Golden Rule Essay Example | Topics and Well Written Essays - 2000 words

Golden Rule - Essay Example It was not meant as a guide to practical choice separate from all other principles of conduct. It has nothing to say about specific choices, nor does it vouch certain moral principles, ideals, or virtues. The golden rule relates, rather, to a perspective thought vital to the exercise of even the most basic morality: that of trying to put oneself in the place of those affected by one's actions, so as to counter the instinctive tendency to moral shortsightedness. It instructs listeners to treat others with the respect and understanding they themselves would wish to come across, and not to cause misfortunes on others that they would detest to have caused upon themselves. The golden rule put emphasis on the ethic of empathy: treat others as you would like them to treat you. Empathy relies on understanding that the other person senses pains as you do or will feel gladness as much as you do if they are properly dealt with. If another person is mourning, you feel his/her grief and offer consolation. If another is hurt, you go out of your way to extend help and you treat the injured person with support to prevent further suffering. Empathy, however, is not equally present among human beings, nor is any person incessantly empathetic for others. Some are deficient in empathy and are selfish, irresponsible and do harm to others with out feeling any remorse. The natural tendency is to treat only a number of other people, immediate members of a select group, and to be distrustful of and unreceptive to everyone else. Empathy can stimulate on in one circumstance and hold off in another situation. Once a particular group labels that non-members are threats, empathy is switched off and group members treat outsiders as though they were intruders. Actual situations may well affect how we relate the golden rule by looking at the practical significance of differences between experiences such as: observing another, how one would feel in the situation of another, what is the feeling of another, what is the world from the perception of the other, the impact of an action on the other, how the other would judged the fairness of another's act, and taking the other's viewpoint clearly into consideration in moral decision-making. Imagining oneself, however, in the situation of another is not plainly required by the golden rule, nor is it a requirement or adequate state for sound moral judgment. At times one acts it but stays unenlightened because of unawareness or self-deception, and occasionally one comprehends intuitively what is to be performed without any definite act of imagination. We normally presuppose that we understand others intuitively, that we empathize truly, that our expressions of sympathy are appropriate. Despite our usual dependence on empathy to enlighten us about another, our emphatic feeling of others often gives the wrong impression. The golden rule instructs us to treat others as we want others to treat us, thus implicitly advancing the assumption that there are important shared aims or similarities between the self and another. Over dependence on commonalities can dull receptiveness to dissimilarity just as much as being overly impressed with dissimilarity can make people blind to empathy. If the golden rule is to be understood as encouraging complacency about empathizing with others, then the rule would seem

Project Communication Plan Assignment Example | Topics and Well Written Essays - 500 words - 1

Project Communication Plan - Assignment Example Project managers should use the available tools of communication such as; letters, telephones, and video conferencing. A good communication plan is the most effective way of letting different end users of a project knows the effects a particular project to them. Project managers who have the responsibility of developing a communication plan should take into account a number of key components to ensure that they have a good communication plan. This will ensure that all the parties who are interested in a project are well served with the relevant information regarding the project. Audience forms a major component of a good communication. Campbell (2012) refers to this as the Stakeholder analysis. Different persons who are interested in the project cycle such as sponsors, stakeholders, and team members will require different information. A good communication plan should identify each audience with the aim of providing relevant information to them. The purpose of identifying audience is to see if we can determine how each audience is concerned. In addition to Audience, Content is the second component of a good communication plan.This component describes the kind of information that each audience needs. Such information may include the details about accomplishments and progress of the project. This information may be very relevant to the high level stakeholders (Biafore, & Stover, 2012). All these audience groups have unique interest in the whole project which the project manager will reflect up on when developing a communication plan. Method of communication is another important aspect of a good communication plan which project management should take into account. With a lot of technological advancements in the methods of communication, project managers have numerous methods of communication to the relevant audience (Heldman, 2011). Means of communication include; in person meetings, videoconferencing, telephone calls, email, and written

Healthcare Training in Simulated Environments

Healthcare Training in Simulated Environments Simulation Introduction â€Å"Clinical simulation is pretending for the purpose of improving behaviors for someone elses benefit (Kyle Murray, 2008, p.xxiv).† All respiratory therapists are trained to manage the airway of an unconscious patient. Endotracheal intubation is the most effective method of securing the airway but is a complex psychomotor skill requiring much practice. Historically, endotracheal intubation had been taught on patients, cadavers or animals, but this was not ideal. Mannequin training is one of the best options for instructing large numbers of students in a variety of skills (Gaiser, 2000) therefore the Respiratory Therapy program at TRU has adopted training on mannequins as a core component of their courses. Intubation trainers have been used for over 30 years (Good, 2003) but there is little published information on the relative merits of the available airway and intubation trainers. A variety of airway trainers with differing features are now commercially available from the low fidelity, part task trainer, that TRU respiratory therapy program utilizes, to the high fidelity, whole patient simulator that is becoming increasingly popular today. Training health care practitioners in a simulated environment without actual patients is a potential method of teaching new skills and improving patient safety (Issenberg et al, 1999; Devitt et al, 2001; Lee et al, 2003). pt