- 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

Thursday, June 29, 2017

Paper - draft: Threshold Concepts and Hodges' model [ii]

Following on from post [i] the progress on the draft will be pursued and tested through our student nurses on placement. I'll get a second opinion from two colleagues on whether this is worthy of the student's time who span 1st year to final. I'd wondered about this last year and am glad I left it. I'll explain Hodges' model in a specific session, then threshold concepts and offer the draft for them to read and comment upon both as an individual and together when we can discuss threshold concepts and what the paper is trying to say. The team are starting lunchtime educational sessions for CPD so I will get my name on the list.

From the outset in 1988-9 essential ingredients in my thinking about Hodges' model have included concepts and reflection. They simply cannot be ignored. I've also thought about deliberation and argumentation. Having listed these in the paper the idea of 'CARD' occurred to me, prompting a tweet:

CARD as a whole is not included in the draft. Hodges' model can help our reflections, but as ever this rests with the user of the model and the situation. A few decades ago I might have come up with the following:

humanistic ----------------------------------------- mechanistic
group - population




In truth even back then I would, without hesitation, say that each one of these can be ascribed across all of the care domains not just one. In an attempt to idealise things, however; conceptualisation and reflection would have been viewed as mental, cognitive and private activities. 
Argumentation would, dealing with logic and reasoning also figure in the intra- interpersonal domain but something would have nudged me to the political domain (you need a forum, or room for an argument?). 
Deliberative suggests something about a group activity, social with a consensus-seeking political angle (mechanistic - you see?). 

Now I have arrived at the following [ which was not necessarily inevitable ;-) ]:





Argumentation is systematic argument, the use of logic and reasoning to make decisions.
(A mistake I have made is to consider 'the system' and 'systems' as a thing that is inherently mechanistic, clockwork-like. This is a very limiting view that I must address.)

Reflection is not just how it is conducted, but what is reflected upon. The various frameworks for reflection that are brought into play by students following a critical incident, for example, are a mix of objective and subjective details. The criteria on what should be reflected on - often includes who, what, where, when, why and how. The informational value of the facts of what happened, the student's thoughts and feelings, how they have changed, learned from the experience are diminished if (confidentiality duly factored in) when (date, time) and where# are omitted. This information loss extends to 'greatly diminished' and a potential legal liability if this is part of a formal record.

Conceptualisation is an individual ability (I assess individual patients for this), but it is in the outcome of this ability that we find its power: language and shared meaning and understanding.

Deliberative is allied with politics, as in deliberative democracy; plus discussion and consultative.

# Whether GPS, post code, basic location - home, hospital, context is often associated with place.

I'm not sure where this gets me, but there we go ...

See also:
Paper - draft: Threshold Concepts and Hodges' model [i]

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