Mathemacy and Mathematical archaeology c/o Ole Skovsmose

(Ack. quoted at length and hopefully justified?)

"Mathemacy

The notion of “literacy” has been developed by Paulo
Freire to mean much more than just being able to read
and write. Literacy also includes competence in interpreting
social life. The notion of mathemacy can be developed
in a similar way to mean more that an ability to
calculate.

In order to do this, it is important to pay attention to
the notion of reflection. When a calculation, based on a
mathematical task, is carried out, it is possible to reflect
on the actual result. Such a reflection has mathematical
concepts and algorithms as its objects. A question guiding
such a mathematics-oriented reflection can be: Are the
calculations made correctly?

When setting up a mathematical model, in order to
solve a non-mathematical problem, we face many difficulties.
Thus, any modelling process presupposes that
certain simplifications are established. This means paying
attention to certain aspects of “reality” and neglecting
others. This is, for instance, what takes place when a
population model is used for the purpose of forecasting.
Reflections referring to a modelling process are of a different
kind than mathematics-oriented reflections. While
this kind of reflection has mathematics calculations as its
object, a model-oriented reflection has the relationship between
mathematics and an extra-mathematical reality as
its object. A question guiding a model-oriented reflection
can be: Is the output of the modelling process reliable?
Model-oriented reflections are carried out with an interest
in improving the model, i.e. with a technological interest.
Such reflections concern the validity of the model." p.199.

 INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

reflection "Be the difference!" ... Said, one number to another - hopefully!

reflection

"Mathematical archaeology Social structuration, at macro or at micro level, often takes place with reference to mathematics. Such an interplay between knowledge and power is referred to by the thesis of the formatting power of mathematics. As mathematics is basically an “invisible” part of social structuration, we need strong analytical tools to capture the role of mathematics. This leads to the notion of mathematical archaeology." p.199.

"A reflection guided by such questions can be called a context-oriented reflection. “Context” is here understood as a political, social or cultural context." p.199.

Hodges' Health Career - Care Domains - Model

'health career' - 'life chances'

"lifeworld-oriented reflection"p.200.

Skovsmose, O. Linking mathematics education and democracy: Citizenship, mathematical archaeology, mathemacy and deliberative interaction. Zentralblatt füur Didaktik der Mathematik 30, 195–203 (1998). https://doi.org/10.1007/s11858-998-0010-6

 #HealthTheory

c/o Marschalek (2017) Public Engagement in Responsible Research and Innovation

This blog often features EU research initiatives and conferences and a European project (2014-2016) to build a Responsible Research and Innovation (RRI) Toolkit also has a conference series and various publications. Marschalek's dissertation is a invaluable resource on RRI, drawing on the need for reflection, reflexivity, critical thinking and highlighting many models within sciences and participative methods. Reading the following you will hopefully glean the basis for my interest in the document and what might follow the project overall.

1.2 The Relevance of (Self-)Reflection and Reflexivity  

Scientists are not typically asked to anticipate future societal effects of their work. ...  

... But reflections, particularly on non-intended effects, are rarely undertaken. Reflection is not (yet) viewed as an integral part of scientific work. Many other more important issues need to be addressed within a scientific career. ...  

... Studies like this and others have revealed that researchers are rarely encouraged to self-reflect. ... 

... What is needed is to »step into the helicopter« (Schuurbiers, 2011, p. 784) to look at one’s own work from a distance. A look from the outside and feedback also help reflection. »Researchers are not accustomed to viewing their decisions from a normative perspective or discussing the normative aspects of decisions explicitly. ... 

... Unfortunately, not many reflection tools are available as yet. Quality standards and codes of conduct should »stimulate the reflection of the relation between one’s own values and that of external parties« (Asveld, Ganzevles & Osseweijer, 2015, p. 585) and there are self-reflection initiatives to motivate individuals to reflect on the impact of their work, e.g. a »Hippocratic Oath for individual scientists« (Sutcliffe, 2011), but even fewer ask organisations for self-reflection. Marschalek (2017) pp.15-16.

Marschalek, Ilse. (2017). Public Engagement in Responsible Research and Innovation.
A Critical Reflection from the Practitioner’s Point of View. University of Vienna, Vienna.
https://www.zsi.at/object/publication/4498/attach/Marschalek_Public_Engagement_in_RRI.pdf


My source and with thanks:
International Science Shop Contact Point
Norbert Steinhaus
Wissenschaftsladen Bonn - Bonn Science Shop
Reuterstr. 157 - 53113 Bonn – Germany

Responsible Research & Innovation: RRI Tools
www.rri-tools.eu
www.facebook.com/RRI.Tools.Project
Twitter: @RRITools

The health career model, reflection, curriculum development

There are many new insights and remembrances available in the content of -

Occasional Paper No 10
Connecting Reflective Learning, Teaching and Assessment
October 2009 by Helen Bulpitt and Mary Deane

We tend to speak of reflection as if it is merely a case of being in the right place at the right time:
in front of a mirror or other reflective surface.

Among the issues raised in OP #10 (which I will expand and explore further) are:

• the need to embed reflection in learning, teaching and assessment at the curriculum design level;
• the existence of an optimal curriculum design that can foster effective critical reflection (Clouder, 2009);
• reflection to meet specific learning outcomes can be said to be 'reflection to order' (Dalley, Chap 2, 2009);

As this short list shows reflection is a complex and serious component and activity of learning. A central problem is in the assessment and marking of reflective writing (Deane, Chap 5, 2009; Dalley, Chap 6, 2009). Marking a piece of reflective writing what would we look for:

• Observation
• Structure
• Reasoning
• Critical review
• Argument
• Personal disclosure
• Writing?

There really is the basis for a paper here on the health career model, reflection and there on the horizon - curriculum development.

Image source:
http://www.reelcollectibles.co.nz

"Nurses' ability to reflect on their practice is vital to the profession" Is it?

