Every reasoning tool, by layer.
Each tool is mapped to the ACGME Child & Adolescent Psychiatry Milestones — adopted as an educational benchmark and paraphrased, never pasted. The program is not ACGME-accredited.
01 · Diagnostic reasoning
Open the layer →Illness Scripts
Experts keep clinical knowledge as **typical patterns**, called illness scripts. They diagnose by matching the case to a script — not by checking off facts one by one.
Learn →Dual-Process Thinking
Your mind solves a case two ways: **fast pattern-matching** and **slow step-by-step thinking**. Most of the skill is knowing when to lean on each — and knowing that slowing down cannot fix what you simply do not know.
Learn →What Is · What It Means · What Should Be
Keep three things apart: **what you see**, what it means, and what you want. Set the goal as the flip side of the problem.
Learn →Developmental Framing
The same sign means different things at different ages. So you check every observation against what is **normal for that age** before you call it a problem.
Learn →Inductive & Deductive Reasoning in the MSE
Reasoning runs two ways. **Inductive** builds ideas up from what you see. **Deductive** tests one idea against its rules. Always know which way you are going.
Learn →Risk Formulation, Not a Checklist
Risk is a **working story** that drives a plan — not a one-time score you read off a scale.
Learn →02 · Logic & debiasing
Open the layer →Sound vs. Valid Reasoning
**Valid** means the conclusion follows from the premises. **Sound** means it is valid AND the premises are true. A **sound** argument passes both checks.
Learn →Anchoring & Premature Closure
Two common reasoning traps: leaning too hard on the **first thing you hear**, and **closing the case too soon**. Plus one simple move that reopens the differential before you commit.
Learn →Base Rates & Natural Frequencies
Before you trust a positive screen, ask how common the condition is here first. Then count it out in whole people — "of 1,000 patients…" — instead of percentages.
Learn →Affect & Visceral Bias
A feeling about a patient — anger, worry, or liking — can quietly bend your read. The feeling is a **clue to check**, never the answer.
Learn →Argument Mapping
Lay a claim and its reasons out where you can **see** them. Then you can tell if the conclusion really follows — or if it just **sounds** right.
Learn →03 · Mental models & systems thinking
Open the layer →Inversion & Second-Order Effects
Think backwards. Ask **"what would make this go wrong?"** first. Then ask **"and then what?"** one step past the obvious result.
Learn →Systems Thinking — Patient, Unit, Hospital
See the case inside the bigger picture — the unit, the team, the hospital flow — not just the one patient in front of you.
Learn →04 · Reflection & communication
Open the layer →Calibration & Self-Monitoring
Knowing how good your judgment really is — making how **sure you feel** match how **often you turn out right**.
Learn →Articulating Reasoning & Uncertainty
Say your thinking out loud — your best guess, one other guess you still hold, the one question that would tell them apart, and how sure you honestly are. That lets a teacher coach the **thinking**, not just the answer.
Learn →Shared Decision-Making & Values
A good plan weighs two things: **what the evidence shows** and **what matters to this patient and family**. When more than one option is reasonable, you decide together, out loud.
Learn →05 · Knowing the person
Open the layer →The Big Five
Five traits cover most of how people differ. Knowing where a person sits **changes how you read and engage them** — without labeling them.
Learn →Five belief areas trauma touches
Trauma can bend a person's beliefs in **five areas**: safety, trust, power and control, esteem, and closeness. Knowing the five areas gives you a map for what a survivor may be carrying. It is a lens for assessment, not a therapy.
Learn →Reading the person in the case
Personality and beliefs are **clues you reason from**, not labels you stick on a person. They help explain the case. They are never the diagnosis.
Learn →