- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Monday, January 29, 2007

Hodges model: Reading List?

From the few and much appreciated comments received thus far, Hodges' model is clearly being used by students and clinical tutors.

If h2cm were a taught module and part of a course then what texts and other resources would the reading list include?

Are there any books / thinkers that you would recommend, authors whose ideas are in sympathy with h2cm or themes that are an absolute must? Sometimes we also learn through difference and change. Is there an opportunity here to compare and contrast Hodges' approach with others?

Apart from a chapter in Hinchcliffe (1989) and other references, there is no substantive text or book on Hodges' model. If browsing your favourite bookshop you found the h2cm book, what would you expect to see in the contents? What chapter titles would be listed and could you contribute a chapter?

I look forward to hearing from you, whether by commenting to this post or mailing me at h2cmng @ yahoo.co.uk.

Many thanks.

Hinchcliffe, S.M. (Ed.) (1989). Nursing Practice and Health Care, [1st Edition only], London, Edward Arnold.

Friday, January 26, 2007

Hodges model: What is it? [4] A Periplus for Lifelong Learning

PeriplusAccording to Cunliffe’s (2001) book about the voyages of the ancient Greek explorer Pytheas, early mariners navigated using a text called a periplus. Providing some of the earliest recorded observational views of the world, the periplus described coastlines by landmarks, winds and topography.

Within care education h2cm acts as a periplus for learners, an aide memoir and reflective tool, a space to record those initial sightings and learning encounters. A map providing reference points for group discussion, engagement and debate. The model provides place holders for knowledge, the exact position, content and process of revision are not fixed. Hodges’ model provides the coastline in template form; the context defines the topography – the landmarks.

We would usually expect that learners maps will change more rapidly than the geographic coastlines, but for how much longer...

Cunliffe, B. (2001) The Extraordinary Voyage of Pytheas the Greek, Penguin.

Sunday, January 21, 2007

Podcast 2 - Must start work and THE comet!

I've just drafted 650 words that I hope can be used in a newsletter. With that done - bar some final edits - maybe I can start to think about podcast #2 (not that podcast #1 is top of the charts)?

This time I must make use of the software and not do it in 'one take'!

If you are South of the Equator I hope you've managed to catch sight of Comet McNaught? On this page of photos there (was) a 3D orbit java applet. This shows why it was difficult to catch in the Northern hemisphere - must be an amazing sight. With the weather locally - no chance!

Thursday, January 18, 2007

Hodges model: What is it? [3] The science of sailing...

Thanks Lorraine for your comment on Hodges' model: What is it? [1] - hope to hear more from you.

Like good weather and a pair of familiar lived-in walking boots Hodges' model should encourage exploration, but should it do more than that?


Policy, the health and social care literature and the media often refer to care pathways and the patient journey. A journey imposes cognitive and physical demands on the individuals concerned and involves the interplay of various forces and the expenditure of energy.

Care pathways require negotiation, especially if everyone is truly unique and services and care delivery are person-centred. The patient journey has a start and end point: whatever the outcome. For all travellers there is no such thing as a free-lunch in energy terms.

So far Hodges' model has been described as a house of ideas, a sailing vessel and an interface. What next? Well there's more to sailing than meets the I-skipper!

You see setting sail there are four forces at work...

The FIRST is the wind of time that blows fair and foul, from tranquil, stillness and peace to unpredictable, chaotic and turbulent. Foul winds exact pressure on the rigging, the sails, the whole boat suffers: noise. Relentless pounding. Physical forces act on our bodies and the sails. The winds attempt to heel the boat over. We use SCIENCE to understand this force.

The SECOND force is that of the keel, which seeks to counteract the wind of time. Pushing against the water the keel provides ballast. In health and social care there is a social and POLITICAL contract at work, health and social care services are provided to help those buffeted and battered by the wind. Break this contract and all-aboard are imperilled. Check the charts, take a regular bearing. Reflect. Beware the false lights of the wreckers.

THIRDLY, the wind creates pressure on the sails, high pressure to the windward and low pressure behind. This difference in pressure draws the boat forward. This equates to the combined effects of groups of individuals, carers and volunteers and the wider SOCIAL community whose energies help the patient (and their family) to muster their resources, strengths and progress whatever the context (heading).