I beg to differ with the title of this editorial, as I wonder how vital reflection really is; and not just to nursing, but to the profession. I wonder from the rather detached perspectives of:

• Wigan Pier - and the parochial view this engenders (#globalhealth - where on Earth do I think I am?);
• As a 'local' nurse practising in Bolton;
• As a mental health nurse practising in the community within the NHS
• As a champion of a pivotal* resource for reflection and critical thinking (where is everyone?);
• and several others ...

Nursing Management

Quinn notes how "Nursing continues to develop to meet the needs of the society in which it operates." Plus: "A core part of revalidation is the ability to reflect on, and learn from, our interactions with others." My reading of Kinchin (and others over the years) suggests that reflection needs to be more a practice and revalidation based. I understand this is not what Quinn is saying in this issue on "Reflection as part of revalidation". Reflection using Hodges' model can be preemptive and anticipatory. We need to get beyond introspection and the retrospective important as this is.

As to where people are, it seems they are elsewhere, maybe reflecting in the sciences domain seeking theories and evidence. Perhaps, current teaching and exposure to models and theories of nursing and healthcare has them reaching for 'pure' models of reflection - Boud, Gibbs et al. when necessary. As we talk about the legacy issue that is integrated care, in Hodges' model here is a tool - a 'freebie', a 'takeaway' yes an Ubercare, that can grow with students, newly qualified nurses and experienced staff as lifelong learners.

Now that is vital to me. When reflection is hard-wired**, a part of a practitioner's cognitive apparatus and their educational toolkit to share with the public explicitly or implicitly as the context and engagement demands.

*Pivotal? Yes, and of course in light of the above, I'd be pleased to explain and even argue the case. The irony here is the current (ongoing!) focus upon recruitment and retention. Hodges' model is 'just' a tool, I recognise this; but could the application of Hodges' model energise, inoculate and so prime students for their course of education and practice placements?

**soft-wired too - humanistic

Quinn, B. Nurses' ability to reflect on their practice is vital to the profession, Nursing Management, April 2019. 26:2, p.5.

GRADE CERQual, Reflection, Mixed Methods and Threshold Concepts

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

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

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

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

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

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

The final paper for now:

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

- begins with a quotation:

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

—Greene (2008, p. 20)

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

Evans, Coon, and Ume (2011) write:

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

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

It is the mast and sail.

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

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

Qualitative-Quantitative

Objective-Subjective

Socio-Technical

Mind-Body

....

...

..
.

     Past-NOW-Future

Drupal musings 6: Content types - Reflection!

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

• education (nursing, public health, information technology)
• practice
• therapy
• supervision
• carer support
• eHealth
• ... ?

If so please get in touch [h2cmng at yahoo.co.uk].

In its initial downloaded state Drupal has two content types:

1. story
2. and page.

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

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

This also provides an opportunity to adopt a model of reflection that is itself supported by research. This may be Gibbs:

• Stage 1: Description of the event
• Stage 2: Feelings and Thoughts (Self awareness)
• Stage 3: Evaluation
• Stage 4: Analysis
• Stage 5: Conclusion (Synthesis)
• Stage 6: Action Plan

John's Model of Structured Reflection

• Aesthetics – the art of what we do, our own experiences
• Personal – self awareness
• Ethics – moral knowledge
• Empirics – scientific
• with its Cue Questions

Smyth’s Framework for Reflection on Action

• Activity
• Inform (Analysis)
• Confront (Self awareness)
• Reconstruct (Evaluation and Synthesis)

There are many others. ...

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

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

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group

The self - personhood Reflection (as core concept) has value and limitations Non-reflection to protect the self Unbearable anxiety psychoanalysis - findings defended nature of the self thinking & non-thinking 'suspended self-preservation' Self - Two perspectives - Service User emotional intelligence internal supervision intuition - improvisation Reflexive Helicoptering - metacognition Sexuality (form of bracketing-off of oneself)* lived experience of the senses RATIONALE

Theories of reflection Frameworks for reflection (reflective practice) physical / somatic effects of anxiety ethnographic study audio recordings Reflective practice demands that you learn from experience. It requires you to be self-critical. It expects you to analyse what you think, feel, and do... #When is it better NOT to reflect? 'Containment' 'splitting' risks (being completely non-reflective) experiences and the (mobile) body TECHNICAL

*limits capacity of some aspects of relational work  Social Work Practice Home visits Family home children and parents 'tacit knowing-in-action' Reflection in Practise Fieldwork - home, car SW composed when service users in distress, absorb their sadness, shame, fears, and at times their joy # Face-to-Face interviews Relationships: sexuality, gender offloading informally - office

Social Work / Clinical Case Supervision  offloading formally Two Local Authorities Management Supervision and Governance Child protection Power Organisational risk management Policies, Procedures Lone working... Influence in 'advocacy' [comment on twitter - see below] (as a Professional or 'Independent'?)

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

My source: Twitter
 

Reading: Doing reflective practice - a data-led way forward

Abstract

This article makes the case for an approach to reflective practice (RP) that is both evidence-based and data-led. We argue that, while RP within the field of TESOL enjoys a relatively high level of acceptance and status (perhaps even an orthodoxy), it has little corresponding knowledge base that demonstrates how RP ‘gets done’. We propose a need for more concrete descriptions of RP in order for teachers and teacher educators to fully engage with its possibilities, and in order to establish a knowledge base for promoting and supporting research by and for practitioners. In this article, we focus on the approaches that might be adopted to promote data-led and evidence-based reflection. Such a data-led approach would encourage the use of professional data, alongside appropriate tools (presented below) as a means of aiding and promoting practitioner reflection. In the first part of the article, we briefly outline what we consider to be some of the main challenges facing RP; in the second, we put forward a number of tools and procedures for enhancing RP and making it collaborative, data-led, and evidence-based.

