Threshold concepts workshop durham 11 july 2014


Published on

Published in: Education
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Threshold concepts workshop durham 11 july 2014

  1. 1. Hodges’ Health Career –Hodges’ Health Career – Care Domains – Model*Care Domains – Model* Threshold Concepts in Practice 5th Biennial International Threshold Concepts Conference 9th – 11th July 2014, Durham, England Peter JonesPeter Jones *Hodges’ model created by Brian Hodges*Hodges’ model created by Brian Hodges
  2. 2. My background:My background: Community Mental Health Nurse Older AdultsCommunity Mental Health Nurse Older Adults Intermediate Support Team Older AdultsIntermediate Support Team Older Adults Ribbleton Hospital, Preston, Lancashire, UKRibbleton Hospital, Preston, Lancashire, UK RMN, RGN, CPN(Cert.) BA(Hons.) Comp./Phil.RMN, RGN, CPN(Cert.) BA(Hons.) Comp./Phil. PG(Dip.)COPE, PGCEPG(Dip.)COPE, PGCE Graduate student, Technology Enhanced Learning, LancasterGraduate student, Technology Enhanced Learning, Lancaster University.University. 1.1. Nursing Mental health, General, Community MH.Nursing Mental health, General, Community MH. 2.2. Informatics – ZX81, BBC micro – computer-aided learningInformatics – ZX81, BBC micro – computer-aided learning 3.3. Hodges’ model - 1998Hodges’ model - 1998
  3. 3. Aims and ObjectivesAims and Objectives 1. To introduce Hodges’ model 2. Apply Hodges’ model 3. Research directions 4. Tentative links to Threshold Concepts 5. To learn from this community!
  4. 4. Hodges’ model is…Hodges’ model is…  A conceptual frameworkA conceptual framework  Combines two axes to create five domains ofCombines two axes to create five domains of knowledgeknowledge  HISTORY: Created in the 1980s Brian E HodgesHISTORY: Created in the 1980s Brian E Hodges (Senior Lecturer, Ret.) at MMU.(Senior Lecturer, Ret.) at MMU.  Not widely published.Not widely published.  No evidence base.No evidence base.  Simplistic in appearance.Simplistic in appearance.  Worthy of research!?Worthy of research!?
  5. 5. The need for research…The need for research… 2020thth – 21– 21stst CenturiesCenturies ORIGINAL PURPOSES:  to support holistic practice and person- centred care  to help direct curriculum development  to help bridge the theory – practice gap  and to facilitate reflective practice
  6. 6. StructureStructure In this and the next slide the structure and content – care domains - are explained in the workshop. This includes the purposes of Hodges' model and other background.
  7. 7. Content:Content:
  8. 8. Exercise 1Exercise 1 Conceptual sorting [ A4 template provided ] Mobility Infection Fluid intake Subjective Agitation Sleep Mood Feeling safe & secure Data Law Freedom Smartboard Body Emotional Contentment Eyesight & Hearing Friends Dignity Respect Spiritual activities Family Statistics Discuss (speaking) Belonging Choice Attitude Policies Advocacy Consent Staffing numbers Community of Practice Nutrition Pain Tablet (computer) tablet (medicine) Culture Thought Accreditation Government policy Insight Autonomy Process Qualitative Objective Time Curriculum Lecturer Weight Community Hope Aspiration Personality Inspiration Military Engineering Therapy Software Who What Funding When Where Why How Moodle (LMS) Equality Organisation Activism Virtual International Identity
  9. 9. Exercise 1Exercise 1 Conceptual sorting – suggested… Agitation Subjective Sleep Mood Feeling safe & secure Emotional Contentment Choice Attitude Thought Insight Hope Aspiration Personality Inspiration Therapy Who What When Where Why How Identity Body Mobility Pain Fluid intake Infection Data (digital!) Nutrition Smartboard Eyesight & Hearing Tablet (computer) tablet (medicine) Process Software Engineering Statistics Time Virtual Weight Qualitative Discuss (speaking) Community of Practice Family Culture Community Belonging Friends Spiritual activities Respect Dignity Policies Advocacy Consent Staffing numbers Curriculum Equality Law Military Freedom Organisation International Funding Autonomy Government policy Accreditation Lecture Objective Activism Moodle (LMS)
  10. 10. Exercise 2Exercise 2 case studycase study  James is a first year student at Durham (Earth Sciences) from the Midlands who is living in a shared flat. His flat mates are concerned for his welfare. Greg and Amy say his appearance, behaviour and studies are suffering.  He has often kept to himself in that he visits his grandmother a lot who lives locally. Apparently his father turned up 11pm two weeks ago last Friday. The news: his parents are splitting up. A fellow student who answered the door also thought his dad had been drinking and driving. Since this news James has been late, or missing lectures. He was reliable with the flat rota but this has lapsed. He was due to move to his grandmothers who is local to help her. Last w/e James was smoking something ‘special’ and ended up getting upset, and wet near the river. While upset James told a friend trying to help him that his gran has dementia. James has been expressing some odd even paranoid ideas but won’t seek some help thus far. Ordinarily he is studious and was making good progress.  Using Hodges’ model can you outline some of the key aspects of the information provided and next steps.
  11. 11. Exercise 2Exercise 2 Case study – suggested… Low mood, stress, risky behaviours Family expectations? Sleep Mental impact of cannabis – motivation, being organised, concentration, attention Which substance? Physical health status Nutrition, Weight, Hygiene Physical risks Away from home, Parental problems Grandmother – does James need help with her care? previous history Student counselling. Moving into grandmothers – his choice? Friends Confidentiality, Referral to student support Engagement, Choice, Consent Grandmother – access to services? James' access to services? Father’s behaviour James - disciplinary procedures?
