Interview Question Time #2

Discussion in 'Interviews' started by Matt, Nov 16, 2010.

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  1. Season

    Season Emeritus MSO Staff Emeritus

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    I think this was a very good answer. Well done

    One thing I would go further in is discussing briefly the impact that one parent's decision to not vaccinate their child has on another. ie how ethical is a parent's decision to not vaccinate their child and put others at risk? Do they have an ethical responsibility as a member of society as well as that of a parent? Further isn't it hypocritical to demand having the right to not vaccinate when that very action puts another at risk? Are you allowed to demand a right that takes away someone else's right?

    Again not entirely necessary, but if you did go down that ethical road, I'm sure you'd get bonus points :)
     
  2. Season

    Season Emeritus MSO Staff Emeritus

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    hey, I personally completely disagree with your answer, so this may come across in my feedback.

    I think its very brave in taking a hardline principles/individual rights approach to this question. However I think you fail to acknowledge the public health/community health side. Vaccinnation is a wonderful health measure, and it has done a lot of wonderful things.

    There are two main reasons to get vaccinated
    a) to not get the disease yourself
    b) to not infect others, and contribute to eradicating a disease for society.

    Most people are very happy to do the first one. However eradicating a disease for mankind? Most humans are lazy. Although we might like to deny it, we do not always make the best decisions for the community, or about our own health. Too often short term priorities take over. This is why there are other complusary policies in our society. Think complusary saving= superannuation, complusary life insurance? medicare, complusary school education = australia. These things are all good, yet they all had to be made complusary. It is important that you at least acknowledge the fact that not all complusary things are bad.

    You did answer the question though, you took a very hard approach, and provided appropriate ethical backing. Well done.
     
    Last edited: Nov 26, 2010
  3. Matt

    Matt Emeritus MSO Staff Emeritus

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    Since Season's done a terrific job of providing individual feedback I thought I'd give my own answer to this question because I think I take quite a different approach and this might be instructive. Again, this is not a model answer, it's not the correct answer, it's merely my own contribution to this question the same as the members who have posted before me:

    Vaccination is a really important public health measure but I think any move to make it compulsory for students attending public schools puts us into dangerous territory. Essentially making anything compulsory starts to infringe on people’s personal liberties and, in this case, hinging a person’s right to an education (in a country such as Australia) to their vaccination status is clearly hindering a person’s right to make their own choices and I don’t think many Australians would agree with that. Personally I don’t agree with this suggestion of compulsory vaccination.

    That’s not to say I don’t think vaccination is important, certainly I’m all for just about anything that will improve vaccinations rates in the community because I know it has such a positive public heath impact. I know there are people who disagree with this though, they’re called conscientious objectors, and I think they’re the target of a lot of ill-will. As much as I don’t agree with their beliefs, I think it’s important to try and develop an appreciation for where they’re coming from. I have a couple of family friends who are conscientiously opposed to vaccination and I know that their reasons are based in genuine concern for their children. I can think of many different scenarios where things that are unknown or poorly understood are met with fear by different groups of people, arguably the fear people show towards people of different racial backgrounds or cultures is related to the unknown. I think the ideal answer is education in both scenarios, the reason people conscientiously object to vaccination seems to be genuine fear that something bad will happen to their child. The logical solution, to me, seems to be educate rather than enforce. I hate to think of the emotional trauma and likely protest through school absenteeism this suggestion would create and I really believe it’s the wrong way to go about things.

    This answer is the product of about 5 minutes (emulating an interview scenario) and is written as if I might be answering an interview question - I stopped where I thought I might be likely to be challenged. Things to note are my introductory paragraph where I identify that this question is centred on individual liberties and state my position. The 2nd paragraph where I clarify my appreciation of how important vaccination is and also the use of anecdote/personal experience to ground my answer in reality but also introduce a personal approach. I it is important, in this as well as the last question, to include some appreciation for the person/people for whom your answer has consequences as this will make you seem more empathic. Someone like Dr. Worm would be well placed in this question to mention that's shes a mother and that this is an issue that is important to her. These techniques will make you appear more 'human' and caring and complements the more rigid logical or factual approach to answering questions. It's also important that I introduce an alternative option (education) because this shows a broader appreciation of the issue (not getting stuck in the ethical question). I also used analogy in my answer, which I think is an argumentative technique you can take or leave, used appropriately it can be very convincing (although I don't think my analogy was all that great).

