Evidence of Learning #1

January 24, 2020

Subject
Reflection of the Past Semester

Analysis
As a Senior coming into her last semester of high school, it seems as though time has passed me.
It has been roughly 5 months since I began my ISM journey, and I have experienced a multitude of
emotions and events. On a personal level, I believe I have grown for the better. In the past, I remember
my timidness and the fear I held when I was tasked with speaking in front of my classmates. However,
such shyness has faded through the speeches we are assigned. I can now stand confidently and share my
thoughts without having to worry about my voice. Furthermore, my work ethic has improved greatly. I
now write all my assignments and arrangements in an agenda so that I may allocate my time wisely. I am
sure to turn in assignments accordingly and meet with my teachers if I have any questions regarding
lessons. This change has allowed me to improve my professionalism and relax since I am not
procrastinating and working on homework early in the morning. Even so, such improvements did not
come without their difficulties. I can still recall multiple times where I questioned my participation in the
ISM program because I could schedule interviews or I made a mistake during my presentation. This
would soon lead me to great periods of anxiousness where I began to doubt every action I take. However,
one of the greatest lessons I have learned is that change does not come without action. Rather than letting
such pessimism consume my motivation, I pushed forward and furthered my goals, knowing one day all
my desires will come to fruition. Since changing my mindset, I am glad to have not left the ISM program.
It has taught me multiple lessons and has allowed me to explore my favorite career field.
Through my research in ISM, I have acquired a variety of knowledge ranging from gynecology
and obstetrics. From topics covering the basics of becoming an OB/GYN to strange cases of pregnancies,
it seems as though there is still plenty to learn. At the beginning of my research, I had no particular
direction. I knew I wanted to become an OB/GYN, but I lacked knowledge over the basics of obstetrics.
Rather than beginning at an advanced level, I research the “historic and social” side of OB/GYN. This
included viewing the growths and advancements of technology and patient-physician relationships from
the past to the present. Evidently, the progression of technology in medicine, especially with sonograms,
have allowed OB/GYNs to efficiently care for their patients. Furthermore, I also researched how language
benefits or hinders patient interactions with their physicians. With transportation and immigration in the
United States gradually increasing, it is imperative for physicians to learn more than one language. Since
not all patients can effectively communicate in English, speaking the native language of the patient allows
for a relationship and trust to build between the two individuals since they can properly understand one
another. After Business Symposium, I gained the confidence to research more in-depth topics of
OB/GYN. Such topics included vaccinations during pregnancy, advancements in surgery, and ectopic
pregnancies. These topics gave me insight into the field of obstetrics and gynecology and strengthened
my understanding of my career. All these topics combined hold great significance to me. Not only do they
strengthen my determination to become an OB/GYN, but it allowed me to uncover a hidden goal I have
held. Looking at the advancements and improvements of medicine in the United States made me question
how childbirth and women’s healthcare is handled around the world. I quickly came to the realization that
there are still third-world countries that lack proper healthcare for women and expecting mothers.
Knowing that such a problem exists, I hope to one-day further research and funding in healthcare so that
women in low-income countries may receive proper care.
When reviewing my research, I am surprised by how much time and energy I have spent on
learning. Though others may view this as discouraging, I am greatly motivated by this. Of course, I hope
to learn more information about my career and achieve my title as a doctor in the end. However, in the
present, I want to cherish all my moments. I may have wasted time in the past through procrastination and
laziness, but now I am encouraged to utilize my opportunities properly. If I have learned this much from 5
months, I wonder what else I will acquire these next 4 months under the guidance of my mentor. As stated
before, I will properly allocate my time so that I may effectively learn all there is to know about obstetrics
and gynecology.
 Research Assessment #9
February 6th, 2020

Subject
Pregnancies and Reality TV (Part 3)

