World Patient Safety Day 2026

World Patient Safety Day calls for global solidarity and concerted action by all countries and international partners to improve patient safety.

The Day brings together patients, families, caregivers, communities, health workers, health care leaders and policy-makers to show their commitment to patient safety.

The resolution WHA 72.6 ‘Global action on patient safety’ recognizes patient safety as a global health priority and endorses the establishment of World Patient Safety Day to be observed annually on 17 September. ...

Source:  https://www.who.int/campaigns/world-patient-safety-day

Hear* are the Global Evidence Results: Health 10 :: Education 1

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

EDUCATION 1 MENTAL HEALTH X?	HEALTH 10
	DEFENCE 10

Key recommendations

Our main recommendation is for countries to collaborate on evidence synthesis. The most promising avenue for evidence synthesis is Living Evidence Reviews (LERs), which are systematic reviews that are continuously updated. We propose that ‘meta’ LERs are conducted across all areas of social policy to answer the questions that really matter to policymakers.

“Globally, it may be helpful for countries to join forces in producing systematic reviews and identifying evidence gaps. One proposal, currently being shaped by David Halpern and Deelan Maru, proposes that a handful of likeminded governments join forces to produce better systematic reviews and avoid duplication (Halpern and Maru, 2024)… Like the Cochrane Collaboration and the Campbell Collaboration, such an approach can help expand our knowledge of what works, and put a spotlight on the areas where more evidence is needed.”

A Blueprint for Better International Collaboration on Evidence

https://www.bi.team/publications/international-collaboration-evidence/

My source:
Harford, T. Intellect. Used in evidence. FTWeekend, Magazine 2-3 November 2024, p.9-10.

*We really need to listen and respond to this!

Learning Health Systems: Volume 8, Issue 1 - January 2024

Learning Health Systems is an Open Access journal.

Volume 8, Issue 1 (January 2024)

All articles shown below are freely available and downloadable.

COMMENTARY

Socio‐technical infrastructure for a learning health system

 

Charles P. Friedman, Edwin A. Lomotan, Joshua E. Richardson, Jennifer L. Ridgeway

LEARNING FROM DATA

Privacy‐preserving record linkage across disparate institutions and datasets to enable a learning health system: The national COVID cohort collaborative (N3C) experience

 

Umberto Tachinardi, Shaun J. Grannis, Sam G. Michael, Leonie Misquitta, Jayme Dahlin, Usman Sheikh, Abel Kho, Jasmin Phua, Sara S. Rogovin, Benjamin Amor, Maya Choudhury, Philip Sparks, Amin Mannaa, Saad Ljazouli, Joel Saltz, Fred Prior, Ahmen Baghal, Kenneth Gersing, Peter J. Embi

RESEARCH REPORTS

Analysis of FRAME data (A‐FRAME): An analytic approach to assess the impact of adaptations on health services interventions and evaluations

 

Heather Z. Mui, Cati G. Brown-Johnson, Erika A. Saliba-Gustafsson, Anna Sophia Lessios, Mae Verano, Rachel Siden, Laura M. Holdsworth

 

Automated generation of comparator patients in the electronic medical record

 

Joseph Rigdon, Brian Ostasiewski, Kamah Woelfel, Kimberly D. Wiseman, Tim Hetherington, Stephen Downs, Marc Kowalkowski

 

Stakeholder perspectives on data sharing from pragmatic clinical trials: Unanticipated challenges for meeting emerging requirements

 

Stephanie R. Morain, Juli Bollinger, Kevin Weinfurt, Jeremy Sugarman

 

Learning healthcare systems in cardiology: A qualitative interview study on ethical dilemmas of a learning healthcare system

 

Sara Laurijssen, Rieke van der Graaf, Ewoud Schuit, Melina den Haan, Wouter van Dijk, Rolf Groenwold, Saskia le Sessie, Diederick Grobbee, Martine de Vries

 

Frameworks, guidelines, and tools to develop a learning health system for Indigenous health: An environmental scan for Canada

 

Emma Rice, Angela Mashford-Pringle, Jinfan Qiang, Lynn Henderson, Tammy MacLean, Justin Rhoden, Abigail Simms, Sterling Stutz

 

Predictive modeling for infectious diarrheal disease in pediatric populations: A systematic review

 