    Things I didn't (and should have) mentioned were the flipside of the coin regarding the potential harm imposed by not vaccinating. This didn't come to mind while I was answering but is nevertheless important and would be a useful thing to challenge me on. So I might add my response to one of Season's challenges a little later.
     
  4. Dr Worm

    Dr Worm Regular Member

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    Many thanks both Seaoson and Matt,

    I really struggled with this one. I wanted to write a thesis on it! This WAS my second effort, and I tried to be brief. And I still wasn 't...I felt that wanting to talk a lot about the ethical approaches to the issue were interfering with my ability to summarise it.

    I think for the next question I'll try to write out 5 or 6 minutes of what I think, and somewhat spare the reasoning. I want to know - I guess - that I can answer a question in 8 minutes, not 20.

    But I'm reassured that you got what I was saying...and that - if too long - it was coherent.

    Once again, thanks heaps, you guys! This is really, really helpful, and I appreciate your time.

    x
     
  5. Dr Worm

    Dr Worm Regular Member

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  6. Matt

    Matt Emeritus MSO Staff Emeritus

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    This question was put together by Season and we both think it'd be a useful one to include in this thread, its a critical appraisal type question:

    Dangers of Cigarettes, Cigars and Smokeless Tobacco
    [FONT=&quot]Smokers have a 50% chance of dying earlier than non smokers. Smoking cuts down around seven years on an average from a smoker’s life. The risk of developing diseases is eliminated in smokers who quit smoking before an age of 35. Quitting smoking before the age of 50 reduces the risk of dying due to diseases by half. Quitting smoking is beneficial at all stages, but the earlier the better. People who quit at the age of 65 to 69 also can increase their life expectancy.[/FONT][FONT=&quot]

    [/FONT][FONT=&quot]Cigars and pipe tobacco are sometimes used as Natural ways to quit smoking . They are not as addictive as cigarettes. But research has found that they too are not completely safe. Cigars increase the chances of developing lung cancer by 1 to 4 times than people who do not smoke. The probability of developing cancer of the mouth, tongue, gums, lips, voice box and esophagus are almost the same as that of people who smoke cigarettes. People who smoke cigars are also at a higher risk of developing lung diseases like emphysema and chronic bronchitis and heart diseases.[/FONT][FONT=&quot]

    [/FONT][FONT=&quot]Spit or smokeless tobaccos are other natural ways to quit smoking. These include chewing tobacco and snuff. Tobacco in the form of smoke is the most harmful. Hence some people believe that spit tobacco is less harmful but it is known to be as addictive as cigarettes. Spit tobacco leads to the development of white leathery patches on the inside of the cheek or the gum which is called leukoplakia. This can further lead to cancer of the mouth, lips, tongue or cheeks. People who use spit tobacco are at twice the risk of developing gum disease. This can cause tooth loss or other dental problems. Smokeless tobacco also contains high levels of nicotine similar to that in cigarettes. They also cause addiction and become hard to quit.[/FONT]

    Summarise the information in your own words
    [FONT=&quot]Critique this message, in terms of the strength of the
    arguments presented and their logical consistency.
    Your critique might include an indication of the
    issues that you would like to delve into further before
    assessing the validity of these claims
    [/FONT]


    As an aside, I still have more feedback to give for the previous question but I think we ought to get a new question out in the meantime.
     
  7. papermoth

    papermoth Regular Member

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    I'm replying to the cigarettes question in parts (I'll just edit this post) because I'm getting kicked of the computer (sad but true). Also place me at the bottom of the feedback list or give me none at all since I'm doing it for fun anyway :]

    Summary of first paragraph:

    It is in one's best interest to quit smoking; preferably as soon as possible.

    Critique:

    This argument's main weakness is the ambiguity surrounding "smoking". Whenever the term "smoking" comes up I wonder; smoking how? The way in which the argument is conveyed suggests there is only one way of smoking- one that isn't explicitly stated either i.e. smoking = pack a day since age 15. And since the habit is unique to the individual, and an archetype for what smoking is isn't given, it's hard to make sense of any of the claims.

