Dear Reader,
Process:
I started off the process by reading blink, by Malcolm Gladwell. I had read one of his other books, Outliers, beforehand but had heard (from Benedict, actually) that this was a must-read. Although I was disappointed with the lack of focus and conclusive statements in the book, I learned a lot about the process of decision-making and thin-slicing. I would still recommend it, 100%. From here I was nervous about choosing a topic for my expository essay (that is obvious from my second blog post). I was wondering if I should go broad, rather than specific. I ended up deciding on a more specific topic (to prevent falling into the same trap as Gladwell). To decide on this topic I reviewed the anecdotes that stuck out to me the most throughout blink, made a list and then did some basic research on all of them. Once I found out how relevant the Cook County Hospital story was, mainly in the past two years, I knew I had my topic.
Outcome:
I decided to focus on Analysis vs. Intuition in the area of medical decision-making--whether protocol or instinct should be the structure of health care. Because I am interested in going into public health (although not necessarily be a doctor), this topic really spoke to me and I enjoyed my research. This made the project a rewarding experience instead of a requirement, and I was thankful I found such an interesting area to focus on. This idea of "Intuition vs. Evidence" translated unbelievably well into my four genres. I will talk about my golden thread more later, but I hope you can see the dichotomy being explored throughout my project. By the end of writing my essay and genres, I came to the conclusion that there can be a middle ground between the two. It is when people use both forms of thinking that they truly flourish.
Golden Thread:
"Art and science, intuition and analysis, gut instinct and evidence, experience and knowledge.”
- Donald Woolever
This quote is my golden thread. I found it while researching for my expository essay and used it in its conclusion. I think it was the perfect way to express all forms of the spectrum I was attempting to explore throughout my genres and loved all of the options for interpretation it presents. I used these parings in all of the titles of my genres and embedded them in the creative writing as well. My goal was to use each genre to highlight the different parings. For example, my double sided poem worked with analysis and gut instinct, my painting worked with intuition and evidence, my haikus worked with art and science and my quality worked with Judgement's relationship with experience and knowledge (I choose Judgement as my main subject because I thought in embodied much of the other focus points of the project as well).
Overall Reflection:
Thanks for everything, Ms. Romano, including this final project that gave us one last push. I know I wrote this in my thank you letter to you, but this class has revolutionized my views on English classes. I can't thank you enough. See you soon, Aly
Friday, May 22, 2015
Thursday, May 21, 2015
Experience and Knowledge
Judgement watches everyone. His eyes flit around a mile a minute taking in every hair twirl, every wistful sigh, every side-long glance. For him there is always an opinion to be made, a stance to be taken, and an argument to whisper to the person he’s sitting next to.
Judgement watches everyone. His eyes flit around a mile a minute taking in every hair twirl, every wistful sigh, every side-long glance. For him there is always an opinion to be made, a stance to be taken, and an argument to whisper to the person he’s sitting next to.
Judgement is never satisfied. He takes a sip of lemonade and wants it to have a bit more sugar. He sees a girl’s prom dress and wants it to have a few more sparkles. He talks to a freshman and wants to hear some more enthusiasm. But for him dissatisfaction is the same as forward thinking. He uses Knowledge and Experience to inform himself. He realizes: everything can be better. He dedicates himself to getting it there.
He decides who wins and who loses and this gives him enemies upon enemies. Walking the street, he’s on the receiving end of dirty looks and people sometimes purposefully run into him. This is confusing for Judgement, he equates himself with Fairness. But while Fairness is smiling and waving along the dirt roads in Wyoming, Judgement is slouched under an umbrella in NYC. Instead of being accepted by the public like Fairness, Judgement is forever an outsider. Judgement believes he is facilitating a better world, but the public simply does not agree. People do not know how to take his real criticism.
Judgement sees the potential. He pushes people to take it. But sometimes he just goes too far and they fall off a cliff. Confidence rushes to catch them. Experience and Knowledge watch the scene and just shake their heads.
