PBL Midterm Review PDF

Week 1: Introduction to Learning at McMaster and Group Process in PBL RR 1: What is PBL-PBL and what steps of the PBL process Active, participatory inquiry in the classroom Self-directed and group learning for conceptual thinking Required to respond to rapidly changing professional and h...

Week 1: Introduction to Learning at McMaster and Group Process in PBL RR 1: What is PBL-PBL and what steps of the PBL process Active, participatory inquiry in the classroom Self-directed and group learning for conceptual thinking Required to respond to rapidly changing professional and healthcare environments STEPS: The problem is presented, terms are revised, and hypotheses are generated Issues and info sources are identified Information is gathered Acquired information is shared with the group and debated Knowledge is applied to the problem and hypotheses are evaluated Reflection on the content and process RR 2: Concept mapping ❖ Gathers all information and connects it visually ❖ Improves critical thinking, understanding, and concept differentiation ❖ Critically think through decisions and interventions in clinical settings ❖ Road map approach (am I in the right city (organ), going in the right direction, which direction is right, how do I get there, where is the map) RR 3: Narrative medicine ➔ A model for human and effective treatment ➔ Reach and join the patients in illness (see from their perspective) ➔ Bridging the divides that separate nurse from patient (empathic) ➔ Scientifically competent medicine isn't enough to help the patient grapple with the loss of health, nurses need to listen to narratives and grasp the meaning from the patient's perspective ➔ Narrative competence= ability to absorb, interpret, and respond to stories ➔ Allows empathy, reflection, professionalism, and trustworthiness. ➔ Authentic engagements are transformative for patients ➔ Required to answer the patient's narrative questions ➔ Without the patient might not tell the whole story, might not ask the most frightening questions, and might not feel heard, leading to a less precise diagnosis RR 4: TED Talk: Honoring the stories of illness Dr. Rita Charon ★ Getting paid to pay attention to the narratives they gave me, so they made sense ★ In words, body language, facial expressions, pauses ★ Human learning in addition to scientific knowledge ★ NARRATIVE MEDICINE= clinical practice fortified with the knowledge of what to do with stories (receive all the story, even unsaid parts) ★ With improved reading of every word count, improved listening of every word ★ Instead of a million questions, ask them what they think you need to know and just listen ★ Lady thinks the tumor will return, make sense of narratives, and help her deal with the fear of death RR 5: Working in groups (BIG ASS TEXT SPLIT WITH SAM) Virtual teams will become the norm in conducting business  Teams are more efficient when the problem is complex, common goal, or is properly organized Synergy=when effective collaboration produces better results than what is expected when members work alone Theory= a clear, systematic, and predictive explanation of a phenomenon Strategy= a method for dealing with issues that arise in a group Skill= an ability that helps groups collaborate to achieve a goal Norms= expectations of behaviors and opinions that are acceptable or unacceptable in a group (rules) ○ Explicit norms: norms written or stated verbally, often imposed by the leader ○ Implicit norms: rarely discussed but expected. Evolves through interactions Interaction norms: how members should communicate Procedural norms: how the group should operate Status norms: levels of influence and how status is earned Achievement norms: quality and quantity of work expected Conformity= occurs when members adopt attitudes that follow group norms ○ Constructive nonconformity= members don't follow group norms to alert the group ○ Destructive nonconformity= don't follow group norms for no reason (don't care) Group motivation= inspiration/incentive for members to work together Extrinsic motivation= motivation from external sources (EX: boss) Intrinsic motivation= motivation from internal sources Group member needs (when not met, 2 extremes) ○ Need for inclusion: need to be given attention, feel significant and accepted ○ Need for control: desire to feel competent, free to make decisions ○ Need for affection: desire to be liked by others Group member roles ○ Task roles: affects workflow (coordinator, analyzer, etc.) ○ Social maintenance roles: affects how ppl get along (motivator, harmonizer, etc.) Belbin’s team-role theory members take on roles compatible with their personality, need role flexibility, the best work when members know their roles and work to their strengths ○ 9 roles: Coordinator, monitor, innovator, shaper, implementer, completer, resource investigator, team worker, specialist Communication apprehension= fear associated with talking to others Hyperpersonal communication= when someone is more confident communicating online