學術(shù)英語(醫(yī)學)-課件

學術(shù)英語醫(yī)學AcademicEnglishforMedicine1ppt課件Unit7Physician-PatientRelationshipLifecanbehard.Relationshipsareoftendifficult.Inaneraoffastadvancingmedicaltechnology,rapidlychangingmedicalethics,andinincreasinglylitigioussociety,goodphysician-patientrelationshipiscriticallyimportantforeffectivehealthcaredelivery.Thisunitshedssomelightonhowtobuildsucharelationshiptohelpusthroughtheunpredictabilityinlife.2ppt課件Unit7LifeandMedicineUnitContentsLead-inTextATextBTextCListeningSpeakingWriting3ppt課件Lead-inIssuestobecoveredTaskUnit7LifeandMedicine4ppt課件Lead-inIssuestobecoveredTheshiftfrompaternalisticparadigmtopatient-centerparadigminmedicaldecisionmakingTheimportanceofgoodphysician-patientrelationshipinboththemedicalpracticeandthepatient’srecoveryThingsthatcountsinmaintainingaamiablephysician-patientrelationshipThewaytocommunicateproperlyandeffectivelywiththepatientsUnit7LifeandMedicine5ppt課件Lead-inDecidewhetherlife-supportsystemshouldbecontinuedorwithdrawn;Decidewhethereuthanasiashouldbeconsidered;Decidewhetheranewtherapyshouldbetried;Decidewhethersurgeryshouldbethefirstchoiceorthelastresort;Decidewhethertransferorreferralisneeded.Task:ReadthetitleofTextAandimaginethreedifferentsituationsinwhichdoctorsmaybeaskedtomake“toughdecisions”fortheirpatients.Thenwritethemdown.Unit7LifeandMedicine6ppt課件TextACriticalreadingandthinking–Topicsforpresentation–Usefulexpressions–DifficultsentencesLanguagebuilding-up–Signpostlanguage–VocabularytestSuggestedanswersUnit7LifeandMedicine7ppt課件TextA

CriticalreadingandthinkingTopicsforpresentation1Whatdifficultsituationistheyoungdoctorfacing??AdyingpatientDecisionwhethertowithdrawlife-supportmachinesandmedicationandstartcomfortmeasuresThefamily’srefusaltomakeanydecisionorwithdrawanytreatmentsUnit7LifeandMedicine8ppt課件TextA

Usefulexpressions護士站nursingstation停止使用呼吸機并停藥/停止治療withdrawlife-supportmachinesandmedications/treatment…whowasimpressivenotonlyforhisclinicalskillsbutalsoforhisdevotiontopatients…whowasimpressivenotonlyforhisclinicalskillsbutalsoforhisdevotiontopatientsItoldthemsufferingorcomfort—

itwastheirdecision.Butintheend,theymadenodecisionandjustwalkedrightoutoftheroom

CriticalreadingandthinkingUnit7LifeandMedicine9ppt課件2Whatispaternalisticdecision-makinginmedicine?TopicsforpresentationTextA

CriticalreadingandthinkingDoctorsasexclusivedecisionmakerPatientsasparticipantswithoutlittlesayinthefinalchoiceUnit7LifeandMedicine10ppt課件TextA

UsefulexpressionsThewaydoctorsandpatientsapproachmedicaldecisionshaschangedsharplyoverthelast50years.…andpatients,iftheyparticipated,oftenhadlittlesayinthefinalchoice.CriticalreadingandthinkingUnit7LifeandMedicine11ppt課件TextA

Topicsforpresentation3Inwhatwaycanpatientempowermentbegoodforthepatient?CriticalreadingandthinkingRespectforthepatient,especiallythepatient’sautonomyPatient-centercareThePatientsasdecisionmakerbasedontheinformationprovidedbythedoctorUnit7LifeandMedicine12ppt課件TextA

Topicsforpresentation3Inwhatwaycanpatientempowermentbegoodforthepatient?CriticalreadingandthinkingTwoprinciples/tenets/notionsinvolvedinthedecision-makingprocessrespectforthepersonanewclinicalideal:patient-centeredcareinwards,clinicsandoperatingroomsrespectforaperson’sautonomylettingpatientsmaketheirowndecisionsUnit7LifeandMedicine13ppt課件TextA

Topicsforpresentation4Whydoestheauthorsaytoomuchphysicianrestraintmaynotbethatgoodforthepatient?CriticalreadingandthinkingThepatientsareforcedtomakedecisionstheyneverwantto.Patients,atleastalargemajority,prefertheirdoctorstomakefinaldecisions.Shiftingresponsibilityofdecisionmakingtothepatientswillbringaboutmorestresstothepatientsandtheirfamilies,especiallywhenthebestoptionforthepatientisuncertainUnit7LifeandMedicine14ppt課件TextA

Usefulexpressions…amajorityofpatientsarebeinglefttomakedecisionsthattheyneverwantedtointhefirstplace.Whenitcametomedicaldecisions,almostalltherespondentswantedtheirdoctorstoofferchoicesandconsidertheiropinions.Butamajorityofpatients—twooutofthree—alsopreferredthattheirdoctorsmakethefinaldecisionsregardingtheirmedicalcare.

