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1 - Public Health AE > PPS week > Flashcards

PPS week Flashcards

1
Q

What happened during the Montgomery case?

A

Child of diabetic mother was born with serious disability due to shoulder dystocia that the doctor had not told her was a risk of vaginal delivery so the mother still had a vaginal delivery. Judge ruled the doctor should have explained the risks

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2
Q

What questions must a doctor ask themselves about informed consent?

A

Does the patient know about the material risks of the
treatment I am proposing?
Does the patient know about reasonable alternatives to this treatment?
Have I taken reasonable care to ensure that the patient actually knows this?

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3
Q

What does article 8 involve?

A

The right to respect for privacy and family life, even in end of life care. (qualified)

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4
Q

What did the Tracey case involve?

A

DNACPR given without discussion with the patient nd the trust was sued

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5
Q

What are the things that have changed due to the Tracey case?

A

Patients (or their families) will be included sensitively and compassionately in DNACPR decisions.
Where consultation is expected to cause psychological anguish or distress (but not actual harm) doctors may avoid a DNACPR decision even where resuscitation will be futile

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6
Q

What factors come into play when considering rationing healthcare?

A

Clinical, value based and socio-psychological.

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7
Q

What is the libertarian approach?

A

Each is responsible for their own health, well being and fulfilment of life plan

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8
Q

What is Article 2?

A

The right to life (limited)

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9
Q

What is Article 3?

A

The right to be free from inhuman and degrading treatment (absolute)

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10
Q

What is Article 12?

A

The right to marry and found a family

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11
Q

What did the Kerry Wooltorton case involve?

A

She committed suicide, wrote a note saying she didn’t want any life-saving treatment, but she wanted to be kept pain free. Judge ruled that she should be allowed to die

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12
Q

What is the Bolam test?

A

A test that arose from English tort law, which is used to assess medical negligence. Bolam holds that the law imposes a duty of care between a doctor and his patient, but the standard of that care is a matter of medical judgement. It states that if a doctor has acted according to proper and accepted practice, he is not guilty of medical negligence.

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13
Q

What is the Bolitho test?

A

The defence could not be considered reasonable if the body of doctors or supporting witnesses were not capable of withstanding logical analysis.

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14
Q

When are DOLS needed?

A

The Mental Capacity Act allows restraint and restrictions to be used – but only if they are in a person’s best interests. Extra safeguards are needed if the restrictions and restraint used will deprive a person of their liberty. These are called the Deprivation of Liberty Safeguards.

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15
Q

Where can DOLS be used?

A

The Deprivation of Liberty Safeguards can only be used if the person will be deprived of their liberty in a care home or hospital. In other settings the Court of Protection can authorise a deprivation of liberty.

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16
Q

What are the types of error regarding patient safety?

A 
Sloth
Fixation and loss of perspective
Communication breakdown
Poor team working
Playing the odds
Bravado
Ignorance
Mis-triage
Lack of skill
System error
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17
Q

What is an example of a sloth error?

A

Not bothering to check results/information for accuracy. Incomplete evaluation. Inadequate documentation.

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18
Q

What attribute is used to prevent a sloth error and an example of how to put that into practice?

A

Conscientiousness. Attention to detail. Completeness. Not assuming that information presented to you is correct. Full documentation.

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19
Q

What is an example of fixation and loss of perspective?

A

Early unshakeable focus on a diagnosis. Inability to see the bigger picture. Overlooking warning signs.

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20
Q

What attribute is used to prevent fixation and loss of perspective and examples of how to put that into practice?

A

Open mindedness. Situational awareness. Recognition of the clinical patterns but considering facts that don’t fit. Re- evaluation if deviation from the expected.

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21
Q

What is an example of communication breakdown?

A

Unclear instructions or plans. Not listening to or considering others opinions.

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22
Q

What attribute is used to prevent communication breakdown and examples of how to put that into practice?

A

Effective communication. Being approachable and open. Listening. Clear explanation with appropriate terminology and reinforcement.

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23
Q

What is an example of poor team working?

A

Team members working independently. Poor direction. Some individuals out of depth, others underutilised.

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24
Q

What attribute is used to prevent poor team working and examples of how to put that into practice?

A

Good team working. Clear team structure and roles with sharing of views, concerns and management plans. Clear logical leadership.

