Training:

Evidence-based thinking – 2


 

Instructions:
Read our assessment of an evidence-based clinical issue.
View a list of questions to keep in mind before you start the case.
Study the case history and videos.
Make your own assessment, determinations and reflections.

Note: This is an intermediate-to-advanced activity requiring open-ended analysis and clinical judgment.

 

Case 8     Case 27     Case 28     Case 37     Case 38    Case 42     Case 43     Case 44     Case 46

Case 8

TIPS procedure


Preview:

In Case 8, the provider had important evidence but did not seem to share it with the team.

 
Scroll down to view questions.

 

Questions:

-What was the evidence?

-What was the consequence to the team’s decision-making to function without it?

-What might they have done differently with it?

-What was the consequence to the patient?
 

Ready? Assess the history.

Case 27

Dialysis


Preview:

In Case 27, the provider had important evidence and correctly interpreted it, but did not act on it in a timely way.

 
Scroll down to view questions.

 

Questions:

-What was the evidence she had?

-What is your view of her judgment?

-What was the consequence to the patient? 

Ready? Assess the history.

Case 28

Peripheral vascular disease and recent angioplasty


Preview:

In Case 28, the provider had a set of evidence. The weight of evidence did not support his conclusions. He seemed to decide the evidence had to fit his conclusions anyway.

 
Scroll down to view questions.

 

Questions:

-What evidence did he have?

-What evidence did he lack?

-What was the consequence to the patient? 

Ready? Assess the history.

Case 37

Alcohol use disorder and pacemaker replacement


Preview:

In Case 37, the provider had key evidence, but misinterpreted it.

 
Scroll down to view questions.

 

Questions:

-What evidence did he have?

-In what way did he misinterpret it?

-What was the consequence to the patient? 

Ready? Assess the history.

Case 38

Lung mass


Preview:

In Case 38, the provider sought evidence. The evidence he obtained did not support his own opinion. He seemed to override evidence-based principles in favor of his own opinion.

 
Scroll down to view questions.

 

Questions:

-What evidence did he have?

-What evidence did he skip?

-What was the consequence to the patient? 

Ready? Assess the history.

Case 42

Death during rehab


Preview:

In Case 42, a provider had important evidence but did not act on it.

 
Scroll down to view questions.

 

Questions:

-What was the evidence?

-What action did he skip?

-What was the consequence to the patient. 

Ready? Assess the history.

Case 43

Mental status change followed by hypotension


Preview:

In Case 43 a provider had evidence but dismissed it.

 
Scroll down to view questions.

 

Questions:

-What evidence they dismiss?

-What was the consequence to the patient? 

Ready? Assess the history.

Case 44

Longstanding urinary incontinence and frequency


Preview:

In Case 44, the providers had important evidence but incorrectly interpreted it.

 
Scroll down to view questions.

 

Questions:

-What evidence did they incorrectly interpret.

-What was the consequence to the patient? 

Ready? Assess the history.

Case 46

Pacemaker and chronic back pain


Preview:

In Case 46, the providers made an assumption about new evidence that was incorrect.

 
Scroll down to view questions.

 

Questions:

-What was the assumption they made?

-Was it a reasonable assumption?

-What was the consequence to the patient? 

Ready? Assess the history.

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