Hodges' Model: Welcome to the QUAD: March 2015

- 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

Saturday, March 28, 2015

A survey: Nurse Lecturers undergraduate students, e-learning, e-portfolios, innovation in reflective skills

For the latest module in my TEL studies at Lancaster University Researching Technology Enhanced/Networked Learning, Teaching and Assessment I'd wondered about a focus group combined with a survey. The constraints remain non-trivial doing this part-time and from outside academia - in practice. This past week I've also attended the final residential of part 1 (more on this soon). Returning to the module's study, the focus group isn't going to happen and with Easter upon us this is not the best time to engage in studies, but of the course this applies for all students.

As the blog nears its ninth birthday in several posts I've mentioned the many assumptions that are exercised in certain items. Here I am in Wigan (WN4), Lancashire (all flat caps, pies and Northern Soul) and also looking South, East and West with global health a key concern. The same applies to my experience of nurse education as a mentor and sign-off mentor. I'm making what may be some very large assumptions based on the studies so far, work with students on placement and as was pointed out, nursing and health make up a small part of the strategic adoption and influence relating to an institution's learning management system [LMS]. Does anyone have any figures on this?

The assumptions are that many lecturers do not have the time, or possibly the skills to make full use of the features and potential of the LMSs. So, I am wondering about the scope for innovation to support our student's reflective skills and practice; that is, beyond written essays and forums on the LMS. Is this symptomatic of feature bloat as per office applications? Does this make the 'walls' higher? These are issues I can investigate in the brief literature review within my report submission.

So I am pursuing a qualitative study with an interpretive stance. If you are nurse lecturer for undergraduate student nurses, or other courses and including social care I would greatly appreciate your assistance with the survey already posted in the sidebar. This is an experiment too in terms of using Survey Monkey for the first time and a basic account. I'll look at Bristol Online Survey in future.


Many thanks

Innovation & Change: Pick an edge, any edge...

humanistic ------------------------------------------- mechanistic
...  "change
starts with
the activists
 and it
starts at the

"Very often our change management approaches aren't very sophisticated. We'll pretend this change is an objective process when it can't be." 
Endless transformation using the same processes is another well trodden path. p.23




 "... there is no clearly understood model
for how services can adapt
to changing population needs." p.23

Gbadamosi, N. (2015) Turn the tables on top-down change, Health Service Journal, 16 January, 125, 6430: pp. 22-23.

Friday, March 27, 2015

Book: Madness in Civilization - A cultural history of insanity

humanistic ------------------------------------------- mechanistic
Need for asylum
Book cover: Madness in Civilization
physical health

stigma, sense making, community care,
social history

power, institutionalised care, custodial,
parity of esteem, 'asylum'

Image source:

Wednesday, March 25, 2015

A cheap post... the cost of Zero?

Sometimes things become blurred
- unresolved -
things do not touch as they should,
lines of communication and care
are compromised; things fragmented...

humanistic ------------------------------------------- mechanistic



5 minutes travel time client to client

Zero Hour Contracts

BBC Radio 4 Today: Care workers not paid for travel between patients, 24 March 2015.

Image sources:
5 minutes -

Zero as coins: original image -

Friday, March 20, 2015

Book: "Touch" - Line of sight, light touch, looking for (care) assurance if not truth

Sometimes things become clearer
- resolved -
when they touch,
even if as lines they cross
and all is rendered more complex...

humanistic ------------------------------------------- mechanistic

Learning of self and other
greetings, friendship, relationships, intimacy
the POLITICS of touch

See also:
Reading between the lines...

2011... looking ahead: Line of sight - Lines of insight

Image source:

Thursday, March 19, 2015

Reading between the lines...

n.b. This post my not display in some browsers, older versions of IE - please upgrade if needed.