Billy Ogwel, Vincent Mzazi, Bryan O. Nyawanda, Gabriel Otieno, Richard Omore

TECHNICAL REPORT

Learning health system benefits: Development and initial validation of a framework

 

Lisa C. Welch, Sarah K. Brewer, Titus Schleyer, Denise Daudelin, Rechelle Paranal, Joe D. Hunt, Ann M. Dozier, Anna Perry, Alyssa B. Cabrera, Cheryl L. Gatto

BRIEF REPORTS

Exploring nationwide policy interventions to control COVID‐19 from the perspective of the rapid learning health system approach

 

Ayat Ahmadi, Leila Doshmangir, Reza Majdzadeh

 

Developing LHS scholars’ competency around reducing burnout and moral injury

 

Sirin Yilmaz, Michele LeClaire, Abbie Begnaud, Warren McKinney, Kasey R. Boehmer, Cory Schaffhausen, Mark Linzer

 

Assessment of learning health system science competency in the equity and justice domain

 

Patricia D. Franklin, Denise Drane

EXPERIENCE REPORTS

Training the next generation of delivery science researchers: 10‐year experience of a post‐doctoral research fellowship program within an integrated care system

 

Richard W Grant, Julie A Schmittdiel, Vincent X Liu, Karen R Estacio, Yi-Fen Irene Chen, Tracy A Lieu

 

Implementing the learning health system paradigm within academic health centers

 

Douglas Easterling, Anna Perry, David Miller

 

Learning from an equitable, data‐informed response to COVID‐19: Translating knowledge into future action and preparation

 

Morgen Stanzler, Johanna Figueroa, Andrew F. Beck, Marianne E. McPherson, Steve Miff, Heidi Penix, Jessica Little, Bhargavi Sampath, Pierre Barker, David M. Hartley

 

Conceptualizing and redefining successful patient engagement in patient advisory councils in learning health networks

 

Madeleine Huwe, Becky Woolf, Jennie David, Michael Seid, Shehzad Saeed, Peter Margolis, ImproveCareNow Pediatric IBD Learning Health System 

COMMENTARIES

Toward a common standard for data and specimen provenance in life sciences

 

Rudolf Wittner, Petr Holub, Cecilia Mascia, Francesca Frexia, Heimo Müller, Markus Plass, Clare Allocca, Fay Betsou, Tony Burdett, Ibon Cancio, Adriane Chapman, Martin Chapman, Mélanie Courtot, Vasa Curcin, Johann Eder, Mark Elliot, Katrina Exter, Carole Goble, Martin Golebiewski, Bron Kisler, Andreas Kremer, Simone Leo, Sheng Lin-Gibson, Anna Marsano, Marco Mattavelli, Josh Moore, Hiroki Nakae, Isabelle Perseil, Ayat Salman, James Sluka, Stian Soiland-Reyes, Caterina Strambio-De-Castillia, Michael Sussman, Jason R. Swedlow, Kurt Zatloukal, Jörg Geiger

 

Can we identify the prevalence of perinatal mental health using routinely collected health data?: A review of publicly available perinatal mental health data sources in England

 

Sarah Masefield, Kathryn Willan, Zoe Darwin, Sarah Blower, Chandani Nekitsing, Josie Dickerson

 

My source: Email request by -

Kathleen Young
Editorial Assistant, Learning Health Systems journal
Victor Vaughan
1111 East Catherine Street
Ann Arbor, MI 48109

Review: A systematic review and mixed- methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm

The systematic review featured here was tweeted:

https://twitter.com/t_hewson/status/1533800510343499779

- and being mixed-methods caught my eye. 

Below, I have mapped some of the concepts, themes and findings of the review to Hodges' model, adding some italicised points of my own.

The relevance of Hodges' model, in carceral, forensic, health and justice contexts is marked. The vertical axis's distinction of individual and group and the need to protect the public from dangerous individuals stands out. As does an individual's physical and mental state to the State - in the political domain. This extends to the Sociological as to the public's expectations over 'law and order' and what - should, must - happen to wrong-doers.

Where the model can help reflection, scoping, critical thinking and problem solving is in the disciplinary bridges it provides between knowledge, or what can be 'silos'; and, the many interfaces that are found within our activities, health, educational or generally. There are several interfaces in this systematic review: Prison staff - prisoner; prisoner - prisoner; prisoner - family; and where the custody function, butts up against that of the health - and how physical and mental health needs are met - or in this environment (literally) negotiated. There is a related finding (page 6):

"In contrast, in one establishment with low rates of self-harm, staff felt that their roles of ‘carer’ and ‘security officer’ were well integrated."

INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

SELF: Prisoner / Prison Officer (and Other roles) Prison staff - perceptions & attitudes self harm (thoughts, motivation) suicide (thoughts, motivation) Staff confidence, skills: Awareness - Prevention Caring - empathy 'manipulative', 'attention seeking' Insufficient training expressed emotion Staff member's wellbeing Capacity to care 'deep acting' emotional intelligence 'hope' QUALITATIVE

SELF: Adult Prisoner, Prison Staff [repetitive] self harm (means, action) suicide (means, action) Carceral environment (PRISON) self-harm - factors Research: Methodology, [Mixed] methods Systematic Review self-report - non-validated questionairres TIME [shift]: 'all the time', 'every time' location, time Staff member's wellbeing Capacity to care 'surface acting' Effect of COVID on self-harm: men/women Assessment tools ACCT - Assessment, Care in Custody and Teamwork processes QUANTITATIVE

Prison - Staff Culture male::female staff -> prisoner -> relatedness Staff - Prisoner interactions in self-harm management Behavioural - learning/copying role - models clarity 'shared/pervasive sense of hope' 'Life skills - literacies' Social determinants of Health (Crime?)

Self-harm: Policy NICE guidelines 'Correction', Young Offender Inst. control–support model demands - resources model Occupational stress Staff Support Training Prison officer training 'Intro 101'?

The comments gleaned from staff are very informative. Also of interest here are ongoing developments in trauma-informed care and this can cover emotional trauma, as in abuse, plus head injury which is a key screening initiative. Achieving parity of esteem across physical and mental health, demands a more delicate balance in health and justice.

'Hope' is a concept subject to much analysis, for example, in the healthcare, sociological and philosophical literature. Incarceration, must bring its own 'trauma', which will vary in its signature across individual, age, first-offence, recidivism, offence, legal processes ... and its impact upon hope. From the challenge of the individual prisoner and their hope, there is the challenge for prison management and policy to instill, facilitate a shared, sense of hope. Amid the news on the state of prisons, there are no doubt examples where this can and is delivered.

Hewson, T., Gutridge, K., Bernard, Z., Kay, K., & Robinson, L. (2022). A systematic review and mixed-methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm. BJPsych Open, 8(4), E102. doi:10.1192/bjo.2022.70

 

Individual & Group process - Collective Intelligence [CI] c/o Radcliffe, et al. (2019)

No explanation is needed as to why this paper caught my attention in a tweet that featured the figure [2] below? The context is medical, not nursing and the extended multidisciplinary team, but as per the threshold concepts post the focus is decision making.

From a nursing perspective and using Hodges' model the 'individual processes' would include data gathering, patient assessment, liaison with relatives and colleagues and reflection to integrate information. Evidence-based sources will also be involved depending on the reason for referral, the patients (relatives) account, and the status of the diagnosis. Information technology input will be through the electronic health record that should also provide a history of previous episodes of care and the conclusions reached.

Within Hodges' model below I have added socio-technical and governance. Perhaps, as a systematic scoping review and applied to a specific healthcare profession there is less emphasis on the 'political' dimensions of decision making (management, policy, rules, reporting, targets). Equally from a nursing perspective there is the 'data cleaning' within the research process but then also nurses, and students in particular not being negatively impacted by comments about a forthcoming clinical placement, or a patient / client who has been referred (or referred) to the service / team.

individual - self

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group- population

individual as subject of mental health Dx Individual knowledge and experience Reflection Learning and decision-making styles and bias (positive and negative?) Feedback from Collective Intelligence?	individual as subject of physical Dx Analysis Individual Input Group Input Synthesis Information Technology
Collaborative working Clinical Teams Level of SOCIO-technical integration	outcomes Studies were:  individual or group process several a combination. governance

My source:

TIL about collective intelligence in medical decision-making: Radcliffe, @UrmimalaSarkar &co found 15 studies thereof. Interesting! There are tech-supported forms now, but no strong evidence about their effects on patient care. https://t.co/TdQwwRQ4tg pic.twitter.com/odtjjv5hUg