Analysis Gut Instinct
What to do? What to do?
I want to
figure this out
I need to I need to
just go for it
It’ll work out
I think I think
I should click
around some more
on Google
Just to be safe Just to be sure
I’ll ponder for
Five more hours Five more minutes
Will make all the difference
Study one more topic
Prepare myself
It’s time to start It’s time to start
I’ve got this
I can figure everything out
on the spot
on the spot
… Problem No problem
I need more time
Please wait Don’t wait
Jump in
Start now
Go with your gut
Ready? Ready?
… I’ll never be As I’ll ever be
Expository Essay
Analysis + Intuition = ?
The November 2006 British Medical Journal reported that Google, a search engine, can give a correct diagnosis of a condition given three symptoms 58% of the time (Woolever). Doctor’s clinical decision making has received ample attention over the past two years. A book released three years ago, How Doctors’ Think, brought up the debate between how valuable doctors are for the decision making process in the health-care system. From then on, efforts have been made by many administrators to determine how much should be through an analytical protocol system and how much through the intuition and training of medical staff. Going deeper, discussion has even sprung up about how protocol should be structured and whether outside resources are necessary or unwanted. It is time to explore if there is a middle ground, and, if there is, if it is the best direction to take medical care.
In Malcolm Gladwell’s book, blink, he explores how different amounts of information affect the decision-making process. While he discusses these ideas relating to more than medicine, he does linger on how protocol took effect at Cook County Hospital in the late 1990s. In an attempt to save money, Cook County Hospital implemented a new form of diagnosing heart attacks. Instead of doctors making a complete judgement call based on all of the information they could gather, a three question process was put into place. This decision tree, Gladwell says, “was a whopping 70 percent better than the old method at recognizing the patients who weren’t actually having a heart attack” (Gladwell, 135). Cook County Hospital switched methods in an instant. The take away from the switch is that society’s normal view is that decision-makers should gather all the possible information they can to make an educated, rational decision. However, Gladwell advocates for the fact that, “extra information is more than useless. It’s harmful. It confuses the issues. What screws up doctors when they are trying to predict heart attacks is that they take too much information into account” (Gladwell, 137). Leaving judgement calls to only doctor’s intuition and thoughts can often hurt their ability to make a correct decision. The decision tree, a form of protocol, gave the doctors a way to monitor themselves and how much information they really needed to make a health care decision.
There is intense pushback from implementing protocols across medical care, and often with good reason. People want to treat doctors as, “intelligent human being who [are] capable of exercising good medical judgment” (Clawson). Current protocol documents define that, “EMDs should follow a structured, predetermined interrogation process to activate preprogrammed response modes and provide medical instructions to callers prior to EMS arrival” (Clawson). This undermines doctor’s judgement calls and makes them feel like talentless rule-followers. Gladwell, again referencing Cook County Hospital, says, “Doctors think it’s mundane to follow guidelines… it’s much more gratifying to come up with a decision on your own” (Gladwell, 139). The average doctor goes to four years of undergraduate school, four years of medical school, and three years of residency. Doctors want to believe that their expensive, extensive education was worth something more than being able to follow a handbook. They remark, “Anyone can follow an algorithm” (Gladwell, 139).
There is a heavily supported middle ground, guidelines. While there is a big contingent that claims protocol and intuition create a zero-sum equation--having more of one results in less of the other--the general public calls that a “false dichotomy” (Greenhalgh). Advocates of guidelines claim that it gives doctors the respect they deserve while maintaining structure that gives doctors a reliable starting place (Clawson). Along with the more flexible guidelines comes education tools to support them. Specifically, critical reflection on past intuition driven assessments highlights, “areas of ambiguity in complex decision-making, sharpens perceptual awareness, exposes the role of emotions in driving ‘hunches’” (Greenhalgh). Taking the time to fine tune the use of intuition in medical care is a necessary responsibility. Rising technology has played a big role in the attempt “to integrate the ‘science’ of evidence-based medicine with the intuitive ‘art’ of clinical judgement” (Greenhalgh). Online diagnostic tools have become commonplace and allow doctors to save time and effort. Support for guidelines in rising, and the use of technology in conjunction with classic medical training has begun to be commonplace.
