Hodges' Model: Welcome to the QUAD: nursing education

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Showing posts with label nursing education. Show all posts
Showing posts with label nursing education. Show all posts

Saturday, January 30, 2016

Video: Concepts for Nursing Practice, Giddens



With an email seemingly lost I have registered and applied for a review copy of Gidden's Concepts for Nursing Practice. The 2e is published next month. I do hope for a positive response.

Gidden's approach, also proposed by others clearly has a great synergy with Hodges' model in concept-based learning and the learner's career. The most interesting aspect of this is to try to respond to the short-comings of a purely conceptual basis for curricula. I'm sure this is possible combining a pragmatic view of knowledge, an evaluation research design, threshold concepts and conceptual spaces with Hodges' model.

Giddens, J. (2013). Concepts for nursing practice. St. Louis, Mo.: Mosby/Elsevier.

Saturday, November 14, 2015

Student's intellectual and ethical development (Gyurko, 2011)

I need to trace out a theoretical basis for Hodges' model. The paper in this post provides a piece of the jig-saw. Hodges' model is a conceptual framework that can act as a starting grid for the ongoing intellectual, ethical and professional development of all students.

In a post to follow I have also found some insights to underpin the objective and subjective within Hodges' model...

individual
|
INTERPERSONAL : SCIENCES
humanistic --------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group
relativism

duality


multiplicity

commitment


Perry identifies themes or stages of experience, which cluster around nine positions that are classified into four broad categories: duality, multiplicity, relativism, and commitment (Billings et al., 1998). Duality views the world dichotomously as good–bad, right–wrong, or black–white. Those who make meaning from a dichotomous point of view do so with the belief that right answers exist for everything. With regard to learning, in this stage students simply seek the right answer. With multiplicity, students learn to honor “diverse views when the answers are not yet known” (Evans et al., 1998, p. 131). As students advance toward relativism, they begin to recognize that right and wrong and good and bad are not enough to deal with the situations of real life. In this stage, students learn how to look at specific situations in an abstract view and weigh information by problem solving (Evans et al., 1998). Finally, the movement to commitment occurs when “ethical development,” involving choices, decisions, and affirmations, is incorporated in one's lifestyle (Evans et al., 1998, p.133). (p.508)

Gyurko, C. (2011) A synthesis of Vroom's model with other social theories: An application to nursing education. Nurse Education Today, 31(5), 506-510. doi:10.1016/j.nedt.2010.08.010

Wednesday, September 25, 2013

Surveys, Nursing Education, Drupal and Webform

Just before heading to Drupalcon Prague I learned of a new paper by Gill et al.:

Using a web-based survey tool to undertake a Delphi study: Application for nurse education research

Background: The Internet is increasingly being used as a data collection medium to access research participants. This paper reports on the experience and value of using web-survey software to conduct an eDelphi study to develop Australian critical care course graduate practice standards.
Methods: The eDelphi technique used involved the iterative process of administering three rounds of surveys to a national expert panel. The survey was developed online using SurveyMonkey. Panel members responded to statements using one rating scale for round one and two scales for rounds two and three. Text boxes for panel comments were provided.
Collecting data and providing feedback: For each round, the SurveyMonkey's email tool was used to distribute an individualized email invitation containing the survey web link. The distribution of panel responses, individual responses and a summary of comments were emailed to panel members. Stacked bar charts representing the distribution of responses were generated using the SurveyMonkey software. Panel response rates remained greater than 85% over all rounds.
(in press)
The paper is interesting in combining surveys and an e-variant of the Delphi research method. Conclusions highlight the improved accessibility to experts and how ethics needs to keep pace with technical change and affordances.

Yesterday at Drupalcon there was a presentation on Webform:

Webform 4.0: Surveys in Drupal Improved




I've mocked up a enquiry form using Webform, but this session pointed to how the module can be extended for polls and contact forms. Based on Gill et al. and the eDelphi technique they explain this could be a really powerful combination.


Gill, F.J., et al., Using a web-based survey tool to undertake a Delphi study: Application for nurse education research, Nurse Education Today (2013), http://dx.doi.org/10.1016/j.nedt.2013.02.016

Saturday, June 01, 2013

Review: Philosophical And Theoretical Perspectives For Advanced Nursing Practice

If you are a miner for insight, a pearl diver for knowledge or seeking blue sky wisdom this book can deliver and sign-post in plenty through its references. In summary: this book is a history book that nods at futurology.

