week 11: flesh-and blood decision-making jerome groopman
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Week 11: Flesh-and Blood Decision-Making
Jerome Groopman
Dr. Peih-ying Lu
May. 13, 2010
According to Groopman, in 1980s, what were interns like? What did they have to do?
How did the first day of intern influence
Dr. Groopman? How has his feeling changed?
In medical school, how do students study paper cases?
Pre-reading questions
How long will it take in a didactic exercise for the senior doctor and students to arrive at a working diagnosis?
How long will it take an expert clinician to form the notion of what is wrong with the patient?
Pre-reading questions
Pre-reading questions According to Dr. Pat Croskerry, what is
pattern recognition?
According to Dr. Donald A. Schön, what is heuristics?
What is the Yerkes-Dodson law? How does it relate to doctors’ performance?
Pre-reading questions
What is the function of the high-tech mannequin named Stan?
Case 1: William Morgan
Case 2: Anne Dodge
• In case 1, Dr. John Burnside spent only 15 seconds finding out what was wrong with Morgan while others spent 15 years figuring out Dodge’s illness in case 2. What’s the difference?
In-Class DiscussionWhat are Dr. Groopman’s inner feelings
towards both Anne Dodge’s and Mr. Morgan’s cases?
What do you think the differences and similarities are between these two cases?
Do you think doctors’ medical decisions are made subjectively or objectively? Why?
What is “see one” and “do one”?
In-Class DiscussionIs a fast and frugal medical decision always
better than a nice and slow one? Why or why not?
Do you think the technical errors in medicine, which are like prescribing the wrong dose of a drug, transfusing a unit of blood matched for another person, mislabeling an x-ray of an arm as “right” instead of “left”, are inevitable?
In-Class Discussion
• When are intuition (in The Blink), pattern recognition by Dr. Pat Croskerry, and heuristics by Dr. Donald A. Schön being used?
• How should doctors avoid mistakes when using intuition? Why?
Christine Borland said,
“I’ve tried to speak to young doctors and talked to
them about their real experiences, for example,
of breaking bad news, and how they compare
their experiences as students and whether
they’re drawing on these experiences with actors.
Once they get out there into the real medical
world and they are looking back at their
education, what do they think about it?
However, going by their descriptions, of the
difficulties of breaking bad news, for example, in
a real situation compared with the learning
situation, a lot of them were questioning the use
of simulated patients.” (Lu, 96)
Lu, P.-y. (2010). Medical communication as art – an interview with Christine Borland. Language and Intercultural Communication. Vol.10, No.1, 90-99.)
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