Thursday, June 09, 2016

The first five minutes of a lecture

I'm writing this because of the article in Times Higher Ed about the
the first five minutes
 Its a great attention seeker, but IMHO article does not deliver.

Nonetheless,  its a great provocation. So just what do you do in the first 5 minutes?
Do you, as this article suggests, return to the last session?
Personally, that does little for me.
I would rather have my attention grabbed and run with it. Given alarge part of my teaching has been about human growth and development  I am more inclined to think about what wa slife like for you when you were  5..6...7 etc
And from such imaginings just what do you 'imagine' the theories say of such times. Are they right? wrong Somewhere in between?

Up until now Ive tried to set a scene using music that relates to what is typical af the age  group discussed;
 for example
Barney and the I love you, you love me etc song for early childhood,
You have a fast car with Tracey Chapman   for early adulthood...
24 by Taylor Swift for early adulthood...
Ed Sheeran lego house for later stages of early adulthood
etc etc

 but this has tended to produce a mellow start to the session. I think the provocation to thoughtfulness may be better.

Saturday, September 12, 2015

Interprofessional education; some research in progress

Building a Safer Health System (2000) documents risks associated with adverse events in hospitals in the USA. Such adverse events are not new. In 1976 Illich named such adverse events as iatrogenesis, the preventable harm that people experience in association with health practitioners. In a New Zealand study, Davis, Lay-Yee, Bryant, Scott, Johnson, and Bingley, (2002) reported an iatrogeneic rate 12.9% for those hospitalised. This involved a retrospective study of documented incidences across 13 NZ hospitals. The undocumented adverse event rate can be presumed to be much higher.

Evans (2007) reified the staggering size of these preventable events by providing the following provocative illustration: These 1500 deaths are equivalent to four Boeing 747’s crashing in New Zealand every year, a rate that is three times the road traffic death rate, and double the deaths from both homicide and suicide (Evans 2007, p. 16).[Computer generated photo of the collision. Photo/]
This study set out to investigate the concerns raised with regard to communications being implicated in the preventable harm caused by health practitioners in New Zealand in current times. The safe provision of health and disability services in New Zealand is overseen by the Office of the Health and Disability Commissioner(HDC).

Miscommunication is a significant contributor to iatrogenesis in healthcare practice in New Zealand.

In studying this, our analysis of complaints made to the HDC (100 complaints lodged with the HDC between February 2012 and May 2014) we found miscommunications implicated in 99 out of 100 case notes reviewed. Of particular note expanding on earlier research into communications related iatrogenesis is the multi-model nature of health related communications in current times. One third of the cases analysed involved technologically mediated communications, these included telephone calls, text messaging, faxed communications, and computer mediated communications such as emails.
However, while the technology is recognised as having influence, miscommunications do not occur in any of the reported discussions and case notes without there also being human involvement. While media representation tends to conflate what is new with also being causative, this is an attribution error.

Our findings provide irrefutable evidence of the need for healthcare practitioners to have well-developed interpersonal communication skills. The analysis also identified the need for health practitioners working with emergent technologies to understand how these technologies enhance or hinder practice. Of further significance is the amount of error that occurs involving communications between health practitioners.

Conclusions: As has been previously reported in the literature, the incidence of miscommunication within the health sector remains a serious and critical concern, one implicated in preventable deaths, as well as in the development of significant and ongoing disability, delays to treatment and the development of needless distress.
What is reported on here is an uncomfortable truth. However, there is scope to alter how communications are taught and learned by health professionals. Shifting the acquisition of communication skills from mastery of content to instead sharing a common skill set and practicing these inside of processes where we as health professionals learn to talk with each other,is but one step forward on this much needed path. This argument supports providing greater opportunities for interprofessional education, of having diverse groups of health professionals learning with and from each other rather than within siloed curricula.


Davis, P., Lay-Yee, R., Briant, R., Ali, W., Scott, A. J., & Schug, S. (2002). Adverse events in New Zealand public hospitals I: Occurrence and impact. The New Zealand Medical Journal, 115(1167).
Evans, S. (2007). Silence kills--challenging unsafe practice. Kai Tiaki: Nursing New Zealand, 13(3), 16-19.
Illich, I. (1976). Limits to medicine; Medical nemesis: The expropriation of health. London, England: Marion Boyars.

Tuesday, May 12, 2015

Interfering in Hinterlands of Discontent: Making a difference, differently

Given youth work is frequently entered into with the intention of making a difference in young people's lives, this article has been undertaken with the intention of making a difference differently. Drawing on actor-network theory, and the concept of hinterlands, influences shaping the practice of text counselling at a youth oriented helpline are discussed. This is however a contested space. There is no evidence base for such practice; but for new practices there never is. How then does novel practice come into being and become accepted? And how does this occur for people whose ways of engaging involves being neither seen nor heard? In presenting stories of practice as it is shaped there is opportunity to consider whose stories are heard and perhaps whose should be. In uncovering relations that would hold this particular practice more and less stable, scope is also provided for considering how making a difference might also be done differently.