Passivity= non-assertive, lack of confidence, shy, fearful Aggressiveness= critical, intense, often disliked Passive-aggressive= uncooperative and obstructive, undermining others, fake cooperating, agreeing then planning something else Perks of assertiveness: more satisfied, more likely to lead, well-liked Week 2: Introduction to the Fundamental Patterns of Knowing in Nursing RR 1: Nursing’s Fundamental Patterns of Knowing  There are many situational factors that affect something that cannot be known until faced with a specific situation with a specific patient Emancipatory knowing: understanding and addressing social justice and equity, proved by authentication Paraxis: critical reflection and action on emancipatory knowing, undo social inequities Knowing: way of perceiving and understanding the world and self Knowledge: expression of knowing in a form that can be shared There are 4 patterns of knowing and emancipatory knowing that integrate itself: ○ Emancipatory knowing: reflection on social, political, and cultural status SEEKS EQUALITY (Paraxis is used to achieve equality) ○ Ethical knowing: focuses on what ought to be done Moment-to-moment judgments Authenticated by reasoning process (subjective) instead of objective ○ Personal knowing: knowing yourself and your relationship with others Developing and growing as a person Increases personal authenticity and genuineness ○ Aesthetic knowing: Appreciation of a situation and connect with others (the art of nursing) Expressed through actions, conduct, attitudes, narratives, and interaction Creating meaningful moments with patients Empathize with others ○ Empiric knowing: The scientific approach to care What is known is accessible through physical senses: seeing, touching Conscious problem-solving, logical reasoning, and awareness Developing nursing knowledge is a non-linear process Critical questions start the process of creating knowledge All patterns of knowing are required to work together to avoid distortion and bad patient care Developing all patterns of knowing are important to a rounded and effective nurse who is able to treat patients efficiently TAYLOR WILKS CARE SCENARIO RR 1: PBL: an overview Promotes critical thinking and problem-solving in learning situations Learning by engaging with meaningful problems and collaborating with others to problem-solve and form self-directed learning habits The problem is presented, and prior knowledge and resources are grouped to engage in small-group discussions Improves quality of learning by developing reflective, critical, and collaborative skills RR 2: Self-directed learning ❖ Learning process where individuals take initiative in all the steps of learning ❖ Individuals determine their own learning needs and how to achieve their goals ❖ More independent, requires making choices about learning RR 3: Supporting nurses in self-care USELESS AF WEBSITE Week 3: Information Literacy RR 1: Information literacy web module Popular vs. scholarly vs. trade sources Primary source=unedited, firsthand information directly from involved persons Secondary source=commentary or analysis of primary source. Often after event Tertiary source=source that analyses or compiles secondary sources Narrow research by including time, place, population or viewpoint CRAAP tool to evaluate sources (Currency, relevance, accuracy, authority, purpose) RR 2: McMaster’s Health Sciences Library website ➔ 6S are used to answer foreground questions: ◆ Systems: integration of info from lower levels and individual patient records ◆ Summaries: regularly updated clinical textbooks ◆ Synopses of Syntheses: summary of info found in syntheses ◆ Syntheses: summary of all evidence about a research question ◆ Synopses of Single Studies:Summary of evidence from high-quality studies ◆ Single Studies: unique research to answer a specific question Background questions= general, fill in gaps of knowledge Foreground questions= Focused on a specific client problem Search terms: think of synonyms, concepts of your question, rewording Week 4: Professionalism, Academic Integrity, and Scholarly Writing RR 1: Academic integrity policy McMaster University Academic dishonesty= knowingly act or fail to act in a way that results in unearned academic credit or advantage Plagiarism, submit same work, submit purchased work, help others being dishonest, alter a grade, steal or destroy work, forge or alter anything, etc. RR 2: Professional responsibility Accountability to individuals and society ○ Nurses are held accountable for their actions by organizations ○ Must establish ethical practice within the framework of professional codes ○ Nurses relationships with patients are built on trust, which must not be broken ○ Must address barriers to health promotion, uphold justice, protect human rights, equity and fairness, and promote good Code of ethics ○ Nurses are responsible for adhering to the code of ethics  ○ the profession is responsive to the evolving needs of society ○ Nurses should advocate for quality practice environments