Analysis
As seen from previous assessments, Dr. Jones gave insightful commentary on the reality of
the pregnancies presented on reality TV. To learn more about pregnancies, I decided to continue
watching Dr. Jone’s Ob/Gyn Reacts series.
In this episode of her series, Dr. Jones follows a flight attendant. The patient meets her
husband at 19 years old and has been with him since. During her relationship, the patient used birth
control pills as a contraceptive. Dr. Jones states that birth control pills are effective because it has
less than a 1% failure rate. However, this does not mean the method is 100% effective. Since there
is still a less than 1% failure rate, there are rare occasions where the pills do not work. Even if a
patient is pregnant while using birth control pills, it will not harm the baby. After discussing birth
control pills, Dr. Jones gets back to watching the episode. During the next scene, the patient explains
her symptoms. She was very tired but assumed it was connected to jet lag. Furthermore, she
recently gained weight. She inferred that because of her lifestyle of going to restaurants and
drinking wine was the reason for the weight. In her description, Dr. Jones caught a crucial detail. As
stated, she was drinking wine. Dr. Jones said wine is concerning during pregnancy because it can
lead to Fetal Alcohol Syndrome. Though you do not want to purposefully drink alcohol during
pregnancy, a higher amount of alcohol can lead to more severe symptoms of Fetal Alcohol
Syndrome. Even though there is no official “safe” alcohol level, occasional wine is unlikely to cause
problems. Hearing this surprised me. In all of my health-related classes, it is always emphasized
that women should never drink alcohol when pregnant. However, hearing that small amounts of
wine should not harm the baby spikes my curiosity. In the future, I would like to research different
articles on what types of alcohol can harm a baby and how much alcohol is considered “safe.”
Regardless, I will greatly reiterate to my patients that I highly am against drinking during
pregnancy. As the episode continues, we learn that the patient has stayed up for 48 hours due to a
flight to Hawaii. Dr. Jones says that being in the air for 48 hours should not be problematic for
someone with a low-risk pregnancy. However, she states that we don’t know for sure the effects of
the flights on the patient since we have no background information about her. Dr. Jones states on
average flying is okay until a certain time period. After 35 weeks, most airlines don’t allow pregnant
passengers onto their flights. She also advises her patients that if they will be on a flight for more
than an hour, they should walk around and stretch every couple of hours. This decreases the
chances of having a blood clot in the legs which can lead to a blood clot in the lungs. Furthermore,
Dr. Jones states it is a good idea to wear compression socks during the flight because it helps with
circulation to the feet. She also used terminologies such as DVT and Venus Stasis. In the future, I
would like to research these terms.
Soon, the episode transitions into the final day of the patient’s pregnancy. At 1:00 in the
morning, the patient reports having pain in her abdomen. Her lower body felt numb and she was
unable to feel her legs. She was scared and laid on the floor to cool off. Dr. Jones comments that it’s
interesting that the patient experienced numbness since it’s not typical in most patients and hopes
that the episode will follow up on this. Soon enough, the patient dials 911 because she thinks she
will die. As Dr. Jones has stated before, the pain during labor is so immense that it is logical to think
you will die. Going back to the show, the paramedics eventually arrive. When the patient describes
her symptoms, the paramedic states everything points to the patient having a kidney stone,
meaning she would have to go to the ER now. Eventually, the husband arrives before the patient
and anxiously waits for her. As the patient is treated in the ER, there is water everywhere with little
bits of blood. That was when the Er doctor stated that the patient is pregnant and her water broke.
The doctor tried to explain to the patient about her pregnancy, but the patient was not fluent in
English so she did not understand. This is where my passion for multilingualism came to play.
Knowing how it feels to be in a foreign country and not be fluent in the national language, I felt
empathy for the patient, especially because she could not comprehend that she was pregnant. Not
long after, the husband was informed about the surprise pregnancy. Thankfully, he was proficient in
English so he could communicate with his wife about her predicament. When the patient is rolled to
the maternity room, the doctor says to start pushing. When the baby’s head comes out, the doctor
tells her to stop because the umbilical cord was around the baby’s neck. Dr. Jones states that during
5-20% of deliveries, the baby will have the umbilical cord around the neck. This is not significant
because the umbilical cord doesn’t cause problems. When this happens, the doctor has to reduce
the umbilical cord. This means the doctor has to bring the umbilical cord over the head of the baby
to properly deliver. The umbilical cord around the head rarely causes issues because of the
anatomy of the umbilical cord. Wharton’s Jelly, it is formed like a cushion so that it helps to keep the
blood flow from getting compressed. This cushion-like build prevents any constriction of blood flow
inside the umbilical cord. After labor, the baby is safely delivered with no complications for the
patient.
Looking over this episode, I have many emotions and opinions. For starters, I never
considered how someone’s occupation can affect their pregnancy. Typically, most patients will have
common jobs that require less movement. However, on rare occasions where the patient is a flight
attendant or a pilot, and they must move around, you must take into consideration how much
exposure to radiation the patient is receiving. On average, you want to avoid have any exposure to
radiation during the first trimester, so it is interesting how the patient’s pregnancy turned out.
Furthermore, the pregnancy came with no complications, even though the patient was drinking
wine, which greatly surprises me. I would like to research more about Fetal Alcohol Symptom in the
future and learn more about how wine affects pregnancies. Overall, I learned much from this
episode, and hope to learn more about obstetrics and gynecology from Dr. Jones

