The media plays Essay Example for Free

The media plays Essay The media plays a major role in relation to womens football and womens sport as a whole. In fact the media is most probably the main culprit behind the small amount of interest generated in women sports. In as early as the 1980s is was included in a federal report which presented a set of figures which demonstrated that the media is almost solely concerned with mens sport. Another form of media, a survey in 1980 revealed that only two percent of reportage was devoted to women in sport, this figure however decreased in 1984 to just 1. 3 percent. In terms of photographic articles, photographs of males in sport were thirteen times as much as of females in sport. A large majority of individuals have the opinion that women shouldnt play football as they arent suitable or well equipped. This was promoted by the F.As quote in 1921 when they banned womens football, the game of football is quite unsuitable for females and ought not to be encouraged. This is mainly due to the medias portrayal of the womens game. The medias technique gives more attention to the males sport, it also can create stereotypical views, such as all female shot putters are lesbians. It can affect the way in which female sport players are perceived. This kind of stereotype directly affects the opinion of womens football. Moreover, television both shapes and reflects the attitudes of our society (Messner, M.A. et al). Furthermore it reveals something in terms of womens status in our society. According to Archer and MacDonald, sport is seen as traditionally a masculine preserve. Only a few sports are seen as more feminine sports such as gymnastics and therefore are more accepted by society than sports such as rugby and football which are seen as more masculine sports. Women are often seen as lesbians if they play a more masculine sport. Hargreaves (2000) quoted that because the muscularity and power invested in female sporting bodies inverts the myth of gender by rendering women apparently less feminine and more masculine sportswomen have feared being labelled as lesbians. Hargreaves continues to point out that lesbians themselves face discrimination and barriers in sport, which many have bravely contested. The media can also refer to the stereotype that women should act as a wife and spend their time in the house, and not working. Moreover, in 1988 Chris Evert announced her retirement from sport. This event was seen as so significant that Evert appeared on the cover of Sport Illustrated, something which is rare to a sportswoman. However rather than focussing on her successful career, the magazine framed her retirement with the caption, Im going to be a full time wife. The main point acceptance of womens sport will only occur when womens physicality is associated with traditional, stereotypical beliefs regarding the females body and its proper use-in graceful and aesthetically pleasing ways (Greendorfer, 1990). Moreover, women in sports such as gymnastics and figure skating, which are seen as more feminine, have greater social acceptance and media coverage. If sport is not seen as a feminine pastime, football is even less so. As we are often told, it is a mans game. (Gadgil, A., 2003). This opinion is held by many and is certainly created by medias portrayal of women footballers. The media can also however have a beneficial influence on the perception of women footballer, for instance, the creation of role models. There is a distinct lack of role models in the womens game in the UK; however this is different in America. After the Womens World Cup in 1999 which was set in America, a majority of players in the U.S squad were made households names, made appearances in advertisements and also received sponsorship. A role model is a very important tool in order to attract young females to football. It is a person who is regarded by others as a good example to follow (Collins dictionary 2003). The English equivalent to womens football hasnt created many female role models on the pitch; however, it has seen certain females in a position of authority within football. One early example of women in positions of authority in the males game was Annie Bassett, who became the first senior female Marketing Executive of a professional football club in 1987. Using my previous knowledge there are only a couple of females which come to mind when I think of role models in connection with football. Firstly Kelly Smith, who is currently playing football for England and a team in the U.S, she was the first English female to be transferred to America. The second person who comes to mind is Karren Brady, the first female managing director at a professional club. Sepp Blatter could be correct with his prediction that the future is feminine however there is still a great deal of development needed in the womens game. Females are starting to appear more and more in the male game, however there isnt enough publicity given to them, therefore it is difficult to find a role model. Most of the better known females which could be classed as role models are involved more with mens football rather than womens football, for instance, Wendy Toms the first female football assistant referee in England. The fact that football is so popular worldwide confuses the fact that womens football isnt as popular as the males equivalent. I have already discussed possible reasons why womens football isnt seen in a good light by many individuals, both females and males. Obviously individuals in connection with the womens game want to improve interest, attendance and enthusiasm for the sport, however without using certain decision making techniques and problem solving skills, they may struggle to improve this. I am going to continue to firstly introduce some problem solving tools, and then will go on to try and suggest certain improvements which could be made to the womens game. As I have already addressed some problems which I am faced with in relation to this issue, I am going to further investigate into problem solving. G. Brown and M. Atkins (1988) devised a problem solving technique which involved four stages. Stage one involves identifying and stating the problem, dissecting it and exploring it. The problem that I am addressing is related to why womens football isnt as popular as the men game. I have identified possible reasons behind this in my essay, including the medias influence, the lack of role models, and the bad publicity which female athletes or players receive. The second stage requires me to use previous knowledge of problem and relate it to similar problems. Thirdly I need to devise an approach to try and solve the problem. Finally I need to evaluate my approach. There are many approaches to help to solve a problem. Brainstorming is a good method which usually involves setting a question then in a group deciding on many possible answers. These answers are usually written down without judgement and accuracy. However once enough answers have been brainstormed, they need to be evaluated to see exactly how accurate they may be. For all problem solvers there is a process to follow. Moreover in conjunction with G. Brown and M.Atkins theory, there needs to be certain stages. The problem needs to be firstly recognised, and then defined. Before the problem is analysed there is a need for some decision making, for instance, the desired situation and objective need to be clear. Once this is completed, the problem needs to be analysed, and furthermore possible solutions need to be suggested. Once this has been completed the solution needs to be assessed and evaluated.