The FOURTH force is the friction borne by the yacht's surfaces and the water. Those who sail do so largely because of the interplay of this and other natural forces. Water. Wind. Salt. Friction lets us know we are alive. Friction helps bring us into being, but this friction can hurt especially over time. See worthiness is tested, confidence wanes. Psychically isolation challenges us. The loneliness of the long distance runner. Sailing alone - true courage. We must go on drawing on INTERPERSONAL resources, with occasion to reach to others. To reach our destination.

WHO is at the helm? Well, I'll leave the 5th domain for you to decide as we all endeavour to travel in peace...

Thursday, January 11, 2007

Health: myths about the developing world (Amazing graphics) TEDTalks, with Hans Rosling

Another video presentation from TED 2006 - this time global health and visualization. We often assume there is no data for analyses...

Brilliant! 20 minutes well spent.

Wednesday, January 10, 2007

Hodges model: What is it? [2] It’s an interface...

A further response to the “What is Hodges' model?” question is that the model is an interface. We tend to think of the word interface as a modern invention, referring to an information solution or computer system aspect that conjures up hopes of qualities like ‘user-friendly’, ‘open’, ‘accessible’ and ‘uncluttered’.

2001 A Space Odyssey - Ape bone toolsOf course technology is not new, interfaces have been around for several millions of years, as realised in Clarke’s 2001. More recently, someone recognised the need for a H.H.I.: human-horse interface and reins were born (or emerged).

Just like the courage, patience and skill needed to manage horses, the same applies to sociotechnical interfaces realised in software (and hardware). If you don't listen and whisper and get it wrong, the rider could have the whip out, someone might be thrown and even if you do reach the finish line you’ll be chasing dust (even worse than that the dust may have settled!).

In the 1980s writing some (very BASIC) educational software (see, a,b,c below) on the Sinclair ZX81 and BBC microcomputer, this word interface even then demanded your attention. Interfaces present many challenges; they should be fit-for-purpose, safe! (health, air-traffic control...), logical, structured and organised (usually), also self-explanatory or self-describing if possible. In short intuitive and many would now also demand some 'intelligence'.

Those four perspectives from the house of ideas I mentioned the other day, that were combined into the ship or yacht's sails is a powerful analogy for another reason. It's an example of economy of effort – otherwise why bother? Bringing those four disciplines together folds space and time. We can start to relate items in one disciplinary domain (perspective) with others. Previously disparate disciplines are suddenly more accessible. (I'm not sure if that last line is a sentence, but never mind isn't accessibility a feature of interfaces?)

This is NOT just about creating an overview. In interface speak it can be fairly easy to create a quick and aesthetically pleasing 'front end'. If that's what is needed fair enough, but Hodges' model - while simplistic in appearance - is much deeper than that.

globe & compassWith reins in hand and sails trimmed our forebears shaped history, with a compass in mind the possibilities for travel are endless.

a) CAPA: COMPUTER AIDED PATIENT ASSESSMENT Sinclair ZX81, advertised in Nursing Mirror c.1982
b) THE NURSING PROCESS - CAL program BBC Micro published by Open Software Limited (OSL) 1983
c) HAEM (see 4 below) BBC Micro - (OSL) 1984
1 CAPA: Computerised Patient Assessment Nursing Times (BBC micro program - OSL) 1986 82, 36 1500
2 Thunderbirds are Go? (Impact of technology in society - disasters, macro-engineering) Popular Computing Weekly 1988 500
3 Modems are Cheap, it's the phone bills that hurt Popular Computing Weekly 1989 500
4 HAEM: Computer Aided Learning: Creating A Program (Described production of a BBC micro program on blood and blood groups) Nursing Times 1989 85,5 1500
5 Information Technology is Good For You!
(Effects of information technology)
IT in Nursing, BCS-Nurs. Specialist Grp. 1989 1,1 2000
6 Creating a Community Mental Health IS (Creation of a community mental health resource centre - a
multidisciplinary research project)
IT in Nursing and Paper at BCS NSG Conference 1990 2,4 2000
7 The Ins and Outs of a small mental health IS (et al.) as per 6 HC91 Conference Paper 1991 2000
8 Nursing: All in the mind (and machine?)
(Models of nursing and computing)
British Computer Society -Nursing Specialist Group Conference Paper 1992 2000
9 Community Mental Health: IT in the Buffer Zone
(co-author: David Beckingham)
Healthcare Computing 92 Conference (Poster) 1992 500
10 Computerised Models of Nursing
(Data types in nursing - opportunities and problems)
Conference Paper
1993 2000
11 Using a Semantic Network to Represent Nursing Terminology
(project for B.A. (Hons).
Supervisor J Kirby - Medical Informatics Group)
Conference Paper
1993 2000
12 Nursing: All in the mind (and machine?) IT in
1993 5,4 2000
13 An Enthusiast's View of CAL
(Problems in production of CAL - Simulation effects of Nuclear
Weapons - conversion of GWBASIC to BBC BASIC from BYTE (with original author's permission - J Fanchi))
IT in
1994 6,2 2000

