The Global Health Research Process Map

As a conceptual ready reckoner Hodges' model helps us locate, isolate and contextualise the commonly cited 4Ps. In the h2cm matrix below I have related the 4Ps, as before, to the four care domains:

individual
INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

group

PURPOSE	PROCESS
PRACTICE	POLICY

I raise this learning of a new process oriented resource for global research produced by The Global Health Network.

Processes are critical.  

Think of the relationship of purpose, practice and policy in relation to triage and emergency care? When I reflect on a situation even if the priority, context is process driven I am mindful of the bigger picture.

+++++++++++++++

The Global Health Network has launched a brand new, interactive Global Health Research Process Map, the first digital toolkit designed to enable researchers anywhere in the world to initiate rigorous global health research studies.

As the HIFA community know all too well, health research is often lacking in the regions where evidence to improve health is needed most. Crucial evidence is not being generated because doctors and nurses lack access to training, information, and support. Effort is also regularly duplicated or conducted using different criteria in different territories and studies, and sometimes it falls by the wayside from lack of simple resources and guidance on best practice. The Global Health Research Process Map (http://processmap.org/) is set to change this. It’s an open-access internationally-available online resource that guides every process and method needed to initiate a health research study. For each step researchers and their staff are provided with the information, support and training that they need to successfully run a health study. Researchers will also gain the opportunity to engage with their peers along the way, aiding collaboration and the spread of ideas.

The Process Map was released just over one week ago, and has already generated nearly 2,500 views from around the world. It is the product of four years of best practice gathered and refined by the research community who use the pioneering Global Health Network to guide and support their effort to conduct research in challenging settings. The Global Health Network works like an online science park for exchanging knowledge, sharing research methods and facilitating collaboration among global health professionals to fuel faster and better evidence to improve health. The Global Health Network facilitates global partnerships between researchers ­ allowing researchers in low-resource settings and those with more support to learn from each other ­ and conduct research studies in places where this is difficult and unusual.

The Process Map is a pioneering research tool that centralises the information and resources that researchers anywhere in the world need to develop and initiate rigorous and effective global health studies. It has the potential to revolutionise the current process, speeding the development of new drugs and vaccines, and improving how diseases are managed. With this toolkit, researchers can access the guidance, training and support that they need in order to run their own studies. This is important because there is much evidence that shows that locally-led research rarely happens in low-income settings because health workers lack research skills and any access to training and support. Therefore the Global Health Network is meeting that gap and the Global Health Research Process Map will take them through the process of conducting accurate research, step-by-step. 

Visit the tool today, and click on each node to access formally written information, links to eLearning courses, guidance articles, discussions, blogs, up-to-date news, and all sorts of tools and templates which will help you complete each step. As with everything else on the Global Health Network, it’s completely free and open-access, and always will be. Your feedback is always greatly appreciated, so feel free to have a look and leave comments, either here* or on the map itself.

Thank you!
Tamzin

Tamzin Furtado
Project Manager
The Global Health Network

*My source: HIFA2015
 

PROCESS and tick the boxes DO

For four decades at least and much longer (70 years?) within many health services there has been a preoccupation with process. Patients and carers may then perceive such services and how services are delivered as machine-like. As a whole the experience then constitutes an actual output - an outcome of clinics, appointments, waiting lists, tests and treatments. This is very unfortunate amid ongoing claims for services that are person-centred, individualised, patient oriented and even patient-first.

The patient is left to feel like a diagnosis, or even worse a problem in search of a diagnosis; tossed from one clinical encounter to another. In-between all this activity there are hopefully some compassionate brush strokes that soften the picture and patient experience. If not people notice the impact on values and quality of care ...

One of my pet hates right now is 'process before patients'. It's becoming more prevalent in healthcare and IMO it's wrong.

— Clive Blanchard (@blanchyshed) September 28, 2017

Whenever I see the word 'holistic' I wonder if it really is holistic? Yes, you can be holistic by ticking all the boxes, but nursing involves much more.

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

✓	✓
✓	✓

'Process' has been delivered at the door of nursing by management and the appeal to theory to inform practice. Nursing itself produced the 'nursing process'.

The nursing process through the stages of assess, plan, implement and evaluate prompted the argument that nurses were processing patients. To nurses of a certain age the nursing kardex, the record filled in every shift mirrored the nursing process. In a way recourse to process is not a problem, it is inevitable. It is to be expected. As we deal with space, time, risks and decisions ... we have to make judgements that are invariably process bound.

The four P's can help to 'balance the books' ...

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

PURPOSE	PROCESS
PRACTICE	POLICY

We need to remind ourselves of the four P's as they affect us individually and as organisations and collaborative agencies.

PURPOSE	PROCESS
PRACTICE	PURPOSE PROCESS PRACTICE POLICY

Perhaps, patient engagement can be defined as when the tick-boxing is obvious but it is also taking account of the 4Ps (and in a way beyond tokenism). For example, patients, carers and the public involved in policy review? The patient is then more realistically involved in the activity. Anything else, really is a tick-box exercise.

Progress has been made (at least in the four decades of my purview). Government policy is in continuous development but there remains - as ever - much to do. Especially in spanning the various distances that apply from policy, experience, care to be delivered and how; from the individual to the health services and health system as a whole.

('P'rogress! Mm... Is there another way to measure progress?) ;-) 

International Workshop on Knowledge Representation for Health Care (KRH4C'13) & Process-oriented Information Systems in Healthcare (ProHealth’13)

Call for Papers

5^th International Workshop on Knowledge Representation for Health Care (KRH4C'13)

+

6^th International Workshop on Process-oriented Information Systems in Healthcare (ProHealth’13)

Organized as One Full Day Workshop

Acronym: KR4HC’13 / ProHealth’13

Murcia, Spain –  June 1^st, 2013

In conjunction with the 14th Conference on
Artificial Intelligence in Medicine (AIME'13)

Web site: ...

Important Dates

Deadline for workshop paper submissions: 8 March 2013
Notification of Acceptance: 9 April 2013
Camera-ready version: 7 May 2013
KR4HC/ProHealth Workshop: 1 June 2013

Workshop Goals

Healthcare organizations are facing the challenge of delivering high quality services to their patients at affordable costs. These challenges become more prominent with the growth in the aging population with chronic diseases and the rise of healthcare costs. High degree of specialization of medical disciplines, huge amounts of medical knowledge and patient data to be consulted in order to provide evidence-based recommendations, and the need for personalized healthcare are prevalent trends in this information-intensive domain. The emerging situation necessitates computer-based support of healthcare process & knowledge management as well as clinical decision-making.

