Week 1 Flashcards
1
Q
Define Problem Solving
A
- Working through the problem to find a solution
2
Q
Define Clinical Reasoning
A
- Process during which we structure meanin, goals and health management strategies based on clinical data, pt preferences and values, knowledge and professional judgement
3
Q
Deine Clinical Judgement
A
- Application of information based on actual observation of a pt combined with subjective and objective data that lead to a conclusion
4
Q
Define Critical Thinking
A
- Clarifies goals, examines assumptions, uncovers hidden values, evaluates evidence, accomplishes actions and assess conclusions
5
Q
Define Clinical Decision Making
A
- Complexprocessinvolvingobservation,information processing, critical thinking, evaluating evidence, applying relevant knowledge, problem solving skills, reflection and clinical judgement to select the best course of action
6
Q
What are the three decision making theories
A
- Normative models
- Descriptive model
- Prescriptive model
7
Q
What is a Normative Model
A
- The analysis of individual decisions, using logic, rationality, scientific evidence based decisions: eg clinical trials testing drug efficacy or ‘normal range’ SpO2 reading to minimize judgement error of physiological processes
What theory dictates people should do when making a decision
8
Q
What is a Descriptive Model
A
- Examines how people make decisions in reality when choosing the options available to them
What people actually do when making a decision
9
Q
What is a Prescriptive Model
A
- A combination of the theoretical aspect of normative theory and observations of descriptive theory. Provides a practical aid to decision making, whilst aspiring to rationality: eg. Frameworks, guidelines, algorithms designed to improve specific decision tasks
What people should/can do when making a decision
10
Q
How do we explain decision making
A
- Combination of experience, knowledge, expertise of others, research and available
evidence - Numerous frameworks and models used to explain the process of decision making with many overlapping themes.
11
Q
What are the two opposing conceptual frameworks underpinning decision making
A
- The intuitive framework (also known as inductive framework (Hamm, 1988) Data is collected and leads to generation of a hypothesis
- The analytical framework (also known as deductive framework) Hypotheses are used to predict the presence/absence of data to confirm/deny hypotheses
12
Q
What is Intuition
A
- Understanding without rationale’ (Benner and Tanner 1987)
- An irrational act
- Guessing
- Unfounded knowledge
- Supernatural inspiration Hunches Non-conscious process
13
Q
What are the FIve Levels of the Benners Model and the explanations
A
- Novice = No experience Need rules
- Advanced Beginner = Demonstrate acceptable behaviour Principle- based
- Competant = Same role 2-3 years Deliberate planning
- Proficiant = Whole situations Holistic under standing
- Expert = Intuitive grasp Deep under standing
14
Q
What are the 6 parts of the Dreyfus skill acquisition
A
-1. Patternrecognition
2. Similarityrecognition
3. Commonsenseunderstanding 4. Skilledknow-how
5. Senseofsalience
6. Deliberativerationality

15
Q
Explain Similarity Recognitionin the Dreyfus Model
A
- Awareness that this patient
reminds you of a similar patient - Sets up conditions for recognising dissimilarities as well
- This is despite objective features of past & current situations
- Helps the expert select the most relevant patients for comparison
16
Q
Explain Common Sense Understanding in the Dreyfus Model
A
- Basis for understanding the illness experience in contrast to knowing the disease
- A deep grasp of the culture & language
- Allows flexible understanding in diverse situations
- The language of illness is a human language with emotions & lived experiences.
