Clinical Decision Making

Question 1

What is the Analytical Model

Answer 1

• The differential diagnoses of the presenting complaint are learnt
• Requires careful history taking, thorough examination and the ability to interpret clinical findings correctly
• Requires the appropriate use and correct interpretation of tests
• Information gathering allows diagnosis to become more likely and others less
• Making a diagnosis based on probabilities

Question 2

What is the Pattern Recognition Model

Answer 2

• Practice and experience is what helps doctors hone in on problems more effectively because they recognise patterns
• Text book facts begin to associate with experience
• Begin to store clinical knowledge as stories and templates (patterns) rather than collection of abstract facts
• Experience leads to better discrimination and intuitive clinical decision making

Question 3

Khaneman’s Theory: System 1 thinking

Answer 3

Fast, unconscious, automatic, instinctive, everyday decisions, error prone

Question 4

Khaneman’s Theory: System 2 thinking

Answer 4

Slow, conscious, effortful, complex decisions, reliable

Question 5

Heuristics

Answer 5

Mental shortcut that allows people to solve problems and make judgments quickly and efficiently

Question 6

Biases and Heuristics

Answer 6

• Similar does not always mean the same
• Doctors may emphasise things that they are more familiar with
• Overconfidence and hasty diagnosis
• Tendency to look for and remember information that fits in with pre existing expectations and ignore evidence which contradicts this

Question 7

What is a Clinical Handover

Answer 7

The transfer of professional responsibility and accountability for some or all aspects of care for a patient or group of patients, to another person or professional group on a temporary or permanent basis

Question 8

SBARR

Answer 8

Situation, Background, Assessment, Recommendation, Response