Models, Metaphors and Reflective Practice -Human Development Chapter 1

Big Picture Idea

• Problems cannot be solved using only objective, scientific facts

• Human behavior must always be understood within context.

• Complex Human Issues—-Complex responses

• Scientific knowledge + ur personal insight = effective care.

Reflective Practice

• traditional teaching focuses on objective, scientific, information

Unique (Role of YOU in care) -Chapter 1

• Every person is biologically and psychologically different,

• Differences include: life experiences, cognitive processes, emotions, and DNA.

• Just like you are unique, every patient is unique?

Authentic (Role of YOU in care) -Chapter 1

• Being true to your knowledge, experiences, and emotional awareness.

• Authentic interventions are more successful.

Reality- Reflective Practice

Human nature does not follow universal rules

Effective Care Requires?

• Scientific knowledge

• personal understanding

• awareness of context.

Reflective (Dewy, 1933)

The active, careful consideration of beliefs or knowledge and the evidence that supports them, including their consequences.

Reflection-ON-Action -Types of Reflection

Happens after an event

• Looking back to evaluate what happened.

Ex. Reviewing a patient interaction later.

Reflection-IN-Action -Types of Reflection

Happens during the events.

• Learning and adjusting in real time.

• “Thinking on your feet”.

Reflection-FOR-Action (Ultimate Goal) -Types of Reflection

• Uses: Reflection-ON-action, and Reflection-IN-action.

• Focuses on: improving future performance and applying lessons learned.

• Leads to long-term growth

5 Stages if Refection (Ross, 1989)

• Reflection is a process, not a single step.

• Encourages deeper and more critical thinking over time.

Classic Stage Theories (Freud, Erikson, and Piaget)

• Development occurs in distinct stages.

• Change is qualitative (transformational).

• Periods of growth followed by stability.

Differentiation- Margarnet Mahler: Separation- Individual Theory

• 5-10 months

• Baby notices the external world but stays close to mom.

Practicing -Margarnet Mahler: Separation- Individual Theory

• 10-16 months

• Crawling/ exploring, returns to mom for comfort.

Rapprochement -Margarnet Mahler: Separation- Individual Theory

• 16-24 months

• More independence but still demands attention

Consolidation and Object Constancy -Margarnet Mahler: Separation- Individual Theory

• 24- 36 months

• Accepting being separate, less anxiety.

Freud’s Personality Structure

1. Id: Primitive, instinctual drives —Unconscious level

3. Ego: Rational, mediates between Id and Superego — Conscious level

2. Superego: Moral conscience —- Preconscious level

Anna Freud

• Founder of child psychoanalysis

• Focused on: ego defenses, how the mind protects itself from painful thoughts, and feelings.

• Expanded understanding of child development.

Erik Erinkson

• Emphasized social and cultural influences

• 1 of the only founders to address: minority status and social devaluation

• Believed: external oppression affects development, and acknowledging reality helps overcome it internally.

Incremental (Continuous) Theories -Watson, Skinner, Bandura

• Development is gradual and continuous

• Emphasize: leaning, environment, and behavior

Critical and Sensitive Leaning Periods -Universality, Specificity, and Human Development

• Some learning happens more easily at certain ages.

• These time windows shape brain development and behavior.

Neural Plasticity -Universality, Specificity and Human Development

The brain’s ability to change across the lifespan.

• Nothing about the brain is static

• Brain changes are continuous throughout life, and influenced by genetic + environment.

• The rate and type of change var by brain region and function.

Sensitive Periods -Universality, Specificity and Human Development

• Times when experiences have an especially strong influence.

• Learning is still possible later, but effects are weaker.

Critical Periods -Universality, Specificity and Human Development

• Limited time windows

• Experiences (or lack of them) cause lasting changes

• Once closed, the brain is less flexible in that area.

Brain Development Timeline

• Brain develops back—front. Sensory areas first (vision, hearing), and higher-order thinking areas later.

• Critical periods likely follow this same progression,

• During periods, brain regions are extra flexible and experience strongly shapes neural connections.

What happens During a Critical Periods (Neurobiology)

• Inhibitory (GABA) neurons strengthen

• Excitation/ inhibition balance shifts toward inhibition.

• This allows connections to: strengthen, weaken, and be pruned

• Structural changes occur: myelin formation and perineuronal nets.

• These changes close the critical period by reducing plasticity.

Sensory Development -Examples of Critical Period Learning

Vision and hearing rely in early experiences

Ex. Binocular vision depends on early visual input.

Skill Acquisition -Examples of Critical Period Learning

Motor and cognitive skills are learned more efficiently.

Ex. Music, sports, and skill-based learning.

Language Acquisition -Examples of Critical Period Learning

• Critical period lasts until age 10

• Easier to learn grammar and pronunciation.

• After this period, language learning is harder, and native-like fluency is less likely.

Universality

Development looks the same across groups.

Key question: Are developmental changes the same across cultures, socioeconomic groups, genders, and historical periods?

Specificity

Development depends on culture, time, and context.

Key question: Are developmental changes the same across cultures, socioeconomic groups, genders, and historical periods?

Role of Culture

• Culture included: customs, beliefs, social institutions, and shaped practices.

• Cultural Shapes: development, behavior, and health outcomes.

Group Identity in Developmental Study

Possible categories include: race, socioeconomic status, gender, sexuality, religion, country of origin, and education level.

Cultural Competence (Applies to Nursing)

Key Components

• Self-awareness

• Knowledge of other cultures

• practice skills

• professional training

• knowledge of systems

Important Skils

• Understand ur own beliefs and values

• Respect cultural differences

• Recognize effects of stigma, discrimination, and oppression

• advocate for equitable care and access.

Prevention: Key Concept

• Timing of intervention is what distinguishes types of prevention.

Primary Prevention -Types of Prevention

• Prevents problems before they start.

• Targets the general population

Ex. Vaccinations, seatbelt laws, Head Start, and developmental guidance in schools.

Secondary Prevention -Types of Prevention

• Tangents high-risk groups

• Early detection and intervention

Ex. Screenings (pap smear, depression, and scales), learning disability tests, and suicide hotlines.

Tertiary Prevention -Types of Prevention

• Focuses on rehabilitation

• For individuals with established disorders

Ex. Diabetes glucose monitoring, detox programs, post-hospitalization care, and reentry programs after incarceration.

Selective -Universal, Selective and Indicated Prevention

Targets groups at higher risk.

Ex. Children of alcoholics and high-crime neighborhoods.

Indicated -Universal, Selective and Indicated Prevention

Targets individuals already showing early signs.

Ex. Prediabetes, behavioral problems, and early substance misuse.

Risk and Protective Factors

Increase the likelihood of negative outcomes.

Can be: biological, psychological, family-based, community-based, and cultural.

Protective Factors

• Reduce or buffer risk

• Act as positive counterbalances

• Lower chances of negative outcomes.

Universal, Selective and Indicated Prevention

Applies to everyone

Ex. Speed limits, nutrition labels, masks, and exercise promotion.