I had high expectations for the text, also anticipating an exacting read. After all, as a 5th edition this is a well established text. The expectations were not wholly realized, however; many of the papers are quite dated being published originally in the 1990s.

The book is an important collection and can certainly be regarded as essential reading for advanced nursing practitioners and those pursuing post-graduate nursing studies. Several chapters hail from the same journal publisher and perhaps - as a positive - this contributes to the readable and accessible style throughout the book. The text format and size are also easy to read. I found one spelling mistake within the index entry for 'diagnosis' p.387. In addition to the historical development in part 1 the book's division into five parts - 31 chapters in total - acknowledges the reliance on the past and from it appears from a previous edition the arrival of the 21st century. Apart from the current date of issue 2013 I cannot accurately place the most recent additions to the volume. The contents listing and preface are limited in this respect. Judging from the references they are not that recent. 2010 is one of the most recent references I could find, and this, the 75ed of Toby & Mariner.

Many of the papers are seminal and include an overview of particular aspects of nursing thought - analysis and synthesis. Unsurprisingly, there is philosophy and ethics in great abundance, together with ecocentricism, several forms of feminism, aboriginal peoples and their world views, evidence, health, beliefs, art, professionalism, research, patterns, advanced practice, theory and much more. The distinction between evidence based theory and evidence based practice is something of which all nurse students should be aware.

There is specific reference to Advanced Nursing Practitioners. There could obviously be some variation in how this professional group are considered as opposed to Advanced Nursing Practice. Having just returned from Belfast and the University of Ulster there is ongoing currency in McCormack's chapter 17 A Conceptual Framework for Person Centered Practice with Older People. While dated 2003 McCormack's work was emphasized at a recent conference in Ulster I was able to attend (and there are plans for another). I am sure other chapters may be enlivened by such reviewer found co-incidences as this.

I wonder if the scope of the book and acknowledgement of the passing of time seems to shout for a two-volumed approach. As suggested above, the previous acknowledgement of the future seems to have hailed from the 20th century and got lost. We are now after all more than a 1/10 of the way into the 21st century.

Having started my nursing career in the RN, chapter 22 on military metaphor in nursing and the need for another. A researcher contacted me several years ago about using Hodges' model (a conceptual framework) in a study on bullying in nursing. I've never heard anything since, but Hodges' can help in such research in two respects. The inclusion of a political domain and the organization of groups of people, emphasizes process, procedure, protocol, routine, and may proceed to regimentation, discipline, hierarchy so to a degree language games will follow. As this chapter notes, several professions, including nursing are said to eat their young. A commentary after the chapter provides a useful balance and makes this point. The chapter is nonetheless a reminder of the role of language and how professionalism arises and is sustained (disciplines too?). The proposal of frontier as a new metaphor is fitting as Hodges' model identifies five conceptual fronts - frontiers that must be integrated. 

As a frontier - Chapter 21 on rapture and suffering with technology in nursing holds many lessons and insights. Heidegger's "standing reserve", the human-technology interface, what it means to live like a human being and the distinction of being a human being. Mobile technology, m-health, e-health are making a huge contribution to global health and need a place here. I found Macurdy's four principles 326-327 on what patients need to assume power and control over their care very illuminating, especially in highlighting information access and the importance of health literacy.

In the text and the index I could not find specific reference to capacity, as in mental capacity, informatics, global health, information (access), justice, law, legal, management, human rights, literacy, mental, political, psych-, long-term medical conditions and recovery. While the book would become incoherent if a disease/diagnosis-based approach was adopted, we might ask: does dementia deserve specific inclusion? This is an interesting (and potentially vociferous) debate in itself - to what extent should such a book record change through several decades? Of course the book is not an encyclopedia and it is easy to critique according to omission. These are pressing times demographically, however; while there is a population focus: global communities and aboriginal communities in chapter 23 and 24, this merely scratches the surface of very large world.