Tuesday, March 17, 2015

Healthcare: theDataMap [subjects, agents & agencies] c/o Harvard University

humanistic ------------------------------------------- mechanistic

patient, self, client

physician, nurse, allied health professional, social worker...
public health, 

payer, insurer, provider, government, tax payer,
(corporate social responsibility)

theDataMap - Copyright © 2012-2013 President and Fellows Harvard University

Monday, March 16, 2015

The Willis Report on Nursing Education [ III ]

See also:
The Willis Commission on Nursing Education [i]
The Willis Commission on Nursing Education [ii]

Having related (in part ii) some of the skill sets within the technical papers to Hodges' model what next? Well, instead of the 2x2 table, below I've included a screen capture of the quads page [no longer available]. This indicates the potential conceptual scope of the four care domains of Hodges' model. If the skill set listing by Watts and Gordon (2012) is succinct, the quads page is anything but. It might however drive home, the need for the Willis report and the educational challenges for nursing and other healthcare disciplines. Another common element here with Willis' findings are some of the original purposes that Hodges' model can address:

  • the theory - practice gap (Watts and Gordon, 2012, p.7)
  • curriculum development 
Just for the moment imagine picking up the curriculum? Yes, picking it up; all of it.
Can you feel it? Can you? OK well, try this (odd - Find Wally-like?) exercise:
  1. Visit the quads page.
  2. Print the page (in black and white).
  3. Make a cup of your preferred beverage.
  4. Cross out what in your opinion is NOT part of the nurse curriculum.
    • Most of these items are learned through our being socialised and during formative education (when available)?
  5. Outcomes are certainly in vogue, so what are yours in completing steps 1-4? Any surprises, frustrations; did you find the plumbing - kitchen sink and all...?
  6. If you feel there is something - important - missing please let me know.
humanistic ------------------------------------------- mechanistic
Former web page - Indicative content of Hodges' model

You have to hand it to educationalists and policy makers who wrestle with curricula. The very word could almost be some disorder of the posture, such are the contortions the curriculum demands. What to include, what as a consequence to remove. One thing not included in quads.htm is the hidden curriculum. Additional complications are no doubt many; I'll add just one. Such are the recruitment challenges that a Trust setting out to train their own student nurses, that is through non-Health Education England places (Hazell, 2015).

The word 'innovation' is all over the media, the HSJ, and this blog. As I read the recommendations of Willis (see emphasis in first post), the technical papers and Hodges' model I can't help but wonder about history and the potential here - and now. Especially in terms of supporting learners in their acquisition, practice and delivery of compassionate care or caring behaviour.

View the full report here (1,105kb)

Hazell, W. (2015) Lancashire trust to train its own nurses, Health Service Journal, 16 January. 125:6430, p.15.

Hazell, W. (2015) First self-funded nursing course launched to tackle shortage in NW, Nursing Times, 7 January.

Sunday, March 15, 2015

The Willis Report on Nursing Education [ ii ]

The Willis Report -


includes a series of technical papers one of which Pre-registration nurse education: Overview of themes from literature 2010-2012 outlines Skill Sets. I could relate Hodges' model to the identified skill sets in this paper using the 2x2 HTML table, but perhaps there's another way by considering the skills sets:

  • ICT skills/health informatics 
  • Literacy and numeracy skills
  • Life support and airway management 
  • Infection prevention 
  • Genomics
  • Bioscience 
  • and Learning disabilities
Using these I can also explain how they both help and hinder the case for Hodges' model and illustrate the complexities of nurse education.

The subjects of genomics and bioscience can be placed quite reliably in the sciences domain. Life support and airway management are pretty explicit in their physicality. In an emergency you need to act. The individual's physiological (mechanics) functioning is compromised. This must be assessed urgently and compensated for. The model was also created with people living with learning disability very much in mind; consider the reference to the individual, the family, the increasing relevance of the POLITICAL domain to this client group and their families? ICT skills are primarily directed at intrapersonal knowledge and skills, physical and virtual spaces, drawing on the sciences. These domains are the preserve of the individual, in terms of learning, experience and sense making.

The biggest challenge for Hodges' model is context. Context is rarely rectilinear, try as we might it springs out of the intended boxes and categories we try to stuff it into. We very quickly have to acknowledge the social and political dimensions of ICT skills and health informatics. For example, the importance of information governance, confidentiality, legislation, policy and training provision. Returning to the learning disabled individual, they must contend (often as a community) with ongoing social stigma and the socio-political matter of having access and opportunity to education, buildings, facilities and technologies. Access then is not just a matter of cognition and physical mobility, movement and proximity.

If Hodges' model encourages us to place concepts in boxes
(the care domains)
 it also forces the realisation of the need 
to think outside the box. 

To relate, to associate with the domains adjacent - 'next door'. Ultimately can we integrate the care concepts providing a conceptual scaffold for person-centred, holistic care? There is in effect a cognitive rule, a heuristic - that is not necessarily very expensive cognitively or temporally, but can (I believe) pay huge dividends in assuring the quality of care. It runs as follows:

For any given care concept in learning
 consider how it applies and relates 
to each of the care domains.

