Week 7 Lab: Lab 7 — Triage Under Pressure

Sort forty cases into five categories in ninety seconds each, then find out how you did and where your errors clustered.

19 April 2027

Before the lab#

Read the week 7 notes, including Priya’s section. Nothing else — preparation would defeat the exercise.

In the lab#

The sort. Forty case cards, adapted from published triage training material. Ninety seconds each, alone, no discussion. Assign a category 1 to 5. You will feel rushed. That is the working condition, not a flaw in the exercise.

The reference. We reveal the reference categories. Everybody scores themselves. Expect to be wrong on somewhere between six and twelve, which is roughly where experienced clinicians sit on unfamiliar cards, so do not read your score as a verdict on you.

The interesting part: the pattern. Errors are not evenly distributed and yours will not be either. Cross-tabulate the room’s mistakes against the card features — was the patient described as calm, as a frequent presenter, as distressed, as elderly, as not speaking English as a first language? Nearly every cohort discovers the same two clusters, and discovers them in their own data rather than being told about them.

The consequence. Then we put the classifier back in the queue. Take your own error rate from part two and apply it to the priority discipline from the lecture. A 15% misclassification rate does not degrade the queue by 15%; it concentrates almost the whole cost on the small group being misclassified downwards, who then wait under the wrong category’s target with the wrong condition.

Afterwards#

This lab has upset people in previous years, and it is meant to be uncomfortable rather than gratuitous. If it raises something about clinical work you would like to talk about away from the room, email me and we will find a time.

The design point carries into the final brief: every priority scheme contains a classifier, the classifier has an error profile, and the error profile is part of the design whether or not the designer looked at it.