This book is a valuable asset and has stimulated many ideas here (and potential blog posts). I am very pleased to have read it and would recommend it to students and practitioners alike. I am grateful to the publishers for the review copy.

Sunday, May 12, 2013

International Nurses' Day 2013: "The drama of it All"



There is a new nursing drama series starting on BBC TV next week - Frankie:
District nurse Frankie Maddox is a saint. At least she would be if it weren’t for her fondness for red wine, loud music, ghastly singing and fast cars.

Whether it’s an elderly man with dementia, a pregnant woman whose husband is on duty in Afghanistan or a sickly young child who’s never at school, nothing is too much trouble for this caring, smiley character. “Why do you always insist there’s something we can do, when sometimes there isn’t?” snaps Dr Evans (Jemma Redgrave). Because “the world is my patient,” Frankie explains, although she has the grace to grimace after delivering such a clunking line (from Radio Times).
That line may be clunking as a piece of dramatic prose, but there is a need to make some noise that extends beyond nursing's one-to-one encounters.

We are well aware of the challenges that the NHS faces, the themes are well known and read like a script that is increasingly played out on wards, the media and in parliament. The latest playwright is Francis. This is the drama we cannot ignore locally.

What of nursing globally on IND 2013?

The nursing communities within the various nations must also listen to the world. We can make a difference as individuals by challenging our often parochial perspectives; by trying to travel, seeking to engage with others electronically and learn what global nursing organizations are doing on our behalf.

Best wishes to nurses everywhere.


Friday, April 06, 2012

Virtual International Day of the Midwife - start 10.00 5th May New Zealand


Hello everyone

For those of you who do not know me, I am one of the facilitators of the Virtual International Day of the Midwife. This is a free online conference that runs for:

24 hours starting 10.00 5th May New Zealand. 

The conference is designed for midwives and anyone interested in birth. And if you cannot attend, we'll be recording the conference sessions for you to watch in your own time.

I am delighted to announce that the program for the conference is now confirmed: http://internationaldayofthemidwife.wikispaces.com/

Please go to the website above for all information, including how to access the web conference room that we'll be using, as well as practice sessions where you can get one-to-one help with setting up your technology.

You can also follow us on Facebook:
http://www.facebook.com/VirtualInternationalDayoftheMidwife
and Twitter: https://twitter.com/#!/VIDofM

There is also a poster that you can download and print off, in order to advertise this event to your colleagues. Look forward to seeing you at the conference. If you have any queries about the program, or the technology, please let me know or leave a comment on our Facebook page.

regards Sarah
Sarah Stewart

Monday, August 22, 2011

Drupalcon London - Day 1 Education Open Space #drupalEdu

Today at Drupalcon London there was an Education Open Space organised by Mixel:

http://groups.drupal.org/node/152964

Amongst many discussions and points raised is the state of play of 'learning environments', LMSes, SCORM ..... and where / how Drupal might fit in?

In terms of engaging the wider education community this p.m. I suggested the Digital Humanities community as one who could benefit from Drupal's capabilities with media, extensibility and other positive qualities. This evening I received a message from Digital Humanities developer list about CMSes and Drupal 7. How timely! So this post is based on the flag waving there - already some very helpful replies inc. CMS course or content - and on http://www.digitalhumanities.org/humanist/.

Mention was also made of previous meetings outside of a Drupalcon and within (e.g. 2009). What can we learn from the organizers of other sessions? Of course at Drupalcon 'education' must compete for a slot with the other submissions.

mixel et al. are using #drupalEdu

The table I joined was on LMSes and other points. On one level I don't need an LMS, but on another I do. I need to manage the learning experience of users on a new Drupal driven website. Drupal offers a great many educational modules. Do I need SCORM? What is the latest on such standards? What needs to be in the h2cm learning core?

h2cm is an item on the [cross ;-) ] curriculum, it is not a curriculum. 

Mention was made of current and target knowledge and how we get from the one to the other. I also liked the mention of designing learning experiences. This is where (for me) h2cm comes in: in a care situation what is the current - target knowledge taken across the four* - care - knowledge domains? h2cm isn't vested in managing the administration of learning experience, but I believe it can play a positive role in facilitating reflection and the design of learning experiences.