MLA Citation
Ob/Gyn Reacts: I Didn’t Know I Was Pregnant | Flight Attendant,​ YouTube, 22 Jan,
2020, ​https://www.youtube.com/watch?v=pU3oUrlDexE​.
 Evidence of Learning #2
February 06, 2020

Subject
Original Work - Revised Idea

Analysis
During the second semester of ISM, the center of focus shifts from Independent Study to
Mentorship. One aspect of this Mentorship is the Original Work. This is a “project” that each
student must produce in order to further their understanding of their subject. Some students can
produce different projects depending on their subjects, such as fundraising or prototypes. When
considering my circumstances, I did not focus on making a prototype. If I were to make a
prototype, it would be on improving surgical instruments or sonograms. However, not only is my
knowledge in engineering limited, multiple surgical instruments have greatly improved due to
advancements in medicine and technology. Because fundraising was only advised for students
studying event planning, I had no direction for my Original Work. I knew I wanted my project to
impact others, but I had no clue to make it a reality. When thinking it over, my idea landed on
making a book. From the beginning of my ISM journey, I have learned much about the field of
obstetrics and gynecology. Speaking with OB/GYNs, and conducting research of my own, has
allowed me to explore this career in great depth. However, in order to preserve these memories
and knowledge, I wanted to create a book.
This book would include multiple subjects regarding obstetrics and gynecology that go
over the bases of the career field. This book would be a tool for learning about obstetrics and
gynecology. This can range from students researching different future careers to expecting
mothers wanting more information about pregnancies. The book would be dived between
obstetrics and gynecology with each section including similar topics, such as diseases and
surgical procedures. There can also be minor topics such as check-ups and career paths. In order
for this book to be helpful and informative, the pages need to be accurate. This means finding the
correct sources and websites to obtain information. I can also refer to books regarding obstetrics
and gynecology for more information. Once I have created a layout of the book (how each topic
will be located, how the information will be arranged), my research will begin. This will include
my past and present research assessment. Each week, I will focus on a specific subject in the
book (diseases of the female tract, normal pregnancy check-ups). This will be fun with my own
research of the defining information about the subject and examples in the past. After research, I
will discuss with my mentor about any questions or misconceptions I have. I will edit my page
with the correct information and finalize the pages. These steps will be related to each subject in
the book. Some subjects will extend to more than a week. However, I will need to be diligent and
keep to my schedule I order to prevent extending my workload.
However, though my idea is feasible, there were still faults in my plan. For example,
adding my information into a book would not be wise. In the 21st century, nonfiction books have
lost their popularity. If I wanted to spread awareness of my project, and the information
compiled inside it, a book was not the way to go. Instead, I decided to create a website. This
would be a separate website aside from my Digital Portfolio. A website would allow me to easily
attach my research and information without having to deal with the complexities of printing a
book from a print shop. Furthermore, I can share my website through multiple medias such as
my mentor’s website and other social media platforms. In order to complete all of this, I will
need discipline and dedication. I will need to create a timeline of the project and create due dates
for each topic. With a strong attitude and passion for my topics, I know my Original Work will
grow to become extraordinary.
 Evidence of Learning #3
February 28th, 2020

