Emotional Intelligence and Diagnostic Reasoning in Medicine

Flashcards covering emotional intelligence, clinical interview techniques, the Suchman model, Lonergan’s method of knowing, diagnostic reasoning steps, cognitive biases, and biostatistics definitions.

Emotional Intelligence (EQ)

The ability to make healthy adaptive choices based on identifying, understanding, and managing our emotions and the emotions of others.

Self-Awareness

A domain of personal competency involving emotional awareness, accurate self-assessment, and insightfulness to recognize emotions as they happen and understand general tendencies for responding.

Self-management

A domain of personal competency involving emotional self-control, transparency, integrity, adaptability, achievement, confidence, and initiative.

Social awareness

A domain of social competence involving empathy and organizational awareness.

Relationship management

The ability to inspire and influence others, develop or mentor others, act as a change agent, manage conflict, build bridges, and facilitate teamwork and collaboration.

Patient Centered Medicine Exception

Circumstances where a physician would not begin with a patient-centered approach, including medical emergencies, psychiatric emergencies, cognitive limitations, legal mandates, and structured required assessments.

Empathetic listening

Using attentive listening to understand a patient’s experiences and emotions, effectively communicating that understanding back so the patient feels heard and supported.

5 Steps of Empathetic Listening

1. Honor the first golden moments; 2. Listen for underlying feelings, needs, and values; 3. Remain fully present; 4. Know when to speak vs. listen; 5. Reflect on the interaction.

Suchman Model: Emotive component

The ability to emotionally connect with and feel concern for others.

Suchman Model: Moral component

The internal motivation and willingness to care about a patient’s emotional experience.

Suchman Model: Cognitive component

The clinician’s accurate understanding of the patient’s feelings and perspective.

Suchman Model: Behavioral component

The clinician communicating their understanding effectively so the patient feels heard and understood.

NURS

A mnemonic used to respond with empathy: Naming, Understanding, Respecting, and Supporting.

Hypothesis Driven History Taking

An approach where the clinician forms and tests possible diagnoses while taking the history, using patient responses to guide follow-up questions in real time.

The Cardinal Questions (6)

Quality, Location/Radiation, Intensity/Severity, Onset, Timing/Duration, and Modifying factors (Aggravating/Alleviating).

Lonergan’s Method Level 1: Experiencing

The level of collecting broad data and being attentive without making any analysis.

Lonergan’s Method Level 2: Understanding

The level of being intelligent through questioning and developing a differential diagnosis.

Lonergan’s Method Level 3: Judging

The level of being reasonable by testing what is known to determine what actually is true.

Lonergan’s Method Level 4: Deciding

The level of being responsible once a truth is valid, leading to ethical clinical reasoning.

Lonergan's Transcendental Imperatives

The virtues corresponding to the levels of consciousness: Be attentive, Be intelligent, Be reasonable, and Be responsible.

Neurotic bias

Unconscious bias rooted in trauma or hidden motivations that influences decisions without awareness.

Egotistical (individual) bias

A conscious choice to prioritize personal self-interest over the common good and refusal to understand what benefits others.

Group bias

A narrow prioritization of a group's own interests, creating blind spots to exaggerated self-interest; it is more dangerous as it is reinforced by others.

General/common sense bias

A preference for easy, short-term solutions to complex problems while ignoring deeper long-term solutions.

2-Process Model of Diagnostic Reasoning (Croskerry)

A model explaining two clinical reasoning approaches: Intuitive thinking (fast, automatic) and Analytical thinking (slower, logical, deliberate).

5 Steps of Diagnostic Reasoning (Stanford Strong Medicine)

1. Acquire data; 2. Identify key features; 3. Create a problem representation; 4. Choose a framework; 5. Apply key features to the framework.

Anchoring bias

A cognitive bias involving fixating on an initial diagnosis or information despite new evidence to the contrary.

Semantic qualifiers

Opposing descriptors (adjectives) used to clarify symptoms, such as acute vs. chronic, sharp vs. dull, or bilateral vs. unilateral.

Anatomic Framework

Organizes differential diagnoses by the physical location of symptoms or organs involved; best for localized symptoms like abdominal pain.

Physiologic Framework

Organizes diagnoses by failing body mechanisms or functions (e.g., oxygenation, acid-base balance) rather than location; best for systemic symptoms like fatigue.

Problem Representation

A brief 1–2 sentence summary using precise medical language and semantic qualifiers to describe a patient's specific presentation.

Illness Script

A clinician's mental model of a disease, including epidemiology, pathophysiology, symptoms, time course, tests, and treatment.

Heuristics

Adaptive mental shortcuts or 'rules of thumb' used for rapid, efficient decision-making.

Availability bias

Judgments influenced by recent experiences, memorable cases, or emotions rather than objective frequency.

Confirmation bias

Seeking evidence that supports a preexisting belief while ignoring conflicting evidence.

Diagnostic momentum

When a previous diagnosis continues unquestioned by future clinicians.

Satisfaction of Search bias

Stopping the diagnostic search after finding one abnormality or explanation.

Occam’s Razor

The principle that a simpler explanation is usually more likely than a conjunction of multiple rare conditions.

Cognitive Disposition to Respond

Mental habits like analytical thinking and metacognition that support logical, evidence-based clinical reasoning.

Affective Disposition to Respond

Emotional attitudes and skills like empathy and emotional regulation that support patient-centered care.

Cognitive Autopsy

A strategy used to understand medical errors and diagnostic failures by reconstructing a day step-by-step to recall thoughts and decisions.

Sensitivity

$Sensitivity = \frac{TP}{TP + FN}$; measures how well a test identifies people with disease, useful for ruling out (SnNout).

Specificity

$Specificity = \frac{TN}{FP + TN}$; measures how well a test identifies people without disease, useful for ruling in (SpPin).

Positive Predictive Value (PPV)

$PPV = \frac{TP}{TP + FP}$; the probability a patient has disease when a test is positive; increases as prevalence increases.

Negative Predictive Value (NPV)

$NPV = \frac{TN}{FN + TN}$; the probability a patient does not have disease when a test is negative; decreases as prevalence increases.

SPin

Specific test, Positive result, rules IN disease (few false positives).

SNout

Sensitive test, Negative result, rules OUT disease (few false negatives).

Rule out threshold

The point where the probability of disease drops low enough that further testing is no longer needed; lower for life-threatening diseases.

MMAH (Past Medical History)

Mnemonic for Medical conditions, Medications, Allergies, and Hospitalizations/surgeries.

TARD (Social History)

Mnemonic for Tobacco, Alcohol, and Recreational Drugs/prescription misuse.