Exam 2 Chapters 5-8

Hidden curriculum (C5)

The attitudes and practices that others model, even though they do not explicitly teach them. Learning through examples of other healthcare professionals "We can teach extensively about the respecting different cultures, beliefs and health practices, but when the student hears a resident dissing a patient's mistaken notions of disease or hears them making fun of a patient's body, the lesson is clear - to be a part of the club of this expected behavior" Socialization occurs partly as a result of the hidden curriculum.

High power distance (C7)

Degree to which they defer to people of greater power and status.

Advance-care directives (C8)

Describe in advance the medical care a person wishes to receive or not receive if they become too ill to communicate. This takes pressure off caregivers/loved ones who might be forced to make those decisions on their own.

Palliative care (C8)

Designed to keep a person as comfortable and fulfilled as possible at the end of life but not designed to cure the main illness once it has been determined that medical care will not improve it.

Naturopathic medicine (box 7.6) (C7)

Diet and use of herbal therapy to help people maintain good health

Racism

Discrimination based on a person's race. People often judge race by visible characteristics, such as skin color, although appearance is not a reliable indication of race.

Ageism (C6)

Discrimination is based on a person's age. Occurs when people judge others by preconceived notions about their age group as when managers refuse to hire people over 65 because they believe employees of that age are not productive. Ageism results from negative stereotypes of older adults. Health personnel can reinforce these stereotypes by referring to older patients in derogatory terms (coffin dodgers/digging for worms). Older adults are often portrayed in the media as unhealthy, lonely, unhappy, and irritable. People with ageist beliefs are unlikely to regard older adults as unique individuals who can change, learn, react, and grow physically stronger. They tend to patronize older adults by speaking slowly, using baby talk, and restricting conversations to happy subjects. They may even avoid communicating with older adults.

Esteem support (part of nurturing support) (C8)

Efforts to make another person feel valued and competent.

overempathizing (C8)

Emotional contagion that is overdone. Can be detrimental to both support providers and recipients. Another dange is that people may hesitate to express themselves to listeners who are likely to become upset. Some people find emotional empathy overwhelming or belittling. They may avoid scenes in which others seem to pity them.

Holistic care (box 7.6) (C7)

Emphasizes overall well-being (physical and emotional) with an emphasis on maintaining health, not just curing ailments

Transcendent experiences (C8)

Episodes in which people come to perceive an overarching meaning, or supra-meaning, within experiences that might otherwise seem senseless or unthinkable. Ex. people who do not have long to live sometimes says life takes on a new larger meaning that makes everyday concerns seem trivial. Others say they have been able to lay old grievances tourist and have developed a heightened appreciation for nature and loved ones. Say they have found larger meaning in a spiritual quest that involves helping others, dedicating themselves to a cause larger than themselves, allowing themselves to be creative and have fun, and seeking to live up to their full awareness and potential.

paternalism (C7)

The idea that patients are like children and caregivers are like parents

coping (C8)

The process of managing stressful situations that range from everyday hassles to life threatening events. Involves problem solving and emotional adjustment. Depend on how much control someone believe they have over their situation.

Voice of medicine (C5)

The vocab of traditional biomedicine, characterized by carefully controlled compassion and concern for accuracy and expediency. Designed to help people. Answers to demands of time and emotion are exacted from health professionals and suits society's image of them as stoically objective and in control. LIMIT- not designed to facilitate emotional expression. It focuses mostly on medical terminology and physical details. Patients' individuality is treated as less important than bodily conditions.

Double bind (C5)

There are negative consequences no matter which option they choose. They may feel like its unacceptable to challenge the orders they have been given. At the same time, it may seem insupportable to put patients in danger.

Homeopathic medicine (box 7.6) (C7)

Very small doses to escalate symptoms in effort to stimulate the body's immune system.

normalcy (C8)

Essentially the sense that things are comfortable predictable and familiar. Requires cooperation of other people. Resuming life as normal.

Faith healers (C7)

Expected to channel the curative power of the holy spirit which they pass to believers through ceremonies known as the laying on of hands.

Emotional contagion (C8)

Feeling emotions similar to the other person's. This can be overdone.

