PBL Final EXAM Review - Summary Introduction to Nursing and Health I PDF

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Exam Review N1F03: Semester 1 Learning Aims Introduction*to*Learning*at*McMaster* * Learning*Outcomes! ! ü Discuss!the!definitions!of!self-directed!learning!(SDL),!small!group!learning!and!personbased!learning!(PBL)!within!a!small!group!problem-based!learning!(PBL)!framework! - McMaster*Nursing*PBL*model:!person!based!learning!within!a!problem-based! learning!approach;!the!problem!is!person-situational!! 1. What*is*PBL?*An!active!approach!to!teaching!and!learning!where!problem! drives!learning**! 2. Why*is*PBL*important*à *allow*for*self-directed*and*small-group*format*! • To!become!self-directed!and!conceptual!thinkers/learners!! • To!have!the!skills!necessary!to!respond!to!changing!healthcare! environments!! 3. Why*is*PBL*within*PBL*important?! • !Causes!language!to!shift!to!person!centered!which!allows!for! learning!for!student!and!healing!for!patient!! • brings!clinical!situation!to!classroom! • allows!student!nurse!to!act!as!an!experienced!nurse!! 4. What*is*PBL*dependent*on?** • Classroom!dialogue!! • Preparing!for!class!! - SGL:!small!group!learning!! § Cognitive!abilitiesà!critical!thinking!PLUS!social!cohesion!àcollaborative! skills!

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! SDL:'self'directed'learning'' § Forming!goals!and!evaluating!learning!outcomes!!! § Assuming!responsibility!for!own!learning!! SCL:'student-centred'learning'' § Self!efficacy!+!Self*Regulation!+!Learning!Style!=!motivation!to!learn!! • Self-regulation!is!guarded!by!the!theory,!tutor!and!peers!! • Self-*regulation*requires:*self*assessment,*self-judgement*and* reflection** • Very!much!in-class!structure!!

Exam Review N1F03: Semester 1 Learning Aims * -

LGL:*large*group*learning** § Transfer!of!knowledge!or!concepts!to!group!!

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LLL:*lifelong*learning*à** 5. Life*long*learning*capabilities:!Knowledge!translation!+!right!fit!for! client/patient!à!critiquing!resources!à!effective!and!efficient!databases! àformulating!researchable!questions!!

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! ü Review*the*steps*of*PBL/PBL:** - WALSH:** 1. Encounter!person!through!situation/scenario!(individual,!family,!group,! community!or!population!! 2. Identify!issues,!challenges,!problems,!assets!and!strengths! 3. Explore!pre-existing!information!and!current!knowledge!base!! 4. Generate!hypothesis![assumptions!are!made!here]!! 5. Identify!information!gaps;!identify!and!prioritize!learning!issues!! 6. Research!learning!VIA!self!study!! 7. Apply!new!knowledge!to!hypothesis!! 8. Assess!and!reflect!on!group/individual!learning!!

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Exam Review N1F03: Semester 1 Learning Aims ! -

RIDEOUT*AND*CARPIO:** 1. Problem!(person-situational)!is!presented!! 2. Terms!reviewed!! 3. Hypothesis!generated/assumptions!are!made!!! 4. Learning!issues!and!information!sources!identified!by!group!! 5. Info!gathered!and!independent!study!occurs! 6. Knowledge!gained!through!independent!study!is!discussed!and!debated!! 7. Reflect!on!content!and!process!of!learning!!

! ü Describe*the*process*of*brainstorming*a*learning*question.***

* 1. Hypothesis*generation** 2. Concept*maps** 3. Identifying*learning*gaps*à*what*we*know*and*what*we*don’t*know** * ü Describe!the!tutor!and!the!student!roles!in!SDL,!small!group!learning!and!PBL! ! SDL! SGL! PBL! Tutor! Builds!learning! Facilitating! Bridging!learning! environment!! dialogue!through! gaps!! Helps!students! appropriate! determine!what! questioning!! to!learn!! Guidance!! Student!! What!they!need! Independent! Identify!issue!! to!learn!! study!! Create! hypothesis!!

Exam Review N1F03: Semester 1 Learning Aims Setting!learning! goals!! Evaluating! progress!! !

Sharing!of! information!!

Learning! questions!! Researching! effectively!!

! ü How!do!student!adapt!to!PBL?!à!Woods!Learning!Curve!! ü NOTE:'performance'level,'decrease,'increase,'higher'performance'level'' - Performance!level!high!! - Shock!with!change!! - Denial!! - Strong!emotional!! - Resistance!and!withdrawal!to!new!routine!! - Acceptance!! - Struggle!! - Better!understanding/direction!! - Integration!! - New!HIGHER!level!of!performance!!

