PPS Flashcards
(120 cards)
1
Q
HUMAN RIGHTS ACT 1998
What is the WHO definition of health?
How does this link to the HRA?
A
- The state of complete physical, mental + social wellbeing + not merely the absence of disease or infirmity.
- The highest attainable level of health is the fundamental right of every human being.
2
Q
HUMAN RIGHTS ACT 1998
When did the HRA come into force?
What is the importance of it?
A
- 2000 + is set out in the European Convention on Human Rights.
- (Should) form part of an organisations decision-making process to ensure people’s rights are respected + is part of all policy making.
3
Q
HUMAN RIGHTS ACT 1998
What are the underlying assumptions with the HRA?
A
- State/organisations have a duty to uphold these rights + they’re universal.
- All basic rights are claim rights i.e. others wanting things.
- The irreducible moral status of individuals demands that people are treated in ways that are compatible with that moral status.
4
Q
HUMAN RIGHTS ACT 1998
What are some issues with the HRA?
A
- ?Universal or Western concept (FGM, judicial executions).
- Which interests are significant enough to justify it being a human right?
- Can absolute claims conflict? All rights are interdependent + inter-related.
5
Q
HUMAN RIGHTS ACT 1998
What are the 5 articles that are frequently engaged in healthcare?
A
Art 2 – the right to life.
Art 3 – the right to be free from inhumane + degrading treatment.
Art 8 – the right to respect for privacy + family life.
Art 12 – the right to marry + found a family.
Art 14 – the protection from discrimination (sex, race, sexuality etc).
6
Q
HUMAN RIGHTS ACT 1998
What is meant by absolute rights?
Give some examples
A
They’re never limited i.e. they hold under ALL circumstances.
- Art 3, Art 4 (prohibition on slavery + enforced labour), Art 7 (protection from retrospective criminal punishments).
7
Q
HUMAN RIGHTS ACT 1998
What is meant by limited/qualified rights?
Give some examples
A
They are limited under explicit + finite circumstances.
- Art 2 (limited), Art 5 (the right to liberty), Art 8 (qualified).
8
Q
HUMAN RIGHTS ACT 1998
Explain why some rights may be limited/qualified.
A
- Art 5 – if your freedom affects other’s safety.
- Art 2 – medical Tx a pt requests is not a right. Obligation upon state to take appropriate steps to safeguard life but cannot impose a disproportionate burden on the authorities to provide unlimited resources.
9
Q
HUMAN RIGHTS ACT 1998
What is the exceptionality criteria with the HRA?
A
Applicable to public bodies like NHS trust where they adopt a general policy for the exercise of ‘administrative discretion’, to allow for exceptions from it in ‘exceptional circumstances + leave those circumstances undefined’.
10
Q
HUMAN RIGHTS ACT 1998
What are some topics in individual rights vs. collective groups?
A
- Should vaccines or blood/organ donation become compulsory?
- Is screening a form of collectivism?
- Wearing a face mask to prevent spread of disease despite disagreement.
11
Q
RESOURCE ALLOCATION
What is rationing?
A
Where resource is refused because of lack of affordability rather than clinical ineffectiveness.
12
Q
RESOURCE ALLOCATION
Why have rationing needs increased in terms of resource allocation?
A
- Shift from acute>chronic complex conditions.
- Increase in choice + availability of more expensive drugs.
- Medicalising what used to be ‘normal’ physiology (childbirth, menstruation).
- Ageing population with increasing demand on services.
- Funding has barely increased.
13
Q
RESOURCE ALLOCATION
What are the 3 ethical theories in context of resource allocation?
A
- Egalitarianism.
- Maximising/Utilitarianism.
- Libertarian.
14
Q
RESOURCE ALLOCATION
What is the concept of egalitarianism?
What are the pros/cons?
A
- Provide all care that is necessary + required to everyone.
Pros: equal for everyone (supports belief people deserve equal rights/opportunities)
Cons: economically restricted, tension between egalitarian aspirations + finite resources.
