Hodges' Model: Welcome to the QUAD: supervision

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 supervision. Show all posts
Showing posts with label supervision. Show all posts

Friday, June 19, 2026

'Curiosity': child safety and safeguarding c/o BBC News

'Teacher who killed his adopted son given whole life prison sentence

14:30 18 June

That concludes our live coverage of the sentencing hearing.

To recap what happened at Preston Crown Court earlier: A teacher who sexually abused and murdered the 13-month-old baby boy he adopted with his partner has been told he will spend the rest of his life in prison.

Preston Davey died in July 2023 at the hands of Jamie Varley, 37, who subjected the child to physical, sexual and emotional abuse during the final four months of his life.

Varley, from Blackpool, told police Preston had accidentally drowned in a bath, but a post-mortem examination discovered the child had suffered 40 injuries.'

Continued ...

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





PROFESSIONAL
CURIOSITY



Source (Various): BBC Live News https://www.bbc.co.uk/news/live/c4gyrewq8xkt

 Previously: 'curiosity' : 'risk'

Tuesday, June 09, 2026

Typologies in nursing - Macduff (2007)

This paper was brought to my attention by the author Colin Macduff (now retired) who was Principal Investigator in a project [2018-2020] RIPEN. This included a series of workshops to which I was able to contribute. I knew this would be useful and must find the paper (in 14,1) also mentioned.

"What are typologies?

In relation to this initial question. Patton (2002) offers a useful definition and  distinction: 'Typologies are classification systems made up of categories that divide some aspect of the world into parts along a continuum. They differ from taxonomies, which completely classify a phenomenon through mutually exclusive and exhaustive categories, like the biological system for classifying species. Typologies, in contrast, are built on ideal types or illustrative  endpoints rather than a complete and discrete set of categories'." p.41.

'Most commonly, typology constructors such as Roberts-Davis et al  (1998) and Nolan et al (1995) present them as ways of clarifying thinking  rather than as rigid structures that are universally applicable. The difficulty  here is that within nursing discourse a number of other devices such as conceptual frameworks and models are also commonly used to this end.' p.42.

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

 



Box 1: Typology of family care (Nolan et al 1995)
  1. Anticipatory care
  2. Preventive care  
  3. Supervisory care  
  4. Instrumental care  
  5. Protective care  
  6. Preservative care  
  7. (Re)constructive care  
  8. Reciprocal care p.44.




If you can obtain a copy^, do check out Box 2 and Figure 1, plus the discussion and conclusion.

Macduff, C. (2007). Typologies in nursing: A review of the literature. Nurse Researcher, 14(2), Article 2.  https://doi.org/10.7748/nr2007.01.14.2.40.c6020 (^Paywall)

Saturday, October 18, 2025

Just imagine ... caseloads, payloads and careloads

Just imagine ... no, not like that - really imagine!

You are in a situation. Unsurprisingly, let's say it's in health, or social care. We find ourselves in a care or nursing home, on a ward, or in the individual's home, even if the patient does not currently recognise it as such.

The patient is mobile. That is, and isn't a problem.

Physically, apart from thoughts about a chest, or urine infection, yes they are mobile, but they're also confused - disoriented.

We are concerned about their safety. 

Noisy, increasingly agitated, they are making it clear they want to leave.

Their carer, family, or staff are trying to limit the patient / resident's access to the exits, be that the front, or back door, the spare room, their room, or main entrance. They are not in agreement about where they need to be. Persuasion and distraction aren't working either. They appear to lack the level of mental capacity required to decide for themselves what needs to happen.

It is one thing to have this assessment of the situation running through one's mind; but quite another to 'pick up' a care concept mentally and carry it over the care (knowledge) domains of Hodges' model.

Hodges' Health Career - Care Domains - Model
Try it for yourself ...

Have a think about the following care concepts: mobility, capacity, consent, confusion, mobility, liberty, a locked-door while spouse/partner goes shopping, and safeguarding

As we engage in critical thinking, these concepts have a literal payload. They carry varying degrees of informational value, salience that helps us prioritise, what else do we need to factor in, what help is needed, and when; how do we  decide what to do?

As a concept is evaluated against Hodges' model, it changes. It is as if it morphs subtely, or starkly as other concepts, by association, are brought into play.

This process is influenced in so many ways; our training to date, our prior experience, biases and cultural baggage we might also carry, who else is present (this is of course potentially both a positive and negative), past and current role-models, our (team's) preparedness - what to do if .., teamwork, access to leadership (who is 'duty'?), and our confidence in them (Oh no!). And, them in us.*

Vitally, there is the small matter of our understanding, attititude and response to the person in-front of us. 

