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Facebook vs twitter the coming facebook twitter collision

Many conversations about clinical decisions hinge around this elusive, slippery and somewhat obscure term. Perhaps it is in a rather circular manner something that is difficult to define, yet we know it when we see it…. This very brief introduction is a start on a number of future posts linking perception, interpretation, judgement and clinical decision making.

So for starters, do you agree with Linda? Why has the word "gestalt" suddenly started popping up more and more?

What does Gestalt mean?

What does Soros want?

Where does the term come from? Gestalt originated in the psychological literature towards the beginning of the last century. It was a counter to the structuralist arguments promoted towards the end of the 19th Century.

Structuralist approaches suggest that everything can be broken down into individual components, thus by knowing the nature of constituent parts we can understand the whole. For example a structuralist approach would suggest that by understanding all the aspects of automotive engineering we can understand what a car is.

Gestalt would argue that we perceive a car as a whole and not as components. Properties in Gestalt systems Much of the literature around gestalt focuses on visual perceptions and there are several examples around that you may be familiar with.

There are four properties in gestalt systems, emergence, reification, invariance and multistability. Emergence Emergence is the phenomena where a complex pattern emerges from simpler forms.

Perhaps the best known example of this is the following picture of a Dalmation dog. There is clearly no picture of dog here, but our minds are able to form the final image from the component parts. None of the components in itself is dog like, yet the sum of the image gives a dog sniffing the ground Reification Reification is the process by where we construct spacial relationships from elements outwith those presented to use.

Several examples are shown below where geometrical objects are perceived by the relationship with the components presented, yet they do not actually exist.

Examples below include the Necker cube and the Rubin vase, but there are many others. Similarly we perceive the same shape regardless of environmental effects such as setting, time of day, location etc.

Do such visual elements of Gestalt exist in medicine? We build towards a diagnosis from elements of its form rather than an entire picture or a consistent form.

How do we use it medicine? We seem to use it a lot. It is referred to in conversations between clinicians and also appears in a number of clinical decision rules.

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JudkinsSimon EMManchester davehartin docib I'm still hearing a description of what I've always thought was just clinical expertise… — Linda Dykes DrLindaDykes June 28, EMManchester mmbangor davehartin docib Think it's a combination of education, experience, knowing the lit and gut feeling.

So, if the objective measures are evidence of low risk, what then is the original perception of the treating clinician that this is a low risk patient. Similarly in the Wells DVT score we assign a score of -2 for patients in whom we feel an alternative diagnosis is likely.

This soft perception on the part of the clinician is again arguably embracing Gestalt within a scoring system.The latest Tweets from SLOStringer (@SLOStringer).

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Dear Twitpic Community - thank you for all the wonderful photos you have taken over the years. We have now placed Twitpic in an archived state.

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