Emotional exhaustion (C5)

Feeling of being drained and used up. People experiencing this feel like they can no longer find motivation or compassion.

culture (C7)

Set of beliefs rules and practices shard by a group of people. Cultural assumptions suggest how members should behave, what roles they are expected to play and how various events and actions should be interpreted.

Rote learning (C5)

Under pressure, students may memorize information without understanding it (rote learning). Students may perform well on MCQ exams but may be incapable of applying the info to actual situations.

Herbal therapies (box 7.6) (C7)

Use plant extracts (St. John's wort, chamomile, licorice) to treat ailments from skin conditions to asthma and depression

Know basic details from the Profile of the Family Caregiver. (p.200)

66 million people in US provide some amount of at-home care for a loved one. Average age of family caregivers is about 49, ⅔ of them are women. At least 37% also have children/grandchildren living with them. Challenge to balance many factors at once including costs. Stress and burnout Provide medical care and assistance Maintaing households and budgets Working at careers outside the home Providing info and support to others Easy to feel stressed exhausted and resentful Emotional strain/grievance over future plans that may no longer seem possible Painful to watch a loved one suffer/change Feeling of unpreparedness to perform tasks delegated to them Often receive only minimal instruction on what to do and expect. May feel overwhelmed Worry they will do something wrong Worried they will miss important warning signs.

Concrete-logical conceptualization (C6)

7-10, children begin to differentiate between external causes, such as wind and cold, and between internal manifestations, such as sneezing and talking funny.

overinforming (C8)

Forcing info on people when they are too distraught to understand or accept it, may only heighten their stress. Health-related info can be frightening/confusing.

Divergence (C6)

Acting differently from the other person (whispering while they shot). Implies that they are socially distant. Diverge by paraphrasing the explanations more slowly to make sure they understand them. Socially, divergence is risky because it shows that the participants are out of sync. Extreme divergence may even be disrespectful or rude.

Accommodate (C6)

Adapt to another person's style or needs. Communication accommodation theory People tend to mirror each other's communication styles to display liking and respect. Convergence Use of similar gestures, tone of voice, vocabulary. To converge with a doctor's rapid explanation, they may converge by speaking rapidly or by being silent to accommodate the physicians' speech.

Emotional adjustment (C8)

Adapting to what cant be changed.

Depersonalization (C5)

Tendency to treat people in an unfeeling impersonal way. From this perspective, people may seem contemptible and weak, and the individual experiencing burnout may resent their requests.

ethnocentrism (C7)

Attitude that one's culture is better than others.

empathy (C8)

Ability to show you understand how someone is feeling

What supportive listening recommendation are described in chapter 8?

- Focus on the other person - give person a chance to talk freely. Focus on what they said rather than your own feelings and experiences. - Remain neutral. Resist urge to label people and experiences as good or bad. Encourage speaker to describe experiences rather than label them. - Concentrate on feelings. Focus on feelings rather than events. It is usually more supportive to explore why someone feels a certain way than to focus on events themselves. - Legitimize other person's emotions. "I understand how you might feel that way" is typically more helpful than telling the person how to feel or how not to feel. - Summarize what you hear. Calmly summarizing hte speaker's statements can help clarify the situation and help the distressed individual understand what they are feeling.

karma (C7)

(hindu) energy that results from either good or bad deeds in the past. A disabling injury may be regarded as the inevitable consequence of bad karma. Recovery may involve not only physical healing but a resolve to be more altruistic in the future.

Germ theory (C7)

(part of health as organic) Disease is caused by microscopic organisms such as bacteria and viruses. organic model Based on the assumption that health can be understood in terms of presence or absence of physical indicators. Caregivers and researchers began to rely heavily on scientific tests to diagnose patients and to conduct medical research. At the core of the organic approach is the conviction that, if health professionls are vigilant enough, they can minimize/eradicate most illnesses. Limit - Inability to account for conditions that cant be physically verified (undetectable chronic conditions) Excludes social spiritual and psychological factors that may be relevant to the lived experience of health and illness.

Identify & explain the 2 types of order in Newman's theory of health as expanded consciousness.

