1. Step 1
1.1. Identify terms and cues
1.2. New terms
1.2.1. interpreter
1.2.2. tingling sensation
1.2.3. doing up buttons
1.2.4. kitchen hand
1.3. cues
1.3.1. chinees female (looks old, with glasses) working at a local chinees resturant
1.3.2. sore hand
1.3.2.1. last 9 months
1.3.2.2. right hand
1.3.2.3. burning and tingling sensation in the early morning
1.3.2.3.1. 3 lateral fingers
1.3.2.4. radiated to the upper arm and shoulder
1.3.2.5. mainly at night (in bed) and at work
1.3.2.6. tries to reduce the pain by shaking and hanging her hand
1.3.2.7. worried that it might affect her work
1.3.2.8. numb and swallown
1.3.2.9. sleep is affected
1.3.3. problems with fine movements
1.3.4. doctor visit a week ago
1.4. 10 minutes
2. Step 4
2.1. Hypothesis organization (tentative solution)
2.1.1. Truma
2.1.1.1. Nerve injury
2.1.1.1.1. carpul tunnel syndrom
2.1.1.1.2. median nerve injury
2.1.1.1.3. radial nerve injury
2.1.1.2. tendon/ligamint enjury
2.1.1.3. synovitits
2.1.1.4. tendinitis
2.2. 20 minutes
3. Step 5
3.1. Formulate learning objectives
3.1.1. Review anatomy upper limb (breifly)
3.1.1.1. mucles of fine movements
3.1.1.2. Innervations
3.1.2. What causes these symptoms in hand workers?
3.1.2.1. is it ligament, muscle, or nerve injury?
3.1.3. Why burinign - tingling sensation?
3.2. 10 minutes
4. Step 2
4.1. Problem formulation (put it in a senates)
4.1.1. Chinees female kitchen hand suffering from sore right hand with burning and tingling sensation for 9 months envloving her lateral 3 fingers, radiating to the upper arm and shoulder, and limiting her activites.
4.2. 10 minutes
5. Step 3
5.1. Hypothesis generation (brainstorming)
5.1.1. Vascular
5.1.1.1. hypoxia
5.1.2. Infections
5.1.2.1. Osteomylitis
5.1.2.1.1. through knife cut
5.1.2.2. infection of midpalmer space
5.1.3. Truma
5.1.3.1. carpul tunnel syndrom
5.1.3.1.1. her work
5.1.3.2. median nerve injury
5.1.3.3. radial nerve injury
5.1.3.4. muscle stress
5.1.3.5. brachial pleuxes injury
5.1.3.6. tendon/ligamint enjury
5.1.3.7. tendinitis
5.1.3.8. synovitits
5.1.4. Autoimmune
5.1.4.1. RA
5.1.5. Metabolic
5.1.5.1. Gout
5.1.6. Newplastic
5.1.7. conginital
5.1.8. others