Daisy Zheng - Reflective Journal

[dzheng918]

Hi I'm Daisy! I'm a first year doing a double degree in law and science. My major in science is pharmacology. A fun fact about me is that I love napping. I nap for 2+ hours every day and I cannot function without it. I'm hoping that from this project I can improve my independent learning skills and build on my confidence when it comes to group work, and also learn about our essential medicines.

[yaelago]

Welcome @dzheng918, great to have you join the team! Looking forward to working together :)

[SerriMat]

A power nap a day, keeps the uni student awake! I love a good nap. Hope to have a great semester working with all.

[polekim]

Hi Daisy :) I love pharmacology as well! Looking forward to working together.

[kym834]

Love me a good nap! Be it true or false I always use this to explain why I nap https://thecarousel.com/wellness/11-most-surprising-famous-people-who-loved-to-nap/

[dzheng918]

Survey Queue https://redcap.sydney.edu.au/surveys/?sq=9V5hjMFr5q

21/08/21 - News Flash Challenge

The first challenge, News Flash, was a relatively general survey collecting data on our recent exposure to the topic of medicines from the media. The medicine that immediately came to mind for me was the Covid-19 vaccines, Pfizer and AstraZeneca. It actually took me a while to decide which category to select as I felt that the news have read or heard of fall into multiple categories: Clinical trials or processes, shortages in medicine availability and side effects. The challenge also led to consider in detail where I actually gathered all the information from. Upon reflection, I realised that it came from a huge variety of sources: the newspaper, online news, TV news, social media and word of mouth. I believe it might be interesting to consider what type of information, knowledge, response or sentiment each kind of source brings, and how they impact on our knowledge of medicines differently.

UPDATE 23/08/21

As suggested I completed this challenge again for five medicines in the list. The medicines I selected were:

• Insulin
• Carbetocin
• Methadone
• Fluoxetine
• Warfarin

This was a little different to my train of thought when I was doing the survey on the Pfizer vaccine because for most of the medicines on the list, I had not read or heard any news about them. To complete this survey for the medicines, I looked at latest articles and picked one that I believe would be something that would interested in reading in my private time. The articles I chose covered a wide range of topics from clinical trials to changes in price.

I found myself learning new technology during the process. For example, the article chosen on fluoxetine was on clinical trials testing the effectiveness of fluoxetine in prevention of post-stroke depression. To answer the survey, I had to understand what Phase I, Phase II and Phase III meant. Additionally, I found that sometimes it was hard for topics to fall under one category precisely. For example, the article I read on methadone was about how Covid-19 has changed the requirements of administering methadone. I found myself adding other relevant topics to the "Other" option to the final page of the survey.

[dzheng918]

21/08/21 - Price Hikes Challenge

Medicines selected:

• Insulin
• Carbetocin
• Methadone
• Fluoxetine
• Warfarin

The challenge both built on my prior knowledge, and also led me to discover new issues and statistics about drug price changes around the world. The five medicines I chose to explore were: insulin, carbetocin, warfarin, methadone and fluoxetine. The two drugs that I were previously aware of were insulin and warfarin, of which I was only aware of the price hike of insulin in the US. The challenge added onto my prior knowledge; I learned that the price hike of insulin was not an overnight occurrence but instead a sustained increase over two decades attributed to market monopoly.

The challenge also exercised my research skills and introduced me to the PBS website. The research process practiced my ability to reasonably evaluate source reliability. It also had me using synonyms such as "price increase" instead of "price hike", and "Prozac" in place of "fluoxetine" to maximise my access to sources on the topic. I was familiarised myself with the purpose and use of the PBS which is a primary resource for everyday access to medicine information.

Even for certain medicines that I was not able to find a price hike for, the challenge also leads me to explore and inadvertently discover new facts and statistics on related or substitute drugs. For example, researching methadone led to explore the drastic price hike of its substitute, Buprenorphine, in 2018. It is interesting to look into the cause and effect that interlinks different drugs.

Finally, the challenge also led me to consider more deeply some of the phenomena in the statistics. For me, the majority of drugs that I found price hikes for had these hikes occur in the US. More importantly, a lot of the medicines that experienced major price hikes in the US like fluoxetine, did not in Australia. Upon reflection, this can be attributed to the healthcare system in Australia. The US does little to intervene in the market in the form of price caps or policies, hence the prices of medicine are susceptible to changes in market forces and monopoly. As such, the challenge helped me develop my general knowledge and also stimulated thought on the underlying causes of arising phenomena.