safety Simulations are defined as activities that mimic the reality of a clinical environment and are designed to demonstrate procedures, decision-making, and critical thinking through techniques such as role-playing and the use of devices such as interactive videos or mannequins. A simulation may be very detailed and closely simulate reality, or it can be a grouping of components that are combined to provide some resemblance of reality. (Jeffries, 2005) definition of simulation Computer based simulations and part-task training devices can provide a certain degree of real-world application. These focus on specific skills or selected areas of human anatomy. High-fidelity patient simulators can provide real physical inputs and real environmental interactivity. To recreate all elements of a clinical situation, a full-scale or high fidelity simulation would be used. Costs of simulators will vary widely depending on purchasing costs, salaries, how faculty time is accounted for, and other factors. (Jeffries, 2005) simulators, high fidelity, costs Modern technology, such as high fidelity simulation offers unique opportunities to provide the â€Å"hands-on† learning. High fidelity simulation offers the ideal venue to allow practice without risk and there are an infinite number of realistic scenarios that can be presented using this technology. As an example, life threatening cardiac arrhythmias can be simulated on a life like fully computerized mannequin. Mo nitors, identical to those used in the clinical situation can replicate the arrhythmia and corresponding changes in vital signs. The ‘patient can be fully and realistically resuscitated with technical and pharmacological interventions. Viewing of videotaped performances allows personal reflection on the effectiveness of the case management. Morgan et al, 2006 example of use of high fidelity sim. High fidelity simulation provides a venue to teach and learn in a realistic yet risk free environment. The ‘patient is represented by a computer-controlled mannequin who incorporates a variety of physiological functions (e.g. heart and breath sounds, pulse, end-tidal carbon dioxide). An instrumentation computer network can replicate situations likely to be encountered in an emergency room, critical care environment or operating room. A second person controls the mannequin and the monitors. The simulator mannequin will respond on an accurate way to induced physiologic or pharmacologic interventions. The ‘patient will respond according to pre-set physiological characteristics (e.g. a young healthy adult or a geriatric patient with severe emphysema). In addition, the ‘patient has the ability to speak, move his arm, and open and close his eyes and has pupils that can dilate and constrict. The simulation room can be set up to appropriately reflect the environment, either an emergency room, a recovery room, or a fully equipped operating room. Attached monitors respond to a medical intervention. Feedback from participants in the simulated environment has attested to the ‘realism of the environment (Morgan Cleave-Hogg, 2000). Morgan et al, 2006 set up of HPS A simulator replicates a task environment with enough realism to serve a desired purpose and the simulation of critical events has been used instructionally by pilots, astronauts, the military and nuclear power plant personnel (Gaba, 2004). The fidelity, or the â€Å"realness†, of simulations can vary in many ways, such as the use of simple case studies, utilization of human actors to present clinical scenarios, computer-based simulations, and the use of high-fidelity patient simulators that respond to real-world inputs realistically (Jeffries, 2005; Laerdal, 2008; Seropian, 2003). Recently, literature has described that using full-sized, patient simulators are a way of creating â€Å"life-like† clinical situations (Fallacaro Crosby, 2000; Hotchkiss Mendoza, 2001; Long, 2005; Parr Sweeney, 2006). While simulation has been used by the aviation industry with flight training for years (Gaba, 2004), the use of a rudimentary human patient simulator in the health care fiel d was first introduced in 1969 to assist anesthesia residents in learning the skill of endotracheal intubation (Abrahamson, Denson, Wolf, 1969; Gaba DeAnda, 1988). The more realistic human patient simulators were not created until 1988 and were used primarily to train anesthesiologists (Gaba, 2004). Defining simulation in health care education The literature on human patient simulation has tried to define several of the terms used in this study. However, there is no general consensus on many of these terms, including a debate on whether the simulator is a mannequin or a manikin (Gaba, 2006). One key term that requires specific definition for this study is high-fidelity mannequin-based patient simulator. The term â€Å"fidelity† is used to designate how true to life the teaching experience must be to accomplish its objectives (Maran Glavin, 2003). Using this definition, fidelity becomes a scale where if given the objectives, a single piece of medical simulation equipment may be able to provide a â€Å"high-fidelity† experience for one objective but be â€Å"low-fidelity† for another objective. An example would be the insertion of a radial arterial catheter. If the objective were to only teach the psychomotor skills required for inserting the catheter, a relatively simple arterial blood gas access arm, part-task simulator would be adequate and provide a high-fidelity experience. But if the objective were expanded to include communication with the patient and members of the health care team, then the same device would suddenly become low-fidelity, as there is no feedback being delivered with catheter insertion and communication with the patient is not possible. Beaubien Baker (2004) noted that the term ‘fidelity is frequently documented as a one-dimensional term that forces a static classification of simulation devices. Individuals with this view would have difficulty agreeing with the use of the terms as explained in the previous paragraph. Maran and Glavin (2003) offered this definition: â€Å"Fidelity is the extent to which the appearance and behaviors of the simulator/simulation match the appearance and behaviors of the simulated system (p.23).† Yaeger et al (2004) broke fidelity down into three general classifications: low-medium-and high-fidelity and explained that low-fidelity simulators are focused on single skills and permit learners to practice in isolation while medium fidelity simulators provide more realism but lack sufficient cues for the learner to be fully immersed in the situation. High-fidelity simulators, on the other hand, provide adequate cues to allow for full immersion and respond to treatment interventions. For the purposes of this study, the following definitions will be used: 1. High-fidelity patient simulator A full-bodied mannequin that replicates human body anatomy and physiology, is able to respond to treatment interventions, and is able to supply objective data regarding student actions through debriefing software. 