Jones Act(s)

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

Jones act - to highlight to the worlds of education, health - social care, informatics, global health, politics, ecology...	... a way and means to step beyond comfort zones, familiar ports of call and turn the stones to assure and grasp the whole, the big, the rich picture ...
... to see people in their context, their environment, what matters to them, their families and communities. To see and acknowledge past, present and envision a new future individually and collectively.	Jones Act - "which requires that only American-flagged ships carry goods between domestic ports." p.22

 

See also previously on  W2tQ:

https://hodges-model.blogspot.com/search?q=periplus

My source:

Briefing: Joe Biden's economic plans, The pragmatist, The Economist, 3rd-9th October, 2020, 437:9214. pp. 19-22. 

Erasmus+ Survey - Invite

Dear INHWE Members,

We need your help with a research proposal we are submitting soon. If you teach elements of leadership or IPE in your role then we would be delighted if you could spare 3 minutes of your time to complete the following survey: https://inhwe.org/erasmus-survey (Deadline: end of play Tuesday 27th October)

Also, you might be interested to know that we are now producing results (with more to come later this week) for our StoryAidEU project which you can view and download here: https://storyaid.eu/results/

If you would like to know more about our research projects or how to partner with us, feel free to get in touch.

Best wishes,

David

David Smith

Director | www.inhwe.org International Network for Health Workforce Education

 

The 'transdisciplinary' (and other forms - in Hodges' model?)

A transdisciplinary model of practice

"This model is different from the multidisciplinary and the interdisciplinary models, where occupational power, status and professional recognition are key issues.

‘Representatives of different disciplines are encouraged to transcend their separate conceptual, theoretical and methodological orientations in order to develop a shared approach to ... building a common conceptual framework’ (p.1351). Rosenfield.

The shared philosophical perspective that is created by all disciplines and public representatives enables practitioners to provide integrated services. All team members, including consumers, parents and community members, are involved in discussion, consensus building, decision making and implementation of the plan or the programme. Team members work together to explore different theories, conceptual frameworks, concepts or approaches that might be in the best interest of the patient, family and the community. This sharing of knowledge enables team members to learn from one another. Boundaries between disciplines are loosened, and overlap between services is recognized and incorporated into the plan, so that patients and families benefit from using similar but different resources in increasingly more practical and more meaningful ways." (p.1351).

Rosenfield, P.L. (1992) The potential of transdisciplinary research for sustaining and extending linkages between the health and social sciences. Soc Sci Med. Dec;35(11): 1343-57.

cited in:
Anderson, G.W., Monsen, R.B., Rorty, M. V. (2000) Nursing and Genetics: a feminist critique moves us towards transdisciplinary teams, Nursing Ethics, vol. 7, 3: pp. 191-204.
https://journals.sagepub.com/doi/10.1177/096973300000700302

Threshold Concepts Special Edition - Int. Journal of Practice-Based Learning in Health and Social Care

Dear Members

We thought you would want to know about the Threshold Concepts Special Edition Journal which has just been published in the International Journal of Practice-Based Learning in Health and Social Care.

 

The Journal is free-to-read. The articles explore:

• Ways in which threshold concepts can inform understanding about how students become practitioners in their chosen profession.
• Thresholds associated with practice placements and practice-based learning.
• Ways in which the threshold concepts framework may inform development of curricula in healthcare disciplines.

They are all available on http://e-learning.coventry.ac.uk/ojs/index.php/pblh/issue/view/31

 

Please share the link with anyone else who may be interested.

 

Best wishes

 

Hilary and Linda

                                 

 

Website:  www.plymouth.ac.uk/peninsula    We hold an Athena SWAN Silver award from the Equality Challenge Unit

My source:
Threshold Concepts in Health and Social Care special interest group

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
Peter

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.

individual

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

group

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.

The Willis Report on Nursing Education [ ii ]

The Willis Report -

https://www.macmillan.org.uk/documents/newsletter/willis-commission-report-macmail-dec2012.pdf

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]

Book review: Quinn's Principles and Practice of Nurse Education [ 6th Edition ]

I owned the 3rd edition of this book and approached the publisher for a copy of the most recent, which is gratefully received. This review is quite delayed in fact, I've a few other reviews to get on with too.

From the outset while a book on nurse education, the text serves general students and practitioners in education in parts one and two. I completed my PG Cert almost twenty years ago and this book would be an asset to current students (see the content listing for parts 1-2 below). There are many technical concepts within what is a comprehensive text; for example, there are 54 index entries related to 'assessment'.