15
Q
RESOURCE ALLOCATION
What is the concept of maximising?
What are the pros/cons?
A
- Healthcare should be distributed to bring about the best possible outcome (criteria that maximises public utility).
Pros: resources allocated to those most likely to receive most benefit.
Cons: those with ‘less need’ receive nothing.
16
Q
RESOURCE ALLOCATION
What is the concept of libertarian?
What are the pros/cons?
A
- Each individual is responsible for their own health, wellbeing + flourishment i.e. incentives for behaviour change, screening participation paid (all paid with savings made from better health outcomes).
Pros: onus on pt therefore may be more engaged.
Cons: not all diseases are self-inflicted, should people be held accountable for their current/future health?
17
Q
RESOURCE ALLOCATION
What is the harm principle in relation to Libertarian theory?
What is the con to this principle?
A
- People should have autonomy in life so long as it doesn’t affect anyone else, even if others see actions as being wrong
- BUT doesn’t appreciate the impact choices has on others
18
Q
RESOURCE ALLOCATION
What is Johnson’s rule of rescue?
A
A tension sometimes arises between the injunction to do as much good as possible with scarce resources + the injunction to rescue identifiable individuals in immediate peril, regardless of the cost.
19
Q
RESOURCE ALLOCATION
Give an example of Johnson’s rule of rescue.
A
It’s a perceived duty to save endangered life through disproportionate efforts regardless of cost + usually seen in vulnerable groups like children.
- E.g. treat rare cancer in child with experimental drug that may be effective.
20
Q
RESOURCE ALLOCATION
What is meant by a sustainable process?
A
One that meets the needs of the present without compromising the ability of future generations to meet their own needs.
21
Q
RESOURCE ALLOCATION
What are the aspects of sustainability
A
- Economic factors.
- Social factors.
- Environmental factors.
22
Q
RESOURCE ALLOCATION
Explain how the NHS can contribute to unsustainable practice
A
- NHS emissions come directly from everyday clinical practice.
- E.g. inefficient use of resources which can lead to clinical waste (over investigating, overprescribing, over intervention).
23
Q
RESOURCE ALLOCATION
How can we respond to the unsustainable practices in the NHS?
A
- Reduce clinical waste via appropriate prescribing, pt education to improve adherence.
- Requires system-level action i.e. changes through legislation.
- Encourage active travel (improved air quality + reduced risk of CVD).
24
Q
RESOURCE ALLOCATION
What is the ladder of interventions?
A
- Starts at doing nothing/monitoring.
- Next steps are education or enabling choice (can be via changing the default).
- Ends with incentives, disincentives + then restricting/eliminating choice.
25
MEDICAL NEGLIGENCE
| Define negligence
A breach of duty of care which results in damage.
| - There is failure to take proper care over something.
26
MEDICAL NEGLIGENCE
| What 4 questions should be asked when negligence is suspected?
- Was there a duty of care?
- Was there a breach in that duty?
- Did the patient come to any harm?
- Did the breach cause the harm?
27
MEDICAL NEGLIGENCE
| What 2 tests can be used to decide if there was a breach in a duty of care?
- Bolam test = would a group of responsible doctors do the same?
- Bolitho test = would it be reasonable of them to do so?
28
MEDICAL NEGLIGENCE
| What factors influence how much money a patient may get from a successful negligence claim?
- Loss of income.
- Cost of extra care.
- Pain + suffering.
29
MEDICAL NEGLIGENCE
| What are 6 broad factors which contribute to negligence?
- System failure.
- Human factors.
- Judgement failure.
- Neglect.
- Poor performance.
- Misconduct.
30
MEDICAL NEGLIGENCE
| Explain what is meant by system failure.
- Computer system may shutdown > losing notes.
- Pt may be unconscious + unable to communicate so important info lost at critical moment.
- Hackers could access computer systems = remove confidential information.
– Confidentiality breaking in this way could be negligent.