Advocacy ○ Responsible for recommending a course of action, on behalf of the patient, in order to create better health ○ Speak up on behalf of patients whose rights have been compromised ○ Moral agency= requires actions motivated by morals that is enacted through relationships RR 3: Academic dishonesty among nursing students ★ Dishonesty can be detrimental to patient care and outcomes as well as maintaining patient safety ★ Falsified vital signs are the most common dishonest behavior ★ Emphasis on perfection and good grades is a big source of academic dishonesty since nurses feel the need to be perfect ★ Weigh of an assignment, unfairness of a test, and desire to not fail rather than excel SKIPPED 2 READINGS CAUSE USELESS RR 4: Entry to practice competencies for registered nurses ➔ Clinician: ◆ provide safe, ethical, compassionate, evidence-informed care ➔ Professional ◆ Demonstrates accountability ◆ Demonstrates professional presence and judgement ◆ Maintains confidentiality ◆ Professional boundaries ◆ Identifies and addresses ethical issues ➔ Collaborator: ◆ Demonstrates collaborative professional relationships ◆ Group communication ◆ Determines interprofessional role ➔ Coordinator: ◆ Organizes workload, sets priorities, effective time management ➔ Leader: ➔ Scholar: RR 5: Writing an essay ❖ Has 3 parts: introduction, development, and conclusion ❖ Before writing, identify all components of the question being answered, do research, create an outline  WHAT IS NURSING CARE SCENARIO RR 1: Development of nursing in Canada ★ Knowing nursing’s past is important since by studying nursing’s past, we can anticipate nursing’s future, and it allows us to relive historical ideas ★ Indigenous caregivers ○ Often excluded from nursing history since they were not professionally trained ★ Indians were given separate hospitals which were underfunded, overcrowded and understaffed ○ Similar to residential schools ○ Some would be moved to the south for TB treatment, disrupting communities ★ Catholic nurses: sisters ran hospitals in NA, which were funded as charitable institutions, and followed specific roles ○ Marie Rollet Hebert= first person to provided nursing care in Quebec ○ Florence Nightingale= lead a movement to improve stands of nursing care with knowledge, attitude, and cleanliness. Made a system of care ○ Mary Seacole=wanted to join Florence but was black, went by herself ★ Nursing education in Canada (shaped by Florence’s system of care) ○ Hospitals started providing education in return for free work ○ Theophilus Mack decided to replace untrained nurses with trained ones. Started the first training school. ○ The Weir report spoke on concerts about untrained nurses working in the hospital during their studies. Lead to the demise of hospital training schools ○ WW1 and the influenza pandemic made people realize that nurses should have a university degree. The red cross gave grants to universities to develop a nursing program. ○ The Victorian Order of Nurses (VON) set professional standards of education for nurses ○ Mary Agnes Snively joining the internation council of nurses for Canada. Helped form the CNA and became its first president. ○ Racism very present in beginning of nursing education. Only young, white, single women to insure nursing was a “respectable” profession RR 2: Framework for the practice of registered nurses in Canada ➔ What is an RN? ◆ Self regulated health-care professionals whore collaborate with other individuals, families, groups, communities, and populations to achieve health  ◆ RNs deliver health care services in situations of health, illness, injury, and disability ◆ Receive a broad education to prepare them to several different groups, however they can specialize on a specific field (CNA recognizes 20 nursing specialty areas ➔ 4 nursing professions in Canada: RN, NP, practical nurses, psychiatric nurses ➔ 4 concepts for the framework of RNs: the patient, the environment, health, nursing ➔ Self-regulatory profession ➔ Domains of nursing: clinical practice, education, administration, policy, research (SEVERAL DIFFERENT PLACES NURSES CAN WORK) ➔ Nursing is shifting to a more person and family-centered care ➔ Future RN leadership is characterized by 8 essential skills: ◆ Global perspective on health care and nursing issues ◆ Technology skills that facilitate mobility and potability of care ◆ Decision-making skills rooted in empirical knowledge ◆ Ability to create organization cultures ◆ Understanding and acting properly in political processes ◆ High collaboration and team building skills ◆ Balance authenticity and performance expectations ◆ Able to envision and adapt to healthcare systems ➔ Nursing has several goals for the future, including: ◆ Leading individuals and communities to manage their own health ◆ Assist clients in making their own decisions about care and quality of life ◆ Take a leadership role in addressing the SDoH ◆ Prescribing medications and working across the continuum of care ◆ Lead collaborative teams of health care