1. Explicate order - Tangible elements of existence. Real things, can see, hear, taste, feel. 2. Implicate order - Patterns beneath the surface. The meaning of what we do often lies within the underlying, implicate order.

Identify and explain the 5 sick roles & healer roles. pp. 170-175

1. Mechanics and machines - Caregivers are similar to mechanics and patients to machines. The implication is that patients are relatively passive and care providers are expected to be analytical and capable of fixing the problems that are presented. Stifles emotional communication between patients and health professionals. Focus is more on identifying physical abnormalities and fixing them. 2. Parents and children - a relationship in which physicians issue directions that patients are expected to obey. Certain cultures honor a high power distance where members of that culture consider if rude to disagree with or question an authority figure. 3. Spiritualists and believers - Physicians have been described as "little gods" - a powerful and mysterious authority figure, reinforced by patients revering their physicians. 4. Providers and consumers - Patients are regarded as shoppers or clients; they pay providers to give information and carry out their wishes People can look up extensive healthcare information by themselves 5. Partners - The mutually satisfying option, "Partners" perspective has the health professional and patient work together to find an agreeable solution

Identify and provide examples of the forms of too much support.

1. overhelping - Providing too much instrumental assistance. Can make people feel like children or shield them from life experiences. EX: offering to do housework for someone/fluff their pillows etc. can overwhelme people and make them feel like children. 2. overinforming - Forcing info on people when they are too distraught to understand or accept it, may only heighten their stress. EX: handing patients pamphlets and asking them for a decision on a procedure before they have time to process. 3. overempathizing - Emotional contagion that is overdone. Can be detrimental to both support providers and recipients. Another danger is that people may hesitate to express themselves to listeners who are likely to become upset. Some people find emotional empathy overwhelming or belittling. They may avoid scenes in which others seem to pity them. EX: may make the patient feel like they need to comfort the person overempathizing when they are not the victim.

Formal-logical conceptualization (C6)

11+, children are adept at envisioning the complex influence of agents they cannot readily see.

Know the suggestions for delivering bad news

208-209: Build caring relationships from the beginning Foreshadow the disclosure. "The news isn't as good as we hoped" may prepare people for what is to come. Invite the recipient to bring along supportive others. Talk in a quiet, private place. Resist the temptation to deliver bad news in a hallway or semiprivate space. Likewise, avoid delivering bad news over the phone whenever possible. Tell the truth. People typically cope better when they know what is happening and what to expect. This is true even when death is expected. Be clear about your meaning. Patients often interpret hedge terms such as possible to mean that the news giver is attempting to soften the blow of bad news rather than convey actual uncertainty. Avoid medical jargon

Rite of passage (C5)

A challenge that qualifies students for advancement.

Detached concern (C5)

A sense of caring about other people without becoming emotionally involved in the process. Some degree of detachment is useful to keep from feeling overwhelmed. However, the expectation that health professionals will avoid their own emotions may lead them to become apathetic, cynical, and confused.

role (C7)

A set of expectations that applies to people performing various functions in the culture.

Team (C5)

A set of individuals who work together to achieve common objectives. An issue with having positions with little overlap (how healthcare professionals used to do things), there is little communication. Advantage- Apply multiple perspectives to a problem. Interdisciplinary teamwork blurs lines between departments and presents opportunities for diverse employees to take part in decision making (linked to job satisfaction and retention) Reduces costly oversights that may occur when people are devoted to highly specialized tasks. Well suited to biopsychosocial care. Drawbacks- Can be time-consuming Danger of groupthink Scheduling difficulties Can involve competition and conflict

Socioeconomic status (C6)

A term that factors in education, income, employment level, and similar variables. People of low SES are more likely than the general population to suffer from depression, to have ADHD, be obese, to smoke, to have poor oral health, to have various forms of cancer etc. Low SES' low health ≈ receive less health and dental care, partly because limited financial resources partly because they tend to be dissatisfied with care received. Health professionals tend to offer less info and guidance to patients of low SES than to others. Low SES are less likely than others to feel confident reading health info and understanding health stas. Also less likely to seek out health info online, thus they turn to TV and people they know for health info contributing to a knowledge gap because these sources do not offer as much info as the web. Education is a predictor of health, because people with limited education often experience poor living conditions, financial strain,s tress etc..

mindfulness (C5)

An awareness of one's self and others and non-judgemental respect for diversity. Nurses reported that using mindful techniques helped them focus, manage stress, sleep better, and be more fully prepared to interact with patients. Physicians reported an increased sense of empowerment and engagement. Patients report feeling satisfied with highly mindful health professionals and say that mindful caregivers seem more patient-centered and affiliative than others.