I hope some momentum can be gained. Education is a massive edifice, but if interested parties can nudge and pass around #drupalEdu that's got to help?

* Five with the spiritual domain.

Tuesday, March 08, 2011

Students at Paipa Nursing Theory Conference 24 - 25 Feb 2011

I will post a few more photos as I sort and (hope to) receive them.
Still pinching myself here - a great experience!

I've emailed a few nursing lists that I subscribe to as GICS - the three universities who organised this conference and are planning another - are keen to reach out to the academics and students of other nations.
If anyone would like more details / contacts please get in touch with me: h2cmng at yahoo.co.uk.



On the Friday it was quite sunny and being asked for photos I struggled myself in the sun it was really bright (lovely!):


Happy International Women's Day also - and great to see some guy's and at a nursing theory conference too! Best wishes to all!

Friday, March 04, 2011

Notes (ii) from Paipa Conference: Q & A

Q. What is the appeal and relevance of Michel Serres to the Health Care Domains Model [h2cm]?
c/o Fred Manrique / UPTC 

(As per the paper - Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons. 2008)


A. I cannot remember how I came across this French philosopher (Bruno Latour?), but in 2004 I started to read some of his translated texts. Serres' work is not easy to read, but rewards perseverance. Thus enthused I wrote (in my spare time) and eventually submitted a paper to a prestigious nursing journal. This was rejected - twice. Using the feedback I was able to produce the paper that found publication in the informatics field. This is listed in the W2tQ bibliography. Serres' ideas were remarkable in how they spoke to me and reflected in many ways the conceptual framework of h2cm. I need to read more of Michel Serres' work. Ideas of particular appeal include his use of several tropes:
  • Harlequin: the uninvited guest (disease, illness?), mischief (health taken-for-grantedness), chaos (the unpredictable);
  • blanc: in my presentation I included a blank slide. There it represents every new person, new page - no judgements, positive regard. A page for lifelong learners and being able to self-reflect.
  • Hermes: the Greek God, the messenger - information and Serres' early study of information science. The 'underworld' - nursing and medicine - are not for everyone. The importance of ports as a means of information and cultural exchange - today economies see themselves as information ports and the rise of information portals.
  • Serres states (as do other commentators) that the Internet will provide opportunities for new scholars, outside of established academic institutions.
  • borders, boundaries - the middle: in life we often have to ask do we continue and cross the middle?
  • The Planet: Serres is concerned for how we treat the planet. The health care domains can also be utilised to explore the physical and psychological impacts of climate change and the need to attend to human ecology. We are rocking the boat - Earth is our boat.
  • ... plus many others - fluid, dynamics, life - rivers - choices, narratives, Home, Angels, statues.
Finally, within "... S E R R E S ..." you will also find H2CM!  

Please see the bibliography for the paper.

Additional links:

Michel Serres on this blog.

http://michelserres.blogspot.com/

More Q and A to follow plus photos and slides. Photo source (PJ, Copenhagen shop window, 2010).

Wednesday, March 02, 2011

Notes (i) from Paipa Conference: Q & A and sessions

Questions from the delegates (once more interpreted by Andrea Ramirez) at the plenary session on Friday 25th February included  - with my response (extended here):

Q. Could you please give some specific examples of the model's application and its achievements?

A. The model was created by Brian Hodges to facilitate reflective practice and encourage holistic care - especially balancing physical and mental health - psychological - care. In the mid-1980s the model was used in several locations in England and the Isle of Man. The model was taught and learning assessed through case studies in community mental health nursing, learning disability and health visiting.

As highlighted in the presentation unlike other models of care h2cm has not had the benefit of specific research. The models of care we use must be evidenced based. The website and blog represent a call for research in the health care domains model. This is why I appreciate so much this invitation to Colombia and being able to present what I believe is a very useful and increasingly relevant care resource.

In terms of achievement there are an as yet limited number of papers published and listed on the blog in a bibliography.

A couple of individuals have contacted me for advice on using the model in academic work, which has also been posted on the blog.

In my presentation and the plenary I did not mention the planned workshop in the afternoon!

Q. What has been the experience of applying the model in the practice (clinical area) and in the community?

A. The model is used in two centers for forensic psychiatry (low and medium secure) where the inclusion of the interpersonal and political care domains are pivotal in the tensions between the custodial context and need for person-centred nursing care that arise.

