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Explaining the unexplainable?


chbare

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It is not uncommon to come across concepts that are so far beyond our experience in medicine, they simply cannot be explained in any intuitive way. Often, they are explained with mathematics, but an intuitive model is often lacking. One concept I have come across is the concept of spin. I have had an exceptionally difficult time explaining this concept without all the talk of Pauli matrices and so on.

Going away from that, I would like to hear about concepts that you guys have found difficult to explain as students or instructors, (EMT, Paramedic, RN, RT, MD, DO, PA and so on) or non-intuitive to describe. Even better, I would love to hear about the different models and pictures you use to attempt to intuitively describe some of these concepts.

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It is a different concept I mentioned. It is a type of spin that very small objects such as electrons have, but it is not a literal spin like the angular momentum a spinning basketball has, rather it is something that cannot be directly visualised but is present nonetheless.

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I find it difficult to explain that intuitive synthesis of information that one begins to acquire as a healthcare provider. That a patient's condition is more than the sum of the pieces (BP, respiratory effort, labs, psychosocial situation, etc). Some folks understand that concept, but others look at you like you have three heads or imply that your "spidey sense" or "intuition" is useless in practicing medicine... I beg very strongly to differ...

I usually have to draw lots of parallels to non-healthcare related things to get someone to understand it that's having a hard time with it.

That's the hardest thing I find to explain...

Wendy

RN-ADN

CO EMT-B

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Through that "Spidey Sense" developed through the training, I'm not the only one who has made a life saving call.

I know it has saved my own arse quite a few times.

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I'm not sure if this is in the spirit of what you're asking, and if not, then my apologies...not trying to be a dork and derail your thread..

But one thing that makes me a bit crazy trying to explain, even though it seems to me that it should be intuitively obvious to everyone, is using a patients movements, postures, facial expressions, and how they relate to each other as an assessment tool.

I used to write it off to laziness, but now thing that maybe my history as an animal trainer made me a little more sensitive to it (see 'Clever Hans').

Even something so simple as a call that I was the second ambulance on scene. First ambulance had mom in the rig, minor trauma if I remember right, fire was cutting two kids out of another car that would come with me. (Yeah, I know, not the way it's supposed to work, but first medic in was already off in the ditch mentally, no one served by schooling him on triage/MCI management) I asked the first medic about dad, "He's fine, I've already talked to him" yet dad is running around trying to keep track of his whole family and it's as if his entire upper body is made out of cement. Nothing moves in relation to each other...legs and hips shift to shift dad's line of sight.

I called dad into my ambulance and took him and his two kids...he ended up with some flavor of spinal fracture despite insisting that he was fine (and yeah, he rode in sitting up wearing a collar. Two kids pretty damaged, next ambulance in would have been 30 mins or more..so there you have it). I asked the medic later, "Couldn't you tell by looking at him that he was injured?" He said, "He looked ok, he said he was fine." I said, "What did you expect him to say when he saw one medic and he had three injured family members?? Screw them, take care of me first! Don't most people that you see normally move their upper body part somewhat independent of each other?"

Anyway, probably most providers of any level have a million stories just like that, the uncoordinated patient that swears they're "tired" with a bgl of 25, stroke patient that's jolly and laughing, no issues on the stroke scale but can't seem to button their shirt or shows uncharacteristic repetitive movement or tics...just strange stuff that doesn't seem catastrophic but should be explained before a description of "fine" is accepted by any provider...

Maybe it's just a matter of really caring whether or not they are in fact fine or not that makes the difference? Anyway, I've had almost zero success trying to pass this assessment value on despite trying to explain it while the behavior is occurring and able to be observed...Grrrrrr

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  • 3 months later...

At one time in my checkered "career", I taught computer applications to adults. The entry level course (operating systems) was the most difficult to teach. It was all concepts, important to impart to form a solid base for people of the transition generations, those having reached early middle age without the presence of computers.

I used everything in my arsenal - pictures, sound, demonstrations, etc. I learned that everyone learns differently, so I stacked each concept with many different analogies. A representation that clicked with one student left another cold.

Short answer - analogies, diagrams and demonstrations

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"It is a different concept I mentioned. It is a type of spin that very small objects such as electrons have" E.g. quantum spin states. Were you teaching MRI theory?

I was doing a fairly standard lecture on general chemistry and quantum numbers. However, there are always students who ask the tough questions and I have yet to really find a good, intuitive answer. I know many people use a planet orbiting with a certain spin about it's axis analogy, but this fails when people start pushing for better answers. Likewise, saying spin is an intrinsic type of angular momentum due to anti-symmetric wave functions, the Pauli exclusion principle and so on does little to help.

Spin is simply something so bizarre and outside of the human experience, there are no good classical analogies that I can think of to describe it.

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