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Table 1 Summary of King and Kitchener's Seven Stages of Reflective Judgement[11]

From: Can ill-structured problems reveal beliefs about medical knowledge and knowing? A focus-group approach

Stage

View of knowledge

Concept of Justification

Consequences

Level

1

"What I have seen is true" Knowledge is absolute and predetermined.

Beliefs need no justification.

Failure to understand that 2 people can disagree about something

 

2

Knowledge is available through the senses or via authority figures.

Knowledge is absolutely certain or certain but not immediately available.

Beliefs are unjustified or justified by beliefs of authorities

Dogmatic and naïve views - belief in right and wrong answers

Pre-reflective thinking

3

Knowledge is absolutely certain or temporarily uncertain (future data will demonstrate the truth).

Predominance of personal opinions in areas of temporary uncertainty.

Reference to authorities' views in areas of certainty.

Confusion when asked to make decisions about problems for which no absolute answers exist.

 

4

Knowledge is understood as an abstraction.

Knowledge in certain fields will never be certain.

Knowledge claims are idiosyncratic to the individual.

Arguments and choice of evidence for justification of beliefs are idiosyncratic.

New tolerance of alternative perspectives.

Quasi-reflective thinking

5

Knowledge is contextual and subjective because it is filtered through a person's perceptions and criteria for judgement.

Justification by rules of inquiry for that context.

Different views are seen as potentially legitimate interpretations of issues. What is missing is the ability to compare and contrast evidence across contexts.

 

6

Inadequacy of purely contextual and subjective knowing becomes apparent.

No understanding of larger system of knowing in which comparisons are embedded.

Justification by comparing evidence and opinions and construction of solutions (based on weight of evidence, utility of the solution,...)

Conclusions remain limited and situational.

Reflective

thinking

7

Belief that while reality is never a given, interpretations of evidence and opinion can be synthesized into epistemically justifiable conjectures about the nature of the problem. (recognition of its temporary character)

Beliefs are justified probabilistically on the basis of a variety of interpretive considerations.

Possession of a general framework about knowledge and justification.

Conclusions are defended as representing the most complete, plausible or compelling understanding of an issue on the basis of the available evidence.