The delivery of healthcare is often stressed as emotional labour. Whether we use Hodges' model or not, perhaps the labour, the physical and psychological work involved, is experienced through carrying and feeling the careload. A reason too for supervision.

*Do seek help - advice if needed.

Further reading [ please contact me if needed - h2cmng AT yahoo.co.uk ]:

Jones, P. (2025), A Generic Model and Conceptual Framework to Prime Curiosity Across Health and Social Care Disciplines to Facilitate Lifelong Learning. Journal of Evaluation in Clinical Practice, 31: e70252. https://doi.org/10.1111/jep.70252

Jones, P. (2025). A Conceptual Mapping Exercise of Deprivation of Liberty Safeguards in Residential & Community Care Using Hodges' Model and Threshold Concepts. Journal of Evaluation in Clinical Practice, 31: e70085. https://doi.org/10.1111/jep.70085

Sunday, June 01, 2025

RCN Congress 2025 iv - AI & quality improvement

Discussion: Artificial intelligence in nurse education &
Discussion: The role of nursing staff in quality improvement


We'll cover two agenda items in this post. First, resistance is futile in the apparent rise and ubiquity of artificial intelligence.

Discussion: Artificial intelligence in nurse education

Here is, another thing 'we need to get right'. Without checking, I'm sure I posted/tweeted about 'essay factories'. Now Generative AI has put the automated generation of academic essays on steroids. If a student is not motivated to learn, enthusiastic about their seemingly chosen course of study and the professional reward to be earned, then we are in trouble. Public and patient safety are at risk. AI, is however is here to stay - change and help us prosper(?). AI and GenAI are tools, just another step forward, an advance on finger tips, palms, stick, chalk, pencil, and pen. The brief for the discussion includes, with specific points emboldened:

'... Additionally, AI-driven simulations and virtual reality scenarios can provide hands-on experience in a controlled environment, enabling students to practice and refine their skills with greater confidence. 

Creating an engaging and supportive learning environment is key to helping nursing students embrace AI. HEIs can introduce AI concepts early in the curriculum and provide ongoing training and resources. Encouraging collaboration and open discussions about the benefits and challenges of AI can further enhance students' confidence in using these tools.

By taking these steps, nursing education can seamlessly integrate AI, ensuring future nurses are equipped to excel in an evolving health care landscape.

To effectively integrate AI into nursing education, RCN Wales, for example, advocates for higher education institutions (HEIs) to equip students with the skills to continually enhance their digital and biotechnological literacy, ensuring they meet their programme outcomes.

HEIs can incorporate regular assessments and feedback mechanisms to monitor a student’s progress and determine where AI tools add the most value.' . . .

Computer-aided learning has matured greatly since the 1980s and 1990s. AI and GenAI mark the seeming leap in progress over the past two years, with governments, professional bodies and society having to adjust and quickly. We need to watch how simulation, and virtual reality and other approaches to learning are applied, to assure the quality, safety and learning experience provided to students. There appears to be a risk in mental health nursing curricula being 'diminished'. Interpersonal skills are critical in psychiatric and psychological care. This might afford the advocates of technically-laden solutions to side-step the nuances of face-to-face human interaction. Amid the pursuit of what is mechanistic, let us value the humanistic also.

The biotechnical, is one a several literacies to keep sight of. AI, is of course bound up in bio-political concerns, that are still emerging. The 'health care landscape' is plural too: consider the patient's home, a ward, out-patient department, e-consultation, e-learning intervention, brief psychotherapy, occupational health, carceral care, and field hospital, veterans, migrant - refugee health and the homeless.

There's more, and references and a reading list are also provided on the above link.

'Quality improvement is about making a difference to patients by improving safety, effectiveness, and experience of care.

All nursing staff should have the abilities and support to become involved in addressing health care pressures, utilising their expertise in the profession as leaders, not only in care delivery, but also within the system. However, the work of nursing staff to deliver quality improvement is often limited to opportunities that are dependent on staffing, seniority and availability. 

Nurses’ willingness to attend training is often superseded by patient demand making attendance impossible. Other health care colleagues undertake work on research and service improvement alongside their role and as a requirement for their revalidation, this is not the case for nursing staff who don’t get these opportunities.

