Tuesday, April 17, 2012

CCME - Workshop on Diagnostic reasoning

Great facilitator's job (Dr Fisher and Dr Rolfson- U Alberta)

The analytic x non-analytic (intuitive) lines of though and their interaction towards the diagnostic reasoning.

What makes an expert - Model - After the detection of the problem context, has the ability of rendering a core knowledge to   formulate questions and solve them through an internal  model of "scripts", searching a "best-fit" interactively - all this is in the "intuitive" side of the thought  - when a true doubt appears that toggles or signal the analytic component, which will look for a solution and feedback it to the non-analytical part, until there is a satisfactory solution. An expert does that in the most efficient and shortest way, using only sufficient and necessary elements for the decision (therefore optimizing the time of this whole process)
Heuristics - "rules of the thumb" - shortcuts to the solution. They are embedded with bias and possible errors, and although they are the key of a fast solution, care should be taken to minimize the risks

Some other concepts such as Syntax of the problem and Semantics of the information were also discussed, and it culminated in practical interesting role-playing examples in the room.

This was a top workshop...

I think that an approach through reasons of probability and predictive values and the dance of sensitivities/specificities and pattern recognition we do in radiology is also another nice model of diagnostic reasoning. Fist time I heard that was in med school (5th year) through our internal medicine teacher Dr Francisco Aguiar. His explanation was so simple and clear that the concept was learned at once, imprinted and never more forgotten.

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