2. Low-fidelity simulator A part task trainer or a full-bodied mannequin that replicates human anatomy, but does not have physiologic functions (including spontaneous breathing, palpable pulses, heart and lung sounds, and voice capabilities), does not have a physiologic response to treatment interventions, and does not have a debriefing software system. Use the next two statements at the beginning of other sections on simulation: * â€Å"Simulation is a training and feedback method in which learners practice tasks and processes in lifelike circumstances using models or virtual reality, with feedback from observers, peers, actor-patients, and video cameras to assist improvement in skills (Eder-Van Hook, 2004, p.4).† * â€Å"Simulation is a technique†¦.to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner (Gaba, 2004, p.i2).† When we are looking at the use of high-fidelity patient simulators in health professions education, we have to be aware of and not confuse the simulator with the simulation. As Gaba (2004) described, â€Å"Simulation is a technique not a technology (i2).† The mannequins or other devices are only part of the simulation. Dutta, Gaba and Krummel (2006) noted a gap in the research literature, stating, â€Å"A fundamental problem in determining the effectiveness of surgical simulation has been an inability to frame the correct research question. Are the authors assessing simulation or simulators (p.301)?† Simulation has many applications. The teaching of psychomotor skills seems an obvious use for simulation but there are other areas that simulation can be utilized effectively. Rauen (2004) listed several areas in addition to psychomotor skill training where simulation has been used. Her list included teaching theory, use of technology, patient assessment and pharmacology. Rauen (2004) notes that the â€Å"emphasis in simulation is often on the application and integration of knowledge, skills, and critical thinking (para 3).† History and Development of Simulation in Healthcare education The history of simulation in healthcare has been well documented by several authors including Bradley (2006), Cooper and Taquito (2004), Gaba (2004) and Rosen (2004) and began with the use of models to help students learn about anatomical structures. Although the use of mannequins as the simulation model is relatively new (Bradley, 2006), simulation using animals as models dates back over 2000 years. Mannequins were utilized as models in obstetrical care as early as the 16th century (Ziv, Wolpe, Small, Glick, 2003). The more modern medical simulators originated in the 1950s with the development of a part-task trainer called ‘Resusci-Anne that revolutionized resuscitation training (Bradley, 2006; Gaba, 2004). Part-task trainers are meant to represent only a part of the human anatomy and will often consist of a limb or body part or structure. These low fidelity modesl were developed to aid in the technical, procedural, or psychomotor skills, such as venipuncture, catheterization and intubation (Kim, 2005), allowing the learner to focus on an isolated task. Some models provide feedback (visual, auditory or printed) to the learner on the quality of their performance (Bradley, 2006; Good, 2003). Another general classification of patient simulators that combines some of the elements of both three-dimensional models and task-specific simulators is partial or part task simulators (Kyle Murray, 2008). Issenberg, Gordon, Gordon Safford, and Hart (2001) used the term procedure skills simulator for this type of device. Maran and Glavin (2003) stated, â€Å"part-task trainers are designed to replicate only part of the environment (p.24).† and replicate anatomy and physiology of a single portion of the human body. As described by Beubien and Baker (2004), the skills taught with part task simulators â€Å"segment a complex task into its main components (p. i53).† Rather than creating complex scenarios commonly done with high fidelity patient simulation, part task trainers permit students to focus on individual skills instead of more comprehensive situations. Examples would be an arm with vascular structure to teach arterial blood gas procedures or a head with upper airw ay anatomy to practice advanced difficult airway procedures. The second wave of modern simulation, with the development of full-scale, computer controlled, mannequin based patient simulators started in the 1960s with the development of Sim One (Bradley, 2006; Gaba, 2004; Good, 2003). SimOne had many of the features found on the high-fidelity mannequin-based patient simulators used today. SimOne was quite lifelike, and fitted with a blood pressure cuff and intravenous port. SimOne was able to breath, it had a heartbeat, temporal and carotid pulse and a blood pressure (Abrahamson, 1997). Patient simulators have become very sophisticated over the years and now allow a wide range of invasive and non-invasive procedures to be performed on them, as well as enabling teamwork training (Davis, Buono, Ford, Paulson, Koenig and Carrison, 2006). When they are set up in a simulated and realistic environment, they are often referred to as high-fidelity simulation platforms (HFSP) or human patient simulators (HPS) (Kim, 2005). Components of the human patient simulator (HPS) include a mannequin and computer hardware and software. The HPS has characteristics expected in patients such as a pulse, heart and lung sounds, and blinking eyes with reactive pupils. The mannequin also supports invasive procedures, such as airway management, thoracentesis, pericardiocentesis and catheterization of the bladder (Laerdal, n.d.). Medical Education Technologies, Inc. (METI) introduced the Human Patient Simulator (HPS) in 1996. It has subsequently followed with PediaSim in 1999, a simulator utilizing the HPS software but scaled down to mimic a child. In 2005, BabySim was introduced. While being the first to enter the market with a full-bodied mannequin for patient simulation purposes in resuscitation with the Resusci Anne in 1960, Laerdal Medical did not introduce a high-fidelity patient simulator until 2000 with the introduction of SimMan. This device does not possess all the high-level functionality of METI HPS, but does provide adequate fidelity for many medical emergency situations. The Laerdal Medical SimMan also differs from the others in that it does not operate on mathematical models for simulator responses. Instead, it operates on instructor controls combined with script-based control logics. The Laerdal Medical SimMan patient simulator is the device to be used in this study. Details of the simulators functions are found in appendix ____. Aside from high-fidelity mannequin based patient simulators, there are many other types of simulation used in healthcare provider education and training. Collins and Harden (1998), Issenberg, Gordon, Gordon, Safford, and Hart (2001), and Ziv, Small and Wolpe (2000) discussed several other forms of simulation. The list includes animal models, human cadavers, written