Week 1- AMC lecture Flashcards

1
Q

At what point in development does the brain double in size? And why?

A

Third trimester to age 2 due to increased synapses and myelination

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2
Q

Describe Hubel and Wiesels theory of critical periods of brain development

A

Periods when environmental stimulation causes very active wiring/reshaping the brain: Experience causes constellation of neural firing patterns, Experience repeats, firing pattern repeats, Neurochemicals finalise pattern by switching off ability to rewire/refire in alternate pattern, Critical period ends

No stimulation during critical period: no proper brain development

Development of social brain: empathy, ability to regulate emotions, ability to delay gratification

Childrens’ brains more plastic than adults

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3
Q

Describe Piaget’s theory of human cognitive development

A

Children all go through same universal process of cognitive development

Child is born with a small number of innate schemas (cohesive, repeatable action sequence possessing component actions tightly interconnected and governed by core meaning) including thoughts, actions and knowledge about a particular situation

Due to biological maturation and environmental stimulation, child builds more and more schemas of increasing complexity Eg Innate and simple: sucking reflex, Learned and complex: ordering food at a restaurant

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4
Q

According to Piaget, what are the 2 ways in which a child can build up knowledge?

A

Assimilation: existing schema works well for new situation, knowledge attached to new situation is assimilated into existing schema

Accommodation: No existing schema fits new situation, so a schema must be altered to accommodate the new information

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5
Q

What are piagets stages?

A

Sensorimotor 0-2 y object permanence

Pre-operational 2-7 y egocentric

Concrete operations 7-11 y conservation of number

Formal operations 11+ y abstract thinking

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6
Q

What is object permanence?

A

infant looks for an object after it is hidden

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7
Q

Describe the pre operational stage of Piaget

A

Child is egocentric: sees the world from own perspective, language development rapidly progresses, use of symbols (play, magical thinking), does not yet understand conservation of number/volume

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8
Q

What is the concrete operations stage of Piaget?

A

onset of logical thinking, children can now understand conservation of number, volume

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9
Q

What is the formal operations stage of Piaget?

A

onset of abstract, systematic thinking, ability to manipulate different aspects of a problem to come to imaginative solutions If A>B and B>C, then A>C

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10
Q

What are the implications of piagets work?

A

Children need to be ‘ready’ before they can move to the next stage (don’t try teaching trigonometry to a three year old)

Students must be active in their own learning

Teachers should help children ‘discover’ the world, providing experiences that force accommodation of schemata

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11
Q

What are criticisms of piagets work?

A

Research based on subjective data, small sample size No account taken of culture

Underestimates childrens’ abilities

Overestimates adults’ abilities (only 40-60% of college students may reach formal operations)

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12
Q

Describe Vygotskys social and cultural development theory

A

Learning does not follow a universal process in all cultures

Learning happens socially, and can be rapidly increased through help from others

Learning happens through language: self-talk, private (inner) talk

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13
Q

Describe the theory of mind

A

Children do not automatically know that others do not know the same things they know: it develops over time

Developing this skill helps children to understand and anticipate the actions of others, understand feelings of others, empathise

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14
Q

Which groups of people may have deficits in their theory of mind skills?

A

Autism Schizophrenia Attention deficit disorder

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15
Q

What factors may affect the way a person responds to a situation?

A

Temperament: inborn tendencies: (novelty-seeking, reward dependence, harm avoidance, persistence) Personality: develops with experience Life experience People tend to have set patterns of perception, emotional and physical reactions, automatic thoughts, and behavioural tendencies in response to a situation

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16
Q

What are the Theories of cognitive development?

A

Piaget

Vygotsky

Theory of mind

17
Q

What factors increase the complexity of healthcare?

A

Patient: co morbidities Deprivation index Hospital environment: culture, leadership, staffing Workload: defensive practice, paperwork, training, understaffing, no time Team: supportive? Right mix? Adequate training? Culture: how doctors are perceived

18
Q

What is heuristics?

A

Rule of thumb solutions quick decision-making process, takes best-fit approach to find solution,

Often does not take all information into account allows one to focus on KEY facts

Often the easiest…but not always the BEST solutions

19
Q

What shortcuts in thinking do we have?

A

Heuristics: best fit, rule of thumb

Auto pilot: use pre-existing schema to react to a situation often works well, trouble occurs when schema does not fit the situation

20
Q

What is attribution bias?

A

Attribute our errors to situational factors

We attribute errors of others to character flaws

21
Q

What is Discounting of disconfirmatory evidence?

A

Tendency to stick with a diagnosis once it’s been chosen, even when new/conflicting information comes in

22
Q

What errors of thinking do we have?

A
  • Attribution bias
  • Discounting of discomfirmatory evidence
  • Inadvertently putting people into sets
  • Availability bias
  • Affective bias theory of cognitive dissonance
  • Pressure to conform
  • Effects of stress and fatigue
  • Diffusion of responsibility
23
Q

What is availability bias?

A

Tending to come up with a solution that happens to be on your mind that’s the fifth depression I’ve seen this week

24
Q

What is affective bias?

A

Basing your decisions on your emotional reaction to a patient Oh, she’s really needy, she’s just looking for attention

25
Q

What is the theory of cognitive dissonance?

A

If we find ourselves acting in a way that does not fit with our thoughts or values, this causes discomfort… Often we change our thinking, rather than altering our actions… ‘Stealing is wrong’ I have taken 3 staplers from work, Well, I’ve only borrowed them

26
Q

What is pressure to conform?

A

several people give a wrong answer, even if clearly wrong, others feel pressured to agree

Having a ‘mate’ greatly increases ability to give correct answers 3 or more opposing people is enough to encourage conformity

27
Q

What effects do stress and fatigue have on thinking?

A

To fully perceive a situation accurately and respond appropriately is effortful

When stressed, our ability to think flexibly declines

We are far more likely to resort to quick/automatic/error-prone thinking Errors are more likely

28
Q

What is diffusion of responsibility?

A

The more people are aware of a problem, the more everybody else thinks someone else will do something about it

29
Q

How can you best avoid medical errors?

A

Be realistic: have a system that helps recognise when likely to make errors, ensure to check thinking at those times with others

Safety netting: ‘Come back in 2 days if you’re no better’

Diagnosis: Every diagnosis is provisional, until new information

Red flags: prompts to help you act Insert thinking points into your care plan: rethink cases from scratch

Hierarchy and pressure to conform: Errors more likely if junior staff too trusting of what they are told, teams should have processes to help people speak up

Teams: Share your work, be supervised, keep checking your work against others (reflective practice)

30
Q

Aside from feelings, what other things can affect the way we act?

A

Environment around us

Roles we are assigned

What we learn from others

31
Q

Describe early baby brain development

A

What happens in adult happens in baby’s brain. Eg: stressed mum –> cortisol released & impeded neuronal growth & connectivity

OR happy mum–> dopamine released: stimulates neuronal connectivity

32
Q

What are the models of thinking?

A
  • System1 :Quick, Automatic, Prone to irrational bias
  • System2: Slower, Morelogical, Morerational
  • Unconscious: Thalamus –> Amygdala (doesn’t use cortex)
33
Q

What is Loss aversion?

A

Loss Aversion

  • Loss x2 psychologically more powerful than winning
  • Irrational decisions when fearful of losing