The Difference that Makes a Difference: an interdisciplinary workshop on information and technology

Location: The Open University, Milton Keynes, UK

Dates: 7-9 September 2011

Few people would argue that the development of information technologies has had a profound impact on modern society. Information is communicated, stored and manipulated using digital computers, the Internet, and fixed and mobile telephony, resulting in a deep and extensive impact upon all aspects of our lives. While talk of information is routine and unproblematic for engineers and technologists, it has been recognised since the early days of digital technologies that there is an uneasy relationship between the engineer’s concept of ‘information’ and wider uses of the word (cf. Roszak, 1986).

It is nevertheless appreciated that information, whatever is meant by this concept, is important – indeed it is foundational – to a quite remarkably diverse range of disciplines. Information is emerging not only as the new language of science - from quantum information to the genetic code - but as a key commodity of business, a major concern of the state, the front line for crime and crime prevention, the primary arena of technological development, an increasing concern of philosophy, and even a focus for conceptual art. Indeed, it is difficult to identify any field of life in the developed world that can not now be seen to some degree to have a significant information aspect, and to a greater or lesser extent this has all emerged because of developments in information technology.

The idea of information as a distinct concept, applicable across a wide range of disciplines, is growing in prominence. It has been especially emphasised within the natural sciences (von Baeyer, 2003; Vedral, 2010; Davies and Gregersen, 2010) and philosophy (Floridi, 2010). Much of this work takes information theory as developed by technologists, beginning with Shannon (1948), as its starting point, but draws little on contemporary work of technologists. At the same time, a different strand of work has arisen, drawing its inspiration from the growing influence of the Internet, and largely conducted by technologists (e.g. Weinberger, 2007; Brown and Duguid, 2000). This research in turn has little connection with the work in natural sciences and philosophy.

As we move further into the ‘information age’, we need to make the bridge between information of the information technologist and understanding of information in other disciplines. As researchers and practitioners in diverse fields grapple with an understanding of information – what it is, how it can be modelled and tools for coping with it – now more than ever is the time to share insights and bring some clarity and coherence to these differing perspectives.

We have begun some of that work, largely with colleagues around the Open University, resulting in a recent edited book (Ramage and Chapman, 2011). However, these discussions need to go much wider and deeper. We therefore propose to hold an international workshop to bring engineers and technologists together with scientists, philosophers, social scientists and artists – leading thinkers from all and any discipline that uses the language of information – to talk and listen, and to share their insights with us all.

There have been and continue to be many conferences, symposia and workshops addressing the technology, the applications and the consequences of information technology, but it is rare to find opportunities to address the understanding of the nature of information itself.

The need for work addressed more specifically at understanding the nature of information is exemplified by a problem expressed by Terrence Deacon (2010):

For more than half a century we have known how to measure the information-conveying capacity of any given communication medium, yet we cannot give an account of how this relates to the content that this signal may or may not represent. These are serious shortcomings that impede progress in a broad range of endeavors, from the study of basic biological processes to the analysis of global economics.

This workshop seeks to bring together those working with information in a wide range of disciplines - engineers and technologists together with scientists, philosophers, social scientists and artists - to discuss and expand our collective understanding of what we mean by information in our different disciplines. We are not seeking to combine these different understandings, but to share them and to explore commonalities.

The title of the workshop is based on a celebrated definition of information by Gregory Bateson (1972, pp.457-9), who wrote:

A difference is a very peculiar and obscure concept. It is certainly not a thing or an event. This piece of paper is different from the wood of this lectern. There are many differences between them – of color, texture, shape, etc. But if we start to ask about the localization of those differences, we get into trouble. Obviously the difference between the paper and the wood is not in the paper; it is obviously not in the wood; it is obviously not in the space between them, and it is obviously not in the time between them. (Difference which occurs across time is what we call “change”.) ...

Kant, in the Critique of Judgment – if I understand him correctly – asserts that the most elementary aesthetic act is the selection of a fact. He argues that in a piece of chalk there are an infinite number of potential facts. ... I suggest that Kant’s statement can be modified to say that there is an infinite number of differences around and within the piece of chalk. There are differences between the chalk and the rest of the universe, between the chalk and the sun or the moon. And within the piece of chalk, there is for every molecule an infinite number of differences between its location and the locations in which it might have been. Of this infinitude, we select a very limited number, which become information. In fact, what we mean by information – the elementary unit of information – is a difference which makes a difference.

The workshop will consist of four main sessions, each with keynote speakers and a number of presentations from others. Our goal is for maximum participation. If you are interested in the role and nature of information, we invite you to join us in Milton Keynes in September.

Magnus Ramage and David Chapman

Thanks to David for my being able to post these details here. I have registered and if time permits will submit an abstract. I'm really looking forward to this workshop. pj

Jones, P. (1996) Humans, Information, and Science, Journal of Advanced Nursing, 24(3),591-598.

'information' on W2tQ

Musings... the elusive transdisciplinary particle(s!)

At any moment there are concepts and phrases that creep into the everyday and academic vernacular, even when their precise meaning is not clearly defined or understood. Such terms may be used interchangeably, as if one means the same as another. Two examples are multidisciplinary and interdisciplinary, followed by intradisciplinary (perhaps not as common) and transdisciplinary. We are already familiar with multidisciplinary; in the form of the team and the record, but what of these other terms?

These musings are not an attempt to define them (the above title would differ). Reading 'transdisciplinary' et al. it may seem like they should be restricted to the keyword list of an academic paper; or found in the very title of a journal as can be readily found. My fascination lies in them all, but for me it's Transdisciplinarity that invites the high-five.

I came across what sounds a marvellous course of study in Zurich - the Master of Arts in Transdisciplinary Studies. Zurich is not alone in offering such programmes. Reading their course introduction on the above link you will see the instant appeal as a champion for #h2cm.

These terms are of relevance here – due to another: complexity. In truth every age has its complexities. In this age and here on W2tQ the complexity stands out as we mix health, education and information technology. It is often suggested that the World's problems are such that they demand transdisciplinary solutions. Success in assuring a sustainable food supply, climate change, energy production, and our general well-being ... depends on the researchers in one field being aware of, testing and utilising ideas, materials, methods and methodologies from what are usually totally disparate disciplines – fields of enquiry. Making these connections calls for opportunities to take time out, network, engage in (variously mediated) dialogue, and funding to fuel insight, innovation and creativity. (Sometimes, disciplines need their heads banging together). Although seemingly denoting a broad scope, the term is often used in specific problematic areas of research including sustainability, transport, energy, waste management. ...