31
MEDICAL NEGLIGENCE
| Explain what is meant by human factors?
- Personal factors (having a bad day>mistakes).
- Teamwork problems (miscommunication, tensions between staff).
- Working environment (lighting, space).
- Decision density (leaving one person to make all decisions = pressure so more likely to make a mistake).
32
MEDICAL NEGLIGENCE
| Explain what is meant by judgement failure?
- Defective decision making, bias.
- Analytical or intuitive.
- Wrong amount or type of information, wrong decision making strategy.
33
MEDICAL NEGLIGENCE
| Explain what is meant by neglect.
- Not showing enough care.
- Falling below expected standard.
- Often chain of minor failures which may/may not lead to harm.
- Can be multidisciplinary (communication + assumptions).
34
MEDICAL NEGLIGENCE
| Explain what is meant by poor performance.
- Repeated minor mistakes or not learning from mistakes.
| - Usually extends beyond attitude to pt care (timekeeping, reliability, illness).
35
MEDICAL NEGLIGENCE
| Explain what is meant by misconduct.
- Deliberate harm, covering up errors, improper relationships (staff/pts).
- Fraud/theft/abuse i.e. falsely claiming sickness, substance misuse.
36
ERROR
Define error?
What can medical error lead to?
What should you do in the event of a Patient Safety Event?
- A preventable event that can cause or lead to an unintended outcome.
- Medical error is a preventable event that can lead to pt harm.
- Notify, inform patient, explain + apologise under the Duty of Candour policy
37
ERROR
| What are 2 types of medical error?
- Adverse event = incident that results in pt harm.
| - Near miss = event which had potential to cause harm but didn't develop further thereby avoiding harm.
38
ERROR
| What are some examples of human (individual errors)?
- Omission (required action delayed/not taken).
- Commission (wrong action taken).
- Sequence (action taken in wrong order).
- Fixation (regular act so don't recognise if something goes wrong).
- Negligence (actions/omissions do not meet standard of an ordinary, skilled person).
39
ERROR
| What are 4 broad classifications of errors?
- Intention.
- Action.
- Outcome.
- Context.
40
ERROR
| What is meant by intention?
- Failure of planned actions to achieve desired outcome.
41
ERROR
| What are 3 types of intention error?
- Skill-based (action made is not what was intended i.e. performing well-known task>little attention>error if distracted).
- Rule-based (incorrect application of a rule/incorrect plan or course of action taken i.e. in emergencies).
- Knowledge based (lack of knowledge in a certain situation.
42
ERROR
| What are the issues with knowledge based errors?
- Automatically make us prone to actions not as planned.
- Memory may contain mini-theories rather than facts (liable to confirmation bias).
- Limited attentional resources.
43
ERROR
| What is meant by action?
- Generic factors (omission, intrusion, sequence).
| - Task-specific factors (wrong blood vessel/organ/side, bad knots in surgery).
44
ERROR
| What is meant by outcome?
- Near miss.
- Death/injury/loss of function.
- Successful detection + recovery.
- Prolonged intubation/stay in ICU.
45
ERROR
| What is meant by context?
- Equipment + staffing issues.
- Accumulation of stressors.
- Interruptions + distractions.
- Team/organisation factors.
- Nature of procedure.
46
ERROR
| What are some red flags for errors?
- Anomalies.
- Broken communication, missing information or confusion.
- Departures from normal practice.
- Stress.
47
ERROR
| What are the 10 types of basic error?
- Sloth.
- Fixation + loss of perspective.
- Communication breakdown.
- Poor team working.
- Playing the odds.
- Bravado + timidity.
- Ignorance.
- Mis-triage.
- Lack of skill.
- System error.
48
```
ERROR
Give an example of...
i) sloth.
ii) fixation + loss of perspective.
iii) communication breakdown.
iv) poor team working
v) playing the odds.
