- 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, July 08, 2019

Inaugural Scottish Threshold Concepts Conference: TCs in Action [ii]

After Prof. Land's keynote and the previous post on 'work-as-X' I can see the value of the academically agnostic - neutrality of Hodges' model in terms of the spaces it affords. It can be used to reflect as a safe space or problematic, troublesome or unsafe. As an example, consider the task of reflecting upon the current state of residential and nursing home care?

individual - self
humanistic ----------------------------------------------- mechanistic
group- population

Next reflect upon residents and sexuality within these care environments. This could be from any perspective, or even work through several: resident, a new care worker, other team members, staff nurse, home manager, family member, GP, or inspector. ...

Prof. Land raised the matter of extreme vulnerability and experience of Syrian refugees. Individual and Population are forced through a threshold that is catastrophic: that of identity. The scale of this event is being stressed as an urgent issue that must be accorded attention in parallel with physical relief

Perhaps, it is not just individuals who must encounter and pass through a threshold in their learning, their liminal journey. The problems we face demands that disciplines must find the disciplinary bridges that will enable them to solve the interdisciplinary and even transdisciplinary problems we face.

Geopsychiatry is a key bridge here. Research has determined that trauma can be intergenerationally transmitted. Governments, aid organisations and policy makers must take this into account and not just respond with physical relief. Unfortunately, the imbalance that is a lack of parity of esteem in general physical and mental health has its global-scale analogue in humanitarian crises and conflicts, especially those that displace populations.

Prof. Land referred to eduChaos and this is where 'lived experience' is found: not just in 'real time'.


Uncertainty, kept repeating itself Prof. Land describing the work of Ilgen et al. (2018) and the need in (and through) education to find comfort with uncertainty. The challenge of this is acute in medicine and mental health care as Ilgen's work highlights. The previous post's nod to box-ticking and elsewhere the quest that is the 'comprehensive record' stresses at point of initial encounter - the initial assessment, perhaps to the detriment of an outcome oriented approach?

The question posed of "how professionals can manage the uncertainty arising from complex, ill-defined problems with conflicting assumptions, evidence and opinion" [another slide] is not just concept-bound as I tend propose. The terrain of Hodges' model can be used to map wells of uncertainty that help make the more certain, concrete data - information stand out. It helped me to see the situatedness of this discourse repeated. The definitions of 'uncertainty' and 'certainty' attributed to Ilgen et al. (2018) are a helpful adjunct to information science based sources.

In subsequent parallel sessions I switched rooms in  trying follow what was most relevant. First was,
'Where have all the empathetic professionals gone? An exploration of empathy as a threshold concept for the helping professions'. This provided a multidisciplinary insight into social work education, with overlaps that included safeguarding and child protection. Jayne Lewis's format had us engaged, well me clearly as I've no notes or photos. The talk of empathy made me recall twitter and student nurses remarks on their placements (accepting too that 'No news is good news') and student-mentor-placement relationships. If the practice/placement environment is stressed/contested for a variety of reasons, to what extent does this influence empathy role models, student experience and study of TCs? Do researchers need to record the emotional and political 'temperature' as a baseline measure?


Next, on the programme; TCs, medical students and population health learning. From an acute angle (I was late arriving) Hothersall explained a study with a small sample, and yet findings that (as ever) call for more study, with implications for teaching in the lecture theatre, as a whole, in practice and relevance for me.

I'm sure there are many threshold concepts in public health and public mental health (to ensure inclusion). Even if specialty posts in public health are filled 2013-2016 (and amid recruitment pressures) I wonder if there is an issue for students (generally) in the perception of  'public health' and their respective discipline? Is there something in the old debate of pure - applied disciplines? Do medical and other students feel they must focus attention on the 'hard' learning rather than the 'soft' fuzzy concepts that public health encompasses? What has been the impact of the most recent series of re-organisations?


Of course, given the big themes identified, for me, the first lecture 101 should include a conceptual framework that can readily incorporate the (socio-)technical, (psycho- socio-) political, conceptual and much more.

The presenter also informed us that a paper is in press: 'The Clinical Teacher'. These findings of concepts that were troublesome for students appears to support my '101' role for Hodges' model - but then I would say that ...

Tierney's Exploring threshold concepts in the scholarship of teaching and learning was a rich source on a model of scholarship (Trigwell, et al. 2000) with tables also drawing on Perkins (1999, 2006) that I must try to follow-up as with Visual Art as navigation of affective thresholds: implications for the classroom.

The afternoon keynote discussed The dual development of professional identity as physicians and mentors, with Profs Hokstad and Kvernenes. Using a narrative reading (Reismann, 2008) the content and findings to me call for simultaneous duality in identity, the medical and the non-medical (practitioner - interaction with the patient and their family), clinician and mentor.

Being struck by the thought (on science, knowledge, holism - whole / part distinctions) of Goethe in the past it was a marvellous to attend Jonathan Code's session; Mind the Gap - Ontological discontinuity as threshold concept. I imagined Hodges' model and several leaves in various stages of growth.

It creates an overhead for conference organisers, but video recordings would be a great help. I think there is one more short post on this conference.

Ilgen, J.S., Eva, K.W., de Bruin, A., Cook, D.A., Regehr, G. (2018). Comfort with uncertainty: reframing our conceptions of how clinicians navigate complex clinical situations.
Adv Health Sci Educ Theory Pract. Nov 2. doi: 10.1007/s10459-018-9859-5.

See also:
Inaugural Scottish Threshold Concepts Conference: TCs in Action [i]