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Time Stamps

  • 1:13 A new challenge and the rules of the game
  • 3:06 Introduction to Human Dx
  • 5:28 The case: An 85 year-old woman with paranoid delusions
  • 15:15 What exactly is problem representation?
  • 19:53 Building the differential

Show Notes

  • Affective biases are ways in which a provider’s emotional state influences their decision-making contrary to rational judgment.
    • Although we must first recognize our vulnerability to biases in order to counteract them, simply acknowledging the problem is not enough to prevent us from continuing to fall victim to them.
  • When faced with a problem we are trying to solve, a problem representation is a mental model we construct that summarizes our understanding of the problem’s essential nature.
    • The problem representation is critical because it shapes how we will attempt to solve the problem, and predicts our efficiency and likelihood of success in doing so.
  • The essential nature of a clinical case revolves around three key questions:
    • Who is the patient?
    • What is the tempo of illness?
    • And what is the clinical syndrome in question?
  • Problem representation is not the same as summarizing all of a patient’s abnormal findings. Experienced clinicians abstract data into meaningful chunks that facilitate robust hypothesis generation without overtaxing working memory.
  • Chekhov’s Gun” is a term that describes each part of a story should contribute to the whole.
    • It originates from Anton Chekhov’s famous book writing advice: “If in the first act you have hung a pistol on the wall, then in the following one it should be fired. Otherwise don’t put it there.”


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