•👍 I did not listen enough to the patient's story. •I didn't know enough about the disease. •I didn't reassess the situation when things didn't fit. •I was overly influenced by a similar case. •I was in denial of an upsetting diagnosis.
These could all be (dis)honorable mentions! I originally had didn't listen to the patient on my list, but then decided it's more of a communication error (probably the biggest communication error) rather than a clinical reasoning error, per se - but the point is very well taken!
Great job as always Dr. Strong. The only one of these that I don't see as often as you (not saying you are incorrect, just not one that is as common with my trainees) is having too long of a differential diagnosis. Unfortunately my junior students often have too short ddx list, and I'm a bit envious of you having to tell them not to include their entire diagnostic framework for that chief complaint in the presentation. I particularly like this (new to me) term Zebra retreat, and definitely agree with your list of common not-done physical exam things. Gait and skin exams matter very frequently on any wards.
Thank you Dr. Gowen! The too long differential diagnosis is only with med students in their first few clerkships..that gets overcorrected very quickly! I also first encountered the term zebra retreat just recently, but it looks like it's been around for a while - I wish I knew who coined it so I could credit them!
I'm glad you enjoyed it! I wish I could say specifically when I'll get to the final group of videos in this series, but aside from ones on cognitive theories and the threshold model (which I am hoping to record over winter break), the remaining ones will probably not come until spring/summer 2021.
I would say that when the ED orders a bunch of stuff even if not totally relevant it helps communicate to the transfer center, receiving hospital, and the slew of non physician staff about the patients disease process. Tests are not always about diagnostics. They can be communication tools for bed placement by nursing staff. They communicate the severity of a patients condition. Yes we know he has liver and kidney failure but to what degree?? Do we need a dialysis bed right now or tomorrow? These operational decisions are often based on test results that physicians don’t see. They just show up to the inpatient bed and see the patient not how the patient got there.
There are always grey ares, however for operational decision in ED is essential for clinician to know the troponins, creatinine and the ECG result stat, in order to direct patient to the cath lab in 90 min since the start of symptoms.
Thanks for your interest! The remainder of them will continue, eventually. Unfortunately, they weren't generating as much interest as some of the other topics I posted on last year, so I took a break from this particular series. But I anticipate posting 1-2 more in mid-late Feb, with the rest of them to come over the course of 2021.
No. I took a break from this series for a while because audience for it seemed smaller than with many of my other videos (i.e. fewer subs were interested in them), but I still think it's an interesting and important topic. I'm actually planning on posting the next video this weekend on the topic of the threshold model of decision-making.
@@StrongMed Great news thank you for taking your time to make such wonderful series I´m from Peru and your channel (especially this kind of videos) really helped me a lot
@@StrongMed Thanks re feedback . Most doctors will not do a Cranial 12 exam for a back ache Probably I did not understand you fully but in a busy practice Urgent Care and Primary Care skill is Stable or Unstable Sick or Not Sick
Exceptional presentation! In my professional infancy as a medical doctor, this discussion proves to be extremely helpful!
•👍
I did not listen enough to the patient's story.
•I didn't know enough about the disease.
•I didn't reassess the situation when things didn't fit.
•I was overly influenced by a similar case.
•I was in denial of an upsetting diagnosis.
Me too.
These could all be (dis)honorable mentions! I originally had didn't listen to the patient on my list, but then decided it's more of a communication error (probably the biggest communication error) rather than a clinical reasoning error, per se - but the point is very well taken!
Don’t forget follow up .
Great job as always Dr. Strong. The only one of these that I don't see as often as you (not saying you are incorrect, just not one that is as common with my trainees) is having too long of a differential diagnosis. Unfortunately my junior students often have too short ddx list, and I'm a bit envious of you having to tell them not to include their entire diagnostic framework for that chief complaint in the presentation.
I particularly like this (new to me) term Zebra retreat, and definitely agree with your list of common not-done physical exam things. Gait and skin exams matter very frequently on any wards.
Thank you Dr. Gowen! The too long differential diagnosis is only with med students in their first few clerkships..that gets overcorrected very quickly! I also first encountered the term zebra retreat just recently, but it looks like it's been around for a while - I wish I knew who coined it so I could credit them!
Essential video as usual, 3rd point, "classic picture" is a code name for "YNS" you ll never see it,
Thank you so much sir for ur valuable lectures & ur efforts ....💥💫🌟✨🙏
Thanks for another great video. Cannot wait to hear your perspective on Bayesian analysis, that was always tough for me to understand!
I'm glad you enjoyed it! I wish I could say specifically when I'll get to the final group of videos in this series, but aside from ones on cognitive theories and the threshold model (which I am hoping to record over winter break), the remaining ones will probably not come until spring/summer 2021.
Thank you Dr Strong ! Cool
I would say that when the ED orders a bunch of stuff even if not totally relevant it helps communicate to the transfer center, receiving hospital, and the slew of non physician staff about the patients disease process. Tests are not always about diagnostics. They can be communication tools for bed placement by nursing staff. They communicate the severity of a patients condition. Yes we know he has liver and kidney failure but to what degree?? Do we need a dialysis bed right now or tomorrow? These operational decisions are often based on test results that physicians don’t see. They just show up to the inpatient bed and see the patient not how the patient got there.
There are always grey ares, however for operational decision in ED is essential for clinician to know the troponins, creatinine and the ECG result stat, in order to direct patient to the cath lab in 90 min since the start of symptoms.
Thank you 🌹🌹 Dear
Again. How do I like this twice?
You can get a friend to watch, and have them like it too!
do clinical reasoning training videos continue?
Thanks for your interest! The remainder of them will continue, eventually. Unfortunately, they weren't generating as much interest as some of the other topics I posted on last year, so I took a break from this particular series. But I anticipate posting 1-2 more in mid-late Feb, with the rest of them to come over the course of 2021.
@@StrongMed
how strange !
The content was very informative. I look forward to it. 🙏🙏 Thank you
Is this the last video of this series?
No. I took a break from this series for a while because audience for it seemed smaller than with many of my other videos (i.e. fewer subs were interested in them), but I still think it's an interesting and important topic. I'm actually planning on posting the next video this weekend on the topic of the threshold model of decision-making.
@@StrongMed Great news
thank you for taking your time to make such wonderful series
I´m from Peru and your channel (especially this kind of videos) really helped me a lot
@@franciscomelendez6012 I'm sorry, I wasn't happy with the threshold model video yet. It might take another 1-2 weeks...
They don’t get the same exam : evidence ?
I'm sorry, I don't understand your question. Could you try rephrasing it?
@@StrongMed Thanks re feedback .
Most doctors will not do a Cranial 12 exam for a back ache
Probably I did not understand you fully but in a busy practice Urgent Care and Primary Care skill is Stable or Unstable Sick or Not Sick