Clinical medicine (London, England)
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Diagnostic errors are responsible for a significant number of adverse events. Logical reasoning and good decision-making skills are key factors in reducing such errors, but little emphasis has traditionally been placed on how these thought processes occur, and how errors could be minimised. In this article, we explore key cognitive ideas that underpin clinical decision making and suggest that by employing some simple strategies, physicians might be better able to understand how they make decisions and how the process might be optimised.
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In this article, we discuss the practical usefulness of selecting future medical students on the basis of increasingly popular non-academic tests (eg multiple mini-interviews, situational judgment tests) in addition to academic tests. Non-academic tests assess skills such as ethical decision making, communication and collaboration skills, or traits such as conscientiousness. ⋯ We provide some numerical examples in the context of medical student selection. Finally, we suggest that optimising training in non-academic skills may be a more successful alternative than selecting students on the basis of these skills.
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Movement disorders comprise hyperkinetic involuntary movements (eg tremor, myoclonus, tics, dystonia and chorea) and hypokinetic (parkinsonism) disorders. Tics are cardinal features of primary tic disorders encompassing Tourette syndrome (TS), but are also found in some neurodegenerative conditions and may be induced by psychoactive substances. ⋯ Dystonia and chorea syndromes are considerably heterogeneous in aetiology, and age at onset, body distribution of the movement disorder, accompanying neurological motor and non-motor features, and systemic manifestations are all important to reach a correct aetiological diagnosis. While symptomatic pharmacological treatment remains the mainstay of treatment for choreas, deep brain stimulation surgery has a well-defined place in the management of medically refractory dystonia.