Notes (III) for a 2010 introduction to the Health Career Model

Definition through purpose

The original purposes for the model's creation are as relevant today as they were in 1983-84:

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.

Items 1-4 plus safety are all dependent in one way or another upon knowledge. Admittedly, this is a case of stating the obvious and something of a non-statement in that everything comes down to being knowledge (or nonsense). Resort to some global notion of 'knowledge' amounts to non-differentiation and this tells us nothing. On the contrary: this is how the simplicity of Hodges' model can cultivate and give rise to global complexity. This can help explain the model's potential and utility as a cognitive tool, an aide memoire, a mental prompt and structured conceptual checklist to frame:

• thought
• knowledge (ontology)
  
• perspectives
• dialogue
• problems
• strengths - weaknesses
• plans and actions
• outcomes
• and much more ...

Whether student or specialist practitioner various conceptual elements and (care) threads can be acquired, constructed, integrated and mapped from the dual (in-situ) worlds of theory and practice to the cognitive (personal - reflective) and virtual [cogeographic?]. This means the model can be used as a mental prompt helping to inform theory as in a lecture and subsequent essay; or practically during an interview or care assessment. Beyond this cognitive application, the model's produced can then also be captured and represented on paper, or as an electronic record - by various user communities. ... (Notes IV to follow)

[These are notes. If you have any thoughts, views on a new introduction to the model please get in touch:
h2cmng @ yahoo.co.uk What do you feel needs to be explained? Which audience should be addressed in the first instance? What assumptions can be made? ....? Many thanks PJ ]

Notes I intro for 2010

Notes II intro for 2010

h2cm: Original purposes and 21st century additions

Listed below are the four reasons that prompted Brian Hodges to create Hodges' model in the early-mid 1980s, these being to support:

1. reflective practice (Moon, 2004; Jasper, 2006) ;
2. holistic care (Brooker and Waugh, 2007);
3. curriculum development;
4. bridging the theory – practice gap. (Doherty, 2009)

Although nursing, health care and society have changed to a revolutionary extent these original purposes are still outstanding some 25 years later as the authors above and many others testify.

Perhaps in the next few years it would be timely for researchers to revisit the original stimuli and consider afresh the role of Hodges' model within nursing theory and practice and beyond. I believe the relevance of the model grows not because of the constant need for the big picture, but the need to represent and consider new dichotomies and challenges. To the original four then we might add:

• To inform the socio-technical application of information and communications technologies in health and social care;
• To conceptually ground (domain relate) and integrate the 4Ps of PROCESS, PURPOSE, PRACTICE, POLICY in theory and practice;
• To provide a universal conceptual framework to conjoin all multidisciplinary teams across the 4Cs of COMMUNICATION, COLLABORATION, CO-ORDINATION, CONTINUITY and COMPLEXITY*;
• To inform research in what may be termed ‘cogeographics’ the fusion of conceptual spaces and visualization in the humanities - social sciences.

The 4Ps and 4Cs provide a further aide memoir for students and practitioners to accurately locate situated care. Finally, nursing and health, social care as a profession is bound to a code of practice, accountability and has an educational – public (mental) health duty to the aims and objectives of the global health community. Cogeographic (or cogneographic) may be a neologism, but seeks to conjoin the cognitive (cognition) involved in defining, representing and using concepts in conceptual spaces; AND the finding that knowledge is invariably situated - that is knowledge has a geography.

References:

Brooker, C., Waugh, A. (2007) Foundations of Nursing Practice: Fundamentals of holistic care, Mosby.
Doherty, C. (2009) A qualitative study of health service reform on nurses’ working lives: Learning from the UK National Health Service (NHS), International Journal of Nursing Studies,46,8,1134-1142.
Jasper, M. (2006) Reflection, Decision-making and Professional Development (Vital Notes for Nurses), Blackwell.
Moon, J.A. (2004) A Handbook of Reflective and Experiential Learning: Theory and Practice, Routledge.