! ! ! ü Explore*the*use*of*mind/concept*maps*as*a*strategy*to*assist*learning.** - What!is!a!concept?!à!Concepts!can!range!from!broad!to!narrow:!! 1. Broad:!clarify!questions,!comments,!brainstorm!cues,!what!you! know/knowledge!gaps,!identify!hypothesis!and!learning!questions!! 2. Narrow:!core!concepts!of!each!care!scenario!! - What!is!a!concept!map?!! 1. Graphic!illustration!of!key!points!which!guides!the!focus!of!patient! problems![body!systems!approach!used]! 2. Can!be!used!to!form!a!clinical!question!! - Why*do*we*use*concept*maps?**

Exam Review N1F03: Semester 1 Learning Aims 1. Logical!flow!! 2. Thorough!planning!! 3. Prioritizing!problems!! 4. Minimize!learning!curve!for!novice!nurses!!! 5. Increases!critical!thinking!skills!! 6. Bridge!gap!between!scientific!theory!and!nursing!action!skills!! - Vee!Heuristics!=!Type!of!concept!map!in!which!planning!and!evaluation!are!used! to!determine!the!most!effective!intervention!! 1. Planning:!Values!basis!(why?),!Theoretical!basis!(what!do!you!know?),! Conceptual!basis!(what!are!the!most!important!concepts?),! methodological!basis!(what!methods?)!! 2. Implementation:!How!do!we!answer!focus!question?!! 3. Evaluation:!Quality!(What!kind!of!data?),!Process!Data,!Knowledge!claims! (What!are!the!main!conclusions?),!Values!claims!(Was!this!worthwhile?)!! - Road!Map!answer!=!correct!body!system!being!affected!à!signs/symptoms! àdiagnosis!àtreatment!à!safe!caring!! - à!assessment!à!independent!nursing!actions!and!assessments!à!safe!caring!! ü Discuss*the*value*of*narratives*in*learning*and*professional*practice.* - Patient’s*narrative:*their!illness!and!the!meaning!it!has!for!their!life** - Narrative*competence:*how!human!beings!absorb,!interpret!and!respond!to! someone!else’!story* - Narrative*knowledge:** Narrative*Knowledge** Logico-scientific*knowledge** Understanding!meaning!of!illness!! Detached!observers!w/!impersonal! actions!! One!person-one!observer!! Seeing!patient!as!their!case!! * - Narrative*medicine:**using*narrative*competence*to!practice!medicine!with! empathy,!reflection,!professionalism!and!trustworthiness!* 1. The!narrative!model!of!medicine!is!informed!by!the!biopsychosocial! medicine!and!patient-centered!medicine!!* 2. Bridges*gap*between*4*areas:** • Doctor*and*patient:!discussing!disease!and!the!impact!it!has!on! their!life,!using!diagnostic!listening!to!address!questions:!what!is! wrong!with!me,!why!did!this!happen!to!me,!what!will!become!of! me!* • Doctor*and*self:*recognize!journey!with!medicine!* • Doctor*and*coworkers:*acknowledge!duty!to!profession,! accountability!* • Doctors*and*society:*narrative!competence!to!re-establish!trust!in! doctors* • Others:*doctor*and*their*family,*patient*and*their*family,*among* patients**

Exam Review N1F03: Semester 1 Learning Aims - Integrate!narrative!medicine!through!medical!humanities!! - Narrative*conditions:*probe!the!relationship!between!2!people*! - Narrative*discourse:!someone!telling!someone!else!(2!people!are!NEEDED)!! Group*Work*notes:* - Advantages:!superior!resources,!social!aspect,!learning,!cultural!understanding,! creativity,!civic!engagement!* - Disadvantages:!more!time,!conflict,!people!problems!* - Synergy:!whole!is!greater!than!the!sum!of!its!parts!(needs!3+!people)!* - Group*norms:!expectations!that!dictate!what!is!appropriate!and!what!is!not! appropriate!! - Norms:!accomplish!group!goals!or!predict!behaviour!à!explicit!norms!and! implicit!à!interaction!norms!(communication),!procedural!norms!(group! operates),!status!norms!(power!and!control),!achievement!norms!(standards)!* !!

Interaction!norms!!

Procedural! norms!!

Status!norms!!

Achievement!norms!!

Key! What!communication! How!does!the! Who!has!power! What!are!the! question!! behaviour!is!appropriate!! group!operate!! and!control!! group's!standards! Implicit! norms!!