This workshop brings together researchers from two communities who have been addressing these challenges from two different perspectives. The knowledge-representation for healthcare community, which is part of the larger medical informatics community, has been focusing on knowledge representation and reasoning to support knowledge management and clinical decision-making. This community has been developing efficient representations, technologies, and tools for integrating all the important elements that health care providers work with: Electronic Medical Records (EMRs) and healthcare information systems, clinical practice guidelines, and standardized medical vocabularies. The process-oriented information systems in healthcare community, which is part of the larger business process management (BPM) community, has been studying ways to adopt BPM technology in order to provide effective solutions for healthcare process management. BPM technology has been successfully used in other sectors for establishing process-aware enterprise information systems (vs. collections of stand-alone systems for different departments in the organization). Adopting BPM technology in the healthcare sector is starting to address some of the unique characteristics of healthcare processes, including their high degree of flexibility, the integration with EMRs and shared semantics of healthcare domain concepts, and the need for tight cooperation and communication among medical care teams.

This joint workshop brings together two approaches: healthcare process support, as addressed in previous ProHealth workshops, and healthcare knowledge representation as dealt with in previous KR4HC workshops. The workshop shall elaborate both the potential and the limitations of the two approaches for supporting healthcare process & healthcare knowledge management as well as clinical decision-making. It shall further provide a forum wherein challenges, paradigms, and tools for optimized knowledge-based clinical process support can be debated. We want to bring together researchers and practitioners from these different, yet similar fields to improve the understanding of domain specific requirements, methods and theories, tools and techniques, and the gaps between IT support and healthcare processes yet to be closed. This forum also provides an opportunity to explore how the approaches from the two communities could be better integrated.

History of the Joint Workshop 

Providing computer-based support in healthcare is a topic that has been picking up speed for more than two decades. We are witnessing a plethora of different workshops devoted to various topics involving computer applications for healthcare. Our goal has been to try to join forces with other communities in order to learn from each other, advance science, and create a stronger and larger community. In 2012, the two workshops, KR4HC and ProHealth held a joint workshop, which proved to be very successful. This year, we are aiming to continue the collaboration initiative and hold another joint workshop.

The two workshops have quite a long history, as briefly described below.

The first KR4HC workshop, held in conjunction with the 12th Artificial Intelligence in Medicine conference (AIME'09), brought together members of two existing communities: the clinical guidelines and protocols community, who held a line of four workshops (European Workshop on Computerized Guidelines and Protocols (CPG'2000, CPG'2004); AI Techniques in Health Care: Evidence-based Guidelines and Protocols 2006; Computer-based Clinical Guidelines and Protocols 2008) and a related community who held a series of three workshops / special tracks devoted to the formalization, organization, and deployment of procedural knowledge in healthcare (CBMS’07 Special Track on Machine Learning and Management of Health Care Procedural Knowledge 2007; From Medical Knowledge to Global Health Care 2007; Knowledge Management for Health Care Procedures 2008). Since then, two more KR4HC workshops have been held, in conjunction with the ECAI’10 and the AIME’11 conferences.

The first ProHealth workshop took place in the context of the 5th Int’l Conference on Business Process Management (BPM) in 2007. The next three ProHealth Workshops were also held in conjunction with BPM conferences (BPM'08, BPM’09, and BPM’11). The aim of ProHealth has been to bring together researchers from the BPM and the Medical Informatics communities. As the workshop was associated with the BPM conference that had never been attended by researchers from the Medical Informatics community, we had included Medical Informatics researchers as keynote speakers of the workshop, members of the program committee, and to our delight, saw a number of researchers from the Medical Informatics community actively participating in ProHealth workshops. Following the keynote talk given by Manfred Reichert from the BPM community at the Artificial Intelligence in Medicine 2011 (AIME’11) conference, where KR4HC was held, the organizers of ProHealth and KR4HC workshops have shown their interest to hold their workshops in conjunction as part of the BPM'12 conference, which marks a landmark in the collaboration between the two communities. We are continuing the efforts that started four years ago by members of the Software Engineering in Health Care (SEHC) community to strengthen the collaboration between the ProHealth and SEHC communities.

Workshop Theme

Original contributions are sought, regarding the development of theory, techniques, and use cases of Artificial Intelligence and / or process management in the area of healthcare, particularly connected to patient data, clinical guidelines and healthcare processes.

Submitted papers will be evaluated on the basis of significance, originality, technical quality, and exposition. Papers should clearly establish their research contribution and the relation to the goals of the workshop. The scope of the workshop includes, but is not limited to the following areas:

• Process modeling in healthcare
• Computer-interpretable clinical guidelines / protocols and decision support
• Workflow management in healthcare
• Semantic integration of healthcare processes with electronic medical records
• Knowledge representation and ontologies for healthcare processes
• Temporal knowledge representations and exploitation
• Facilitating knowledge-acquisition of healthcare processes
• Visualization, monitoring and mining healthcare processes
• Knowledge extraction from healthcare databases and EPRs
• Knowledge combination, personalization and adaptation of healthcare processes
• Compliance of healthcare processes
• Evaluation of quality and safety of careflow systems
• Managing flexibility and exceptions in healthcare processes
• Process optimization and simulation in healthcare organizations and healthcare networks
• Experiences in deploying knowledge-based tools in healthcare
• Patient empowerment in healthcare
• Linking clinical care and clinical research
• Lifecycle management for healthcare processes
• Context-aware healthcare processes
• Ambient intelligence & smart processes in healthcare
• Mobile process support in healthcare
• Process interoperability & standards in healthcare
• Process-oriented system architectures in healthcare

Format of the Workshop

The 1-day workshop will comprise accepted long and short papers, tool presentations, and 1 keynote. Papers should be submitted in advance and will be reviewed by at least three members of the program committee. An informal proceedings will be available during the workshop. At least one author for each accepted paper should register for the workshop and present the paper. The selected best long (full) papers will be included in the formal proceedings, which are expected to be published as part of the LNAI Springer series, as it was done in all previous editions of the workshop.

