Hodges' Model: Welcome to the QUAD: June 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

Tuesday, June 30, 2015

Triplanetary HOME ?

I didn't make it HOME to PLANETARY last evening. I hope it will be shown again.

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




Ack: Triplanetary

Sunday, June 28, 2015

Non-Cartesian points, opposing corners and capital redux

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"I felt

capital Patient?

Patient capital?

 in the corner,"

senior NHS figure said of recent top level meetings discussing the financial travails and sliding performance of the provider sector. ... The delineation between these two camps is becoming clearer. ... p.3 

Source: McLellan, A. (2015) Leader: Modernisers must cut the deficit to keep their side of the deal. Health Service Journal, 3 June. 125;6449:p.3.

See also:
Capital 'p': Patient, Person, Person-centred, Personhood

Thursday, June 25, 2015

Capital 'p': Patient, Person, Person-centred, Personhood

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

capital Patient

Patient capital

Whenever financial markets get hyperactive - the norm rather than exception over the past three decades - we hear calls for "patient capital" that can fund long-term investment in the productive capabilities that are essential for a prosperous economy. ...
The problem is not just "short-termism" but more fundamentally value extraction that far outstrips contributions to value creation, with financial interests, including top executives, reaping gains that should go to taxpayers and workers.
For the sake of stable and equitable growth, it is time that these real patient capitalists lose their political patience, and demand fundamental economic reform. p.24.

Lazonick, W. Why patient capital is running thin, Armchair Alphaville, FTMoney. July 26/July 27 2014: p.24

Wednesday, June 24, 2015

GRADE CERQual, Reflection, Mixed Methods and Threshold Concepts

On leave this week and as per a previous post I attended the GRADE CERQual workshop last  afternoon. It was a very helpful exercise, a presentation and some group work. ...

I've now 5000 exploratory words on Threshold Concepts with Hodges' model and bringing in prospective research methodologies. The final module of Part 1 beckons (reading, reading...) and this work will help and might be worthy of publication. I'm just adding some other points from the following sources:

Knight, S. (2015) Realising the benefits of reflective practice. Nursing Times; 111: 23/24, 17-19.

I can cite the above as reflection is never far away in theory, practice and students on placement. Is there is a role for Hodges' model? I believe there is and Collins et al further demonstrate the need as nurses evidence reflection on their professional reading for revalidation from April 2016. Collins writes (my emphasis):

Reflection should be undertaken using a recognised model as this adds structure and provides direction. The model used should be chosen by the individual and influenced by a number of factors such as ease of use, understanding and ease of flow when writing. Models without these elements will give the writer a negative experience of the reflection process (p.14).
Collins, G. et al (2015) Using reflection on reading for revalidation. Nursing Times; 111: 23/24, 14-16.

The final paper for now:

Evans, B., Coon, D., & Ume, E. (2011) Use of Theoretical Frameworks as a Pragmatic Guide for Mixed Methods Studies. Journal of Mixed Methods Research, 5(4), 276-292.
DOI: 10.1177/1558689811412972

- begins with a quotation:
A mixed methods way of thinking is an orientation toward social inquiry that actively invites us to participate in dialogue about multiple ways of seeing and hearing, multiple ways of making sense of the social world, and multiple standpoints on what is important and to be valued and cherished.
—Greene (2008, p. 20)

The paper refers to maps, conceptual and theoretical frameworks. H2cm is a map and a conceptual framework, but not a theoretical framework; unless theory is implied (instantiated) in its structure?

Evans, Coon, and Ume (2011) write:
Clearly, such frameworks could assist with navigation in mixed methods studies consisting of concurrent or sequential investigations, facilitate integration of methods in at least one phase of the inquiry, and provide a map for combining the what with the why to gain a multidimensional understanding of causal mechanisms. Utilization of such frameworks could, then, fit snugly into Tashakkori and Creswell’s (2007) recent definition of mixed methods: “Research in which the investigator collects and analyses the data, integrates the findings, and draws inferences using both qualitative and quantitative approaches or methods in a single study or program of inquiry” (p. 4). (Evans et al. p.278)

Researcher's are by definition forced to adopt a methodological position and argue it; defend it too! I'm not advocating for something else, but for Hodges' model this is akin to being pressed to hear the Song of the Sirens and suffer the consequences. This model does not want to be tied to the mast.

It is the mast and sail.