Empathic concern (C8)

An intellectual appreciation of someone's feelings

crisis (C8)

An occurrence that exceeds a person's normal coping ability. First sign of crisis is usually a sense that events are out of control which may give rise to panic or denial. Sense that one is helpless/not in control. Major crisis may serve as a turning point/dividing line.

hospice (C8)

An organization that provides support and care for dying individuals and their families. Provides palliative care. The Center of belief is that death is a natural part of life, personal and unique. People are encouraged to die as they have lived, surrounded by people and things they love most.

Coraje (hispanic) (C7)

Anger Susto and coraje refer to emotionally intense and unpleasant episodes. The idea is that a traumatizing experience can diminish one's spiritual vitality and upset the link between body and soul.

Prelogical conceptualization (C6)

Around 2-6, children define illness as something caused by a tangible external agent, such as a monster or the sun.

Affirmative action (C6)

Based on civil rights legislation passed in the 1960s, state affirmative action laws require publicly funded universities to give preference to minority applicants who meet admission requirements. This is meant to offset historic patterns of discrimination that have limited opportunities for women and minorities, resulting in them being significantly underrepresented in professional positions.

reiki (box 7.6) (C7)

Based on the Japanese tradition of channeling energy through the healer's hands to increase the patient's spiritual strength.

Theory of problematic integration (C8)

Based on the idea that we orient to life in terms of expectations (what we think will happen) and evaluations (whether occurrences are good or bad). However, our expectations and values are challenged constantly in large andd small ways. Occurs when expectations and evaluations are at odds, uncertain, changing, or impossible to fulfill. Communication will play a pivotal role at every stage of the experience. In recognizing that communication helps to define, challenge, and transform our experiences, this makes uncertainty no bad or good, and we are not always able to extinguish uncertainty by dousing it with info. Sometimes uncertainty exists because we have too little or too much into or because we are not sure what to make of the info presented to us.

Internal locus of control (C8)

Belief that people control their own destinies. More general than self efficacy though they are related. Locus of control can influence how we interpret people's acitons/health.

Acupuncture (box 7.6) (C7)

Believed to stimulate and balance the body's energy flow (Qi) through the use of needles inserted in the skin.

Nurturing support (C8)

Building self esteem, acknowledging and expressing emotions, providing companionship

Qi (C7)

Central life energy. illness/death may result if Qi is wasted or if yin and yang is not balanced. Life energy is sustained and balanced by awareness, rhythmic breathing, physical regimens, meditation. Unlike in organic medicine where practitioner and patient are treated as separate, Qi is a force that flows through them both. Theory of health as expanded consciousness A health crisis is not necessarily negative or undesirable, instead, health events are integral parts of life that provide opportunities for growth and change.

Queer theory (C6)

Challenges the notion of static identities and rigid social categories. Captures fluidity of gender. Holds that labels such as man and woman underrepresent the multitude and complexity of gender identities that people actually experience.

Problem-solving (C8)

Changing what can be changed

Integrative medicine (box 7.6) (C7)

Combines biomedical and naturopathic therapies

Burnout (C5)

Combo of factors: emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. At elevated risk for heart disease, depression and accidents. More likely than others to be apathetic, miss work, and leave the profession. Burnout is also linked to poor patient outcomes.

Organizational culture (C5)

Comprises members' basic beliefs and assumptions about an organization, its members, and the organization's place in the larger environment. Part of systems theory.

