Introduction to Clinical Thinking
Michael O’Toole, MD
Course Description
This course provides an exposure to the clinical environment throughout the health center. It is designed for students not previously involved in clinical medicine as well as those trained in medicine outside the U.S. The course features problem-based learning and traditional medical informatics task domains. It will also cover medical terminology and basic pathophysiology.
Topics include the clinical setting, eliciting information from patients, synthesizing the history and physical examination, establishing diagnosis, treatment planning, integrating evidence-based medicine, and using an intelligent medical record in a complex environment. This is an entry track course for students with little clinical experience and should be completed before attempting core course work beyond MED INF 403.
Course Goals
Understand the current clinical care environment
Establish a clinical thinking perspective
Appreciate the complexity of applying an EMR context to clinical care
Know the how and why for narrative and structured content
Apply specific clinical case examples
Explore future EMR approaches
Desired Course Outcome
Appreciate the current clinical care environment in which problem solving occurs
Appreciate the complexity of applying an EMR context to clinical care
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Artifacts
EHR Decision Support with Bayesian Analysis.ppt
First, Do No Harm.pdf
Sample Patient note.doc
The EHR Decision Support with Bayesian Analysis artifact clearly demonstrates the current clinical care environment and how clinical data availability is essential for a comprehensive differential diagnosis. The "First, Do No Harm" pdf is a Harvard Business School reprint of "Why Complex Systems Fail". It demonstrates how latent pre conditions in a well organized hospital can make it hard for people to do the right thing despite their best efforts and training and can lead to catastrophic outcomes. The sample patient note demonstrates the wealth of historical information a patient brings to a clinical encounter and must be considered by the clinician for a comprehensive understanding of the patient.
Main Take-Away
Complete data is an essential component for making a diagnosis. The data comes from patient histories; the clinical encounter, the clinician’s knowledge and can incorporate any evidence based medical data base.The clinician must use statistical analysis, logic, past experience and intuition to sort through differential diagnosis.
Recommended reading:
Areas of Strength
Clear understanding of the current clinical environment
A good appreciation of clinical thinking perspective
An excellent understanding of importance of HER and their importance to the future of health care
Areas for Development
Work on digitization of patient information at point of collection