In health and social care Hodges' model figures here because in effect the model declares that it wants its cake and will eat it. By this I mean that to the model the disciplines are distinct and need to be treated as such; but also that the disciplines with their history, epistemological qualities, theories and practices, and respective research agendas need to step outside their box. They need to traverse the conceptual space represented within the model – and be prepared to travel back and forth outside the comfort zone.

In struggling to resolve the 'transdisciplinary' perhaps there are devices up to the task and fit for purpose; that is if we care to look, feel, smell, taste and listen hard enough?

Can we find evidence for this trend towards transdisciplinarity?

What about evidence in the movement and advocates for interprofessional education? Some disciplines are churlish, reluctant bed-fellows, eschewing the opportunities offered. Others embrace interprofessional learning. As per the Web they readily, even if unconsciously, adopt the mash-up mentality and attitude. They may preserve their status and integrity with a hybrid approach; keeping discipline centred training (essential for continuing professional development) but also taking advantage of what interprofessonal education and training might offer. As health services standardise on assessment and outcome measures then this approach, this trend toward the transdisciplinary seems common sense in terms of efficiency.

If in a health context you feel that transdisciplinary is a step too far, then please recall* those recurring health conundrums that constantly exercise theory, practice and management. You know the line-up:

• multidisciplinary care
• health care records
• person-centered care
• health care vs. education...

Solutions that are not derived on a transdisciplinary basis may well work; but not as well as they might. It may be that appeal to the transdisciplinary is merely blue sky thinking. It has its place on the leading edge of scientific and technical innovation but not here. Given the challenges outlined previously it appears health and the idealism of staff need an injection of idealism. Could it be that transdisciplinary approaches can form the basis for a new idealism? To complete this interprofessional educational point, perhaps this means of educational engagement can potentiate future transdisciplinary initiatives? Not directly on the level of ward, community team, clinic but tackling those so called bigger picture themes like health education, health promotion, service access.

A further give-away trail that might provide evidence of the elusive transdisciplinary particle is the curriculum? While some institutions may find their compromise (because this is a problem) informatics is struggling to retain or even find a place on the nursing curriculum. The curriculum is full. It is packed. If nothing else this highlights the complexity alluded to earlier. Like the increased embedded functionality our electronic devices provide both within the circuit boards and when in our hands, clinical informatics needs to be embedded in the respective curricula. What does this say of education, of the curriculum? Perhaps the reason why transdisciplinarity seems ephemeral and quixotic is that our transdisciplinary efforts are tantamount to a collective (group) mindfulness. First steps and collisions are never easy. ...

Additional links:

Transdiscipline - TheATLAS
Journal of Transdisciplinary Federation of Science and Technology

Image source - Drakenstein Palliative Hospice

* The above musings and the others on #W2tQ are from a longer text in draft. PJ

Argumentation - Journal: Informal Logic

Early evening (UK) yesterday, I joined a further webinar on argumentation. Through the speaker, and discussion, I was led to a journal

INFORMAL LOGIC

It is in informal logic that I see a role for Hodges' model. The model's structure providing a universal foundation of knowledge domains to be applied in practice. The bonus of this journal, is its being open access, a search revealed the following paper:

Mark Weinstein. Towards a Research Agenda for Informal Logic and Critical Thinking. XII.3, Fall 1990.
https://ojs.uwindsor.ca/index.php/informal_logic/article/view/2609

'This paper recommends that the recent concern with informal logic and critical thinking be redirected from its general philosophical focus and towards a greater appreciation of the particulars of practice in the various domains of human understanding. The redirection recommended is prompted by the central role that critical thinking and informal logic can be seen to play in meaningful educational reform, especially at the undergraduate level.' 

'Critical thinking, similarly, should be redirected from concerns typical of philosophers and towards issues and approaches more representative of critical thinking both within and across the wide range of disciplines represented by the course of undergraduate studies.' p.121.

'The sense that there is an internal relationship between arguments, argumentation and domains of knowledge persists despite attempts to show relevant and useful notions of critical thinking that are generally available for instruction and neutral in respect of the disciplines. The resolution of the issues generated by these competing views, requires that reflective practitioners of the disciplines, students of the history of ideas, methodologists and specialists in teaching increasingly engage in the task of generating and organizing the data upon which an informed and adequate notion of critical thinking across the disciplines must be based.' p.125.

I believe that the structure of Hodges' model provides a basis for Weinstein's ordinary argumentation and stylized argumentation.

For me (at present) ordinary argumentation, is 'open' argumentation. That is, without differentiation in (using) Hodges' model. I might (well, I would) have Hodges' model in mind, but choose not to apply it. As per the paper, stylized argumentation is using Hodges' model and doing so in a multidisciplinary manner - within my discipline. 

The problem and challenge for nurses and other health professionals is the need, if:

• person/patient-centred;
• integrated;
• and holistic - having regard for parity of esteem (mind - body)

- not to stray, extend the disciplinary scope, while working within one's professional scope.

In highly effective multidiscioplinary teams that touch on being transdisciplinary (hybrid?), can experienced team members have insight into the stylized argumentation of their colleagues?

Ack. ​Argumentation network of the AMERICAS - https://www.argnet.org/ethics-of-arg.html

Previously: 'critical thinking'

Use and ab-use of knowledge

The effective ‘use’ of knowledge is constantly espoused in health care both informally with patients and formally in evidence based research. Knowledge is the key to improving patient safety and delivering efficient, high quality care interventions and effective outcomes. Things become complicated in health and social with the number of potential knowledge sources and the disciplines intent on seeing, gathering, recording and utilizing knowledge that is theirs. From that adopted vantage point they are bound to have a certain perspective.

There are still vestiges of C.P. Snow’s The Two Cultures (1959) when we view the use and ab-use of knowledge, particularly the way knowledge is sliced, diced, partitioned and housed into disciplines. In the Introduction to Michel Serres' Parasite, Cary Wolfe notes that:

... the Latin prefix ab- meaning, the Oxford English Dictionary tells us, “off, or away from”: "abuse" value at a tangent to use and exchange value, at a distance from it: a different vector, a different type of value (Wolfe, 2007). p. xx.

Literally looking at the model we see that whilst there is increasing interdisciplinarity and collaboration between disciplines, practitioners and managers, academics and policy makers … there remains much ab-use between the domains of (care) knowledge.

If by definition abuse brings individuals, agencies and whoever falls in-between into disagreement, dispute and possibly much worse then clearly a tool that can help furnish a common understanding and insight should be welcomed.



