Kind Of Experience Research Articles

Acting Intern On-Call Simulations

OPEN ACCESSJanuary 11, 2012Acting Intern On-Call Simulations Norman Benjamin Fredrick, MD Norman Benjamin Fredrick, MD Pennsylvania State University College of Medicine Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9076 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractThis resource provides instructors with three clinical scenarios for use in a simulation lab. The three cases are intended to be used by fourth-year medical students on their acting internship (subinternship) rotation. The cases all feature inpatient adults with acute undifferentiated complaints. The purpose of the cases is to provide acting interns with a realistic experience of fielding floor calls on their own until backup help arrives. Because the simulations run for only 10 minutes before backup appears, acting interns are placed in a position of having to assess a patient's acute complaints, order tests, and manage the undifferentiated issue. In this capacity, they are challenged to make clinical decisions on their own that have consequences for the patient. Through these experiences, acting interns develop a discomfort with having to make time-pressured patient-management decisions. This discomfort is useful in motivating them to develop personal learning objectives related to assuming increased clinical responsibility of patient care.Students routinely find this to be a valuable experience, albeit uncomfortable. They regularly report that they have never had this kind of experience before and did not realize what it would feel like to be an intern on call. The students also realize the need to begin view medical conditions from a new perspective, namely, that of having to manage patient care. They are forced to step outside the observer role they typically assumed in third year. As an intern on call, they need to know medication names, doses, and routes of administration. For example, they realize that while they may know about atrial fibrillation, they have not paid attention to the management of an acute episode. Educational Objectives By the end of these simulation cases, learners will be able to: Demonstrate increased assumption of clinical responsibility for patient care, similar to the responsibilities of an intern on call.Demonstrate advanced clinical thinking, including the independent development of differential diagnoses, evaluation, and management plans appropriate to the clinical scenarios.Appraise their decision-making skills in the initial management of patients with acute-onset undifferentiated problems.Recognize the importance of good communication during patient handoff at sign-out.Properly evaluate the acute issue by obtaining an adequate history, performing targeted physical exam, reviewing the sign-out sheet, and correctly interpreting vital signs, lab results, EKG, and chest X-ray.Prioritize diagnoses, develop an action plan, and commit to a course of action to stabilize the patient. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Simulation Instructor's Guide.doc Nurses Responses for All Three Cases.doc Parameters and Guidelines for Simulation Technician.doc Photos of Folder.doc Sign-out Sheet.doc Simulation Set-up and Preparation.doc To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. CitationFredrick NB. Acting Intern On-Call Simulations. MedEdPORTAL. 2012;8:9076. https://doi.org/10.15766/mep_2374-8265.9076 Copyright & Permissions© 2012 Fredrick. This is an open-access article distributed under the terms of the Creative Commons Attribution license.KeywordsActing InternSeizuresSub-InternInternship and ResidencyCongestive Heart FailureEpilepsy Disclosures None to report. Funding/Support None to report. Loading ...