Subject
Expanding Knowledge - The Teenage Brain

Analysis
For the past few weeks, I have spent much of my time researching for my Original Work.
However, what began my interest in the field of obstetrics and gynecology was how the career is
constantly changing. Seeing as I have only been teaching myself the basics of the career field, I
decided to expand my knowledge to other fields, specifically psychology. Last semester, I was able
to take the class and found multiple topics that struck much interest in me. Coincidently, as I was
browsing through youtube, I found a video about the physiology of the adolescent brain, which
aided me in better understanding myself and my peers.
The video is a TEDxYouth, speeches videos geared towards teenagers. This specific
presentation is given by Adriana Galv​án, a scientist at UCLA that studies adolescent brains. Seeing
as she’s giving this speech at TEDxYouth, the audience is middle and high school students. ​Galv​án
states that in recent years, scientists have discovered that the adolescent brain changes every day.
Like the audience members sitting in the room, their brains are responding to her voice and the
people next to them. In fact, the experiences and personal affiliations teenagers make shape the way
their brains develop. The brain matures past childhood, into teenage years, and well into your
mid-20s. This means that middle and high school students don’t have a complete, matured brain.
This lack of maturation can be beneficial to the functions of adolescence. This statement greatly
confused me because we are always taught that teens are irrational and immature because they do
not have a fully developed brain. Knowing this, I was also curious about her explanation. ​Galv​án
says the main reason why this is beneficial is because of the function of adolescence: establishing
independence from your caregiver. Compared to children and adults, the teenage brain is good at
seeking out new experiences, exciting thrills, and risks. The adolescent brain is also good at being
sensitive to social and emotional information. Hearing this statement, I agreed with ​Galv​án. As
teens, we are to understand human nature much more easily when compared to being children.
However, I also have met a handful of acquaintances and classmates who struggle with
understanding social and emotional information. Taking my own experiences, I interpret ​Galv​án’s
statement that our brain begins to develop how we handle social and emotional information, that is
how to affect we are by this information.
Galv​án continues her speech by stating the teenage brain is very responsive to rewards and
emotions when making decisions. In her laboratory, her team wanted to uncover a question: how
does the teenage brain make decisions? Her first discovery related to question was the prefrontal
cortex. This is the front part of the brain and the last brain region to develop (the brain develops
from back to front. This area continues to develop until your mid-20s. The prefrontal cortex is
relevant because it helps you think about the potential consequences of your actions and regulate
your behavior and emotions. It makes sense why teens make more impulsive decisions, with less
regard for the potential future consequences, because this part of the brain isn’t fully available until
we pass adolescence. Now, ​Galv​án continues, the story gets more interesting. Her team begins to
think about how brain regions in deeper layers change. One region she focuses on is the striatum.
This region is a key component of the reward system because it releases dopamine when it is
“rewarded.” This is also the case in multiple organisms, such as rats and monkeys, where there is
excitement in the brain when we experience something we like. In the laboratory, her team began
to study the reward systems across different stages of development, especially teens. In an
experiment, they asked different groups of people, specifically teens and adults, to come to the
laboratory and perform a Functional Resonance Imaging Scan (fMRI). An fMRI can take a snapshot
of the brain in motion and the activity of the brain. To study the reward system, the scientists gave
someone a reward - sugar. While taking the fMRI, the people were hooked to a straw that fed
squirts of sugar water. ​Galv​án’s team asked the participants if they liked the sugar, and, overall, they
responded with yes. However, it was the teen group that showed exaggerated sensitivity to the
sugar because they loved it. I inferred this could be linked to the developing brain because
teenagers are more sensitive than adults. I also began to wonder if different companies, such as
cigarette or vaping companies, use this tactic to increase addiction to their products in adolescents.
Galv​án’s team also started to wonder if there was anything neurobiological that represented
this difference. ​Galv​án showed a human brain image averaged together among all participants and
saw that the striatum was really excited to the sugar water across all age groups. Most interesting
difference was between teens and adults. ​Galv​án displayed a Graph of Magnitude of activation - how
excitable the brain was between teens and adults. The teenagers were much more excited about the
exact same stimulus and region of the brain as adults. When associated with ratings of sugar, only
the teen group is where people showed a greater response in the brain, showing that they liked the
sugar more. ​Galv​án states that in teenagers when the brain gets something it likes, it will make you
think that it’s better. Again, I was reminded of vaping and smoking, and how the increase in
stimulation can lead to addiction. ​Galv​án continues to states that in future circumstances, the brain
will encode that information and remember you liked it, so it bais your decisions towards more
rewards, which is what happens in adolescence.
To ensure it wasn’t specific to sugar, ​Galv​án’s team gave people what they liked the most -
money. In this experiment, they brought in a new group of teenagers, adults, and kids around the
ages of 7 to 10. They found again that part of the brain that was most responsive was striatum.
Galv​án showed yet another graph of the average activation of the brain. On the graph, you can see
clearly that the teens were more reactive to money than adults. ​Galv​án acknowledges that you can
argue because teens have less money, they liked it more. However, that is not the case. Children
probably have even less money than teenagers, but the teenagers still showed an exaggerated
response when compared to the children. This analysis shows that there is something really special
about the adolescent brain. There is a sharp increase in sensitivity to rewards and novel info from
childhood to adolescence and a sharp decrease from adolescence to adulthood. This probably has
something to do with the prefrontal cortex as it is starting to “come online” as you go into
adulthood and regulating emotional responses to rewarding information.
But what does this mean for teenage behavior and everyday life? ​Galv​án states there are
three take-home points: the teenage brain is constantly changing, even at this moment, the teenage
brain is responsive to the environment, and the teenage brain gets really excited about rewards,
emotions, and new experiences. ​Galv​án predicts that as we continue to conduct more of this
research, we will learn how to take advantage of the sensitivity of the brain during adolescence to
generate new ideas and promote creative thinking. Perhaps we’ll learn that taking risks and seeking
out rewards are really adaptive behaviors in many contexts that lead to good decisions and help
individuals navigate the often challenging and intimidating transition from childhood to adulthood.
Galv​án encourages her audience to savor the excitability of the teenage brain, the new people we
meet, and the adventures we take.