For all that Hodges’s model can offer as a common foundation and bridge for the disciplines, we must ask where is the patient, the carer and the public? Is there a new discipline emerging?

What is needed to help gauge the potentials of use and ab-use in health and social care ...?

Additional links - for the image:
Coxeters Loxodromic Sequence of Tangent Circles
http://mathworld.wolfram.com/CoxetersLoxodromicSequenceofTangentCircles.html

Donald Coexeter
http://www.geometry.net/detail/scientists/coxeter_donald.html

Snow, C.P. (2001 [1959]). The Two Cultures. London: Cambridge University Press.

Wolfe, C. (2007). Introduction to the New Edition. Bring the Noise: The Parasite and the Multiple Genealogies of Posthumanism. In Serres, M. (1980). The Parasite. University of Minnesota Press.

Image source:
http://en.wikipedia.org/wiki/File:Coxeter_circles.png

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

A transdisciplinary model of practice

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

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

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

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

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

'Holistic pluralism'

Individual

|

      INTERPERSONAL    :     SCIENCES               

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

 SOCIOLOGY  :    POLITICAL 

|

Group

Rational choice theory	Natural sciences theoretical & methodological pluralism functionalism
Social sciences - Humanities	policy

from Abstract:

"The theoretical and methodological pluralism that we suggest here, holistic pluralism, is one way to overcome incommensurability between the natural and the social sciences while avoiding functionalism, technological and environmental determinism, and over-reliance on rational choice theory." 

from Introduction:

"The fact that sustainability science is “dealing with interconnected problems” (Kauffman and Arico 2014:413) requires that researchers in the field take a comprehensive, integrated, and participatory approach to science and reality (Sala et al. 2013). This explicit ambition to integrate knowledge—across scales, sectors, and substance domains, and across the nature-society, science-society, and knowledge-action divides—implies that sustainability science must inherently live up to (at least) three things. It must build on several foundational disciplines and have the capacity for interdisciplinarity; it must embrace theoretical and methodological pluralism and have the capacity for reflexivity (Isgren et al. 2017); and it must integrate knowledge generated from engaging with different disciplines, theories, methods, and contexts, and thus aspire to transdisciplinarity. Rather than merging or unifying the actual disciplines or their theories and methods into integrated frameworks, we argue that pluralism is the best way forward for dealing with sustainability challenges, such as biodiversity loss, climate change, land use change, water scarcity, and ill health. In this article, we use ontological, epistemological, and theoretical reasoning to support our argument. The critical ambition is to provide the rationale for a new approach that has the potential to capture the best available knowledge on social and natural dimensions of sustainability; we call it social fields and natural systems. The problem-solving ambition is to describe the approach and illustrate it in two empirical examples. If successful, this will show how holistic pluralism is one possible way of integrating knowledge across the social and natural science divide."

Figure 2 Olsson, L., & Jerneck, A. (2018).

It may be useful to consider figure 2, using the domains of Hodges' model?

Note how in Hodges' model, as 'political ecology' seeks to interrogate the relationship between society and nature (the environment, the sciences): we see a diametric relation. Inevitably then, the political ecologist must also negotiate, interpret, seek the policy evidence from within; perhaps an output, a creation of citizens?

Olsson, L., & Jerneck, A. (2018). Social fields and natural systems: integrating knowledge about society and nature. Ecology and Society, 23(3). https://www.jstor.org/stable/26799148

Extraordinary lives: Demographic influences on academic studies - Life Writing, Life Story Work

Recent reading for studies at Lancaster included
Ethics of Internet Research: Contesting the Human Subjects Research Model

Beyond a week's focus on ethics the above refers to Life Writing:

The study of Life Writing spans many disciplines, and represents 'a fast changing terrain' which is concerned with the study of the writing of lives, encompassing auto/biography as well as aspects of life story that originate outside the written form, such as oral history, testimony, and artifacts such as photography and the visual arts (Jolly, 2001, p. ix). The written text is viewed as a vehicle for an individual's construction of identity, the personal narrative that it records being

…a fundamental means by which people comprehend their own lives and present a 'self' to their audience. (Borland, 1991, p. 71)
...
The multiple approaches taken in Life Writing research can arguably be attributed to the multidisciplinary background of its practitioners. Like Internet researchers, those researching Life Writing have been trained in a variety of disciplines including anthropology, sociology, history, linguistics and literary theory. These various disciplines have contributed a range of insights into the collection of oral history and analysis of the resultant texts (Gluck and Patai, 1991, p. 3). Ethical guidelines for the conduct of Life Writing researchers, such as those published by the Oral History Society in the UK, appear to follow a human subjects model, focussing on the undertaking of the interview, and restricting discussion of the resultant text to issues of copyright. Yet practitioners emphasise the need to remember that as:

…the typical product of an interview is a text, not a reproduction of reality …models of textuality [are] therefore needed. (Gluck and Patai, 1991, p. 3)

What chance is there that Life Writing will be - is being influenced by current demographic and societal trends? Trends and challenges that inevitably present new meanings for history within life and with this new ethical issues? While life writing is clearly an established discipline, how might it develop and what other challenges might apply?

In health and social care Life Story Work is an important part in of assessment and interventions. Has it been discussed, is it appropriate, completed and if so, is this work available and accessible? Do we need people beyond the existing establishment with a dedicated set of skills and knowledge to engage with people diagnosed early on, or will treatments soon make this less of an issue? Will dementia and early dementia especially, with the latest technology prompt new perspectives, or reinforce existing life writing practices? What is an archive? In life story work these people, persons, individuals (and their lives?) are more than subjects.

There are many overlaps already in the mental health state of past and present national leaders, while health services continue to bridge the dementia gap in diagnosis. Biography: world leaders, other recognised lives in Life Story Work and seeking to preserve personal identities in dementia care: clearly these are figures that count.

The Difference That Makes a Difference 2015 (DTMD 2015) Information and values: ethics, spirituality and religion

Dear colleague,

The Difference That Makes a Difference 2015 (DTMD 2015) is the third in a series of biennial workshop on the nature of information. The theme of this event is Information and values: ethics, spirituality and religion. It forms part of a larger summit on information organised by the International Society for Information Studies, held on the 3rd-7th June at the Vienna University of Technology, Austria. DTMD 2015 is organised by The Open University, UK.