Modern American Abortion Narratives and the Century of Silence

finally found a doctor in West New York, New Jersey. doctor very sweet. He had pictures of crucifixes walls. It only cost $900. I went to a bank and took out a vacation loan. I am still paying it off. found two psychiatrists who said that for $60 each they'd write a report which said I mentally unstable and ought to have abortion. I had to prove that I crazy to get a legal abortion--and sanest thing I had ever done in my life. When you tell man you're pregnant, he says, 'How do you know it me? I'm not only guy you ever slept with, am I? just living with this middle class guy, and my life just like his. We were just going along, together. I didn't do anything strange or unusual. I didn't make any decisions. But one day I pregnant. Then there a difference. --Redstockings Abortion Speak-Out On March 21, 1969, women's liberation group Redstockings organized first public speak-out, Abortion: Tell It Like It Is, for a crowd of 300 people in Greenwich Village's Washington Square Methodist Church. The idea, organizer Irene Peskilis explains, was to get examples of different kinds of experiences--women who'd had babies that were taken away women who went to hospital for a therapeutic abortion, women who'd gone illegal route, different kinds of illegal routes (qtd. in Brownmiller 108). Credited with taking out of realm of private secrets and ma[king] it issue that women could talk about in public, speak-out has been hailed as an important political tactic (Reagan 230) and a pivotal event in development of contemporary feminist discourse abortion (Dubriwny 396). What's forgotten in this tale of secrecy and outburst, though, are large numbers of narratives written and published by American writers in 1910s, 20s, 30s, and 40s, narratives that helped set stage for later movement to decriminalize by building new vocabularies and interested publics ready to out about abortion. The Century of Silence story that historians usually tell about American politics says that after nationwide criminalization of in 1880s issue of fell silent. Early histories of American practice and politics by Carroll Smith-Rosenberg and James Mohr skipped over 1890s-1950s, and sociologist Kristin Luker, first to study years of criminalized abortion, declared this era the of (40), a time when on public level, rarely discussed (54). More recently, historian Leslie Reagan has complicated century of thesis by reminding us that women did have abortions during years when a crime and did speak of their abortions among themselves and within smaller, more intimate spaces (21). But like Luker, Reagan finds little public discussion of during early twentieth While Luker suspects that 'ownership' of abortion caused public silence around it by undercut[ting] potential opposition from all other quarters (41-42), Reagan points to red scare, arguing that the association of legal with Soviet socialism ... ensured that a public discussion of idea never developed (142). It not until late 1950s, and early 1960s--or so story goes--that people began speaking publicly about abortion. By 1950s and 1960s, advances in obstetrical science had virtually eliminated need to perform abortions to save life of mother. With this old justification for therapeutic abortions gone and new medical dilemmas at hand--namely, a rubella epidemic and new research linking morning sickness drug Thalidomide to birth defects--controversy erupted amongst medical community as doctors entered into new debates about conditions under which they would perform legal therapeutic abortions (Luker 66-91). …

In the footsteps of…

A glimpse into the lives of qualified vets with various kinds of experience of the profession, beginning with a longer interview with Grant Petrie. Grant is a double certificate holder, has been a faculty member at the RVC and works in general practice offering a second opinion/referral service. Grant has been a BSAVA volunteer in a variety of roles and became President in 2010.

‘Hunting the light’. A study of a tourist group and its learning experiences on board the Norwegian coastal steamer Hurtigruten

Learning is a central part of any experience. The effects of learning and well-being may vary greatly depending on what kind of experience is being consumed by the tourists. Listening to a guide wh...

Physicians’ experiences of participation in healthcare IT development in Finland: Willing but not able

Objective To learn (1) about the kind of experiences that physicians have with participation in healthcare IT development; (2) whether physicians are interested in participating in IT development activities, and if so, how; and (3) the visions that physicians have regarding future IT systems. Methods A web-based questionnaire which was answered by about one-third of the working-age physicians in Finland, which is exceptionally broad and sizeable a sample. This research deals with only a small part of the entire questionnaire. The questions used for this study were both quantitative and qualitative. Statistical methods were applied to the former and content analysis to the latter. Results The responding physicians were highly critical of their IT systems, and their experiences with the current methods of participation, or rather the lack of it, were quite negative. However, a very significant proportion of the respondents were willing to contribute to IT systems development, contrary to a common assumption that clinicians are disinterested. Visioning of future systems was quite cautious, dealing mainly with usability improvements to the current systems. Conclusions Major improvements are needed both in the usability of the systems currently in use in Finland and in the collaboration between end-users and developers. Improved methods of participation need to be developed and applied, particularly for the procurement, deployment and on-going development of commercial-off-the-shelf applications.

The Guitar Hero's Performance

In this article the author argues that the kind of experience that music oriented videogames, such as Guitar Hero or Rock Band, affords brings about a number of shifts in our understanding in the act of music as performance in general. In order to understand and read the act of playing these music games as performing music and not merely as a low grade simulation – many musicians have vocally dismissed it as just that – one needs to embrace a number of shifts of emphasis in what constitutes making music: the article argues that music-oriented videogames extend certain habits and conventions with regard to the interplay of acoustic and visual aspects of both performing and perceiving music; that they add layers to both our notions of performers and performance material; that they draw our attention to how integral ‘paratexts’ are to the performance of rock music by making them the key creative outlet of the game; and that they question the assumption that the ‘parasitic’ performances in Guitar Hero could not still be serious and forceful performative acts, but that instead they are a different but not ‘lesser’ form of music making. By looking at these re-negotiations in more detail the author argues that “real” and “virtual” ways of making music are connected in an iterative loop of mutual influence and inspiration and that the perceived static opposition between the two is a problematic construction that needs further interrogation and perspective.

What is a Significant Educational Experience?

