Patient Confidentiality Learning Process

ooooo nasty. this is a pretty tricky issue to deal with, especially when it comes to TEENAGE pregnancy.

it really struck me that as a doctor next time, i'm gonna have to make such decisions(about letting the girl's parents know about her pregnancy or not). well, as i'm a person with rather traditional values, i think it's already kinda "absurd/unacceptable" for a girl to get pregnant and i really think that as the older generation with more knowledge and experience, parents are the people who know how to best help their pregnant daughters, 'cos no parent would ever harm his/her child. so yep, i will tell the parents. but looking at the teenager's point of view, they may have their difficulties as well. so it's really hard to decide.

for me personally, besides taking care of the biological aspects, i will definitely try my best to be a counsellor to the pregnant girl as well. if she really doesn't want her parents to know, then i guess i'd have to take that role(partially, one way or another). this is what i truly believe in i guess.

this is a very thought-provoking learning issue which i enjoyed mulling over. but still, i believe that getting pregnant as a teenager is such a big mistake. no matter how u justify it.

Social Determinants of Health Learning Process

this is where i need more time in the digestion of the learning issues... 'cos this one is based mainly on aboriginal people's healthcare situation.

well being an international student, i SO have not been educated about this whole stolen generations... aboriginal people stuff. (there are aborigines in taiwan as well but they don't suffer as much from this healthcare access imbalance afaik)

anyway, i had the impression of aborigines in australia as those people in tribes... so how did they get all that alcohol and cigarettes lol... but apparently alcoholism & smoking are 2 factors that contribute to their poor health outcomes, especially in terms of pregnancy. & apparently THESE are caused by the huge magnitudes of stress they undergo due to their poor financial/employment situation. and THAT, usually arises from a certain extent of discrimination i think. & yeah, i can remember more from this teaching session than in embryology, 'cos this isn't so scientific, HAHA.

but anyway because of this social stigma that the aborigines face, the aborigines approach healthcare services less "naturally" than normal aussies do(as in, they may hesitate and stuff). well in deb's scenario video, apparently she goes to this support centre for aborigines, & i think that's pretty good. though i still think this aborigines v.s. aussies issue is still quite apparent, and i wonder if it will take some time before they are just regarded as normal aussies and the social stigma gets dissolved. i think they're a little unfortunate but hopefully this changes with time.

i think this learning issue was pretty straightforward, and so was the quiz. so i did pretty well for this one(compared to the embryo one LOL).

basically this teaching session helped me have a better understanding of the situations of the aborigines in australia now. :)

Embryology Learning Session

I really got a little lost in this teaching session, 'cos I'm really not good at absorbing scientific stuff through "lecture" style. But the notes/ppt slides sent out helped when I did my own review at home.

Basically, this teaching session aimed to bring us through the embryo/fetal development scientifically... and because at this time, many concepts had not been covered yet, my learning process was rather hazy.

The pictures/diagrams in the powerpoint slides helped a lot though(i think i'm more of a visual learner than an "aural learner" or "textual learner" or whatever). & i became clearer about the process of implantation specifically(and also got clear of what the syncytiotrophoblasts and cytotrophoblasts were respectively).

There were loads of biological jargon that I couldn't retain in my mind... so for the quiz I totally died... only was sure of the answers for question 2(the one about the 2 kinds of trophoblasts). But this quiz really does serve as good exam revision anyway, lots of information there. I guess the open-ended questions will need more reviewing of the lecture notes(formation of heart tube & primitive streak leading to gastrulation), but at least I now remember that the sperm binds with the ZP3 glycoprotein in the zona pellucida(now that is one nasty "trivia" knowledge to remember).

Hopefully when I look back at this teaching session few weeks from now, I'll be more well-versed with everything.

Edit: We had a FACEBOOK discussion online at night about implantation in particular LOL what a convenient medium(though it really clogged up my fb inbox). It was pretty good. I was still unclear about the timing of implantation and all but my question was answered(it happens on the 5th/6th day after fertilisation).