In forensic nursing the model informs care philosophy and is also represented in care documentation. A paper is in production describing the model and this application.

The model is I understand being used in a research project investigating bullying within midwifery. I will post more details on this when I have them. The researchers approached me seeking permission to use the model, I indicated the model's origin - as in "It is not 'mine'", and furnished a letter indicating the model's status. I understand the appeal of the model in this instance may be in scoping the research project.

Currently the model is helping me in my role (as a Nursing Home Liaison Specialist) to plan and deliver education sessions to residential care staff on communicating with people who are coping with dementia.

Being simple in structure and basic content once learned the model is accessible as an aide memoire, while you are assessing, planning and evaluating.

I have also used the model when working on informatics projects, as the model can help integrate the SOCIAL and TECHNICAL aspects of ICT.

More Q and A to follow plus photos.

Saturday, February 26, 2011

Presentation(s) at 1st Int. Congress of Nursing Models and Theories in Colombia

I will revise this post over the coming week and add more, including one of the Spanish slides.

Many thanks to Danny Eduardo Rodriguez for meeting me at the airport (and to everyone who waited  with Eduardo). Hearing my name and seeing the university transport proved instantly reassuring. Thanks also Eduardo for the in-session translation - a great help and for your efforts to ensure I felt at home and a part of things: I certainly did. ... 

Well I am due to leave Paipa soon for Bogota El Dorado airport and the trip home via Paris. It is a beautiful day in Paipa. Very warm, bright sun, from my room I can see people water skiing on the lake.


Yesterday's presentation, workshop and Q and A session were very well received through a lecture and workshop. These would not have been as successful with the brilliant work* of Interpreter Andrea Ramirez on both occasions.
I had started to add some Spanish translations to my slides and these were checked and extended by Luz Stella Saray and Prof. Wilson Canon Montanez, (UDeS) to whom I extend sincere thanks (a good photographer too!).


In the morning session Andrea related each slide in Spanish after my account. For the workshop I had emailed the case study in English with a Spanish version c/o Google translate. This had been checked and improved and the format we followed was for students to read the case study and then individually draw out the aspects of Alice's case (fictitious yet based on 20+ years of experience) which they feel significant across the care domains. During this exercise for 20-25 minutes Andrea assisted again with some questions from individual students. Then in groups of 4-5 they collectively reflected on their 'results'. Finally each group in turn offered one item for each of the four domains. Astute questions from the floor and discussions followed. Not having done this before, with the addition of translation I was surprised at how well it worked: instant teamwork!

At 5.30 Luz had arranged to meet to discuss nursing in England. A little jet-lagged, I thought she meant with 2-3 colleagues, but in the end the room was filled as we were joined by 60-70 students in a circle. I can't believe that 90 minutes passed. The students and faculty are so very enthusiastic, charming, friendly and knowledgeable. Two days is not long to learn and make judgements, but from the student's questions they seem acutely aware of the specific health challenges and issues they face in Colombia. Their professor's approach in pursuing this meeting reflected an awareness of 'nursing as it is learned and practiced elsewhere'. I advised I was not able to speak generally, outlining my specific role and location. I let them know I was drawing from matters I do know (as highlighted on W2tQ) and personal experience. The notion of 'basic nursing care' is clearly and unsurprisingly universal given this encounter.

You do need to consider such travel very carefully: your health, security, travelling alone... The organisers took care of this assuring a personal meeting at the airport, transport and accommodation. The journey was hard for me from the UK. A short hop Manchester to Paris 1.15-30 was followed by an 11 hr and 10 hr flight back home passing through Bogota. Travel is difficult due to the condition of the roads, driving laws and the traffic situation that the populous of Bogota faces; but where there are 'gaps' (pot holes!) there is a way through.

I never would have believed I would set foot in South America. To stand under Orion and see Canopus was another dream come true. As Space Shuttle Discovery set off on her last flight I was making discoveries of my own in helping others do the same.