Paper Submission

Prospective authors are invited to submit papers for presentation in any of the areas listed above. Only papers in English will be accepted. Three types of submissions are possible: (1) full papers (12 pages long) reporting mature research results, (2) position papers reporting research that may be in preliminary stage not yet been evaluated, and (3) tool reports. Position papers and tool reports should be no longer than 6 pages. Papers must present original research contributions not concurrently submitted elsewhere.
Papers should be submitted in the LNCS format. The title page must contain a short abstract, a classification of the topics covered, preferably using the list of topics above, and an indication of the submission category (regular paper, position paper, or tool report). Papers (in PDF format) should be submitted electronically via the Easychair system ...

Problem solving, case formulation and policy formulation

On W2tQ this year, and possibly in a previous paper, or conference presentation, I've stated that the nursing process is basically a problem solving algorithm. Nothing profound there of course. 

'Problem solving' is a developmental threshold and an evolutionary skill obvious in humans, with learning passed on across generations. Evidence of problem solving in animals and nature is becoming increasingly apparent; with examples over recent decades of problems solved not witnessed before.

In healthcare, and psychotherapy more specifically, we shift to case formulation. Again a step-wise process to arise at a sufficiently complete rationale for therapy. Ideally, this extends beyond the individual. As an parent, grandparent, guardian, teacher, supervisor ... teaches a child so therapy is an opportunity for learning and, it must be added, unlearning.

Returning to (and passing on):

Hague, R., & Harrop, M. (2007). Comparative Government and Politics (7th ed.). New York, NY: Palgrave Macmillan.

Chapter 18 (pp.377-395) concerns 'Public Policy'. Clearly, here there is a shift from the individual to the collective, population and citizenry. The chapter's second page on 'Initiation and Formulation' quickly provides a flowchart 'Figure 18.1 Stages of the policy process'. Box 18.1 informs readers about 'Rational and incremental models and policy-making' (p.380):

'The key contrast between the two models is this. The rational model views policy formulation as emerging from a systematic search for the most efficient means of achieving defined goals. By contrast, the incremental model sees policy as emerging from a compromise between actors who have goals which are ill-defined or even contradictory. Where the rational model seeks the best policy in theory, an incremental framework seeks out a practical policy acceptable to all the interests involved.' p.380.

The book highlights Simon (1983) as a source for the rational or synoptic model:

 

Simon H.A. (1983) Reason in human affairs. Oxford: Basil Blackwell.

Plus, for the incremental model:

Lindblom, C.E. 1979. Still muddling, not yet through. Public Administration Review 39: 517–526.

If needed, online, you will find accounts and diagrams on problem solving, the nursing process, case formulation and policy formulation. That's quite a family is it not? 

While not referred to as explicitly today, the nursing process (now routinized) should address parity and integrate care across mental and physical health. The individual (person, patient) should be assessed and care planned with their social and community context taken into account. Collaboration in care should help assure that this is indeed the case. The nursing process in the sociological domain acknowledges the role of parents, guardians, and families as informal carers. The social care sector can also be represented and further the objectives of a more open and integrated care community as per the local situation. While not added to the sciences domain; case formulation should also factor in the physical and political. 

Politically, are all instances of problem solving, and formulation recognised for their importance and influence on outcomes and effectiveness, economy, efficiency (another 'box' p.357), plus efficacy? Are services politically afforded the resources, as defined across the domains of Hodges' model required to deliver, improve and change (achieve sustainability, educational, preventive)? 

The elephant here of course are the determinantS. Ultimately, all these forms of problem solving should be at 'home' in the political domain, but they are rarely there. It is not just the practitioner who can make the difference - be the difference.

Enough of l-implementation

Policy needs to be fit for 21st century purposes, and not hollowed-out but allowed out - beyond the legislative walls where it can make a real difference.

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group-population

Nursing process Case  formulation	Nursing process
Nursing process Case  formulation	Policy formulation

    

See also: https://herbertsimonsociety.org/

 'nursing process' : 'case formulation'

Holistic care 3: Location

Through February and March I looked at holistic care definitions and other aspects. Now for location.

The place to look for holistic care is literally everywhere. Every - where?

Well yes, if we take holistic to really mean holistic.

There is the obvious physical where that applies in the various care sectors such as; primary, secondary, community and tertiary care and the places they all encompass and contain. The locations associated with buildings and other architectural and organisational structures however permanent: hospitals, hostels, surgeries and clinics, homes, schools, prisons, refugee camps and workplaces - including inner and outer space.

The other where comprises the cognitive and virtual. Our thoughts about care, the thought processes and conscious decision making about care assessment, planning, intervention and evaluation. Except in specific psychoanalytical therapies the unconscious is a less frequently acknowledged and yet undoubtedly factor. If values are to have an origin and a safe harbour (governance) then a light must be cast on the darker, uncertain places. Accepting and utilising these places facilitates a holistic perspective, an adjunct to the more usual analytically derived views.

Speaking of analytical: recently, working on a 2nd temporary secondment, I've been preoccupied (and still am) with PROCESS and CONTENT. We tend to lose ourselves in process; the nursing process, care process, process mapping workshops abound. The problems take centre stage and because they are the patient's problems that qualifies the process as being person-centred. A tick goes in the box.

At times outside of medical emergencies this may be a mistake.

In deploying 'IT' the argument goes that the benefits of information technology in health care (various reports, effective case management, safer practice...) should be transparent, that is -

a by-product of the care process: not an add-on.

To me this suggests that the care process, the energy spent negotiating the care pathway produces a reaction. Informationally this reaction can be desirable. (I'll leave you to contemplate the alternative.)

If the person is truly at the centre of care then maybe the reaction can also be characterised as precession? Just as the Earth precesses on its axis, so our care processes result in precession around the person - the 'whole' individual and their situation at the centre of care?

But only IF we choose to take notice, factually, emotionally and informationally.

There's no disputing that care is frequently wobbly. But this oscillation can provide a periodic peek into the four (5) care domains.

At times these presentations, or windows of opportunity may be physically and emotionally draining, and arise in a highly disordered manner, they are nonetheless there.

Allied with a problem space, that other for me essential location of holistic care, you have a potentially very powerful tool.

I know this may be twaddle and I may be on shaky ground, but at least I'm trying to follow the wobble...

As highlighted previously there are alternate ways of seeing.

Before I close and follow a countdown: Thank you Darcy - a star on stage : GO STS 117 stars in space.

From a Distance: 4Ps, Nursing Process & Socio-Tech I

In the 4Ps post last year each 'P' (purpose, process, policy and practise) sat in its own domain. I made no effort to differentiate them; each 'P' was left to stand for itself - so here's a question for you...

Assuming you agree with this 4P formulation, which 'P', if any, do you think is primary?