Walsh and Mann write:

We believe that there is a need for more emphasis on:

■ data in helping to make RP more concrete so that we can see how reflection ‘gets done’ in practice;
■ reflective tools that produce data that might act as evidence for practitioner reflection.

This central challenge can be broken down into four issues that need to be addressed, namely, that RP is:

■ insufficiently data-led;
■ heavily focused on the individual at the expense of collaborative options;
■ dominated by written forms of reflection;
■ lacking in detail about the nature and purposes of reflective tools (p.352).

Walsh, S. & Mann, S. (2015). Doing reflective practice: A data-led way forward. ELT Journal. 69(4), 351-362. doi: 10.1093/elt/ccv018

TESOL = Teachers of English to Speakers of Other Languages

Reflection: programming and caring II

Reflection: (Ruby Pocket Reference, O'Reilly, 2007, p. 147.)

The ability of a language such as Ruby
to examine and manipulate itself.
For example, the reflection method class from Object
returns an object's class ("hello".class # => String).

Reflection within health and social care - is there a further definition ...?

Well yes, there are several, but there may be another ...?

The ability of a health and social care model such as Hodges' model
to examine and manipulate itself ^*
in response to an individual's (and family's)
care situation and context.
For example, the reflection method class from Object
returns an object's class (Intrapersonal.class # => Domain)^#.

^*This would require of course that Hodges' model is represented as a programming language or formalised conceptual space of some sort....
^#Or something like this....

Interested in writing? [ II ] Hodges' Health Career - Care Domains - Model

In the side bar beneath the bibliography (on a desktop) I've listed a few topics worthy of critical attention. The real need is to link practical application of Hodges' model and further some theoretical underpinnings for the model. This is now happening and it's quite a challenge as I chase questionnaires and write up a draft report for next week. This report is set out as a paper using an author's template from a nursing journal.

Trying to get the message out on writing about this free, holistic bandwidth defining, holistic wrangling, (self-) caring info-portal I blogged an appeal of sorts in 2010. Here we are again. The existing topics in that list relate to the original purposes of the model, plus a few 'extras':

• reflection;
• curriculum development;
• case formulation;
• holistic care;
• conceptual spaces

I'll revise the above as a result of this post and ongoing studies at Lancaster University. I will also add the journal to the most recent recovery paper. Expanding on the above for the benefit of anyone interested in using Hodges' model, reflection (as in 2010) is for me the primary purpose of the model.

Reflection: I'm sure that Hodges' model can complement existing and established approaches to reflection. It would be interesting to compare the use of Hodges' model with a control in clinical reflection, reflective practice with a patient/client, and in clinical or managerial supervision. (You see why this is a challenge, and I appreciate it is easy to generate suggestions!)

Curriculum development: If you need a map that incorporates an academic compass (sat-nav even) look no further. Where are the curricula hot-spots and how are they distributed?

Case formulation: There is an existing draft that needs to be revisited at some point, but the scope here is huge in terms of disciplines and applications. As mentioned above it is coming up with questions and research methods.

Holistic care: Is it time to revisit this phrase? Break it apart and put it back together if it still fits?

Is it a case of damaged goods?

Is this a broken currency as it originally did not include the patient as an active participant? Is it one of several linguistic tropes, said in earnest yet what does it mean? How do we measure it? Could there be a role for Hodges' model in defining or measuring it in theory (through the health record) in practice through outcomes that are demonstrably holistic? Does this make sense...? What is this holistic bandwidth that PJ witters on about? Is an informatics metaphor too far, or this a means to a definition?

To conceptual spaces I need to add threshold concepts and there is a literature here for health and social care, something to build upon and post here....

Reflection, Revalidation, RCN Congress and Research

Thinking Out Loud: Journal 'Regulars'

Like many people I looked forward to experiencing RCN Congress again in June. Now of course Congress itself is a casualty of COVID-19.

Last May as already posted, I picked up several nursing journals too. Having time(!) I've read about reflection, I submitted the required reflective accounts to complete my revalidation last month (so good through to March 31 2023) and I've time to reflect now.

Reading some of the papers and browsing through the journals I notice one has "CPD reflective questions" which are specified for full-length article submissions. Here are some examples from one journal issue:

"If a patient presents with red flag signs of impeding airway obstruction, consider the aspects of the 6Cs in nursing and reflect on the care, compassion, and communication required to the patient and family.
Consider the different dimensions of a person-centred climate of a long-term care setting.
Reflect on the nurse's role in the provision of person-centred care in an older adult residential setting.
How could you make the care of patients in your setting more person-centred?
Reflecting on the case study, what do you consider may help nurses in recognising the condition early and minimise the need for investigations?
Reflect on how the time perspective [can] be an indicator of health and quality of life in people with HIV or another patient group.
Consider how the time perspective can be incorporated into the health care of people with HIV.
Think about how nurses can assess the time perspective in people with HIV."

If you understand Hodges' model then you will appreciate how the model can facilitate reflection on all of the above.

The contents page of many publications usually differentiate between 'features', or 'special focus' and pages listed as 'regulars'.

For quite a while I've not only worked on papers (two advanced drafts at present) but (quietly) wondered about those 'regular' pages and what would it take for journals to adopt Hodges' model as a common resource?

Of course, this begs questions of legitimacy, evidence-base, standards ... and as I have acknowledged Hodges' model is no panacea for a practitioner's or a health system's limitations. Hodges' model itself may constrain the adopted perspectives of readers; as opposed to as I believe, liberating them? If all the posts here were analysed, what is the holistic bandwidth of the content?* If Hodges' model was adopted what trends, if any, would be revealed? If students used Hodges' model to reflect on their own well-being in year 1 - year 3 what would they learn? Are there wells of reflection about which reader's reflections would congregate? Would this in turn be influenced by other recognised biases in publishing and the way the above questions are selected?