Analysis + Intuition = ?
The November 2006 British Medical Journal reported that Google, a search engine, can give a correct diagnosis of a condition given three symptoms 58% of the time (Woolever). Doctor’s clinical decision making has received ample attention over the past two years. A book released three years ago, How Doctors’ Think, brought up the debate between how valuable doctors are for the decision making process in the health-care system. From then on, efforts have been made by many administrators to determine how much should be through an analytical protocol system and how much through the intuition and training of medical staff. Going deeper, discussion has even sprung up about how protocol should be structured and whether outside resources are necessary or unwanted. It is time to explore if there is a middle ground, and, if there is, if it is the best direction to take medical care.
In Malcolm Gladwell’s book, blink, he explores how different amounts of information affect the decision-making process. While he discusses these ideas relating to more than medicine, he does linger on how protocol took effect at Cook County Hospital in the late 1990s. In an attempt to save money, Cook County Hospital implemented a new form of diagnosing heart attacks. Instead of doctors making a complete judgement call based on all of the information they could gather, a three question process was put into place. This decision tree, Gladwell says, “was a whopping 70 percent better than the old method at recognizing the patients who weren’t actually having a heart attack” (Gladwell, 135). Cook County Hospital switched methods in an instant. The take away from the switch is that society’s normal view is that decision-makers should gather all the possible information they can to make an educated, rational decision. However, Gladwell advocates for the fact that, “extra information is more than useless. It’s harmful. It confuses the issues. What screws up doctors when they are trying to predict heart attacks is that they take too much information into account” (Gladwell, 137). Leaving judgement calls to only doctor’s intuition and thoughts can often hurt their ability to make a correct decision. The decision tree, a form of protocol, gave the doctors a way to monitor themselves and how much information they really needed to make a health care decision.
There is intense pushback from implementing protocols across medical care, and often with good reason. People want to treat doctors as, “intelligent human being who [are] capable of exercising good medical judgment” (Clawson). Current protocol documents define that, “EMDs should follow a structured, predetermined interrogation process to activate preprogrammed response modes and provide medical instructions to callers prior to EMS arrival” (Clawson). This undermines doctor’s judgement calls and makes them feel like talentless rule-followers. Gladwell, again referencing Cook County Hospital, says, “Doctors think it’s mundane to follow guidelines… it’s much more gratifying to come up with a decision on your own” (Gladwell, 139). The average doctor goes to four years of undergraduate school, four years of medical school, and three years of residency. Doctors want to believe that their expensive, extensive education was worth something more than being able to follow a handbook. They remark, “Anyone can follow an algorithm” (Gladwell, 139).
There is a heavily supported middle ground, guidelines. While there is a big contingent that claims protocol and intuition create a zero-sum equation--having more of one results in less of the other--the general public calls that a “false dichotomy” (Greenhalgh). Advocates of guidelines claim that it gives doctors the respect they deserve while maintaining structure that gives doctors a reliable starting place (Clawson). Along with the more flexible guidelines comes education tools to support them. Specifically, critical reflection on past intuition driven assessments highlights, “areas of ambiguity in complex decision-making, sharpens perceptual awareness, exposes the role of emotions in driving ‘hunches’” (Greenhalgh). Taking the time to fine tune the use of intuition in medical care is a necessary responsibility. Rising technology has played a big role in the attempt “to integrate the ‘science’ of evidence-based medicine with the intuitive ‘art’ of clinical judgement” (Greenhalgh). Online diagnostic tools have become commonplace and allow doctors to save time and effort. Support for guidelines in rising, and the use of technology in conjunction with classic medical training has begun to be commonplace.