Much of the book's value is accentuated for readers here in the UK. Here is an established and high quality textbook that provides a UK perspective. As a 7th edition the references for each chapter are expansive taking in key historical sources and more recent publications. There are many illustrations in the form of flowcharts and figures. Following each chapters references, suggested further reading is provided. Review exercises at the end of chapters serve the added purpose of sign-posting content. The information architecture and design of the book makes for a logical, clear and readable experience. Even if the content were lacking, which it is not, the book is fairly substantial at 550 pages. The book is well produced, the paper quality (lending to the weight) and the binding works! Yes, the binding serves to secure the pages and works well when the book is opened flat. This is an obvious requirement and yet so frequently it is a struggle.

As to specifics: Parts 1 and 2 are a welcome refresh. The discussion on thinking and critical thinking are sufficiently detailed and of special interest (pp.58-66) to me. Intuition receives a 'nod' with a dedicated paragraph on p.66, sufficient no doubt to give our students a troubling 'prod' in their future and ongoing careers? I wonder if pages 51-59 might benefit from review and more references, acknowledging what is a well-executed historical account within part 1? An educational challenge I am pondering at present is that of values within nursing. How can we teach these (including the 6Cs)? Amongst what is new to the book is that it meets NMC standards. It would be easy to produce a list of omissions, but I would expect to see abuse, safeguarding, whistleblowing, and vulnerability in this book. How students encounter these concepts and subsequently learn about such sensitive topics must be critical to their insight (life experience to date), self-awareness and skills development. Reflection is very well represented throughout the parts of the book which encourages my efforts with Hodges' model.

I mentioned the book's relevance to current PG Cert Education students and must add that I have referenced the text in a paper for my current studies in technology enhanced learning. On this front the publishers clearly recognise the extended potential of additional e-learning services through CourseMate. An Instant Access Card accompanies the book. Part 4 extends this relevance to continuing professional development and lifelong learning. Chapter 11 is very helpful for its practical dimension, describing placement learning, link lecturers, mentoring and the challenge of the failing student. Sometimes ESOL - English for Speakers of Other Languages is a factor and 'language' could be noted more specifically. This is not a matter for student selection but should be ongoing and would also be addressed within the public (equality and diversity pp.129-134). In mental health I am acutely aware of the importance of communication skills. This comprehensive treatment includes supervision, sign-off mentoring, practice educators plus triennial review.

If I have a bad habit it's looking through the index of a book and asking: What might I expect to see here? The bad aspect is it's tantamount to reviewing by exclusion. And I'm already guilty too. The book fulfills its purpose and does not need to reflect the whole nursing curriculum. But... I would have hoped to see 'open source', Massive Open Online Courses (MOOCS), the role of mobile e-learning, learning management systems - Blackboard is mentioned but not Moodle. Perhaps there are commercial considerations at work? 'Threshold levels' are mentioned but not 'threshold concepts'. This is understandable as we are only just on the cusp of a special interest group in health and social care (more on that to follow I hope). For those like myself who are on the service-practice side chapter 8 is insightful, on marking and providing student feedback beyond the student-mentor relationship. There is constructive support and encouragement for new lecturers and advice on quality and evaluation in higher education.

A year ago I reviewed an even larger textbook on Nursing Informatics, and in truth informatics still has a long way go to prove itself to most of the nurses I meet and work with. I keep doing the sales pitch and this includes acknowledging the student's awareness of coding and classification, or  pointing them (usually 1st and 2nd years) to this knowledge. Health Informatics is represented in the text and the glossary (pp.539-541). In terms of professional accountability it is vital that as nurses we are aware of what happens to the data we help to create. Students are also the researchers of tomorrow and as such they need to be aware of diagnostic schemas and ongoing issues in this area. It is true that this is the curriculum and yet the authors do right by including classification in the context of the library, and coding as in the types of fractures (figure 3.6, p.77); some mention of coding and classification within nursing and healthcare surely seems justified?

Nursing has struggled to make itself visible - for the right reasons for many years. As we look to our students to resolve this are they to rely upon some form of reverse-magic* alone? Despite this proverbial bee, I can highly recommend this book - it is a great resource.

1 Introduction: Nurse Education in the university and the clinical setting
PART ONE – THE PSYCHOLOGICAL BASIS OF TEACHING AND LEARNING
2 Adult learning theory
3 Perspectives on teaching and learning
PART TWO – LEARNING, TEACHING AND ASSESSMENT
4 Curriculum theory and practice
5 Planning for teaching
6 Teaching strategies
7 Assessment of learning
8 Student feedback / feed-forward
9 Teaching study skills
10 Evaluation
...

*It is of course customary to marvel at the visible becoming invisible.

HUGHES, S.J. & QUINN, F.M. (2013) Quinn's principles and practice of nurse education. 6^th Edition. Andover, Hampshire: Cengage Learning.

