IMreasoning - Clinical reasoning for Doctors and Students

If you missed us live on Facebook last week, here's you chance to catch up.  Enjoy our STC session.  The case is from Australia, sent to us by Elise Perger (Allan) and Alison Miller... and we invited Chang as a guest host, back by popular demand.

Or, you can still watch the Facebook video at the link below.

Let us know if you liked the Facebook live event.  We can do it again!

Direct download: episode_37_STC_International_Live_event_-_151217_2.53_PM.mp3
Category:general -- posted at: 9:23am NZST

Enjoy our live Stump the Chumps at Main Medical Centre.  We were honoured to be invited by Bob Trowbridge and it was a pleasure to visit Portland, Maine.

Direct download: episode_36_STC_at_MMC_-_151117_7.00_AM.mp3
Category:general -- posted at: 7:22am NZST

Part two of our exploration of the connections between art, artistic thinking, creativity, with clinical reasoning and diagnosis.

We speak to Alexa Miller, a medical educator who uses arts-based learning and visual thinking skills to train students and seasoned professionals alike to better observe, describe, communicate, and to tolerate uncertainty.

We also speak with Jay Baruch, a writer, medical educator, and emergency doctor who is also the director the clinical arts and humanities at Brown Medical School.

Direct download: episode_35_-_turning_the_wheel_part_2_Alexa_edits_amplified.mp3
Category:general -- posted at: 1:37pm NZST

Another enjoyable Diagnostic Error in Medicine conference, this time in Art's home town of Boston (actually, Newton...).  In this episode we discuss our thoughts inspired by one of the sessions, run by Doug Salvador and Harry Hoar from Baystate Medical Centre. They addressed how to get one's own hospital administration to engage in Diagnostic Error.  Remember to check the website for the attachment so you can follow along while you listen.

This is part one of a two-part series exploring the deep connections between creative thinking and clinical reasoning.  We discuss Art's and Glenn's work as poets and physicians, and how each endeavour enriches the other.

Enjoy an episode of STC.  This time WE weren't in the hot seat!  Humbling to see an excellent trainee in action.

Direct download: episode_32_STC_with_Chang_-_110917_2.35_PM.mp3
Category:general -- posted at: 4:03pm NZST

We finally got the chance to collaborate with Genevieve on her case for STC.  And we were keen to get this out just before GPTEC. Enjoy!

Direct download: episode_31_STC_international_with_Genevieve_Yates_-_90817_final.mp3
Category:general -- posted at: 11:25am NZST

We were privileged to speak to one of our patients, recently treated by our service, about her experience while her doctors struggled with diagnostic uncertainty.  The usual suspects were at play; uncommon diagnoses, uncommon presentations, cognitive biases, systems issues, etc.

Check out the new look to our website! 

This time, we did not have a pause button! and we could not edit out all the times we sounded a little thick.  So enjoy the raw experience.  We did!

Direct download: episode_29_STC_at_AusDEM_-_220617_5.48_PM.mp3
Category:general -- posted at: 6:24pm NZST

Coined by the New York Times as the "leading debunker of preconceived notions in the medical world", Don Redelmeier is an award winning researcher, teacher, and clinician.  Enjoy our conversation with Dr. Redelmeier where we discuss pitfalls in clinical well as New Zealand idioms...

Tell us what you think on:

Twitter, @IMreasoning

or email us at


Direct download: episode_28_-_Don_Redelmeier.mp3
Category:general -- posted at: 9:26pm NZST

Finally, our first STC International.  An interesting case from Broome, Western Australia.  Thanks Casey Parker.

Direct download: episode_27_-_STC_international_Casey_Parker_from_Broome_-_160417_4.26_PM.mp3
Category:general -- posted at: 10:28pm NZST

While waiting for another of our home-grown cases we decided to do a STC using a published case from the Clinical Problem-Solving series of the New England Journal of Medicine.

Let us know what you think of this format!

or now you can make noise at us on Twitter.  Our handle is @IMreasoning


Direct download: episode_26_STC_from_NEJM_-_160317_11.45_AM.mp3
Category:general -- posted at: 11:56am NZST

Do all diagnostic errors occur because we're rushing, and prematurely jumping to conclusions? Can we course-correct by simply slowing down and by being mindful of our own inherent biases?

Geoff Norman and his colleagues review the literature to try to answer these and other questions about where errors in clinical reasoning come from.

The Causes of Errors in Clinical Reasoning: Cognitive Biases, Knowledge Deficits, and Dual Process Thinking

And get your own Cognitive Bias Codex poster here: Cognitive Bias Codex

Please write us with comments and feedback on Facebook at

or on our webpage at

and send us your STC cases to


Direct download: episode_25_revisiting_dual_process_thinking_-_210217_8.22_AM.mp3
Category:general -- posted at: 8:44am NZST

Doctors should always strive to present themselves as unbreakable to their patients...  All doctors are smart...  All patients have a definitive diagnosis...

Believe it or not, versions of these ideas, and many others, are pervasive in our medical education institutions, and to varying degrees are believed and practiced by doctors everywhere.

In this episode, we debunk and discuss our favourite myths. Enjoy!

Don't forget to write us with feedback on our Facebook page at

or on our webpage at

and write to us with your STC cases to


Direct download: episode_24_myths_2_-_110117_9.37_PM.mp3
Category:general -- posted at: 9:52pm NZST