Hodges' Health Career
Model : H2CM
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Frequently Asked Questions
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2nd DRAFT Published
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What ... ?
Q1. What is Hodges' Health Career
A1. Hodges' Health Career Model
is a tool to help an individual or group develop ideas connected with
a problem or issue.
Conceived by Brian E. Hodges in the UK,
was developed in health and social care,
but can be applied universally.
this mean Hodges' Health Career Model is a type of brainstorming
A2. Not exactly. Brainstorming might
be used when you or usually a team of people are stuck and in need
of a creative stimulus to help and identify new, radical ideas.
While h2cm can trigger creativity, it
also ensures that the knowledge the user has is comprehensively
deployed. The model can also be used in the process of obtaining
information, for example in an interview.
At the same time the model encourages
the user to consider aspects of the problem they may otherwise pay
little attention to, thereby reducing bias.
Q3. So what does Hodges' model
A3. Hodges' model provides a framework
to guide identification of facts, ideas, problems, and the way they
are related to each other. The model relies on the there being knowledge
domains, in health for example Hodges' identified four
Referring to two of these SCIENCES
and SOCIAL: investigations, BP, medications,
and diagnosis would be placed in the SCIENCES domain; while
in the SOCIAL domain - next of kin, marital status and dependents would
This placement is not ad hoc, the framework
provided by Hodges' model is a graphic organiser, one of numerous diagrammatic
examples that people employ routinely. Our links pages
list several well known and more esoteric examples.
Q4. Does this mean the model
can only be used by experts?
A4. No definitely not. In health and
social care Hodges' model recognises the value of the patients' (and
is important that gaps in the mutual understanding of a situation
are rectified whenever possible.
It is this property of Hodges' model
that gives it universal potential.
More technically, Hodges' model is
a conceptual framework.
Q5. What is a conceptual framework?
A5. A conceptual framework provides
a means to represent the thoughts, actions and outcomes that
arise within a field of human activity and inquiry. Whilst
it may be possible to pre-define a conceptual framework, many
emerge from investigation into the phenomena, ideas and significance
applied in a given field of human action. In contemporaneous
form a conceptual framework will encapsulate the knowledge
of a community of people, comprising one or more disciplines/agencies.
A conceptual framework can
be derived from its agents and subjects and the evidence base
accrued from research. A conceptual framework will provide
a means to relate concepts to each other, with varying degrees
of subjectivity / objectivity and granularity. A conceptual
framework implies structure, but not necessarily stasis. The
ability to represent a conceptual framework in diagrammatic
form is not necessarily an indicator of validity.
makes Hodges' Health Career Model an example of a conceptual
|A6. Hodges' Health Career
Model uses two axes (or continua);
to create a space upon which the user can place the care
they have identified.
Two questions prompted this
1. Brian asked himself - who
do nurses nurse?
Answering: individuals, their
families/carers, communities and populations; in other words
2. Then he asked: what do
nurses do? What types of knowledge and skills must they learn
The response being they support,
utilise and enact mechanistic procedures, characterised
specific algorithms and heuristics. These strict rules and
tests maybe declared in a procedure manual. While such
may be routine, they exhibit many features that denote professionalism.
At the other extreme, nurses
make use of 'self' to provide humanistic care to
another. In this humanistic role nurses rely upon interpersonal
attitude, empathy, emotional intelligence and other skills
and qualities inherent in the personality of the agent
that of the patient / carer subject. The humanistic aspect
of health (and social) care prompts talk of
'art' of nursing. In a mechanistic context the sciences are
pre-eminent: for example, biology, physics, and chemistry.
are the HCM's applications?
1. Post-basic training students
and qualified staff can use the HCM as an aide memoire, a cognitive
tool (the most ready to hand) a mental prompt.
2. The HCM can form the basis for curriculum development and review.
3. The HCM is an excellent
instructional tool facilitating; critical thought, problem
solving, exploration, collaboration, self-discovery, knowledge
integration and sharing, engagement - rapport building. (The
HCM is one of many such tools).
4. Sometimes in sessions with
clients/patients/carers it is not easy to be comprehensive.
From an information perspective the purview of the record
is mechanistic being prescriptive, bureaucratic, a professional
requirement. The humanistic informational component differs
and this difference must be acknowledged by management, policy
makers and in informatics solutions, due to the following:
A) The HCM can act as an assessment
scratchpad, recording in keyword - hence outline form, the
session content. While capturing specific details that may
not be recalled post-session.