This workshop starts from the premise that information and values coexist in a relationship of tension, and that they engage in a dialectical process in certain key areas of human society. Within these areas, information and values co-construct a synthesis which includes but transcends both aspects. This synthesis is particularly expressed in the fields of ethics, spirituality and religion.

Particular inspirations for this workshop include the work by West Churchman on The Systems Approach and its Enemies, which argued for a dialectical relationship between the rationalist ‘hard’ systems approach and perspectives such as morality, politics, religion and aesthetics which are apparently opposed to it. Ethics and religion have also been long-standing interests in various areas of cybernetics, which is the starting point for this exploration of information, and were central concerns in the later work of Norbert Wiener, Heinz von Foerster and Gregory Bateson. In this sense the workshop is continuing an ongoing stream of work.

As well as leading to new insights into ethics, spirituality and religion, this work also acts as a further lens through which to explore the nature of information. The language of information is increasingly used in many different disciplines, and comparing the usage in different fields contributes to a better understanding of information in its own right. The areas of spirituality, ethics and religion are somewhat less examined in the context of information than many other disciplines, and so this workshop will continue the ongoing process of exploring multi-disciplinary aspects of information.

This workshop follows two international workshops held in Milton Keynes, UK, in 2011 and 2013, both entitled The Difference that Makes a Difference. These workshops explored the nature of information in a range of disciplines (including physics, biology, sociology, computing, systems thinking, philosophy, geography and art, among others). Proceedings of both workshops can be found at http://www.dtmd.org.uk/.

Key questions which the workshop will address include:

• Can newly-emerging insights into the nature of information inform ethics, spirituality and religion? And does our understanding of ethics, information and religion contribute to a new understanding of the nature of information?
• If information is the new language of science as Von Baeyer suggests, can it also be a new language of ethics, spirituality and religion?
• If we are re-ontologising the world as an infosphere, does that make information ethics the new universal macroethic, as Luciano Floridi suggests?
• Is the language of information effective in talking about spirituality?
• Can we interpret the theologies, mythologies and praxis of religion using the language of information? How do religions use information and informational concepts? Conversely, what might it mean to think about information as theological or mythological?
• Can a theory of information provide a weltanschauung to replace or supplement religion as the motivation for ethics, spirituality and community, and if so, is such a replacement necessary and / or desirable?

The workshop organisers welcome submissions which address themselves to the above and related questions through the medium of art as well as traditional academic formats – DTMD 2013 had a major focus around the interplay between art and information, and we hope to continue this in the current workshop.

Submission deadline (extended abstracts of 750-2000 words): 27 February 2015
Notification of acceptance: 20 March 2015

Workshop organisers (all at The Open University, Milton Keynes, UK):

David Chapman, Magnus Ramage, Chris Bissell and Mustafa Ali (Department of Computing and Communications)
Derek Jones (Department of Engineering and Innovation)
Graham Harvey and Paul-Francois Tremlett (Department of Religious Studies)

Online version of call for papers: http://summit.is4is.org/calls/call-for-papers/the-difference-that-makes-a-difference-2015
...

Hope to see you in Vienna in June!

David

Fallacies of Work as Imagined: c/o Steven Shorrock - HSJ Patient Safety

I came across the following image on twitter. The tweet is also copied below.

This post is prompted by one from 'The Varieties of Human Work' on the Humanistic Systems blog 05/12/16 by Steven Shorrock. The focus is understanding and improving work, and in his opening there is a sense of very large net having to be deployed to capture all the disciplines and dimensions that are invariably involved in work.

"One of these is the simple observation that how people think that work is done and how work is actually done are two different things. This observation is very old, decades old in human factors and ergonomics, where it dates back to the 1950s in French ergonomics (le travail prescrit et le travail réalisé; Ombredanne & Faverge, 1955) and arguably the 1940s in analysis of aircraft accidents in terms of cockpit design (imagination vs operation). Early ergonomists realised that the analysis of work could not be limited to work as prescribed in procedures etc (le travail prescrit), nor to the observation of work actually done (le travail réalisé). Both have to be considered. But these are not the only varieties of work. Four basic varieties can be considered: work-as-imagined; work-as-prescribed; work-as-disclosed; and work-as-done. These are illustrated in the figure below, which shows that the varieties of human work do usually overlap, but not completely, leaving areas of commonality, and areas of difference."

The varieties of human work.

It immediately struck me how well the diagram can be translated and transposed on to Hodges' model on several levels and as per Steven Shorrock's excellent post. I acknowledge I am playing with language, but initial thoughts included:

1. As per Shorrock: the difference between how people think about work and how work is actually done.
2. Shorrock explains how for example 'work-as-imagined' draws on the other forms of work.The level of overlap in between the forms of 'work-as-' is as diverse as the contexts that arise and constantly change.
3. There are many 'gaps' identified in Steven's post [not in the sense of a fault with his post]. A subset of these may relate to the theory-practice gap which was one original purpose of Hodges' model, to help close this gap.
4. Orders of scale: from a single action to a whole job and its specification.
5. The way the 4Ps process, policy, purpose and practice can be used (I identified the 4Ps within Hodges' model, one per care domain, many years ago).

As has been pointed out to me (on twitter) the context here is 'work' and not healthcare, but as Steven notes there are many disciplines, with commonalities and differences. I am really grateful to Steven for his post, in which he also stresses the overlap. 'Work-as' is a flux. Hodges' model can be viewed through time as series of frames. Below are some rather unstructured notes [musings] relating and extending the context of Shorrock's image and post to Hodges' model:

individual - self

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group- population

'Work-as-Imagined': Of the four P's I have placed 'PURPOSE' here, since the individual's purpose must (ideally) achieve synergy with colleagues and the organisational objectives and goals. 'Work-as-Imagined' involves thought (and so is infinite in variety) whether use of imagination is day-dreaming, or radically innovative. Until AI does take over, this is the 'meta' - cognitive domain. Amid many, Shorrock makes an important point in how we imagine the work other disciplines do. Often so many stereotypes follow that are often revealed in referrals and expectations. Shorrock highlights this at the macro level of policy makers [lower right in #h2cm] having to imagine the operational aspects of work; and the simplified accounts of surgery for a patient by anaesthetist and surgeon (while meeting the requirements of informed consent). This domain may be 'work-preserving' in humanistic terms as it is the realm of tacit knowledge, creativity and innovation. Although the artifacts of simulation are ultimately produced in the SCIENCES domain, they are 'imagined' in case studies and scenarios. Shorrock helps make it clear how much of work is theorised and practised virtually, but with recourse to imagination not technology. Mental illness and the systemic - organisational response is mediated diametrically in Hodges' model. Ongoing critique of psychiatry and mental health services in some quarters appears to suggest that being unable to work-as-imagined here, means loss of self and identity that is then outsourced and effected by proxies and advocates. [Discuss?]	'Work-as-Prescribed': Reading 'prescribed' literally then drugs and other physical treatments arise here in the SCIENCES domain. The 4'P is PROCESS suggestive of procedures, specifications, instructions and formal rules. Process is important allied with PURPOSE in that if (your) can be described formally, by a set of rules then you may be vulnerable to your job being taken by a robot through 'robotic process automation'. When I started in the NHS in the 1970s there was a shift taking place from being task-oriented (mechanistic) to individual/patient-centred (humanistic). Shorrock notes how there are relatively fewer examples of work-as-prescribed. Developed nations are waiting to see how many existing jobs are lost to AI and robots, but how many new ones emerge. (Can the developing nations 'skip' several prescriptions?) Here, we also apply time to work. The past, current work and the future. Will we still work the same hours? Is there a lesson in '0' hour contracts? An obvious aspect of work is day vs. night shifts. 'Work-as-Prescribed' also reinforces the presence and context of the SOCIOLOGICAL domain. Now, conferences are devoted to 'social prescribing'. By its nature this is more often than not 'public' and therefore 'disclosed'. Citizen science and patient involvement provide a further angle on work-as-prescribed. As does what is prescribed (especially in what is used) must to some degree influence what is proscribed in what is not used.
'Work-as-Disclosed' Sharrock writes concerns how work is explained and communicated. This will also involve teaching formally and health professional to patient, carer and public.  The challenge is that thinking about work and actually doing work is a SOCIO-POLITICAL act - transaction (as the literature demonstrates). Socially, whether or not someone is working is also disclosed in their domestic  comings and going to work. The socio-political dimension is evident in the assumptions that follow homeless peopleand their apparent 'staying' (many do work?)? There are those who opt not to disclose at all and live off-the-net. SOCIO-ECONOMICALLY there are constant references to 'pay-gaps' especially by those groups and their representatives most affected by low pay and austerity. While the social care workforce toil in the community, social care funding, provision and integration is pushed into the long grass that is green papers. Despite the social value and importance of this work, the status of this sector is signalled - disclosed as poor. Nurses globally are campaigning to establish in law the requirement for safe-staffing levels. Sharrock alludes to the challenge of nursing as PRACTISED on the 'shop-floor' and ongoing studies on staffing - establishments and skill-mix. In the 1980-90s expert systems specialists interviewed workers  in an attempt to understand the knowledge acquisition and elicitation associated were their profession - community of practice. These humanistic care (knowledge) domains reflect the qualitative approach to research. Work-as-disclosed also communicates to would-be future recruits. How are the aspirations of teenagers and mature entrants first experienced, discussed and carried forward socially?	'Work-as-Done' simultaneously speaks of power, employment, accountability and regulation.  As four conceptual spaces #h2cm indicates the 'distance' between concepts that shifts according to context. The space that work takes place within and how people are managed, organised, controlled for efficiency with reminders, queues, appointments, and waiting areas are signs of the institution. The person was a long way from the creators of the Victorian asylum, even as they sought to establish (stamp?) a 'standard' level of care. What difference does it make when work-as-done is bound to an individual and collective sense of duty? The counterpoint is precisely [mechanistic] work-as-done. Work-as in shift completed and recorded - clocked as such. Work-as-done: the 12 hour shift or as already mentioned work-as-NOT-done due to the flexibility afforded by zero hour contracts. Work-as-done also denotes [scientifically] the concepts of power, energy and effort. So, work-as-done must result in personnel actually feeling 'done': burnt-out when safe-staffing is not assured. The old saying: "If it is not documented it was not done.", springs to mind. Shorrock refers to surgery and loss of life. What was 'done' and what does an inquiry reveal? What is actually done and the way it is done if varies - contravenes 'norms' rules then there is a issue of whistle blowing. The question then becomes was the work done as it should - must - be? The 4P in this domain is POLICY.  Perhaps a box-tick here also accounts for 'work-as-' elsewhere?

#HSJpatientsafety Fallacies of work as imagined. More info on Steve’s great blog https://t.co/i5TCs6CLvJ @StevenShorrock

— Iain Moppett (@IainMoppett) July 3, 2019

Book: Refuge in a Moving World [open access]

Tracing refugee and migrant journeys across disciplines

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

	Refuge in a Moving World Tracing refugee and migrant journeys across disciplines

My source:
https://twitter.com/HealthSyria/status/1286761841373466626?s=20

The Contribution of Disciplines from the Arts and Humanities to addressing Antimicrobial Resistance: final report

The Contribution of Disciplines
from the Arts and Humanities
to addressing
Antimicrobial Resistance

 Dear RIPEN workshop participants

 

It is now over a year since our last main sets of RIPEN workshops and of course so much has happened in that time that I don't know quite where to begin (!!). So I won't start into talking about COVID. Only to say that I very much hope that you and yours are managing to get through this ok so far. I know that I speak for the rest of the RIPEN team when I say that recent events have only served to highlight the central place of nursing and caring in society which is a source of pride (if not so much monetary reward!).

 

Anyway, I thought that some of you might be interested in this link to the final report from a follow-on study that I've just completed. It draws together learning from all the 11 projects funded by the AHRC at the same time as RIPEN: http://radar.gsa.ac.uk/7418/ . 

 

The report is best viewed in double page layout (download, save then open). Obviously, it is of less direct relevance to hands on nursing applications, but I think our experiences on RIPEN showed how important the wider picture often is (as evident in the events of the last six months!).

Please feel free to share with others through any of your own networks as relevant. 

with best wishes

Colin

Dr Colin Macduff

Senior Research Fellow

School of Design

Glasgow School of Art

 

MacDuff, Colin (2020) The Contribution of Disciplines from the Arts and Humanities to addressing Antimicrobial Resistance (CODA AMR). Project Report. The Glasgow School of Art, Glasgow.  

n.b. I will have a read myself and post again before the end of the year.

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.

Boyer's model, Hodges' model, scholarship, future website and Drupal

Ack: This blog post draws on a brief but informative two page text by Marta Nibert, Educational Consultant for Occupational Therapy, University of Idaho.