Hodges' is mixed methods incarnate - out of the box, in and between them:

Service Centered-Person Centered
Health-Well Being-Disease

Tuesday, June 23, 2015

Monday, June 22, 2015

Healthcare: Reserved spaces to be comic-al

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Psychiatric Tales

The Bad Doctor

c/o Amazon.co.uk

Wednesday, June 17, 2015

Hodges' model as a Leitbild framework

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(to ensure, process, distribute,
use, maintain, use,
and preserve human service demands)


ECOLOGY (as Nature)

related activities*

distribute   'hard systems'  use




'soft systems'




ensure (assure)

Image and reference:
Klug, H., 2012. An integrated holistic transdisciplinary landscape planning concept after the Leitbild approach. Ecological Indicators 23, 616–626. doi:10.1016/j.ecolind.2012.05.019

“A Leitbild (pl. Leitbilder) is a summary statement describing a desired and releasable future state for a specific issue or spatial unit, which takes account of the primary objectives and drivers in a holistic and integrated way. All present knowledge is used to balance future constraints and demands from social, economic, cultural, political and environmental perspectives. Therefore, a commonly accepted Leitbild projects a specified trajectory for the future spatial structure, distribution, utilisation, condition and development of the socio-natural system. It provides a set of guidelines that shape actions, and a framework within which the impact of particular developments can be judged and socially negotiated.” p.617.

Friday, June 12, 2015

Sharing of Knowledge: Culture, Community, Conceptual Spaces and Economics (Gärdenfors)

"Culture, in the form of interaction between people, may in itself generate constraints on conceptual spaces. For example, Freyd (1983) puts forward the intriguing proposal that conceptual spaces may evolve as a representational form in a community just because people have to share knowledge (Freyd 1983, pp. 193–194):

There have been a number of different approaches towards analyzing the structures in semantic domains, but what these approaches have in common is the goal of discovering constraints on knowledge representation. I argue that the structures the different semantic analyses uncover may stem from shareability constraints on knowledge representation. [. . . ] So, if a set of terms can be shown to behave as if they are represented in a three-dimensional space, one inference that is often made is that there is both some psychological reality to the spatial reality (or some formally equivalent formulation) and some innate necessity to it. But it might be that the structural properties of the knowledge domain came about because such structural properties provide for the most efficient sharing of concepts. That is, we cannot be sure that the regularities tell us anything about how the brain can represent things, or even “prefer” to, if it didn’t have to share concepts with other brains.
Here Freyd hints at an economic explanation of why we have conceptual spaces: they facilitate the sharing of knowledge." p.17.

From: Gärdenfors, P. (2004) Conceptual Spaces as a Framework for Knowledge Representation. Mind and Matter. Vol. 2(2), pp. 9–27.

Wednesday, June 10, 2015

More Human - istic?

subtitle: Hey! ... Steve, Tories, Labour, Liberals, Greens, DoH... over here!

More Human by Steve Hilton
            INTERPERSONAL  SCIENCES              
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Saturday, June 06, 2015

P( l ) AY: Spot the difference?

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Nurses get 1% pay rise

MPs should get 10% pay rise, says regulator

NHS Pay Review Body (NHSPRB)

Independent Parliamentary Standards Authority (IPSA)

BBC Radio 4: World At One 5 June 2015 clip Mark Field: "Many of my constituents wonder how it is that any MP could live on £70,000 a year"

Yahoo Finance: Sky News - UK Wage Growth Jumps To 2.7%

Definitions of: 'independent', 'upwards', 'downward', 'vocation'.

Source: link - The Guardian, and various media.

Wednesday, June 03, 2015

Medical history - I

Hostius Pamphilus. Rome. Tablet of stone [Photo: PJ Musei Capitolini]

Hostius Pamphilus. Rome. Tablet of stone. 
Gaius Hostius Pamphilus, a doctor of medicine, freedman of Gaius, bought this memorial for himself and for Nelpia Hymnis, freedwoman of Marcus; and for all their freedmen and freedwomen and their posterity. This for evermore is our home, this is our farm, this our gardens, this our memorial.
Frontage 13 ft., depth 24 ft. [ http://www.attalus.org/docs/cil/epitaph.html ]

C(aius) Hostius C(ai) l(ibertus) Pamphilus / medicus hoc monumentum / emit sibi et Nelpiae M(arci) l(ibertae) Hymnini / et libert{e}is et libertabus omnibus / poster{e}isque eorum / haec est domus aeterna hic est / fundus h{e}is sunt horti hoc / est monumentum nostrum / in fronte p(edes) XIII in agrum p(edes) XXIIII [ http://db.edcs.eu/epigr/epi_einzel_en.php?p_belegstelle=CIL+01,+01319 ]

Prezi: Slave doctors in Rome

Monday, June 01, 2015

Rich Pictures - rich pickings?

