Clinical Reasoning Flashcards
Premature Closure
Cloncluding evidence gathering and making a diagnosis prior to thorough reflection on all of the data. “Pattern recognition”
Flase consensus
a form of premature closure. You offer limited analysis and/or information because you believe that others have reached an identical conclusion
Confirmatory bias
the tendency to seek or favor data that confirms one’s prefered diagnosis while ignoring or disregarding data that would disfavor the diagnosis
Unintentional sequestration of data
pertinent information is unintentionally omitted by someone on the team (Clinical sign, previous medical history, etc)
Illusory transactive memory system
method by which people store and retrieve knowledge. The ullusory transactive memory system provides the medical team with a deceptive sense of security that because youre working with a team, someone before you got all of the data that you need
“Someone must have read the chart”
Contagious illusion
respect for authority or desire for consensus allows data to be interpreted as valid by others
Supervising clinician states that a collection of clinical signs means the patient has the disease
Selective perception
your expectations influence your sense such that you can feel, hear or see something that you expect to hear
Primacy effect
initial events in the patient’s medical history or disease are weighted more heavily than events that occur later
Recency effect
the most recent events in the patient’s medical history or disease are weighted more heavily than events that occured later
Availability heuristic
estimating what is more likely by what is more available in your memory. bias towards vivid, unusual, or emotionally charged examples
Intrinsic errors
Time pressure
OVerconfidence
Faulty or incomplete data gathering (failure to obtain relevant data)
Knowledge gap or inexperience
Physical factors of doctor (fatigue, illness, familial)
Consciois or unconscious bias by the doctor
Systematic errors
Wrong site surgery
Failure of clinician or nurse to recognize documented drug interactions or patient allergies
Miscommunication/misunderstand of verbal orders
Mislabeling of syringes, fluid bags, or other items containing medication
Improper rate of admin of fluids
Equipment failure
Poor lay-out of facility
What are the steps of the clinical reasoning cycle
1) Acquire data
2) Summarize Data
3) List problems
4) Generate differentials
5) Justify differentials
6) Justify top differentials
Pattern Recognitions
“It just looks like this”
Pros: quick, cost effective, safer
Cons: Can lead to jumping to conclusions, bias, misdiagnosis-premature closure, differences in experience
“Hairy horse… it has Cushings”
Arborization/ Decision tree
Pros: Standardization, emergence situtations or referrals
Cons: Less for multifactorial disease, expensive, only as good as the designer, doesnt account for comorbid disease
