Final Review

Question 1

Flexner Report

Answer 1

A report written by Alexander Flexner in 1910 that transformed American medical education

Question 2

Changes brought about by the Flexner Report

Answer 2

Establishment of the biomedical model as the gold standard of medical training;

An attempt to standardize medical education;

Caused many medical schools to close down and most of the remaining schools were reformed to conform to the Flexnerian model

Traditional folk medicine, plant based medicine was exiled

Social characteristics of graduates were generationally passed on

Question 3

Differential diagnosis

Answer 3

the hypothesis formation of multiple conditions that could be causing PT symptoms and involves several tests to confirm the suspected diagnosis

Question 4

The epistemological problem of medicine

Answer 4

biological variation: the difference in test results within a single individual and a defined population

Question 5

Confirmation bias

Answer 5

a tendency to look for evidence that supports or confirms a claim without taking into consideration the evidence that goes against the claim

Question 6

Base-rate neglect

Answer 6

fallacy and false-positive paradox; people ignore or undervalue the probability of some condition but more intuitively appeal to information about an individuals case

Question 7

Configural Analysis

Answer 7

the act of discerning the relationship between two variables

Question 8

Statistical Prediction Rules (SPRs)

Answer 8

rules derived from compiling expert knowledge over time that are quantified into a formula or rule; derived from medical practice unlike EBM

Question 9

Why we would want to remove human judgment from medical practice, and what is the limit this faces?

Answer 9

Inconsistency, overconfidence, and cognitive limitation; doesn’t take into account values and emphasises intuition

SPRs and EBM, and they both have the same limits—biologic variation & doesn’t take into account a patient’s values and moral — value-based medicine

Question 10

Evidence-Based Medicine (EBM)

Answer 10

medicine that is predictable and repeatable with evidence for why a certain action brings about healing/cure

Question 11

Randomized Controlled Trials (RCTs)

Answer 11

the gold standard of scientific research that rules out confoudning variables by randomizing participants and controling variables to identify a specific cause and effect relationship.

Question 12

Disease

Answer 12

profession perspective–the underlying pathology

Question 13

Illness

Answer 13

first-person perspective– subjective experience of symptoms

Question 14

Sickness

Answer 14

the societal perspective–cultural beliefs and attitudes of a condition

Question 15

Phronesis

Answer 15

Aristotle’s concept of ‘practical wisdom’ to judge what the best course of action is; refers to an action that has its end in itself; the basis of clinical reasoning

Question 16

Pathophysiologic rationale

Answer 16

PR decision making bases a claim of an intervention produced outcome on rational observation

Question 17

Tonelli’s example of pathophysiologic rationale

Answer 17

Hypertension is predicted to be caused by raised blood pressure, so our practical wisdom insinuates to alter the therapeutic approach to manage elevated levels of bp