— Hilda Bastian (@hildabast) August 13, 2019

Radcliffe, K., Lyson, H. C., Barr-Walker, J., & Sarkar, U. (2019). Collective intelligence in medical decision-making: A systematic scoping review. BMC Medical Informatics and Decision Making, 19(1), 158. https://doi.org/10.1186/s12911-019-0882-0

c/o BMJ Open: Mapping of modifiable barriers and facilitators of medication adherence in bipolar disorder to the Theoretical Domains Framework

Finding this item on twitter c/o @Stuart__Maddock its interest and relevance to me is explicit in the title, but also as a protocol, with more to follow. The range and application of the domains listed and the four themes also have significance here. The abstract includes:

"This systematic review aims to identify modifiable barriers and facilitators (determinants) of medication adherence in bipolar disorder. We also plan to report determinants of medication adherence from perspectives of patients, carers, healthcare professionals and other third parties. A unique feature of this systematic review in the context of mental health is the use of the Theoretical Domains Framework (TDF) to organise the literature identified determinants of medication adherence."

Of course there are many potential overlaps. For example, knowledge; the decision processes - to what extent are they collaborative - studies with patient involvement, also concerned with concordance not just adherence? Are they supported through the use of digital technology? Goals can be multiple as in person - patient centred, to support carers, policy development or an assessment instrument. That 'emotion' is all too readily experienced by families too in the event of relapse.

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

(1) Knowledge (4) Memory, Attention and ... (7) Beliefs about Capabilities, (8) Belief about Consequences (9) Optimism, (10) Intentions (11) Goals, (12) Emotion	... Decision Processes (4) (13) [Physical] Environmental Context and Resources
(2) Skills (3) Social Influences (5) Behavioural Regulation (6) Professional/Social Role and Identity (13) [Social] Environmental Context and Resources (14) [Social] Reinforcement	(13) [Political] Environmental Context and Resources (14) [Political] Reinforcement.

"Within Nvivo V.12, we will create four themes in line with the aim of this study" ...

I have mapped these themes to Hodges' model as follows:

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

Patient Perspective	HealthCare Professional Perspective
Carers Perspective	Others Perspectives

These themes reflect to some degree the original website (1998-2015) introductory pages for potential users (four audiences) of Hodges' model per each care domain, as follows:

INTRA- INTERPERSONAL: Patients, Service users, Clients
SCIENCES: Students, Lecturers, Health care professionals, Researchers, Social workers ...
SOCIOLOGY: Carers, the Public, Communities
POLITICAL: Managers, Policy makers, Law makers ..


See also: Elizabeth Mamo
https://twitter.com/ehmamo/status/1095322471224537092

Prajapati AR, Dima A, Clark AB, et al. Mapping of modifiable barriers and facilitators of medication adherence in bipolar disorder to the Theoretical Domains Framework: a systematic review protocol

BMJ Open 2019;9:e026980. doi: 10.1136/bmjopen-2018-026980

WHO Housing and health guidelines

"Recommendations to promote healthy housing for a sustainable and equitable future"

The quality of housing has major implications for people’s health. Housing in cities is of particular concern, with the world’s urban population predicted to double by 2050 and, with it, the demand for housing. In both developed and developing countries, improving housing conditions and reducing health risks in the home is thus critically important.

Improved housing conditions can save lives, reduce disease, increase quality of life, reduce poverty, help mitigate climate change and contribute to the achievement of a number of Sustainable Development Goals, including those addressing health (SDG 3) and sustainable cities (SDG 11). Housing is therefore a major entry point for intersectoral public health programmes and primary prevention. [Foreward, p.xii]

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------ SDG 3 HEALTH----------- mechanistic

SOCIOLOGY : POLITICAL

|

group

Mental Health Peace of Mind Sense of Well-Being Confidence Identity "Functional impairments are often operationalized in terms of whether a person can accomplish activities of daily living (ADL) or instrumental activities of daily living (IADL). IADL refers to basic tasks of everyday life such as bathing, dressing, transferring, toileting, continence and feeding. -	SDG 11 Sustainable cities Housing - Dwellings Indoors - Pollution - Outdoors benzo[a]pyrene carbon monoxide, particulate matter, ... Indoor heat :: Indoor cold Injury hazards, structure Research Weatherization Heat - Temperature - Cold Insulation Space, Noise, Fuel, Energy, Light Accessible home environments for people with functional impairments
ADL refers to a range of activities that are required for independent living in the community, such as preparing meals, housekeeping, taking medication, shopping, managing one’s own finances, travelling and using the telephone." p.69. HOME -  belonging, security and privacy Household Crowding - health Community Water access WASH water, sanitation and hygiene Social interactions	local, regional, national government Ministries of Health Housing regulations Standards Policy Funding - Cost Effectiveness Reduce poverty Impact of housing on: morbidity staying well, relapse risk hospital admissions recidivism  ...