LGBTQQIAAP (C6)

Gender and sexual identities Lesbian - woman attracted to women (S) Gay - man attracted to men (S) Bisexual - attracted to men and women (S) Transgender - feel biological sex is not a good description of who they are (G) Queer - ambiguous, feel that gender adjectives don't describe them well (G (S?)) Questioning - gender not always a fixed or static construct (G (S?)) Intersex - combination of both male and female genitalia (externally or internally) (G) Asexual - uninterested in sex (S) Allies - heterosexual but support the idea of nuanced gender/sexual identities Pansexual - attracted based on qualities that are not gender specific (S)

Groupthink (C5)

Going along with ideas that they would not normally support.

Family and Medical Leave Act of 1993 (C8)

Guarantees that people can take up to 12 weeks off work to care for ailing family members, seek medical care themselves, bring new children into families. Does not require employers pay workers while they are on leave and it doesnt apply to all companies/employees. Employees must have worked at the company at least one year for an average of 25+ hrs a week.only companies with at least 50 employees are provided to provide medical and family leave.

Organizational processes (C5)

Habitual or prescribed ways of doing things Part of systems theory.

Empathic communication model of burnout (C5)

Health care is appealing to people who are concerned about others and are able to imagine others' joy and pain. These people are typically responsive communicators (able to communicate well with people in distress), but they may easily feel overwhelmed by constant exposure to emotional situations.

Harmonic balance perspective (C7)

Health is not simply the absence of physical signs of disease, rather, it is a sense of overall well-being and equilibrium. Keeping with biopsychosocial and sociocultural perspectives.

Describe a time when you experienced problematic integration. Explain. Read Box 8.2

I experienced problematic integration when my father suffered a stroke. I noticed that he was having a stroke due to his mumbled and disconnected speech. This was an example of problematic integration as his communication (or lack thereof) challenged my stable orientation to the world, that my father might die. It was at this moment that I discovered another aspect of problematic integration, that I was not unable to fix my uncertainty of his survival by overinforming myself. Having done research in strokes, particularly those that resulted in low quality of life or death, over-dousing of intormationw as not helpful in my scenario. His GCS was high (indicating lack of severity) and we got him to the hospital on time. He is perfectly healthy now.

Social support (C8)

Includes a broad range of activities, from comforting a friend, to listening, to performing an internet data search, to acknowledging that a handicapped person is normal. Most people perform supportive behaviors more than they realize, and have positive effects on people's health and moods.supportive communication can help speed healing, reduce loneliness, reduce symptoms and stress, lessen pain, build self esteem. People who provide social support often feel an enhances sense of wellbeing themselves.

Emotional support (part of nurturing support) (C8)

Includes efforts to acknowledge and understand what another person is feeling. This is valuable when people must adapt to what they cannot change. f

Traditional asian medicine (C7)

Includes therapies such as herbal remedies, acupuncture, and massage. Based on establishing a healthy flow of energy through the body and achieving harmony between mind, body, spirit, and surroundings.

Ayurveda (box 7.6) (C7)

Indian practices include yoga diet and meditation

Physician-assisted suicide (C8)

Instances in which, at the request of a terminally ill person, a doctor provides the means for that person to end their ow life. Different from euthanasia. PATIENT does the "killing".

Informational support (part of action facilitating support) (C8)

Involve performing an internet data search, sharing personal experiences, passing along news clips. Information can help people increase their understanding and make wise decisions.

Reduced sense of personal accomplishment (C5)

Involves feeling like a failure. People who feel this way may become depressed, experience low self-esteem, and leave their jobs/avoid certain tasks.

Glossolalia (C7)

Involves trancelike state during which a worshipper seems to speak in a foreign language. It is believed that the language is only known to God, or that its a foreign tongue known to some but unknown to the worshipper, except through divine inspiration.

Reflective negotiation model (C7)

Involves two enacted commitments and an end goal. Commitments involve sensitivity to cultural differences and to self-awareness. Goal is that these will foster a collaborative space for negotiation in which patients and professionals can respectfully exchange ideas without feeling constrained by status or cultural differences. Sensitivity to cultural differences involves knowledge that emerges to varying extents when people seek out info and when they interact with people from different cultures. Knowledge is a helpful but insufficient measure of cultural competence for three reasons: Health professionals cannot know the ins and outs of every culture that they come into contact with. People operate within complex webs of cultural significance and it is impossible to know which of them are most salient in each situation. People differ from one another, even within the same culture.