simulations, audio simulations, video-based simulations, three dimensional or static models, task specific simulators and virtual reality simulation. (Add VR reference?) Perhaps the next step in the evolution of health care teaching modalities is virtual reality (VR) simulation. Commercial VR simulators now exist to teach various trauma skills (Kaufman Liu, 2001). In a study of the effectiveness of using a VR bronchoscopy simulator, students quickly learned the skills needed to perform a diagnostic bronchoscopy at a level that was equal to those who had several years of experience (Colt et al, 2001). Simulation has been used for many years in the aviation and nuclear power industries and other highly complex working environments in which the consequences of error are costly (Bradley, 2006). A simulator designed to mimic the anesthesia patient was first developed in 1988, and since then, the number of hospitals and universities buying simulators for educational purposes is increasing (Henrichs, Rule, Grady and Ellis, 2002). The human patient simulator is used in health care education because it is a high-fidelity instrument that provides both educators and students with a realistic clinical environment and an interactive â€Å"patient† (Feingold, Calaluce and Kallen, 2004). The cost of simulation is related to the level of fidelity and the technology being used. For high fidelity patient simulators, purchase costs can range from $30,000 for the Laerdal Medical SimMan or the METI ECS to over $200,000 for the METI HPS. Optional equipment available for these simulators can make the purchase costs even higher. In addition to the simulator, it is important to create a learning environment that replicates real-world settings, complete with appropriate medical equipment. Halamek et al. (2000) stated, â€Å"The key to effective simulation-based training is achieving suspension of disbelief on the part of the subjects undergoing training, ie, subjects must be made to think and feel as though they are functioning within a real environment (para 15).† Creating this environment adds additional costs to setting up a simulation-based medical education program. Advantages of using simulation in health care education Patient simulation of all types, including high-fidelity patient simulation, is becoming more common in many aspects and levels of healthcare provider education (Good, 2003; Issenberg, McGaghie et al., 1999; leblond, Russell, McDonald et al, 2005). The reasons behind the increased use of patient simulation include the advancement of medical knowledge, changes in medical education, patient safety and ethics. For new healthcare providers it is also important to consider the changing student demographic, as todays students are more comfortable with technology. Issenberg, McGaghie et al. (1999) pointed out several advantages to the use of patient simulators, stating â€Å"Unlike patients, simulators do not become embarrassed or stressed; have predictable behavior; are available at any time to fit the curriculum needs; can be programmed to simulate selected findings, conditions, situations, and complications; allow standardized experience for all trainees; can be used repeatedly with fid elity and reproducibility; and can be used to train both for procedures and difficult management situations. (p. 862)†. Advancement of medical knowledge Medical knowledge is continually growing with new tests, medications, and technologies that all bring about innovative understandings and expertise. The problem with educating health care providers with this new knowledge is that their curriculum is of a finite length therefore innovation in the curriculum is needed in order to prepare future health care providers. Issenberg, Gordon, Gordon, Stafford, and Hart (2001) made the following comments: â€Å"Over the past few decades, medical educators have been quick to embrace new technologies and pedagogical approaches†¦ in an effort to help students deal with the problem of the growing information overload. Medical knowledge, however, has advanced more rapidly than medical education†¦Simulation technologies are available today that have a positive impact on the acquisition and retention of clinical skills. (p.16) Changes in medical education Healthcare provider education has typically been taught using a lecture/apprenticeship model (McMahon, Monaghan, Falchuk, Gordon, Alexander, 2005) that relies on observation and repetition (Eder-Van Hook, 2004). Halamek et al. (2000) noted the traditional model of medical education has three components: the learner performs a reading of the literature, the learner observes others with greater experience, and then the learner develops hands-on experience. This is the traditional medical model of education that has been in use for over 2,000 years (Current state report on patient simulation in Canada, 2005). In relation to the traditional model, Issenberg, Gordon, Gordon, Stafford and Hart (2001) observed, â€Å"This process is inefficient and inevitably leads to considerable anxiety on the part of the learner, the mentor, and at times the patient (p. 19).† McMahon, Monaghan, Flachuk, Gordon, and Alexander (2005) stated this model â€Å"is inefficient in promoting the highest level of learned knowledge, as reflection and metacognition analysis occur independently, often without guidance and only after extended periods of time when students are able to piece together isolated experiences (p. 84-85).† Customarily, this format is often referred to as the â€Å"See one, do one, teach one† model of medical learning (Brindley, Suen Drummond, 2007; Eder-Van Hook, 2004; Gorman, Meier, Krummel, 2000; Yaeger et al., 2004). Halamek et al. (2000) identified several problems with the current medical education model which includes; 1. Reading of the literature does not produce competency. More active rather than passive participation in the learning experience is needed; 2. Learners may have difficulty determining if their model for observation is a good or poor model. Just because the model may be senior does not mean they are competent. 3. The variability of experiences in the apprenticeship model is high, therefore learners experiences will not be equal, and 4. Many training settings do not fully represent the complexity of the real world resulting in an inability of the learners to adequately practice their decision-making skills in a â€Å"real† environment. Yaeger et al (2004) reinforced these points stating that healthcare education rely on two fatally flawed assumptions. The first assumption is that all clinical role models are effective and skilled, and all behaviors demonstrated by these role models are worthy of replication. The second assumption is that the end of the training period implies that a trainee is competent in all the skills necessary for successful clinical practice (Yaeger et al, 2004). Yaeger (2004) also noted that in the apprenticeship model, there is a need for a preceptor but this preceptor may not have the necessary skills to be an effective educator. Patient safety A predominant theme in many discussions of high-fidelity simulation is the concept of patient safety. In the education of healthcare providers, there are sometimes conflicting goals. As Friedrich (2002) commented in quoting Atul Gawande, â€Å"medicine has long faced a conflict between ‘the imperative to give patients the best possible care and the needs to provide novices with experiences (p. 2808).