Professional socialisation

Question 1

What is socialisation?

Answer 1

The process by which individuals learn about the culture of their society.

Question 2

What is primary and secondary socialisation?

Answer 2

Primary - from infancy, by family

Secondary - occupational, peer and educational groups, a lifelong process.

Question 3

Who are the primary agents of socialisation?

Answer 3

Parents
Peers
Education system

Question 4

What are the agents for socialisation in becoming a patient?

Answer 4

Media
Lay referral system
Self help groups
Handbooks e.g. national eczema society
Leaflets for patients 'what to expect'
Chronic illness
Experience of the healthcare system
Expert patients

Question 5

What is Dramaturgy - Goffman (1959)?

Answer 5

The consultation is a performance between two actors - doctor and patient role. He believes all human behaviour is a performance dependent on the situation.

Stage props e.g. stethoscope
Words, accent and clothing
Front stage vs backstage behaviour: behave differently whether they are in front of patients or not
patients do the same - dressing up, not swearing

Question 6

What did Goffman say about the hospital as a total institution? How does this relate to medical students?

Answer 6

A hospital is a place where the inmates are separated from social intercourse with the outside world. This also happens with socialisation of medical students.

Question 7

What are the characteristics of total institutions?

Answer 7

all aspects of life are in the same place
group living - batch processing - meal times are fixed
basic distinction between the managers and the managed –> little communication between patients and staff
institutional perspective, and therefore the assumption of an overall rational plan

Question 8

What are the mechanisms used to facilitate management of inmates?

Answer 8

physical and psychological reminders of the person identity are removed
mobility restricted
information about the individual and the institution is controlled

Question 9

What are the effects of institutions on people?

Answer 9

depression and anxiety
depersonalisation
Institutionalisation - patients become apathetic with an ability to udertake simple tasks or make decisions.

Question 10

What are the models of adaption used by patients to avoid institutionalisation (Haralambos and Holborn 1990)

Answer 10

1) situational withdrawal - pt withdraws attention from everything except events immediately surrounding their own body, minimises interactions with others
2) intransigent line - patient flatly refuses to cooperate with staff, exhibits hostility, short lived as strong efforts by staff to break resistance
3) colonisation - patient define life in institution as more desirable than life on outside, may try to remain inside as discharge approaches
4) conversion - individual adopts staffs definition of model inmate and acts out part
5) playing it cool - alternating between other modes of adaption depending on situation

Question 11

What is the permeable institution? (Quirk et al, 2006)?

Answer 11

Evidence of permeability - ward stay is temporary, contact with outside world maintained, institutional identities blurred
Consequences of permeability - reduced risk of institutionalisation and increased risk to staff and patients
Management of permeability
-limiting unwanted movements
using discretion
patient input:negotiation and subversion