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25
What is an example of playing the odds?
Choosing the common and dismissing the rare event.
26
What attribute is used to prevent playing the odds and examples of how to put that into practice?
Probability assessment. Evaluation based on scenario features as well and likelihood
27
What is an example of bravado?
Working beyond your competence or without adequate supervision. A show of confidence to hide underlying deficiencies (not taking on that which you should)
28
What attribute is used to prevent bravado and examples of how to put that into practice?
Humility. Accurate self evaluation. Open communication of mistakes
29
What is an example an ignorance?
Lack of knowledge. Unconscious incompetence. Not knowing what you don’t know.
30
What attribute is used to prevent ignorance and examples of how to put that into practice?
Self-awareness. Aware of your own abilities and limitations. Consideration of factors which may affect your judgement (e.g., stress, fatigue)
31
What is an example of mis-triage?
Over/underestimating the seriousness of a situation.
32
What attribute is used to prevent mis-triage and examples of how to put that into practice?
Prioritisation. Appreciation of the relative importance or urgency of each situation.
33
What is an example of a system error?
Environmental, technology, equipment or organisational features. Inadequate built in safeguards.
34
What is used to prevent system error and examples of how to put that into practice?
System design. What attribute is used to prevent mis-triage and examples of how to put that into practice?
35
What are the benefits of doctors using social media?
Establishing wider and more diverse social and professional networks Engaging with the public and colleagues in debates Facilitating public access to accurate health information Improving patient access to services
36
What are the risks of doctors using social media?
Loss of personal privacy Potential breaches of confidentiality Online behaviour that might be perceived as unprofessional, offensive, or inappropriate by others Risks of posts being reported by the media or sent to employers
37
What are the red flags for error chains?
Ambiguities/anomalies/conflicting information/surprises. Broken communication or inconclusive discussions Confusion/loss of awareness/uncertainties Missing information/incomplete briefing Departures from standard procedures/normal practices Fixation/pre occupation Time distortion/event runaway Unease/fear; Denial/stress/action Alarm bells in your mind or warning from equipment
38
What are the factors that lead to accident and injury?
``` Organisational factors (cost cutting) Unsafe supervision (improper team pairing, deficient training programme) Preconditions for unsafe acts (mental fatigue/distractions) Unsafe acts (failure to verify correct medications) ```
39
What about the clinical culture leads to clinical errors?
Top-heavy structure (i.e., power/control) Lack of clear identity No clarity on who was responsible Lack of inter professional collaboration
40
What is the conformity problem?
The greater the benefits and lower the likely consequences, the more common it is for people to ‘migrate’ towards working in ways that they know to be wrong or that break the rules. Over time these ways become normalised and are integrated into the culture “This is how we do it here”.
41
What is transactional leadership?
Transactional leadership is a style of leadership in which leaders promote compliance by followers through both rewards and punishments.
42
What is transforming leadership?
Where the leader taps into his followers' higher needs and values, inspires them with new possibilities that have strong appeal and raises their level of confidence, conviction and desire to achieve a common, moral purpose.
43
What can change your behaviour?
Behaviours are altered by behaviour intention, which is altered by attitude towards behaviour, subjective norm and perceived behaviour control
44
What is Heinrich's triangle theory?
For every 1 fatality there are 2 million unsafe acts
45
What are the examples of safety interventions that have been successful?
``` Behaviour Change Safety Huddles Simulation Collaborative working Culture Surveys ```
46
What are allocation theories based on?
Egalitarian principles Maximising principles Libertarian principles
47
How are the egalitarian principles used in the NHS?
NHS was founded on a requirement to provide all care that is necessary and appropriate to everyone
48
How can maximising principles be put into action?
Criteria that maximize public utility
49
What is the libertarian approach?
Each is responsible for their own health, well being and fulfilment of life plan.
50
What are the motivations for unhealthy behaviours?
The costs of most unhealthy activities impact in the future, but the benefits from them occur in the present The challenge of affluence to self control
51
What are the problems with human rights?
Are they universal? Female genital mutilation, judicial executions Which interests are significant enough to justify ennobling a human right? All basic rights are claim rights Can absolute claims conflict? All rights are interdependent and inter-related
52
What are some examples of liberalism?
Should vaccinations become compulsory? What about blood/organ donations? Minority group representation in policy? Is screening a form of collectivism?
53
What is a judicial review?
Opportunity for an individual to challenge the exercise of power by a public body.
54
What does deep learning involve?
Involves critical analysis of new ideas Linking them to already known concepts and principles Leads to understanding and long term retention of concepts Enables problem solving in unfamiliar contexts Promotes understanding and application for life