See also:

The Willis Commission on Nursing Education [i]
The Willis Commission on Nursing Education [iii]

Saturday, March 14, 2015

The Willis Commission on Nursing Education [ i ]

from the commission website:

The Willis Commission has now published its full report into the future of nursing education.

See the key findings from the report below (with my emphasis)
  • Patient centred care should be at the heart of all pre-registration nursing education and continuing professional development.
  • There were no shortcomings found in nursing education that could be directly responsible for poor standards of care or a decline in care standards.
  • Nurses and their organisations must stand up to be counted on the challenge of poor care and loss of public confidence in order to restore professional pride.
  • Nursing education needs to imbed patient safety and dignity as a top priority.
  • Better evaluation of and research into nursing education programmes is necessary to ensure a programme that is fit for purpose.
  • The future nursing workforce requires nurses to work in a variety of settings.
  • Recruitment campaigns need to widen their diversity in order to encourage the widest, best possible range of applicants.
  • Health care service providers must fully support nursing education.
  • Universities need to recognise nursing as a practice and research discipline.
  • Attention needs to be paid to developing a strategic understanding of the nursing workforce as a whole and as a UK-wide resource.
View the full report here (1,105kb)

Previous posts:
The Willis Commission on Nursing Education [ii]
The Willis Commission on Nursing Education [iii]

Friday, March 13, 2015

"The Five Phases of Psychosis" - a 2:38 minute film by Jim van Os

Jim van Os is a consultant psychiatrist and Professor of Psychiatric Epidemiology at Maastricht University, in The Netherlands.

I wonder, is it possible to conceive of an approach (model of madness) and response system sophisticated enough to allow us to jump straight from Phase 2 to Phase 5 in the model the film describes?

This would mean a jump straight from the 1:00 second mark to the 2:00 second mark in this film and miss as much as possible of the messy, often horrific and, arguably, mostly iatrogenic, two stages in between?

For a more detailed discussion of one possible model of madness that could support the development of a response system, here is a 15 minute film by Jim van Os - Connecting to Madness, TEDxMaastricht

Jim is a psychiatric epidemiologist and has co-authored 198 journal articles since 2013 according to Google Scholar.

He most recent work is published in a leading Dutch newspaper this week, co-authored by other leaders of Dutch psychiatric organisations. In this Click hear, outlining the case that schizophrenia does not exist at http://www.nrc.nl/handelsblad/van/2015/maart/07/laten-we-de-diagnose-schizofrenie-vergeten-1472619 (download and use Google Chrome for instant translation).

Part of this opinion has translated for us by Margreet de Pater, who wrote:

Their declaration includes 12 points
  1. There is no clear difference between psychotic and other human experiences.
  2. 15 % of adolescents have psychotic experiences and 80% of these disappears during development.
  3. 3.5 % of people have psychotic experiences that need help, their diagnosis is psychosis susceptibility syndrome, which is different for every person.
  4. 20 % of these people have an unfavorable prognosis.[with the right help people with psychosis do bounce back]
  5. A psychotic experience is often a reaction on trauma, a life event, disappointment, discrimination or humiliation. The thesis that it is a symptom of an underlying brain disease is scientifically not correct, and leads to a negative view [expectation] of recovery.
  6. Everyone has his own special mix of psychotic symptoms, the classifications which psychiatry makes in schizo- family of diagnoses etc. is incorrect. [But everyone has a different mix of symptoms, and does not fit well in a diagnostic box.
  7. People with psychotic experiences need hope and a perspective. Recovery is a mental process. People need to cope with their psychosis susceptibility with help of a schooled person with lived experience and if necessary of a doctor and a therapist
  8. (These services should be there) From the very first moment
  9. Going back to own environment, work and school is most important also when there are still some symptoms, waiting for complete cure is counterproductive.
  10. Everyone with psychotic symptoms must be invited to talk about it, the theme of the psychosis is the key to underlying problems
  11. Everybody with psychotic experience must be offered psychotherapy
  12. Sometimes anti-psychotic medicines can be useful when experiences are too overwhelming, but they don´t cure.
They conclude that: Schizophrenia fortunately does not exist, psychosis does and is treatable

Best Wishes
Philip Benjamin
MHN BEd MMind&Soc
Chair, ISPS Australia


My source:

Thursday, March 12, 2015

Book: The Looting Machine

humanistic ------------------------------------------- mechanistic

     oil                diamonds       
   copper        zinc      iron
gold     nickel          platinum        silver...
"The products come through to London on planes and boats, and great oil tankers carry the fuel that drives our cars. The tankers are carrying valuable cargo and are kept to high standards. On the same seas approaching Europe, thousands upon thousands of African refugees in ramshackle boats sink and drown. There could not be a crueller contrast, and Burgis has the good sense not to present it in an alarmist way, but with an understatement that is far more powerful."