† When looking at the broader topic of medical simulation, the concept of patient safety is a frequently mentioned subject (Bradley, 2006; Cleave-Hogg Morgan, 2002; Ziv, Ben-David, Ziv, 2005). Much of the incentive behind the focus on patient safety relates back to the Institute of Medicine 2000 report To Err is Human: Building a Safer Health system (Kohn, Corrigan, Donaldson, 2000). This study reported over 44,000 people and possibly up to 98,000 people die each year in United States hospitals from medical errors. The total annual cost of these errors is between $17 billion and $29 billion. Even more alarming is the fact that these findings represent only the hospital sector of the healthcare system. The number of lives affected would be even higher if other parts of the healthcare system were included such as long term care facilities and Emergency Medical Services. In its summary of recommendations, the report specifically mentions simulation as a possible remedy, stating â€Å"†¦establish interdisciplinary team training programs for providers that incorporate proven methods of team training, such as simulation (p.14).† In Canada, it was estimated there were 70,000 preventable adverse events in Canadian hospitals with an estimate of deaths associated with those errors ranging from 9,000 to 24,000 (Current state report on patient simulation in Canada, 2005). The Canadian Patient Safety Institute supports the use of simulation as a means of improving patient safety in Canadian hospitals. In the conclusion of its report on patient simulation, the institute stated: Growing awareness of adverse events in Canadian hospitals, combined with increasing emphasis on patient safety, has changed the traditional â€Å"learning by doing† approach to healthcare education. Anecdotal evidence reveals the promising potential of simulation to fundamentally change the way healthcare professionals practice and further hone their skills, interact across disciplines, and manage crisis situations. (Current state report on patient simulation in Canada, 2005, p.23) Ethical perspective One of the strongest statements made regarding the ethical perspective of simulations was presented by Ziv, Wolpe, Small and Click (2003). Under the title â€Å"Simulation-Based Medical Education: An Ethical Imperative†, the authors presented an argument that not using simulation was more than just an education issue, it was an ethical issue. As they report, there is often an over reliance on vulnerable patient populations to serve as teaching models when other resources exist that would provide adequate and possibly, more superior replacements. The education of healthcare providers requires a balancing act between providing the best in patient care while also providing learning opportunities for the healthcare professions student (Friedrich, 2002). To protect patient safety, actual patient contact is often withheld in the healthcare provider learning process to a later period in their education. One of the principle reasons patient simulation is being indicated as a partial remedy for the medical errors crisis is its ability to impact on a particularly vulnerable time in the learning process. As Patow (2005) cited, the â€Å"learning curve† faced by many healthcare professions students is a source of medical errors. He continued, stating that the realism of many of the currently available simulators is quite high and allows for procedures to be practiced to mastery prior to being tested on real patients. But simulations offer much more than just practice. Since medical errors often result from ineffective processes and communication, simulation allows teams â€Å"to reflect on their own performance in detailed debriefing sessions† (Patow, 2005, p.39). This opportunity to review, discuss, and learn from the simulation is an important step in the learning process. The use of patient simulation in the training of healthcare providers is not limited to new students. There is also a need to maintain education in the health professions and simulation can be utilized effectively in this area as well (Ziv, Small Wolpe, 2000). As in other reports, Ziv, Small and Wolpe (2000) restated the shortcomings of the traditional model and explained that simulation was not just for the beginner but also for the expert who is expected to â€Å"continuously acquire new knowledge and skills while treating live patients (p.489).† These authors feel simulation, when used across the range of health professions education, can make an impact on patient safety by removing patients from the risk of being practiced upon for learning purposes. Gaba (2004) pointed out there are also many indirect impacts of patient simulation on patient safety. These areas of impact include improvements in recruitment and retention of highly qualified healthcare providers, facilitating cultural change in an organization to one that is more patient safety focused, and enhancing quality and risk management activities. A final point on patient safety is the ability to let healthcare providers make mistakes in a safe environment. In real patients, preceptors step in prior to the mistake being beyond the point of recoverability or if the mistake occurs (particularly for those healthcare providers who are not longer students), there is a very limited instructive value to the case. Ziv, Ben-David, and Ziv (2005) stated, â€Å"Total prevention of mistakes, however, is not feasible because medicine is conducted by human beings who err†¦[Simulation Based Medical Education] may offer unique ways to cope with this challenge and can be regarded as a mistake-driven educational method (p.194).