We,!us!over!I,!me,!my!!

Explicit! norms!!

Group!leader!ensures! Agenda!in! everyone!gets!a!chance! advance!to! to!speak!! meeting!! -

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Everyone*turns* Group!leaders! off*cells*phones*! always!sits!at! head!of!table!! Group!vote!is! tied,!leader! breaks!vote!!

Everyone!shows!up! on!time!or!as! scheduled!! All!members!must! have!full!!citations!!

Dialectic*tension:!can!arise!when!members!challenge!group!norms!or!standards!* 1. Ethical*dilemmas*can*arise*from*unavoidable*dialectic*tensions*(Milgram* experiments,*Zimbardo*experiments)** Conformity:!following!norms!* Nonconformity:!counteracting!norms;!constructive!à!re-evaluation!of!norms!for! groups!best!interest;!destructive!à!resistance!of!norms!against!groups!best! interest!=!discussing!norms!value,!deals!w/!disruptive!member!(acceptance,! confront,!exclude)!* Motivation:!extrinsic!rewards!vs.!intrinsic!rewards!* 1. Kenneth*Thomas*Motivators*[4x]:*sense!of!à!!meaningfulness,!choice,! competence,!progress!* • A*sense*of*meaningfulness:** o Feeling!shared!in!pursuing!a!meaningful!goal!* o If*you*are*leader:!feedback!on!how!efforts!contribute!to! group!goal* • A*sense*of*choice:** o Power!and!ability!to!make!decisions!about!how!to!organize! and!do!its!job!*

Exam Review N1F03: Semester 1 Learning Aims

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o If*you*are*leader:!encouraging!members!to!make!decisions! about!how!the!group!does!work!* • A*sense*of*competence:** o Group!is!doing!high-quality!work!* o If*you*are*leader:!giving!and!listening!to!constructive! feedback,!complimenting!member!abilities!and! achievements!and!setting!high!standards!for!yourself* • A*sense*of*progress:** o Staying!motivated!means!making!progress!towards!goal* o Creating!good!objectives!and!working!towards!them,! tracking!and!measuring!progress!* o If*you*are*leader:!sustain!motivation,!celebrate! accomplishments!* Balance:*balance*needs*for*inclusion,*control*and*affection*w/*group’s*needs* for*productive*results* Member*roles:** Benne*and*Sheats*Functional*Group*Roles:** 1. Group*Task*Roles:*Ability*to*reach*goal** • Initiator!-!contributor!à!gets!group!started!!* • Information!seeker!à!makes!group!aware!of!info!gaps!* • Opinion!seeker!à!asks!for!other's!opinions* • Information!giver!à!presents!needed!info!* • Elaboratoràhelps!explain!ideas!and!suggests!examples!* • Coordinator!àsummarizes!ideas,!raises!questions!about!direction! of!discussion!* • Evaluator-critic!à!functions!as!critical!thinker!* • Energizer*à !serves!as!groups!cheerleader!* • Procedural!technician!à!admin!work!* • Recorder!à!minutes!* 2. Group*Maintenance*Roles:*group*dynamics** • Encourager!à!supporter:!praises!and!agrees,!empathetic!! • Harmonizer!à!conflict!resolution!! • Compromiser!à!suggestions!that!minimize!difference!! • Tension!releaser!à!friendly!humour,!ice!breaker,!relaxor!! • Gatekeeper!à!enables!quieter!members!to!speak!and!shuts!up! talkative!members!! • Observer!–!commentator!àmonitors!and!interprets!feelings! • Follower!à!serves!as!an!attentive!audience!member!! 3. Self-centered*roles:*individual*>*group*needs** • Aggressor!à!puts!down!members!! • Blockerà!stands!in!the!way!of!progress!! • Dominatorà!prevents!others!from!participating!! • Recognition!seekerà!boasts!about!personal!accomplishments!!