For me the mainstay is PROCESS because chronological and pathological TIME ticks in the SCIENCES domain. Plans and actions are situated (see Hodges' model) in time and besides pathologically speaking I only have one pair of hands tied to a finite metabolism and hence limited information processing capacity.

Now, casting my vote to PROCESS within the SCIENCES domain, may seem something of a sell out to advocates of the humanities and me a mental health professional to boot... Where is the warm-touchy-feely essence of care? So, as we look to the HUMANISTIC hemisphere for quality assurance the next query is yours:

Without a sense of PURPOSE tasks x, y, and z will not be done properly, if even initiated?

Very true. PROCESS like PURPOSE has its micro-macro dimensions. PROCESS in particular is notorious in the extent to which it can be reduced to ever finer detail.

Looking at h2cm, the antipodes must not be ignored. Sometimes people believe they are on solid ground, secure (smug even) literally in the knowledge where PROCESSES abound; but the need to take in other perspectives can prove a wake-up call in the form of a sudden dousing.

Balancing POLITICAL need, encapsulated coherently in POLICY, must constantly be weighed against actual PRACTICE in the SOCIOLOGICAL domain and the constraints that operate there.

Just because you have TI:ME and individuals allotted on the Gant and PERT charts, subjective ti:me can literally slap us in the face if the mood is judged wrongly. PROCESS may be primary, but its ramifications are and must be constantly transformed-translated and enacted in personal and social form.

Paper: Wang and Nickerson (2017). A literature review on individual creativity support systems

Hodges' model can lay claim to being a creativity support system [CSS]. While I do not have evidence, the model presents a diversity of stimuli in its structure and the care - knowledge - domains. It follows then that from the outset it is a motivational primer on both affective and achievement counts. Immediately, there is the motivation provided by the blank space, viewed as one or four conceptual spaces to find an initial starting concept. Affective as users gravitate towards their chosen reflective and creative journey, and achievement priming as having a goal that is prompted by professional, interpersonal and educational goals. If there is a case of 'creativity block' then perhaps a group approach can be adopted? Hodges' model then becomes a collaborative creativity support system. With Hodges' model and no doubt the proposed CSSs the collaborative agents add their own affective and achievement priming, whether student-student; patient-student (supervised); or mentor-student.

With the important caveat that the studies identified do not include healthcare but many papers are general. The authors provoke many questions: "Creativity support systems, like other information systems, are most effective when they instantiate underlying theories..." (p.140). I have already posed this question - which is (as ever) compound. As per the review's general domain papers, is there an underlying theory for all of Hodges' model; or is there a need for a theory per care domain?

"The literature on individual creativity support systems has drawn from theories about design, human computer interaction, information systems, and creativity.. " (p.140). 

If 'design' can be complex, what of 'care design'? That is what we are about. This in turn impacts upon the other sources of theory above.

There is much to draw upon in Wang and Nickerson (2017) but finally on page 145:

"the authors did a survey to verify the notion that creative self-efficacy, individual knowledge and IT support affect individual creativity through mediating variables: individual absorptive capacity, exploration and exploitation." 

Creativity must contribute to literacy, Wang and Nickerson allude to a relationship, referring to self-efficacy above. This is what we are seeking in health literacy and self-care. An ability to explore and exploit available resources being a sign of autonomy and efficacy.

Table 3
A framework for designing individual creativity support systems.

Aspects	Components	Features to Support the Component
Motivation	Motivational priming	Affective priming Achievement priming
Creative Process	Process completeness Process control	Modules to support each step in a complete creative process Allowing iteration and selection of steps
Divergent thinking	Stimuli Long term memory Working memory Creativity techniques	Providing different levels of stimuli, Providing stimuli dynamically External long term memory, such as knowledge base and case library; Facilitating search Supporting association, Visualization, Random combination Facilitating the use of creativity techniques; Computational creativity techniques
Convergent thinking	Comprehension Decision	Labeling, classification, simulation Criteria based comparison, Decision support

Table 4
The steps in a complete creative process.

Process Stage	The Divergent Step	The Convergent Step
Problem finding	Formulating problem presentations in various ways	Selecting the best ways to present the problem
Information finding	Collecting potentially relevant information	Selecting the most relevant information
Idea finding	Generating many ideas	Selecting the best ideas
Solution finding	Improving the selected ideas	Selecting the improved ideas and integrating them into a solution

Reference:
Wang, K., & Nickerson, J. (2017). A literature review on individual creativity support systems. Computers In Human Behavior, 74, 139-151. (tables p.145).
http://dx.doi.org/10.1016/j.chb.2017.04.035

4Ps - human-MACHINE :: HUMAN-machine

HODGES' MODEL: Axes & Domains

As visited many times here on W2tQ, in Hodges' model I've associated one of 4P's with each of the model's care/knowledge domains. I immediately associated PROCESS with the sciences domain (physical, chemical, biological, geological..), driven by the seemingly process-bound approach of project management, logistics, automation and sequencing. 

This preoccupation can work to the detriment of the user(s) of systems (the public!), devices, interfaces and administrations - record management for example. Allied with POLICY in the political domain you can end up with a massive and technocratic bureaucracy. 

In nursing there was concern when the nursing process emerged that progress of individualised, person-centred care would be overwhelmed with a return to task-oriented care. Patients would literally be processed, in what is a problem-solving algorithm: assess, plan, intervene, evaluate.

Of course,  as in all idealised models, there is overlap between the 4Ps and the model's domains. We speak routinely of social, psychological, and political processes.

The rise of AI however prompts (demands) this debate be re-visited:

SELF / INDIVIDUAL  -  OBJECT / THING

|

      INTERPERSONAL    :     SCIENCES               

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

 SOCIOLOGY  :    POLITICAL 

|

GROUP

the human - PURPOSE(S) the machine -	- can become machine PROCESS - can become human
PRACTICE socio-	POLICY -political

Previously: 'ethics' : 'nursing process' : '4Ps'

Drum Beat Network: Development Policy Ideas and Critique

To: Academics and other Researchers in The Drum Beat Network
From: Warren Feek - Executive Director - The Communication Initiative

Development Policy Ideas and Critique

Dear Peter

Many best wishes. Never has consideration, analysis and debate of Development policies been more important. We would welcome your Development policy ideas, analysis and thoughts being shared through The CI's policy process [with and supported by The BBC WST].