It would still be amazing to see Hodges' model as a regular and universal prompt. Even as a research project - the aide-mémoire it is intended to be. The journal would then actively engage with its readership and provide invaluable CPD.

My new folder is already open for the next three years ...

Be Well :: Be Safe All

*I admit that there are topics I have avoided posting, as they are potentially fraught 'politically' or in other respects.

British J. of Nursing, 28,9. 2019 (9 May, Congress Bumper Issue!).

Papers - reading: Metalearning, Case-Based Learning, Reflection and Threshold Concepts

Working on the latest paper for module 4...

Jones, P. R. (1995) Hindsight bias in reflective practice: An empirical investigation. Journal of Advanced Nursing, 21(4), 783-788.

Within any web tool-resource based on Hodges' model can I try to ensure that reflection is a more 'contemporaneous' activity?

Ward, Sophie C., & Meyer, Jan H. F. (2010) Metalearning Capacity and Threshold Concept Engagement. Innovations in Education and Teaching International, 47(4), 369-378.

Metacognition, metalearning, reflection, reflective practice?

Kinchin, I., & Miller, N. (2012) ‘Structural transformation’ as a threshold concept in university teaching. Innovations in Education and Teaching International, 49(2), 207-222.

McDonald, K. (2013) Is reflective practice a qualitative methodology? Nurse Education Today, 33, 13–14. doi:10.1016/j.nedt.2012.07.011

Reflective practice as a single case study?

Kantar, L.D. & Massouh, A. (2015) Case-based learning: What traditional curricula fail to teach. Nurse Education Today, 35(8), E8-E14.

Three learning practices that were developed by the case study approach: (a) recognizing the particulars of a clinical situation, (b) making sense of patient data and informing decisions, and (c) reflection. Indepth analysis of these practices helped unravel four professional attributes that form the tenets of case-based learning: (1) a salience of clinical knowledge, (2) multiple ways of thinking, (3) professional self-concept, and (4) professional caring.

Several forms of situatedness are also described.

I am wondering about the possible role of 'worked examples', but am also aware through Kantar  & Massouh and others of the labour intensive nature of producing case studies (as worked examples). Is there another way to present them? One that is also student produced?

Situated Noticing
Drawing on students’ experiences in CBL, three categories emerged from the data to describe the sequence of noticing activities: (1) grasp of patient data, (2) holistic grasp of every aspect of the patient, and (3) clinical imagination (e10).

Assumpta, A. (2015) Transdisciplinary technology education: a characterisation and some ideas for implementation in the university, Studies in Higher Education, 40:9, 1715-1728, DOI: 10.1080/03075079.2014.899341

No mention of 'holis*' interesting for that?
Figure 1. Conceptual framework to understand complexity theory (Jackson and Ward 2004).

Figure 2. Traits of transdisciplinarity as a process group (Wenger 2000, 233) - includes 'A set of maps'.

(btw - the first paper is not mine.)

Book review: Handbook on the Ethics of AI #2

Well, I am sold. So, encouraging again to read 'reflect -ion' on the first page and throughout chapter 1:

'... why the very idea of AI gives rise to (or should give rise to) ethical reflection.' (p.21), and I'm sure the book as a whole.

Most readers may pass this by, but to me this matters. Ethics scholars however will see how important and conjoint reflection is to deliberation and argumentation of ethics. Especially, as noted in post #1 the five part division of the text Foundations and Context; Responsibilities; Rights; Politics and Power; and Thinking Otherwise. 

Tables break up and inform the text. I like the way for many tables the source is: Author's own elaboration.

Given the subject matter, yes, the authors have the literature but they are also formulating their chosen theme against the present, near future, socio-political scenarios and much more. So, reflection - this should be expected. With Hodges' model I'm often asked why are those concepts placed in that particular domain? Perhaps that is a question for general artificial intelligence? Subjectivity is a key challenge, and its effective communication.

If I say, chapter 1 is a great primer on What Is This Thing Called the Ethics of AI and What Calls for It? I'd sell the book short, the whole text fulfills this purpose. The definitions and responses to What is A.I. are very helpful, taking into account ancient to more recent history. I've a book in a box by David Chalmers (sorry Prof.) - one day - which helps here discussing intelligence and consciousness.

I'm primed to pick up on 'gaps' (Theory-Practice) and in human experience they are inevitably legion. The responsibility gap (and meaningfulness!) c/o Sven Nyholm is a place to return to, to debate why A.I. raises such a broad range of ethical issues. Patiency is never far away. Here, the patient is stark: in  moral agents and moral patients (p.20 and 89). This blog is littered with posts on Drupal, which to date I have never mastered. I remember sitting in DrupalCon presentations, in the midst very skilled professional coders. A member of the community stood at the podium recounting their lived experience of impostor syndrome. In November with a presentation of my own, I had my own encounter. Well into reading this book, it really did help. The conclusion of chapter 1 contrasts the frequent need for a big-picture overview and reflection on more specific issues. That's quite fitting for me.

I am biased in the encouraging kernels I find: as seek them I do. Yes, as chapter 2 AI Ethics before Frankenstein begins: 'there remains work to be done in charting the long-range conceptual development of  AI in the history of political thought.' (p.27, my emphasis). And much more I hope. Chapter 2 combines literature, myth and I enjoyed the discussion on techne, Prometheus, Hobbes, the interdisciplinary bridge of techno-politics and articulating the mechanistic in our lives. Focussed recently on thresholds and threshold concepts in revising two papers: Hunt writes, 'Frankenstein is a "threshold" text for "modern political science fiction" (p.31). 

This  resonated - especially 'for its prediction that the nascent Enlightenment-era sciences of chemistry, anatomy, and electricity could be used to artificially make a human being' (p.31). The exploration of bad education and bad governance through Shelley and social history is other-worldly in itself. Hunt's conclusion which includes 'Wollstonecraft was the pivotal figure in the process of refracting ideas of AI from Hobbes to Shelley, ...' left me wondering about the refactoring of code. 