This article analyses the nature of an educational experience by taking as its starting point Dewey’s Art as Experience in order to identify what it is that counts as a significant or worthwhile experience. Dewey suggests that an experience needs to have an integral character in which the different phases of the experience are related and which tends towards a conclusion. Furthermore, an experience also needs to have the character of what Dewey calls an ‘undergoing’, an engagement with content which may be difficult or painful. It is suggested that this kind of experience may be seen in terms of a ‘light’ pedagogy in which content is allowed to unfold. This is contrasted with educational experiences that are ‘teacher-driven’ or ‘learner-driven’. Education is often analysed in terms of process or outcomes. But in this article I wish to focus on the experience of education from the standpoint of the child or student who is having the experience. I want to see if there are characteristics of this experience that can be identified in such a way

Experience and Confidence in an Internet-Based Asset Market Experiment

The experience effect in asset markets is one that was thought to be settled. As subjects gained experience with the interface and each other, they typically exhibit fewer instances of mispricing and at lower magnitudes. But questions regarding trading experience are not easy to address in the lab with the typical subject pool since the kind of experience one can typically generate in the lab is experience with the experimental environment itself—not with external environments. However, in virtual worlds asset markets are highly evolved, providing a subject pool with skilled and experienced traders that can be accessed via the Internet. This study compares experimental asset markets with participants recruited from virtual world trading groups to experimental markets with participants recruited from the virtual world at large. I further examine trader performance and trading behavior within markets. The findings indicate that asset markets with virtual world participants recruited from trading groups are more prone to exhibit bubbles than are markets with virtual world participants recruited at large. Within condition, experienced traders are less likely to follow fundamentals and more likely to engage in strategies that result in loss of earnings. Excess confidence is rejected as an explanation for this pattern, as confidence is found to be related to higher earnings and fundamental value trading strategies.

The locked box in the attic: ghosts and memories

The author discusses the technical difficulties encountered in clinical work with children who have suffered an early trauma, as is often the case for fostered and adopted children. An account of the first five years of psychotherapy with a nine-year-old boy, who was removed from his birth family at an early age, will be elaborated in some detail to explore these issues. Particular difficulties are discussed that relate to maintaining an analytic position while working with highly disturbed object relations. Questions are raised about how to facilitate a therapeutic space within which the trauma is worked but does not become the sole focus of treatment in a destructive way. It is argued that the acknowledgement, sharing and greater understanding of the trauma together with the patient helps to transform traumatic memories or ‘ghosts’. When therapy can become a place of change and restitution, this lays the foundation for another kind of experience.

Can Neurotheology Explain Religion?

Neurotheology is a fast-growing field of research. Combining philosophy of mind, neuroscience, and religious studies, it takes a new approach to old questions on religion. What is religion and why do we have it? Neurotheologists focus on the search for the neural correlate of religious experiences. If we can trace religious experiences to specific parts of the brain, chances are we can reduce religion as such to that grey soggy matter as well. This article predicts neurotheology will not be able to locate the neural correlate of religious experiences. As we cannot decide phenomenally what makes an experience religious, neurologically we cannot find its correlate either. That is, if there are fixed neural correlates to begin with, because their existence is still a matter of debate. In addition, religious experiences seem to be a kind of experience, like emotional or relational experiences, making them indistinguishable from similar nonreligious experiences. Even if one manages to trace the neural correlate of religious experiences, neurotheology will still not be able to account for the rise of religion without resorting to theories from other disciplines. In the end, we do not know enough about consciousness and the way it relates to the brain to make conclusive claims about the search for religious states of consciousness. It seems, however, that even though neurotheology could provide fascinating insights in the workings of the religious brain, on its own, it will prove unable to explain religion fully.

Children with their dreams – what kind of reveries are accepted in school context?

The media and the contemporary consumer culture are central categories in modern childhood. They have opened new kinds of experiences and learning situations for children. In this article we are interested in the role of the media and consumption in schoolchildren's daily life. The data consist of writings and drawings of 7–12-year-old schoolchildren. Children have told us about their dreams, social worlds and doings in the mediated world. By asking children about all these things we are most likely able to find out how modern childhood and the learning situations in the class are influenced by the media and consumer goods. It is important to analyse children's experiences in the virtual environments because today's teachers have to confront these new mediated meaning structures in schools. At all events, the experiences are deeply embedded in teacher–pupil relationships.

Developing acoustic measures to evaluate the emergence of phonological contrast.

