John Oliphant

I enjoy my "double life" as both a university professor and a practicing medical provider. I find that I can apply what I learn in the academic setting to my patient care and administrative work in the clinical setting and vice versa. I am also passionate about global / public health and leadership within healthcare systems, both domestically and internationally. My driving goal is to finish my life with no regrets and to leave my little piece of the world better than I found it.

1. How Do You Teach Applied Critical Thinking in the Context of Disaster?

In my Introduction to Global Health Issues class, we talk about complex humanitarian emergencies, natural disasters, terrorism and other unexpected calamities that negatively impact humanity. I try and have the students develop their critical thinking skills regarding ways that such disasters could be prevented, how society can prepare to respond to such disasters, and what can be done to minimize the damage once such disasters do occur. We use readings, case-studies, presentations, and group projects where students take on the role of project managers and leaders of disaster response teams so they can get a 360 degree look at these scenarios. Inevitably the students realize how complex these scenarios truly are and how much critical thinking it requires to navigate them.

2. Why Do You Think Applied Critical Thinking is Important in Your Domain?

As a healthcare provider, critical thinking is imperative to unravel diagnostic mysteries, to navigate complex treatment options, to ensure appropriate billing and coding for visit complexity, and to ensure proper interactions occur between medical staff and their patients, patient family members, and co-workers. If critical thinking skills are not highly developed, lives will be lost, trust will be damaged, workplace dysfunction will exist, and medico-legal issues will occur.

3. Can You Share a Story Where Quality Applied Critical Thinking Was Key to Your Success?

I was recently tasked with organizing a healthcare system's COVID-19 plan as it pertained to their employees who might be exposed to the virus, contract the virus, or have symptoms that were consistent with the virus. NY State provided some high-level guidelines, but these changed every day or two for a while and they were not designed to explain exactly how each healthcare system would operationalize their high-level recommendations. It required a lot of critical thinking to determine how we could screen our employees effectively; decide who should get COVID-19 testing; determine where and when that testing would be done that kept potentially infected people away from the other patients; figure out how we could minimize the use of personal protective equipment that was in short supply; establish a call center staffed 7 days a week so employees could have someone to talk to about their symptoms or concerns; develop tracking and follow-up plans for employees with concerning symptoms or confirmed COVID-19 infections, and much more. Multiple departments and people needed to work together to make this happen and new decision-making algorithms and standing orders needed to be created. It was very challenging with lots of moving parts and all of it required critical thinking. Once our system was working as we had hoped, it was a very satisfying experience!

4. How Do I Use Critical Thinking in Other Areas of Your Life Outside of RIT?

I have become very involved in cross-cultural medical and public health work in the low-income countries of Haiti and Liberia. I have had to rely heavily on critical thinking as it is clear that what works in the USA, may not work at all or may be harmful in these other countries and cultures. I have had to realize that it is vitally important to listen to and learn from those who are leaders in the location and culture we are visiting and attempting to help. Without culturally competent critical thinking, medical providers with very good intentions can cause significant harm and even death. There are many examples of people who feel very good about the work they have done during a short-term medical missions trip, but never learn that their medical care may have put a local provider out of business when patients are diverted from his/her clinic because of the free care offered by the providers from afar; may have resulted in a medication causing a severe allergic reaction, with no clear mechanism to respond; that people who need medicines for chronic issues, like hypertension, are not really helped by a 2-4 week supply of pills donated by the visiting team with no plan on how to get more once the team leaves the country; that pills dispensed in a Zip-Loc bag may cause the death of a child who sees them and thinks they are candy and is able to swallow them because they are not stored safely in childproof bottles; or that dosing errors can happen if medication info is given to the patients in English when they only speak their local indigenous language or are unable to read. Critical thinking is required to both recognize the potential for issues such as those described above and to develop strategies to prevent these adverse events from occurring.

5. Any Last Critical Thoughts You Wish to Share About What We Are Experiencing Now or What You Have Learned in Past Work?

I think the COVID-19 crisis has made it crystal clear how important critical thinking really is. As this crisis began to play out, it was described as fake news or a political effort to harm the current administration and many were slow to begin to take the necessary steps to slow and stop the spread of the virus and prepare to manage the thousands that would become sick. Leadership was lacking and false beliefs were propagated. This led to a loss of precious time and perhaps an impact on the morbidity and mortality associated with this pandemic. People seemed ignorant of how exponential growth in cases would occur or to understand that we really didn't know how many cases were around us because so few were being tested in the beginning. I even saw footage of people who were COVID-19 positive proudly walking around in crowded places, putting hundreds at risk for illness and death because they felt the whole thing was an overreaction. It is very likely that improved critical thinking across all aspects of our society could have resulted in a different outcome in this pandemic.