Script focused deduction uses minimal information to develop and test a hypothesis. A few key pieces of information are gathered to develop your first hypothesis or the ” H1″. From the H1, 2-3 questions and 2 tests are then used to support or reject the hypothesis. This is very useful for the developing therapist to establish a provisional hypothesis.
Experts use pattern recognition where 4-5 common differential presentations are compared to the patient presentation. These are the common conditions seen in clinic and they focus the subjective and objective examination on ruling in or out this condition. Script focused deduction allows the therapist to start developing pattern recognition. Over the next 8 modules we will be working on developing clinical reasoning skills starting with script focused deduction.
The next section is adapted from Jim Meadows work on script focused deduction. He uses elbow pain as an example case. In the next post we will look at the lumbar essential illness scripts.
In short more time can be spent on the more complex aspects of the problem (level of inflammation, etiology and contributing remote pathologies etc.) when less time has to be spent on the differential diagnosis
The uncomplicated diagnosis should be easily available to non- experts and not a struggle
It mimics what experts do with pattern recognition, that is ask a few supporting questions and do a few tests, without the experience of expertise being required
But by completing all aspects of the examination after the diagnosis has been made it reduces bias and error
For more information here is a link to moodle for Jim Meadows manual on Script focused deduction. If not in a current course email me and I can forward you the text.
For those of you who want to go further there is our fellowship program.
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