Hemolysis in the Hospitalized Patient
Practice separating terrain, stance, and execution to reduce category error.
1. How this module fits in Consult Practice
| Lens | What it contributes here |
|---|---|
| Orientation | Defines the clinical terrain and tempo |
| Thinking | Assigns cognitive weight and stance |
| Execution | Makes judgment visible through action and communication |
2. What this module is for
To help trainees practice separating terrain from stance and stance from action.
3. How to use this module
Use as a teaching tool during rounds or consult handoffs.
4. Why this matters
Most consult errors arise from category confusion, not knowledge deficits.
5. Core Content
| Clinical statement | Domain | Why |
|---|---|---|
| “Hemoglobin fell from 9 to 6 overnight.” | Orientation | defines tempo |
| “Given the tempo, this deserves reserve-threat weighting.” | Thinking | assigns posture |
| “We need to repeat the smear and labs.” | Execution | visible action |
| “LDH and bilirubin are elevated, suggesting a destruction-type terrain is plausible.” | Orientation | defines terrain |
| “We will hold judgment until trajectory stabilizes.” | Thinking | uncertainty discipline |
Teaching prompt:
Which statements define the terrain, which define how to assign weight, and which define what must become visible to others?
6. Bottom line
This module reinforces the separation between Orientation, Thinking, and Execution in real consult work.