Chapter 3, Smith's Faith, Tech, and Ethics of AI brings more reflect -ion with the bonus for me of Descartes. On faith, the human situation is also repeatedly stressed. Delving into creation too, this is detailed on forms of theology - Augustine, Bede, for example, and philosophy Bacon, Hume, Kant and their role in diminishing the influence of religious thought and epistemology (p.39). How long a push was that? Surely it is ongoing - in some quarters? Medieval thought is discussed, and I recall this broad period also being regarded as misunderstood [Medieval Philosophy - Bryan Magee & Anthony Kenny (1987)] . 

On a personal level, I've always placed belief in the intra- interpersonal domain of Hodges' model. In psychosis, depression, anxiety, phobias in short mental health, beliefs can be disrupted, and influenced of course when all is well. Religion I have framed at the individual and socio-political level. Clinically, it is the individual patient's beliefs, if they follow a particular religion that we also need to be cognizant of as health personnel. Machine, or human; object or being as Smith asks:

SELF / INDIVIDUAL  -  OBJECT / THING

|

      INTERPERSONAL    :     SCIENCES               

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

 SOCIOLOGY  :    POLITICAL 

|

GROUP

the human - the machine -	- can become machine - can become human
socio-	-political

There is depth of discussion too: in AI and Power; a Christian response to AI ethics. This handbook is not just for quick reference. There is indeed redemption (p.43) to be found:

'It is easier to cover a blemish than examine why it resulted in the first place: genetics, diet, stress, or lack of self-care.'

I argue for Hodges' model as a tool to identify, (re)present, and relate the determinants of health: all of them. The points and paragraphs on theology, mind, body and self are well worth revisiting.

Johnson's chapter 4, What are Responsible AI researchers really arguing about? provides support for my ongoing belief in the value of sociotechnical theories and approaches, and another book on enactivism. Given the ethics of the global south (and technological/electronic colonialism) more could perhaps be made of LMIC, but the point is made in Table 4.1 (Examples of functionalist evaluations of AI models, p.52). Constructivism 2.2 is a rich seam for me. Table 4.2 touches on medical diagnosis and socio-technical. Johnson notes that in seeking answers to AI ethics problems, scientists see constructivist approaches and '.. constructivism as a metaethic, holding a rich space for more research into pluralistic AI-Alignment', (p.53). And, the potential for much more. This is suggested (for me) in reference to the need for a holistic view of AI model's genesis, and 'two sides of one coin' - dichotomy, polarity, oppositions, binary reductions ... ? 

Johnson's conclusion is an indirect thumbs up (cue Arnie style - of course) to Hodges' model as a project. Conceptual frameworks can indeed:

'... offer unique perspectives on the methods commonly employed and to understand and mitigate the risks and dangers of AI.' (p.62).

If ethics gets 'technical' then the book's full title is well-earned. Two case studies demonstrate functionalist and constructivist debates in responsible AI. I don't remember Capt. Kirk et al. stating to a malign alien 'intelligence' "The trophy doesn't fit in the suitcase because it's too large (small)," (p.58). The writer's put other solutions to the characters lips. Spock, however, would find the discussion here on 'Artificial General Intelligence, 4E Cognition and Enactivism' - "Fascinating!"

Much more to follow ...

Handbook on the Ethics of Artificial Intelligence. David J. Gunkel (ed.). Cheltenham, UK: Edward Elgar Publishing Ltd. ISBN: 978 1 80392 671 1245
https://www.e-elgar.com/shop/gbp/handbook-on-the-ethics-of-artificial-intelligence-9781803926711.html

Book review: Handbook on the Ethics of AI #1

Related previous posts: 'general + AI'

New Media Consortium Horizon Report & Reflection in a Time of Connectivism (c/o Khan & Ally, 2015, Chaps 3, 4 and 21)

My reading of Khan and Ally's International Handbook of E-Learning could amount to a review by a thousand snippets at this rate.

As other priorities also demand attention I'm still on Volume 1 and avidly looking f/w to the 2nd with thanks to the publisher. I've references for my latest study to contribute to other reading. What is interesting is contrasting the place of reflection in nursing, nurse education, education generally and technology enhanced learning. Reflection and reflective practice is a personal activity that is also extensible, something that can and must educationally be shared with others. If there are already challenges in proving the value of Hodges' model within nursing (and global health!) there are other pressures from within education and technology enhanced learning specifically. As João Mattar notes:

Although Hirumi (2011) argues that his grounded approach neither subscribes to, nor advocates any particular epistemology, his decision of distinguishing internal interactions from all others as one of the three fundamental levels within his framework seems indeed to privilege a specific type of learning in an era where connectivism claims that learning should no longer be considered an internal and individualistic activity (Siemens, 2004; Anderson & Dron, 2010,2012). (p.301)

There are lessons in all these chapters for me. Pencilled observations and things to pospost (new word?) are scrawled throughout the 320 pages so far and here are a few more:

The NMC Horizon Report 2015 Higher Education Edition is a collaborative effort between the NMC and the EDUCAUSE Learning Initiative (ELI). This 12th edition describes annual findings from the NMC Horizon Project, an ongoing research project designed to identify and describe emerging technologies likely to have an impact on learning, teaching, and creative inquiry in education. ...

In chapter 4 Stephen Downes writes:

My own theory of education is minimal (so minimal it hardly qualifies as a theory, and is almost certainly not my own): "to teach is to model and to demonstrate; to learn is to practice and reflect." Thus, minimally, we need an environment that supports all four of these on a massive scale. In practice, what this means is a system designed so that bottlenecks are not created in any of the four attributes: modeling, demonstration, practice, and reflection. p.66.

More to follow, read and write!

