The Management Script in Action: Putting a Practical Tool to Work

In our recent Academic Medicine Perspective, we proposed the term “management script” as a concept for teaching management reasoning. Analogous to the illness script, an essential component of diagnostic reasoning, management scripts are high-level, precompiled, conceptual knowledge structures of the courses of action that a clinician might undertake to address a patient’s health care problem(s). Not to be confused with a checklist, where specific interventions are mandated in a sequence, management scripts are more like a menu: a collection of options in various categories (e.g., appetizers, courses, desserts versus tests and treatments) for the provider to choose from depending on the situation.  In our experience, teaching management scripts can be most helpful for learners early in their clinical training, which is hardly surprising. Creating management plans is hard! Even the most straightforward chief concern could invoke many diagnoses, each of which informs numerous management options that have their own specific harms and benefits. Providing a management script template, an educational scaffold of potential types of interventions, can augment that first, challenging step of identifying what a clinician could do. Our favorite management script template is laboratory studies, imaging studies, procedures, specialists, medications, and monitoring (LIPS M&M).  Consider this familiar scenario of a new intern presenting their assessment...
Source: Academic Medicine Blog - Category: Universities & Medical Training Authors: Tags: Featured care management decisions clinical decision making residency training residents Source Type: blogs