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5-Step Problem Solving Guide

This is a guide to the Clinical Reasoning Course, providing an overview of the course structure for working on cases online and in small groups. Addresses Nervous System cases (also applies to all 1-session cases in the NEW CRC). Guide Prepared for the Clinical Reasoning Course Directors by Karen Spear Ellinwood, PhD, JD, Director, Faculty Instructional Development, Assistant Professor, Obstetrics & Gynecology, University of Arizona College of Medicine, Tucson. Course Directors: Paul St. John, PhD, and Alice Min, MD

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PRESENTATION OUTLINE

1.

5-Step Structured Approach

Clinical Problem Solving
2.

Step 1

Frame the Problem
Photo by JD Hancock
3.

What do we need to explain?

Photo by JD Hancock
4.

Identify pertinent facts

Photo by JD Hancock
5.

Articulate questions for investigation

Photo by JD Hancock
6.

Example: Are these symptoms all due to one cause? Are these related? Does one condition cause the other? What stands out?

Photo by JD Hancock
7.

Step 2

Formulate Hypotheses with Rationales
Photo by Davide Restivo
8.

Describe two or more hypotheses

that might be causing the patient's symptoms
Photo by Davide Restivo
9.

Articulate why

these are possible or plausible
Photo by Davide Restivo
10.

Relate these to

 scientific concepts and/or clinical facts
Photo by Davide Restivo
11.

Step 3

Develop Strategies for Assessment
Photo by jurvetson
12.

What do I need to know?

Photo by jurvetson
13.

How could I find out?

Photo by jurvetson
14.

Why do I want this particular test?

Photo by jurvetson
15.

How will results help me to

differentiate from among possible causes?
Photo by jurvetson
16.

Are there social or economic factors

that I should consider?
Photo by jurvetson
17.

the patient's culture & language?

How can I adapt my approach to respect
Photo by jurvetson
18.

Physical Exam Findings

Released AFTER Student Submits Ideas for How to Proceed (Step 3)
Photo by COMSALUD
19.

Step 4

Narrow Diagnoses with Rationales
Photo by *Tom*
20.

Prioritize hypotheses

based upon facts, clinical facts & scientific concepts
Photo by *Tom*
21.

Determine which hypotheses

explain adequately the patient's symptoms
Photo by *Tom*
22.

Prepare to bring

an open mind to the session
Photo by Alex //Berlin _ Alexander Stübner
23.

Step 5

Post-case Reflection
Photo by Bert Kaufmann
24.

Reflect on the Case

What you learned
Photo by Bert Kaufmann
25.

Reflect on Process

How you or your group approached the case
Photo by Bert Kaufmann
26.

Reflect on Progress

Recognize and describe progress and challenges
Photo by Bert Kaufmann
27.

Reflect on How to Improve

Strategies for future individual and collaborative problem-solving
Photo by Bert Kaufmann
28.

University of Arizona College of Medicine - Tucson

Prepared by KC Spear Ellinwood, PhD, JD, FID Director
Photo by Al_HikesAZ
29.

Course Directors

Paul St. John, PhD, and Alice Min, MD

Karen Spear Ellinwood, PhD, JD, EdS, BSW

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