  12. 12. The need for research…The need for research… 2020thth – 21– 21stst centuriescenturies ORIGINAL PURPOSES: to support holistic practice and person-centred care to help direct curriculum development to help bridge the theory – practice gap and to encourage reflective practice. NEW PURPOSES: Political dimensions of health care Self-efficacy, responsibility To integrate the literacies Highlight socio-technical perspectives E-learning...!
  13. 13. Research influences - directions 2 –Research influences - directions 2 – interdisciplinaryinterdisciplinary…?…?  SituatednessSituatedness  MulticontextualMulticontextual  EmbodimentEmbodiment  LiteraciesLiteracies  InformaticsInformatics  Visualization – mind mappingVisualization – mind mapping  ArgumentationArgumentation
  14. 14. Research influences - directions 3Research influences - directions 3 specificsspecifics……  Michel Serres – philosophical-critiqueMichel Serres – philosophical-critique • InformationInformation • ComplexityComplexity • EcologyEcology  Conceptual spaces (Gärdenfors, 2000)Conceptual spaces (Gärdenfors, 2000) • Adapting ‘quality dimensions’... +?Adapting ‘quality dimensions’... +?  Threshold concepts (Meyer and Land, 2003)Threshold concepts (Meyer and Land, 2003) • TCs in health literature and here!TCs in health literature and here! • OtherOther thresholdsthresholds in healthcare?in healthcare? • Reflection, interrogative wordsReflection, interrogative words
  15. 15. Threshold concepts within Hodges' model?Threshold concepts within Hodges' model? Student's thought, reasoning, cognition Ontological – 'Being' Transformative (Not just the concepts - Context dependent – not forgetting – sundowning phenomena?) Authentic? Troublesome: situational awareness. Engagement in psychosis Troublesome, 'Complex concepts', maths, technical, programming, formal languages. Iatrogenesis Bounded – balance: standing sitting, swallowing: dementia, anti-psychotics, (also specific instances – exceptions) levels of distress: risk Integrative titration of meds; bloods-infection- behaviour Communities of practice, Languages – Discursive – patient, client, service user...? Jargon Troublesome, integrative: Cost as a means of control re. Public health: Alcohol, substance misuse, sugar, smoking. 'Welfare state' Individual as 'citizen'. Self-care, 'recovery'. Professional values (where are they?) Measure & Outcomes: 'holistic bandwidth'? Complexity?
  16. 16. Threshold concepts – discussionThreshold concepts – discussion (thoughts only…)(thoughts only…)  Transformative:Transformative: Caring for the other. Rapport-Empathy.Caring for the other. Rapport-Empathy. One context – several domains of care OR one conceptOne context – several domains of care OR one concept across several contexts, e.g.across several contexts, e.g. consent, mental capacity, ill-consent, mental capacity, ill- advised decisions.advised decisions.  Troublesome:Troublesome: Axial in terms of Hodges’ model?Axial in terms of Hodges’ model? Individual-group. Ethics. Positive risk management.Individual-group. Ethics. Positive risk management. Interplay of process – practise, e.g. deprivation of liberty,Interplay of process – practise, e.g. deprivation of liberty, risk in the community, progression of dementia.risk in the community, progression of dementia.  Irreversible:Irreversible: Values!?* Not taking things personally, notValues!?* Not taking things personally, not ‘retaliating’, unconditional positive regard.‘retaliating’, unconditional positive regard.  Integrative:Integrative: Could this also be in part the process ofCould this also be in part the process of socialisation into a profession?socialisation into a profession? *But what of POLITICAL factors?*But what of POLITICAL factors?
  17. 17.  Bounded:Bounded: Constraints, data reduction, (role of domains /Constraints, data reduction, (role of domains / disciplines?) context dependent as in person centered care?disciplines?) context dependent as in person centered care? Communication skills, e.g. silences.Communication skills, e.g. silences.  Discursive:Discursive: Demonstrated in vocabulary 1-3 yrs, recordDemonstrated in vocabulary 1-3 yrs, record writing and case discussion/presentation.writing and case discussion/presentation.  Reconstitutive:Reconstitutive: 'Windows of opportunity' for (care)'Windows of opportunity' for (care) delivery an individual living with dementia, student’sdelivery an individual living with dementia, student’s learning about resources – care in the community – (peoplelearning about resources – care in the community – (people being socialised into care) and ‘political realities andbeing socialised into care) and ‘political realities and rhetoric’.rhetoric’.  Liminality:Liminality: Student’s own (dynamic) conceptual space.Student’s own (dynamic) conceptual space. Threshold concepts – (thoughts only…)Threshold concepts – (thoughts only…)
  18. 18. The future … discussionThe future … discussion Five Ws and ‘H’ Reflective Frameworks (Gibbs, Johns) Threshold Concepts What, Where, When, Who, Why & How Nursing, Interprofessional? Nurse education, Social care sector Conceptual Spaces Hodges’ model Visual tools – mind mapping Quality dimensions, domains, regions? Domains, nursing’s values, quality dimensions, ‘holistic bandwidth’? Software packages Drupal: content management system Visual tools – mind mapping SVG, RDF, dedicated content types? Quality dimensions, domains, regions (re- factored for h2cm?) Buzan  early influence! SW in LMS? For Hodges’ model?
  19. 19. Thank you for your participation!Thank you for your participation! Blog: Welcome to the QUAD –Blog: Welcome to the QUAD – Since 2006…Since 2006… Includes a bibliographyIncludes a bibliography  Work: +44(0)1772 773496Work: +44(0)1772 773496  Mob: +44(0)7753222286Mob: +44(0)7753222286 @h2cm@h2cm