† They continued stating that Simulation Based Medical Education is a powerful learning experience for students and professionals where â€Å"students are permitted to make mistakes and are provided with the opportunity to practice and receive constructive feedback which, it is hoped, will prevent repetition of such mistakes in real-life patients. (p.194)†. Ethical Use of Simulation (incorporate these paragraphs into previous on pt safety) Health care educators, whether from nursing, respiratory therapy, or medicine, find themselves in similar situations in deciding how to teach patient management to their students. Bioethicists have long condemned the use of real patients as training tools for physicians (Lynoe, Sandlung, Westberg, Duchek, 1998). Unfortunately there have been times in which the student learning has occurred to the detriment of patients (Lynoe et al, 1998). However, with the advent of high-fidelity human patient simulation approaches to learning, it may be time to adopt this method of instruction in the development of interprofessional education. The Institute of Medicine (IOM) recently issued a report on medical errors and recommended the use of interactive simulation for the enhancement of technical, behavioural and social skills of physicians (Kohn, Corrigan Donaldson, 1999). Numerous accounts are found in the medical literature touting the use of human patient simulation in the education of health care personnel at all levels, from student to attending physicians. Patient simulation is used for training personnel in several areas of medical care such as trauma, critical care, surgery and anaesthesiology, mainly due to the extensive skill required to perform adequately the procedures and techniques relevant to these areas. Several researchers have demonstrated the effectiveness of simulation in the skill development of medical personnel (Morgan et al, 2003; Lee, Pardo, Gaba, Sowb, Dicker, Straus, et al., 2003; Hammond, Bermann, Chen Kushins, 2002). In areas with low technology, such as internal medicine and in acute care areas providing less procedural skills but greater decision making requirements, the use of simulation in the education of its clinicians has progressed (Ziv, Wolpe, Small Glick, 2003). Despite the growing support for the use of simulation in health care education, there is not yet enough evidence to support its use. Simulation Research in Medical Education In 1998, Ali, Cohen, Gana Al-Bedah studied the differences in performance of senior medical students in an Adult Trauma Life Support (ATLS) course. This course uses simulated scenarios to both teach and evaluate students performance in trauma situations. The students were divided into three groups; 32 medical students completed a standard ATLS course, 12 students audited the course (without participating in the sessions or taking the written exam) and a control group of 44 matched students who had no exposure to ATLS. Of note is that some participants from all three groups were doing clinical hours in trauma hospitals during this study while others were not. The participants were observed while managing the standardized (live) patient in simulated trauma and non-trauma scenarios. The participants management of the sessions was scored on

The Childhood Obesity Epidemic in the United States :: Obesity in Children

There is an alarming rise in childhood obesity throughout the United States, making it an epidemic in our country. Obesity has become a threat to the health of many children. Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2012. Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to nearly 21% over the same period.(Childhood Obesity Facts, 2015) What is Obesity? Obesity is defined by Webster’s dictionary as increase body weight due to excessive accumulation of body fat. It is a condition or disease in which the â€Å"the natural energy reserve of humans or mammals, which is stored in fat tissue, is expanded far beyond usual levels to the point where it impairs health.† Obesity is most often measured by using the BMI (body mass index). BMI is calculated by dividing the weight in kilograms by the height squared in meters. A desirable BMI for children to sustain a healthy life is between 18.5 and 25. A child with a BMI over 25.0 kg/m 2 is considered overweight. A BMI over 30.0kg/m 2 is considered obese, and a BMI over 40 is morbid obesity. â€Å"An estimated 80% of overweight adolescents continue to be obese into adulthood, so the implications of childhood obesity on the nation’s health are huge†. (Survey on childhood obesity, 2014). Obesity is a chronic condition that develops as a result of genetic, behavioral and environmental factors. Causes of Childhood Obesity There are many factors that may influence the occurrence of obesity in children. These factors can be broad and may vary depending on the individual child. Research has shown the impact genetics has had on the development of obesity in children as well as unhealthy home environments. Other external factors may include the education system and the food industry, because of their promotion of unhealthy eating habits and physical inactivity in children. The Role of Genetics: Genetics can play a huge role in the development of obesity in children. Studies have shown that obesity can be inherited. A child’s chances of being overweight or obese are increased by 25 percent if their parents are overweight or obese. The Centers for Disease Control and Prevention (2015) states that â€Å"the latest study from Stanford University has found that having overweight parents is the biggest risk factor for childhood obesity†(para 1). The Childhood Obesity Epidemic in the United States :: Obesity in Children There is an alarming rise in childhood obesity throughout the United States, making it an epidemic in our country. Obesity has become a threat to the health of many children. Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2012. Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to nearly 21% over the same period.(Childhood Obesity Facts, 2015) What is Obesity? Obesity is defined by Webster’s dictionary as increase body weight due to excessive accumulation of body fat. It is a condition or disease in which the â€Å"the natural energy reserve of humans or mammals, which is stored in fat tissue, is expanded far beyond usual levels to the point where it impairs health.† Obesity is most often measured by using the BMI (body mass index). BMI is calculated by dividing the weight in kilograms by the height squared in meters. A desirable BMI for children to sustain a healthy life is between 18.5 and 25. A child with a BMI over 25.0 kg/m 2 is considered overweight. A BMI over 30.0kg/m 2 is considered obese, and a BMI over 40 is morbid obesity. â€Å"An estimated 80% of overweight adolescents continue to be obese into adulthood, so the implications of childhood obesity on the nation’s health are huge†. (Survey on childhood obesity, 2014). Obesity is a chronic condition that develops as a result of genetic, behavioral and environmental factors. Causes of Childhood Obesity There are many factors that may influence the occurrence of obesity in children. These factors can be broad and may vary depending on the individual child. Research has shown the impact genetics has had on the development of obesity in children as well as unhealthy home environments. Other external factors may include the education system and the food industry, because of their promotion of unhealthy eating habits and physical inactivity in children. The Role of Genetics: Genetics can play a huge role in the development of obesity in children. Studies have shown that obesity can be inherited. A child’s chances of being overweight or obese are increased by 25 percent if their parents are overweight or obese. The Centers for Disease Control and Prevention (2015) states that â€Å"the latest study from Stanford University has found that having overweight parents is the biggest risk factor for childhood obesity†(para 1).