[dzheng918]

23/08/21 - Circle of Life Challenge

Medicines selected:

• Insulin
• Diazepam
• Methadone
• Fluoxetine
• Warfarin

This challenge certainly taught me quite a bit about the history and ownership of each respective medicine. Unlike the price hikes challenge for which I had some knowledge on the issues or at the least was aware, I had little to no prior knowledge on the history of medicines.

There were a couple steps to the research process: firstly we used the database provided by Essential Medicines, and then we were sent off to do our own online research. The use of the database was very straightforward, in comparison, researching to find information on the earliest owner and merger or acquisition events proved more difficult. Sometimes, there would be little information on the internet about the question. Other times, different sources would give different statistics as to the price of the takeover and the reason for a name change. As I reached my second and third survey attempts, I was getting more familiar with how to search up key words, using synonyms to broaden the scope of research. Completing the challenges also had me making better choices between which sources to use, making the research process more effective and efficient.

Some of the answers to the questions were not so apparent, and were implied or had to be assumed. For example, I struggled to find the earliest owner of methadone anywhere on the internet. The quote I was able to find read, “Methadone was first synthesised in 1939 at the pharmaceutical laboratories of the I.G. Farbenkonzern”, so I would infer that I.G. Farbenkonzern was probably the first owner. Similarly for attributing a reason to why Mylan (applicant holder of methadone) and Upjohn chose to merge, the reason was not stated patently, but it could be inferred that the merger was an attempt to gain dominant market share in the pharmaceutical industry.

It was also sometimes difficult to figure out whether my research had been exhaustive. I realised that it was necessary to make an educated choice as to which events are key to include. Since the aim is to get a broad idea about the ownership of the medicine since its debut, I decided it would be better to extract key events which affected the ownership of the medicine. Hence, I only took regard for mergers and acquisitions that took place when a company is the applicant folder of a medicine. It was important to be able to filter out piles of information that were not so relevant to the questions.

The process of researching led me to read on further about the discovery of each medicine in their historical contexts. For example, warfarin was discovered in an incident of cattle haemorrhaging to death. Research attributed the disease to sweet clover, a plant in the diet of cattle, from which the anticoagulant, warfarin, was first extracted. Facts like this were interesting to read about. The challenge exposed me to a lot of thought-provoking information beyond the scope of the survey that I would not have otherwise learned about.

[olwu3220]

Your reflective journal structure seems very effective as you could reflect on the nature of the challenges themselves rather than each individual medicine. Definitely a similarity I found was the need for refining research results, particularly in the Circle of Life challenge where you made a great point about needing to be aware of the purpose of research in order to make effective decisions regarding what sources to consider, the depth of investigation and making inferences about research that was found (e.g. the first owners of certain medicines).

Similarly, in your reflections, you mentioned how the price hikes typically occurred in the US and gave same insightful analysis as to why this is the case - this was definitely something I cam across in my research as well. I did however find this to be quite frustrating as I thought that much of my research was so Western-centric whereas I would have preferred to understand essential medicines from the perspective of other countries but this seemed quite difficult to do in my research. I wonder if this is a case of echo-chambering and internalised confirmation bias, or even the embedded biases that come from researching via Google’s algorithms.

As we were both using a learning resource, I am also interested to see what your experiences was like with using them for 5 challenges. From reading your reflections, I think we probably had similar experiences in terms of the repeatable nature of the resource and perhaps its redundancy during later completions of the challenges. Looking forward to a more in-depth discussion on how you used your resource and its contribution to your learning :)

[carolineson]

Hi Daisy!

I think I totally agree with Olivia when she said that your decision to separate out your journals by challenge rather than medicine was really interesting and very effective in analysing the challenges themselves! I think I definitely agreed with everything you had to say, and found our thought process and approach very similar! It was interesting to see how there were similar themes throughout the challenge themselves, despite being different medicines.

I think I personally most resonated with your price hikes challenge reflection. This is because I realised my personal bias very quickly being very US-centric. While I definitely considered my bias and tried to counteract, or at least research whilst being conscious of it, I would love to hear more about your thoughts on how different geographical locations and political landscapes affect price hikes, as well as our access to certain information regarding these essential medicines. It is definitely something I'd like to further look into.