After 41 years of listening - now it's your turn [ please ]...

If you are a researcher, author, lecturer or editor ... (you get the gist already...) and the project that currently has your undivided attention (well, almost) is a draft paper or literature review on any of the following:

metamodels of care / nursing / healthcare / global health
metacognition of care / nursing / healthcare / global health

holistic care / nursing
integrated care / nursing

models of care

models of nursing
theories of nursing

models of healthcare

conceptual frameworks in health, social care or education
(across - theory, practice, commissioning, funding)
history, current state, future of the above..

(I could add more)

- then please consider this request.

If there is no reference in the work to Hodges' model, as in:

The Health Career Model

Hodges' Health Career Model

Hodges' Health Career - Care Domains - Model

The Health Career - Life Chances - Model

- then I would humbly suggest to you that the work in front of you is incomplete.

Yes. I am variously disappointed, dispirited, desperate* since the terms of a well thought out, comprehensive search strategy should surely pick up a breadcrumb leading to Hodges' model? Fellow mentors and supervisors I need some help.

But, help with which one you may well ask?

Well, here's some background to account for the seeming lack of version control:

The Health Career Model

 &
Hodges' Health Career Model

These were the original titles for the model. The 'health career' has always referred to the idea and phenomena of 'life chances' (see bibliography in sidebar for Hughes).

Hodges' Health Career - Care Domains - Model

The original website from 1998 appeared to cause some confusion with visitors taking career to relate to work and professional opportunities. The 'care domains' addition sought to distract from that, to emphasize the care knowledge quality of the model.

The Health Career - Life Chances - Model

I have always tried to include Hodges' in the titles I have employed. More recently, it appears that using a name appears to accentuate the perception for others that the model was "Not invented here". Plus, there may be copyright and other proprietary provisions.

The reference to Hughes and life chances goes back to 1958, but seems even more relevant now given the importance of epigenetics, technology, sustainability, ecology, universal health care, access to information and healthcare knowledge and global health.

So, even if not germane to the main arguments of the paper or work at hand I would hope that the model might at least be referenced, as per:

Maffissoni, André & Vendruscolo, Carine & De Lima Trindade, Letícia & Zocche, Denise. (2018). Redes de atenção à saúde na formação em enfermagem: interpretações a partir da atenção primária à saúde. Revista Cuidarte. 9. 1-13. https://revistacuidarte.udes.edu.co/index.php/cuidarte/article/view/549

Many thanks!

Loneliness: across the Domains c/o BMJ

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group-population

isolation loneliness mental health feelings  identity  meaning motivation - behaviour SUBJECTIVITY	physical health, coronary heart disease , stroke mortality longitudinal observational studies meta-analysis systematic review OBJECTIVITY
social network  family - relationships - befriending social isolation quality of life family - community cohesion social enterprise SOCIO-	policy social care provision day centers mobility - transport volunteering public - funding - private economic

Valtorta, N.K., Kanaan, M., Gilbody, S., et al. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart. Published Online First: [April 18, 2016]. doi:10.1136/heartjnl-2015-308790

My original source:
Smyth, C. Warning: loneliness as bad for your health as tobacco & Scourge of Loneliness. The Times, 20 April 2016, p.4 and 20.

"eLearning for undergraduate health professional education - a systematic review informing a radical transformation of health workforce development"

"Designing for learning is a complex task which requires a holistic approach. According to Mayes and de Freitas (24), the implementation of blended learning should consider learning at three different levels: as behaviour, as construction of knowledge, and as a social practice.

The behaviourist learning theory (25,26) suggests that we learn by receiving a stimulus that consequently produces a response. It therefore concentrates on low-level cognitive tasks or psychomotor skill learning (27). ... According to Horton (28), drill-and-practice activities are useful when learners need to learn automated procedures that must be performed and applied without much conscious thought as part of higher-level activities (28). 