There is a coming opportunity to give your Development policy ideas wide circulation. We will be doing a theme issue of The Drum Beat e-magazine [subscriber base of 44,000 in development action and thinking) in mid-May based on the blog submissions to the Policy section on The CI site.

That policy site is receiving increasing access and engagement from amongst the 2,700,000 individual user sessions over past 12 months on The CI portal.

A significant and growing percentage of the CI network and user base are policy makers and funders and their support staff.

It would be excellent if you are able to blog - we encourage a substantive op-ed style (my link) - on an interest to you within the overall theme for this blogging process - namely issues of development policy. There are more details at http://www.comminit.com/en/node/286565/bbc

To participate, simply send me your blog [op-ed] contribution in whatever form you wish and we will consider and process it for possible featuring both on the policy blogging site and in the mid-May Drum Beat.

We would also welcome your comments on the present blogs that have commenced this process and can be seen at http://www.comminit.com/en/development_policy

So, if you want to join this blogging process - in the Op-Ed style we have adopted - on development policy issues and themes as featured through Policy tab at top of all pages on site - www.comminit.com - then please check out the guidance notes at
http://www.comminit.com/en/node/286565/bbc and email me your contributions - wfeek AT comminit.com

It would be great to have your reflections in this policy mix. Please do send your contribution.

(edited for length) ...

Thanks - Warren
--------------------
Hi Warren, Thank you for this news and invitation. A very interesting and worthy project all the more so with the use of op-ed style. I'll see what I can do - perhaps using the h2cm matrix ... Good luck! PJ

Book review: Curriculum Development In Nursing Education (2nd. Edition)

It is high time I reviewed a book on nursing so when I came across Curriculum Development In Nursing Education by Carroll L. Iwasiw, Dolly Goldenberg and Mary-Anne Andrusyszyn, I was really pleased to receive a review copy. While I am not a full-time academic I learned a little about curriculum development on the PG Cert. Ed. course. As for all qualified nurses I take the mentoring role seriously, enjoy it immensely and of course we are all life long learners. The other benefit comes from curriculum planning being one of the original purposes for Hodges' model.


To begin the book is a very comprehensive and yet accessible introduction to this subject. The language is clear and not technical, the print is also clear (and large - for an ageing readership!) the format is modern. The book is well referenced overall, leaving me with several leads to follow-up. Although grounded in and with case studies based on hypothetical North American institutions the scenarios, questions and critque are easy to appreciate and relate to, whether you are faculty, nurse (student), or other stakeholder. Iwasiw et al. stress how curriculum development (CD) is ongoing, recursive and the limitations of a 2-D representation of the process on paper. A model is provided on pages 6-10 and in figure 1.1 with many very useful definitions.

The politics of educational settings and their activities are clear as Iwasiw and colleagues explain the 'sales pitch' for CD and the importance of interpersonal skills and foresight. CD the authors make clear is a non-trivial pursuit. It should be ongoing all the time with established curricula under review. At first I was surprised about the lack of mention of project management, specialist consultants are referred to and Gantt charts and project plans are discussed subsequently. The book starts and ends with the nursing and faculty shortage (which seems ironic from here).

In chapter 3 leadership is covered and the need for formal preparation of staff to manage CD.  Faculty development for CD features in the majority of chapters. The case studies engaged me throughout. Chapter 4 leads on to the organizational context of CD, with helpful introductions to change theories and their application. So we have Kotter's 8-Stage process; the Transtheoretical Model of Behaviour Change. Talk of leadership and organizations inevitably leads to the adminstration and management of CD and types of committees. Not exactly page-turning content, but essential to planning, collaboration and ongoing success. CD is viewed as a golden opportunity for change, so decision making and critical reading is emphasized, with several methods of ideas generation outlined in a table (wither Hodges' model?). There is a 2 year Gantt chart, despite my initial reservations about 'project management'. (I am still surprised and must address my impression that academia is largely untainted by external project management and consultancy speak?). Page 80 sees an explanation for the book's cover.

There is a crucial point made in programs and courses taught and how these can act as an assett or a constraint:

Knowledge from the physical, biological and psychological sciences, as well as from the arts and humanities, contributes significantly to the nursing knowledge and well-rounded graduates p.106.

I have always been interested in this word 'infrastructure'. The complexity of education and CD is revealed as the author's explore human resources, physical resources, resources to support teaching and learning. These headings do not do justice to the content here which is dealt with economically, but effectively. Moving to external contextual factors and I can see how Hodges' model is ideally suited to helping to frame CD. The authors also cover demographics, culture, health and health care, professional standards and trends, technology and information and the environment. There is a summary of the social, political and economic conditions and their impact and influence on CD p.115-16.

The section on Approaches to data gathering for CD, seemed familar, reminding me of Management Information System books of old. Here the contrast is between data gathering for CD and data collection for research. Perhaps the distinction here is less important if we are equally open to quantitative and qualitative methods and triangulated approaches p.116-17. Tables 6.3 & 6.4 over four and a half pages run through data, data sources and data gathering methods for internal and external contextual factors. The initial definitions are supported by a further collection (p.136-7) curriculum concepts, professional abilities, curriculum possibilities, curriculum limitations, administration and curriculum nucleus. Data collection is one thing, but it is in subsequent analysis, interpretation and synthesis that value is found. In response five processes are introduced:

1. Examining and integrating contextual data - identifying patterns and trends
2. Inferring curricula conceptions and professional abilities
3. Proposing curriculum possibilities
4. Deducing curriculum limitations
5. Identifying administration issues

Although not stated in the text, I enjoyed reading about the over-riding, over-arching ideas that nurses should learn and apply. The fundamental ideas that shape how nurses relate to their clients, how they think and behave. How are these ideas to permeate and be promoted through the curriculum? In confirming the curriculum nucleus (and another bread and butter point for Hodges' model) has anything important been missed p.148?

Educational establishments are of course living entities. Continuity is essential and is attended to here in the Popularfield case study p.150-169. If things get heavy in the book then currculum philosophy is the focus of chapter 8, and considers the role of different audiences of curriculum outcome statements. Program models (p.201-09) leads (inevitably) to models of nursing - listing Orem, Leininger, Watson. The nitty-gritty of teaching and learning is discussed in contemporary organisational structures and course sequence patterns p.211. Table 9.1 provides an interesting matrix of core curriculum concepts. The table headings include:

health promotion : empowering interpersonal relationships : caring : social justice

Deliberating curriculum delivery requires selection of delivery application, program model, and organizational strategy and course sequencing pattern - all discussed across chapters 9-10. I've been wondering about 'process' across the humanistic-mechanistic divide and there are some lines that set me to thinking:

Process-orientated courses further integrative learning, de-emphasize specific content and reduce reliance on the lecture method p.243.