Realities get made for better, or for worse, in practice. That some people’s realities might be made better or worse through the provision of a helpline service draws attention to the practices provided. Taking Law’s stance that practices always demand effort (Law, 2009) and therefore that such effort might be channeled otherwise, I argue for making a difference differently in the lives of young people.

Haxell, A. (2015). Interfering in Hinterlands of Discontent: Making a Difference Differently. International Journal of Actor-Network Theory and Technological Innovation (IJANTTI), 7(2), 30-40. doi:10.4018/IJANTTI.2015040103 New Zealand (hereafter referred to as Youthline), provides a 24/7 crisis helpline for young people, and has done so since 1976. With recent changes in mobile telephony their helpline hardly rings anymore; young people still have problems, and Youthline continues to provide help through this helpline, however, to a large extent, this now occurs silently. Mobile telephony provides us with more options than making a phone call, and as with any technology, those who would make use of a technology as well as the work that would be undertaken, are simultaneously being reconfigured. That work predicated on talking therapies would shift to a near silent medium, and one that places extreme limits of brevity on each interaction, was not an anticipated outcome in the provision of a text messaging service. The expectation that was described in the launch of this service by Youthline, was that this service would be a portal to the telephone helpline or to the face to face counselling services Youthline offers (Simpson Grierson, 2004).

There was no planned roll out of this innovative practice such as diffusion of innovation studies might suggest (see for example Rogers, 2003). Nor was it the result of reflective practitioners actively seeking a solution to named and framed problems (see for example Argyris, 1997; Argyris, 2004; Schön, 1990; Schön & Rein, 1994). And while a community of young people could be described as having influence on the changes that occurred and which continue to occur, this was not the outcome of a group of people coming together to effect change; the young people making use of this helpline never met to share ideas on the shape of the service. For these reasons it would also be wrong to name this as a user-initiated consumer innovation (see for example van Oost, Verhaegh, & Oudshoorn, 2009). The use of text messaging was initiated by Youthline, albeit, with an expectation that texting might provide a means for young people to contact the service when they might not otherwise. Texting for young people, at least in New Zealand and at least in these times, is very much the commonest way of reaching out when at a distance (Office of Film and Literature Classification and UMR Research, 2010). Youthline’s provision of a text service at least in the form of texting being a portal to other services, was a considered response to the ways in which young people were relating. To attribute such changes to a disruptive technology (see for example Bower & Christensen, 1995) would, therefore, also be wrong. While this change has occurred for Youthline, the technology has not resulted in texting being widespread in similar services, not even by other helpline services that this organization helps to staff. Attempts to explain this in terms of contextual determinants (see for example Schatzki, 2002), are similarly flawed. With the context of same staff and same building, and even same-target population, the unique phenomenon of a silent helpline is accordingly worthy of further exploration.

However, more than curiosity is at stake here; the practice of providing a texting service is one for which there is no evidence base for practice (EBP). How then does an organization justify new practice? How might it be known as to whether new practice is “doing good” or at least that it does no harm? And if a practice is to make a positive difference for people, what might be needed to support such difference making? While there is no evidence base for this particular practice it is also worth noting that for new practice there never is. This provides a conundrum: how can practices evolve when tied to measures developed in a past? In wanting to be responsive to current demands how is this space of past and present to be traversed? The current article explores these concerns through use of the metaphorical construct of hinterlands.

This article is available at

Haxell, A. (2015). Interfering in Hinterlands of Discontent: Making a Difference Differently. International Journal of Actor-Network Theory and Technological Innovation (IJANTTI), 7(2), 30-40. doi:10.4018/IJANTTI.2015040103

Sunday, November 30, 2014

actor-network theory and blogging

I found myself at Patter (Pat Thompson's blog on a post on blogging, and while smarting from a hopeless #acwrimo month where promises made did not get adhered to I found myself writing a response about writng on blogs. Next year I think i will promise to blog in #acwrimo, it might free me from guilt beceause on the blog I write without 'overworking the paint', as it were.

My response to Pat Thompson's account was:

Blogging is not 'one thing'. It's writing and as with any writing, it can serve many purposes.
It may be scholarly, or not. It may be the testing the waters of interest, exemplifying academic literature with local examples.... For myself its a playful space where i do not sweat the small stuff, or if i do, i sweat it less. Writing in a less confining space (than an academic journal or a book chapter) my blogging is a bit like art- its not been overworked. Sometimes this is a good thing, sometimes not.
But i find myself wanting to write here such a long response....i am now going off to my own blog to construct a more fullsome response...
In my doctoral writing it was the thoughtful space somewhere between my data and the word.doc called the thesis, and also somewhere between my exploring how others in my field write and my finding my own voice. In my academic life, it again serves multi purposes: it's the space I can q-code to for conference posters, it's also the space i go to for inspiration and engagement with self and with others.