Models abound of course (not only on catwalks where other career choices are displayed), but in nurse education and the sciences. The review of Curriculum Development In Nursing Education reminded me of Boyer's model of scholarship. I have maintained a link to this for many years, the book review prompted me to read more. Boyer is a gift for this scholar of Hodges' model and any others, a gift not just in that off-the-shelf sense, but in a constructive advisory sense.

The table below highlights Boyer's types of scholarship, purposes and measures of performance. The focus of Boyer's model is the quality of professorial activities, in the same way highly skilled and experiences nurses can be removed from the front-line, so to can specialist faculty be distanced from teaching.

Type of Scholarship	Purpose	Measures of Performance
Discovery	Build new knowledge through traditional research.	• Publishing in peer-reviewed forums. • Producing and/or performing creative work within established field. • Creating infrastructure for future studies.
Integration	Interpret the use of knowledge across disciplines.	• Preparing a comprehensive literature review • Writing a textbook for use in multiple disciplines. • Collaborating with colleagues to design and deliver a core course.
Application	Aid society and professions in addressing problems.	• Serving industry or government as an external consultant. • Assuming leadership roles in professional organizations. • Advising student leaders, thereby fostering their professional growth.
Teaching	Study teaching models and practices to achieve optimal learning.	• Advancing learning theory through classroom research. • Developing and testing instructional materials • Mentoring graduate students. • Designing and implementing a program level assessment system.

What I will try to do here is briefly suggest how Boyer can inform consideration of scholarship in Hodges' model and a future website. This is not just a one-way dialogue I believe Hodges' model can also inform Boyer's model. For example according to Nibert, Boyer proposes using 'creativity contracts'. The creative utility of Hodges' model is surely demonstrated in the posts and archive on W2tQ spanning nursing, education and health care? Since the publication of Boyer's paper in 1997 it could be argued there are new forms of scholarship that cast light and shadows on traditional academia and forms of research. More specifically though we can take Boyer's measures of performance and apply them in turn to h2cm. Even though the purposes differ (I am neither quality faculty nor professor) the reflection is helpful:

DISCOVERY

Publishing in peer-reviewed forums.

• There is a limited bibliography listed here on W2tQ.

Producing and/or performing creative work within established field.

• The bibliography and website constitute a mixture of formal and rather ad-hoc creative works in nursing. Much more needs to be done.

Creating infrastructure for future studies.

• As noted in the book review I am fascinated by this word infrastructure. I recognise the need for a 21st century home for Hodges' model; the limitations of a static website and the need to benefit from the stimulus and energy that a community of users would provide. Drupal is the future (for me), a means to provide an infrastructure out of which a community may grow and inform.

INTEGRATION

Preparing a comprehensive literature review.

• Hodges' model deserves a comprehensive literature review, one that spans education, nursing, global health, informatics and cognitive science.

Writing a textbook for use in multiple disciplines.

• 'Book' is an established content type within Drupal and this is a worthy objective, as Hodges' model is the ideal academic Swiss Army knife.

Collaborating with colleagues to design and deliver a core course.

• This is so dependent upon infrastructure and it seems my actively engaging with academics in curricula design and course planning. Drupal is being adopted in education so the scope to engage from an external position is a possibility.

APPLICATION

Serving industry or government as an external consultant.

• Is professorship a pre-requisite for consultancy work? No. Do we just leave this to the professors? No.

Assuming leadership roles in professional organizations.

• Being in the North West of England, a full-time nurse and with many meetings down South this is a barrier to adopting such roles. For the future should there be any opportunities these must be tried - only that way can they be tested.

Advising student leaders, thereby fostering their professional growth.

• As a mentor in clinical practice with the chance to develop local educational links there is scope here; and possibly others?

TEACHING

Advancing learning theory through classroom research.

• As noted above it would be marvellous to be presented with the task of producing lesson plans to encourage research into Hodges' model.

Developing and testing instructional materials.

• As far as the classroom is concerned this is very much a bullet point for the future. Using Drupal however a future site can incorporate some instructional materials.

Mentoring graduate students.

• Ongoing, but would like to engage more in this - and whilst h2cm is on my agenda I do understand models represent a small part of student learning.

Designing and implementing a program level assessment system.

• Another point for a future departure; how do you demonstrate competency in Hodges' model? There are means of assessment, which were applied in the 1980's, case studies, essays and discussion. ...

More to follow...

Additional link:
Instructional Design Review (ID Review) checklist at Schema Performs

The Difference that Makes a Difference 2013 - Information: Space, Time, and Identity

You are invited to The Difference that Makes a Difference 2013, An interdisciplinary workshop on Information: Space, Time, and Identity.

Location: The Open University and the MK Gallery, Milton Keynes , UK
Dates: 8-10 April 2013
Website: http://www.dtmd.org.uk

Deadline for one page abstracts - 3rd January 2013.

Information has been conceptualised in many different ways in different disciplines, and the DTMD series of workshops is a forum for sharing of those insights . We are keen to involve as many different people, from as many different disciplines, as possible in presenting and participating in the workshop. We invite a wide range of participants to give short (10 minute) presentations on their work as it relates to an understanding of information.

There will be six sessions:

Over days 1 and 2 the first four sessions consist of a keynote speaker followed by six or seven short presentations (which will have been selected by referees from submitted abstracts) then a panel discussion.

1. Information and Space. The relationship between information and space, 'meaning' in our physical environment, and the information landscapes that go beyond physical space.
2. Information and Time. Both the historic framework of the notion of information, and time as a 'dimension' in information – physics, entropy, information and ‘the arrow of time’.
3. Information and Identity. Identity (race, gender, nationality, class and sexual orientation, for example) as information and, conversely, information as identity.
4. What is information? Why are so many disciplines using informational concepts in their narratives? Is a Universal Theory of Information (UTI) possible?

Sessions 5 and 6 on day 3 draw together the insights from the first two days in two ways. First, through art, when the results of the work of the Workshop artist’s collaboration with delegates is presented and discussed. Second, a final keynote speech from Luciano Floridi, Professor of the Philosophy of Information will lead in to a panel discussion with the keynote speakers from the earlier sessions.

For more details see the workshop programme: http://www.dtmd.org.uk/programme and the Call for Papers: ....

Accepted abstracts will be published in a Workshop Digest which will be made available online prior to the event, and, following the workshop, delegates will be invited to submit papers for special issue of Kybernetes, based on papers presented at the workshop.

We hope to see you in Milton Keynes in April.

Best wishes,

Magnus Ramage and David Chapman on behalf of the Programme Committee.

