PPS Flashcards
What is the difference between Speech and Language?
Language: the words we use and how we put them together to make meaning
‘Speech’ relates ONLY to the production of words (the sounds)
What is the difference between Comprehension and Production?
Comprehension: understanding of language.
- SLTs call this ‘receptive language’
Production: language we produce
- SLTs call this ‘expressive language’
What can go wrong with communication?
Speech difficulties
Language difficulties
Comprehension
Expression
Pragmatics
Voice
What is imprecise/slurred speech?
Dysarthria
What is speech sounds in the wrong order?
Apraxia
What is dysfluent speech?
Stammer (UK) Stutter (US)
What is language impairment?
Aphasia
What may dementia cause in terms of speech?
Primary progressive aphasia
What are receptive difficulties?
Trouble understanding (comprehensive difficulties)
Speech is fluent but makes no sense
What are expressive difficulties?
Difficulty writing/talking
Word-finding difficulties- may be completely silent
Define health
The state of complete physical, mental and social wellbeing and not merely the absence of disease/deformity
What is the Human Rights Act 1998?
Decision making processes on people’s rights
Policy making
What does Article 2 of the Human Rights Act involve?
The right to life (limited)
What does Article 3 of the Human Rights Act involve?
The right to be free from inhuman and degrading treatment (absolute)
What does Article 8 of the Human Rights Act involve?
The right to respect for privacy and family life (qualified)
What does Article 12 of the Human Rights Act involve?
The right to marry and found a family
What does Article 14 of the Human Rights Act involve?
The enjoyment of the rights and freedoms set forth in this Convention shall be secured without discrimination on any ground such as sex, race, colour, language, religion, political or other opinion, national or social origin, association with a national minority, property, birth or other status.
What are absolute rights in the Human Rights Act?
NEVER acceptable to do otherwise
Name 3 absolute rights in the Human Rights Act
Acts:
3) Right to protection from: torture, inhuman and degrading treatment and punishment
4) The prohibition on slavery and enforced labour
7) Protection from: retrospective criminal penalties
What are limited/qualified rights in the Human Rights Act?
Limited under explicit and finite circumstances: e.g right to liberty (art 5)
What is Utilitarianism?
Maximising good for the maximum number of people
What is a judicial review?
Opportunity for an individual to challenge the exercise of power by a public body
What is intuitive decision making?
Ability to understand something instantly without conscious reasoning
Name some biases in intuitive thinking
Error of over attachment= confirmation bias (only do tests that confirm provisional diagnosis)
What is Analytical thinking?
Bad at estimating odds/values
Vey good at measuring and calculating them.
Basis of evidence based medicine
What are the disadvantages of Analytical thinking?
Slow
Resource intensive
Cognitively demanding: exhausting
What is the Dual process theory?
Intuitive thinking + analytical thinking + evidence based medicine
What red flags indicate errors?
1) Anomalies
2) Broken communication
3) Confusion
4) Missing info
5) Departures from normal practice
6) Stress/ uneasy
What is the Swiss Cheese Model?
An organisation’s defences against failure are modelled as a series of barriers
Cheese holes = weakness in system
Patients can fall through these ‘holes’ if they line up and end up with an Accident or Injury
What are Never Events?
Serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented.
Intolerable and inexcusable.
E.g surgery (wrong site), wrong meds or suicide
What are the 10 basic types of error?
1) Sloth
2) Fixation and loss of perspective
3) Communication breakdown
4) Poor team working
5) Playing the odds
6) Bravado (timidity)
7) Ignorance
8) Mis-triage
9) Lack of skill
10 System error
Give an example of a sloth error
Not bothering to check accuracy of results, inadequate documentation/ evaluation
Give an example of a fixation error
Overlooking warning signs-: early unshakable diagnosis
Give an example of a Bravado error
Working beyond competencies / without adequate supervision
What is mis-triage?
Over/under estimating the seriousness of a situation
What are common healthcare errors?