Sunday, January 07, 2007

Hodges model: What is it [1] house of ideas or ship?

Of all the questions about Hodges' model “What is it?” probably tops the list. One response - that Hodges' model is a house of ideas is very appropriate. Unlike the play school depiction of a house, with a door and windows 1-4 on the front, this model house is 3D. It comes with windows that provide a vista of the four points of the compass. For Hodges these are the four perspectives required to fully apprehend a given situation whether past, actual or future.

Like any home, people can arrive there by various routes. There is more than one entrance (health & safety!) and the further you have travelled the greater the welcome and the desire to explore. Rather than continuously running from room to room to combine the views (data, information and knowledge) Hodges' model can help you take these separate and distinct views and combine them. They are combined by virtue of the two continua INDIVIDUAL-GROUP and HUMANISTIC-MECHANISTIC that impose structure on the model. Rather like a mast when you think about it. So, you could say that in addition to the four horizons, Hodges' model also provides the rigging for a four-ply sail. Where would you like to go?

Tuesday, January 02, 2007

comment - Hodges model in Learning Disability

Denise M posted a comment [Wednesday, December 27, 2006] which I've repeated below with a reply:

"I an currently writing up my literature review for a MSc and is using a combination of Brian's HCM and Maslow's hierarchy of needs model as conceptual framework to structure the needs of people with profound learning disabilities and multi-sensory impairment (PLD and MSI). I am ever so grateful for the numerous resources on the HCM. Like yourself, I was first introduced to the model when I was doing the ENB 806 in 1986. I have used the model in my career as community LD nurse and nurse tutor and has found it useful in assessing people with LD and in teaching as a framework for discussing aspects of care. I normally reference the chapter in Hincliffe's book. I would be happy to discuss what I am doing and when I have completed the writing up, to evaluate the effectiveness of the HCM as a conceptual framework, in combination with another theory."

Denise M
Hello Denise - Happy New Year!

Your comment is very timely at the start of a year that I hope will see increased interest in Hodges' model and other 'global' approaches. Learning Disability is a key care group, one in which Brian Hodges also trained, practised and taught. I am very interested in discussing your work. At a recent NW (England) RCN Older People Nursing Network meeting a speaker highlighted the unique problems and solutions for this client group, in terms of the possible development of dementia, parents getting much older and subsequent care.

To contact me you will find an e-mail address (see biog page for tel:no.) on the main website.

With the Serres-Hodges paper now submitted, I can think about the future of the website and explore the possibility of using a proper Content Management System. (Recommendations most welcome.) So if you or anyone else have any possible material on your work please get in touch. It pleases me no end to hear that the existing references / resources on the site are a help. If I'm honest though, while much of the current content does need to be accessible, some should be 'archived' to make way for contributions that are practice / research based.

Since starting this blog things do seem a bit more dynamic. It is practitioners, students and tutors like you Denise, and the efforts of others such as Claire, Rachael and Shannon who can shape the future of Hodges' model. For Hodges' model to really arrive I would very much like to add the public (patients and carers) and the global health community into the mix. Hodges' model is something that can by its nature engage and involve everyone. The Learning Disability community MUST be included, within day-to-day service provision of course this group can slip through the net.

Your next step about evaluation sounds quite challenging, but fascinating in terms of what methods you may employ and the results that might be revealed. I and many other people would I'm sure be very keen to learn more. If I can assist in some way - just let me know, happy to comment on your text if you wish...

Thanks for your interest and to the others who have picked up the flag. It makes the effort at this end really worthwhile...
Good luck and I look f/w to an e-mail or chat with you soon.