In contrast to the behaviourists’ approach, the cognitivists focus their attention on how students gain and organize their knowledge (27). Piaget (29) and his constructionism theory of knowledge has been particularly influential with his assumption that conceptual understanding can be reached through intellectual activity rather than by merely absorbing information. The cognitive perspective emphasizes the process of reaching “understanding” through an active process of creating hypothesis, application of knowledge and reflection (30)." (p.97)

Imperial College London, World Health Organization (2015). eLearning for undergraduate health professional education - a systematic review informing a radical transformation of health workforce development. Al-Shorbaji, N., Atun, R., Car, J., Majeed, A., & Wheeler, E. (eds.).
https://apps.who.int/iris/handle/10665/330089

Paper - The effectiveness of internet-based e-learning on clinician behavior and patient outcomes: a systematic review

As I work on my research proposal this paper (in press) is a very useful and timely reference...


Abstract - Background

The contemporary health workforce has a professional responsibility to maintain competency in practice. However, some difficulties exist with access to ongoing professional development opportunities, particularly for staff in rural and remote areas and those not enrolled in a formal program of study. E-learning is at the nexus of overcoming these challenges. The benefits of e-learning have been reported in terms of increased accessibility to education, improved self-efficacy, knowledge generation, cost effectiveness, learner flexibility and interactivity. What is less clear, is whether improved self-efficacy or knowledge gained through e-learning influences healthcare professional behaviour or skill development, whether these changes are sustained, and whether these changes improve patient outcomes.

Sinclair et al. refer to:

"One suitable framework that is congruent with e-learning research is Kirkpatrick’s four levels of evaluation." (p.53).

I have taken the rest of the paragraph and mapped the stated levels to Hodges' model:

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

Level two pertains to learning and the evaluation of knowledge.	Kirkpatrick’s model is hierarchically based with level one relating to student reaction and how well the learner is satisfied with the education program.
Level three expands on this and considers whether the education has influenced behavior. In the context of this review, behavior change is any practice that is intrinsically linked with the outcomes of the e-learning program undertaken.	Finally, level four evaluates the impact on outcomes such as cost benefit or quality improvements.

The author's continue: "The majority of e-learning research has focused on participant experience and knowledge acquisition, outcomes that correspond with the first two levels of Kirkpatrick’s model. To date, few studies have examined the effectiveness of internet-based e-learning programs on HCP [health care profession] behavior, which aligns with Level 3 of Kirkpatrick’s model (p.54)."

Peter M. Sinclair, Ashly Kable, Tracy Levett-Jones, Debbie Booth, The effectiveness of internet-based e-learning on clinician behavior and patient outcomes: a systematic review, International Journal of Nursing Studies, Available online 4 February 2016, ISSN 0020-7489, http://dx.doi.org/10.1016/j.ijnurstu.2016.01.011
(http://www.sciencedirect.com/science/article/pii/S0020748916000122) 

Keywords: e-learning; Systematic Review; Education; Information Communication Technology; Health Care Professional

GRADE CERQual, Reflection, Mixed Methods and Threshold Concepts

On leave this week and as per a previous post I attended the GRADE CERQual workshop last  afternoon. It was a very helpful exercise, a presentation and some group work. ...

I've now 5000 exploratory words on Threshold Concepts with Hodges' model and bringing in prospective research methodologies. The final module of Part 1 beckons (reading, reading...) and this work will help and might be worthy of publication. I'm just adding some other points from the following sources:

Knight, S. (2015) Realising the benefits of reflective practice. Nursing Times; 111: 23/24, 17-19.

I can cite the above as reflection is never far away in theory, practice and students on placement. Is there is a role for Hodges' model? I believe there is and Collins et al further demonstrate the need as nurses evidence reflection on their professional reading for revalidation from April 2016. Collins writes (my emphasis):

Reflection should be undertaken using a recognised model as this adds structure and provides direction. The model used should be chosen by the individual and influenced by a number of factors such as ease of use, understanding and ease of flow when writing. Models without these elements will give the writer a negative experience of the reflection process (p.14).

Collins, G. et al (2015) Using reflection on reading for revalidation. Nursing Times; 111: 23/24, 14-16.

The final paper for now:

Evans, B., Coon, D., & Ume, E. (2011) Use of Theoretical Frameworks as a Pragmatic Guide for Mixed Methods Studies. Journal of Mixed Methods Research, 5(4), 276-292.
DOI: 10.1177/1558689811412972

- begins with a quotation:

A mixed methods way of thinking is an orientation toward social inquiry that actively invites us to participate in dialogue about multiple ways of seeing and hearing, multiple ways of making sense of the social world, and multiple standpoints on what is important and to be valued and cherished.