Exam Review N1F03: Semester 1 Learning Aims Clown!àinappropriate!humour,!distracts!the!group!! Desesrterà!withdraws!from!the!group!! Self-confessor!à!seeks!emotional!support!from!the!group! Help-seeker!à!seeks!sympathetic!responses!from!group!! Special!interest!pleader!àspeaks!on!behalf!of!outside!group!for! personal!interest!! Belbin’s*Team*Roles:*Team*Role*Theory*(*essential*roles)** • *Coordinator* à*clarifies*goals,*allocates*roles,*articulates*group* conclusions** • Shaperàpushes!group!toward!agreement!and!decisions,! challenges!others** • *Innovator à foster*creativity** • Resource*investigatorà explores!opportunities!and!makes! connections!* • Monitor/evaluatorà *sees!all!opinions!and!judges!accurately,! monitors!progression** à !transforms!talk!and!ideas!into!practice!action** Implementer • • *Teamworker àpersonal*support*and*help*to*others,*conflict* resolution** Completer/finisher à completing!tasks** • • Specialistà !provides!unique!expertise!or!skills!* • • • • •

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Member*confidence:** 1. Communication*apprehension:*fear!w/!real!or!anticipated! communication!(help:!constructive!feedback,!prompting!questions,! picking!up!one!cues)** 2. Technology:** • Hyperpersonal*communication:!overconfidence!or!control! through!communication!with!technology!! Conditions*that*affect*group*work:** 1. Cohesion:!ability!to!function!as!one!unit!* 2. Conformity:!to!group!norms!(or!lack!there!of)!* 3. Climate:!environment!(positive!or!negative)!*

* Key*Terms:** 1. Concept!Map:!organization!of!ideas!in!a!logical,!graphical!manner!allowing!for!increased! critical!thinking!skills!and!bridging!the!theory-practice!gap!* 2. Feedback:!input!evaluation!measures,!learning!outcomes,!tutor-student!feedback,! student-student!feedback* 3. Inquiry:!asking!why;!exploring!resources!to!gain!more!information!!* 4. Identifying!learning!gaps:!what!I!know!and!what!I!don’t!know;!filled!by!asking!question,! tutor!providing!information,!exploring!answer!through!appropriate!learning!questions!!* 5. Learning!goal:!What!will!be!covered!through!research,!discussion!and!in-class!material;! provides!backbone!and!reasoning!for!material!*

Exam Review N1F03: Semester 1 Learning Aims 6. Learning!questions:!concepts!maps,!hypothesis!generations,!information!gaps!all! contribute!to!these!* 7. Lifelong!learning:!conceptual!thinker!and!learning!who!can!translate!knowledge,!critique! resources,!research!effective,!form!researchable!questions!* 8. Narrative:!see!above!!* 9. Person-based!learned:!personal-situational!is!the!problem!!* 10. Problem-based!learning:!problem!guides!learning!* 11. Self-directed*learning:*students!are!accountable!for!own!learning!goals!!!* 12. Small!group!learning:!cognitive!abilities!(critical!thinking)!+!social!cohesion!(collab!skills)* 13. Student*centeredness:*self-efficacy,*self-regulation*assessment,*judgement,*reflection)* learning*style*à*puts*student*at*centre*of*learning*(case*studies,*role-play,*creative* writing)** 14. Tutor:!fills!learning!gaps;!graduate!nurses!who!are!able!to!regulate!own!behaviours,! learning!and!enact!professional!behaviours;!guide!student!learning!* * ! Introduction*to*Group*Process* * Learning*Outcomes! ! Through!research,!class!discussion!and!in-class!learning!activities:! 1. Discuss!the!function!of!groups!in!small!group!learning!(SGL!=!individual!critical!thinking!+! group!communication)!! 2. Discuss!group!member!roles!and!their!influence!on!the!dynamics!of!a!group!(see!roles! above)!! 3. Explore!an!awareness!of!one’s!preferred!group!roles!and!the!effect!on!your!group’s! dynamics.! 4. Discuss!providing!constructive!feedback!to!peers!and!tutor!regarding!group!process,! decision-making!and!conflict!management.! ü Destructive*nonconformity:!accept,!confront,!exclude!! ü Group*maintenance*roles:!harmonizeràconflict,!compromiseràdecisionmaking,!observer!àconflict!! ü Team-Role*Theory:!monitor/evaluatoràconstructive!feedback,!coordinator! àconstructive!feedback,!teamworkerà!conflict!resolution!!