-- 
Dr. David A. Chapman CEng, FIET, FHEA
Senior Lecturer
Department of Communication and Systems
The Open University http://cands.open.ac.uk/
Intropy blog: http://www.intropy.co.uk/
... Twitter @dachapman

Disciplines in Disarray - Scope of Practice, Disciplinary boundaries

To be in a state of disarray, is to be disarmed, without access to resources, or at least having an impaired ability to organise strategically for reasons of defence, disputation or argument. Constructive debate will be hard to achieve and so the confusion continues.

Prior to 2013 ideas for a paper with a would-be co-author began. Early that year there were 5000 words. There's probably mention of (another!) project on these pages – somewhere/when? The focus was using Hodges' model to explore 'scope of practice' in nursing. As the conceptual gift that keeps giving, Hodges' model can encompass all health disciplines, curricula, and professions, informal caring and social care too.

This post is prompt-ed (human ‘intelligence’ needs a nudge too) by ‘discussion’ on what was twitter, and currently on ‘X’. So in turn I can reflect on how relevant this paper would be today.

I still have that draft of over 5000 words. It is now woefully out-of-date. Out-of-date? Well the available job postings across the health and care sectors, have always changed. If you scan the paper copies of  Nursing Times, Nursing Standard, Nursing Mirror (anyone?) and the BMJ, The Lancet, Health Service Journal over three-four decades the evidence is clear. Then try the e-media, (and with it AI!)?

Now, for several years the impacts of  policy and change in advanced nursing practice, plus associate roles, that have also been applied in medical training and education are coming home to roost. Depending on your corner, and position in the debate there's a position called 'Noctor' (Vaughan and Kar, 2026).

I find it regrettable that consultants and 'senior' nurses have taken corners, as policy results in grossly negative examples with potentially safety consequences. There has always been a 'distance' to be bridged between health disciplines. In the past any sense of competition was usually, and so constructively patient-centred - grounded in the delivery and quality of care. The contest was tempered through mutual respect and dignity, and recognition of respective roles, knowledge, abilities and contribution to what is (and remains?) the multidisciplinary team?

Now with technology and AI in the mix, maintaining goodwill, common-sense and keeping the patient, public and future generations in sight will need a degree of diplomacy as yet not called-upon.

This made me think of the unions in the 1970s and more recent examples of work-to-rule. 

As health professionals argue between themselves, what is the cost of distraction?

Yes, that paper using Hodges' model on 'scope of practice (and theory!)' would be timely now.
In fact, it is urgently needed.

Vaughan L, Kar P. Vexatious complaints are being weaponised to discourage debate BMJ 2026; 394 :e100697 doi:10.1136/bmj-2026-100697 

Previously: 'scope' : 'publications'

MEMO TO: New College of Humanities and London Interdisciplinary School

Re. "Introduction to Lifelong Learning 101"

Since 1998, when I first went 'online' I've always been conscious of etiquette and note how this has changed - developed - over the years. The email associated with the former website domain p-jones.demon.co.uk saw a lot of emails to quite a diverse range of mail lists. Should I? Should I not? These questions remain a key consideration in trying to spread the thought and word on Hodges' model.

Stepping on toes a couple of times, someone also asked about links to blog posts on LinkedIn. Not had those queries recently so I think readers understand the 2x2 table is critical to the post in representing the model. Twitter presents its own challenges [ #WasteOfTime ]. So please pardon my shouting, but there's an important message here about an important resource.

I've lapsed again with no progress on the new site - maybe it is not just vapourware but a dream.

The creation of new education institutions: 

the New College of Humanities and London Interdisciplinary School

- is encouraging for the work here:

"The London Interdisciplinary School wants its students to be problem solvers with a wide range of academic interests."
(Nicola Woolcock, Polymaths plan to teach universities a thing or two. The Times, October 2, 2021. p.17.)

Does it, really - and by implication the NCH, plus New Model Institute for Technology and Engineering (NMITE) and others?

The Times Education Commission with proposals for reform due in June, adds further impetus and evidence ...

I read this evidence as supporting the argument that education and health are and always will be 'legacy issues', that is in need of change, investment, policy. All disciplines of study and knowledge are always dynamic and should be challenging, personally and collectively.

If institutions can distract themselves from fiscal incentive of the bums on seats for a few moments and policy makers look up from the dotting of  I's and crossing of T's then student's learning can be energised by Hodges' model: a generic bootstrap for lifelong learning.

Just to be clear. This model is NOT about boxes, it is about being aware of boundaries and being prepared to cross and use these journeys.

In the 21st century we are humbled by what now constitutes the pantology - the system of all knowledge. No individual can take in - apprehend and master it all, but we should have a means to at least conceptually touch this incredible gift.

INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

Education Philosophy (Ethics, Logic) Psychology: (Applied, Child, Clinical, Criminal - Forensic, Occupational, Artificial Intelligence ... Cognitive Sciences Theology Arts Creativity and Design Eco-Anxiety Happiness - Metrics ...	Sciences: Biology, Physics, Chemistry* Health: (Medicine, Nursing ...) Occupational Professions Computer Science, Information Mathematics [macro - nano] Engineering Architecture Design and Creativity Environmental Studies Hydrology Land use: Forestry ...
Arts (Music, Dance, Drama ...) Literature Anthropology, Archaelogy Languages Ancient-History, History Future Studies Social Work Sociology (Culture, Ethnography ...) Anthropology Gender Studies Philanthropy ...	Politics, Government Security Law & Crime - Fraud/Corruption Policing - Law Enforcement News and Media studies Political Science - Citizenry Economics Socio-Economics International Development Peace Studies Administration Leadership and Management War and Conflict ...

I am pleased to see that the post re. Nicholas Maxwell's work is popular here:

"How Universities Have Betrayed Reason and Humanity—And What's to Be Done About It" c/o Nicholas Maxwell 

*So many sub-disciplines: Climate studies, Epidemiology, Marine biology, Quantum Computing / Physics, Exobiology, Astronomy, Materials, Demographics, Geology, Genomics, Cybernetics, Systems, Epigenetics, Exobiology, Neuroscience, Public (Mental) Health, Allied Health Professions ...

Waste not - Want not: An Item for Discussion (to refine) ...

Proposed item for discussion:

That this meeting reflect on the need and case for a generic and foundational conceptual framework across health and social care disciplines. This will help all (lifelong) learners to develop as reflective practitioners and critical thinkers to better support integrated and person-centred care, to appreciate and achieve parity of esteem and the leadership required to further high quality healthcare outcomes, health promotion and self-care.