B) Similarly, in sessions
that are client directed (planned or otherwise) this transfer
of control means that some important questions and lines of
inquiry may be omitted. When comprehensivity is vital - as
in positive risk taking/risk assessment and management - these
questions will need to be completed. Not only do assessors
juggle the content of their own therapeutic stance, but they
must negotiate a space also occupied by the client's agenda,
plus that of a carer, and the necessary dictates of policy
and professional standards. More than ever health and
social care personnel are engaged in 'autonomy balancing'.
C) Sometimes clients provide
subtle cues to possibly sensitive issues, that need patience,
rapport, trust and empathy to explore and verify. This is
were observation is often very important. The HCM can allow
these cues to be captured in the absence of audio/video recall
media - with their associated distraction and consent issues.
D) Occasionally, clients may
request that no paper record be kept. They may be reluctant
to engage with services. Taking a lesson from pursuit of concordance
with medication, instead of compliance: a client held record
in the form of a HCM overview/outline may be a compromise.
The care-coordinator can then use the HCM to inform the client
of the professionals responsibilities, the care 'contract'
which includes the need to protect the client. The HCM then
tranfers from educational device to serve as the basis for
5. Further potential applications
of the HCM include:
Benefits realisation - an adjunct
to project management tools and processes.
Ecosystem health, social and political
care impact assessment.
Any complex domain presenting
people, people, organisations and communities with problems
to solve, perspectives to share, histories to reconcile. Therefore,
a key application will be peace studies, especially conflict
situations compunded by combined ecological, religious and
Why ... ?
Q8. Why in
some instances has 'care domains' been added to the title
Hodges' Health Career Model?
A8. Some visitors to our
website are searching for 'career model' and other variations,
connected with the world of fashion and haute couture. 'Care
domains' seeks to highlight the health context of career and model.
Q9. Why do
we need Hodges' Health Career Model?
A9. A simple question with several
1. 'Holistic' care is often
a misnomer. Tools are needed to increase the bandwidth
care across all the essential domains of knowledge.
For example linking and facilitating the physical and psychological
health realms with the sociopolitical. Crucial for the emergence
of 'true' integrated working, necessitating the development
of transdisciplinary and transcultural models and philosophies
of (health, social, and political) care.
2. Comprehensiveness: an aide
memoire is helpful when comprehensive data gathering, sharing
and audit is required - crucial in cases of high risk. ('Comprehensive'
here does not necessarily mean totally complete.)
3. Related to 2. above, we
must address the 'Mind and Body' problem in health and social
care. Primary care must fully acknowledge the role that psychological
health plays in the population. Psychiatry must in turn acknowledge
the limits of pharmacotherapy (especially for older people),
and the value and role of psychological and social therapies.
4. Infocentrism: Life (and
death!) is about information at all levels. The HCM supports
the current infocentric paradigm; conjoining the objective-subjective
and qualitative and quantitative dimensions.
5. Whilst there is the need
for the user to be comprehensive, there is also the need
scope. Any model must be able to include the full range of
potential health, social and political phenomena: From
lab to public health, antenatal education classes to ageism,
beliefs to meta-analysis.
6. The model must be situated,
able to handle multiple contexts and personal perspectives,
e.g. that of nurse, social worker, patient and carer. This
can only be achieved if the model logocentric - that is
there is an underlying structure and proportionality,
that both support explanation.
7. Health and social care
tools should be cognitively accessible, easy to learn
and use, translate and disseminate, cheap in terms of resources
needed (pen and paper, stick and sand) and multicultural
in relevance. If the tool is digital it is vested in the
commons and accessible to all.
There is a danger that amid the cacophony that is life
today in politics and
the media the health and social care agenda is lost. Hodges
Health Career Model
activism within health and social care. Well established
issues include the links between health, education, poverty
and the environment - human ecology.
9. Governance: is a final
and perhaps the greatest rationale for Hodges' health career
domains - model. It permeates all the answers above.
Governance is not of course limited to health and social
care, there is a need to simultaneously promulgate individual,
community, population and global governance.
Q10. Why should I visit again?
A10. If you investigate the many
nooks and crannies of this website - many thanks & congratulations.
Congratulations!? These are due as I recognise much of the content
is not very accessible. Inducements for your return then include:
- Readable examples of Hodges' health
career - care domains - model in use not only in health and social
care, but demonstrating the scope of the model more generally.
- A glossary of terms and philosophical
background: this will also cover synectics, synthesis, conceptual
integration, but emphasis will be on simplicity and ready access
for specific audiences.
Thank you for your patience while these
resources are prepared....
|© Peter Jones 2003
If you have a question
either not posed above,
or if so not
asked/answered adequately please get in touch.
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