    For example in this claim "the risk of developing diseases is eliminated in smokers who quit smoking before an age of 35", what is smoking? It is just smoking. We are given no indication that factors such as amount smoked, duration of the habit, possible genetic predispositions or prior health issues are considered. This is the case every time "smoking" is mentioned.

    Furthermore, specific to this statement, where did "35" come from? Even if there actually is a justified reason for the age being "35", since the claim is one of certainty- eliminated- it is nullified if we can provide a single example of someone who quit smoking before 35 and went on to develop a disease- any disease as no specification is given. Overall it's a very poor claim- the worst in the paragraph actually.

    I also have a problem with these two claims; "smoking cuts down around seven years on an average from a smoker’s life" and "people who quit at the age of 65 to 69 also can increase their life expectancy".

    Again the all elusive "smoking" comes up but never mind that for now.

    My primary problem is the latter statement, be it true or otherwise, totally undermines the former statement. It presents this idea that one could, in theory, win back their 'lost life', minimising the impact of the original claim, and in turn putting the whole argument that quitting earlier is better in jeopardy.

    Overall I think this argument is pretty bad as evidence is baseless- even if because of ambiguity, and self-conflicting.


    Summary of second and third paragraphs:

    Quitting methods, such as the smoking of cigars and pipes and the spitting of and smoking of smokeless tobacco, have health and addiction risks that undermine their use.

    Critique:

    I think the arguments against these natural methods could be better. Firstly, time periods need to be stated, because these are quitting methods after all and therefore temporary. I was under the impression one would use them as means to wean themselves off cigarettes and the habit of smoking completely, and not simply as alternatives to the habit- which is what seems to be subtly implied.

    The onset of listed diseases and conditions maybe long term and since the use of the methods is designed to be short term, this fact could negate the whole argument.

    One thing I liked however is how the addiction risk related to smokeless tobacco was stated, this, I thought, was solid evidence for the argument.

    I'd definitely explore the stats presented, especially to see if the time periods over which said findings occurred was long or short term. If long term then I'd say this is a case of the "lesser of two evils"; cigarettes for life or short term use of methods- particularly the ones that addiction risks weren't explicitly stated- in order to kick the habit?

    Furthermore, it'd be good to see how these methods fair against other quitting methods out there. This I think, would give us more holistic basis to draw conclusions and make judgment.

    Also what's up with the use of 'natural'? I guess it's to highlight how advocators for these methods greenwash them?

    Peace.
     
    Last edited: Nov 28, 2010
  8. Season

    Season Emeritus MSO Staff Emeritus

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    Dr worm, I could cut your response in half easily. Probably as I do this to my own work all the time. Would you like me to show you how?


    Just for some general rules for challenges

    a) like I demonstrated, you will always be challenged. No matter which way you argued the outcome was a child died. So when you first get a "what is your opinion/what would you do" question, be prepared to be able to back up your argument. It is also common in questions about current health issues, JCU in particular.

    b) Stick to your guns, defend your original stance.

    so in the case of this question if you were anti vaccination and that caused a child's death. You'd be like, this is a sad case, however although it is sad, the consequence of this not occuring would be a huge infringements on individual rights. Although we risk the chance that a child may die, taking away individuals freedom could have equally bad outcomes.

    Un the case of pro vaccination challenge. You'd be like, this is a sad case. awful that a parent had to go through that and it is understandable that she'd be horrified to do it again. However although the risks, this does not mean vaccination is bad, vaccinnation saves the lives of thousands of children every year, and with cooperation we can eradicate a disease. The risk indiviudals take is for the benefit of all society.
     
  9. Matt

    Matt Emeritus MSO Staff Emeritus

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    Just adding a reply to this as a follow on from my previous post:

    I remember hearing about this story in the news and thinking what a horrible thing for this little baby and her family, I think it really highlights just how important it is too improve vaccination rates to as high a level as possible because if enough people were vaccinated against whooping cough there is a good chance that this life needn't have been lost. I think the preventable nature of the death must have been really hard for the family and it should underscore the importance of implementing measures to improve vaccination rates around Australia and, particularly, it seems, in this community.

