Medical ethics, reflection, GMC

Question 1

What is feedback

Answer 1

Information about a persons performance which encourages the learner to accept, reflect and learn from it.

Question 2

Feed back BOOST model

Answer 2

Balanced
Observed
Objective
Specific
Timely (ASAP)

Question 3

Value of multi-discipline team

Answer 3

Higher patient satisfaction, care and communication, with less stress for the healthcare staff. Each staff contributes specialist knowledge.

Question 4

The four principal approach to bioethics

Answer 4

Autonomy- duty to allow for informed consent
Benevolence- duty to promote wellbeing
Non-malevolence- duty to avoid hate
Justice- duty of fairness.

Question 5

Utilitarianism

Answer 5

The morally right thing to do is to produce the greatest amount of happiness in the greatest number, type of consequentialism

Question 6

Problems of utlitarianism

Answer 6

The happiness of some should be more important then the happiness of others (criminals). If a good consequence is caused by a bad intention how can it still be good? Utilitarianism is impartial, everyone’s happiness is worth the same whether it’s our children or a stranger.

Question 7

Deontology

Answer 7

Ethical decisions are good if they are made on the basis of rules which are our duty to follow. Intentions matter

Question 8

Deontology problems

Answer 8

Sometimes it is necessary to go against certain rules in order to bring about the right consequences. For example, lying to make someone feel better

Question 9

Virtue ethics

Answer 9

The focus is on the character of the moral agent

Question 10

Virtue ethics problem

Answer 10

Difficult to tell virtue from vice

Question 11

Care ethics

Answer 11

Ethical theories should emerge from caring relationships, careful attention to specific situations is required

Question 12

Care ethics problems

Answer 12

How do we know what counts as care and why should we value ‘caring.’ Instead of focusing on specific situations we should focus on general rules.

Question 13

Valid arguments

Answer 13

The conclusion is derived from the premise, just because something is valid does not mean its ethical as we may wish to reject the premise

Question 14

Necessary and sufficient conditions

Answer 14

just because it is necessary for you to have a certain quality to fit into a category does not mean that it is sufficient. There may be other qualities that you have to have

Question 15

Reflection

Answer 15

Careful consideration of things that have happened in the past, either positive or negative. You then try to learn from the event

Question 16

Three stage model of reflection

Answer 16

What- the thought process when a particular action was taken
So what- why was the experience important
And now what- what can I learn from and do differently next time

Question 17

Experiential learning cycle

Answer 17

Concrete experience- a new experience or situation is encounters, or a reinterpretation of an existing experience.
Reflective observation of the new experience- important to reflect inconsistencies between experience and understanding.
Abstract conceptualisation reflection- gives rise to new idea, or a modification of one.
Active experimentation- the learner applies their ideas to see what happens

Question 18

Key elements of profesionalism

Answer 18

Expertise (technical knowledge), ethics (ethical principles and values such as honesty, respectfulness and reliability) and service (notion of calling)

Question 19

The duties of a doctor defined by the GMC

Answer 19

1) Knowledge, skills and performance (up to date, work within competence)
2) safety and quality
3) communication, partnership and teamwork
4) maintaining trust

Question 20

Role of GMC

Answer 20

Promoting and maintaining the health and safety of the public by ensuring proper standards in medicine as well as ensuring the conduct of medical professionals

Question 21

Fitness to practise and studying medicine

Answer 21

Failure to demonstrate good fitness to practise as stated in the learning agreement will mean you cant progress to the next stage of learning

Question 22

Factors that may influence fitness to practise

Answer 22

Criminal convictions, substance abuse, mental health issues, putting the patient at risk, laziness

Question 23

Professional identity

Answer 23

The degree to which an individual aligns themselves with their profession. Your personal identity is when your existing identity undergoes the process of socialisation. Conscious reflection from role models and experience is better then unconscious acquisitions.

Question 24

How can socialisation to form PI take place

Answer 24

Learning environment, reflecting from role models and mentors, formal teaching, self-assessment and reflecting from clinical and non-clinical experience. Can also be from the attitude of patients, peers, health care professionals and the public.

Question 25

Fitness to practise and GMC

Answer 25

Its about ensuring patient safety and making sure your behaviour reflects well on the profession. You must follow the general medical council policy or you may face a medical school FTP panel

Question 26

Bio-psycho-social model importance

Answer 26

Evaluating all factors leading to illness and patienthood and not just the biological factors. Including society and culture. Explains the emotional reaction we have to physical symptoms. Why someone thinks they are ill whilst someone else thinks its not a big deal

Question 27

What’s included in the bio-psycho-social model

Answer 27

Biological-genetic factors
Psychological- loneliness, self-esteem, power and control
Social- poverty, access to recourses, living conditions, discrimination

Question 28

Mongenic mutation

Answer 28

Affects one gene and follows a known pattern of inheritance

Question 29

Multifactorial disorder inheritance

Answer 29

Don’t follow a known pattern of inheritance, just have risk factors.

Question 30

What to do in an examination

Answer 30

Explain in advance what you are going to do, making sure they understand, let them know if there will be pain or discomfort. Get consent and repeatedly ask for it. Stop the examination if the patients ask. Thank the patient at the end. Keep discussion relevant.

Question 31

Calgary-Cambridge framework

Answer 31

Initiating the session
Gathering information
Physical examination
Explanation and planning
Closing the session

Question 32

Benefits of good communicatiob

Answer 32

1) Accurate diagnosis: (hidden agenda, people may hide why they are there) good history
2) Concordance with treatment plan: agrees with the plan and isn’t just doing what the doctor says. Is in line with their wishes
3) Promoting healthy lifestyle
4) Direct therapeutic benefits
5) Patient satisfaction
6) Patient safety- reduction of errors
7) Reduction in complaints and litigation

Question 33

Communication challenges facing health care

Answer 33

1) technology e.g. medical apps.
2) ageing population with increased fragility
3) increased socio-cultural diversity
4) meeting individuals different communication needs
5) patients expect more involvement

Question 34

Discuss the variety of contexts in which communication takes place in health care

Answer 34

Gathering information, Building rapport and empaths, seeking consent, conducting a sensitive examination, making a diagnosis, Explaining procedures, giving results, making a shared decisions, building a therapeutic relationship, referring to specialist, negotiating management plans, keeping good notes.