Acoustic analysis has been used in studying phonological development since at least the 1960s when Preston and colleagues measured voice onset time (VOT) in English- and Arabic-learning toddlers. Studies applying measures such as VOT, for stop voicing, and spectral peak frequency, for fricative place, show that the emergence of robust phonemic contrast is more gradual than it seems when phonetic transcription is used alone. For example, Japanese-speaking children’s short-lag productions of target /d/ labeled as “[t]” might show somewhat shorter VOT than their productions of target /t/. Studies that supplement acoustic measures with continuous labeling tasks, such as a visual analog scale with “d” and “t” as target endpoints, support the idea that not only is this developmental phenomenon of “covert contrast” ubiquitous, the associated subphonemic variation can be perceived by adult listeners given the appropriate task. Moreover, listeners with different kinds of experience with young children have different sensitivities to this acoustic variation. This finding suggests that appropriate acoustic measures can be developed to provide psychometrically valid measures over the full course of development from initial stages of producing undifferentiated or inappropriate cues to producing the adult community pattern for the contrast. [Work supported by NIDCD grant 02932 and NSF grants BSC-0729306, BSC-0729140, and BCS-0729277.]

Integrating Mathematical, Technologic, and Pedgogical Knowledge in Teacher Preparation

In Principles and Standards for School Mathematics (NCTM 2000), the authors describe a vision for school mathematics in which “all students have access to high-quality, engaging mathematics instruction” (p. 3). Students deserve teachers who are knowledgeable about mathematical content, who understand and use a variety of teaching strategies appropriately, who can effectively integrate technology into classroom learning, and who continually progress as professionals. But what kinds of experiences lead to such professionalism?

Apocalypse Now: An Interview with Joy Garnett

Apocalypse Now: An Interview with Joy Garnett

On paradoxes and the experience of duality

Opposing attitudes, emotions, or perceptions of self and other that set the stage for experiences of duality influence our interactions and self–other schemas. The experience of duality that has been conceptualised as “conflict,” “self state,” and “paradox" in psychoanalytic theory has been extensively considered, particularly in terms of its manifestation in transference–countertransference relations and in the analytic material from patients' experiences. They have not, however, been compared and contrasted as entities that lead to similar kinds of experience. Scant attention has been paid, moreover, to paradox as a mental organisation that underlies certain experiences of duality. The concept of paradox has thus been emphasised and developed in this paper.

Workers as Whole People With Their Own Objectives

Whether or not the industrial–organizational (I–O) psychology literature has been as remiss as Weiss and Rupp (2011) suggest in neglecting the topic of ‘‘experiencing work’’ is potentially debatable (e.g., see George & Jones, 1996, 1997). Nonetheless, a person-centric work psychology would clearly enlighten our understanding of the experience of work. In this regard, there are two related issues that we urge researchers to consider in pursuing a person-centric approach: workers as whole people and the outcomes or objectives of work. By definition, I–O psychology is concerned with matters pertaining to the workplace. However, work experiences and episodes cannot be considered in isolation from workers’ lives as whole people. Needs, cares, wants, values, problems, tragedies, triumphs, grief, and joy experienced in one’s life color the nature of one’s work experience. Performing the same kind of work tasks against the backdrop of different life experiences and challenges likely results in distinct kinds of experiences of working. As much as managers might hope that workers can check the rest of their lives at the workplace door, this is not an option for living and breathing human beings. Although somewhat cliched, a devastating and intractable argument with one’s

Infectious disease management in primary care: perceptions of GPs

BackgroundIt is important to keep the level of antibiotic prescribing low to contain the development of resistant bacteria. This study was conducted to reveal new knowledge about how GPs think in relation to the prescribing of antibiotics - knowledge that could be used in efforts toward rational treatment of infectious diseases in primary care. The aim was to explore and describe the variations in GPs' perceptions of infectious disease management, with special reference to antibiotic prescribing.MethodsTwenty GPs working at primary care centres in a county in south-west Sweden were purposively selected based on the strategy of including GPs with different kinds of experience. The GPs were interviewed and perceptions among GPs were analysed by a phenomenographic approach.ResultsFive qualitatively different perceptions of infectious disease management were identified. They were: (A) the GP must help the patient to achieve health and well-being; (B) the management must meet the GP's perceived personal, professional and organisational demands; (C) restrictive antibiotic prescribing is time-consuming; (D) restrictive antibiotic prescribing can protect the effectiveness of antibiotics; and (E) patients benefit personally from restrictive antibiotic prescribing.ConclusionsRestrictive antibiotic prescribing was considered important in two perceptions, was not an issue as such in two others, and was considered in one perception although the actual prescribing was greatly influenced by the interaction between patient and GP. Accordingly, to encourage restrictive antibiotic prescribing several aspects must be addressed. Furthermore, different GPs need various kinds of support. Infectious disease management in primary care is complex and time-consuming, which must be acknowledged in healthcare organisation and planning.