    This doesn't change my previous stance though, I still don't think compulsory vaccination is the way to go about furthering the cause of vaccination, in fact, I think a story such as this illustrates where my alternative suggestion of education really comes to the fore. This is a community where vaccination rates are lower than national averages and I think this should suggest to governments that a need exists there for more education and more vaccination health promotion. Again, I think forcing vaccination on a community such as this, by making it compulsory through public schools, would cause even more emotional distress to those parents who are afraid to vaccinate their children since having something unknown or uncertain forced upon them it sure to increase fear.

    Alternatively educating these parents is more likely to tackle the root of the problem by addressing the uncertainty.

    If time allowed I would go on to say:

    I feel that I should restate though, this story shows just how important it is to keep vaccination rates high since failure to do so can and here obviously has resulted in preventable death.

    Again a reply written in about 5 minutes in the style I might bring to an interview. I think the key points to remember regarding a challenge are (1) to stick to your original position OR demonstrate your reasoning process if the new information changes your opinion. In a case such as this you should be very decided in your opinion and this would not be a good one to change your mind on mid way through. (2) You also need to explain why this piece of new information doesn't alter your stance (or alternatively, as above, why is does). This really is a case where so long as you provide clear, level-headed reasoning you should do well.
     
  10. happyjuju

    happyjuju New Member

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    Great work everyone! I apologise that my response is too long…any feedback about whether I am on the right track or how to cut down my waffle would be greatly appreciated :lol:

    This article outlines the dangers associated with tobacco use, and discusses different methods of intake. Firstly, I noticed a lack of references and authorship, so the reader is left unaware as to the context or purpose of the text. I would be interested to know who the author was and who the intended audience was, and also the references behind the stated statistics. This would be helpful in understanding the purpose of the text and also in critically appraising the information provided. Moving on...
    The first point relates to cigarette smoking, and some statistics are given to demonstrate the harmful effects of this behaviour. Various comparisons are made between ciggarette smokers (note that no further clasification is given, eg. "a pack a day smoker") and non ciggarette smokers in terms of their morbidity and disease rates. Specifically, cigarette smokers experience worse health outcomes than do non smokers. The general trend presented is that quitting earlier is most favourable, and that quitting when older is still favourable, but less effective. In psychology, this is a technique frequently used in health promotions whereby the audience is firstly presented with an unfavourable consequence, and subsequently told that their change in behaviour WILL make a positive difference.
    The next point relates to tobacco intake via cigar and pipe smoking. The author calls these “natural ways to quite smoking”. I have not heard of this terminology before so would be interested to know about this classification of “natural”. Perhaps it is in the absence of medication (in which case going cold turkey would also be considered natural) or whether it represents some lessened intake of tobacco (which arguably, is not really quitting smoking). I make this point because the word natural has pleasant and healthy connotations associated with it and it is used throughout the text. Furthermore, I am unsure whether someone who switches their daily cigarette intake to a daily cigar intake is actually “quitting” smoking. Moving on, the article identifies both cigar smoking and pipe smoking as natural ways of quitting smoking, which presents them in a positive light. It then goes on to demonstrate the harmful effects of cigar and pipe smoking, saying they are “less addictive” ( I would like to know more about this) than cigarettes, but making the concession “they are not completely safe” (newsflash!! hehe). Various statistics are provided to demonstrate that the harmful effects of this type of smoking are “nearly the same” as cigarette smoking. I would like to know whether any of these differences are statistically significant and how this has been determined, and whether specific diseases and things like frequency of smoking behaviour have been taken into consideration. Is the comparison in the final sentence comparing these pipe/cigar smokers with non smokers or with cigarette smokers? Seemingly the comparison is between pipe/cigar smokers but this is unclear.
    The next point relates to spit and smokeless tobacco and labels them “other natural ways to quit smoking” and reports that smoke-related tobacco intake is the most harmful, and yet these smokeless methods are as addictive as cigarettes (how was this determined?). The author then goes on to list various health problems associated with the intake of smokeless tobacco, seemingly making comparisons between non-smokers and smokless-smokers (does that make sense?), but once again, this is unclear. Smokeless tobacco intake is presented as being less harmful than smoking tobacco intake, and yet the necessary statistical comparisons needed to make this inference are not offered. The proposed statement that smokeless intake of tobacco is less harmful than smoking intake of tobacco is not supported by a comparison in health outcomes with the smoking groups previously discussed.
    The overall structure of the argument is logical, in that the author discusses tobacco intake in a supposed perceived descending order of harmfulness. The statistical comparisons are for the most part meaningless, as there is no evidence offered that cigar/pipe smokers experience better outcomes than cigarette smokers, or that smokeless-smokers experience better outcomes than cigar/pipe smokers. Overall, the article outlines the harmful effects of all types of tobacco use and says that as a group, tobacco users have worse health related outcomes than non-tobacco users. This claim, despite a lack of references, I believe to be accurate. The supposed grading of harmfulness remains unsupported by appropriate comparisons and in the absence of referencing I am unsure of the accuracy of this interpretation.
    If the purpose of this article is to dispel the myth that these “natural ways to quit smoking” are actually particularly harmful, it may benefit from making some appropriate group comparisons, breaking down the perceived “natural” label rather than referring to it throughout the article, and offering non-tobacco quitting alternatives in a final paragraph.
     
