Solving
• Communication and Teamwork
• Assess, Recognize and Care
• Cardiac Chain of Survival for adults, children and infants
• High Quality CPR for adults, children and infants
• The use of AEDs for adults, children and infants
• Single and Multiple Provider CPR for adults, children and infants
• High Performance Resuscitation Teams
• How to handle and obstructed airway for adults, children and infants
• Opioid Care

If you do not need a class geared toward those in the healthcare field, but still need a class to cover adults, children and infants, please see these other course types: Adult & Pediatric CPR / AED or Adult & Pediatric First Aid / CPR / AED

You will receive an American Red Cross certification valid for two years. You will receive an email from the Red Cross with an attached PDF with your certificate. I will also print and laminate your physical card.

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American Heart Association (AHA) - BLS Provider American Heart Association (AHA) - BLS Provider Skills Check Only

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American Heart Association (AHA) - Heartsaver First Aid / CPR / AED American Heart Association (AHA) - Heartsaver First Aid / CPR / AED + Pediatric

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Critical thinking vs. problem-solving skills: distinct differences.

As we move through the rapidly changing terrain of professional development, it is necessary to grasp the subtle differences between critical thinking and problem-solving competencies. Critical thinking refers to the evaluation and analysis of information for thorough comprehension, whereas problem-solving targets the generation of solutions to challenging issues. It’s essential to assess critical thinking vs problem solving skills and identify the distinctions to improve your thinking abilities.

Why are critical thinking and problem-solving crucial skills?

Problem-solving, decision-making, and innovation are crucial competencies that inform critical thinking in dynamic circumstances. According to a recent report from the World Economic Forum, technology is likely to affect more than one-third of core job skills by 2025 . However, such an exercise would require a competent labor force capable of thinking critically about the information provided by the data analysis and spotting something new. Another McKinsey report highlights problem-solving, which entails the ability to navigate through uncertainties and come up with innovative solutions. These skills include flexibility, competitiveness, and resilience, which are vital for success in today’s dynamic world environment.

• Risk Mitigation in Decision-Making: A study published in the Journal for Cognitive Enhancement shows that people who think critically picture better and anticipate the risks. Then they successfully take measures and face fewer surprises.
• Cognitive Flexibility and Innovation: A study conducted by the American Psychological Association noted, however, that critical thinking skills and cognitive fluidity are often neglected. It strengthens cognitive capacities, allowing them to apply flexible cognitive strategies focused on an innovative approach. This is necessary to ensure sustainable organizational change.
• Bias Recognition and Elimination: A study by Stanford University identified and weeded out cognitive biases with regard to critical thinking. A good critical thinker is aware of their personal mental biases, so they look at a problem without bias and make decisions based on facts and not opinions.
• Interdisciplinary Problem-Solving: Interdisciplinarity was one of the elements presented in a report made by the National Academies of Sciences, Engineering, and Medicine concerning problem-solving. Critical thinking includes different insights joined up to form a holistic approach to problem-solving, moving beyond departmental thinking and thus providing innovative and wide solutions.
• Ethical Decision-Making Precision: A study in the Journal of Business Ethics stated that individuals possessing critical skills were more ethically conscious by considering other viewpoints and potential impacts.

How can critical thinking boost your career?

A study published in the “Journal of Applied Psychology”, notes that critical thinking can transform career paths. Professionals can unlock a world of career progression opportunities by diving into the previously ignored details involved in this skill. 1. Problem-Solving Precision: Undoubtedly, critical thinking goes unnoticed by many but achieves such precision in problem-solving by allowing professionals to analyze complex issues systematically. This again, based on McKinsey & Company findings, results in superior solutions and positions people as very useful entities to deal with sensitive problems. 2. Strategic Innovation Contribution: Critical thinking and strategic innovation have a link that is often unexplored. The same article in the “ Harvard Business Review ” discloses that critical thinkers also tend to make more valuable contributions to innovative undertakings while stimulating creativity within firms, hence positioning them as proponents of forward-looking agendas. 3. Effective Communication Impact: It also has a significant influence on communication. According to the “Journal of Business and Technical Communication," critical thinkers can clearly and convincingly articulate complicated notions, thereby boosting their ability to positively affect stakeholders and foster cooperation at workplaces.