Mostly though, I was really curious and interested to read your journal considering we had the same resource (or lack thereof!). Regarding realisations and final thoughts about the medicines and challenges themselves, I think ultimately we all had very similar experiences, regardless of our specific medicines or resource. It was interesting to see though how our reflective processes differed, evidently even ours with the same prompt and resource! I'm excited to hear more about your process!!!

[dzheng918]

Here's the first paper that I chose - it's on the topic of citizen science tools and how we can make them more effective and engaging.

Herodotou, C., Aristeidou, M., Sharples, M. et al. Designing citizen science tools for learning: lessons learnt from the iterative development of nQuire. RPTEL 13, 4 (2018). https://doi.org/10.1186/s41039-018-0072-1

https://telrp.springeropen.com/articles/10.1186/s41039-018-0072-1#Abs1

The paper above is on a 4-year long study that was undertaken on designing citizen science tools for learning strategically to be engaging and easily accessible to members of the public. The project identified some of the current problems in citizen science such as the ‘top-down’ system of citizen science that puts the public at distance to the bulk of the science. The study aimed to mitigate these downfalls and have the public actively participating rather than simply acting as data collectors.

The study held to an inquiry-based approach to learning; they believe that this approach would “make tasks manageable, support learners’ understanding, and encourage self-expression and reflection”. With the guidance of educational software and teachers, the tasks were broken down and spelt out for the participants. The challenging but comprehensive tasks would then keep the participants more motivated.

The study was practically realised by producing the nQuire toolkit, an online platform that provides tools and guides for citizen science investigations. Through a series of user experience experiments, the nQuire toolkit was continuously refined in an iterative process. Using the end product of the nQuire toolkit, researchers essentially extracted the principles behind successful engagement in citizen science to form guidelines on how to produce effective citizen science tools.

[dzheng918]

Here’s another paper — it discusses the effectiveness of a reflective approach to learning relevant to the sciences.

Fakude, L. (2003). Journaling: A quasi-experimental study of student nurses’ reflective learning ability. Curationis, 26(2), 49-55. https://doi.org/10.4102/curationis.v26i2.783

https://curationis.org.za/index.php/curationis/article/view/783/720

The paper above discusses the effectiveness of reflective learning through assessing the impact of journaling on the performance of student nurses. The reflective journaling aspect of the experiment are formulated based on existing literature on reflection, and actually pays homage to the six steps of the Gibbs’ Reflective Cycle that were introduced to in our workshops. The aims of the study were to: assess the ability of student nurses to write reflectively; evaluate the effectiveness of journaling to encourage reflective learning; and to compare the results of students that were exposed to journaling as supposed to those who were not.

The study was not able conclude a definite relationship between journaling and improvement in reflective learning, however it did identify a trend in the performance of students in reflective learning outcomes. The stages of reflection can be organised by difficulty: describing personal experience and exploring their feelings are the rudimentary stages of reflection, identifying alternative and improved actions is the step-up, and formulating responses to similar future situations is the most difficult. Students from both experiment groups performed similarly in the rudimentary stage. In more difficult stages of reflection, students who had been exposed to journaling performed better, though not by significant numbers.

The journaling process in the experiment is much like ours, and I believe it shows the potential of practising reflective thinking in having us better equipped to respond more efficiently and appropriately in real-life scenarios. As this study was done in nursing, I do believe it holds considerable relevance to science in general and can provide some insight on reflection-based learning in the field.

[dzheng918]

I also found this paper on inquiry-based learning to be quite interesting (I haven’t read the whole thing in detail yet — just skimmed it):

Pedaste, M., Mäeots, M., Siiman, L. A., de Jong, T., van Riesen, S. A. ., Kamp, E. T., Manoli, C. C., Zacharia, Z. C., & Tsourlidaki, E. (2015). Phases of inquiry-based learning: Definitions and the inquiry cycle. Educational Research Review, 14, 47–61. https://doi.org/10.1016/j.edurev.2015.02.003

https://www.sciencedirect.com/science/article/pii/S1747938X15000068

This paper essentially reviews a variety of secondary literature sources to formulate a general cycle for inquiry-based learning consisting of five phases: Orientation, Conceptualization, Investigation, Conclusion, and Discussion. The purpose of the study is to produce a framework for inquiry-based learning from a learner’s perspective which educators are able to utilise in order to maximise the effectiveness of learning processes. I found this paper interesting because it seems to align very well with the spirit of the Dalyell showcase and our Essential Medicines project. A lot of the phases mentioned are likely processes we will be going through as a team for this project.