Been reading the psychology literature lately, particularly on cognition and something called activity biasing behavior. So far the studies I have read in this literature (and I have only read a few) have used convenience samples of people with no particular training in making causal inferences, nor, from what I can tell, has an attempt been made to compare people with an education that should improve critical thinking (i.e. a BS, MS or Doctoral degree) with the idea that improved critical thinking should change reasoning during causal induction tasks.
In many ways the research designs being employed in this literature would be an excellent approach to testing whether students entering a program change in their causal reasoning abilities following a program that has an aim to improve such abilities. What I am saying is that a professional program (such as physical therapy) should make actively biasing behavior less likely to appear. And programs that require a bachelor’s degree upon entry should expect it’s matriculated students to have less actively biasing behavior on entry than a program that does not require a bachelor’s degree.
In the next several posts I am going to explain more about the potential impact of actively biasing behavior on clinicians, patients and clinical practice more generally. It is important to keep in mind the causes and consequences of such behavior and be sure that we all understand that as a clinical epistemology built on critical realism, knowledge based practice requires a balance between empiricism and rationalism. Too much empiricism can lead us to skepticism; but too much rationalism can lead us to actively biasing behavior. So please never interpret my call for causal models as a plea for complete rationalism, or forget that induction (the right side of the KPB graphic introduced in the post here) requires strict methodological rigor which is developed and assessed based on it’s ability to reduce bias and minimize actively biasing behavior. In fact it is wise to consider that induction (broadly considered) is reasoning from particulars to universals. But that induction based on unstructured observations of particulars can lead to highly biased universals!
But I do not want to stop there with these posts as I see much potential in a connection. In addition to this research I am also activity involved with developing a new DPT program. In considering the foundations of this new program (mission, vision, goals, approach) I am trying to uncover the essence of practice (generally and then specifically for PT) and how practice is a balance of theory and action that has, in higher education, often been a balance between disciplines and professions (general education and professional education, for example as covered in the book: “A New Agenda for Higher Education: Shaping a Life of the Mind for Practice”). There is an essential linkage between this work - in that the life of a mind shaped for practice is one that attempts to minimize bias, and in minimizing bias it is essential to minimize actively biasing behaviors.
What is an actively biasing behavior? It is using prior knowledge (what you believe about the world, it’s mechanisms, the ontology of causes, effects and causal structures) to actively manipulate events that then influence observations and perpetuates our disregard of, or a misinterpretation of, observations (data). This can occur in both unstructured observations (our every day experiences) as well as structured observations (i.e. a systematic, methodological design). In unstructured observations it can lead to the assumption that a treatment works to lead to it always being used which then increases the interpretation of it working as there is a known “confirmation” bias associated with causes that have a high probability. In structured observations it can lead to biased study designs (selection bias, recruitment bias, analysis bias, etc).
Understanding the risks associated with reasoning about cause, and the potential for bias, is part of a knowledge based practice; which is an attempt to consider what a life of the mind shaped for practice is all about, and a DPT education should have this as it’s aim. Expect to see more in the coming weeks on this topic. If you have any suggestions or want to contribute, just let me know.