Mattar, J. (2015) Designing and Evaluating E-learning Interactions, Chap. 21 In Badrul H. Khan, Mohamed Ally (Eds) International Handbook of E-Learning. Volume 1, Oxford: Routledge. pp.295-307.

Corbeil, J.R. & Corbeil, M.E. (2015) E-Learning: Past Present and Future, Chap. 3 In Badrul H. Khan, Mohamed Ally (Eds) International Handbook of E-Learning. Volume 1, Oxford: Routledge. pp.51-64. (see p.59-).

Downes, S. (2015) The Quality of Massive Open Online Courses, Chap. 4 In Badrul H. Khan, Mohamed Ally (Eds) International Handbook of E-Learning. Volume 1, Oxford: Routledge. pp. 65-77.

World Mental Health Day - Weeks, Months, Years (and Tears: or trying to find them)

Prompted by World Mental Health Day posted below are some thoughts related to each of the domains of Hodges' model in respect of mental health and health and social care in general.

individual

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

group-population

Reflection is an important human ability. It can be variously described as - reasoning, problem solving, introspection ... but an ability of self-reflect and critique our circumstances in a balanced, mature, objective way is an important skill that should ideally be shaped like so many others in childhood. Education and health literacy matters. Evidence for reflection and reflective practice for nurses and other health professionals remains rather sparse and contested. There can be ethical challenges and assessment and measurement of reflection and reflective practice is problematic. Hodges' model can support individual reflection providing a framework to facilitate person centred, integrated and holistic care. Globally there is no generic conceptual framework. Here is a candidate!

The parity of esteem debate that is so often heard in the political domain, becomes a stark fact of life to the individual in their physical and mental health. The two must be integrated. Policy makers look to the SCIENCES domain to find the technical and analytical tools to study demographic trends and produce national statistics.  Health providers are increasingly having to deliver services for individuals and programmes for population health. Data and Big Data all contribute through national governments to regional centers and the WHO.

Far from the binary logic of maths and the technical wonders it gives rise to, here in the SOCIOLOGICAL domain the YES or NO to having next of kin, partner, family and friends is pivotal from a mental health perspective.  There is an irony that the size and stability of someone's social network is an indicator of their staying well; while social media can act as a force for good, or a negative force aimed at those vulnerable to bullying and abuse. Effective communication is situated and ultimately determined by context: personal, local, glocal and global.

In this domain, whichever corner you turn to, it is politicised: be it funding for services; the word 'recovery'; the very existence and acknowledgement of mental health allied to human rights and service provision; employment and welfare; policy for access, diversity, equity, gender, equality.... mental health is manifest with political dimensions. How are the needs of specific groups met, children, youths, women, men...? Mental health law is crucial for personal and public safety. How this is conducted and governed is a measure of a modern state and please note the distance from the INTRA- INTERPERSONAL domain at upper left.

Thanks to @MHChat and community for reminder #WorldMentalHealthDay #WMHD16

ii Seeds in 'architecture'

There is something seductive in architecture, the imagination of ideas on paper, the promise of the cornerstone, the reality of the construction, the space it grasps and the space it bestows.

Arriving at Younés paper, the history and reference to Valéry's Eupalinos ou l'architecte, Socrates and Phaedrus had me captured. 

Healthcare is dialogue. Spoken and unspoken. Discourse. Dialectic. Perspective: One : Shared : (the) Many.

What is said, gestured, and unsaid. Valéry's dialogue sounds worthy of follow-up, appreciating Plato and this form of theatre and learning. There is a latent architect in us all. Patiency too - but not yet - let us build first. Every day and night we construct (hopefully). When necessary we know when to disassemble, de-construct, to initiate change.

Reading Younés I can readily relate the paper to nursing, Hodges' model, and healthcare generally. The paper's three main questions concern (of course) architectural theory:

1. the causal relation between building and theory;
2. the necessary mental conditions that precede theory;
3. a definition of theory in its scope, discourse, and nature.
   

There are many points of note (reading my yellow highlighter) here. 

'Reflection precedes realization, but theory does not necessarily precede practice'. p.234.

'Theory however, is a systemic elaboration that operates based on definitions and concepts, in the sense that definitions build concepts, and concepts in turn build a theory, but not the reverse of the sequence.'

'Theory, then, comes 'late', only because it is the synthesis of a content that was already present'. It is constructed after a prolonged reflection over many experiences, based on common, comparative, or contrasting sets of criteria.

Younés focus is specific the development of theory in architecture, but as he writes: 'there is some element of reflection which can be termed the building's efficient cause' p.234. I wonder about Nursing Theory and the nurse's theory based on the person - in-person: reflection of care, assessed, planned, delivered, evaluated and recorded. There are nurses still preoccupied with Q.1, even if the (primary) focus is within academia(?).

Q.2 seems an invitation for philosophy (as per the journal's title!). Being non-judgemental, if not starting to build nursing Theory, then especially for the nurse co-constructing, co-designing a theory of care with the patient/family. Hodges' model is not just a series of set squares, facilitating design; it is an empty set. Never completely empty, due to the structure. A structure that contradicts. A structure paradoxical as it constrains and releases, records and forgets.

Q.3? Did someone call - continuity? Yes, (and how!) we can carry on from Q.2. Scope - yes. See the space? Listen to all the dimensions. Reduced to those that count, in discourse and nature, by nature.

Person-centred? New patient. RESET. Re-build - but remember humanistically.

See also:

Seeds in 'architecture' i

Seeds in 'architecture' iii

Younés, Samir. “Constructing Architectural Theory.” Philosophy 78, no. 304 (2003): 233–53. http://www.jstor.org/stable/3752046.

 

Book review: Curriculum Development In Nursing Education (4th. Edition)

Revisiting this book Curriculum Development In Nursing Education [CDNE] in its 4th edition is pure co-incidence as I champion and study four care domains (and besides with the spiritual - there are five care domains). Working on a paper in summer 2020 I realised it was a decade since my review of the 2nd edition. 