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 Search for a Better Reality Essay -- Comparative, Kidd, Chrouch

The Search for a Better Reality Life is not easy. It is all about surviving the storms that you will eventually have to face. As a result, sometimes people feel overwhelmed, and they try to find ways that will allow them to break away from reality. In most cases, individuals resort to escape either because they want to be relieved from all of their responsibilities, or because they are trying to avoid facing unpleasant truths or painful situations. Everyone deals with tough circumstances in a different way. For example, some folks try to avoid problems and painful facts in their lives by drinking, or even doing drugs. They know that using these substances will not solve their problems, but it will buy them some time free of stress and troubles. In addition, other people attempt to find some kind of shelter, where they can feel safe and be happy even if it is doesn’t last long. Overall, these behaviors allow individuals to escape from everything that is too hurtful, or hard for them to deal with. Everyone at some point in their lives has felt the need to escape. Take, for example Sue Monk Kidd’s novel The Secret Life of Bees or Katie Crouch’s Men and Dogs. The Secret Life of Bees is about a young girl named Lily Owens, who searches for answers to her mother’s death, while Men and Dogs talks about a now grown woman named Hannah Legare that is looking for answers to her father’s disappearance. Both of these novels focus on characters that constantly try to get away from difficult situations, or even reality itself. Also, in these works of literature, the protagonists try to escape from the truth. Yet, in contrast, they both eventually realize that facing the facts is much more liberating than avoiding them. Thus, clearly th... ... everyone’s grief in her back, which made her life unbearable. Finally, June tries to avoid getting hurt and potentially losing her freedom by declining Neil’s marriage proposals. In the same manner, Hannah’s brother in Men and dogs tries to escape from dealing with his father’s death, and the fact that he was homosexual by doing drugs (pg. 91). In conclusion, the rhetors of both The Secret Life of bees and Men and Dogs provide multiple examples of the elaborate escape mechanisms that were employed by the characters in these narratives. Through these examples, they show that avoiding problems and hurtful situations only makes people’s lives more miserable. Thus, Sue Monk Kidd and Katie Crouch want individuals to realize that accepting the truth, no matter how bitter it might be, is the only thing that will allow them to move on with their lives, and be happy.