I would like to extend my thanks to Mr Matthew Keown at Cengage for my copy of this book.
 

Interprofessional Collaborative Care Will Be Key to Meeting Tomorrow’s Health Care Needs

Maryjoan Ladden, Ph.D., R.N., F.A.A.N., Robert Wood Johnson Foundation Senior Program Officer

A little over a year ago, the Institute of Medicine’s landmark Future of Nursing: Leading Change, Advancing Health report put forward a series of recommendations for transforming the nation’s health care system. Among them was a call for a system in which “interprofessional collaboration and coordination are the norm.” That’s no simple assignment in a system that often operates in silos, from schooling through practice. But a number of innovators around the nation are already making headway.

Their work is the subject of a new policy brief from the Robert Wood Johnson Foundation, part of its Charting Nursing’s Future (CNF) series. The brief delves into what the IOM recommendation means for health care systems, offers case studies of several collaborative care models already in place, and examines the implications of the recommendation for how we train nurses and other health care professionals.

According to the brief, Implementing the IOM Future of Nursing Report–Part II: The Potential of Interprofessional Collaborative Care to Improve Safety and Quality, the “silo” approach must soon give way if we are to meet coming health care challenges. For example, chronic conditions are increasingly common—not surprising given an aging population. But the health care system is poorly structured to provide the sort of coordinated care and preventive services needed to give these patients quality care while reducing costs. Some health care institutions are gearing up for the challenge.

• In Boston, where Harvard Vanguard Medical Associates developed its Complex Chronic Care (CCC) program, primary care has become interprofessional, collaborative and noticeably more efficient. Each CCC patient is assigned a nurse practitioner (NP), a registered nurse with advanced education and clinical training. The NP consults with all the patient’s subspecialists and incorporates their guidance in a single plan of care. The NP then manages and coordinates that care, connecting patients to nutritionists, social workers, and other professionals as needed. The model is dynamic, allowing patients to meet more or less frequently with the NPs and their primary care physicians, who remain responsible for the patients’ overall care.
  

• In New Jersey, the Camden Coalition of Health Care Providers is “revolutionizing health care delivery for Camden’s costliest patients,” according to the brief. These individuals, sometimes called super utilizers, typically rely on hospital emergency rooms for care. Not surprisingly, such patients account for an outsized share of local hospital costs, often with diagnoses that would have been more properly handled in a primary care setting. The Coalition developed its Care Management Project to reduce these unnecessary emergency room visits by treating patients where they reside, even when that means treating them on the street. A social worker, NP and bilingual medical assistant work as a team to help patients apply for government assistance, find temporary shelter, enroll in medical day programs and coordinate their primary and specialty care.
  

Training the Next Generation to Collaborate

Of course, the silo effect usually begins in school. In May 2011, six national education associations representing various health care professions formed the Interprofessional Education Collaborative (IPEC) and released a set of core competencies to help professional schools in crafting curricula that will prepare future clinicians to provide more collaborative, team-based care. Such efforts are already under way at a number of institutions.

• Maine’s University of New England has developed a common undergraduate curriculum for its health professions programs in nursing, dental hygiene, athletic training, applied exercise and science, and health, wellness and occupational studies. The curriculum includes shared learning in basic science prerequisites and four new courses aimed specifically at teaching interprofessional competencies.
  

• In Nashville, Vanderbilt University is also pursuing an interprofessional education initiative that unites students from the medical and nursing schools with graduate students pursuing degrees in pharmacy and social work at nearby institutions. Students are assigned to interprofessional working-learning teams at ambulatory care facilities in the area.
  

• The Veterans Health Administration (VHA) is piloting an interprofessional initiative, as well, focused on preparing medical residents and nursing graduate students for collaborative practice. As part of the initiative, five VHA facilities have been designated Centers of Excellence and received five-year grants from the U.S. Department of Veterans Affairs. Each VHA Center of Excellence is developing its own approach to preparing health professionals for patient-centered, team-based primary care.
  

• In Aurora, Colorado, the University of Colorado built its new Anschutz Medical Campus with the explicit objective of creating an environment that promotes collaboration among its medical, nursing, pharmacy, dentistry and public health students. It features shared auditorium and simulation labs, as well as student lounges and other dedicated spaces in which students from different professions can pursue common interests such as geriatrics in a collaborative fashion.
  

Such initiatives are clearly the wave of the future, if only because the pressures of caring for a larger, older and sicker population of patients in the years to come will drive efforts to identify efficiencies. In the words of Mary Wakefield, PhD, RN, head of the Health Resources and Services Administration, “As the health care community is looking for new strategies and new ways of organizing to optimize our efforts—teamwork is fundamental to the conversation.”

...

My source: Matt Freeman (PRS)