```
i) not bothering to check results accurately, inadequate documentation.
ii) early unshakable focus on Dx, inability to see bigger picture.
iii) unclear instruction of plans, not listening to/considering other's opinions.
iv) some out of depth, some under-utilised.
v) choosing the common + dismissing rare.
49
```
ERROR
Give an example of...
i) bravado + timidity
ii) ignorance.
iii) mis-triage.
iv) lack of skill.
v) system error.
```
i) working beyond competence/without adequate supervision (opposite for timidity).
ii) lack of knowledge, not knowing what you don't know.
iii) over/underestimating the seriousness of a situation.
iv) lack of appropriate skills, teaching or practice.
v) environmental, technology, equipment or organisation features. Inadequate safeguards build into system.
50
ERROR
| What behaviour is lacking in each basic error?
- Sloth (conscientiousness).
- Fixation + loss of perspective (open mindedness, situation awareness).
- Communication breakdown (effective communication).
- Poor team working (good teamwork).
- Playing the odds (probability assessment).
- Bravado + timidity (humility).
- Ignorance (self-awareness).
- Mis-triage (prioritisation).
- Lack of skill (effective technical skills.
- System error (good system deisgn).
51
```
ERROR
Give an improvement for...
i) sloth.
ii) fixation + loss of perspective.
iii) communication breakdown.
iv) poor team working
v) playing the odds.
```
i) attention to detail, full documentation.
ii) recognition of clinical patterns but considering facts that don't fit.
iii) being approachable + open, listening, clear explanations.
iv) clear team structure, leadership + roles.
v) evaluation based on scenario features as well as likelihood.
52
```
ERROR
Give an improvement for...
i) bravado + timidity
ii) ignorance.
iii) mis-triage.
iv) lack of skill.
v) system error.
```
i) accurate self-evaluation, open communication of mistakes.
ii) aware of own abilities + limitations.
iii) appreciation of the relative importance of each situation.
iv) being properly trained in your role.
v) system designed to be easy to use, complete + with design features that identify potential risk.
53
ERROR
| Define a never event.
A serious, largely preventable patient safety incident that should not occur if the available preventative measures have been implemented.
54
ERROR
| Give some examples of never events.
- Medical = wrong route for chemo (i.e. intrathecal vincristine scenario).
- Surgical = wrong site or retained object.
- Mental health = escape of transfer pt, suicide.
55
ERROR
| What organisations must the hospital trust report never events to?
- National Reporting and Learning Systems (NRLS).
- CQC.
- Strategic Executive Information System (StEIS).
56
ERROR
| What are the consequences of never events?
- Financial penalties.
- Reputation loss.
- CQC visit.
- Fitness to practice meetings.
57
ERROR
| What are the 2 perspectives on error?
- Person approach = focus on the individual at fault.
| - System approach = focus on the working conditions/organisations at fault.
58
ERROR
| What is the concept of the person approach to error?
- Looks at + blames an individual/group of individuals.
- States errors are the product of unpredictable mental processes (inattention, distraction, negligence).
- Focusses on the unsafe acts of people on the frontline.
59
ERROR
| What are the cons with the person approach to error?
- Anticipation of blame promotes 'cover up' + need for a detailed analysis to prevent recurrence (retraining, discipline).
60
ERROR
| What is the concept of the system approach to error?
- Adverse events are the products of many causal factors.
- The whole system has some kind of flaw at fault to blame.
- Adapt system to prevent recurrence (recognise errors + implement defences).
- Errors occur due to interaction between active failures + latent conditions.
61
ERROR
| How can errors + harm be reduced?
- Simplification + standardisation of clinical processes.
- Checklists + aide memories (SBAR).
- Team training.
- Risk management programmes to remedy latent factors.
- Mechanisms to improve uptake of evidence-based Tx patterns.
62
ERROR
| What tools can be used for risk identification?
- Incident reporting.
- Complaints + claims.
- Audit, service evaluation + benchmarking.
- External accreditation.
- Active measurement/compliance.
63
ERROR
| Name the 2 models for errors.