All Quiet On The Western Front :: essays research papers

The story centers around a young soldier named Paul in some unnamed regiment in the German army. They fight the Allied forces of the United States of America and Europe, plus their friends. The story is about how Paul and the other soldiers with him, who are also his closest friends, deal with the many aspects of the war. They do this in the only way that they know how, and they are not always successful. Remarque deals with the characters' fears and thoughts by mixing them together into the story. You form a kind of bond with the various characters throughout the book. Although the author does not offer great detail on any one character, you still find yourself caring and hoping for each of them as they fight, love, hate, and in many cases, die. This is mainly through each of the character's personalities, which are so well-developed that you find yourself wondering if these were real people at some time or another and you might travel to Germany to meet them. The plot is not linear , and in most cases I would say that this is a negative thing. However, in the book the author actually uses it to enhance the storyline by not dwelling on any one scene for too long. Many chapters end and you find yourself wondering if there was supposed to be more. By the end, you realize that it actually enhances the plot greatly. One moment the people might be eating and bathing in the barracks, and the page after they are fighting on the front lines. It skips around a lot, but I became used to it. I may even grow to miss it in the future. This story's real strength lies somewhere else, though. This is in the portrayal of the characters' thoughts and feelings. Each character reacts to situations so realistically that many times I found myself thinking: "That's what I would have done!" This blends well with Remarque's many ventures into human nature throughout the book. He uses his characters to go into the depths of all of our souls, and he does it with skill. Especial ly well done was the part where Paul gets some leave of his duties and he goes back home to his family for a few weeks. While there, he realizes that he is no longer one of these people, that he is changed forever from what he has seen and what he has done.

L.A. Confidential :: essays research papers

L.A. Confidential   Ã‚  Ã‚  Ã‚  Ã‚  L.A. Confidential is a movie of cops that are more corrupt than the criminals they arrest. Throughout the movie Bud White is portrayed to have a personal hatred for women abusers despite becoming enraged and hitting Lynn Bracken. At the beginning of the movie, Bud and two other officers are seen sitting in a car, observing a man beating his wife. Officer White gets out of the car, approaches the house, and then pulls the family’s Christmas decorations from the roof. When the man comes outside to see what is making all the noise is about, Bud White immediately begins to beat him. Afterwards, Bud handcuffs the man to a rail.   Ã‚  Ã‚  Ã‚  Ã‚  In another scene from the movie Bud White is seen leaving a bar. When Bud exits the bar, he notices a woman, with bandages on her nose, sitting in a car with two men. Bud approaches the car to investigate. In the process, the driver jumps out of the car and tells him to get lost. Then Bud White beats him up. Bud is thinking that someone has abused the woman, when in actuality the woman had been hit in the face with a tennis racket. Throughout the movie Bud is seen beating the information out of suspects. Such as when he is seen at a bar squeezing a man’s testicles until the man told him the information that he wanted to hear. During an interrogation at the precinct, Bud White hears a suspect confessing to have raped a girl. The officer in the room is having trouble getting the criminal to tell him where the girl is, so Bud storms into the room, and pins the guy against the wall and puts a gun in his mouth until the guy tells him where the girl can be found. He became enraged and lost control when he found out Exley and Lynn had slept together. He went to Lynn’s house and overcome by anger hit her. After hitting her he realized that he had done something he never wanted to do which was hit a woman. Bud White’s hate toward women beaters seems to have come from seeing his mother beat to death by his father.   Ã‚  Ã‚  Ã‚  Ã‚  Although White is portrayed as being brainless in the beginning of the movie, by the end of the movie he had proven himself to be intelligent. He is seen as being a tough cop with no brains.