…notwhenthemedicalchoicesareobvious,butwhenthebestoptionforapatientisuncertain…whendoctorspasstheburdenofdecision-makingtoapatientorfamily,itcanexacerbateanalreadystressfulsituation.CriticalreadingandthinkingUnit7LifeandMedicine15ppt課件TextA

Topicsforpresentation5.Whatkindofconsiderationsmayhavepreventeddoctorsfrommakingdecisionsfortheirpatients?CriticalreadingandthinkingDoctorsareverymuchcautiousaboutcommittingsomekindofethicaltransgression.‘WhoamItopresumetoknowwhatmypatientsneed?’Unit7LifeandMedicine16ppt課件TextA

ACaseinPoint:LanguageMakesaDifferenceTellrelativesthatitistheirchoicetowithdrawlifesupportfromadyingpatient.Butthatdoctormayalsousevalue-ladenlanguagetodescribetheoptions.Onealternativemaybedescribedtothefamilyas“reasonable”or“comforting,”whiletheotherisdepictedas“invasive,”“aggressive”or“painful”.CriticalreadingandthinkingUnit7LifeandMedicine17ppt課件TextA

ACaseinPoint:LanguageMakesaDifferenceDr.Curlin’sWisdomIBizarredishonestofcommunicationPatientsendupfeelingmanipulatedandwillresistmakinganydecisionatall.CriticalreadingandthinkingUnit7LifeandMedicine18ppt課件TextA

ACaseinPoint:LanguageMakesaDifferenceDr.Curlin’sWisdomII“Wehavetostopdrawingacirclearoundpatientsandtheirfamilies,”“Wehavetostopsubjectingthemtothelonelinessandburdenofautonomyandinsteadbeginstandinginthatcirclewiththem.”CriticalreadingandthinkingUnit7LifeandMedicine19ppt課件6Doyouagreethatdoctorsshouldbepreparedtomakeanydecisionstogetherwiththeirpatients?TextA

TopicsforpresentationCriticalreadingandthinkingShoulderingresponsibilitytogetherwiththepatientmaybebetterthanhavingthepatientmakedecisionontheirownalone.Balancingbetweenpaternalismandrespectforpatient’sautonomyconstitutesalargepartofmedicalpractice.Unit7LifeandMedicine20ppt課件TextA

Usefulexpressionsthekeytopreservingpatientautonomy—andpatient-centeredcare—liesnotinlettingpatientsmakethefinaldecisionsalonebutinrespectingtheiropinionsandshoulderingtheresponsibilitytogether.Iadmit,myself,willneedtobemoremindfulofwhetherpatientswantthemtoshareinformation,bedirectiveorhandovertheresponsibilityofthedecision.CriticalreadingandthinkingUnit7LifeandMedicine21ppt課件TextA

AdditionalActivityWatchtheVideoandseewhataretipsgivenbyDr.ThaddeusBelltobuildaAmiablePPRelationshipDoctor-PatientRelationshipCriticalreadingandthinkingUnit7LifeandMedicine22ppt課件TextA

DifficultsentencesHewaslargeandpowerfullybuiltbutneverseemedtoloomoverhispatients…Criticalreadingandthinking他身材高大偉岸，但是從來不讓病人有咄咄逼人的感覺Unit7LifeandMedicine23ppt課件TextA

Difficultsentences…asmovementscallingforpatientempowermentgrewandmedicalethicistsbeganarticulatingprinciplesregardingtheethicalcareofpatients.Criticalreadingandthinking…要求病人授權(quán)的呼聲越來越高，而且醫(yī)學倫理學家也開始闡述病人倫理關(guān)懷的相關(guān)原則。Unit7LifeandMedicine24ppt課件TextA

DifficultsentencesOnetenetthatgainedparticulartractionamongclinicians…Criticalreadingandthinking臨床醫(yī)生們尤為擁護的一條宗旨…thisethicalprincipleledtoanewclinicalideal:patient-centeredcare…這條倫理原則導致了一種新的臨床理念的出現(xiàn)：以病人為中心的醫(yī)護。Unit7LifeandMedicine25ppt課件TextA