Stephen Chan, Poverty amid plenty, Life & Arts, FT Weekend, 7-8 March 2015. p.9

The Looting Machine
The Looting Machine

Book image:

Additional link:
Transparency International:

Monday, March 09, 2015

Ngrams: E-portfolios, nursing theory, models of nursing...: Do the lines run true?

For the latest module I'm looking at e-portfolios in nursing education and possibly wider afield. In the FT Weekend Life & Arts there is an extract -

Capitalism’s secret love affair with bureaucracy

- from David Graeber’s book: The Utopia of Rules: On Technology, Stupidity, and the Secret Joys of Bureaucracy published this week on March 12. It includes a graph from Google Books Ngram a word count through time of 'bureaucracy'. I'd read about Ngrams and tried them quite some time ago, but never used them. Now's my chance.

The graph below began with e-portfolio and eportfolio. I tried nursing e-portfolio... but these were not found. With conceptual framework the scale was disrupted. Adding models of nursing and nursing theory provided a frame that also nicely encompasses, at least in this rendering, conceptual space and threshold concepts.

At the risk of asking too much of the graph if not the source, we might be disappointed that models of nursing is not running concurrent with e-portfolio and reassured that nursing theory has waned but is 'still up there'. This is to forget though that the count for e-portfolio here is general not nursing specific.

Ngrams are another tool and a dynamic one no doubt, when the API is utilised, the data downloaded and words are re-examined over time. In answer to the title's question, I do not believe the lines do run true but this is about nursing and e-portfolios.

Sunday, March 08, 2015

International Women's Day: Health, Employment, Equality, Philosophy...

c/o Pan American Health Organization

Did you know that a girl born today in the Americas can expect to live to age 79.5? Nearly four years more than she could two decades ago.

Happy International Womens Day! March 8!
Progress in women’s health has made great strides in the last decades, but there is still work to be done to make health for all women a reality!
We can ‪‎make it happen!

¿‪Sabía Usted que una niña que nace hoy en las Américas puede esperar a vivir 79.5 años? Casi cuatro años más que hace 20 años.
¡Feliz ‪Día Internacional De La Mujer! 8 de marzo!
Durante las últimas décadas, hemos avanzado mucho en mejorar la salud de las mujeres, pero todavía hay mucho que hacer para que la salud para cada mujer sea una realidad!
Todos podemos hacer algo!

Saturday, March 07, 2015

When does art prompt 'total internal reflection' ?

humanistic ------------------------------------------- mechanistic

Stichting Ambulance Wens

Related posts:
Woman says goodbye to beloved horse from hospital bed hours before she dies

Rijksmuseum Amsterdam - health in art : art in health

My source:
The Times, 7 March 2015, 71450: pp.38-39.

Photo source:

Let More Light In - Reflection

humanistic ------------------------------------------- mechanistic

'total internal reflection' 

tungsten oxide 
has a 
high refractive

The researcher's cells use iron oxide and tungsten oxide to do the light-capturing. Iron oxide absorbs visible light and tungsten oxide absorbs ultraviolet. Also tungsten oxide has a high refractive index. This means that light finds it hard to escape once it is inside a piece of tungsten oxide because it is bounced back and forth by a phenomenon called total internal reflection, increasing the chance it will be absorbed. p.78.

Solar Cells: Tiny Balls of Fire, The Economist, June 28th-July 4th 2014, 411: 8893, 78-79.

Additional link:
HowTheLightGetsIn 2015

Thursday, March 05, 2015

Hodges' model: Across the Humanities and Sciences Respond - React

humanistic ------------------------------------------- mechanistic

...to respond  
is to let relationship

To react
is to let the facts 

Tillmanns, Maria daVenza, (2015) The Need To Move Beyond Homo Faber, Philosophy Now, February/March. 106: p.14.