ii Editorial: Persistent Positive Change in Challenging Times ...

To Howden's editorial it's worth highlighting that Hodges' model is situated. So, whether the 'challenge' that is faced is individual, or collective Hodges' model can help to identify the issues, problems, strengths, opportunities, threats, where we are, where we would like to be and more. Surely, reflection, critical thinking is about confiming, or regaining our perspective, correcting our orientation or improving alignment and synchronisation with others? The time this entails, whether exercised on paper, or cognitively (yes, humans thinking is still an option) this is equivalent to a time-out even if momentary. This can be critical in clinical encounters, were emotions are raised, or there is risk of escalation.

So whether the challenge is personal, lived experience, bullying, finance, physical, or mental health, simulation (fidelity, testing), ethical ...; or collective (a team) - service and organisational change, major incident, policy, clinical or management supervision, whistleblowing, public / patient engagement, complaints and challenging relationships; Hodges' model is a tool (one of many) to call upon.

It could be the context causes you to focus on one or two care (knowledge) domains. Or, there is a need to step back in order to 'see' the big picture (integrated care, risk assessment, holistic care, psychosocial view ...) - the spiritual too.

While Hodges' model is simple, please consider this: there aren't many tools that can facilitate articulation and dissemination of the 'big picture' in a form that is (imho) readily transferable and translatable.

Howden, S. (2025). Editorial: Persistent Positive Change in Challenging Times. International Journal of Practice-based Learning in Health and Social Care, 13(1), ii-iii.

c/o Ridgway - assimilation & accommodation

An approach to testing and teaching

'Consider the problems of acquiring new knowledge; two ideas are particularly important. The first is that existing knowledge and conceptual structures affect the way that new materials are perceived and learned; the second is that new experiences bring about changes in our knowledge and conceptual structures. These two processes are referred to as assimilation (analogous to the way in which the stomach digests food, whose later structure cannot be recognized as being similar to its earlier structure) and accommodation (analogous to the way that the pupil of the eye adjusts itself different light levels). Biological analogies make it easier to understand these concepts but leave unresolved the question of when one accommodates and when one assimilates. In general, one accommodates (i.e. changes one's conceptual structures) when fresh knowledge provides strong challenges to what is in mind; so dramatic counter-examples to currently held beliefs, or coherent patterns in the world, which cannot be explained by existing beliefs are both likely to bring about accommodation. Assimilation (interpreting new events in terms of old ideas) can be made to work when the number of counter-examples to predictions made from old beliefs are rather low. It follows, therefore, that if misconceptions are to be remedied (i.e. the mechanism of assimilation is overcome and the mechanism of accommodation stimulated) a representative sample of questions in the domain of interest is unlikely to have the desired effect because the number of cases which violate pupils' misconceptions and which therefore  might cause accommodation, will be relatively small. To foster accommodation it is necessary to provide dramatic examples which violate current conceptions and to provide these examples in quantity. Examples which are most likely to be dramatic are those in which it is obvious to pupils that the results they are obtaining using particular misconceptions are at variance with what they 'know to be true' from everyday experience.' pp.46-47.

Jim Ridgway (1988). Assessing Mathematical Attainment. Chapter 3, Using Test Results.Windsor Berkshire. NFER-NELSON. pp.40-52. [Ack. length of quote - See also: https://www.nfer.ac.uk/ ]

Thanks to Lancaster Univ. Library.

Previously 'assimilation' : 'accommodation' : 'math'

h2cm: Globalization, Accommodation theory and Relativism (Grayling, 2010)

From A.C. Grayling's Ideas that Matter, 2010, Phoenix.

Globalization: p. 235-236.

A more neutral account of globalization describes it as the process of making things known, done, available or possessed worldwide - such as Internet access, telecommunications, medical knowledge and benefits such as vaccines, transport technologies, political ideas, art and music, books and much besides.

Grayling also explains how the increased distribution associated with globalization is unequal, hence the sense of injustice that is felt resulting in protest.

The health care domains model is concerned with making things known - helping to make knowledge available on a personal, group and family level. This is no Mercator projection, not even Peter's projection but it is a global map.

Accommodation theory: p. 3-5.

Accommodation theory states that when people talk to each, they adjust their behaviour and manner of speech to take account of (to accommodate themselves to) the topic, the circumstances, and the other people engaged with them in conversation.

There are many theories to explain how we communicate and thereby model(?) ourselves, others and the world. Imagine a doctor's surgery and the morning's clinical consultations, it is easy to envisage the role that accommodation routinely plays. The one-to-one conversation (dialogue, argumentation, debate) can be extended, and viewed as the combined chatter, the whole series of multidisciplinary Q&A with the breaks (the silences when we are listening!). Accommodation theory has proved of value in multiculturalism, especially on policy concerning immigration and integration. p.5

The care domains provide an ethnoculturally neutral space (it could be argued) for the accommodations that are demanded in the 21st Century. 

Relativism: p.433.

There is a distinction to be drawn between moral or cultural relativism, on the one hand, and cognitive relativism on the other. The former concerns the difference between cultures, or between different historical phases of the same culture, with respect to religious, social, and moral values and practices, that is, with respect to what might be called the 'superstructure' of the culture's conceptual scheme. Cognitive relativism concerns the 'infrastructure', the level of basic beliefs about the world, such as that there are perception-independent, re-identifiable and individually discriminable objects or events, occupying space and time, interacting causally, and bearing properties of various kinds.

Much is said of the games that people play. Whether the care domains model provides a game board that can accommodate both the super- and infrastructural conceptual levels is open to question. In the health career model the infrastructure level concepts are light - as we find that they reside in the upper part of the model: perceived, individually discriminable (INTRApersonal) objects occupying space and time (SCIENCES) with mass, weight, inertia. ... The political domain prompts access to values and how these shape the total conceptual landscape(s), the conversations and silences that go on there ...