Exam Review N1F03: Semester 1 Learning Aims

! * * * * * Key*Terms:** 1. Group*norms:!explicit!or!implicit!expectations!!! 2. Group*roles:!functional!group!roles!(group!maintenance,!group!task,!self-centered),! team-roles!theory)!*see!above!! 3. Group*maintenance*functions/roles:!help!maintain!group!dynamic!! 4. Group*tasks*functions/roles:!group!working!towards!common!goal!! 5. Negotiation:!coming!to!a!compromise! 6. Followership:!willingness!to!accept!guidance!and!direction!from!a!leader! 7. Leadership:!the!act!of!guiding!! 8. Conformity/nonconformity:!to!group!norms!(nonconformity:!constructive,!destructive)!! * * * * * * * * *

Exam Review N1F03: Semester 1 Learning Aims Health*&*Health*Promotion* Learning*Outcomes! ! Through!research,!class!discussion!and!in-class!learning!activities,!students!will!be!able!to:! ü Describe!the!World!Health!Organization’s!definition!of!health!and!compare!to!how!you! define!health.! o WHO:!! § State!of!complete!physical,!mental!and!social!well-bring!and!NOT!merely! the!absence!of!disease!! § A!resource!for!everyday!life;!not!the!object!of!living!! § Positive!concept!emphasizing!social!and!personal!resources!as!well!as! physical!capabilities!! § Fundamental!human!right!à!Universal!Declaration!of!Human!Rights! (1948)!! § An!essential!component!of!development!(economic!growth!à!more! healthy!people!can!contribute!to!the!economy!and!internal!stabilityàless! likely!for!people!to!be!content!w/!their!current!system)!! § Better!health!outcomes!=!can!reduce!poverty!! o Health*in*terms*of*resiliency!à!capability!of!individuals,!families,!groups,! communities!to!cope!successful!in!face!of!risk!! o Health*in*terms*of*population*health!à!success!with!which!the!population! adapts!to!change!such!as!shifting!economic!realities!or!natural!disasters!! o Ecological*definition:!a!state!in!which!humans!and!other!living!creatures!with! which!they!interact!can!coexist!indefinitely!! o 4*key*values*to*address*health*issues:!recognition!of!the!universal*right!to! health,!continued!application!of!health*ethics!to!policy,!research!and!service! provision,!implementation!of!equity*orientated!policies/strategies!that! emphasize!solidarity,!integrating!gender*perspectives!into!health!policies!! o Conceptualizations*of*health*(comparison):** WHO/McGill*Model* of*Nursing** Coping*and* Development** Realize!aspirations!! Satisfy!needs!! Change!or!cope!w/! environment!! Health!is!a!resource! for!everyday!life!and! not!the!objective!of! living!!

Pender*et.*al**

Jones*and*Meleis** Labonte** Stability*and* Health*is*empowerment* Actualization* (builds*on*stability*and* Stability:!maintaining! actualization)** physiological,!functional! Feeling!vitalized!and!fully!of! and!social!norms!! energy!! Actualization:!potential!! Having!satisfying!social! Stability!+!actualization!=! relationships!! goal-directed!behaviour,! Having!a!feeling!of!control! self-care,!relationships! over!one's!life!and!living! w/!others!! condition!

Raeburn*and*Rootman** Health!needs!to!be! positive!(not!based!on! pathology!or!deficit),! comprehensive!(w/! broad!set!of! determinants),!mental! health!focus,!inclusive!of! quality!of!life!and! spirituality!

Exam Review N1F03: Semester 1 Learning Aims !

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Being!able!to!do!things!that! one!enjoys!! Having!a!sense!of!purpose!! Feeling!connected!to! community***

! ü Discuss*the*difference*between*illness*and*disease*and*how*individual*differences*in* people’s*ideas*about*health,*illness*and*disease*affect*the*nurse’s*approach*to*a* situation.* o Health:* § Negatively!defined:!Absence!of!disease!! § Positively!defined:!Person!can!have!disease,!but!also!have!health! characteristics!! § Includes!health!promo,!maintenance,!health!care!system,!practice! (EIDM),!behaviour!(personal!health!behaviours),!health!care!costs,! insurance!! o Functional!health:!present!or!absent;!ex.!High!level!functioning!of!low!level! wellness!! o Wellness*(health)*+*Illness:*interrelated*but*distinct*à *can*be*wellness/health*+* illness*continuum*(both*are*experienced*in*developmental*context)** § High-level*wellness*@*positive*end*to*lack*of*health*@*negative*end*! o Moving*from*center*to*the*right*=*illness** o Moving*from*center*to*the*left*=*health** o Moving*above*line*=*increasing*wellness** o Moving*below*line*=*decreasing*wellness** § High-level*wellness** o Sense*of*well-being,*life*satisfaction*and*quality*of*life** o Based*on*environment,*personal*and*societal*levels** § In*keeping*with*eudaimonistic*model*of*health** § Lack*of*health** o Adaptation*to*disease*and*disability*through*various*levels*of* functional*ability** § Fits*w/*clinical*model*of*health* o Disease:** § Objective!state!of!ill!health!! § Pathological!process!which!can!be!detected!by!medical!science!! § Failure!of!...