Consider the benefits of the nursing workforce undertaking quality improvement, conducting local research, reorganising working environments, translating or updating patient materials, trialling novel approaches to care or addressing health inequalities. These skills would not only improve the quality of care we provide but also prepare the nurse to influence and change systems throughout their career.

This is relevant UK-wide. Scotland's 2030 vision for nurses, states an intention to equip nurses with quality improvement tools and support, but only nurses in non-hands-on roles. NHS Wales offers quality improvement training through e-learning  via the ESR to health care professionals, in Wales. In Northern Ireland training is available, but only for Band 7 and above.'

What is the role of all nurses to get involved in quality improvement?'


There is a point with IT security that if it was 100% assured with all the prospective log-ins of an average user, would we ever get any 'real' work done? Does the same apply to research? I have heard this as an argument in practice; and a response to a drive for quality improvement too. Data takes time to collect, especially to answer new questions. Such arguments were also fielded when models of nursing were spoke of with eye-rolls and sighs of experience. Quality improvement is a fight, opportunities and resources can be found, especially if a culture of research is nurtured and sustained. What questions does a ward, unit, team have currently? What queries might new starters, newly qualified, students, and placement candidates provoke? If my reference to fighting seems strong; the fight is for time. The raw truth is in the NHS that quality improvement, research and supervision (in its various forms) are in competition, in the absence of coherent integration.

In bold above, the discussion includes:

'trialling novel approaches to care or addressing health inequalities'.

I wonder what that springs to mind? More seriously, we need be aware of what happens to 'quality'; in whatever educational form it is encountered and experienced. 

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

interpersonal skills

informal / formal education
QUALITY
lifelong learning

biotechnical

landscape

quality improvement - clinical supervision?
inequity

social preparedness for AI/GenAI


management supervision?


Monday, November 13, 2023

Empathy - Relating, Knowing, Objects, Patterns ...

INDIVIDUAL
|
     INTERPERSONAL    :     SCIENCES               
HUMANISTIC --------------------------------------  MECHANISTIC      
SOCIOLOGY  :   POLITICAL 
|
GROUP

"Logos is our capacity to separate ourselves from the surrounding world, making it into objects in order to recognize it objectively, reflect about it. Any fully developed human relationship needs both principles, the relating and the knowing. Knowing in this sense means the possibility of discriminating between the common ground and the difference of I and Thou. Without knowing, there is fusion or identity but not relationship between a separate I and a separate Thou." p.64.



"Recently a woman training to be an analyst came for supervision and brought with her for the first time a tape of an analytic session she had had with a woman patient of hers. To our amazement, in listening to this tape, we both had at certain times quite some difficulty in distinguishing her own voice from the voice of the patient. This happened mostly when the patient was talking very softly and obviously fighting to overcome feelings of shame. The candidate felt rather shocked at first and asked me whether she might have identified with the patient in an unhealthy way. I heard her interventions on the tape as being genuinely in tune to the atmosphere and situation of the patient at those moments, so I told her that to my mind she was responding in an empathetic way to her patient. It was apparent that the patient needed this kind of response, for later in the tape one could hear that the patient became more confident in exploring her feelings. I think the candidate reacted to the needs of her patient with a concordant countertransference reaction." p.38.




Jacoby, M. (1984) The Analytic Encounter: Transference and Human Relationship. Toronto: INNER CITY BOOKS.

In this text and other reading I can see a possible means as to how the concept of identity can be used between the Individual - Group (other).

To follow soon:

Book review iii. General Psychotherapy: Principles and Common Theoretical Aspects - Rediscovering Humanity

Friday, November 26, 2021

URGENT: Clinical Academic Internship Programme

Dear colleagues,

Please could you circulate this opportunity to appropriate networks.  Many thanks,

***Closing date for applications: 5pm on Monday 6th December 2021.

Dear colleagues,

Hosted by Sheffield Hallam University on behalf of Health Education England (NE&Yorks), the NIHR Integrated Clinical Academic Research Internship programme (pre masters) is now open for applications. 

Please could you cascade this opportunity to your networks. A summary of the scheme is provided below, but please visit the website for further information: 

https://www.shu.ac.uk/study-here/options/health-and-social-care/integrated-clinical-academic-programme-internship-scheme

Integrated Clinical Academic Programme Internship Scheme | Sheffield Hallam University

Sheffield Hallam University are proud to co-ordinate the Integrated Clinical Academic Programme Internship Scheme across the North East and Yorkshire region of Health Education England.

www.shu.ac.uk

About the Internship opportunity

The Internship is the foundation programme of the NIHR/HEE Integrated Clinical Academic career development pathway. This cohort will commence on 26th January 2022 and complete in October 2022, and is open to non-medical clinical staff employed by a NHS organisation in the North East and Yorkshire regions of Health Education England. 