Source
What adolescents (or teenagers) need to thrive | Charisse Nixon | TEDxPSUErie,​
YouTube, 05 May, 2016,​ ​https://www.youtube.com/watch?v=S05PBOIdSeE​.
 Research Assessment #10
March 6th, 2020

Subject
Diabetes and Pregnancy pt. 2

Analysis
In order to expand my knowledge about pregnancies and diabetes, I decided to find a
video and analyze the information stated in the video. In this specific video, Dr. Neale, a
specialist in Maternal and Fetal Medicine, answers common questions regarding pregnancies
and diabetes. The first question that is discussed in the video is if diabetes makes a pregnancy
higher risk. Dr. Neale responds that diabetes is actually dangerous for pregnant women
because of multiple organ systems. Diabetes can affect the heart, which can lead to ischemia
within the heart. It is also normal that during pregnancy, there is a physiological change in the
heart where it increases blood volume by about 50%. This excess blood must then be pumped
into the placenta so that the developing baby may be fed. However, if you have cardiac disease,
this can cause problems with the circulation of blood. Furthermore, diabetes can also affect the
kidneys. Dr. Neale goes on to say that glucose has multiple functions in our bodies. With a baby,
it can act as a growth hormone and increase the size of the baby if the mother is facing diabetes.
This increase in size can make it very difficult to deliver the baby vaginally, meaning the baby
must be delivered through C-Section. Furthermore, glucose has an impact on the tissues of our
bodies. So far scientists know that mothers with diabetes that are expecting, their babies are at
an increased risk of having structural problems, especially in the spine and cardiovascular
system. Though not confirmed, it is hypothesized that this can be due to the way the increase in
glucose attacks the baby’s tissues and how it impacts the development of these tissues. Later on
in the video, Dr. Neale is asked how diabetes is managed during pregnancy. Dr. Neale states
that if a patient takes care of her diabetes properly, this doesn’t mean that she will not have a
good pregnancy outcome. The key component, as she states, is maintaining euglycemia. This is
making sure your blood sugar is in good control and that any end-organ damage has been
assessed. Dr. Neale also goes on to state that with a multidisciplinary team, which can be made
up of a general obstetrician, maternal-fetal specialist, endocrinologist, and, most importantly,
the patient, there is certainly a chance of having a good outcome with diabetes. However, it is
also crucial to come pre-conceptually for a consultation to understand what it means to be
pregnant with diabetes and allow their physician to properly take care of them. Lastly, the
video ends with the question of if gestational diabetes goes away after birth. Dr. Neale answers
that if a woman has gestational diabetes during her pregnancy, somewhere along her lifetime,
she will have a 40% chance of having diabetes. Of course, it will not happen right away, but
there are higher chances at some point in their lifetime. This is important to know, Dr. Neale
continues, because cases of obesity have been increasing in the United States, gestational
diabetes has also been increasing linearly. It’s important for patients to know that when they
come back for their postpartum visit, they should have a screen to see whether they have
diabetes. If that is normal, they should also know that throughout their lifetime, when they’re
not pregnant anymore and they go to visit their primary care physician, they should be
screened for diabetes regularly throughout their lives.