Of particular interest to me is designing individual classes with table 10.5 providing example of instructional events and teacher activities. Gagne, et al., may be a primary source, but the date of 1992 troubles me. It is undoubtedly difficult to encompass the whole range of instructional events and activities in 2-3 pages, but future editions would benefit from a revision of the 'state of technology' in the book as a whole.

Chapter 11 throws CD into a public light in planning curriculum improvement and making curriculum plans public. Discussion includes division of criteria along structural and process lines. The former - adherence and duration; the latter - quality of delivery and program of differentiation. Contractual agreements are raised between health care and community agencies, legal areas of concern and insurance. The human side of CD cannot be ignored looking at the existing work force - skills - and demands and requirements of a new curriculum. The phasing of the change to a new curriculum from an old needs to be handled sensitively is an issue well made in the text. New students must not feel they are missing out and being experimented upon, while students on existing programs feel they are missing out on what is 'new and shiny'. As noted faculty development remains a constant throughout the book.

Chapter 12 is an excursion through planning curriculum evaluation taking in outcomes, human and physical resources, learning climate and policies. Skills and means in judging curriculum quality, reporting results, and reflecting on the process are explored with further definitions supplied. Utilization-focussed evaluation is described - in which the focus is on the intended use by the intended users. Program evaluation is broken down into internal and external forms (p.281) and as if to give credence to the adage "All work and no play makes Jack (and Jill) dull people"... the benefits of CD for faculty are explored.

Typologies of Curriculum Evaluation Models are presented, a generational view 1st-4th, again with resort to a table. The 4th generation - the post-late 1970s is described as holistic and inclusive. RCAR stands out Relevance-Congruence-Adequacy-Reasonableness and other examples. I thought about learning management systems here and was surprised that there is no tie-in, or mention in the index as a reporting resource. Planning evaluation of curriculum components also touched on philosophical aspects.

Chapter 13 on Flexible Delivery of Nursing Education Curricula is central to my interest and criticism of the book if there is one. Distance education and flexible delivery are differentiated. Guidance at a distance is stressed not technology (p.315). There may be be too much reliance on 2-way communications between tutor and student, and the important thing for me to remember here is the focus is on CD (academic responsibility, obligations, affirmation), not teaching methods, multimedia and instructional technology. That said, the problem of instructional technology models and their integration into curricula appears to be a key challenge: [ previous discussion on http://it.coe.uga.edu/itforum/ ] Tied to this as the authors state are the politics of schools of nursing who are obliged to follow the strategic plans of their institutions. There is reference here to an online critical care nursing course p.318. Plus integrating pedagogy and technology with Blackboard Learning System, Moodle, Desire2Learn and Knowledge Hub, so this book is far from a technology-software desert. Virtual reality is in the index.

Surprisingly or highlighting how enclosed (institutionalized) CD is, 'open source' is not considered. Too risky perhaps? Nevertheless, this is a surprising omission from the index (unless I have missed it in the text?). There are some marvellous open source projects in education, and surely some of these touch on curriculum development, especially in the developing world? Drupal the content management system (and many other open source tools) is increasingly being adopted. Libraries are deploying Drupal on the 'front desk'. The closing chapter 14 draws attention once again to the nursing and nursing faculty shortages and related politics. This really is an important message with global implications for the future of local training of nurses, job readiness, the refocus of existing nurse curricula, subsequent migration and standards within the profession. In summary:

• I enjoyed reading CDiNE.
• Learned a great deal about this important subject.
• It is accessible and readable.
• I have many leads - references to follow up.
• The book is a comprehensive in its treatment of CD in nursing education.
• The many definitions are informative.
• The tables are a great signposting and summary resource.
• The book encourages further reading and study - and actual engagement
  in the CD process.

If the book has a problem for me there is not enough on technology AND information - as a lever for change and source of metrics. My impression admittedly from one book is how untainted academia is by project management and an information (consultancy?) driven ethos. This is just an impression and I am biased as this blog demonstrates. I do believe that in discussing CD (p.195-99) that while the Web is clearly mentioned, more could be made of learning management systems. I would have thought that 'systems' to a organization of any sort, would be viewed across operational, tactical and operational levels. Where is the management dashboard here? If it is an issue of maturity this could be stated. I thought these may feature in a more integrated way, also being used as a data gathering resource. To the author's credit the book is nicely balanced as an introductory source.

Recent students have highlighted that they do not cite (unless the work is historical) references older than four years. The references here that relate to technology are for me quite dated and should be revisited and considered afresh. Recent literature suggests that the days of the university are numbered. Whether you take this seriously or not the position of instructional technology, the web, scholarship and future of academic publishing - the smoke under the door - should at least merit examination. Otherwise - from my external locale - this a very comprehensive, informed and accessible account of CD in nursing education that continues and must continue to build on previous editions. Meanwhile thanks to this good book - I must also re-visit Boyer's model of scholarship.

Acknowledgement: Thanks to Clare McMillan, Marketing Specialist and Jones & Bartlett International for the review copy.

Ref:
Carroll L. Iwasiw, Dolly Goldenberg abd Mary-Anne Andrusyszyn, (2009) Curriculum Development In Nursing Education (2nd edition), Jones and Bartlett Publishers.
(My) additional image:
Möbius Strip As Quotient Space

Review: iii Kinchin's Visualising Powerful Knowledge to Develop the Expert Student

Also aimed at general as well as readers in education, this is an accessible read. The book's compact size, eight chapters across 134 pages invites completion even though I took quite a few weeks.

Book reviews here are a bit 'unconventional' with the two axes I have to grind [ ;-) ]. Returning to chapter 2 momentarily and map topography. Kinchin explains how concept maps of various types can be better understood and evaluated - a process of 'topological normalisation' (p.27). On W2tQ I may sound like 'I have it in' for process and processes. I do, in the importance they seem to assume within project management. I do 'get this'. A focus on processes is inevitable and readily appreciated in Hodges' model.

No process then ... no time, sequences, events, change, movement, spatial references and so on ... Kinchin's inclusion of  'topological normalisation' is very constructive (imho) as it indicates a method (as with measuring concept maps) and suggests something beyond an algorithmic approach.

