From SGIM:
Teacher’s guide
Definition of PR:
Ask what the key ingredients of a problem representation are, can then click to reveal the 3 questions, and discuss examples of the kind of information that should be included
Who is the patient? What are the pertinent demographics and risk factors
What is the temporal pattern of the illness? What is the duration (hyperacute, acute, subacute, chronic) and tempo (stable, progressive, resolving, intermittent, waxing and waning)
What is the clinical syndrome? What are the key signs and symptoms
[ ] Separate this into a new slide
Goal: separate signal from noise in each aliquot.
A problem representation (PR) is a one-sentence summary that defines a patient’s condition in abstract terms. Sometimes clinicians state the PR, but often it can be inferred based on the features of the data set they choose to analyze and which data elements they disregard. The PR in this case is a middle-aged man and smoker with subacute productive cough, dyspnea,and abdominal pain. The dyspnea and cough elements collectively trigger illness scripts for various respiratory infections, but abdominal discomfort is not a characteristic of those conditions. At this early stage, the clinician does not know whether this isolated data point is part of the patient’s underlying syndrome or is unrelated. Signal detection theory (SDT) describes how decision makers determine whether data in the environment is meaningful for solving a problem (Bsignal^) or will have no bearing on the solution (Bnoise^) (DOI: 10.1007/s11606-016-3887-8)
Focus on discriminating pieces of information over nonspecific ones (e.g. malaise)
By comparing and contrasting opposing diagnostic features, these abstract semantic qualifiers (e.g. acute vs. chronic, dull vs. sharp, distal vs. proximal) add differentiating power to a problem representation
Pruning data = necessary for complex cases. involves risks/benefit calc on how aggressively to prune. Involves determining which features are epiphenomena vs causal). By summarizing the most salient features and minimizing distractors, effective problem representations reduce cognitive load and facilitate problem-solving
Facilitator tasks
refining
Comparing vs contrasting things on the differential