  11. Dr Worm

    Dr Worm Regular Member

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    Nuts whered my answer go? Ok. Well...ten minutes, right? For typing, which on this computer is a bit slower that talking. go...

    This article starts out with a reminder of the fairly well accepted fact that smoking has negative health effects, and that quitting smoking is beneficial before going on to discuss so -called natural approaches to quiting smoking by replacing cigarreet smoking with other forms of tobacco use. The article seems to suggest that pipe smoking and cigar smoking are less addictive, although they continue to have significant health risks nearly as high as smoking. The article states that some people belive spit tobacco causes less lung diseases, but notes that it causes more oral health problems including serious diseases such as cancer, and is addictive.

    A real problem with this article seems to be that it doesn';t define it's terms: switching from cigarettes to cigars may infact be a strategy some people attenpt to quit cigarrette smoking, but the article doesn't provide any information on whether this leads to quitting smoking, or merely to a different form of smoking. The article doesn't say waht it means when it refers to concepts like "äddictive" (whether they mean physical or psychological dependance), or how they would measure this. I can't tell whether the article is presenting the views that these are forms of smoking cessation, or merely something people attempt, in the way people will try all sorts of ideas. No real comparitive data is presented here and no sources. Is the risk of bronchitis in cigar smokers high compared to the population, or compared to cigareette smokers, etc. No comparitive data or the risks, benefits and success of other quite smoking methods such as nicotine replacement, going cold turkey, cutting down, or pharmacological treatments is given

    I think there is something inherently inconsistent is talking about "natural methods to quite smoking", anf then going on to talk about other forms of smoking. There isn't enough information here to make an asset of the risks and benefits of "switching smoking", at best this article describes approaches some people might attempt, and points out that there are risks involved with these forms of tobacco use.

    12 minutes,but I got the washing off the ;line midway...
     
  12. Dr Worm

    Dr Worm Regular Member

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    PS - I have had a look at the other responses now. I was, like papermoth, initially tempted to nitpick at the argument, but I tried to be more concerned with getting to my answer: summarise and critique (broadly, given the time).

    Reminds me of a comment my friend just got on an english essay - "this is a fascinating topic and you have demonstrated an excellent understanding of the problem...unfortunatly, it isn't very relevant to the question". A perennial problem of mine: however interesting the tangents are, they may be irrelevant to the question. Especially given the time limit.
     
  13. papermoth

    papermoth Regular Member

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    Dr W; haha nitpicking = product of too much time and not playing this game right :]
     
  14. JeremiahGreenspoon

    JeremiahGreenspoon Regular Member

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    The piece seems to be suggesting that the risk of an early death due to smoking is high, although it can be reduced by quitting early. It then discusses a number of natural ways to quit smoking that are used by people, and are claimed to be less harmful but are far from risk free.

    There is a little structure to the argument contained in the article, as it presents alternatives to smoking that may be interpreted as a good option to increase life expectancy (given that quitting smoking as early as possible is presented as the best possible option), but then identifies similar health problems between the options such as addiction and forms of mouth cancer. The article does not then identify the impacts on life expectancy of these illnesses.

    Given that the title of the article is ‘Dangers of cigarettes, cigars and smokeless tobacco’, it is within its rights to deal with the dangers of each of them individually. However a more useful analysis, given the flow of the article and the suggestion that people seeking to quit smoking often take up other forms of tobacco, would be a comparative analysis of the relative risk of developing identified diseases for each form of tobacco and impacts on life expectancy.