Government Strategies Learning Process

This learning issue, government/community management strategies for young mothers, is closely related to the issue I'm teaching(Maternal Responsibility).

Basically, mothers have to lead a conscientious lifestyle that doesn't inflict harm on their babies(maternal responsibility), and the government strategies generally educate the moms on how to do so, in areas such as(what I have retained at this point in time):

• how to breastfeed
• drug/alcohol use(really related to my learning issue)
• ensuring that teenage moms continue to receive education(i think this is pretty important)

so basically these are the 3 that i have a stronger impression of, but more of the latter 2 'cos they're related to the topics i'm gonna discuss in my learning issue.

i think that when moms(esp. teenage ones) are all alone and especially when they're indigenous(well i don't really understand very much of the population in oz 'cos i've only been here for less than 4 months X/ ) and may not be able to receive as much support as other aussies do, i think these indigenous-directed government strategies are really helpful and provide adequate support, especially when the educating medical professionals are indigenous as well, that makes these indigenous teen mothers more receptive and feel more secure/safe. i think cultural aspects are really important as a form of consideration when making policies/strategies to improve the welfare of people. this issue is really interesting, and shows us that medicine is not just all the science-y stuff, but there are so many patient aspects we have to consider.

we did a quiz after the teaching session. lol i'd have to say, that quiz is so technical!!! my main takeaways from this teaching sessions were mainly reflected in two questions, which asked about the issues that are taken into account in the making of those government strategies... & also one asking about the effects of smoking on pregnancy. i think these are pretty important subpoints in this learning issue. :) and also, these government strategies obviously require some budget, so yeah, better make sure they really solve those identified issues/problems before implementing the strategy.

in my vague impression i think the situation of indigenous patients' v.s. an average aussie's access to healthcare is still imbalanced, so hopefully as time goes on these government strategies' effects will just keep improving instead of stopping at an "asymptote".

Maternal Responsibility Teaching Session Reflections

This is the learning issue I undertook in this project. I feel that it's pretty important because I felt that my mom really had a GREAT sense of responsibility when she had me(drinking so much soy milk, which explains for my fair skin - she said, & she definitely took enough folate). So personally, PLUS general reading about abnormal babies coming from mothers with bad lifestyle habits, I feel that maternal responsibility really plays a major role in the development of a healthy and normal child.

So basically I picked out the main subpoints in this learning issue by rewatching the scenario vids & reviewing the lecture notes on Clinical Teratology as well as Folate & Vitamin B12.

Main Subpoints

• Biological factors: Nutrition, Teratogen Sources(smoking/drinking habits)
• Social factors: Education & Finding a job

I simply wrote a paragraph or two elaborating on the points listed above and sent them to the group members. I also used simplified presentation slides to present to the group. I think that's really the most "conventional" way to teach. The pictures helped too.

As the learning issues were pretty straightforward, it wasn't met with disagreements from group members. An interesting issue we discussed briefly was the fact that one baby(Jessica) would have a father and the other(Deborah) wouldn't. We all agreed that that's gonna have a large effect on the child's quality of life, plus the fact that Deborah had significantly less financial support than Jess(who still had her family backing her up). Though this isn't entirely relevant to maternal responsibility, it was another interesting issue we looked into.

On the whole, this teaching session was basically a presentation of this learning issue, which also started a discussion about new ideas/issues, so I think it was really interesting/effective for learning.

I gave a quiz at the end. The quiz was more scientific than my presentation was(I think I'm better at presenting social issues, they're less "boring" LOL) now that I think of it. Some of the feedback forms I got was that my presentation lacked scientific depth. My defence for that is that we could always refer to our lecture notes for those information :P But yeah, I agree I could have elaborated a little bit more on the scientific basis of some of my topics especially teratogenesis. But overall, the delivery of the content was pretty smooth and I'm pretty satisfied with it.