- Swiss Cheese model.
| - Three bucket model.
64
ERROR
| Explain the concept of the Swiss Cheese model
- An organisations defences against error are modelled as a series of barriers, represented as slices of cheese.
- The holes in the slices represent weaknesses in individual parts of the system.
- The holes are continually varying in size + position across the slices.
- System failure occurs when a hole in each slice momentarily aligns.
65
ERROR
| What is the difference between latent failures and active failures?
- Latent failures = flaws to the system e.g. organisational influences (culture, politics), unsafe supervision (oversight, Mx issues), preconditions for unsafe acts (lack of training, system + tools used).
- Active failures = unsafe acts that are mistakes + errors at the frontline – the sharp end of the stick.
66
ERROR
What is the concept of the three bucket model?
What do the 3 buckets represent?
- Error evolves due to interaction between personal, environmental + physical factors as well as organisation – this tool can help stratify risk.
- Self, context + task.
67
ERROR
| Three bucket model – what comes under self?
- Level of knowledge (newly qualified, senior support available, unaware of current protocols).
- Level of skill (competence + experience).
- Level of expertise (confidence, automaticity, expectations/assumptions).
- Current capacity to do task (fatigue, stressors, illness, life events).
68
ERROR
| Three bucket model – what comes under context?
- Equipment (maintenance, availability, usability, power sources).
- Physical environment (lighting, surfaces, noise, temperature).
- Workspace (working environment, handovers, layout).
- Team + support (leadership, trust, briefing + reflection).
- Organisation + Mx (communication, safety culture + reporting, workload).
69
ERROR
| Three bucket model – what comes under task?
- Errors (omission, commission, fixation, sequence).
- Task complexity (calculations, double checking).
- Novel task (unfamiliar events, rare events, new ways of working).
70
ERROR
| What are some common issues with accidents/safety in healthcare?
- Wrong Dx>wrong plan.
- Medication reconciliation (if forget to reconcile the meds list then pts may end up with duplicates, interactions).
- High concentration medication solutions.
- Pt identification.
- Pt care handovers.
71
ERROR
| Why is safety compromised so often in healthcare?
- Complex, high risk environment.
- Responsibilities are often shared.
- Practitioners often take risks unknowingly.
- System, pt + practitioner interaction.
- Resource intensive.
72
ETHICS
Define...
i) ethics.
ii) morality.
i) system of moral principles + a branch of philosophy that defines what is good for individuals + society.
ii) concerned with the distinction between good + evil or right + wrong.
73
ETHICS
| What are the 4 pillars of medical ethics?
- Autonomy (respecting pt's right to make informed decisions about their own medical care).
- Beneficence (duty to 'do good' i.e. provide benefits to the pt).
- Non-maleficence (duty to 'do no harm' i.e. not doing bad.
- Justice (ensuring all pts treated equally + equitable i.e. fairness in distribution of Tx).
74
ETHICS
What is the concept of Utilitarianism?
What are the cons?
- An act is evaluated solely in terms of its consequences to maximise good + minimise harm.
Cons: treats minorities unfairly to promote majority happiness, how do you define what is good?
75
ETHICS
What is the concept or virtue ethics?
What are the cons?
- Focuses on the person who is acting – do they express good character?
- An act is only virtuous if the person is acting with the genuine intention of doing the right thing – are they integrating reason + emotion.
Cons: virtues are culture-specific + too broad for practical application, no focus on consequences i.e. compassion may lead to not telling harmful truth = lying.
76
ETHICS
| What are the 5 focal virtues that are acquired?
- Discernment (ability to judge well).
- Conscientiousness (being thorough, careful + vigilant).
- Compassion (showing concern for others).
- Trustworthiness (ability to be relied on).
- Integrity (being honest + having good moral principles).
77
ETHICS
What is the concept of deontology?
What are the cons?
- Features of the act determines worthiness.
- Teaches that acts are right/wrong + people have a duty to act accordingly (treat others how you would like to be treated).