Single Parenting Stigma

Single-Parenting Families: Attached Stigmas The social deviance that interests me is single parenting, one who chose to have a child out of wed-lock. The stigma attached to being a single parent is rising anew. Many media commentators blame America's uptrend in violence and other social problems on family breakdown – on single parents. This stigma is based on myths and stereotypes that have been promoted by half-truths and, often, by prejudiced viewpoints. Many in our society still regard single parenthood as a unwelcome status.I as a single parent myself, I am often admired, but at the same time looked upon with pity, disgust, sympathy, and perhaps with uneasiness. In defense of single parent families I would argue to de-stigmatized single motherhood by society, in which the shifting of family type in single parent household is now normal and acceptable. One obvious identity is I am a woman and my hidden identities are I am a mother, unmarried, and parenting alone. A complex of set social and cultural stigma perceived as making a selfish or misguided decision to have a child and raise it on my own as a unmarried single mother.Growing up I was told by my parents the unwed mothers were bad girls who make mistakes and gotten pregnant, whom family, friends, and the community shamed and reject. There is a clear cultural, moral, and religious message of stigma. In my parents generation, it would highly scandalous of a single woman raising a child alone and never married. In those days it was expected for the man to do the honorable thing, and marry the woman who is carrying his child. It did not matter whether he love her or not, having a child out of wedlock is unacceptable and the child would be considered a bastard( child born to unmarried parents).I am a single parent. I never planned on being a single parent. Few do. I grew up with an ideal of parenting as something I would do with a husband, within a marriage. Choosing to parent alone was simply not a o ption in my household growing up. Unwed pregnancy was to be avoided at all costs! Divorce with children was quickly remedied with remarriage. The honored and supported single mothers without stigma is through the death of a husband is a widow. Today, nearly one-third of American families with children under the age eighteen are in single-parent families, and this has double the number less than two decades ago.Separation and divorce creates most single parent families, that accounts for twice as many single parent families (60%) as failure to marry (30 %), while the death of a parent creates less than (7 %) of such families. Single parent families are raised by single mothers are becoming the majority family type culturally in United States. However, there is still a powerful negative images associated with Black single mothers and rarely does the dominant culture identify individuals, but instead stigmatized the entire class of Black mothers.Many presume the color of the typical we lfare recipient is a Black mother and that is not entirely true, but Black mothers are disproportionately represented. I personally can not explain why single parent never been married families are far more prevalent in the Black communities than in the White communities. Marriage is the most common for all women and for most women the only way out of poverty. For Black women, however the economic gain of marriage is often few and far between due to the poor economic opportunities of Black men.Although, I am a single mother raising three sons. My children have not and will not suffer from the outcome of poverty, simple because I am a single parent. I am not poor. I am gainfully employed and I own my own home for the last fifteen years. There is a strong stigma attached to single mothers households are living below the poverty line. What are the critics saying about the single mothers? Stigmatizing the single parent families as part of the underclass, broken, and deviant. Their child ren are mostly to have emotional or behavioral problems.To have children out of wedlock, are more likely to have trouble in school, and likely to commit crimes. Therefore, because I chose to raise my children alone†¦Ã¢â‚¬ ¦society blames me for the decline in social order. The two parent families is still compared as the traditional family formation and contribute to a healthy and successful society. I recently saw on TV an interview with Ann Coulter on the talk show The View †¦. she blames many of society’s problems on single moms. She goes on to say that our jails are filled with the offspring of single moms.To accuse single moms of being responsible for all society’s problems is absolutely crazy. There are many reasons relationships end, and when there are kids involved usually the bulk – if not all – of the responsibility of raising the kids is assumed by the mom. We single moms should be applauded and not attacked for this. Sure, there are some women that decide to have a baby on their own with no man in the picture, but can you blame them?It is hard to find a decent man who also wants to raise a family. Even when you do there are no guarantees he will stick around for the long haul. Nevertheless, single fathers have biological link or legal status as a non-custodial parent. What that actually means is they are expected to pay child support for their children, but rarely do they have sole or joint custody of their children. Some men have this immature concept of fathering that expects men to separate from their children and their responsibility, if they do not maintain a connection to the children’s mother.There is a layer of stigma that is laid upon Black single mothers complete with highly fertile capacity( having many babies), being lazy and shiftless, and being in a relationship with uncaring and equally lazy black man. In which he is not willing to work, will not marry her, and will not support his family. This stereotype does not fit all single African American mothers and fathers. Unfortunately, those are the views of the dominant culture in our society of unwed African American single mothers. There are confronting stigmas and myths of single parenting as society continues to view that stigma as appropriate and justified.The first, single-parent families are poor and single parenting causes poverty and social problems. Second, single-parent families are physiologically unhealthy. Third, single-parent families are immoral. The religious standpoint the families are sinful because they lack the blessing and validation of marriage through the church. Finally, there is a underlying undertone of stigma attached to race and gender beliefs that further support the badge of social scorn and economic hardships. What I know about single mothers is far different from the myths that are circulating in society, resulting in powerful stigmatizing.The truth and reality is many single mother are r aising their children very successful alone, including myself. Parenting is the hardest job, that one will ever have. However, single parenting is even harder, but not impossible to be successful in providing for your family. Society must look at