4. Risk Management Proficiency: The role of critical thinking in the management of risks often escapes notice. Specialists with critical thinking ability can foresee, estimate, and decrease risks (Journal of Risk Research). This capability not only protects organizations but also presents individuals as shrewd risk-takers necessary for their professional development in fast-changing industries.

5. Leadership Adaptability: The relationship between critical thinking and leadership adaptability is largely unexplored. According to a report by the National Bureau of Economic Research , critical thinkers are more adaptable leaders who can address and guide their organizations through fast-changing business environments. This adaptability goes a long way in making the leaders effective, enhancing their career progression opportunities and chances of securing strategic decision-making positions.

What are the key differences between critical thinking and problem-solving?

The terms critical thinking and problem-solving are commonly used in the same sense, but they refer to two different cognitive functions. This helps individuals develop the right skills in a nuanced way. Here are the key differences between critical thinking and problem-solving:

1. Foundational Processes: Critical thinking is a discipline of cognitive reasoning that entails logical analysis, interpretation, and extrapolation. This is a higher cognitive ability, which can contribute to the efficiency of problem-solving. On the other hand, problem-solving is an individual’s application of critical thinking to specifically resolve a certain issue or problem, thus making it more vivid and useful in the range of cognitive action.

2. Scope of Application: Critical thinking is broader than field-specific problems and includes the evaluation of information, ideas, and arguments. Its uses are wide and cut across different referents, starting from routine decisions to intricate professional problems. Problem-solving, however, is more based on tasks and deals with clear goals with no demarcation of limits or particular circumstances.

3. Decision-Making vs. Solution Implementation: The main role of critical thinking in decision-making processes helps evaluate information. However, it stresses the need to sense meaning beneath human choices. On the contrary, problem-solving concentrates on rectifying problems by using consequences designed from critical thinking for recognition in case of posed difficulties or realization of wanted results.

4. Cognitive Processes and Creativity: It encompasses cognitive skills like analysis, synthesis, and evaluation with the objective of understanding and interpreting information rationally. It stresses disciplined thinking and intellectual rigor. Problem-solving, in contrast, combines creative processes with critical thinking and enables people to develop new solutions that are unconventional but appropriate for unique problems.

5. Continuous vs. Targeted Development: As a skill, each incident improves critical thinking that offers new and diverse data. It involves the development of intellectual abilities primarily geared toward lifelong learning. On the other hand, environments help develop skills wherein critical thinking principles help generate application-oriented responses.

Critical thinking serves as the basis for an orderly analysis and well-reasoned decision-making in different domains; problems, on the other hand, direct these cognitive faculties to specific practical applications. The relevance of upskilling in both of these contexts is revealed by the changing nature of today’s work environment, which values adaptability, creativity, and effective decision-making. People at the forefront of innovation and success in any industry require refined critical thinking and problem-solving skills, which is why continuous upskilling is strategically crucial for sustainable career growth and attractiveness.

About the Author

Sohini majumder.

Sohini Majumder is an avid writer, a researcher and a part-time traveller. With an insatiable curiosity, Sohini researches on multiple topics that ignite conversations. She is also an advocate of sustainability, and through her writings, she intends to encourage eco-conscious living. 

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Critical thinking vs problem solving: what’s the difference.

In our blog “Importance of  Problem Solving Skills in Leadership ,” we highlighted problem solving skills as a distinct skill set. We outlined a 7-step approach in how the best leaders solve problems.

Table of Contents

Critical thinking vs. problem solving

But are critical thinking and problem solving the same? Also, if there are differences, what are they? Although many educators and business leaders lump critical thinking and problem solving together, there are differences:

Problem solving  uses many of the same skills required for critical thinking; e.g., observation, analysis, evaluation, interpretation, and reflection.  Critical thinking  is an important ingredient of problem solving.

Critical thinking vs. problem solving: Not all problems require critical thinking skills

Not every problem-solving skill is a critical thinking skill. That is because not every problem requires thinking. A problem like opening a stubborn pickle jar could simply require brute strength. On the other hand, it becomes a thinking skill when you remember to tap the edge of the pickle jar lid to loosen the seal.