professionals RR 3: RN and RPN practice Interprofessional relationships: multiple professions working together to provide care Intraprofessional relationships: multiple members of the same profession collaborating The Regulated Health Professions Act (1991) and the Nursing Act (1991) provide the framework for the nursing profession and include the following: ○ Nursing’s Scope of Practice Statements: Describes in a general way what the profession does and the methods it uses ○ Controlled acts (potentially harmful activities) Authorized to Nurses ○ Nurses’ accountability To determine which client gets which type of nurse, 3 things are taken into account: the client, the nurse, and the environment  ○ Client factors: complexity, predictability, risk of negative outcomes ○ Nurse factors: leadership, decision-making, critical thinking, application of knowledge, seniority. NURSES ARE REQUIRED TO KEEP LEARNING (expertise, education, participation in activities, consulting) ○ Environmental factors: supports, consultation resources, stability of the environment Week 5: Defining Health & Health Models RR 1: Health and wellness Conceptualization of health ○ Negative conceptualization= a range of health where death and absolute health are on opposite sides ○ Positive conceptualization= someone can be sick by have healthy traits at the same time (more complex than negative) ○ Disease and health = objective (medically proven), Illness and wellness = subjective (personal view) ○ Health has been conceptualized in a variety of ways, including: Health as stability (functional and social norms) Health as actualization (achieve human potential) Health as actualization and stability (human potential while adapting to everyday demands) Health as resource (fulfil roles, meet demands, engage in living) Health as a unity ○ Labonte’s conceptualization of health = feeling vitalized, satisfying relationships, control, do things that one enjoys, sense of purpose Historical approaches to health ○ Medical approach (medical intervention restores health) ○ Behavioral approach (lifestyle affects health, victim blaming) ○ Socio-environmental approach (determinants affect health) (CURRENT) Acts that shaped health in Canada ○ Ottawa Charter: identified prerequisites for health as peace, shelter, education, food, income, equity, etc… ○ Achieving Health for All (WHO goal): identified 3 major health challenges (reducing inequity, increasing prevention, enhancing coping mechanisms) and ways to address challenges (fostering public participation, strengthening community health services, coordinating healthy public policies) ○ Strategies for Population Health: Emphasized the SDoH and identified 14 SDoH ○ Jakarta Declaration: Added 4 prerequisites to Ottawa Charter, declared poverty as the greatest threat, set new priorities  ○ Toronto Charter: Identified particularly important SDoH, focused on equity instead of equality, emphasized societal responsibility Social determinants of health ○ Income and income distribution ○ Education ○ Unemployment and Job security ○ Employment and working conditions ○ Childhood development ○ Food security ○ Environment ○ Housing ○ Social exclusion ○ Social Safety Network ○ Health services ○ Indigenous status ○ Gender ○ Culture, Race, Racism ○ Disability ○ Social environments Health promotion strategies ○ Health prevention= averting the development of disease ○ Primary disease prevention: activities that protect against disease before symptoms occur ○ Secondary disease prevention: activities that promote early detection of disease ○ Tertiary disease prevention: activities during recovery that mitigate residual disability ○ Build healthy public policies ○ Create supportive environments ○ Strengthen community action ○ Develop personal skills ○ Reorient Health Services RR 2: Health Defined: Health Promotion, Prevention, and Protection ❖ Health promotion: the process of enabling people to increase control over and improve their health (societal change and SDoh) ❖ In 1946, WHO declared health is also a person ability to fulfill a role in society. The biomedical approach was predominant during this era (health=lack of signs and symptoms of disease) ❖ In 1947, Saskatchewan introduced universal hospital insurance, which was implemented by all of Canada in 1961 ❖ In 1974, the Lalonde report was released (consider societal factors in health) ❖ Health-related quality of life (HRQL)= multiple life factors that affect a persons' perception of health ❖ Health equity: everyone has a fair opportunity to reach their health potential and reduce unfair differences among groups ❖ Health promotion is conducted at 3 levels: Public level’ Community level Personal level ❖ Role of Public Health Agency: Prevention of disease in society with a focus on addressing the SDoH 6 targets to address: infectious diseases and immunizations; healthy living and injury prevention; mental health promotion and suicide prevention; older people and aging; vulnerable children and families; and innovation and experimentation