- Cons = consequences not looked at, duties can conflict.
78
ETHICS
| What are categorical imperatives?
- Version of deontology.
- Categorical imperative is a rule that is true in all circumstances.
- Act in a way you would be willing it to become universal law.
79
GMC DUTIES AS A DR
| What are the 4 domains encompassing duties of a doctor?
1) Knowledge, skills + performance.
2) Safety + quality.
3) Communication, partnership + teamwork.
4) Maintaining trust.
80
GMC DUTIES AS A DR
| Give some examples of the varying duties of a doctor.
- Provide a good standard of practice i.e. keep professional skills updated (1).
- Recognise + work within limits of competence (1).
- Take prompt action if think pts safety/dignity/comfort is being compromised (2)
- Protect + promote the health of pts + public (2).
- Tx patients as individuals + respect their dignity + confidentiality (3).
- Work in partnership with pts (3).
- Work in collaboration with colleagues to best service pts interests (3).
- Be honest, open + act with integrity (4).
- Never discriminate unfairly against pts/colleagues (4).
81
GMC DUTIES AS A DR
| What are the benefits of doctors using social media?
- Facilitating public access to accurate health information.
- Improving patient access to services.
- Establishing wider + more diverse social + professional networks.
- Engaging with the public + colleagues in debates.
82
GMC DUTIES AS A DR
| What are the risks of doctors using social media?
- Loss of personal privacy.
- Potential breaches in confidentiality.
- Online behaviour that may be perceived as unprofessional, offensive or inappropriate by others.
- Risks of posts being reported by the media or sent to employers.
83
```
DIVERSITY EDUCATION
Define...
i) culture.
ii) acculturation.
iii) stereotypes.
```
i) a socially transmitted pattern of shared meanings by which people communicate, perpetuate + develop their knowledge + attitudes about life.
ii) Adapting to a new culture.
iii) generalisations about the 'typical' characteristics of members of a group.
84
```
DIVERSITY EDUCATION
Define...
i) ethnocentrism
ii) prejudice.
iii) discrimination.
```
i) the tendency to evaluate other groups according to the values + standards of one's own culture group, especially with the conviction that one's own culture group is superior to others.
ii) attitudes towards another person based solely on their membership of a group.
iii) actual positive or negative action towards the objects of prejudice.
85
DIVERSITY EDUCATION
| What makes up someone's individual culture?
- May be based on heritage, as well as individual circumstances + person choice – it's a dynamic entitiy.
86
DIVERSITY EDUCATION
| Explain the iceberg model of culture.
- Parts of culture which are visible from the surface (can be deducted from appearance e.g. you can have idea of their age, nationality, ethnicity, gender).
- Parts of culture which you cannot possibly see from the surface (more embedded within the person e.g. socioeconomic status, occupation, health, religion, education, sexual + political orientation).
87
DIVERSITY EDUCATION
| How can we bridge cultural distance?
- Self-awareness = being aware of your own feelings + reactions.
- Respectful curiosity = suspend judgement, don't assume – ask.
- Greater the culture distance, more likely it is that any assumptions you make will be wrong.
88
DIVERSITY EDUCATION
| What are the benefits of diversity training?
Pts – adherence more likely as more satisfied with their care, fewer diagnostic tests + referrals, pt Sx burden is reduced.
Drs – fewer complaints, more time efficient.
89
DIVERSITY EDUCATION
| What are some challenges + solutions concerning diversity in healthcare?
- Language barriers (longer appts, interpreters).
- Fasting + needs for medications (speak to religious leader ?exemption).
- Health beliefs such as different expectations in Dr/Pt relationship (paternalistic), Jehovah Witnesses' refusing blood (talk to pts + understand their beliefs, education).
- Expectations of healthcare system private vs. NHS (education).
- Taboos (i.e. sexual health in some cultures).
90
```
COMM DIFFICULTIES
From a SALT perspective, what is meant by...
i) speech?
ii) language?
iii) pragmatics?
iv) comprehension?
v) expression?