55
What does surface learning involve?
Tacit acceptance of information Memorisation as isolated and unlinked facts Leads to superficial retention of material for exams Does not promote understanding or long term retention of knowledge and understanding
56
What student approaches are needed for deep learning?
Having an intrinsic curiosity in the subject Being determined to do well and mentally engaging when doing academic work Having appropriate background knowledge for a sound foundation Having time to pursue interests through good time management Positive experience of education leading to confidence in ability to understand and succeed
57
What student approaches are needed for surface learning?
Studying for the qualification and not being interested in the subject Not focussing on academic areas but emphasising others (social, sport) Lacking background knowledge and understanding necessary to understand the material Not enough time, too high a workload Cynical view of education, believing that factual recall is what is needed
58
What teacher approaches are needed for deep learning?
Showing personal interest in the subject Bringing out the structure of the subject Concentrating on and ensuring time for key concepts Confronting students misconceptions through active learning Using assessments that require thought Relating new material to what students already know and understand allow students to make mistakes without penalty
59
What teacher approaches are needed for surface learning?
Conveying disinterest or even a negative attitude to the material Presenting material so that it can be perceived as a series of unrelated facts and ideas Allowing students to be passive Assessing for independent facts (short answer questions) Rushing to cover too much material Emphasising coverage at the expense of depth Having a short assessment cycle
60
What is the theory of learning?
Learning is the process whereby knowledge is created through the transformation of experience, not an independent entity to be acquired or transmitted”
61
What is the reflective cycle?
Description - what happened? Feelings - what were you thinking and feeling? Evaluation - what was good and bad about the experience? Analysis - what sense can you make of the situation? Conclusion - what else could you have done? Action plan - if it arose again what would you do?
62
In Blooms taxonomy, what are the three types of learning?
Cognitive: mental skills (Knowledge) Affective: feelings or emotional areas (Attitude) Psychomotor: manual or physical skills (Skills)
63
What are psychomotor domains?
Unconscious incompetence Conscious incompetence Conscious competence Unconscious competence
64
What are the different learning styles?
Theorist Activist Pragmatist Reflector
65
What are theorist learners good at?
Complex situations Clear Purpose Can question ideas Offered challenges
66
What are theorists bad at?
Showing feelings Unstructured learning Doing but not knowing With dissimilar people
67
What are activists good at?
New experiences Extrovert Likes the deep end Leads
68
What are activists bad at?
``` Lectures Reading and writing Thinking alone Absorbing data Understanding data ```
69
What are pragmatists good at?
Links for learning Wants feedback Wants a purpose May like to copy
70
What are pragmatists bad at?
No obvious benefit No guidelines Learning is theory
71
What are reflectors good at?
Watches others Reviews work Analyses Collects data
72
What are reflectors bad at?
Leading Role playing With deadlines Sudden challenges
73
What are the features of an effective self-learner?
analyzing task requirements; setting productive goals; selecting, adapting, or inventing strategies to achieve objectives. Self-monitor progress as they work through the task, managing intrusive emotions and waning motivation These are the students who ask questions, take notes, be in charge of their own learning
74
What are the different metacognitive components of knowledge?
Declarative knowledge Procedural knowledge Conditional knowledge
75
What is declarative knowledge?
Knowledge about oneself as a learner—the factors that influence performance
76
What is procedural knowledge?
Knowledge about strategies and other procedures
77
What is conditional knowledge?
Knowledge of why and when to use a particular strategy
78
What makes up motivation to learn?
``` Self-efficacy (degree to which one is confident that one can perform a task or accomplish a goal) Epistemological beliefs (beliefs about the origin and nature of knowledge). Teaching activity: goal setting, monitoring and displaying of progress, an everyday feature of instruction can assist these learners to replace negative self-talk with positive self-instruction and a sense of self as an effective learner. ```
79
What are the roles of a clinician?
Facilitator (Mentor, learning facilitator), Assessor (Student assessor, curriculum evaluator), Role model (On the job role model, teaching role model), Information provider (Lecturer, clinical or practical teacher), Resource developer (study guide producer, resource material creator), Planner (course organiser, curriculum planner), Assessor (curriculum evaluator, student assessor)
80
What is an aim?
What the teacher or course plan for the session/broad generic statements of educational intent
81
What is an objective?
An outcome statement that captures specifically what knowledge and skills the LEARNERS should exhibit following the activity
82
What are the cognitive domains?
``` Evaluation (judging) Synthesis (creating) Analysis (exploration of reasoning?) Application (solving) Comprehension (understanding) Knowledge (recall) ```

1 - Public Health AE (11 decks)

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