Published 9 March 2009, doi:10.1136/bmj.b796
Cite this as: BMJ 2009;338:b796

Practice

Commentary: The value of complexity

¹ Medical Teaching Centre, Warwick Medical School, University of Warwick, Coventry CV4 7AL

doi:10.1136/bmj.b6doi:10.1136/bmj.b246doi:10.1136/bmj.b799doi:10.1136/bmj.b846doi:10.1136/bmj.b868doi:10.1136/bmj.b867

The first 150 words of the full text of this article appear below.

This case is complex.¹ For undergraduate learning "complex and elaborate examples are likely to be suboptimal as effective teaching tools,"² but is the same true for postgraduate learners? What do we learn in the midst of complexity? Initially we are caught up in the urgency of lifesaving measures as the desperately ill patient fails to respond to primary interventions, and then when she does respond to steroids we have to ask ourselves why. The authors reflect the frustration of clinicians and patient alike as potential diagnostic clues are followed down blind alleys.

There is rich learning here about our clinical reasoning processes. Now that we know the denouement of this fascinating case, can I encourage those who engaged with the puzzles posed at the stage of case progression to think back. My listing of the information presented about Mrs Barroso as she recovered was as follows:

• This hypotensive shock triggered . . . [Full text of this article]

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