the parent and not the circumstances that lead to their being a single mom or dad. The first priority and full responsibility is towards the child, put the child first in every and all decisions. My personal story is I have always been there for my three sons and it is my job to take care of them, until they can take care of themselves.I have raised boys to men and at the sometime to be gentleman. In my household it is filled with love and support. Education was always instilled and valued in my home. My sons are very intelligent, respectful, good human beings and all because I took full responsibility for them and I took parenting very seriously. I can argue strongly that children need love, discipline, structured, boundaries, and guidance . Children who lack these exposures will perhaps become menace to society, but not from living in a single parent household. Two parent families can be dysfunctional, don’t place the blame solely on single parent families.The house with white picket fence is only a disguise, one can only guess what is truly going on behind closed doors. For the love that I had for my son’s father and yes, they have the same dad (a myth that African American single mothers children have different fathers). We drifted apart and we decided to separate and I focus on being a mom. In neither case was it my choice to be a SINGLE mom; my choice was to just be a MOM. Sorry to report that single mom bashing is nothing new. And, the â€Å"double standard† is nothing new, either.Single dad who pays his child support and see his kids on a regular basis is a hero! Single moms, on the other hand, seem to be held to nearly impossible standards. I can only suggest what has worked for me. I hold my head high, keep my decisions grounded in what's best for my sons , and ignore the small minded people. My sons are my blessings, they are beautiful, and I am very proud to be their mother. Being a single mom presents additional and unique challenges and experiences. I feel I can conquer the world, because being a mom is the toughest job there is.Life is never boring! These myths and stigmas can be confronted successfully and new strength can be found in the truth. As with so many aspects of single parenting, myself and other mothers rise to the challenge and become better people because of it. The myths are sometimes subtle and subconscious, but the more we examine them, the more clearly we take responsibility for our lives and the lives of our children. My deepest love and appreciation goes to my sons, who have taught me more than they will ever know. I love you†¦.. higher than the moon, wider than the sky.

Chilean Mine

Over two months trapped underground waiting to be rescued their waiting had finally come to an end on October 13, 2010. Two months ago on August 5th, 2010, in the city of Copiapo, Chile, near the Atacama desert an underground mining had collapsed trapping 33 miners 2300 feet below the surface. Now, given under the circumstances that the mine had a history of previous accidents and deaths, this led everyone to believe that the 33 men underground had died in the rumble. What will become of them?Having to be open-minded in such a gloom situation, was difficult nowing that the miners were still alive and well. There had to be something done to help them. The first thing that needs to be done is understand the crisis or disaster, only after that can a decision is made as how to handle the situation. In a situation like this it is best to appoint someone who can handle the discussions that arise and control the media. someone who can think outside the box and be sincere In executing the ta sk at hand.Someone who Is not afraid to ask questions and Is well versed with business rule: When you cannot answer the question, get someone who can. (Crisis Management 5th Para. Not only will this be the best for the company but for the families of the miners as well. Some considerations to remember is that the audience may be emotionally distressed and when communicating with them about the topic that we are straight forward. There has to be control in such a chaotic situation. Their expectations want to be addressed.How quickly will this be resolved? When will their loved ones come home They want answers, The needs of the families receiving the messages of this incident would want to know that their families would be coming home safely and that there is a plan to get the know out I OF3 saTely. Also, Is tnere a support system to nelp out tne Tamllles going tnrougn t crisis? Some family members, such as the children of those trapped below may need therapy. The families may want to know as well if there will be any compensation for what had happened.Will the company do what's right or Just walk away? Another potential need about receiving a message would be that, is the company safe? What measures have taken place to ensure the safety of the employees? Have preventive measures been taken so it won't happen again? The people would want to know that the company is doing something for their fellow employees trapped below. They would want to see that the company is taking steps to show that they care about what happened to their employees and that something like this would not happen again.Actions that would be taken before delivering the message is make sure that the one person appointed is an expert to read a memo and handle any questions that arise in the public. Also, at times of chaos there has to some level of comfort, tell them what they would want to hear. Letting them know that their loved ones are well, and that all steps are being taken to bring them h ome safely can bring them some ease. In any crisis or tragedy there are precautions take and how to handle the situation.The main concern is, how is the message being delivered and how the audience will will react to it. The key component is to communicate and show sympathy for the employees and families. Such a message would be delivered in person, face to face especially with the families involved. Another way would be to broad cast it so that city sees your trying to do what is best to bring them home safely. To hide behind letters and not be a around shows no empathy or concerns for the individuals that are involved. Our thoughts and prayers go out to those affected by this tragedy.Memo to Family Members and Employees As you may have heard on August 5th, 2010, there was a tragic accident in the mines of Chile located deep in the Atacama desert. The mine had caved in trapping 33 of our miners 2300 feet underground. They are working diligently to find the men and ensure that they have enough food and water to help them while they wait to be rescued. There are three large teams including the expertise of N. A. S. A working on ensuring their safe return to their loved ones. We know that working in the mining usiness can often be hard and cruel but I assure we are doing everything possible to bring them home.As more information or changes develop, the families will be the first to be notified and if there are any questions or needs please feel free to contact us. Our thoughts and prayers are with you and your loved ones.