Title: Medical education and research UDLCO through CRH: Creating precision medicine tailors instead of rote memorising retailers
Summary:
The content discusses the need for a paradigm shift in medical education and research, from a reductionist, rote memorization approach to a more holistic, precision medicine approach. It highlights the complexity of living systems, the importance of environmental factors, and the limitations of current approaches. The conversation also touches on the role of intuition in decision-making and the need for a more nuanced understanding of biological systems.
*Keywords*
- Precision medicine
- Medical education
- Complexity of living systems
- Reductionism
- Holistic approach
- Environmental factors
- Intuition and decision-making
Keywords and phrases: Medical Cognition UDLCOs published and detailed earlier (ref 17: glossary https://
Conversational Transcripts:
[29/04, 17:32] Kmcq: Three profession of Medical are socially enforced.Dental
.Physiotherapy. Psychiatry
With our traditional wisdom,yoga etc..
Not required
[29/04, 17:37]hjcn: Why do you think Dental, Physiotherapy and Psychiatry are not required?
What's your rationale behind such comments
[29/04, 17:40] Kmcq: Depends on complaints at presentation
[29/04, 17:42] Kmcq: Most of the time*
Or avoidable/preventable
[29/04, 18:01]bpck: That's your personal view.I think they are as much required as other medical professions rather they are most neglected (except dentistry).
[29/04, 18:03] Kmcq: Agree
[29/04, 18:44 hjcn: How can we validate this personal view
Can we verify or falsify these personal bias that exist in bright medical students?
[29/04, 18:48] Kmcq: Mostly we do peer review and discussion and exposure to different perspectives.
And reflections.
[29/04, 18:46]hjcn: Preventable and avoidable ??
What if the patient doesn't have insight and don't really know how to avoid these conditions
[29/04, 18:50] Kmcq: Thats psychosis NOS..
As per definition.
If theres loss of insight..
But management is individualised or tailored
[29/04, 18:54] Kmcq: When rational decision-making becomes irrational: a critical assessment and re-conceptualization of intuition effectiveness
[29/04, 18:58] Kmcq: In research, it is considered common sense that the characteristics of a decision task have an influence on whether the task should be accomplished rather intuitively or analytically. One characteristic of the task that researchers have discussed in this context is the uncertainty of the task-related environment. Because uncertain decision tasks often do not allow an analytical derivation of a clearly correct solution, researchers have suggested that intuition may be an effective strategy for dealing with uncertain decision tasks (Agor 1986; Gigerenzer 2008; Parikh 1994; Sadler-Smith and Shefy 2004). Scholars argue that intuition helps decision makers to react timely and accurately to the environment’s changing stimuli
(Eisenhardt 1989; Manesh et al. 2022), to integrate large amounts of data and cope with incomplete information (Khatri and Ng 2000), and to perceive possibilities that have not been identified previously (Crossan et al. 1999).
Sinnaiah et al. (2023) argue that utilizing intuition as a decision style can enhance organizational performance, particularly when faced with limited resources or knowledge. According to Goldberg (1990, p. 73), any “forecaster has to use intuition in gathering and interpreting data and in deciding which unusual future events might influence the outcome”.
Conversely, other researchers propose that intuition may falter under conditions of uncertainty, leading to biased or unreliable decisions. Most prominently, Kahneman and Tversky (1973) observed several cognitive biases that occur in intuitive predictions in the context of uncertainty and probabilities. Schirrmeister et al. (2020) emphasize that, in uncertain environments, the use of intuition can lead to cognitive biases because it is based on incomplete information and implicit assumptions. Luoma and Martela (2021) generally consider intuition as an inferior strategy in novel or rapidly changing environments. In the context of clinical decision making, Hall (2002) states that clinicians rely on intuition particularly in uncertain situations, despite this may result in lower performance and is susceptible to cognitive bias.
[30/04, 07:20] cm: 👏👏 system 1 thinking in medical cognition
[29/04, 19:07]hjcn: Doesn't individualized/tailored management with medicine come under *personalized medicine*, which is the most emphasized topic these days.
[30/04, 07:18]cm: Medical students are currently taught to be rote memorizing retailers whereas what we need them to become is more akin to a precision medicine 'tailor'!
[30/04, 07:23]cm: Another book that nails the current misconceptions around precision science that attributes disproportionate importance to genetic internal medicine mechanisms and less to environmental external medicine mechanisms👇
Book Summary: Understanding Living Systems by Raymond Noble & Denis Noble
Understanding Living Systems (2023) by Raymond and Denis Noble offers a fresh perspective on biology, challenging reductionist views and emphasizing the dynamic, interconnected nature of life. The authors argue that living systems cannot be fully understood by studying genes or molecules in isolation—instead, life emerges from complex interactions across multiple levels of organization.
Key Themes & Arguments
Beyond Genetic Determinism:
Critiques the "gene-centric" view of life (popularized by Dawkins' "selfish gene" theory).
Genes are tools used by organisms, not the sole drivers of biology.
Multi-Level Causation:
Life operates through interactions at all levels: molecules, cells, tissues, organisms, and ecosystems.
Example: The heart’s function depends on genes, cellular networks, and the body’s needs—not just DNA.
Purpose & Agency in Biology:
Living systems exhibit goal-directed behavior (e.g., homeostasis, adaptation).
Agency isn’t mystical but arises from self-organizing processes.
The Role of Constraints:
Life is shaped by physical, chemical, and historical constraints.
Evolution works within these limits, not just through random mutations.
Biological Relativity:
No single level (e.g., genes) has primacy; causation flows bidirectionally.
Example: Environment influences gene expression (epigenetics).
Life as Process:
Organisms are dynamic, ever-changing systems, not static entities.
Death and renewal are intrinsic to biological continuity.
Implications for Medicine & AI:
Reductionist approaches fail in complex systems (e.g., treating diseases holistically).
AI models of life must account for agency and adaptability.
Why It Matters
The book bridges philosophy and science, advocating for a more integrated view of biology. It aligns with systems biology, complexity theory, and post-Darwinian perspectives like the Extended Evolutionary Synthesis.
Final Thought: Life isn’t a machine—it’s a layered, self-sustaining process shaped by history, environment, and emergent creativity.
Thematic Analysis
*Codes and Categories*
1. *Medical Education*:
- Current state: rote memorization
- Desired state: precision medicine, tailored approach
2. *Precision Medicine*:
- Tailoring treatment to individual needs
- Considering genetic and environmental factors
3. *Complexity of Living Systems*:
- Interconnectedness and dynamic nature of life
- Multi-level causation and constraints
- Agency and adaptability in biological systems
4. *Limitations of Reductionism*:
- Gene-centric view limitations
- Importance of environmental factors
- Need for holistic approaches
5. *Intuition and Decision-Making*:
- Role of intuition in uncertain environments
- Potential biases and limitations
*Learning Insights*
1. *Shift in Medical Education*: There's a need to move from rote memorization to a more tailored, precision medicine approach.
2. *Complexity of Biology*: Living systems are dynamic and interconnected, requiring a holistic understanding.
3. *Importance of Environmental Factors*: Environmental influences play a significant role in shaping biological systems and disease.
4. *Limitations of Current Approaches*: Reductionist views and gene-centric approaches have limitations in understanding complex biological systems.
CC licence: https://commons.m.
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