Perception (from the Latin perceptio, percipio) is the organization, identification, and interpretation of sensory information in order to fabricate
a mental representation through the process of transduction, which sensors in the body transform signals from the environment into encoded neural signals.[1] All perception involves signals in the nervous system, which in turn result from physical stimulation of the sense organs.[2] For example, vision involves light striking the retinas of the eyes, smell is mediated by odor molecules and hearing involves pressure waves. Perception is not the passive receipt of these signals, but can be shaped by learning, memory and expectation.[3][4] Perception involves these "top-down" effects as well as the "bottom-up" process of processing sensory input.[4] The "bottom-up" processing is basically lowlevel information that's used to build up higher-level information (i.e. - shapes for object recognition). The "top-down" processing refers to a person's concept and expectations (knowledge) that influence perception. Perception depends on complex functions of the nervous system, but subjectively seems mostly effortless because this processing happens outside conscious awareness.[2] Since the rise of experimental psychology in the late 19th Century, psychology's understanding of perception has progressed by combining a variety of techniques.[3] Psychophysics measures the effect on perception of varying the physical qualities of the input. Sensory neuroscience studies the brain mechanisms underlying perception. Perceptual systems can also be studied computationally, in terms of the information they process. Perceptual issues in philosophy include the extent to which sensory qualities such as sounds, smells or colors exist in objective reality rather than the mind of the perceiver.[3] Although the senses were traditionally viewed as passive receptors, the study of illusions and ambiguous images has demonstrated that the brain's perceptual systems actively and preconsciously attempt to make sense of their input.[3] There is still active debate about the extent to which perception is an active process of hypothesis testing, analogous to science, or whether realistic sensory information is rich enough to make this process unnecessary.[3] The perceptual systems of the brain enable individuals to see the world around them as stable, even though the sensory information may be incomplete and rapidly varying. Human and animal brains are structured in a modular way, with different areas processing different kinds of sensory information. Some of these modules take the form of sensory maps, mapping some aspect of the world across part of the brain's surface. These different modules are interconnected and influence each other. For instance, the taste is strongly influenced by its odor.[5]
The handling of subcultural diversity is increasingly viewed as an essential part of health care management in connection with quality improvement [1,2]. This article discusses doctor and nurse perception of co-operation in hospitals based on survey data from both professions working together in the same hospital wards. Nursing and medicine are inseparably intertwined in hospital care. Patient outcomes are contingent upon the physicians skills in diagnosis and treatment, as well as upon nurses continuous observations and their skills in communicating the right information to the right
professional partner. Good hospital care depends on a system that secures continuity of information and inter-professional collaboration [35]. Patient outcome has been shown to depend on inter-professional collaboration in intensive care units [6]. Also, hospitals where nurses report good co-operation with physicians have been described as magnet hospitals with lower nurse turnover and higher job satisfaction [7,8]. However, the relationship between doctors and nurses in hospitals has never been a symmetrical one. The two professions look at co-operation from different perspectives of patient care, different levels in the status hierarchy, and different sides of the gender gap. The field of doctor nurse collaboration has been sociologically attractive as it condenses the classical discourse of profession, power, and gender. Since the origin of the study of professions [9], the interface between health professions, and particularly that between doctors and nurses, has been extensively analysed by sociologists [1015]. Steins studies from 1967 [12] and 1990 [13] document a major changes in the nurses attitudes to what he calls the doctornurse game. From discretely evading their subservient status in the late 1960s by influencing decision-making by observations, experience, and information, but in a way that did not challenge doctors positions, they explicitly claimed a say in clinical decisionmaking in the 1990s. An important background for this change is the nurses strategy for building their own academic profession [16,17]. Emancipating nursing implicitly changed the nursing perspectives [18] making them more independent of the medical profession. One consequence is an increasing gap between the professions in the daily clinical work. Sociologists have provided major contributions to the understanding of the dynamics of hospital professions, yet this knowledge has remained theoretical and academic. During the last decade, however, a more practical perspective of collaboration in hospital has been applied. These studies focus on inter-professional co-operation as a condition for effective health care, they are related to patient outcomes, and most importantly, they are published in journals read by health care professionals. One example is the British Medical Journal, which addressed doctornurse co-operation in a special joint issue with the Nursing Times in April 2000. The main message was the need to start from scratch. Zwarenstein and Bryant [19] asked Whats so great about collaboration? answering We dont really know. Celia Davies [20] suggested that co-operation does not necessarily mean using each others resources to reach common ends, it may just be a term used to describe the fact that people of different professions are employed by the same organization. If so, the very concept of co-operation may conceal divergent meanings. One study of two Dutch hospitals reported discrepancies between role concepts and expectations of nurses and doctors [21]. Nurses were more critical towards doctors than vice versa, but neither party lived up to the expectations of the other party. Another study, of four hospitals in the UK and two in Australia [22], concluded that doctors and nurses have somewhat different conceptions of hospital work. Doctors viewed clinical work more as an individualistic venture than did nurses, who considered clinical work more as a collective undertaking. In Norway, three empirical studies have touched upon the issue. Their main message is that inter-professional co-operation is not experienced as a big problem in Norwegian hospitalsat least not by male doctors. Yet, the findings indicate, like those of the Dutch and Commonwealth
studies mentioned above [21,22], that differences in professional culture may affect interprofessional co-operation. A national survey of Norwegian doctors conducted in 1993 showed hospital doctors reporting favourable impressions of doctornurse co-operation [23]. Fewer collaboration difficulties were reported by male doctors, older doctors, and psychiatrists. Differences were, however, undramatic and the general impression was friendly co-existence. Based on the same survey of Norwegian doctors