I am very grateful to GICS - the three Universities UPTC, UdeS and Unillanos who invited me and supported my attendance; plus my employer Lancashire Care NHS Foundation Trust and colleagues covering duty for new referrals at the Beechurst Unit, Chorley, Lancashire. This has been a marvellous experience, with many contacts made that I hope will grow in the future.

*Presenting in Spanish at the conference (Teoría “Marco de la Organización Sistémica” con enfoque en Familia), Dr Marie Luise Friedemann - RN, PHD and her husband informed me of Andrea's effectiveness and memory feat. Dr Friedemann, Profesora de la Universidad Internacional de la Florida, in Miami and I also hope to compare our respective interests.

Tuesday, January 25, 2011

1st Int. Congress of Nursing Models and Theories: Colombia 24th-25th Feb. 2011


I am delighted to report the news that the
Health Care Domains Model
will feature at this International conference.

In November I received an invitation to be one of the main speakers from the Grupo Gics Investigacion Team; and so next month I will be heading south to Paipa, Boyacá, Colombia.

This prospect would not be possible without the support of the conference organisers - GICS and Prof. Wilson Canon Montanez, Nursing Faculty of the University of Santander UDES (Bucaramanga-Colombia) and my employer Lancashire Care NHS Foundation Trust.

Recently a group of Nursing Faculties of three major Universities in Colombia (Universidad de Santander UDES, Universidad Pedagogica y Tecnologica de Colombia UPTC y Universidad de los Llanos UNILLANOS) have come together to organize the First International Congress of Nursing Models and Theories.

This congress will be held in the city of Paipa-Colombia 24 and 25 of February, 2011:
http://www.uptc.edu.co/eventos/cong_enfermeria/index.html

I very much look forward to this trip for several reasons:
  • New people to meet and things to learn.
  • This invitation literally puts h2cm on the map (so I must deliver)!
  • It is marvellous to see faculty and nurses in Colombia re-invigorating thought about models of nursing.
  • I have never travelled this far south - how will Orion look?
This will be a great adventure, but before then - where's my checklist: presentation(s), jab, tabs, passport...

Sunday, November 28, 2010

Buller and Butterworth: Skilled nursing practice - four domains?

The health care domains model identifies four domains within health and social care and medicine. What evidence is there to support the model's inclusion of:

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

- plus the spiritual within and without? Steve Buller and Tony Butterworth undertook a ethnographic study in 2001 'Skilled nursing practice - a qualitative study of the elements of nursing'. With skilled nursing practice at the center (Fig. 5.) they identified:

relating and communicatingdoing the job
being professionalmanaging and facilitating

There is some overlap, reflection arises in relating and communicating and doing the job. Overall however there is a definite correspondence between these domains and those within h2cm - the health care domains conceptual framework. I have equated being professional with the SOCIOLOGY domain as for the authors this includes being with patients, conveying confidence, handling situations, being informed. Managing and facilitating is undoubtedly POLITICAL with supervising, auditing, making sure things get done. Doing the job - is based upon planning, informing, assessing, intervening, and being confident (with equipment, procedures, manual dexterity..?).

Having been thinking and writing about h2cm for many years it is a shame that other models have benefitted from funding and gain "ward and community (research) cred" while here evidence is retrofitted. Looking at the paper just in the decade since submission and publication I wonder which elements remain local, and where other elements of the skills base (care concepts) have migrated to ethnographically?

Steve Buller, Tony Butterworth (2001) Skilled nursing practice — a qualitative study of the elements of nursing. Int. J. of Nursing Studies. 38, 4, 405-417.

Thursday, October 28, 2010

Fran Biley's video: Students on nursing theory

I came across this great video created by Francis Biley Bournemouth University through the Martha Rogers list:


Quite some time ago I wondered about having dummy - animated heads to carry out a dialogue. It is great to see how e-media forms and tools have developed now.

I have my own thoughts and ideas on nursing, perhaps over time I am drafting them in the bibliography and here on W2tQ?

Additional links:

Nursing theory resources SCIENCES links
Virtual Reality in Nursing: A dialogue from 1991
Nursing Telemachus and Computers: A dialogue from 1995

[The above are no longer available but the dialogues may reappear in an archive.]

