How to improve clinical judgment/decision making/what to do next for patients?

[IonClaws]

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Hi everyone,

I'm about 2.5 months into intern year and have asked for feedback from a couple of attendings on my current rotation. Basically, they believe I'm very good at presenting information - but one thing I need to work on is how to make decisions based on the knowledge of the data.

They also say it's pretty early and this is not necessarily expected of me yet, but I'd like some insight. How do I gain the ability to plan/make decisions on what to do next for patients? It's been kind of an evasive target so far...

 

[gutonc]

You keep doing what you’re doing. 6 months from now, you’ll have a pretty good chance of telling your *** from your elbow. A few months after that, this question will be irrelevant.

 

[WheezyBaby]

Knowing what to do for your patients consistently is not an expectation of a block 3 intern. Read more, pay attention to what's ultimately being done for your patients and the rationale why, and ultimately just gain more experience. The most efficient way you can probably benefit your attendings perception is reading specific to your current patient census

 

[WingedOx]

volume.

 

[Saddleshoes]

What the others have said is true. Let me add this observation.

As an attending I have noticed that young healthcare professionals these days share a reluctance to make a decision. I suspect this is a result of your being raised in the information age. When there is always more data to collect and the additional data is readily available. I find my young charges waiting for more information to come forward when they already have more than enough info to "pull the trigger". For those of us older providers we only had half the data available to us that you have today to make our calls. Much of that extra data is only noise.

With that in mind I would suggest that you start paying attention what data is most valuable in the decision making process and which data is least important. Soon you will learn zero in on the key items and ask for those key items early on in the process. You will also learn what items are dross and not waste valuable time dealing with foolishness.

Good luck with it.

 

[FutureInternist]

Read the condition specific “Review” articles from NEJM