The underlying theme throughout this discussion is that medical care is a balancing act between “art and science, intuition and analysis, gut instinct and evidence, experience and knowledge” (Woolever). A final piece of advice spread throughout teaching facilities is to formalize a personal approach to diagnosis and treatment that lies between protocol and intuition. Defining a consistent, individual decision-making process will lead lead to more confident, and more accurate, clinical decisions. Doctors should be given freedom to their academic success to work, but have a system in place to structure their work to gain the best results possible.
Bibliography
Clawson, Jeff J., Robert L. Martin, and Scott A. Hauert. "Protocols vs. Guidelines: Choosing a
Medical-Dispatch Program." Protocols vs. Guidelines: Choosing a Medical-Dispatch Program. Emergency Medical Services, Oct. 1994. Web. 19 May 2015.
Gladwell, Malcolm. Blink: The Power of Thinking without Thinking. New York: Little, Brown, 2005. Print.
Greenhalgh, Trisha. "Intuition and Evidence — Uneasy Bedfellows?" British Journal of General
Practice (2002): n. pag. May 2002. Web. 19 May 2015.
Woolever, Donald R. "The Art and Science of Clinical Decision Making."Family Practice
Management. AAFP, 15 May 2008. Web. 19 May 2015.
Clawson, Jeff J., Robert L. Martin, and Scott A. Hauert. "Protocols vs. Guidelines: Choosing a
Medical-Dispatch Program." Protocols vs. Guidelines: Choosing a Medical-Dispatch Program. Emergency Medical Services, Oct. 1994. Web. 19 May 2015.
Gladwell, Malcolm. Blink: The Power of Thinking without Thinking. New York: Little, Brown, 2005. Print.
Greenhalgh, Trisha. "Intuition and Evidence — Uneasy Bedfellows?" British Journal of General
Practice (2002): n. pag. May 2002. Web. 19 May 2015.
Woolever, Donald R. "The Art and Science of Clinical Decision Making."Family Practice
Management. AAFP, 15 May 2008. Web. 19 May 2015.
Sunday, May 17, 2015
Aly Singleton
Ms. Romano
AP English Lit and Lang
Ms. Romano
AP English Lit and Lang
blink, Round Two
Hey there Ms. Romano!
So I have finally finished the book and am so ready to get into this paper. I'm still unsure about what I want to write about, but I'm hoping to use this blog post as a way to organize my ideas. Hopefully I'll know by the end of this post.
I have three broad ideas. Number one is to look farther into this idea of when you should use your "unconscious" side and when you should use your "conscious" side. I can try and do some research to draw that line and decide for myself where the decision should be made. I talked about this in my previous blog post. Gladwell does an awful job of narrowing down his advice. He basically ends the book saying that thinking with both mindsets is important and would have net benefit on the world. However, he never goes into depth about where to to use which. This was endlessly annoying me throughout the book and it would be nice to give myself the satisfaction of guidelines.
Number two.
I can just look into more research about intuition and the unconscious/conscious parts of the brain. Looking into the repercussions of intuition sound like a very interesting road to take. I also really like Sarah's idea about researching how the brain developed throughout history and when the conscious part of the brain took over the animalistic one. I'm leaning toward this option.
Number three is still worth mentioning. Final idea, I could further research one of his abundant anecdotes. I have a few in mind that I'm intrigued by. The first is the hospital I mention in my first blog post. I would love to look into how the decision making process works in the health care system. How much of the process is laid out for them and how much is intuition? Second, Gladwell spends a lot of time in the back half of the book talking about autism and how people with autism process information differently. This would lend itself to some interesting realizations about how people without autism process information as well.
So I'm leaning towards #2... but we will see!
Adios for now,
Adios for now,
Aly
Subscribe to:
Posts (Atom)