—Greene (2008, p. 20)

The paper refers to maps, conceptual and theoretical frameworks. H2cm is a map and a conceptual framework, but not a theoretical framework; unless theory is implied (instantiated) in its structure?

Evans, Coon, and Ume (2011) write:

Clearly, such frameworks could assist with navigation in mixed methods studies consisting of concurrent or sequential investigations, facilitate integration of methods in at least one phase of the inquiry, and provide a map for combining the what with the why to gain a multidimensional understanding of causal mechanisms. Utilization of such frameworks could, then, fit snugly into Tashakkori and Creswell’s (2007) recent definition of mixed methods: “Research in which the investigator collects and analyses the data, integrates the findings, and draws inferences using both qualitative and quantitative approaches or methods in a single study or program of inquiry” (p. 4). (Evans et al. p.278)

Researcher's are by definition forced to adopt a methodological position and argue it; defend it too! I'm not advocating for something else, but for Hodges' model this is akin to being pressed to hear the Song of the Sirens and suffer the consequences. This model does not want to be tied to the mast.

It is the mast and sail.

Hodges' is mixed methods incarnate - out of the box, in and between them:

Demand-Supply
Service Centered-Person Centered
Self-Other
Health-Well Being-Disease
Individual-Population

Qualitative-Quantitative

Objective-Subjective

Socio-Technical

Mind-Body

....

...

..
.

     Past-NOW-Future

How do you Balance and Elevate Holism and Patient Safety?

We have tended to focus on problems in isolation, one harm at a time, and our efforts have been simplistic and myopic.

To significantly reduce patient harm, we need to adopt a holistic, systematic approach that extends across cultural, technological and procedural boundaries - one that is based on the evidence of what works.
...
Taking its lead from developments in highway and airline safety, the report^* argues in favour of a holistic approach, integrated systems, comprehensive risk assessment and performance reporting, regulation and the creation of a "science for safety".
Darzi (2015).

What instruments does a "science for safety" need?

How can we balance procedure, patients, practice, drug delivery connections, cost, staffing and technology... How can we elevate care, competency, compassion, communication, commitment, courage and values between individual and group levels?

Having agreed and identified the essential sources of evidence (humanistic and mechanistic), how can we integrate them?

Ara Darzi (2015) Patient safety needs to be improved. Health Service Journal, 13 February. 125: 6434, p.18.

^*Transforming Patient Safety: A Sector-Wide Systems Approach
Peter J Pronovost, Alan D Ravitz, Robert A Stoll, Susan B Kennedy
https://www.imperial.ac.uk/media/imperial-college/institute-of-global-health-innovation/public/Patient-safety.pdf

Issue 2, 2009 of The Cochrane Library

Issue 2, 2009 of The Cochrane Library is now available. Among the new and updated Cochrane Reviews you will find :

• Homeopathic medicines for adverse effects of cancer treatments
• Music for stress and anxiety reduction in coronary heart disease patients
• Interventions for preventing falls in older people living in the community
• Extraction of primary (baby) teeth for unerupted palatally displaced permanent canine teeth in children
• Psychological therapies for the management of chronic pain
• Topical treatments for chronic plaque psoriasis
• Alcohol and drug screening of occupational drivers for preventing injury
• And many more … www.thecochranelibrary.com

Some of these reviews have been highlighted in Evidence Podcasts and are free to access.

Please see the Release Notes for a summary of the updates in this issue. Users can also access our Highlights PDF to learn more about the findings of new and updated Cochrane Reviews.
The Cochrane Library

The Cochrane Handbook for Systematic Reviews of Interventions is now available in print format. It is published by John Wiley for The Cochrane Collaboration.

Editors: Julian P. T. Higgins MRC Biostatistics Unit, Cambridge, UK Sally Green Australasian Cochrane Centre, Monash University, Melbourne, Australia

There is a 25% discount for Cochrane Review authors and an information page for the book where authors can also order, with a prompt to enter their discount code.

Wiley authors are entitled to a 25% discount not only on their own titles, but on all Wiley books, when ordering either via the site, by phoning customer services or filling in any printed order forms.


Images and my source: John-Wiley mail-list