Many nurses, including students, will no doubt have heard the words of wisdom: “Things go round in big-big circles, some of them decades long. You'll see!” We realise there are problems that seem perpetual. Health care seems to have its share of legacy issues, that is, problems that stretch across the decades and confound successive generations of practitioners, managers and policy makers. These issues are ongoing subjects for discussion and debate like this proposal. Nursing is a vibrant profession, things, including 'us' change. There are theories and practises that (thankfully) fall out of fashion. Nurse education is no exception with its own approaches. Some are permanent becoming accepted fixtures, while others wax and wane. Respective examples are educational technology, a fixture whether on the desk, one's lap, in the hand or simulation lab; nursing theory and models of nursing had their moment several decades ago as now they struggle for attention. To a degree this is understandable; curricula are over-crowded, practice must be evidence-based, healthcare is multidisciplinary, nursing is person, patient and carer-centred. Society also 'moves on'. Crucially, however; we must remember that to nurse - is to be a reflective practitioner and critical thinker.

Mention of models and theories of nursing may reveal something of the proposer. Much has changed for the profession since the late 1970s. Nursing [UK] has been challenged both publicly and from within; culminating in serious individual and organisational failures. Such incidents, plus associated reports and recommendations, called into question the quality of nurse education, nursing and care. No system is 100% effective in terms of checks and balances: to err is human. In nursing, however, our constant aspiration should be to disprove this fact of human frailty. In healthcare and nursing so much of what we do is predicated on the quality of our communications. Demographic trends impose pressure on proportionally fewer staff. There are more patients and carers who need reassurance, explanation, time and attention. How can nursing solve the ongoing productivity conundrum?

While communication is the common factor for all health disciplines and the essence of humanity, there is no accepted overarching theory of health communication. Although this may seem an academic question, in healthcare it is paramount. Poor communication can undermine shared awareness, responsibilities, understanding and is a constant factor in patient safety. Now, we must also recognise the patient as expert and raise the level of health literacy of the public. While there is progress in overcoming stigma within mental health, public mental health remains lost within public health. The issue of parity of esteem, extends beyond the much debated and still to be reconciled fields of physical and mental health care.

In response, this discussion calls for a generic, foundational conceptual framework across all fields of nursing, including midwifery, learning disability, mental health, veterans and prison services and end of life. If more argument is needed then without such a generic framework, the health and social care goal of our times - that of truly 'integrated care' - will just be (circular?) hyperbole. For the people who are self-caring and those in our care, the empathy and rapport they experience will more likely be process-driven, our patient-carer-public-centred care invariably off-target.

Supporting information: (links deactivated and may no longer work)

Francis Report
https://researchbriefings.parliament.uk/ResearchBriefing/Summary/SN06690

NMC Code
https://www.nmc.org.uk/standards/code/read-the-code-online/#fourth

NMC Revalidation
http://revalidation.nmc.org.uk/what-you-need-to-do/reflective-discussion.html

RCN: Revalidation
https://www.rcn.org.uk/professional-development/revalidation/reflection-and-reflective-discussion

NICE: Reflection and reflective practice
https://www.evidence.nhs.uk/search?q=reflection+OR+%22reflective+practice

HSJ: The importance of reflective practices
https://www.hsj.co.uk/workforce/the-importance-of-reflective-practices/5048994.article

The King's Fund: Integrated Care
https://www.kingsfund.org.uk/publications/making-sense-integrated-care-systems

The King's Fund: Shared responsibility for Health
https://www.kingsfund.org.uk/publications/shared-responsibility-health

Health and Social Care Act 2012
http://www.legislation.gov.uk/ukpga/2012/7/contents/enacted

Dualistic- thinking checks and balances [III] (or: The-hyphen)

While dualistic thinking is positive as a means to explain Hodges' model, if a form of thinking (reasoning as ego-defence) is relied upon to excess and not balanced by other evidence then this can contribute to psychological problems. As Johnson (1994) also indicates, the three forms of thinking we are discussing in this series of posts are progressive. Compared to dualistic, Johnson states that multiplistic and relativistic thinking represent a more complex level. Appreciating that there are other sources for answers, possibly more than one answer and a need to relate things together.

Dualistic thinking epitomizes the categorical invitation that Hodges' model affords. In its most primitive form it has to be ready to hand and with the mind in an instant it is: the duality of fight or flight. A reflex arc circumvents the dualistic in an effort of instant reduction to survival.

Of course, the model is not intended to encourage thinking in extremes, polarised and absolutist. This property*, however, affirms the model's potential as a health promoting, educational and self-care resource.

There is another form of dualism that is given to us by life not model. It is the dichotomous variety that often influences and shapes attitudes to others, discourse and debate within our many cultures, politics and religious affairs.

The additional set of axes related to disciplines, for example, psych-social - referred to in the previous post [II] tempers the risks above in two ways:

1. by virtue of the learner expanding their knowledge and hence the number of concepts they understand and in-form their community of practice.
2. there is a space between the disciplines and concepts that might further support the structure, content and utility of Hodges' model.

The space lies in the '-', the hyphen, which can represent a middle ground (Assad, 1999). The axes of Hodges' model could be said to present a continuous hyphen. A cognitive pause (check): a token to collect as we reflect, especially if we cross disciplinary thresholds consciously or unconsciously. This can counter the aforementioned excesses of dualistic thinking with the addition of assessment and supervision.

I started these posts with what Hodges' model declares from the outset. This is the model's structure, the configuration of the axes the appearance of the (empty) quadrants. But as experience is gathered so the axes fade into the distance. They become grey and blue as in a background, a template we start to take for granted and work around, with and within. Content in the form of concepts and associated meaning can then populate the foreground that holds the promise of becoming increasingly more integrated which is stimulated by a shift from dualistic thinking to more pluralistic thought.

Assad, M.L. (1999). Reading with Michel Serres: An Encounter with Time. Albany, NY: State University of New York Press.

Johnson, D.D. (1994) Dualistic, Multiplistic, and Relativistic Thinking as it Relates to a Psychology Major. Honors Theses. Paper 202.
http://opensiuc.lib.siu.edu/uhp_theses/202/

*There are many tools that permit us to compare another duality: the binary. The presence or absence of phenomena, for example, a bone injury, or a new star, comet or asteroid.

See previous posts: Michel Serres

See also bibliography item:

Jones, P. (2008) Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons, IN Kidd, T., Chen, I. (Eds.) Social Information Technology Connecting Society and Cultural Issues, Idea Group Publishing, Inc. Chap. 7, pp. 96-109.