Socialization (C5)

Learning to behave appropriately within a specific community. One impact of socialization is that, once socialized, people may have expectations and practices that differ from others (voice of lifeworld is typically spoken by patients, however voice of medicine spoken by caregivers. Socialization occurs partly as a result of the hidden curriculum.

biofeedback (box 7.6) (C7)

Learning to recognize the body's physiological states (such as tension) and to control them.

Fatalistic (C8)

Likely to regard events as God's will or the natural order of things. People with these worldviews are more likely to feel that cancer is unpreventable and avoid seeking info about the subject.

Never events (C5)

Loosely defined as clear, preventable errors with serious consequences. The idea is that hospitals with a strong financial incentive to avoid never events will be more diligent about preventing them, identifying their root causes if they do occur and avoiding future tragedies. Insurance companies have declared that they will not pay costs associated with never events.

Support groups (part of nurturing support) (C8)

Made up of people with similar concerns who meet regularly to discuss their feelings and experiences. They range from informational self-help groups to treatment groups facilitated by trained professionals and fro groups that meet in person to virtual groups conducted online.support group members tend to experience fewer symptoms and less stress andmay even live longer than similar people who are not members. Adv- Communicating with similar others may help people feel that they are not alone or abnormal. People going through similar experiences can also give firsthand information on what to expect and how to behave. Support group members may feel better about themselves because they are able to express empathy with others and receive empathic messages themselves Convenience and low cost Danger- Counterproductive gripe sessions Members will develop an us-vs-them view May begin to feel that no one outside the group understands them as well as they understand each other (form of oversupport)

Scut work (C5)

Menial chores that no one else wants to do. Commonly accepted that some of these chores are assigned mainly to punish or humiliate students or interns.

Relational health communication competence model (C5)

Observes that communication, social support and emotional resilience are positively associated with each other. (investing in gratifying relationships)

E-quality theory of aging (C6)

Older adults benefit as both teachers and learners when they use, contribute to, influence, and express themselves in electronic environments. Among older adults, they experienced a new sense of freedom when they learned to use an online computer. They feel free again to "go" where they please and choose their own paths and experiences. They can relieve boredom and feel that they are participating in life beyond the facility's borders.

oversupport (C8)

Oversupport defined as excessive and unnecessary help. Three types: overhelping, overinforming, overemphasizing.

Implicate order (C7)

Patterns beneath the surface. (the meaning of what we do often lies within the underlying, implicate order. stigma Social rejection in which a person is treated as dishonorable/ignored.

Biophilia hypothesis (C7)

People have an inherent affinity for nature and often derive a sense of well-being from contact with it.

External locus of control (C8)

People who do not believe they can change their health for the better have low health self-efficay. This is common in culutres which have an external locus of control, the belief that events are controlled mostly by outside forces. Low health self-efficacy may not be motivated to take personal action regarding health matters.

Action-facilitating support (C8)

Performing tasks and collecting information.

Chiropractic medicine (box 7.6) (C7)

Physical alignment of spine, muscles, and nerves

Euthanasia (C8)

Physician of family member intentionally kills the patient to end their suffering. SOMEONE ELSE does the "killing".

Yin and yang (C7)

Polar energies whose cynical forces define all living things. Yin - coolness and reflection Yang - brightness and warmth.

Intersectionality theory (C6)

Proposes that a person's social position emerges within the interface of micro-level personal identities and macro-level socio cultural patterns. Each level is dynamic and complex. Personal identity may reflect age, race, sexual orientation, physical ability and education. Sociocultural variables may include sexism, racism, power, resources, public policies etc. No one is simply a man or a woman, heterosexual or gay, rich or pooer, etc. instead individuals are influenced by how these identities (and many others) intersect within the context of larger environments.

