LEARNER-STATE STACK TEMPLATES
ALL YEARS | PAGE 73B - CURRENT STATE -> SMALLEST STACK -> REQUIRED OUTPUT -> ESCALATION RULE
B. LEARNER-STATE TEMPLATES
| Learner state | Smallest effective stack | Proof of transfer | Escalation rule |
|---|---|---|---|
| Strong school foundation; pathology weak | Primary Qbank + Pathoma + official assessment | Mechanism/pathology errors convert to fresh-vignette transfer. | If failure persists, inspect whether physiology or representation - not pathology - is the true gap. |
| Weak renal physiology | Primary Qbank + narrow renal physiology deep dive + targeted renal questions | Explain mechanism from blank page; solve new renal questions. | Escalate depth only if mechanism still cannot be reconstructed. |
| Micro/pharm facts decay | Primary Qbank + memory/visual system + spaced retrieval | Drug/bug facts retained after delay and used correctly in new vignettes. | Do not add a second memory system unless the current encoding method fails. |
| DO learner: biomedical strong; OMM weak | Core biomedical Qbank + school OMM lab/review + COMLEX/OMM questions + official calibration | Diagnosis/technique/safety reasoning improves; supervised motor skill is demonstrated. | Add only the OMM layer; do not restart the biomedical core. |
| Clinical learner: management sequence weak | Clinical Qbank + targeted algorithm review + illness-script drills + Shelf/COMAT calibration | Can state next step, trigger and reassessment point; transfers to new cases. | If still weak, classify whether problem is instability, diagnosis, sequencing or disposition. |
| Bedside exam weak; written strong | Bedside video/pre-work + supervised observed practice | Correct maneuver, interpretation and documentation in a real/simulated patient. | Written resources cannot certify motor performance; seek direct feedback. |
| Official assessment lower than Qbank | Keep primary bank; inspect repeats, selection bias, timing and broad domains; targeted repair | Fresh mixed performance and official calibration converge. | Do not solve discordance by adding a new general curriculum immediately. |
TOP 10 RESOURCE-GOVERNANCE CONCEPT - 4: STRONG FOUNDATION -> NARROW REPAIR
| DEEP EXPLANATION | WHY STUDENTS MISS IT | EASIEST CLUE |
|---|---|---|
| When the base is sound, the efficient response to a weak domain is focused repair plus transfer testing, not restarting every system from the beginning. | Anxiety after a poor block can make a narrow weakness feel global, especially when a broad curriculum offers emotional reassurance. | If most domains are stable and one pattern repeats, repair the pattern - not the entire year. |
| TOP 10 RESOURCE-GOVERNANCE CONCEPT - 5: WEAK FOUNDATION -> STRUCTURE BEFORE VOLUME | ||
| DEEP EXPLANATION When errors are broad and mechanistic, a structured content pass may | WHY STUDENTS MISS IT Learners may keep increasing question counts even when they cannot explain | EASIEST CLUE If you cannot teach the mechanism simply, rebuild before demanding mixed |
| temporarily deserve more weight than random question volume. Questions then verify reconstruction rather than replace it. | the causal model behind repeated misses. | transfer. |
| TOP 10 RESOURCE-GOVERNANCE CONCEPT - 6: MANUAL SKILLS REQUIRE OBSERVED PRACTICE | ||
| DEEP EXPLANATION OMM and bedside examination can use videos and written resources as | WHY STUDENTS MISS IT High written scores can create false confidence about psychomotor execution. | EASIEST CLUE If the skill depends on hands, positioning or patient interaction, include observed |
| pre-work, but competence in palpation, positioning, technique and examination requires supervised performance and feedback. 2026/27 resource-governance expanded edition - verify official/provider scope and school requirements before use | practice. |