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Guess Gestalt or Genius Simon Carley
| Date post: | 11-Feb-2017 |
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Health & Medicine |
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Guess Gestalt or Genius
Simon Carley
MedicineEvidenceBasedEBM
Medicine
Evidence
Based
Me
Evidence
Belief
Me
Evidence
Belief
“The most common cognitive problems involved faulty synthesis…. in 74% of cases ”
– Graber ML. et al. Arch Intern Med. 2005;165(13):1493-1499
Crosskerry 2009
Crosskerry 2009
Time Critical Information Light
“Few specialities are judged on the basis of their practitioner’s immediate impressions”
–Karen Cosby & Pat Crosskerry
http://lifeinthefastlane.com/pulmonary-puzzle-016/
http://lifeinthefastlane.com/pulmonary-puzzle-016/
Decreased facial expression variability in patients with serious cardiopulmonary disease in the emergency
care setting
Emerg Med J doi:10.1136/emermed-2014-203602 Decreased facial expression variability in patients with
serious cardiopulmonary disease in the emergency care setting Jeffrey A Kline1, Dawn Neumann2, Melissa A Haug3,
David J Kammer4, Virginia A Krabill5
Injury. 2015 May;46(5):807-13. doi: 10.1016/j.injury.2014.12.026. Epub 2015 Feb 4. Clinical gestalt and the prediction of massive transfusion after trauma.
Another spoken example Ministry of silly walks picture
Kurt Koffka Wolfgang Kohler Max Wertheimer
Judgement
Judgement
Does exist
We measure the measurable We perceive the immeasurable We formulate
Part 3: Education
• 2. Ask the right questions
What were you thinking….
Why did that seem to be the right idea at the time…..
How did you/we decide that…
What else were you thinking about….
m&m
Me
Evidence
Belief
Evidence
Belief
Me
Can we teach clinical judgement?
Another spoken example Ministry of silly walks picture
Gestalt: ‘A structure, configuration, or pattern of physiological, biological or psychological phenomena so integrated as to constitute a functional unit with
properties not derivable by summation of it’s parts.’
Read
Patient safety in
Kahneman
Gigerenzer
What the gorilla saw
Irrationality
Bowen JL.Educational strategies to promote clinical diagnostic reasoning. N Engl J Med. 2006;355(21):2217-25.
Teaching and learning Gestalt/Clinical Judgement?
Emergency Situation
Situation typical?
Diagnostic uncertainty
Shot-gunning
Analytical reasoning
Heuristics
AnomalyCognitiveCheckpoint
Action
no
yes
sure
unsure
Klein G. Decision making in action: Models and Methods. Norwood, NJ: Ablex Publishing 1993 via Scott Weingart
system 1 and 2 thinking
Clinical gestalt and the prediction of
massive transfusion after trauma.
Injury. 2015 May;46(5):807-13. doi: 10.1016/j.injury.2014.12.026. Epub 2015 Feb 4. Clinical gestalt and the prediction of massive transfusion after trauma.
Clinical gestalt and the prediction of
massive transfusion after trauma.
Injury. 2015 May;46(5):807-13. doi: 10.1016/j.injury.2014.12.026. Epub 2015 Feb 4. Clinical gestalt and the prediction of massive transfusion after trauma.
Reification
EmergenceInvariance
Multistability