It provides a range of on campus and online teaching sessions combined with the practical skills to undertake a research project supported by an expert clinical academic supervisor.  The key components to the internship programme are:

  • a Clinical Academic Research Experience supported by supervision and research mentorship for 30 days.
  • an Educational Learning Package comprising of 2 days face to face learning and 4 half days of online teaching.

Funding has been secured to support a small cohort in 2022 and the employers of successful applicants will receive £7500 for back-fill and to support research expenses. The employing organisations of the clinical mentors will receive £1000 to support their costs.  

Full details of the programme and the eligibility criteria can be found at https://www.shu.ac.uk/study-here/options/health-and-social-care/integrated-clinical-academic-programme-internship-scheme

Please note the tight deadline (1st December). For any queries please contact the programme lead Prof Julie Nightingale (J.Nightingale AT shu.ac.uk)

Best Wishes 

Prof Julie Nightingale, PFHEA, PhD, MSc, DCR(R), Professor of Diagnostic Imaging Education / Editor-in-Chief Radiography journal, Interim Head of Research (Dept of Allied Health Professions)
Robert Winston Building, Collegiate Campus, Sheffield Hallam University, UK, S10 2BP

My source: Tony Roberts, SHU.

Wednesday, January 01, 2020

2020 Clear Vision - 4 - Clear Care

Care concept ink *

To highlight Care - Assessment, Plan, Intervention, Evaluation, Co-Production through
improved engagement and formulation

Care concept ink
(enhance)

Vs.

Non-Care concept ink
(reduce)


*A definition of collaborative care, co-production and health literacy ... could involve assurance as to whether a particular concept has significance for the patient/carer/guardian.


My source:
https://youtu.be/B2FDbGUzNRI

In a series of videos from BMJ, Prof. Maarten Boers will show you how to choose and design better graphs and tables.

https://www.youtube.com/playlist?list=PLXU14EQbU_V9JpmolAKsaCC0VjJzbxzAN


Tuesday, February 12, 2019

Sunday, April 01, 2018

Paper: How social workers reflect in action and when and why they don’t [Mapped to h2cm]

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

The self - personhood

Reflection (as core concept)
has value and limitations

Non-reflection to protect the self

Unbearable anxiety

psychoanalysis - findings

defended nature of the self

thinking & non-thinking
'suspended self-preservation'
Self - Two perspectives - Service User

emotional intelligence
internal supervision
intuition - improvisation
Reflexive

Helicoptering - metacognition

Sexuality (form of bracketing-off of oneself)*
lived experience of the senses
RATIONALE

Theories of reflection

Frameworks for reflection (reflective practice)

physical / somatic effects of anxiety

ethnographic study

audio recordings



Reflective practice demands that
you learn from experience.
It requires you to be self-critical.
It expects you to analyse
what you think, feel, and do...

#When is it better NOT to reflect?

'Containment'

'splitting'

risks (being completely non-reflective)

experiences and the (mobile) body
TECHNICAL
*limits capacity of some aspects of relational work

 Social Work Practice

Home visits

Family home children and parents
'tacit knowing-in-action'
Reflection in Practise

Fieldwork - home, car

SW composed when service users in distress, absorb their sadness, shame, fears,
and at times their joy #

Face-to-Face interviews

Relationships: sexuality, gender

offloading informally - office

Social Work / Clinical Case Supervision

 offloading formally

Two Local Authorities

Management Supervision and Governance

Child protection

Power

Organisational risk management

Policies, Procedures

Lone working...

Influence in 'advocacy'
[comment on twitter - see below]
(as a Professional or 'Independent'?)


Harry Ferguson (2018): How social workers reflect in action and when and why they don’t: the possibilities and limits to reflective practice in social work, Social Work Education, DOI: 10.1080/02615479.2017.1413083

My source: Twitter
 

Wednesday, May 18, 2016

Hodges' model - draft paper on case formulation informed by Rainforth and Laurenson (2014)

The following is from a literature review by Rainforth, M., & Laurenson, M. (2014) for a draft paper on Hodges' model and case formulation [CF]. They do not refer to diagrams, but two models are included and the role of modelling. The paper is supportive for Hodges' model within mental health, forensic care and supervision more generally.

