My students took their pathology final exam yesterday, which means I finally have a few moments to reflect on what I learned about concepts which are easily confused.
When I studied as a nurse, I already had a degree in physiology. This means I came into the program having already learned the basic biology, chemistry, and physics of normal human function. Many of our students (and many direct entry midwifery students), don’t have a strong background in these sciences. I don’t know that I would call it a deficit…they certainly do not need the level of understanding I have to be successful. But it does make understanding something like blood pressure a little more confusing.
On the surface, the students did understand blood pressure — they knew it was a measure of the force of blood movement.
We started to see a problem when the students couldn’t differentiate between blood pressure and blood flow. They believed if you constricted the arteries to increase blood pressure, it helped because it increased blood flow. In reality, constricting arteries always decreases blood flow – a measure of the volume of blood moved; a smaller tube admits a smaller volume. Slowly we began to identify these misunderstandings and help the students develop a correct schema of how the body adapted when homeostasis was threatened. But the students struggled until we identified these misunderstandings. We could have avoided this if, when we initially talked about blood pressure, we asked them to explain their thinking — and then addressed their hidden misconception.
This morning, as I reflect on this experience, I am considering how common misunderstandings direct the health choices people make.
- How easy is it to ignore something like blood pressure if you believe it is only a measure of your “stress” level without fully understanding that sustained elevated blood pressure will damage your arteries?
- How easy is it to choose more alkaline foods if you believe eating them will change the pH of your body without fully understanding that the pH of your stomach is more acidic than anything you would ever eat but the body will add substances to the digested foods to make the chime alkaline as it enters the intestinal system?
- How easy is it to believe you can make unhealthy choices for weeks or months at a time as long as you “health binge” for a few days by being really active or eating a really great diet — without fully understanding that the damage from an unhealthy lifestyle is cumulative and isn’t cleaned up by a couple days of healthy living.
- How easy is it to believe you can be a “healthy” smoker because you plan to stop before the time most smokers would get cancer without fully understanding that cancer and other progressive lung diseases that are provoked by smoking reflect damage that was building for years, not something triggered overnight after some required amount of smoking.
I think this is another reason why it is so important to listen to our clients as they share their story. If a woman’s health choices are built on misunderstanding the human body, eventually those choices are going to work against her health goals.
If we hadn’t (eventually) asked our students to explain their thinking about something as simple as blood pressure, we wouldn’t have identified their misconceptions. So ask questions; not just the easy ones, and not just about places where you see need for change now.