The phrase (inevitably?) reminded me of database normalization:

".. the process of structuring a relational database."
https://en.wikipedia.org/wiki/Database_normalization

So, topological normalisation and associated structures provides the icing.

Little wonder then that next up in chapter Kinchin's Table 1 lists the characteristics of

'Deep Learning' and 'Shallow Learning'

So cake and icing clearly.

On deep learning the first item is ''Linking new information with prior knowledge'. This is central in Hodges' model and the reflection (individual or group) and critical thinking that the model can help generate. With all the claims for VR AR, this (reflection / reflective practice facilitated by Hodges' model) is conceptually immersive (and a definition of learning?).

From this, another item is realised. As learners engage with content; find, 'own' and sustain their enthusiasm for their learning, understanding and the subjects and parts of the curriculum they find themselves learning within. The sum total is: structured networks of knowledge (p.36).

This gets even better with the subheading: 'Oppositional Binaries'.

Hodges' model provides two binaries - but (apologies - another time!) let's get back to the book.

While 'Deep learning' has its advocates, Kinchin quotes Tormey (2014:4) who warns:

'a framework that is simple enough to be a powerful metaphor may be too simple to adequately account for learning in different contexts' and that its blind acceptance by new entrants to the profession has 'imposed blinkers that make alternative conceptualisations invisible'.

Finding further evidence to support Hodges' model within this debate is invaluable.

to be continued...

Roland Tormey (2014) The centre cannot hold: untangling two different trajectories of the ‘approaches to learning’ framework, Teaching in Higher Education, 19:1, 1-12.
DOI: 10.1080/13562517.2013.827648

Novak, J.D. and Symington, D.J. (1982) Concept mapping for curriculum development. Victoria Institute for Educational Research Bulletin, 48: 3–11.

Kinchin, I., (2016) Visualising powerful knowledge to develop the expert student. Rotterdam: Sense Publishers.

See also:

Intro post

Review One

... Two

... Four

... Five

... Six

Many thanks to Brill for my review copy.

Relationships matter: Society Guardian & The WSJ

Re. Charles Leadbeater's State of Loneliness, The Guardian, Society, 01.07.09

The cover of this weeks Society Guardian immediately caught my eye with its picture (I wonder which corner of which care domain this lady is sat in?):

The text initially passed me by; then yesterday I caught up, it seems the business model quest in one sector is having a domino effect with new models needed elsewhere including health and social care.

Leadbeater's piece reminded me of Lean thinking the improvement process with its drive to identify value, reduce waste and repetition. ... His text points out that:

More efficient services quickly move in and out of people's lives, but they don't really change how people live. That is one reason why we have not made deep inroads into the most deprived communities, the most troubled families, the most intractable social problems. Services manage and process people and problems, but only rarely allow people to change their lives. Service solutions are ill-suited to the emerging challenges of the rise of long-term health conditions, diseases linked to lifestyle and diet, ageing or climate change. You cannot deliver a solution to an epidemic of diabetes the way that DHL delivers a parcel.

So any model, method that is primarily process centered may find itself compromised - providing just one cylinder's worth of power in a four cylinder engine. In Hodges' model I have identified the 4Ps. PROCESS, PURPOSE, POLICY, and PURPOSE (to which we must now add PROBITY). It will be interesting to see how value is defined across service forms of engagement, intervention (including signposting) and the new set of outcome measures to follow whether local, national, service-reported or patient reported outcome measures. Leadbeater continues:

The key will be to redesign services to enable more mutual self-help, so that people can create and sustain their own solutions. The best way to do more with less is to enable people to do more for themselves and not need an expensive, professionalised public service. Enabling people to come together to find their own, local solutions should become one of the main goals of public services. Services do a better job when they leave behind stronger, supportive relationships for people to draw on and so not need a service.

So Jo(e) Public needs to reflect, compare, evaluate, learn, collaborate and make informed decisions in order to stay well amongst many other things. They need to be engaged holistically.

Where is the model for this...?

I believe I know.

The Wall Street Journal has something to add here The Doctor Will Text You Now and relating to my earlier posts on 'Beware Reflex Moves'. Relationships matter, but if nurses are out there assessing, assessing, assessing who is doing the education, dividend added therapy outcome focused?

If e-health is going to make a real contribution in augmenting and freeing high value care resources then this in turn depends on the value invested in relationships.

Louis Petrillo, 57, a psychologist in Westfield, N.J., says he regularly turns to his family’s doctor, Robert Eidus, for online advice about his frail 90-year-old mother, who finds office visits difficult. His son who is away at college also used an online visit when he had sinus problems. “I can get into his virtual office anytime,” says Dr. Petrillo. He feels the online care works well largely because Dr. Eidus knows his family members’ regular health complaints.

If older adults move home and need new primary care services, what are most probably(?) well established patient - doctor (patient - primary care team!) relationships are not just undermined they are undone! A person's sense of community is fractured. ...

Yes that image speaks volumes.

Image source: Guardian

Mathews, A.W., The Doctor Will Text You Now, JULY 1, 2009, The Wall Street Journal Interactive Edition

Bourdieu*: habitus, field, horizons and careers

"For Bourdieu, structure is not only objective in a Levi-Straussian sense. 

Structures can also be highly subjective." p.13.

 

"In one sense, habitus is social inheritance ... but it also implies habit, or unthinking-ness in actions, and 'disposition'. Some dispositions are transferable; fort example, a practical taxonomy can be utilized to find relevance in a new situation." p.14

 

"If habitus brings into focus the subjective end of the equation, field focuses on the objective:" p.15.

"Field is therefore a structured system of social relations at a micro and macro level." p.16.

 

"Education is a field, made up of identifiable interconnecting relations." p.20.

 

"Young people make career decisions within what we refer to as horizons for action. The horizons are the perspectives on and possibilities for action given in any field or intersection of fields." p.97.

 

 

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group - population

subjective	objective
culture, linguistic market, upbringing cultural and social capital	class, institutions, education career guidance economic capital

 

Grenfell, M., James, D. (1998) Bourdieu and Education: Acts of Practical Theory. London: Falmer Press.

Career progression: Moving beyond Bourdieu pp.100-103.

and Chapter 9, Theory as Method pp.152-178. diagrams. 

The 4P's in Hodges' model

PURPOSE	PROCESS
PRACTICE*	POLICY

 

Always conscious of how Hodges' model, like many other 'models' is an idealisation. As such we routinely refer to 'social action', 'political process' and 'social process'. 