Wrong diagnosis
Medication reconciliation
Patient identification
Handovers
Why is safety compromised so often in healthcare?
- Complex, high risk environment
- Resource intensive
- System, patient and practitioners interactions
- Shared responsibilities
- Practitioners take risks unknowingly
How are errors classified in terms of intention?
Skill based
Rule based
Knowledge based
What is the person approach to errors?
Focus on the individual
Errors are due to wayward mental processes
Anticipation of blame promotes ‘cover up’
Retraining, discipline
What is the system approach to errors?
Adverse events are the product of many casual factors
Recognise errors and implement defences
Name 5 tools of risk identification
Incident reporting
Complaints
Audits
External Accreditation
Active measurement/ compliance
What are the 4 domains of the duties of a doctor?
1) Knowledge, skills and performance up to date
2) Safety and quality
3) Communication, partnership and teamwork
4) Maintaining trust
How do things go wrong?
System errors
Human errors
Neglect
Poor performance
Misconduct
How can errors be classified?
Classified based on:
Intention
Action
Outcome
Context
Name 4 human factors
Personal factors
Teamwork issues
Communication
Omissions/lapses
State 3 reasons for judgement failures
Analytical or intuitive
Wrong type of info
Bias
Describe neglect
Not showing sufficient care
Falling below required standard
Chain of minor failures
Multidisciplinary
May lead to harm
Describe poor performance
Repeated mistakes
Not learning from mistakes
Usually due to poor attitude: reliability, time keeping, scruffiness
Describe misconduct
Deliberate harm
Covering up errors
Fraud, abuse, theft, false claim of expenses/ sickness
Improper relationships with patients/ colleagues
Describe the 6 different types of leadership
Great man: born leader
Trait: can’t be learned
Behavioural: learned (adaptable to different conditions)
Transactional: motivated by punishment/reward
Transformational: inspire people to follow a shared vision
Laissez-Faire: individuals free to make their own decisions
What is the best leadership style for healthcare?
Transformational: places needs of patients, carers, families at centre of all your work and intervene when needed e.g. speak up if there is risk to patient, improve systems and improve knowledge
What are the 4 tests of Medical Negligence?
1) Was there a duty of care?
2) Was there a breach in the duty of care?
3) Did the patient come to harm?
4) Did the breach cause the harm?
What is the Bolam test?
Would a group of reasonable doctors do the same?
What is the Bolitho test?
Would it be reasonable for other doctors to do the same thing as you did?
What is the Tripartite Model approach to learning?
- Surface (fear of failure, focuses on particular tasks)
- Strategic (desire to be successful, variable understanding)
- Deep (intrinsic interest, personal understanding, links across materials)
What is Kolb’s learning cycle?
1) Experience (activist)
2) Review, reflect on experience (reflector)
3) Conclusions from experience (theorist)
4) What can I do differently next? (pragmatist)
What are the 4 fundamentals of teaching?
Who am I teaching?
What am I teaching?
How will I teach it?
How will I know if the students understand?
What is Culture?
Socially transmitted pattern of shared meanings by which people communicate and develop attitudes:
- Heritage
- Choice
- Individual Circumstances
What is Ethnocentrism?
Evaluates other groups according to own values
Conviction ones group is superior to others
What is a Stereotype?
Generalises characteristics of members of a group
What is Prejudice?
Attitude towards another person based solely on their membership to a group
What is Discrimination?
Actual positive or negative actions towards objects of prejudice
Why has rationing increased in healthcare?
Shift from acute illness → chronic
Normal physiological events medicalised
Increase in choice and increase in expensive drugs
What is the Egalitarian principle?
Provide all the care that is necessary and appropriate to everyone
What is libertarian principle?
Each person is responsible for their own health and wellbeing
Benefits of Social Media?
- Establishing wider and more diverse networks
- Engaging public in debates
- Facilitating public access to health information
- Improving access to services
Risks of Social media?
- Loss of personal privacy
- Breaches of confidentiality
- Unprofessional online behaviour
- Risks of report to the media/ employers