17
Q
Explain Skilled know-how in the Dreyfus Model
A
- Two kinds of knowledge
Polanyi (1974) & Kuhn (1962) - ‘Knowing how’
Practical knowledge -
learnt through skilled practice
Body taking over a skill e.g. how do you ride a bike? - ‘Knowing that’
Theoretical knowledge - Tacit knowledge
Meerabeau (1992)
Describes the expert knowledge
that professionals use, but find difficult to articulate - Technical Rationality
Schon (1983)
Professional knowledge underpinned by rigorous application of scientific theory & technique
18
Q
Explain Sense of salience in the Dreyfus Model
A
- Certain events or details stand out as more or less important
- In formal models of judgement, sense of salience is replaced by checklists
- Innate sense of what is happening around you
- ‘Insider’ knowledge
- Expert appraisal allowing
flexibility
19
Q
Explain Deliberative Rationality in the Dreyfus Model
A
- The expert practitioner has learnt to expect certain events & selectively attend to certain aspects of the situation
- A means of clarifying the current perspective by considering how your interpretation of a situation would change if your perspective were changed
20
Q
Explain Pattern Recognition in the Dreyfus Model
A
- Perceptual ability to recognise relationships without pre-specifying the components of a situation
- Patients present patterns of responses that expert practitioners learn to recognise
- Novices may require a list of features to identify patterns
- Recognition of subtle variations in the pattern
21
Q
What are the two Analytical Frameworks
A
- The Hypothetic-Deductive Framework
- Cognitive Continuum Framework
22
Q
Define the The Hypothetic-Deductive Framework
A
- Cue acquisition – gathering information/clinical data
- Hypothesis generation – Differential diagnoses
- Cue interpretation – diagnostic testing/observations/history to confirm/refute diagnoses
- Hypothesis evaluation – weighing up pros and cons, choosing evidence based interventions
23
Q
Define the Cognitive Continuum Framework
A
- Matches cognitive tasks to the decisions and the clinicians competence
- This is based on all theories and models have different strengths and weaknesses
- Different decisions need different
approaches, so joined together intuition/experimental and analytical/rational to form the cognitive continuum
24
Q
What can help the decision making process
A
- Protocols – rigid directions….
- Clinical Guidelines – UK Ambulance Services Clinical Practice Guidelines, NICE guidelines, UK Resuscitation Council – best practice, evidence based
- Algorithms – developed from research evidence and patient data
- Decision matrix – quantitative tool to rank/score options using set criteria to gain a total score – SADS score, APGAR, GCS . Can still remain subjective
25
How could we become better decision makers
- Maintain desirable attributes
- Inquisitiveness
- Be well informed
- Stay current – CPD
- Be open minded
- Ask for feedback
- Develop communication skills Use available decision matrices
26
What are the factors that effect decision making
- Confirmation bias
- Optimism bias
- Anchoring
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- Information bias
- Selective perception
- Hindsight bias
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- Belief/behavioural bias
27
Define Confirmation Bias
- misinterpretation of data to suit the decision maker
28
Define Optimisim Bias
- being over optimistic about what will happen as a result of decision
29
Define Anchoring
- relying heavily on a single piece of information
30
Define Information Bias
- seeking too much data which ‘swamps’ the decision process
31
Define Selective Perception
- giving undue/higher importance to data that supports own views
32
Define Hindsight Bias
- using hindsight knowledge of previous events to assign higher weight to those same outcomes in future events
33
Define Behavioural / Beliefs bias
- making decisions whilst being influenced by underlying beliefs
34
What are Lewins Leadership Styles
- Autocratic (authoritarian) leaders
- Democratic (participative) leaders
- Laissez faire (delgative) leaders
35
Define what a Autocratic Leader is, with the pros and cons of this style
- Make decisions without consulting their team members
- Useful if quick decisions are needed or team members don’t/can’t have full picture.
- Ignores team expertise/opinion.
- Can be demoralizing
36
Define what a Democratic Leader is, with pros and cons of this style
- Make final decisions, but take input from team members
- Encourages creativity, and job satisfaction.
- Sense of being valued.
- Not always effective when a quick decision is required
37
Define what a Laissez Faire leader is, with the pros and cons of this style
- Give team members freedom in how they complete work and set own deadlines
- Provides support with resources and advice, but otherwise don’t get too involved.
- Autonomy can be damaging to those who do not manage their time well, or do not have knowledge/experience to work effectively
38
Why do we need Clinical Leadership at Organisational Level
- Adapting to change (e.g. new ways of working)
- Thriving from change (e.g. new roles)
- Coping in an ever changing environment of paramedic practice
39
Why do we need clinical leadership at Individual Level
- Personal development (e.g. career development, progression, financial reward)
- New knowledge (e.g. academic awards)
- New skills (e.g. skills enhancement, evidence based practice)
40
Why do we need clinical leadership at Patient level
- Greater responsiveness to patient needs
- Improved ability to meet patient needs (e.g. user groups)
- Increasing use of expert patients)
41
Definition of Human Factors
- Definition - refer to environmental, organisational and job factors, and human and individual characteristics, which influence behaviour at work in a way which can affect health and safety (Health and Safety Executive 2015)
