skills/hoc-y/references/clinical-reasoning.md

# Clinical reasoning framework

> **Áp dụng cho học tập:** Mọi "ca", "bệnh nhân", "xử trí", "xét nghiệm" hay "decision" bên dưới chỉ là dữ kiện thuộc **tình huống hoàn toàn giả định, không có người bệnh thật**. Đọc cùng `educational-boundaries.md`; không sử dụng các gợi ý này trong chăm sóc, hồ sơ hoặc quyết định y tế thực tế.


## Core sequence
Presentation → Problem representation → Differential → Investigation → Severity/Risk → Management → Reassessment

## Problem representation
Compress the case into one sentence using only discriminating features: age/context, time course, key syndrome, severity, and important positives/negatives.

## Differential diagnosis
Prefer a prioritized list:
- common/likely;
- dangerous cannot-miss;
- mimic/easily confused;
- context-specific.

Avoid exhaustive lists unless explicitly requested.

## Tests as decisions
For each important test:
- What clinical question does it answer?
- What result would meaningfully change the next step?
- Is the test urgent, useful later, or unnecessary now?

## Management
Structure as:
- immediate priorities;
- cause-directed treatment;
- supportive care;
- monitoring;
- reassessment;
- escalation/disposition.

In a completely fictional exam vignette, teach the curricular concept of identifying danger signs and the need for qualified supervision; do not issue real-time stabilization instructions or replace direct assessment.

## Debrief
After a case, summarize:
- decisive clues;
- one tempting but wrong path;
- one safety-critical issue;
- one transfer question to a new case.