Difficultsentences…youngdoctors,myselfincluded,wouldbetrainedtorestrainourselvesfrommakinganythingbutemergencyormundanedecisionsforpatients.Criticalreadingandthinking…包括我在內(nèi)，年輕醫(yī)生將接受培訓，學會除了一些緊急狀況或日?，嵤?，不為病人作其他任何決定。Unit7LifeandMedicine26ppt課件TextA

Difficultsentences…andthatinterpretationwouldworkitswayintotheteachingprogramsofmedicalschoolsandintostatelawsthatmandateddiscussionoftreatmentoptionswithpatients.Criticalreadingandthinking…而且，對病人自主性的解釋逐漸進入了醫(yī)學院校的課程，也被寫進各州的法律，規(guī)定醫(yī)生必須與病人討論治療方案的選擇。Unit7LifeandMedicine27ppt課件TextA

DifficultsentencesWhiledoctorsmightequatelettingpatientsmaketheirowndecisionswithrespect…Criticalreadingandthinking雖然醫(yī)生也許認為讓病人自己作決定就是尊重病人…Unit7LifeandMedicine28ppt課件TextA

DifficultsentencesSomewillresorttoveilingtheirownopinionsinahalfheartedattempttodirectthedecision.Criticalreadingandthinking有些醫(yī)生采取的做法是隱藏自己的觀點，用隱隱約約的方式引導病人作決定。Unit7LifeandMedicine29ppt課件TextA

DifficultsentencesWhilethedoctorsmightbeconvincedthattheyarebeingobjectiveanddispassionate,moreoftenthannottheyaresendingmixedmessages.Criticalreadingandthinking雖然醫(yī)生堅信自己的態(tài)度客觀冷靜，但往往他們在向病人發(fā)出莫衷一是的信息。Unit7LifeandMedicine30ppt課件anursing________(護士站)___________machines(生命維持系統(tǒng))comfort_________(舒適護理措施)to_________treatment(停止治療)___________decision-makingprocess(家長式?jīng)Q策程序)patient______________(給病人授權(quán))medical___________(醫(yī)學倫理學家)ethical__________(倫理準則)clinical_________(臨床理念)________________care(以病人為中心的護理)

TextA

LanguageBuilding-up

VocabularyTeststationlife-supportmeasureswithdrawpaternalisticempowermentethicistsprinciplesidealUnit7LifeandMedicinepatient-centered31ppt課件patient_________(病人自主權(quán))treatment___________(治療選擇)__________purview(專屬領(lǐng)域)__________decisions(緊急情況下做的決定)physician__________(對醫(yī)生的限制)_________andconfusion(焦慮與困惑)ethical_____________(違背倫理)family________(家庭醫(yī)療)

TextA

LanguageBuilding-up

VocabularyTestautonomyoptionsexclusiveemergencyrestraintanxietytransgressionpracticeUnit7LifeandMedicine32ppt課件TextASuggestedanswersTask1OverviewThistextcanbebrieflydividedintothreeparts:introductionofthetopicandthetheme,argumentationforthetheme,andconclusion.Readthetextcarefullyandfillinthemissinginformationforeachpartinthefollowingdiagram.CriticalreadingandthinkingUnit7LifeandMedicine33ppt課件TextASuggestedanswersTask1OverviewCriticalreadingandthinkingBackgroundinformation:Changefromthepaternalisticcaretothepatient-centered

careTwounderlyingethicalprinciples:respectfortheperson

andrespectfortheperson’sautonomy

Conclusion:Thekeyforpreservingpatientautonomyliesinrespectingtheiropinionsandshoulderingtheresponsibilitytogether.Theme:Toomuchphysicianrestraintisharmfulorunethical.

