Clinical Problem Solving – Being Results vs Process Driven
Is the result all that really matters?
Is the goal for physicians to be results driven or process driven? The answer seems simple – all that really matters is the result.
Is it though? In training new physicians in residency programs is the goal to focus on the result or the process?
[blockquote cite=”” type=”left, center, right”]In training new physicians in residency programs is the goal to focus on the result or the process?[/blockquote]
As a student I have only had the privilege to attend morning reports, and M&M conferences for less than two years now. A trend among them though is they are all very results oriented. We only discuss the cases which had a poor or unwanted result. The thought process is clear enough – a mistake was made, let’s discuss why. We often end up discussing the case briefly, but spend more time discussing the condition that the patient ultimately had and in doing so we attribute the error to a failure of knowledge. We missed it because we didn’t know enough about it. It’s a tried and tested way to teach, but for the residents and the students the information is only useful if two conditions are met: We see a patient with a very similar set of presenting symptoms who presents in the same way and two we actually recall the lecture.
It was during one of those morning reports I couldn’t help but wonder – should we consider being process driven instead? Should we not analyze the process in the case, what happened with the patient, how did we respond and what was the thought process behind the diagnosis or even behind the unwanted outcome. Would it serve residents and students better to focus on a process of how we approach patients and tough medical cases, so that not only do we address the disease process in question but rather where our process failed us. Focusing on the process will give us information we can apply to every patient, and allows us to address possible missteps before they occur by discussing not only cases with a poor outcome but rather cases where our process led us astray.
For more information on Clinical Problem Solving visit the article I’ve written on the subject here.