All lessons Module 1: Foundations Lesson 21
Sparring and self-test
How do you ask an acupuncturist a sharp question without tearing down their framework, and then defend a case yourself in ten minutes?
The last lesson of the module, as review and self-test: two traditions side by side, practice with sharp questions, sixteen self-test questions with an answer framework, a final task with a checklist and a practice case, and your route after today.
Know by heart
- Three levels. 1 internal logic, 2 bridge to physiology, 3 clinical evidence; one question sits on one level; the category error: an effect does not prove the explanation, a mechanism does not prove a channel.
- The five questions that always work. which tradition were you trained in; which finding was decisive and what dropped out; what have you ruled out; what do you expect after how many treatments and how do we measure it; how would you explain this to the GP; mnemonic: Lineage, Decisive, Excluded, Expectation, Doctor: "Let Doctors Explain Every Diagnosis".
- Four criteria for a good question. retell in their words, one level, answerable, changes something in what the practitioner does or promises; mnemonic: first their story, then one question with an answer that matters.
- Two traditions. Maciocia: Bian Zheng Lun Zhi, pattern gives principle gives points, with tongue and pulse; Five Element (Worsley): the CF from colour, sound, odour and emotion, blocks first; mnemonic CSOE: look, listen, smell, feel.
- The final criteria. red flags (the fixed start), two patterns, three separators from complaint, tongue and pulse, principle with Root and Manifestation, points or formula with a reason; line; hypothesis with A, B or C and a test, evidence with type, control and effect, one sharp question.
- What to avoid. equations (Qi is ATP), mixing traditions (a CF is not a Zang-Fu pattern), mixing levels, judging someone's tongue or pulse reading, vague questions, three questions at once.
The rest of this lesson is reference.
Three practice questions from this lesson
'Which finding was decisive for Liver-Fire and not for stagnation?'
- Sharp and respectful
- Too vague
- Category error
- Equation or attack
Answer: Sharp and respectful. One question, on level 1, in their language, and it forces the differential.
'Does acupuncture actually work?'
- Sharp and respectful
- Too vague
- Category error
- Equation or attack
Answer: Too vague. For which complaint, against which control, and how much? The evidence differs by indication. Make it concrete: 'What do you expect for his back pain, compared with usual care?'
'Channels have never been demonstrated, so why would LR-3 work?'
- Sharp and respectful
- Too vague
- Category error
- Equation or attack
Answer: Category error. Levels 3 and 1 mixed up: the absence of an anatomical channel says nothing about the clinical effect, and an effect does not prove the channel. Better: 'How do you explain the action of LR-3, and what would convince you that it works differently?'
The rest of this lesson
In the course you get the step-by-step explanation, 12 case-based practice questions, 26 spaced-repetition flashcards, the pitfalls and the bridge to physiology with evidence grades. This lesson belongs to module 1: Foundations.