LettingDoctorsMaketheToughDecisionsAnecdote:ayoungdoctor’sexperienceMainSupports:Studyfindings:mostpatients’positionTwoarguments:ExacerbatingthestressfulsituationCreatingdishonestyincommunicationPartI(P1-P8)PartII(P9-P14)PartIII(P15-P16)Unit7LifeandMedicine34ppt課件TextATask1/MedicalterminologyMatcheachdefinitionwithitscorrespondingEnglishtermandChineseequivalent.EnglishChineseDefinition1medicineordrugsgiventopeoplewhoareill2theconditionorqualityofbeingautonomous;independence3anexpertclinicalphysician4of,pertainingto,orcorrectablebysurgery5causingpain,fullofpainmedication藥物，藥物治療自主性

autonomy臨床醫(yī)生cliniciansurgical外科的painful疼痛的SuggestedanswersLanguagebuilding-up2Unit7LifeandMedicine35ppt課件TextAEnglishChineseDefinition6of,relatingto,orconnectedwithaclinic7aspecialistinethics8notethical9apersonlicensedtopracticemedicine;amedicaldoctor10admitorsend(aperson)intoahospitalfortreatmentphysician醫(yī)生，內(nèi)科醫(yī)生clinical臨床的ethicist倫理學家unethical不道德的hospitalize住院Task1/MedicalterminologyMatcheachdefinitionwithitscorrespondingEnglishtermandChineseequivalent.Suggestedanswers2Languagebuilding-upUnit7LifeandMedicine36ppt課件TextATask2/SignpostlanguageUnderlinethefirstsentencesofparagraphs4,5,6,8,11and12,analyzehowtheauthormanagestobringanewtopicandmaintaincoherence,andcompletethefollowingtable.Languagebuilding-upSuggestedanswersKeywordsrepeatedtoachievesmoothtransitionKeywordsusedtointroduceanewtopic1stsentenceofPara.4decisionschanged1stsentenceof.5tenetrespectfortheperson1stsentenceof.6ethicalprinciplerespectforaperson’sautonomy1stsentenceof.8physicianrestraintnotbeallthatgood,unethical1stsentenceof.11medicalchoices,optionchallenge,uncertain1stsentenceof.12patientsandtheirfamilies(doctors’)ownsetofworriesUnit7LifeandMedicine37ppt課件TextATask3/FormalEnglishThefollowingsentencesaretakenfromTextA.Replacetheunderlinedformalwordswithlessformalones.Forgenerations,thesedecisionsweretheexclusive

purviewofdoctors…(para.4)Onetenetthatgainedparticulartractionamongclinicianswasrespectfortheperson.(para.5)…andthatinterpretationwouldworkitswayintotheteachingprogramsofmedicalschoolsandintostatelawsthatmandateddiscussionoftreatmentoptionswithpatients.(para.6)Languagebuilding-upSuggestedanswersbelief/ideaarea/fieldorderedUnit7LifeandMedicine38ppt課件TextATask3/FormalEnglishThefollowingsentencesaretakenfromTextA.Replacetheunderlinedformalwordswithlessformalones.Whenitcametomedicaldecisions,almostalltherespondentswantedtheirdoctorstoofferchoicesandconsidertheiroptions.(para.9)Butamajorityofpatients—twooutofthree—alsopreferredthattheirdoctorsmakethefinaldecisionsregardingtheirmedicalcare.(para.9)6…doctors,likemyyoungcolleaguesand,Iadmit,myself,willneedtobemoremindfulofwhetherpatientswantthemtoshareinformation…(para.15)

Languagebuilding-upSuggestedanswersconscious/awarerelatingto/aboutanswerersUnit7LifeandMedicine39ppt課件

TextA

Additionalactivity

GrouppresentationHospicemovementhasbeenapopularconceptinrecentdecadesinthefieldofhealthcare.Workinasmallgroupandexplorerelevantinformationaboutthissubjectinthefollowingaspects:

1.definition2.history3.advantages4.developmentinChinaUnit7LifeandMedicine40ppt課件TextBCriticalreadingandthinkingLanguagebuilding-upSuggestedanswersUnit7LifeandMedicine41ppt課件TextB

CriticalReadingandThinking1.Pat’sPersonalStatus(P181)A78-year-oldwomansufferingfromlungcancerwithwidespreadmetastasesandreceivingpalliativecarefromhospiceAdairyfarmerMotherofsixInteriordesignerOneofthebestpiebakersinthecountyWritedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine42ppt課件TextB

CriticalReadingandThinkingKnowledgeofSubjectMatter

Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.lungcancerReportsfromthehospitalandoncologistconfirmedwidespreadmetastases.Pathaddeclinedaggressivetreatment.Shewasreceivingpalliativecarefromhospiceunderthesupervisionofanoncologist.1.Pat’sPersonalStatus(P181)Unit7LifeandMedicine43ppt課件TextB

CriticalReadingandThinking2.Pat’selectronicrecord(P181)Thecomputerizedtomography(CT):extensivebilateralinfiltratesandapossiblesmallnoduleinthebaseoftheleftlungwithfollow-uprecommendedbutnotobtainedAchestX-raymorethanayearago:aleftlower-lobepneumoniawithfollow-upsuggestedbutnotobtained

Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine44ppt課件TextB

CriticalReadingandThinking2.thereasonsforherhavingproblemswithdoctors(P154)KnowledgeofSubjectMatter

Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.pulmonaryembolicomputerizedtomography(CT)extensivebilateralinfiltratesapossiblesmallnoduleinthebaseoftheleftlungAchestX-rayreportfromavisitmorethanayearagowithoneofmypartnersrevealedaleftlower-lobepneumoniaandsuggestedfollow-uptoensureresolutionUnit7LifeandMedicine45ppt課件TextB

CriticalReadingandThinking3.themedicalmistake(P181)Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Theabnormalitynotnoted.FrequentvisitstodoctorsbutnotinformedofthefindingsUnit7LifeandMedicine46ppt課件TextB

CriticalReadingandThinking4.theauthor’sself-reflection(P181)Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Whotoblame?Noneofthehospitalteam,mypartners,ortheradiologiststotaketheblame.AsPat’sfamilyphysician,theauthor’sresponsibilitytofollowupabnormaltests;theauthormadetheseriousmistake.Allsortsofquestionsrunningthroughtheauthor’smind:pat’sresponse,possibilitiesofothermistakes,problemswithhealthcaresystem,causesofmedicalmistakesorerrors,what-ifs,andnextactionsUnit7LifeandMedicine47ppt課件TextB

CriticalReadingandThinking5.theauthor’sthevisittoPat(P181)PatlyinginbedinadarkenedroomwithmildlylaboredbreathingTheauthorkneelingatthebedsidelisteningtoPat’sstoriesTheauthorapologizingfortheseriousmistakePat’sforgivenessfortheauthor’smistakeWritedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine48ppt課件TextB

CriticalReadingandThinking6.thelessonthewriterlearnedfromPat(P181)AcceptingunexpectedForgivingCelebratingHopingLivinganddyingwithcourageanddignityWritedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine49ppt課件TextB

UsefulexpressionsCriticalreadingandthinkingTheprimarylesionwasdetectedyearsago,buttherewasnofollow-up.Someonedroppedtheball.reportsfromahospitalstaymorethan3yearsagoPatpresentedinfrequentlyforcareandusuallyonlyifsomethingwaswrong.sortoutmythoughtsmildlylaboredbreathingdistraughtaboutconflictswithmanyfamilymemberswhowerenotonspeakingtermsnotfulfilledmyresponsibilityto…madeadifferenceintheoutcomeAtremendousloadwasliftedfrommyshoulders.Unit7LifeandMedicine50ppt課件widespread___________(廣泛轉(zhuǎn)移)___________treatment(積極治療)_________lesion(原發(fā)病灶)torecommend_________(建議隨訪)electronic_________(電子病歷)pulmonary__________(肺栓塞)computerized___________(CT,計算機斷層掃描)bilateral__________(雙側(cè)浸潤)a(n)_________X-ray(X線胸片)left__________pneumonia(左下葉肺炎)__________breathing(呼吸困難)thehospice_______(臨終關(guān)懷團隊)

TextB

LanguageBuilding-up

VocabularyTestmetastasesaggressiveprimaryfollow-uprecordembolitomographyinfiltrateschestUnit7LifeandMedicinelower-lobelaboredteam51ppt課件TextB

SuggestedanswersCriticalreadingandthinkingTask1Reflection1.B2.B3.C4.D5.C6.AUnit7LifeandMedicine52ppt課件TextCLanguagebuilding-upSuggestedanswersUnit7LifeandMedicine53ppt課件________illness(慢性病)____________aspects(社會心理學領(lǐng)域)evidence-based__________(詢證臨床指南)to___________aplanofcare(實施治療方案)TextC

LanguageBuilding-up

VocabularyTestchronicpsychosocialguidelinesimplementUnit7LifeandMedicine54ppt課件TextC

Task:Completethefollowingbriefsummaryofthetextaftercarefulreading.Suggestedanswers答案有誤Unit7LifeandMedicine55ppt課件ListeningRecognizingdigressionsSuggestedanswersUnit7LifeandMedicine56ppt課件Listening

RecognizingdigressionsRecognizingthestart:Irememberonce…Thatremindsme…Bytheway…Recognizingtheend:So,asIwassaying…Anyway,wherewasI?Backtothepoint…Unit7LifeandMedicine57ppt課件Listening

SuggestedanswersExpressionforthestartofadigression:Expressionfortheendofadigression:Task1Listentoalectureonceandnotedowntheexpressionsthespeakerusestosignal