MLA Citation
Diabetes and Pregnancy (Q&A),​ YouTube, 7 Jan. 2013,
https://www.youtube.com/watch?v=Ss55W3WTqPQ​.
 Evidence of Learning #4
March 18th, 2020

Subject
Changing Times and Experiences

Analysis
Up until this point, I would say I have lived a decent life. I have a house, a mother who cares
for me, warm meals and showers, and much more that I will ever be grateful for. In this
environment, I never would have imagined what I would do if the worst-case scenario came to
reality. It is also in this environment that I learned that life is always unpredictable.
Near the beginning of this year, there were multiple cases of the coronavirus, or COVID-19,
in Wuhan, China. This caused panic because multiple senior citizens in the city had already become
infected with the disease. This led the Chinese government to act in order to prevent further spread
of the virus, including building two hospitals. Along with this, multiple discussions were brought
about discussing travel in China. Seeing as the news does not strike interest in me, I mostly ignored
the news about the virus. Of course, I felt sympathy for those in China and those infected with
COVID-19. However, seeing as I had multiple tasks related to academics and prepping for college,
the topic slipped my mind and I continued with my schedule. Unknown to my consciousness, the
virus did not stop in China. The virus soon became prevalent in China’s neighboring counties, such
as South Korea, Japan, and India. In fact, the virus outstretched its hands outside of Asia, reaching
Europan countries like Italy. It was not until COVID-19 reached the United States did I became
conscious of the virus. Seeing as the cases were located in California, I was cautious but kept
reminding myself not to panic since it was not in Texas. It was ironic that the thought that kept my
mind at ease soon came to fruition. Not only were there cases of COVID-19 in Texas, but they were
also located in Frisco itself. This caused a great impact not only on me but my classmates and
friends as well. Acquaintances that would typically venture to different countries or cruises with
their families locked themselves inside their homes. At first, I thought nothing of it. I assumed that
all would be resolved after Spring Break and life would resume itself. I would return to school, my
friends and I would laugh about the recent events, and I would once again become a normal Senior
in high school. But, yet again, life is never predictable. Once the news came out about that Spring
Break would be extended one more week, I had conflicted feelings. On one hand, I would be able to
sleep in and catch up on any movies or TV shows I have missed. On the other hand, this was another
sign that life would not be “returning to normal.” Of course, I could not actually sleep in because of
eLearning, but I wondered if extending Spring Break was actually a blessing or curse. While I
contemplated this question, my life began to drastically change. Of course, I now had much more
time to spend with mother and my siblings. This meant I could make up for all the times I was busy
with other tasks. However, my mother soon developed what she labeled “momorona virus” (going
insane due to extended exposure of chaotic children) and deeply wishes that school will open soon.
I have also had chances to chat with my friends over phone calls and check up on their well being
and status. These changes do not seem negative because I have been relaxing around my house
while allocating time for school work. Despite this, they are still odd and foreign to me.
Seeing as COVID-19 has impacted my life and those around me, it will take time before I can
habituate. Currently, everyone is unsure about the future of our schools and multiple events, such
as prom or graduation. Though people are changing plans and putting their effort to stop this virus,
the future is cloudy. Despite this, I always remind myself to stay rational and calm. In worrying
times, it is easy to lose sight of your reasoning and hoard toilet paper due to peer pressure.
However, it is best to remember facts from fiction and maintain an alert, rational state of mind.
These changing times have taught me new lessons and tested my patience, but I only hope that a
safe and bright future is soon to come.