Also, some problem-solving skills are the exact opposite of critical thinking. When you follow directions or use muscle memory or rote (memorization) thinking, there is no critical thinking required. Likewise, skills of persuasion or public oratory are thinking skills, but aren’t necessarily critical thinking skills.

Critical thinking vs. problem solving: The role of emotional intelligence

In our blog “ What is the role of communication in critical thinking ?” we highlighted one author’s argument that critical thinking and problem solving is not always a purely rational process. While critical thinkers are in great demand in the hiring marketplace, employees who are emotionally intelligent bring even greater value to an organization.

Writing for  Business News Daily ,  editor Chad Brooks describes emotional intelligence as “the ability to understand your emotions and recognize the emotions and motivations of those around you.”

So, when looking for star performers, research shows “that emotional intelligence counts for twice as much as IQ and technical skills combined in determining who will be a star performer.”

Further, in today’s collaborative workplace environment, “hiring employees who can understand and control their emotions – while also identifying what makes those around them tick—is of the utmost importance.”

Finally, one expert notes that dealing with emotions is an important part of critical thinking. Emotions can be at the root of a problem. They are frequently symptomatic of problems below the surface. Problem solving when dealing with emotions requires openness to authentic emotional expressions. It requires the understanding that when someone is in pain, it is a problem that is real.

• The Ultimate Guide To Critical Thinking
• Is Critical Thinking A Soft Skill Or Hard Skill?
• How To Improve Critical Thinking Skills At Work And Make Better Decisions
• 5 Creative and Critical Thinking Examples In Workplace
• 25 In-Demand Jobs That Require Critical Thinking and Problem-Solving Skills
• Brainstorming: Techniques Used To Boost Critical Thinking and Creativity

Critical thinking and problem solving: A deeper dive

A recap of the distinct differences between critical thinking and problem solving.

Critical thinking,  according to an article on Drexel  University’s Graduate College webpage  “utilizes analysis, reflection, evaluation, interpretation, and inference to synthesize information that is obtained through reading, observing, communicating, or experience.”

The goal of critical thinking is to evaluate the credibility of both the information and its source. It questions the central issue and how the information will inform intelligent decisions. Finally, it asks the question, “Where does this information lead me?”

Problem solving , as previously mentioned, uses many of those skills, but “it takes the process a step further to identify obstacles and then to strategically map out a set of solutions to solve the problem. That extra step in problem solving is  identifying obstacles  as well as mapping out a strategic set of solutions to resolve the problem.

How to develop critical thinking skills to become a better problem solver

1. develop your analytical skills..

Pay attention and be more observant. Ask the questions “who, what, where, and why” and learn as much as possible about the topic or problem.  Map everything out  to imprint or gain a visual understanding and focus on the differences between fact, opinion, and your own bias.

2. Learn the skill of evaluating

As a subset of analysis, you can become skilled in evaluation by:

• comparing similar and related topics, programs, and issues. How are they different, and where are the similarities?
• looking for trends that support (or refute) what you intuitively feel is the solution
• recognizing barriers or conflicts to successful problem resolution
• asking questions and gathering information—assuming nothing, ever.

3. Interpretation with the help of a mentor or someone more experienced

Interpreting a problem accurately employs both analytical and evaluating skills. With practice, you can develop this skill, but to hone your interpretation skills, it is advisable to seek the help of an experienced mentor.

You’ll need to do the following:

• know how your own biases or opinions can be a roadblock to the best decision making
• recognize that cultural differences can be a barrier to communication
• look at the problem from the point of view of others
• learn as much as you can about the problem, topic, or experience
• synthesize everything you have learned in order to make the connections and put the elements of a problem together to form its solution

4. Acquire the skill and habit of reflection.

Being reflective is applicable to almost every aspect of your personal and professional life. To open your mind to reflection, think back to your educational experience. Your instructor may have asked you to keep a  reflective journal  of your learning-related experiences. A reflective journal requires expressive writing, which, in turn, relieves stress.

Perhaps you have just had a disagreement with a coworker, who became abusive and personal. Not everyone can come up with those instant snappy comebacks on the spot, and it is usually best to disengage before the situation gets worse.