Saturday, October 16, 2010

New to nursing? after Jules (just scratchin the skin)

If you are new to nursing (social care, learning disability, forensic nursing... ) we have some amazing guests on this weeks show, appearing especially for you, because of you: because you care - on four stages .... [with apologies: Jules Holland, BBC 2]


Interpersonal : Sciences
Sociology : Political
Self Awareness
orientation
communication
rapport, empathy
anxiety
values, beliefs
mood, risk
knowledge & skills
aptitude and attitude
anatomy and physiology
(The) Make the Beds
 TPR [BP]
hygiene
birth...........................................death
drugs
journals, books
nutrition
assess, plan, actions, evaluate
tech & equipment
community
family

relationships
culture
traditional medicine
social networks
public involvement
HUMAN RIGHTS
Consent, Choice, Capacity
health economics
Law
DoH, NLM, WHO
health social care services
professionalism
policy

Wednesday, October 13, 2010

Balanced Care: Safe Landings and Recovery

In health and social care patient, family and the health care team are united in what is constantly described as a journey. Sometimes there are several, care pathways into territories unknown.

Unknown?

Well yes, if care delivery is personalised (who are we to assume ...?); and yes again even if the patient - the individual concerned is an 'expert' in their condition.

Apart from the metaphysics of life's journey our physical environment can present dangers and yet fewer and fewer corners are truly  unknown. We leave it to astronauts (and oceanographers) to adventure on our behalf. Prior to the Apollo missions it was essential to confirm the nature, solidity of the lunar surface. Would a spacecraft sink and possibly tilt to the extent that return to lunar orbit and Home was impossible?

The Apollo Lunar Module's four legs provided support for a safe landing and take off. A base in every sense.

In health and social care the health career model can provide a base and re-assurance too. Each of the four care domains allied with knowledge and skills - holistic competence - can bring about a successful mission: however the crew and 'success' are defined.

Image source and original text below from:
http://www.robertaonthearts.com/id763.html
Cartier Replica of a Lunar Module
Three individual 18-karat-gold models of the American lunar module were made in 1969 by the jeweler Cartier of Paris on behalf of the French newspaper Le Figaro and presented to the three Apollo 11 astronauts during their post-flight tour in Paris. This model was presented to astronaut Michael Collins.
Image ©Nick Welsh/Cartier Collection 2006

Friday, October 08, 2010

FROM: A community mental health context TO: Acute EMR/EHR and other ...

or: Will 21st Century health and social care informatics truly begin on Sunday 10 10 10 ?

I've been a nurse AND info tech / informatics enthusiast since 1981. As an advocate of info-tech as a means to improve the quality, effectiveness and safety of health care - I must confess; I feel I have let down those colleagues purely there to 'nurse'. .

After 20+ plus years the nearest we (the team and I) got to a system that answered our questions was a small PICK database and a later MS Access database. These focused on referrals and data capture - demographics, problems, interventions (WHO and what) and outcomes. Although the number of data items was not great, no more than 30 the insights we could glean from queries was surprising. People versed with databases, datasets and research readily appreciate how even small datasets, carefully thought out and planned, can answer a diverse range of questions (and generate countless new ones too!).

I noticed in the mid-1980s to mid-1990s the development of customer management software and recognised that clinicians have a need: caseload management.

Even now the requirement of 'X' visits per day, the number of information systems and lack of integration (health - social care) mean that in many instances there is still no readily accessible caseload manager for the individual practitioner. This is an outcome and amid all the talk around 'engagement' (with a 'E').

Perversely, ironically, paradoxically (take your pick) at a time when Lean is (presented and) needed, there are scarce resources to do the things that should now be embedded (routinised) into the life history of the professional. This includes what the professionals do WITH the patients, carers, data, information ...

I speak to student nurses (and other disciplines) regularly as a nurse mentor and sign-off mentor. Their exposure to health care informatics to me is minimal, adhoc, and when it has happened it has signally failed to strike a cord. A very small (and so non-significant*?) sample admittedly.

Informatics remains an academic 'must do'.
Perhaps 21st century informatics only begins on Sunday -
101010
Whatever:
as it stands informatics is a management pursuit.


Slippage is a fact of project management, but words present their own challenge when target driven 'secondary' uses become 'primary'.

*surely not.