```
i) converting language into an audible form.
ii) can be spoken, writing, gestures. It's to do with words + how we put them together.
iii) how language is used (turn taking, eye contact).
iv) aka receptive language – understanding language.
v) aka expressive language – producing language.
91
COMM DIFFICULTIES
What happens in speech impairment?
How may it present?
What are some causes?
- Words are unaffected, output is affected.
- Dysarthria (imprecise/slurred speech), apraxia (speech sounds in the wrong order), stammer/stutter (dysfluent speech).
- Stroke, cerebral palsy, acute brain injury, MND.
92
COMM DIFFICULTIES
What happens in language impairment?
How may it present?
What are some causes?
- Can relate to written or spoken language + is where ability to understand concepts unaffected just ability to understand the means of the message.
- There may be trouble understanding some words, longer phrases or grammar etc.
- May present as unreliable yes/no, no language produced, word-finding difficulties.
- Stroke, dementia (primary progressive aphasia), acute brain injury.
93
COMM DIFFICULTIES
| What happens in a pragmatic impairment?
- May be a feature in many conditions (Autism-spectrum disorders).
- May present as atypical body language, difficulties with turn-taking.
94
COMM DIFFICULTIES
| What happens in voice disorders?
- Acute vs. chronic.
| - Causes – laryngectomy, common cold, GORD, Parkinson's, environmental pollutants.
95
COMM DIFFICULTIES
| What are the impact of communication disorders?
- Everyday activities (difficulty with work, shopping, transport).
- Social engagement (difficulties ordering food).
- Relationships (both parties may get frustrated, may lead to isolation).
- Healthcare (more vulnerable to medical errors, may face prejudice).
96
COMM DIFFICULTIES
| What are some strategies to support communication?
- Simplify language, use visual aids, check the person has understood, don't rush.
- E.g. break down into smaller chunks, gestures, recap, speak slowly, one Q at a time, different methods of communication, repeat yourself.
97
TEACHING SKILLS
| How should a skill be taught?
- Breaking the task down into smaller components.
- Utilising an internal commentary.
- 'See one, do one, teach one'.
98
TEACHING SKILLS
| What is Peyton's 4 step procedure for skill training?
- Trainer demonstrates without commentary./
- Trainer demonstrates with commentary.
- Learner talks through + trainer does.
- Learner talks through + does.
99
TEACHING SKILLS
| What are some critiques of Peyton's 4 step procedure?
- Insufficient time for learner to practice.
- Insufficient feedback.
- Lack of clarity + thoroughness.
100
TEACHING SKILLS
What is a method used in small group teaching?
Give examples.
- Tutor facilitation rather than teaching.
- Micro-facilitation by dividing into smaller groups.
- E.g. rounds (each student has 1m to talk), circular interviewing (students ask each other questions), buzz groups.
101
TEACHING SKILLS
| What are the key responsibilities of small group teachers?
- Manage the group, activities + learning.
- Facilitate the learning by leading discussions, asking open-ended Qs, guiding process + task, enabling active participation of learners + engagement with ideas.
102
TEACHING SKILLS
| What fundamental questions should a small group teacher ask themselves?
- Who am I teaching? (Numbers, levels, names).
- What am I teaching? (Topic, type of expected learning i.e. knowledge, skill, behaviours).
- How will I teach it?
- How will I know if the students understand/understood?
103
TEACHING SKILLS
| What are some question strategies?
- Evidence = how do you know that? Evidence?
- Clarification = can you give me an example? Explain this term?
- Explanation = why is that the case?
- Linking + extending = how does this idea support/challenge what we explored earlier?
- Hypothetical = what might happen if?
- Cause + effect = how is this response related to that?
- Summary + synthesis = what remains unsolved/uncertain?
104
TEACHING SKILLS
| What is the tripartite model of types of learning?
- Surface.
- Strategic.
- Deep approach.