While I, we all like - to think we progress in our thought, I see I'm picking up on the same themes - so this in itself is helpful. The graphics inside the front and back cover pages tell me to remember the 'brief' and not look for clinical practice (content) here. There's continuity in the style of the cover design and format. The text clear and prose easy to follow while very detailed with numerous sources referenced.

The book's webpage covers:

Overview, Table of Contents, About the Author(s), Sample Materials, and Instructor Resources. The latter include:

• PPTs
• Case Studies
• Questions + Activities

CDNE is front (back) and center focussed on the processes involved in curriculum development, through scholarship, faculty development and ongoing appraisal. It's always useful to revisit key terms and definitions. It is not only technology that is dynamic, as the past two years have shown. Plus, things have clearly moved-on since my original PGCE studies, teaching experience, mentoring and mentor updates. 

As regular readers will realize I constantly seek out links, associations and support for the project here. I still have an 'itch' regards nurse theory. The theory-practice gap is noted (p.347) and nursing conceptual frameworks (p.313). So and in due order, the book isn't about the content of curricula, but the organization. The discussion on definitions of 'curriculum' is salutary since 2019-2020:

1. post-COVID-19 (watch this space)

2. nursing - the curriculum - in the 21st century 

    (self-care, nursing workforce, the profession, global health, climate change, technoscience)

This is a major task. CDNE is vested in actions: especially by faculty, data gathering, implementation, checking of standards - fidelity of delivery. Once again there are template - form examples for data gathering. The book is general in terms of specific approaches to curriculum development.

The table (using Hodges' model) below represents figure 13-5 (p.347) "Examples of concepts addressed in Professional, Ethical, and Legal Obligations: A Critical Appraisal 2017-2018." 

I have indicated overlaps. Curriculum planning, design and development is about assurance, so too is Hodges' model with this being an original purpose for the model.*

Individual
|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

Group

clients communication relational practice ethical practice critical reflection patient safety	clients critical reflection (time, events, context, place) patient safety
ethical practice collaboration (team work inc. patient & carers) communication (family) relational practice social determinants of health patient safety (public health) social	health and healthcare policy political influences advocacy patient safety professionalism: accountability, self-regulation  justice

Reconceptualizing curriculum design sounds a rather academic exercise, and as such the book brings home the role that concepts play and the impact of such activities can have not only on teaching staff, but their numbers which are also explored (p.328). Emphasis on innovation and creativity in teaching, learning and deployment of educational technology are discussed at length (chapter 16). Chapter 16 is a reminder of how the combination of LMS and CMS is a non-trivial requirement in education. It seems the book was published just prior to COVID-19's intervention. We are all too aware of the effects of COVID on student's experiences and how suddenly the strengths and limitations of learning technology and video were exposed. Social media was shown in its dual-coated regalia of gift and curse. Social media is in the text (p.350, 353 for example) but is not listed in the index (as with values).

The core of the book delivers:

• Part  II  Core Processes of Curriculum Work
• Part  III  Preparation for Curriculum Development
• Part  IV  Development of an Evidence Informed, Context-Relevant, Unified Curriculum

Of course, I appreciate the book's concept-based content (p.242) which prompts me to continue to study and keep alive the dream of a new website that seems forever virtual. Efforts to ignite learning are listed in table 13-2 (pp.351-353) across three pages from algorithms, humor, to written assignments.

Ideas on teaching, learning, educational frameworks and pedagogies is a further revision exercise and update, and for some readers may act as a primer for more reading. The linking of content to philosophy and curriculum philosophy is once again very welcome. As befits a text that originates in the USA, NCLEX®, external reviews and accreditation are activities that affect curricula worldwide. 'Wanting my cake and eating it' I wondered if some of the references need updating, not - to be clear - that I have specific suggestions; more a case of what a decade in education, today, means? The student nurse who read a draft paper and commented on the references (XXXX) clearly still resonates with me. This may be COVID-induced angst, but may be something for the 5th edition? A decade and more is not long for the educational and philosophical foundations (p.274, psychomotor domain levels), but in EdTech terms...? There are now exacerbating factors too.

As with the author's findings (pp.309-310) I have a sense that in transdisciplinary, and interprofessional education, there is much to understand and unpick - metacognition, reflection (p.310). You will find 'climate of collegiality' (p.392). Am I losing the thread again in reaching for the green spray paint? Should nursing (and all healthcare no less) curricula take into account climate change, or is this a political step too far? 

It seems not:

Anthropocene skills need to be at the centre of curricula, Peter Sutoris  30 January 2021

'Anthropocene skills' - to what extent do these include reflection, critical thinking, integrated approaches..? Wither the global conceptual framework to act as a scaffold?

Is there a top 10 of research themes with fields of study? Perhaps the lack of such a list is a positive, as so many such lists are produced as social media click-bait. It might be worth referencing more recent and emerging fields; threshold concepts, networked learning for example. As in 2009, I am biased. While scholarship is a synonym for research, I would expect to see the latter in the index. The educational establishment must produce research and an ongoing conveyor of newly qualified nurses. Perhaps university and colleges in combination (p.304) may produce an educational ecosystem that can fulfill both purposes. A crucial human resource role at a time when demographics present a challenge that is local, national and global. 

As a practitioner - CDNE is an excellent book, with much educational learning even if you are not working specifically on curriculum review, design, planning and development. Chapters are all accessible, and as standalone reading with the summary and case studies. The index is comprehensive and well organised.

I have some draft notes for a course on Hodges' model. This book is a great motivation to not only return to that task, but complete it.

Special thanks to Clare McMillan, European Manage, Class Professional Publishing

https://www.classprofessional.co.uk/

- and to acknowledge, I received this book in Aug-Sept 2020. Apologies for the delay.