Direct-effect or main-effect model (C8)

Proposes that social support is beneficial even when we are not encountering notable stressors. Strong social network helps us feel valued every day and is a reassuring reminder that friends' support is always available. May encounter fewer stressful episodes and enjoy greater overall health if we have strong social networks.

overhelping (C8)

Providing too much instrumental assistance. Can make people feel like children or shield them from life experiences. People who are overhelped may perceive a loss of control, especially if others take on tasks for them without their consent.

Flexner Report (C5)

Published in 1910 Said that all but a few medical schools don't teach enough biology and other sciences. The report also criticized med schools for not offering more supervised, hands-on experience with patients. This also transferred over into nursing and many other caregiver education programs. Curricula focusing on organic aspects of disease and on clinical and lab research supporting biomedical perspectives remained open, but many other schools had to close.

Health literacy(C6)

Refers to one's ability to access health info, understand it, and apply it in ways that promote good health. Ability to read Understand the language in which info is being conveyed (English, Spanish, jargon, legal talk, etc.) Have access to reliable and relevant info Be interested in health-related info Have the social skills to discuss health matters with others Have adequate hearing/vision to get the info Understand how to apply the info Be willing and able to put health info to effective use.

Role theory (C5)

Role theory proposes that social roles are defined by unique sets of rights, responsibilities, and privileges. By asserting their power, preceptors may be sending the message that initiates have not yet earned the privileges and rights of practitioners. This is to explain the hierarchical thinking between levels of education (pre-med, M1-4, resident, etc.) Students and interns are further reminded of their place with public pop quizzes or called on to do scut work.

Placebo (C7)

Scientists acknowledge the power of faith, although they are not likely to regard it as the central focus of their work. Evidence supports that people who expect to be cured sometimes are, even when the treatment is an inactive placebo. Placebo effects are so common that medical researchers routinely give some research participants an actual treatment and give other people a placebo. If the treatment group doesnt experience greater effects than the placebo group, researchers cant be sure they are measuring anything more than the power of suggestion.

Buffering hypothesis (C8)

Social support is most important when we encounter potentially stressful experiences, in which case knowing htat other people are there for use can cushion (buffer) us from feeling overwhelmed or helpless. Likely to be meaningful if the support offered matches the support you feel you need.

Professional prejudice (C5)

Some professions are considered more prestigious than others, which means that people without impressive titles (including patients) may be excluded from discussions even though they have valuable info and ideas to share.

Problem-based learning (C5)

Students apply information to actual scenarios rather than simply memorizing it. EX presented with a case study and asked to analyze patient condition and identify factors relevant to their health. PBL positively correlated with improved performance and knowledge among pharmacology students. Another technique involves interactions with standardized patients (people who are trained to play the part of patients) with realistic symptoms and emotional concerns. These interactions are usually videotaped so that students can review them later, with feedback from their professors and mock patients who were involved.

Explicate order (C7)

Tangible elements of existence. Real things, can see, hear, taste, feel.

Instrumental support (part of action facilitating support) (C8)

Tasks and favors. Most appreciated when care receivers feel they are active participants in the process and are involved in decision making.

Osteopathic medicine (box 7.6) (C7)

Taught in traditional medical schools. Focuses on muscular and skeletal systems, treating the body as an integrated unit.

dialectics (C8)

We occupy a perspective somewhere between internal or external locus of control, and may shift perspective over time. Describes the ongoing tension of meaning between coexisting but contradictory constructs such as hopeless and hopeful. We continually navigate between meaning within dialectic continua based on circumstances, beliefs, and interactions with others. People manage dialectic between being hopeful and realistic. Many people consider it adaptive to be optimistic, but dialectic perspective challenges the notion that there is one right or static way to think. Instead meaning is adaptive and changing.

Health self-efficacy (C8)

When people can manage their health succesfully. High self efficay are more likely than others to maintain healthy lifestyles because they are confident in their ability to make changes that have positive consequences. Sense of self-efficacy may be fostered by- Positive past experiences Encouragement from others Internal locus of control

Overaccommodation (C6)

an exaggerated response to a perceived need. EX: 1 speaks loudly and slowly to older adults, older people may respond in a similar way, reinforcing 1's belief that older adults are slow and hard of hearing.

Susto (hispanic) (C7)

fright