105
TEACHING SKILLS
| What is meant by surface?
- Fear of failure.
- Desire to complete a course.
- Learning by rote + focus on particular tasks.
106
TEACHING SKILLS
| What is meant by strategic?
- Desire to be successful.
| - Leads to a patchy + variable understanding (well organised form of surface learning).
107
TEACHING SKILLS
| What is meant by deep approach?
- Intrinsic, vocational interest, person understanding.
| - Making links across materials, search for deeper understanding of the material, look for general principles.
108
TEACHING SKILLS
| What are 4 different types of learner?
- Theorist = complex situation, can question ideas, offered challenges.
- Activist = new experiences, extrovert, likes deep end, leads.
- Pragmatist = wants feedback, purpose, may like to copy.
- Reflector = watches others, reviews work, analyses, collects data.
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TEACHING SKILLS
| What is Kolb's learning cycle?
- Conclusions from experience (theorist).
- Experience (activist).
- What can I do differently next time? (pragmatist).
- Review + reflect on experience (reflector).
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TEACHING SKILLS
| What is the relevance of different types of learners?
Individuals should choose activities which best match their learning style + identify least dominant style so that they can strengthen these.
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TEACHING SKILLS
What is meant by intuitive thinking in decision making?
What are some biases?
- Ability to understand something instantly without conscious reasoning.
Biases: confirmation bias (tendency to favour information that confirms or strengthens their existing beliefs or theories).
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TEACHING SKILLS
What is meant by analytical thinking?
What are some cons?
- Lacks skills at estimating odds or values but excels at measuring + calculating them. This is the basis of evidence-based medicine.
Cons: slow, resource intensive, cognitively demading.
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TEACHING SKILLS
| What is the dual process theory?
- Intuitive thinking with its irresistible combination of heuristics + biases, together with analytical thinking, using evidence-based medicine.
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LEADERSHIP
| What are the 5 leadership styles?
- Authoritarian.
- Participative.
- Delegative (Laissez-faire).
- Transactional.
- Transformational (inspirational).
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LEADERSHIP
What is the concept of authoritarian leadership?
What are the pros?
What are the cons?
- Allows one leader to impose expectations + define outcomes.
- Pros: consistent results, time spent on crucial decision reduced.
- Cons: v strict, lack of staff creativity/innovation, lack of group input.
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LEADERSHIP
What is the concept of participative leadership?
What are the pros?
What are the cons?
- Rooted in democratic theory to involve team members in the decision-making process> feeling included, engaged + motivated to contribute.
- Pros: encourages staff creativity, increases staff motivation.
- Cons: decisions may be time-consuming, poor decisions may be made.
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LEADERSHIP
What is the concept of delegative leadership?
What are the pros?
What are the cons?
- Focuses on delegating initiative to team members, letting things take their own course without interfering.
- Pros: environment of independence, experienced staff can offer experience.
- Cons: downplays role of leader, leaders avoid leadership, staff may abuse.
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LEADERSHIP
What is the concept of transactional leadership?
What are the pros?
What are the cons?
- Leader sets clear goals + uses "transactions" such as rewards, punishments etc to get the job done. Staff know how their compliance is rewarded.
- Pros: staff motivation + productivity increased, reward system.
- Cons: innovation/creativity minimised, less leaders created, seen as coercive.
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LEADERSHIP
What is the concept of transformational leadership?
What are the pros?
What are the cons?
- Leader inspires the followers with a vision + then encourages + empowers them to achieve it. The leader serves as a role model for the vision.
- Pros: high value on corporate vision, high morale for staff, not coercive.
- Cons: leaders can deceive staff, may need consistent motivation/feedback.
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LEADERSHIP
| What leadership model is best suited for healthcare and why?
- Transformational.
- It places the needs of pts, carers + families at the centre of all work + people can intervene when necessary.
- I.e. speak up if risk to pt, continually improve system, talk to seniors if lack of skill, knowledge or resources.