Crowe et al. (2008) suggest an advantage of CF is its ability to create understanding of service user needs regardless of their diagnostic classification. Thus an emphasis on the link between training provision, training outcomes and treatment plans is needed so practitioners understand the frameworks for conceptualizing mental distress whilst also being able to recognize the expertise of the service user in CF development.
...
A goal of the person-specific evaluation of CF is the development of an intra-individual statistical prediction model for actuarial prediction tailored to the specific issues and life circumstances. The essence of CF is its ability to provide shared understanding of a person’s presenting problems through theoretical explanation of assumed causes and maintaining factors, so appropriate interventions can be utilized (p.208).

Rainforth, M., & Laurenson, M. (2014). A literature review of Case Formulation to inform Mental Health practice: Case formulation in mental health practice. Journal of Psychiatric and Mental Health Nursing, 21(3), 206–213. http://doi.org/10.1111/jpm.12069

Tuesday, September 09, 2014

Interviews: In the political melee don't forget the green corner...!

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

Therapeutic
alliance



"Sir Robin cited research conducted by two psychologists on interviews during the 1987 general election campaign. Dr Peter Bull and Kate Mayer found that Kinnock and Thatcher avoided more than half the questions put to them. They concluded the party leaders used 31 different forms of evasion, among them ignoring the question, acknowledging the question without answering, questioning the question, attacking the question, attacking the interviewer, declining to answer, giving an incomplete answer, repeating a previous answer and claiming already to have answered the question." FT Weekend. p.1


Source:
Katz, Ian, (2014) The death of the political interview. FT Weekend, Life & Arts, September 6-7th. p.1.

Monday, February 04, 2008

Occupational Health nursing and Hodges' model

In response to Pippa Crouch's enquiry posted here on New Year's Day I eventually sent some Q&A's to her (which I'll post here or through the site soon). Although Hodges' model seemed to fall in place for Pippa, there were some remaining questions about the HUMANISTIC - MECHANISTIC dimensions of the model in the OH context.

Since then (and post-submission/marking) Pippa has forwarded her completed assignment:

SUPERVISED PRACTICE OF OCCUPATIONAL HEALTH NURSING 1
- at 7,000+ words I've some reading to do.

Pippa has obviously explored the website; as her study includes a basic grid for Hodges' model to illustrate a CARE PROBLEMS OUTLINE. This MS Word template is available through the website homepage - resources (which reminds me I must check/update these too!).


Sunday, October 14, 2007

Cognitive Therapy & Community MH Nurses - anyone for tennis?

Last week there was quite an announcement about psychological therapies - specifically cognitive behavioural therapy, with a £170 million boost to help treat the millions of people affected by anxiety and depression. Stuck with their condition many are also stuck on waiting lists.

On the media the inevitable debate followed about research, the evidence base and the possibility that perhaps nurses could undertake some of this work. You guessed it - the 'but' followed in the form of 'training'. True, training will be needed, as the conveyor belt that is the workforce takes on-board the new kids in town and seeks to squeeze the best out of its more senior clinicians. With mention of training though someone had better watch that £170 million, to ensure it really does deliver quality therapy with the required supervision. There's also an invitation here for the various schools of therapy to take up arms - and this could be a further distraction.

A stock-take of EXISTING skills would be in order. Many people have already been trained in CBT as part of a skills set to deliver psychosocial intervention. Personnel information systems that are breathing (alive!) are critical, since there are many nurses (one hand raised here) and other disciplines who have the skills to maximise the effectiveness of that investment. Polish those rusty skills and there's a regular Genie there. So where are they?
Tennis Serve
Well many are playing tennis and it sure is not pretty...

If you listen carefully you can hear the grunts; the thud-after-thud as the players seek the sweet-spot. Any applause was lost a long time ago. You see, primary and secondary care are locked in a tie-break. Primary care refer; secondary care continue to hone their return of service, trying to spot the attempted ace down the centre. Screening tools are perfected, referral thresholds revised - the net gets dizzy; meanwhile, who is doing the therapy, the carer support, the public mental health education? Of course, this word therapy also comes with economic and status baggage.

You have to feel sorry for both these players and their coaches, now they can't just run to return the ball, the rules say that between shots they have to include a gymnastic element too.

Wimbledon 2008 should be fascinating: there's bound to be a break soon - I bet your demographic dollar$

Image source http://www.tennisserver.com/set/set_03_09.html