Use Student Affairs Strategies to Retain Women in STEM

Use Student Affairs Strategies to Retain Women in STEM

Transformative learning and identity formation on the ‘smiling coast’ of West Africa

This paper outlines research undertaken during a study visit to The Gambia (2008) and our thinking about the value of this, and other such visits for education students. The qualitative methodology made use of interviews and reflective journals. We argue that such visits may have the power to transform peoples’ values and, drawing on literature on identity and positioning, we tentatively suggest some possible explanations for such transformative processes. This kind of experience is thought to be of considerable potential benefit to beginning teachers and the paper indicates some of these benefits, with illustrations drawn from interview data.

RULE NUMBER ONE

It was the famous line in the Fight Club: rule number one, ‘don’t talk about Fight Club.’ Surreal as it was, the great thing about Fight Club as a film was the sideways look it took at support group culture. The only thing that’s missing is a support group for people who have no real problems but would like someone to talk this over with. Are support groups and charities really part of the problem more than part of the solution? When my brother died of cancer at the age of 42 I was left so isolated I might as well have been on a desert island with my top 10 favourite records. The advice I heard time and time again was to go and see the nice volunteers at Cruse Bereavement Care. This is all well and good but I suspect at least part of the function of organisations such as Cruse is to provide a ‘feel good factor’ for their volunteers as much as to provide ‘therapy’, doled out in 60-minute bursts, for us poor unfortunates who’ve experienced what is, after all, a purely natural event that is going to happen to everyone sooner or later. As a way of getting to know new people and make friends I’ve been setting up a county-wide yahoo group for Shakespeare fans. It was an idealistic image — a housebound octogenarian chatting online with a 17-year-old GCSE student about the real meaning of ‘get thee to a nunnery’. People lift sharing, offering the seldom used back seat of their car to someone who can no longer drive (perhaps because of failing eyesight, a Parkinson’s tremor, or being unable to afford a car). E-mails have flooded out from this PC to the MS society, the blind association, the deaf association, schools, and sixth form colleges. I was obviously being too idealistic if I thought groups would be interested or even bother to mail a reply. There certainly are people out there who would love to join a yahoo group and chat about Shakespeare, get the old grey cells working, perhaps visit a local amateur dramatics performance, but it’s difficult to break down the barriers that age and ability have placed around us all. Charities have their own agendas. Those poor unfortunates (who are blind or have MS for example), need the help of those lovely volunteers and have to be treated as ‘disabled’ rather than as people who have all kinds of experiences which they could share with the younger generation. I sent an email to Cruse about the Norfolk Shakespeare fans, believing that bereaved people would benefit from the opportunity to chat online about their hobby, have the chance to meet up with other people at the theatre, life share, that kind of thing. I should have known better than to think that Cruse wanted someone treading on their patch and challenging their idea that all bereaved people need a good cry and someone to hold their hand rather than a network of new friends. The Norfolk branch of the Depression Alliance didn’t reply either. Perhaps they’ve already seen Hamlet. We live in a society which is increasingly placing us all in different boxes. Faith schools are going to break us all down by religion. From Lidl to Sainsbury’s, from The Sun to the Telegraph, our class system breaks us down by work and education. Support groups are breaking us down by ‘problem’. Even the egalitarian world of yahoo groups is unable to scale the dizzy heights of the walls we all live behind. Pity really, it was such a nice idea. The Norfolk Shakespeare fans yahoo group welcomes members regardless of (dis)ability, education or income. You just need to live in Norfolk, enjoy Shakespeare and want to chat about the world’s most frequently performed playwright. We’re also on Facebook. By the way, ‘nun’ in Elizabethan England was slang for a prostitute so Hamlet’s famous line to Ophelia is just a way of a young man calling his ex-girlfriend a whore. Shakespeare could prove better than temazepam!