I have, I suppose, allocated the four P's to the respective domains on a primary context - primary domain basis.^ So 'process' as per time, events, sequence, algorithm, logic, cause-effect.

^first come, first served?

Call for contributions: 'Interpreting the Information Age' new avenues for research and display

November 24 – 26 2014

Science Museum, London

In autumn 2014, the Science Museum will open a new permanent gallery, Information Age. The gallery will expose, examine and celebrate how information and communication technologies have transformed our lives over the last 200 years. To mark this launch, the Museum is hosting a three day conference which will discuss how the history and material culture of information can be made relevant for today’s audiences.

From the development of global telegraph and computer networks, the creation of constellations of satellites that silently orbit our earth, and the growth of radio, telephony and cellular networks; each technology can be understood through a network of people, practices, devices and infrastructure. Approaches which focus on overly technical histories, individual innovation or inevitable progress fail to acknowledge the role of users in the history of technologies and marginalise a majority of readers or visitors who are engaged by human stories and social history. By contrast, Information Age has taken a user-centric approach, not only in the stories and objects selected for display, but in the way the gallery has been designed and developed. Participation with a diverse range of audiences has been at the heart of the process, providing new avenues for research, fresh perspectives on our collections and original ways to interpret the information networks of which we are all part. We invite papers that include insights from researchers, academics, museum professionals, community partners and participants.

The conference structure is proposed to include:

Day 1: New avenues in the history of information and communication technologies

Day 2: Interpreting and displaying the history of information and communication technologies

Day 3: Reflections on the process and practicalities of participatory practice

We are especially interested in papers that address the following themes, but are happy to consider other proposals. Please contact the organisers for guidance. 

New avenues in the history of information and communication technologies

• From devices to networks: taking a broader approach to the history of information and communication. How has historical analysis expanded our understanding of information networks as inherently social-cultural phenomena? How can museums move beyond displays of devices, to reveal how networks unite people, places and ideas?
• User-driven innovation: technological change does not only occur at the moment of invention, but in the hands of users, who adapt and appropriate new technologies. What tools and techniques can we use to reveal previously hidden user stories?
• Spaces and places of information: How are institutions celebrating the local and global stories in the history of information and communication technology? What partnerships are being formed to support this?

Interpreting and displaying the history of information and communication technologies

• Collecting information: what are the challenges of collecting the material culture of information and communication? How can opening collecting processes to wider audiences enhance understanding, and what are the benefits for both researchers and the wider public?
• Displaying information: innovative approaches to the history, present or future of information and communication technologies.
• Preserving information: the challenges for museums, libraries and archives in preserving our increasingly digital lives.
• Whose story? As institutions strive to tell the story of information and communication technologies from the perspective of users and co-producers, how can we ensure that we are representing a diverse range of voices? 

Reflections on the process and practicalities of participatory practice

• Breaking down barriers: what approaches are being taken to ensure museum collections are accessible to wider audiences? What interpretation approaches can be adopted?
• Collaborative interpretation and design: how are institutions and audiences working together in exhibition development? What are the benefits to the museum, participant and ultimately the gallery visitor? What are the perceived risks to the museum’s authority?
• Ensuring legacy: how do museums capture the process of participatory practice in a meaningful way? What evaluation methodologies can be adopted? How can museums support partners and participants in the longer-term? 

How to contribute

To submit a proposal, please send a 250 abstract outlining the topic of your paper, along with a 100 word biography, to [ research AT sciencemuseum.ac.uk ] by Friday 28th March 2014.

We welcome proposals which could be delivered either as paper presentations or for consideration as panel discussions with other contributors, along with proposals for workshops which practically address the conference themes.

My source: HUMANIST list

Review: ii Fundamentals of Person-Centred Healthcare Practice

With 30+ pages left I need to remind myself of the book's focus -  the Person-Centered Practice Framework [PCPF]. 

The 'practice' in the title is key too and I am envious of the attention afforded to the PCPF. The book very much seeks to inform student learning and in section 4 on learning and development. The book is very effective in operationalising person-centred care and person-centredness.

I'm constantly fascinated by the way processes arise everywhere. This is inevitable. Time, space, events, the flows of data, information, knowledge and the systems we use are necessarily process-oriented. Who are you at 2pm compared with 8pm - shift patterns permitting?

Purposes are discussed and the 34 chapters cohere very well in style and vocabulary. Perhaps I expect too much. A vocabulary that bridges the process-laden world of the sciences and political machinations with the humanistic - experiential - world of lived experience? I need to accept that 'whole systems' rely on processes that are not just physical, but social, psychological and political. I can't though help but read "Committed to healthfulness as process and outcome" in task-oriented and politicised (outcome) terms (p.15).

In table 2.2 (p.16) on associated concepts a list that includes patient- client- woman- child- family- relationship- centredness, I see this as humanistic and hence as a matter more of purposes and practice than process. A letter explaining 'person-centredness' to an alien visitor the Oscleans, is a welcome creative distraction and reminder for me of SETI@HOME which has stopped distributing work. Here, I read 'service-users' as an unconscious bias towards the dark-side to bring the Force in to the mix. 

On twitter (and here) I've tried to highlight that the BIO-PSYCHO-SOCIAL model is incomplete.

IT IS NO LONGER SUFFICIENT.

Yes: Person-centredness is about an individual's being.

To BE person-centred your stance must include the POLITICAL* (p.19, p.35).

I'm still deliberating on what sort of tool is Hodges' model?

It is far more than a Johari Window (p.36):

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

'Situation' litters the text - oh for a situated model: "Look for alternative ways of explaining a situation (i.e. reframing a discussion)" (p.37).

As you can see, this books gets you thinking and reflecting ...

The book's editors and publishers are courageous and true to the format by including weblinks. I will try some of these and report back.

 

self - individual - PERSON - patient client carer
|

INTERPERSONAL : SCIENCES

HUMAN ----------------------------------------------- MACHINE

SOCIOLOGY : POLITICAL

|

family - group - population

patient- client- beliefs wishes identity hope	time place space
woman- child- family- relationship-	policy power £$

More to follow with many thanks to the publisher for the review copy.

Review i

Review iii

Review iv

*Update 6 August: See 'Political Quotient'

Fundamentals of Person-Centred Healthcare Practice,  McCormack, B., McCance, T., Bulley, C., Brown, D., McMillan, A, Martin,S. (Eds.). ISBN: 978-1-119-53308-5 February 2021 Wiley-Blackwell.