*This was pre-'Project 2000'. Yes a long, long time ago, the 1980s in fact.

Happy New Year everyone!

Hodges' model - the pros ...

Having posted the cons, here are the pros with part of the initial twitter thread once again:

If it is not too confusing, by another - Peter Jones @innov8tor3

4 #h2cm can be a generic conceptual framework for all disciplines: health, education,
contexts: development, edtech, socio-tech*
So scope *global* (utopic?) – more pragmatically - a utility across communities of practice.
*Plus other domain 'bridges': https://t.co/SqzQQnYuKz

— Peter Jones (@h2cm) February 14, 2021

A further query followed:

"can be", but is it?

What would you say has stopped that from happening?

— Peter Jones (@innov8tor3) February 15, 2021

The short answer is clearly that Hodges' model isn't the generic conceptual framework, it follows that is not global either. The reasons why are many and I've posted about several over the years, indirectly and more recently in a more direct manner:

My Moon Mission? "The Stack"

Hodges' model and trial by vampires ... 

Continuing the post on 'cons' here are the 'pros' outlined again along the INDIVIDUAL - GROUP axis (some re-ordering may be needed). To state from the outset that research on Hodges' model is limited, but there is hope for a basic resource for all:

INDIVIDUAL

|

INTERPERSONAL : SCIENCES

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

SOCIOLOGY : POLITICAL

|

GROUP - COMMUNITY - POPULATION

h2cm complements mind-mapping 1. - a cognitive tool: the model has individual utility - formulating the - h2cm provides learners with a scaffold - h2cm can help integrate, understand forms of (health, reflective) literacy/informatics - overvalued? h2cm can encompass value & values - seek pilot study res care / student well-being - ownership: use 'health career model'? - reflection and critical thinking still vital - generation of ideas/associations IS the idea - situation/context bounds model use and scope of inferences - h2cm can be used for lifelong learning - h2cm's application changes with user's vocabulary - Peter's ready to pass this 'baton' - Yes, Nurse 1st -

- h2cm is easy to explain, best via workshop - there is a small bibliography [sidebar] - - 2020 two new independent papers (2. below) - research question is ongoing [ dhyb 3.] - there are ideas/theories h2cm can draw upon - invented here: NW could celebrate - literature still reflects on reflection - student nurses do 'hear of' models & theory - h2cm: as simple/complicated as needed? - - measure of holism, integration ...? - - can encompass all 'spaces' - h2cm remains a response to legacy issues - - person-centred care - - holistic care/ ['holistic bandwidth'] - - integrated care - 'exposure' to Drupal ongoing - learning+ - - Drupal distributions also an option? - 'Peter' is in 'Persistence' (Go Perseverance!)*

h2cm can assist in 1-1 collaboration - care planning - - case formulation - - and small group work - - re. ownership: more 'cost of adoption' not high - there is interest - Yes, time to stop blogging/tweeting - we need a tool to bridge lifespan, healthspan, health career, career span - many dialogues remain contested, patiency, recovery: try this 'space?' - h2cm can help represent the 'hidden' value of labour social, relationships, psychological -

- Safety via Assurance role? - - Spans Quality::Quantity of Care - sense of ownership - make it 'yours' - COVID-19 reveals need & role for h2cm - the model is CC [power to your elbow?] - funding for research would be a bonus - - partnership / studies always welcome - carry the model f/w to 'LeaveNoOneBehind' - - address SDGs at 'home' too - h2cm can also outline the scope of a discipline - an original purpose was in curriculum design - h2cm useful in evaluation/regulation - still seeking benefits: [yes] policy instrument? - reflection/r. practice stressed for nurse re-validation

Further additions / revisions may follow and to the cons post.

To expand on Drupal: the question of its appropriateness to build a new website/platform is not an omission. Drupal 9.0 - 10.0... appear to make the update process and overall experience for non-developers much more user-friendly. I'm looking f/w to a virtual DrupalCon North America in April.

A co-authored paper is on its third journal transfer. Then to address the two-part draft well advanced, related to a conference in July.

1. 

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

2.

Hayward, B.A. (2020), Mental health nursing in bushfire‐affected communities: An autoethnographic insight. Int J Mental Health Nurs. doi:10.1111/inm.12765

Iris Lohja, Yves Demazeau, Christine Verdier. A multi-agent system approach to dynamic ridesharing for older people: State-of-the-art work and preliminary design. 18èmes Rencontres des Jeunes Chercheurs en Intelligence Artificielle, RJCIA’20, Jun 2020, Angers, France. pp.52-59. ⟨hal-02897446⟩ 

3. Don't hold your breath!

*... and yes, at times my head hurts. 

⁺ ... I think and yes to be demonstrated. If not, I do have a 'requirement' and there may be value in that..?

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

H2CM: Some Reflections on Purposes

Of the purposes associated with h2cm:

1. To produce a curriculum development tool.
2. Help ensure holistic assessment and evaluation.
3. To support reflective practice.
4. To reduce the theory-practice gap.

(Source: Brian Hodges)

- the primary purpose must be to facilitate and support holistic practice. The reasoning for this runs (it is hoped) as follows:

Although reflection is often conducted with a particular task - frequently a question - and hence a set of associated experiences in mind; the individual should be encouraged to think universally. If in general reflection is constrained then perhaps the activity is no longer reflection?

If the curriculum developers intend to produce holistic practitioners* then once again holistic considerations should preempt and influence curriculum development.

Theory and practice are surely as 'holistic' as holistic is? This purpose though seeks to assist in closing the theory-practice gap and the existence of this gap suggests that there is something else – even if only space. This space means we must once again defer to holistic.

Or am I getting confused...? What do you think? h2cmng at yahoo.co.uk

*holistic in terms of the range of thought (holistic bandwidth) - not holistic new-age therapies.