Illness Scripts + Critical Reasoning DSA Flashcards
What are the four components most commonly included in illness scripts?
epidemiology, temporal course, pathophysiology/mechanism, and clinical px
What would go under the category of Epidemiology in illness scripts?
Demographics (age, gender and race or ethnicity)
risk factors
exposures (travel, occupation, activities, contacts)
What would go under the category of Time course in illness scripts?
duration of prodrome or syxs: hyperacute, acute, subacute, chronic
pattern of prodrome or syx: constant (stable or worsening), episodic (waxing and waning), biphasic, or interment)
What would go under the category of Pathophysio/mechanism in illness scripts?
What are known derangements in: anatomy, physio, immuno, biochemical pathways, genetics, and metabolomics
what are known environmental contributors: microbio, toxins, and pharmacology
What would go under the category of clinical presentation in illness scripts?
key and differentiating features +/- MUST HAVE/ rejecting features)
What is the process of clinical reasoning?
process by which clinicians collect signs, process info, and understand the pts medical situation or problem, plan and implement appropriate medical interventions, evaluate outcomes, and learn
Info gathering, PE, assessment, and plan formulations
What is analytical reasoning ? who is it used by?
SLOW and conscious thinking process applied by novices and in unfamiliar cases
HOW: first impression–> data colleciton + interpretation–> differential dx/summary statement–> again collect data and interpret–> refine differential dx
this is an iterative process that will eventually lead to diagnosis and therapy
What is pattern recognition (used by expert)?
QUICKER approach applied by experienced clinicians and is an unconscious process that is difficult to explain to others
HOW: first impression–> seen before/diagnosis–> data collection and interpretation–> ask does it confirm diagnosis?
IF so–> therapy
IF not–> differential dx–> repeat
What is an illness script?
an organized mental summary/mental cue card of a providers knowledge of a dz
Describe the anchoring bias:
sticking with a diagnosis
Describe the availability bias:
referring to what comes to mind most easily
Describe the confirmation bias:
assigning preference to findings that confirm a dx or strategy
Describe the framing bias:
assembling elements that support a dx
Describe the premature closure bias:
failing to seek additional info after reaching a dx conclusion
How do clinicians build an illness script:
- gain clincial exposure to classic pxs of a common illness
- organize clinical features within a illness script
- used to rank their differential dxscompare and contrast distinguishing features bw similar dzs
- ask more experienced physicians (resident or attending) to discuss the distinguishing features they