Public Policy on Business Competition Essay

Summary American businesses have been at a disadvantage from their foreign competitors due to the flawed economic system and the capitalist economy of the country. The foreign companies have been continuously improving their efficiency and effectiveness in relation to their American counterparts which means that they have now become more competitive and can even surpass that of the American products. The very strict government regulations and tariffs designed to protect the American economy is now the cause of the lesser jobs available for American workers. Outsourcing had definitely reduced the number of jobs and somehow the capitalist society that America has has relied on outsourcing as a way of cutting costs. Capitalism has its own evils as compared to socialism. Socialism is the opposite of capitalism, in socialism the government has to see to it that wealth is allocated to all members of society. Although, socialism has provided for all of its members it also brought the economy of the country to its downfall. The principle of comparative advantage is the key to ensuring that nations coexist and become interdependent on one another. Comparative advantage means that each country produces a specialized product which is becomes the economic strength of the country. It may have it’s own disadvantages but each country will have their own comparative advantage and disadvantage.   Public Policy on Business Competition   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   For more than four decades now, American businesses have been losing ground to foreign competitors. While 24.8 percent of all vehicles sold all over the world were made in the United States in 1986, by 1992 the U.S. share had declined to 20.7 percent. Now, this number goes further down to a little over 16 percent (OICA). A number of factors have contributed to the loss of the United States’ manufacturing competitiveness. First, foreign competitors have invested in more efficient equipment and processes and have instituted other programs that have raised worker productivity relative to the United States. Second, governments of some foreign manufacturing industries have provided planning, financial subsidies, favorable tax rates, and other industrial policies designed to nurture and support their industrial base. But perhaps the greatest reason why the United States is slipping in terms of global competitiveness is because of public policies based on coddling.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Arbitrary trade barriers, unrealistic quotas, and overly-restrictive tariffs are the norm when it comes to the government’s current stand on business competition. American workers and businesses are in a constant state of consciousness wherein a sense of entitlement pervades. They constantly lobby because they feel that the government is supposed to protect them from the deluge of competition from overseas. The thing is, Americans will continue to lose their jobs to the Indians and the Chinese. Companies aim to cut costs wherever and whenever they can. Given a choice, they will outsource to whomever can give them the best value. Instead of whining and lobbying, Americans should look for ways to adjust. They should do away with wanting to do menial tasks and start looking towards jobs that require more expertise and mental acuity. Not wanting to improve and instead asking for protection from the tides of change will not advance society at all and instead degrades it. In fact, it is the basis of a concept that was proved ineffective and impracticable.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Socialism is based on the flawed notion that members of society should be equals and the government must see to it that everyone is being cared for. One of the major complaints levied by socialists has been that capitalism permits surplus value to flow to capitalists, making capitalism a very unequal, class-ridden society. By contrast, a socialist society would share the return to capital among the workers, thereby promoting much greater equality than a market economy. This â€Å"strength† as socialists put it, proved to be socialism’s downfall.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Indeed, the experience of socialist countries exemplifies how attempts to equalize incomes by expropriating property from the rich can end up hurting everyone. By prohibiting private ownership of businesses, socialist governments did reduce the inequalities that arose from large property incomes. But the reduced incentives to work, accumulate capital, and improve – just because the government will provide for every man – crippled this system and impoverished entire countries.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The principle of comparative advantage holds that each country will specialize in the production and export of those goods or services that it can produce at relatively low cost because it is more efficient in producing them than other countries. Conversely, each country will import those goods which it produces at relatively high cost or those that it is incapable of producing at all. This simple principle provides the unshakable basis for international trade (Samuelson & Nordhaus 663). The most efficient and productive pattern of specialization is that nations should concentrate on activities in which they are relatively or comparatively more efficient than others. And even though countries may be absolutely less or more efficient than all other countries, each and every country will have a definite comparative advantage in some areas while having a definite comparative disadvantage in others. Conclusion The international economic sphere is complex and it is primarily governed by the most powerful country. The American economy had been one of the strongest economic players in international trade. When a country becomes too dependent on other countries for their economic products and services, like the American society, it can be assumed that they are putting their economic welfare at the hands of other nations. This can have a tremendous impact on American economy as the most basic services continue to be outsourced, monetary strength is diminished. It is similar to a gardener who is watering the neighbor’s lawn. The American society is pouring their money to foreign economies without thinking of whether that foreign country will do business with American companies as end consumers. In order to turn the tide, the American government should pursue and adopt the principle of comparative advantage, instead of relying on capitalism or socialism alone. With comparative advantage each country specializes in one or two products and services, thus equalizing power and influence in the international economy. American industries should look into the dangers of outsourcing, the disadvantages of cutting costs in the expense of unemployment and the ill-effects of over dependence on foreign countries. Therefore, the government should realistically examine the present position of the country in international trade. Comparative advantage holds the key for economic stability and progress.   Reference: Hitt, Michael A., Ireland, R. Duane and Hoskisson, Robert E. South-Western College Publishing, 1999. Organisation Internationale des Constructeurs d’Automobiles. Available: http://oica.net/wp-content/uploads/2007/06/worldprod_country-revised.pdf., January 19, 2008. Samuelsson, Paul A. and Nordhaus, William D.2.