Here’s where reflective journaling helps. When you’re in a calmer state of mind, you can journal the incident to:

• gain deeper insights into your thought processes and actions—How do you feel about not defending yourself from the colleague’s accusations or personal abuse? What was the perfect response that eluded you in the stress of the moment?
• build a different approach to problems—It could be that your co-worker perceives you as unapproachable or unreceptive to suggestions and criticism. Maybe it’s time to have a frank discussion to help you see yourself through the eyes of the coworker.
• get closer to making significant changes in your life—Your journal entries may have displayed a pattern of your behavior on the job, which elicits consistent negative reactions from more than one co-worker.

Your takeaways:

• When evaluating critical thinking vs. problem solving, the elements of both appear to blend into a distinction without a difference.
• Good problem solvers employ the steps of critical thinking, but not all problem solving involves critical thinking.
• Emotional intelligence is an attribute that is a hybrid skill of problem solving and critical thinking.
• You can hone your critical thinking skills to become a better problem solver through application of analysis, evaluation, interpretation, and reflection.
• 10 Best Books On Critical Thinking And Problem Solving

12 Common Barriers To Critical Thinking (And How To Overcome Them)

• How To Promote Critical Thinking In The Workplace

Is Critical Thinking Overrated?  Disadvantages Of Critical Thinking

• 11 Principles Of Critical Thinking  

Jenny Palmer

Founder of Eggcellentwork.com. With over 20 years of experience in HR and various roles in corporate world, Jenny shares tips and advice to help professionals advance in their careers. Her blog is a go-to resource for anyone looking to improve their skills, land their dream job, or make a career change.

Further Reading...

15 Best Books on Assertiveness in the Workplace

Ultimate Guide to Setting SMART Career Objectives (with Examples)

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What Is The Role Of Communication In Critical Thinking?  

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ACLS vs. BLS: What is the Difference Between BLS & ACLS?

by Nick - last updated on June 30, 2022

Before we get into the differences between ACLS vs. BLS and ACLS certification vs. BLS certification , let’s begin by defining each. Otherwise, it would be like walking into a movie at the 20-minute mark, and we’d prefer to skip over any confusion.

What is BLS?

BLS stands for Basic Life Support. BLS involves a variety of life-saving skills and techniques, like CPR — a combination of chest compressions and rescue breaths — pulse checks, and rescue breaths without compressions. BLS also involves using specialized equipment like AEDs (Automatic External Defibrillators) and bag valve masks, just to name a couple.

BLS is performed mostly by healthcare professionals, like doctors, physicians, nurses, EMTs (Emergency Medical Technicians), paramedics, but also first responders like police officers and firefighters. 

BLS is performed when patients are in cardiac arrest, respiratory arrest or distress, or when there is an obstructed airway. Besides the skills and techniques involved with BLS, other necessary skills like working well in a team environment, critical thinking, and problem-solving are all vitally important.

What is ACLS?

ACLS stands for Advanced Cardiovascular Life Support. In ACLS, healthcare professionals use a set of algorithms to treat conditions ranging from cardiac arrest and myocardial infarctions (heart attacks) to stroke and other life-threatening emergencies.

Part of ACLS involves healthcare professionals interpreting a patient’s heart rhythm using an electrocardiogram. Based on this heart rhythm, decisions are made regarding treatment options.

ACLS providers must have the skills and knowledge to place advanced airways and insert an IV (Intravenous) or IO (Intraosseous) line for the administration of fluids and medications. And they must have a thorough understanding of all the medications available to them that are used to treat for the variety of heart rhythms and conditions they will encounter.

Together, all of these ACLS skills and knowledge will be used to provide the best possible treatment that will allow for the best possible patient outcome.

What is BLS Certification?

As you may have guessed, BLS certification relates to the necessary training to perform basic life support functions. For healthcare professionals and first responders, this is a requirement of their jobs, but it’s also often a requirement for other professions like lifeguards, coaches, teachers, daycare workers, and nursing home employees.

During a BLS certification course, you’ll learn basic life-saving skills that can be applied when encountering a person who has stopped breathing or whose heart has stopped beating. It’ll be your job to revive, resuscitate, or sustain them until more advanced help arrives.

BLS certification courses can be taken in-person or online and usually take a few to several hours to complete. Well-known organizations that provide such courses are the American Red Cross and the American Heart Association (AHA), along with other professional medical training organizations.