    I don’t know if we should be worried about references within an interview scenario. If they said – “this article appeared on the internet” or something, then I might raise the issue of reliability of information. The biggest concern with the claims to me is the lack of quantitative information regarding the forms of tobacco and relative risks depending on how long one had used them and to what degree. I would want to explore those two issues further before giving the article too much credit, as it is far too general as it stands.
     
  15. johnnoblack

    johnnoblack New Member

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    i've read through all these questions and scenarios
    will these be useful for the uwa med interview?
     
  16. qickin

    qickin Regular Member

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    hi there. heres what i think - i havent looked at the other responses.



    Smoking reduces the overall life expectancy of people, with people quitting earlier reducing the reduction their own life expectancy. Cigars, pipe tobacco and forms of smokeless tobacco use that are deemed "natural" ways to quite, still lead to many health problem.

    This passage lacks a clear sense of an argument in the way that it initially provides statistics and then proceeds to attack "natural" ways to quit, and does not seem to be arguing for a clear purpose. This transition breaks the train of thought and its logical consistancy. Furthermore, the claims that are made are in no way compared against each other not allowing for someone to objectively compare their detrimental effects making it hard for a choice of a "natural" way to quit smoking to be chosen by someone who may want to quit smoking. Also the statistics provided do not seem to be supported by clinical evidence and thus may not be valid. Furthermore, i believe a recommendation of a method of quitting should be recommended to potential smoking quitters.
     
  17. cuddly_bear

    cuddly_bear New Member

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    Hey everybody

    If you got the question, "Explain your understanding of a career in medicine", would you talk about the process of becoming a doctor (internship etc.) or would you just talk about the positives and negatives of being a doctor?

    Also, here are some more scenarios:

    1. A student is working in a clinic where the office double books aboriginal patients. The student asks their reasoning and the receptionist replies that “Those people never show up for their appointments.” How would you deal with this situation?

    2. It has been proposed that there should be a ban on lung transplants for heavy smokers or liver transplants for alcoholics. Discuss the implications of this.

    3. You recently told a long-time patient of yours, Sheryl, that she has multiple sclerosis. After hearing that the appearance of initial symptoms takes two to five years, Sheryl says that she will not be telling her family. You are also the family’s general practitioner and you know that they would want to be told. How do you deal with this conflict?

    4. A neurosurgeon on his day off has been having a few drinks with his extended family, when he is called in by his neurosurgeon colleague to help with an urgent case. The colleague tells the neurosurgeon that the person who's meant to be working with him has gone home due to the flu, and there is a patient that urgently needs to be operated on. The colleague tells the neurosurgeon that he is the best and the closest one to the hospital. The neurosurgeon hops in his car and drives off to the hospital to help.
    What are the issues here?
    Do the neurosurgeon's actions indicate that he is an alcoholic?
    Why do you think the neurosurgeon did what he did?

    What are your ideas on how to answer these? Any suggestions would be much appreciated [​IMG]
     
  18. Havox

    Havox Sword and Martini Guy! Emeritus

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    That's a really big question, I would ask for clarification on specifically what part of my understanding they were asking about.
     
  19. Season

    Season Emeritus MSO Staff Emeritus

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    Hey guys I think you've all done a really good job with this question. Makes me wish I'd posted something a bit more challenging, I'll start posting some feedback tonight.


    The next question I admittedly stole from the other thread, but Matt and I think its a very interesting situation.


    A student is working in a clinic where the office double books aboriginal patients. The student asks their reasoning and the receptionist replies that “Those people never show up for their appointments.” How would you deal with this situation?
     
  20. Season

    Season Emeritus MSO Staff Emeritus

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    Hey a very critical answer, (well done it was a very weak argument).

    However I think what your answer lacks is the fact that there might be some basis to the claims. Underneath all the badly written, facts, conclusions and assumptions there might be something in the argument. You need to bring that out a little bit as well as being critical.

    Also the question asks how would you delve further into this argument. Perhaps suggesting that you would read further about natural ways to quit smoking would improve your analysis. Suggest maybe a direction to begin in, eg some journal articles or experts in the field.

    I know in real life I would have dismissed this piece as soon as I read it. So I completely get the 'not being bothered to investigate futher'. However the question is asking you to look into the validity of the claims, so its a good idea to present both sides.
     
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