Friday, November 22, 2013


Design Thinking Paradigm:  Incorporating patients needs and experiences in medical procedures
One of the topic of discussion and debate in medical understanding is on how to incorporate individual’s experience of illness into medical practice. The irony within the experience of illness and treatment is that medical experts know what is best for their patient. Medicine is always on the run to restore health and in this run the needs, wants, and the experience of illness is often transformed and reconstituted medically marginalizes the patient from himself or herself. There is an imbalance of power between medical authorities and the patient. The article “Operating on a child’s Heart: A pedagogical View of Hospitalization” by Stephen J. Smith argues that careful attention to patients (child’s) experiences and needs are often neglected by the surrounding medical personnel during   hospitalization. He makes his argument through the lens of a child’s experience.
 Empathize
The author begins by narrating the journey of his son’s experience of hospitalization and makes a strong connection with his readers.  His narrative builds and extends to thought provoking questions, 
“To what extend does the child-oriented understanding of medical procedures carry its share of responsibility for the child’s life?” “Whose interest is being served, the child’s or someone else?”  The child’s experience and approach to hospitalization and the effect of it on the child’s future instigates into readers the disconnection between medical personnel (who may have power over) and the patients and calls for the need to bridge this gap.

Define
The author defines the problem and possibilities from a philosophical context. The definition is consistent with my interpretation of the issue. I am able to relate and understand it from my own lens since I had faced similar experience where my needs, feeling of my body, and experience was ignored and overpowered by the views and demands of the medical experts and medical procedures.
Ideate:
The author recommends that medical personnel dealing with the child and carrying out the medical procedure should be mindful of the child's needs and be sensitive to his/her experience of hospitalization. He calls for finding a balance between “what is thought to be good for the child against the fundamental question of what is the good for this particular child” Furthermore, the author gives an awaking call to parents & families who are part of the child’s daily life to speak up for the child during his/her hospitalization. The article provides a strong argument by providing sufficient unbiased evidence to support its conclusion and recommendation.
Suggestions and recommendations 

  •  Family physician to be more sensitive to patient’s needs and experience. One way this could be achieved is by practicing a narrative approach to understanding patient’s problem. Attention should be given to both the ‘ big picture’ and the details of a patient’s life and health.
  • Asking patient's open ended questions to express their bodily feeling
  • Increasing visit time between the patients and the physician. In the current practice environment increasing administrative requirements makes it very challenging for physicians to spend more time with their patients face to face.
  •  Educating patients to speak up and question their medical concerns
  • Educating parents and those connected closely with child’s daily living to speak up for the child.
  • Having a protocol that requires key medical personnel dealing with the child and performing medical procedure be well aware of the child needs and concern
Prototype
The issue raised here is more subjective therefore quantifying it would be challenging, however by raising this issue we are opening up discussion to understand medical and its practices in a broader perspective. Such understanding would help medical personnel be more sensitive towards their patient’s needs, experiences, and understand the importance of incorporating it into their medical practice.
  • Having a curriculum, that emphases on patient doctor relationship, for trainee doctors as a course ( I suspect they might be having one), and for practicing doctors as professional development program may help bridge the listening gap between Physicans and patients . The curriculum should be made mandatory for practicing physicians and be required to take every three years.  Such professional development program would help physicians meet the demands of the current society and know and understand themselves and their role as a physician as well their patients better.
  • Increasing visit time. The current visit time is less than 10 minutes. Increasing it would enable more dialogues between the physician and their patients and more patient participation.
Relating to classroom and pedagogy
When making lesson plan, activities and lesson notes I always relate back to this focused question “whose interest is being served”, the students, mine, schools or the demands of the curriculumI find this does not only guide me to make activities according to students needs, but also helps me understand my students approach to learning and creating a classroom environment that gives a sense of belonging and ownership to my all students.

Hope you enjoyed reading my posting. I am looking forward for your productive feedback


Friday, November 1, 2013

"The Mane Event- 2013"

First I would like to thank Dr Stephen Smith for giving us an opportunity to experience such an astonishing event. I was little aware that this event existed and I may never have if I was not part of the HEAL program. It was marvelous watching the show with my cohort with rich discussion between the shows. I am looking forward and excited to attend the 2014 Mane Event. 
The trainer’s challenge was an opportunity to see the distinct skills, abilities and methods of training an unbroken horse of the 3 trainers. The event was not only entertaining but was enriching and led to my personal growth and development as well. The experience I had watching the relationship between the trainers and their horse, their verbal and non-verbal communication and their understanding of each other that created a meaningful, trustful relationship was amazing. It kept me relating back to my relationship with my students, a meaningful trustful relationship that is important for their learning and development.  The techniques and approaches trainers used to train a naive horse are so related to the techniques that I use in my teaching as well. Although the goal of all three trainers were the same, each trainer took a different approach and techniques to train his horse. Consistency, flexibility of plans, equality of power balance, and maintaining a trustful relationship at the end of the session were some of the key factors the trainers kept in mind throughout their training session. 

Reflection of the event
We are constantly sending, receiving, and reacting to non-verbal messages. Horses like people are good at reading, interpreting and responding to non-verbal messages. All trainers used and depended on non-verbal communication such as patting, touching, various sounds and signals to communicate with their horse. The horses could interpret the meaning of these non-verbal signals and responded accordingly. For example they could interpret their trainers pat as a reward, comfort and trust. A little push from their trainers meant they were to move. Consequently, the trainers knew when their horses were uncomfortable following their directions and changed their techniques to make and maintain their trust with their horses. With common understanding, the trainers and their horses were able to communicate with each other and function effectively. Consciously  and unconsciously the application of nonverbal communication goes on in our everyday life with people around us. 
The Trainers show rejuvenated my belief that a healthy environment is one that is of trust, cooperation and collobration and not one with stress, fear and control. In order to createmeaningful relationship with our studentscollegues and people around us we first need to develop a trustful and sense of belonging relationship with them. This was evident from the trainers show where all trainers tried to build a meaningful, trust relationship with their horses first. They knew that if their horses were able to trust them, then only would they follow their trainers directions without any fear. One of the approaches that I found fascinating was " if you push too hard you create resistance, if you don't you create curiosity and exploration". The trainers did not force their horse to follow their directions or imposed materials on them that they were little aware of.  They first gave them opportunities to feel, touch and explore things they would be exposed to later and understand that it was not dangerous. The horses first felt the rope, the saddle etc before it was actually used on them. It was neat to see that the horses(session two and three) after exploring, (through repeated touch and feel)  managed to overcome their fear and went over thelog.  
I believe classroom is a similar environment where students would learn better through curiosity and exploration rather than force and fear. 
Postures, gestures, and expression conveying particular meaning

Forward ear position.
Alertness  

                               
One ear forward one ear backward
Divided attention