Clinical reasoning and dual process theory

Here is a link https://indianpediatrics.net/sep2015/sep-787-794.htm to a well done review on dual process theories behind clinical reasoning and medical education outcomes. 

The evaluation examples that have been used do reflect our current education system's focus on developing system 1 skills promoting competencies in a simple clinical problem solving skills format while system 2 competencies largely remain ignored?

However the practice ecosystem has evolved such that students may not be able to linearly build on simple competencies when confronted with real illness scripts that are much more complex. 

A way forward would be encouraging students to create better case based online learning portfolios to include complex real patient scripts? 

Can shared decision making SDM be applied at population level?

 

Shared decision making as pointed out has remained a decision made through information communication between individual stakeholders around that decision. 

If these individual level decisions are made transparent in terms of the information flow generating those decisions (after taking an informed consent from those individuals) then one can view the complex trajectories of the information inputs that led to the outcome. In medical education parlance these could be more akin to "formative assessments."

On the other hand an average "consent of the governed" in a political democracy is obtained by an opaque ballot where information transparency is replaced with blatant misinformation often driven by the stakeholders who stand to benefit most from these transactions.

Given the current technology revolution it is possible that transparent individual shared decision making trajectories will soon trump opaque ballot driven summative assessments and political decisions will be driven by a clear collective consensus rather than blurred whims of an elected ruler? 

best 

rakesh 

On Oct 17, 2020 10:59 PM, "Benjamin Djulbegovic MD" wrote:

A really interesting question, Jon

Can SDM be applied at population level?

 

I am not a political scientist, but most countries (at least democracies) function on premise of “consent of the governed”, which means that you and I have consented that our representatives make decisions on our behalf in case of public emergencies (at least we are stuck with them until next election …)

 

Would be interesting to hear from others how indeed we can take public attitudes about benefits and harms into account related to public health decision-making in ongoing crisis?

 

best

 

ben

 

 Link to the entire conversation thread here https://www.jiscmail.ac.uk/cgi-bin/wa-jisc.exe?A1=ind2010&L=EVIDENCE-BASED-HEALTH