Selection of College Major

Purpose 1 is to generate a personal analysis of personal behavior based on the responses that I have formulated and gathered from the Self-Analysis Worksheet. Purpose 2 is to develop critical thinking skills with the use of the available data and information with an integration of the lessons that are discussed in class. Questions Question 1 is about the capability of this assignment to bring out the critical thinking skills that I posses. Question 2 is about the relevance of this assignment in the development of my critical thinking skills. ConceptsAccording to the assignments, concepts are ideas that we use in thinking to be able to make sense of something. In line with this one can generate three basic types of concepts, cognitive concepts, behavior concept and affective concept. Cognitive concepts are ideas that helps us to become aware of the things the surrounds us. Usually these ideas compose the things that we learn through the use of our sense-perception. For instance the co ncept of finishing college in four years is a standard cognitive concept among students taking a four-year baccalaureate degree.Behavior Concepts on the other hand is composed of ideas that makes sense of our habits or those that are formed through everyday experience. Behavioral concepts includes the ideas that one use to justify his/her action. One major Behavior concept could be the optimistic behavior that I have towards finishing college through going to class everyday and taking notes during lectures. Affective Concepts are those that make sense of our fears, goals and ambitions. Somehow, affective concept s is responsible for the purpose of ones actions.Such is the case that one does not do bad things because it generates bad Karma or because it makes one to become hated. Information Study I found out that when I study for two hours for a subject, I anticipate that I could get high grades. This is a cognitive concept since these are information I gathered from observing my ac tion through factual data available in the surrounding. In relation to studying, I turn into behavioral concepts that reflect my study habits, which are taking notes and studying in bulk once a week or before examination.Affective concepts in relation to study can be seen in the way that I sense relief after studying and sense of enjoyment I felt when studying with the music turned on. Motivation to Complete College I have learned that my motivation to complete college basically arise from the changes that college can bring to my life. The commitment that I have, to finish college in four years is actually the main reason why I am striving so hard to finish my studies on time. Mainly, the idea of completing college and enjoying the life that it could open to me motivates me everyday into looking forward to do my best.Selection of College Major In selecting my college major I believe that it will dictate the course of my life and my career. Nonetheless, it is only now that I learned that it also hinders me to study other things besides my major subjects. It somehow limits my horizon and cuts off my other potentials. Family Responsibility and Support I found out that I am not yet ready for any family responsibility. I still enjoy my life as a child and a teenager. My family is very supportive of me and I want to help them in as much as I can. Thus, I seldom ask for financial support if I can manage my own expenses.Support from Instructors or Counselors Instructors and Counselors can really help one out in his or her assignments and the topics that he or she cannot understand. I found out that I do not really ask help from my instructors and counselor as much as I should, especially when I do not understand the lessons. Assumption Assumption 1 is about the reason why I am in college. Before answering the worksheet, I assume that I go to college simply because everyone is in college. But through thinking about it in a deeper sense, I have realized that it is reall y a personal want to finish college and start a new life.Assumption 2 is about taking my major course. Before, I assume that I take the major because it seems fine and I find it easier than other majors, now I realized that there are so many things that I cannot do anymore because I need to concentrate on my major. Thus taking a major is actually a matter of priority rather than of luck or chance. Inference Inference 1 is about the fact that after completing the worksheet I would try to give some more time to my studies. With respect to this, I would try to asked questions to instructors and counselor/s when needed.Inference 2 is about making more appropriate decisions through critical thinking. That is that this assignment will be able to help me practice critical thinking in dealing with ideas and concepts. Implications Implication 1 is if do study on time and if I consult with my instructors, if I will be able to utilize my time more effectively, I would be able to have higher gr ades and I will be able to finish my college degree. Implication 2 is if I do not develop critical thinking during this assignment, I might as well repeat the assignment and find out what might be the reason why I cannot develop critical thinking.Point of View I view myself as a student who is ordinary, I mean someone who is neither a high profile intellectual nor a retard. I study for the sake of having a degree not because I love the major or I dreamed of being successful in the field. As a student I often look into things with lesser depth and with a practical point of view. This assignment has helped me sort out my behavior and my ability to reason. It gives me an idea regarding how I see myself. It develops a deeper and more profound type of thinking that makes one realize that there are reasons behind things. Reference Person. Lecture Notes and Assignments. 2008