HSRT Health Sciences Reasoning Test

This section lays the foundation for the rest of the guide. It explains what critical thinking means in the expert consensus that the HSRT is built on, how skills differ from the attitudes that make people use those skills, why nursing and allied health programs care so much about it, how the two versions of the test are organized and scored, and what an HSRT-style item looks like from the inside. It ends with a general method you can apply to any item. This section is not tested as a separate scale, but every scale on both versions of the test (OVERALL, Analysis, Inference, Evaluation, Induction, Deduction and Numeracy, plus Interpretation and Explanation on the four-year HSRT) draws on the ideas introduced here.

This chapter defines critical thinking the way the test authors define it, introduces the six core skills from the expert consensus, and shows how those skills work together on a single health care problem.

A panel of critical thinking experts, working through a structured consensus process known as the Delphi method, described critical thinking as purposeful, self-regulatory judgment. Two words in that phrase matter most. Purposeful means the thinking is aimed at a goal: deciding what to believe, what to do, or how to solve a problem. Self-regulatory means the thinker watches and corrects their own reasoning along the way instead of trusting the first idea that comes to mind.

Critical thinking is not the same as being negative or finding fault. A critical thinker may conclude that an argument is excellent. It is also not the same as knowing a lot. A person with a great deal of knowledge can still reason poorly about a new situation, and a person who is new to a field can reason very well if they read the information carefully and draw only the conclusions it supports. That is exactly why the HSRT can test reasoning without testing content knowledge.

The Delphi experts identified a set of core cognitive skills. The HSRT scales are built around them, with induction, deduction and numeracy added as ways of applying those skills to particular kinds of problems.

These skills overlap in practice. To evaluate an argument you first have to interpret its terms and analyze its structure. To draw an inference you often have to interpret a table. On the test, a single item may count toward more than one scale, and the OVERALL score uses all of them.

Worked Example: A clinic supervisor reads a memo saying, "Since we started text-message reminders, missed appointments have dropped, so the reminders are working and we should extend them to every department." Which core skills does a careful reader use in responding to the memo?

A careful reader interprets the claim (what does "dropped" mean, and by how much?), analyzes the argument (the conclusion is "extend reminders to every department"; the reason is the drop in missed appointments; the assumption is that the reminders caused the drop and would work the same way elsewhere), evaluates its strength (did anything else change at the same time, such as a new receptionist or a change in season?), and infers what is actually supported (the reminders may have helped, but the memo alone does not show they caused the drop). Then the reader explains this view to the supervisor and self-regulates by asking whether they are being too skeptical. The best choice in an item built on this memo would be the response that names the causal assumption, not one that simply agrees or rejects reminders outright.

• Critical thinking is purposeful, self-regulatory judgment about what to believe or do.
• It is not negativity and it is not the same as knowledge.
• The six core skills are interpretation, analysis, evaluation, inference, explanation and self-regulation.
• The skills overlap, and one HSRT item can draw on several of them.
• Self-regulation, checking your own reasoning, is what turns the other skills into good judgment.