*I can count really ;-)

NHS data breaches: the 'cogeography' of who and where?

Computing this past week featured an item (extract below with link) -

Five more NHS trusts involved in serious data breaches
Written by Tom Young
Computing, 17 Jul 2009

Privacy watchdog the Information Commissioner's Office (ICO) has found five more NHS organisations in breach of the Data Protection Act.

The Royal Free Hampstead NHS Trust reported the loss of an unencrypted CD initially thought to contain medical treatment details of 20,000 patients from the hospital’s cardiology department.

Chelsea and Westminster Hospital Foundation Trust reported the theft of an unencrypted memory stick containing 143 patient details including sensitive medical information.

And Epsom and St Helier University Hospital NHS Foundation Trust has been storing hospital records insecurely for nearly two years following data being transferred between hospitals. ...

Straight away reading this I thought of my previous post about cogeography and commented accordingly (which registered twice - oops!). In light of the previous post here's that comment with some additions....

Such events merely (without trivializing) highlight the human capacity to ERR big(gish) time. Is it not possible for tech to help? If info systems through to mobile devices had a sense of where they are and their status as carrying sensitive data recognised through digital IDs - plus additional meta-dynamic data, then 'cogeographic awareness' might result?

I blogged about this with ref to conceptual spaces.

This would be an artificial example and would make it possible for data previously designated as confidential, sensitive, - HOT data if you will - to self-destruct, 'e-vaporate' if it found itself beyond a given combined virtual or physical environment be that hospital, Trust boundary, SHA, or National border...? This capability already exists no doubt in the security services (although sometimes you wonder) or as suggested in the realms of 'MI' and '007'.

Cogeographic or (cogneographic) may be a neologism and seeks to conjoin the cognitive (cognition) involved in defining, representing and using concepts in conceptual spaces; AND the finding that knowledge is invariably situated - that is knowledge has a geography.

Copies of NHS and social care
data could - should - MUST
have a geography too...?

Another comment rightly questioned the ability to put personal data on
CDs and other media in the first place. Amid the emergence
of renewed debate about the future of e-health
records, clinicians may have a professional
duty to demand cogeographic
properties no
less ...?

Image source: http://www.tapintoquality.com/facts/glossary-d.html

Happy Anniversary 20th July!!

Additional links: Political domain

'cogeographic' or 'cogneographic' - concepts situated and abstract

The term 'cogeographic' materialised while writing a short article for the nursing press on Hodges' model.

Searching SCIENCE DIRECT and similar academic resources I thought I had found the word relating to geography, borders, ethnic groups and geopolitics, but now it seems to have disappeared....?

So I am not 100% sure whether cogeographic is a neologism. In some ways cogneographic better suits my purpose. That Matrix associated addition is a rather bizarre coincidence given the word's status and so with that I should explain how my lexical arrival here came about. ...

I was focusing on two fundamental claims in Hodges' model. Namely:

• The model is situated;
• The model assumes that concepts can be located within its knowledge domains.

For me, cogeographic (cogneographic) conjoins the cognitive (cognition) involved in defining, representing and using concepts in conceptual spaces; AND the finding that knowledge is invariably situated - that is knowledge has a geography.

Philo and Pickstone (2009) highlight the work of Haraway:

No knowledge, however ‘scientific’ or prestigious, can ever truly come from nowhere; it can not but originate somewhere, being thoroughly situated, in Donna Haraway’s (1991) valuable terminology; and it commonly bears marks of that origin - situation wherever it might then travel. p.651.

This combination of physical and mental (abstract) location then supports the use of a metric or measure. I suppose what I am thinking about is GIS for concepts - which in turn is the semantic web?

Should I locate any sources I will update this post, or if you can direct me to any please let me know: h2cmng at yahoo.co.uk

Reference:

Philo, C., Pickstone, J. (2009). Unpromising configurations: Towards local historical geographies of psychiatry, Health & Place, 15, 3, 649-656.