[A version of this post first appeared on the Healthcare Information and Management Systems Society HIMSS group on LinkedIn.]

Friday, October 01, 2010

Caution! spanning the Theory - Practice Gap




As a new academic year begins and we endeavour to bridge the theory - practice gap we need to be cautious:


While we may not burn our bridges we need to be aware of which bridge spans are redundant and which are still active and serving their purpose.

As ever - standards, inspection, audit and governance are critical.

So in our efforts to bridge the theory - practice gap do we also maintain it?

Friday, September 03, 2010

Interprofessional education, philosophy and conceptual frameworks


I received a copy of the following - Interprofessional Education in Wales: case studies in health and social care - July 2010, Editors: Clare Kell and Marion Helme (Health Sciences and Practice). Published by the HEA.


As per other HEA publications there are many papers here of great interest. One stood out at a first reading as in addition to the quote below Mark Edward's also refers to the need for an holistic approach, and this particular MSc. course providing a critical space.

UK Professionals are trained and educated in their own disciplines, learning their own unique and specialist knowledge for their chosen profession. Therefore, although each profession is well equipped for its singular contribution, they find their 'educational preparation a total mismatch for the complex, interactive world into which they graduate and practice' (Sullivan, 1998: 428). Sullivan's view reinforces the WLGA's concerns, that professional boundaries *demarcate* social professions (and others) from each other and that resistance to collaboration and co-operation on any meaningful level has been compounded by the historical development of the uni-professional training model. We need therefore to agree a uniting philosophy and *conceptual framework* that facilitates a dialogue between these professional disciplines and gives reasons for these discrete services to work together in providing effective inter-professional solutions to shared social problems. p.53. Edwards, M.L. (2010). * -- * My emphasis.
I do not merely want to hang word associations here on the blog line. But, I have wondered about how we demarcate the disciplines. This is a major question. In the (previous) glossary I cite Resnik (2002) - A pragmatic approach to the Demarcation Problem. Wether deemed explicit or not Hodges' model seems to address this issue through the care domains.

On the new site a living (dynamic - as is implicit in internet based tools and resources) glossary is a must - the terms we use often vary from context to context, professional to professional. Clearly (or opaquely) I cannot provide all the answers hence the need for a community and a (Drupal) module.


Mark L. Edwards, Case Study 7: Issues in collaboration between undergraduate professional qualifying programmes of youth work and social work. pp.47-55.

Resnik, D.B. (2002) A pragmatic approach to the Demarcation Problem, Stud. Hist. Phil. Sci., 31:2,249-267.

Friday, July 02, 2010

Drupal musings 6: Content types - Reflection!

Does anyone have any experience in using established models of reflection in:

  • education (nursing, public health, information technology)
  • practice
  • therapy
  • supervision
  • carer support
  • eHealth
  • ... ?
If so please get in touch [h2cmng at yahoo.co.uk].

In its initial downloaded state Drupal has two content types:

  1. story
  2. and page.
The option then is to use these which would be rather limiting. Add to these two by enabling other core modules. Drupal administrators can extend the core functionality by adding other modules which provide new content types.

You can also roll your own. A key content type for the new site is one that uses the health career model to facilitate - reflection - one of the original purposes for the model.

This also provides an opportunity to adopt a model of reflection that is itself supported by research. This may be Gibbs:
  • Stage 1: Description of the event
  • Stage 2: Feelings and Thoughts (Self awareness)
  • Stage 3: Evaluation
  • Stage 4: Analysis
  • Stage 5: Conclusion (Synthesis)
  • Stage 6: Action Plan
John's Model of Structured Reflection
  • Aesthetics – the art of what we do, our own experiences
  • Personal – self awareness
  • Ethics – moral knowledge
  • Empirics – scientific
  • with its Cue Questions
Smyth’s Framework for Reflection on Action
  • Activity
  • Inform (Analysis)
  • Confront (Self awareness)
  • Reconstruct (Evaluation and Synthesis)
There are many others. ...

Once the hedgehog-headlights glare has passed, this is going to be a really interesting project. There must be a way to link one (or more) of the above with each of h2cm's care (knowledge) domains. There must be a way to create a first version that can be extended and support other content types. The possibilities are really exciting - hence the glare (reflected of course!).