Seeking conceptual anchors I've often thought of Hodges' model as a rich picture. Reading to complete my latest module and add to the threshold concepts draft I came across:

Berg, T., Pooley, R. (2013) Contemporary Iconography for Rich Picture Construction. Systems Research and Behavioral Science 30, 31–42. doi:10.1002/sres.2121

There are several points with implications for h2cm and future work. From the abstract:

The RP is a diagrammatic means of identifying differing world views with the aim of creating shared understanding of the organization. The RP has predominately been used as a freeform, unstructured tool with no commonly agreed syntax.
Our research suggests that the RP requires structure to become a contemporary knowledge elicitation device. p.31.
The application of rich picture is quite specific within soft systems methodology [SSM], but there is much to learn here. Let's use the abstract as a template:

Hodges' model could be a diagrammatic means of identifying differing personal care needs, with the aim of creating shared understanding of person-centred care aims and co-created health literacy which whenever possible includes the patient and carer.

Hodges' model provides a structure but one that is nonetheless freeform. You could say the coastline is mapped, but only to a degree. I have already likened Hodges' model to a cognitive periplus. A coastline is clearly definable: initially (it is also fractal). For a ship as in years of yore where can it go? Can it turn inland, to new discoveries (and disciplines)? Is this an estuary with a navigable river? Can the ship find a way out to a new sea through this strait? Even if the ship hugs the coast navigating potentially treacherous waters when newly found? Does this flexibility in Hodges' model arise because it is in effect templatized (axialised)? I have often wondered about my concluding that the user of Hodges' model wants to have their cake and eat it too. By this I mean h2cm is simplistic and so it is dismissed by many, but it can serve complex purposes once populated. By deriving the care domains from the structure, h2cm provides conceptual spaces within which users can orchestrate the concepts pertaining to a particular situation, or context.

Back to paper: there is no syntax as yet since there are no designated icons for Hodges' model. There are many sources and libraries including possibly a subset of RPs, the Noun Project too.

Berg and Pooley write that: RP requires structure to become a contemporary knowledge elicitation device. There is a problem here in what we mean by contemporary, given how long RPs have been around. Of course the same applies to h2cm, hence my efforts. Can we, dare we be more ambitious?

From the paper itself:
This holistic methodology [SSM] uses the rich picture (RP)... p.31
Hodges' model is a holistic methodology that combines threshold concepts, conceptual spaces...!?

More specifically Berg and Pooley write:
Avison and Fitzgerald propose that there is an unwillingness to engage in the rather lengthy requirement gathering process of the RPs and further suggest that management want to avoid political issues that could arise. In certain hierarchal organizations, it is suggested that the RP does not appear ‘business like’, and there is a lack of credibility with the approach (Daellenbach, 1994). p.32.
Judging from the graphics in the paper much of the 'political' may be interpersonal-relationships, but this will inevitably also refer to interdepartmental and interdisciplinary wrangling. Hodges' model gets# politics. H2CM includes into its structure a POLITICAL domain. If we expand Berg and Pooley's observation could this account in part for the failure of so many IT projects and the need for socio-technical approaches? Computers feature quite highly as one of the most repeated icons in RPs (graph on p.35). There is also a striking similarity between Hodges' model and RP in the simplicity I referred to previously. Within the 'organization' and the hierarchy (even if levelled to pubescent bumps) there remains a need for efficiency (accounting for time), formality and being 'business-like'.

I suspect that for some people, depictions of RPs and Hodges' model are fine on the training room flipchart paper. Once the turn-is-given and the evidence is there to see on the A1 page then to expect more: time for drawing, reflecting, concept mapping, meeting of hearts and minds, problem solving... is a stretch of credibility for some. It may be that as Berg and Pooley do not refer to vocabulary, so often this is the stumbling block as there is no shared vocabulary. It may be close, but differences remain and technology waits for no organization.

Hodges' model attests that meaning comes from several sources and we need to listen in quadrophonic at least, and all before any pencil is licked.


# Gets is used here in two senses: The model (I mean of course the user) gets politics  in terms of access to the political ramifications of whatever... This bare structure may not be doing anything but it has potential. Concepts, such as, consent, capacity, deprivation of liberty, 7-day follow-up, safeguarding, information sharing... can then be encountered in practice, learned and eventually integrated.
Students (and others) can get political as an activist
; be that as a critical thinker, advocating for healthcare, or within union and professional bodies.

See also (a dated paper and still an excellent read):
Shaw, Mildred L.G., & Gaines, Brian R. (1989) Comparing conceptual structures: Consensus, conflict, correspondence and contrast. Knowledge Acquisition, 1(4), 341-363.

The SSM - RPs community should look f/w with relish to the advent of VR. This can surely overcome many of the difficulties highlighted in Berg and Pooley (2013) and address the point above about contemporaneity. Icons will be ready-to-hand (gesture, look, thought!...): the challenge then becomes shared VR, but then this is central to its purpose.