1. How this module fits in Consult Practice
| Lens | What it contributes here |
|---|---|
| Orientation | Sorts facts that define the terrain (tempo, stability, recency of thrombosis) |
| Thinking | Sorts statements of weighting and trade-off discipline |
| Execution | Sorts visible actions, triggers, and communication moves |
2. What this module is for
To practice: “Which facts define the map, which statements define posture, and which statements are execution?”
3. How to use this module
Run it in 2–3 minutes on rounds. After sorting, ask: “What would change the posture?”
4. Why this matters
In competing harms, teams often jump to execution without shared posture, or jump to posture without correct terrain. Sorting enforces discipline.
5. Core Content
A. Sorting cards
- “Hemoglobin fell from 9.5 to 7.2 in 8 hours.”
- “Last dose of apixaban was this morning.”
- “The patient is tachycardic and borderline hypotensive.”
- “Pulmonary embolism occurred 6 days ago.”
- “This is a competing-harms problem with asymmetric risks.”
- “Bleeding is the dominant immediate threat right now.”
- “We will revise weight as trajectory declares itself.”
- “Hold further anticoagulation while bleeding is active.”
- “Please call us immediately if bleeding worsens or there is instability.”
- “Now that bleeding has stopped and hemoglobin is stable, thrombotic vulnerability deserves more weight.”
B. Answer key
| Card | Domain | Rationale |
|---|---|---|
| 1 | Orientation | tempo and severity define terrain |
| 2 | Orientation | anticoagulant timing shapes terrain |
| 3 | Orientation | stability defines urgency tolerance |
| 4 | Orientation | thrombotic recency defines competing-harms intensity |
| 5 | Thinking | identifies posture type |
| 6 | Thinking | assigns provisional weight |
| 7 | Thinking | commits to revisability |
| 8 | Execution | visible behavior aligned with stance |
| 9 | Execution | explicit triggers and alignment |
| 10 | Execution | communicated recalibration |
6. Bottom line
Sorting protects the framework: Orientation defines map, Thinking assigns weight, Execution makes judgment visible. In competing harms, this discipline prevents premature closure and unsafe drift.