A BLS certification is good for two years following the completion of a course. At that time, the recipient would need to be re-certified. Guidelines are always being updated and new techniques are often introduced, which makes re-certification important.

What is ACLS Certification?

Like BLS, ACLS certification is the process of learning the skills and techniques necessary to properly handle all advanced cardiovascular emergencies. 

ACLS training will focus on the following:

• An understanding of BLS
• How to properly recognize and manage cardiac and respiratory arrest
• How to support and/or lead a resuscitation team
• Advanced airway management skills 
• ACLS pharmacology

ACLS training is often a requirement for doctors, registered nurses (RNs), and paramedics. Providers of ACLS are often the last line of defense when it comes to those patients suffering from a cardiac or respiratory emergency. 

Also like BLS certification, ACLS certification courses range from in-person classes to online courses. And ACLS certification is also valid for two years, at which time that certification must be renewed.

What is the Difference Between BLS and ACLS?

Congratulations!. We’ve finally arrived at our destination. If you’re anything like Scooby-Doo, and we don’t mean a talking cartoon canine, by now you’ve probably already figured out the difference between the two. And if you haven’t, let’s look again at the two acronyms and what they represent.

BLS — Basic Life Support ACLS — Advanced Cardiovascular Life Support

In other words, basic vs. advanced. BLS, a term that is often interchangeable with CPR, is not always performed by healthcare professionals and often performed outside of a hospital environment.

ACLS, on the other hand, is specifically for healthcare professionals. The advanced aspect of ACLS demands a foundational understanding of medical knowledge, of which BLS is simply one part of. 

The good news is that whether you’re looking for a BLS certification course or you are a healthcare professional seeking a more advanced ACLS certification course , ProTrainings is like one-stop shopping. Follow those links above for more specific information on each course. And don’t forget, while the courses are different, the objective remains the same: to save lives!

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A Discrete Geometry Drawing Challenge

Kids Learn “New Math” for Good Reasons

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Critical thinking vs. problem solving: the definitions

I was recently chatting with a colleague about the kinds of skills kids need to develop to be successful on the job, and in life. I started running down a list, and she said something along the lines of, “Well, critical thinking and problem solving… they’re the same thing right?” That’s a really interesting question! For my colleague, “critical thinking” and “problem solving” are just phrases that are out there, somehow related to learning. And just like with anything else in life, when you haven’t had a reason to investigate them deeply, they might just be ideas that seem to mean something vaguely similar… but what do these ideas really mean?

First, let’s start with some basic definitions. Critical thinking, according to dictionary.com, is “disciplined thinking that is clear, rational, open-minded and informed by evidence.” Well, that certainly sounds like something I want my kids to be proficient in! According to Merriam-Webster, problem solving is “the process or act of finding a solution to a problem”, and there’s another no-brainer, definitely something I want to instill in my children. Can we move from these definitions to a real understanding of the differences between these two skill sets?

Looking deeper: what skills are involved in critical thinking?

We’ve looked up definitions for critical thinking and problem solving, but these definitions don’t tell us anything about the skills that are involved in each. For instance, what exactly do my kids need to be able to do in order to think critically? Critical thinking skills are habits of mind that help us be more thoughtful, rational, creative, and curious. Critical thinking can involve collecting information, organizing what we collect, analyzing and evaluating the information we have, making connections between different ideas, understanding what’s relevant and what isn’t, and so much more. All of this gives us a basis on which an informed decision can be made.

But when do we make decisions? When we’re confronted with a task, challenge, or problem . Indeed, we apply critical thinking when we are faced with a problem that demands we apply some of those skills. Critical thinking skills are general plans of attack, applicable to a wide array of problems!

Looking deeper: what skills are involved in problem solving?

So now we’ve discovered something interesting: critical thinking skills are problem solving skills! And if you think about it, any critical thinking skill could conceivably be applied to finding the solution to some kind of problem. (In fact, it's hard to define critical thinking skills and not make them about problem solving in some way!) So, every critical thinking skill is a problem-solving skill.

Does that mean that every problem-solving skill is also a critical thinking skill? Actually, no. For starters, there are lots of skills that help us solve problems, but are not thinking skills! For example, brute strength is a body skill that is also a problem-solving skill. (But probably much of the time, you need to figure out how to use that strength, say, so you don't unnecessarily break your best friend’s TV when helping her move to a new home; critical thinking skills to the rescue!)

