KeyLIME+ [21] Unpacking Medical Expertise: Illness Scripts, Clinical Reasoning, and the Future of CanMEDS
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Jun 10, 2025 
In this discussion, Saleem Razack, a pediatric intensivist and award-winning leader in medical education, teams up with Stuart Lubarsky, an associate professor and director of an urgent neurology clinic. They delve into the intricate concept of medical expertise, emphasizing adaptive knowledge over sheer information volume. The conversation touches on illness scripts, cognitive load, and the evolution of clinical reasoning. Additionally, they advocate for a broader perspective on medical training within the CanMEDS framework, highlighting the integration of ethical and social considerations.
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Adaptive Expertise Defined
- Expertise is not just comprehensive knowledge but how it's organized in the brain for efficient problem solving.
- Experts adapt quickly to novel problems with minimal cognitive effort, embodying adaptive expertise.
ICU Decision-Making Example
- Saleem Razack shared his ICU experience balancing physiological data with the nurse's and respiratory therapist's input.
- This example highlights the integration of multiple knowledge systems in real clinical reasoning.
Illness Scripts Explained
- Illness scripts are organized knowledge networks influencing how clinicians interpret information.
- They enable experts to recognize patterns quickly and respond appropriately without conscious effort.