There are also problem-solving skills that are thinking skills, but just not critical thinking skills. For example, people with “emotional intelligence” can soothe tempers, read other people, and help move ideas forward in contexts that have nothing to do with problem solving. Skills of persuasion and oration are thinking skills, but they don't necessarily have to be critical thinking skills.

There are even problem-solving skills that are the complete opposite of critical thinking, like following directions, and mechanical and rote thinking. For example, learning the steps for solving a linear equation allows you to solve linear equations like a machine, no critical thinking required. However, rote thinking without critical thinking can be dangerous; you don't necessarily want to follow rules without checking that those rules make sense!

Critical thinking and problem solving: sometimes different, sometimes the same

We know that critical thinking skills are fundamental to problem-solving. And we know that there are other skills that help us solve problems, skills that aren’t critical thinking skills. Problem solving involves a wide array of techniques and attacks, some of which fall under critical thinking, and some which don’t. Aspects of critical thinking and problem solving can be different, or the same, but both sets of skills are incredibly important for all kids to have. There isn’t a skill we’ve talked about here where I think “Well, my kiddo could probably live without being able to do that….” Critical thinking is the foundation that allows us to tackle challenges of all kinds, supplemented by other problem-solving skills as needed. We want our kids to have all of these skills at their fingertips, so they can solve problems effectively, using strong evidence, logical thinking, and clear reasoning. All are vital ingredients to a successful and happy grown-up life!

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Explained: Importance of critical thinking, problem-solving skills in curriculum

F uture careers are no longer about domain expertise or technical skills. Rather, critical thinking and problem-solving skills in employees are on the wish list of every big organization today. Even curriculums and pedagogies across the globe and within India are now requiring skilled workers who are able to think critically and are analytical.

The reason for this shift in perspective is very simple.

These skills provide a staunch foundation for comprehensive learning that extends beyond books or the four walls of the classroom. In a nutshell, critical thinking and problem-solving skills are a part of '21st Century Skills' that can help unlock valuable learning for life.

Over the years, the education system has been moving away from the system of rote and other conventional teaching and learning parameters.

They are aligning their curriculums to the changing scenario which is becoming more tech-driven and demands a fusion of critical skills, life skills, values, and domain expertise. There's no set formula for success.

Rather, there's a defined need for humans to be more creative, innovative, adaptive, agile, risk-taking, and have a problem-solving mindset.

In today's scenario, critical thinking and problem-solving skills have become more important because they open the human mind to multiple possibilities, solutions, and a mindset that is interdisciplinary in nature.

Therefore, many schools and educational institutions are deploying AI and immersive learning experiences via gaming, and AR-VR technologies to give a more realistic and hands-on learning experience to their students that hone these abilities and help them overcome any doubt or fear.

ADVANTAGES OF CRITICAL THINKING AND PROBLEM-SOLVING IN CURRICULUM

Ability to relate to the real world:  Instead of theoretical knowledge, critical thinking, and problem-solving skills encourage students to look at their immediate and extended environment through a spirit of questioning, curiosity, and learning. When the curriculum presents students with real-world problems, the learning is immense.

Confidence, agility & collaboration : Critical thinking and problem-solving skills boost self-belief and confidence as students examine, re-examine, and sometimes fail or succeed while attempting to do something.

They are able to understand where they may have gone wrong, attempt new approaches, ask their peers for feedback and even seek their opinion, work together as a team, and learn to face any challenge by responding to it.

Willingness to try new things: When problem-solving skills and critical thinking are encouraged by teachers, they set a robust foundation for young learners to experiment, think out of the box, and be more innovative and creative besides looking for new ways to upskill.

It's important to understand that merely introducing these skills into the curriculum is not enough. Schools and educational institutions must have upskilling workshops and conduct special training for teachers so as to ensure that they are skilled and familiarized with new teaching and learning techniques and new-age concepts that can be used in the classrooms via assignments and projects.

Critical thinking and problem-solving skills are two of the most sought-after skills. Hence, schools should emphasise the upskilling of students as a part of the academic curriculum.

The article is authored by Dr Tassos Anastasiades, Principal- IB, Genesis Global School, Noida. 

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