In noting that for me the blogging intent is about engagement and not habitus I begin to differentiate a theoretical underpinning in how I blog in contrast to Pat Thompson's Bordieu inspired understanding of a Blog.
A space then for a Latourian analysis, because the blogging space has me writing differently than the journal or chapter writing spaces. It also has me writing differently than i would in a notebook. The blog becomes an actor of influence, and when in 'her' presence my writing is engaged with differently.
In the blog space I can try out a new idea (Latour and blogs).
I can connect other actors; and refer the reader to Austin Kleon's book titled "steal like an artist".
(Freeing myself from conventions of propriety, I segue from what Pat has identified with Bourdieu and blogs and align instead my analysis to my own preferred theoretical underpinnings)
Actor-network theory and blogging would have me looking at the social life of the text, how its shaped as well as shaping others; and with my engaging with the medium, how the medium engages with me. The push and the pull of it. And inside of this is the push and pull of identity work- i write differently here than there...I am a different Ailsa here than the one who authors academic journals. (And so the network deepens and broadens, a passing reference to Lucy Suchman (2007), Karen Barad, Judith Butler, and into a more distant past to Simone de Beauvoir - for what I am is made in association). And in referring to these other authors I feel like an alchemist, drawing in the threads both of time and of spaces (networking garlands in time as Latour once beautifully described citing Serres). A blogging space is a space to gather in.

Monday, October 13, 2014

my favourite powerpoint/presentation advice sites

Posted from Diigo. The rest of my favorite links are here.

Sunday, March 09, 2014

Are we there yet? After submtting journal articles, what happens next

Having completed a commitment of the postdoc writing scholarship (3 articles/3 months), what happens next is acceptance, rejection and something in between.
Having submitted 3 articles, one nationally, two internationally plus a conference paper, I looked forward to what others would make of them.

Article one; I thought this was the easiest of my papers. It was a descriptive and hopefully (so i thought), a persuasive account of new practice.
What came back was a thankyou letter.
"The subject matter looks very interesting and ground-breaking.
Thank you too for ensuring that (named organisation) has approved the submission of your article.
We will send your article out to two referees in our double blind review process, and we will be in touch with you
as soon as we have their feedback.

They appeared to like it. I have heard nothing more.
This journal publishes only twice a year. The closing date for submissions for its June publication has only just passed. I chose the journal because the information i present is local and contextually based. Letting others know of whats available locally, how and why it has evolved was written with the intent of local impact on practice. I owed it to my participants to have their knowledge shared locally as a priority.

Article 2; conference paper. This was the most fun one to write. It pushed boundaries on layout and language.
It's a provocative piece.
What came back was an automated acceptance of submission.
Then a few weeks later some more detailed commentary: very positive on form, and some concern on its function.
Under "Changes required for acceptance":
The paper is intriguing and innovative in form but isn’t centrally focused on xxxxx. It really deals with research issues and how to report research ...
Detailed comments
We really like this paper and its bold, playful style. A couple of points for addressing:

1. The focus is methodological, to do with research dissemination, and that is itself a useful contribution to the conference: however, as stated above, it would be good to see more linkage ... connections are currently left unstated.
2. This links to our second point, ... we’d like to see a bit more on the project here as a way of grounding the theoretical/representational work of the paper.
And, as an aside, rather than a requested amendment, the author makes it a bit too easy for the reader not to engage with the txtspk paratext: s/he might include a final sentence or two which is txtspk only, and deny us the comfort of the translation.

For this particular audience, the changes requested were well deserved,: relate it more strongly to the conference.
This was done and it has been accepted.

Article 3; An advance on article 1 for an international audience. Its a better article than article 1; i had mulled it for longer and read a bit more.
What came back was an automated acceptance of submission.
Followed two weeks later by requirement of further anonymity- remove names of ethics boards, remove name of organisation where the study occurred.
Followed by acknowledgement of the resubmission and it being sent for peer review.
10 weeks later the peer review feedback is received, and is very positive:
"The reviews are in general favourable and suggest that, subject to minor revisions, your paper could be suitable for publication. Please consider these suggestions, and I look forward to receiving your revision."
This is followed by commentary from the editor pointing to what seemed contradictory: dramatic use of prose- nonetheless liked by the reviewer and by the editor, but noted as unusual in (this) journal publishing.
The area of emotional support versus counselling, one reviewer and the editor hold the view that helpline work is not counselling but is emotional support. Change the words used.
This is then followed by the detailed feedback of the two reviewers.
"An excellent and timely paper"
develop the relevance section more, persuade reader of what they might do/apply (fair comment, but can i do it in the word count?)
From the other reviewer:
One of the points i thought i had made insufficiently persuasive. (S/he is right).
Clarify term: reference to a PDA, even when also written as a personal digital assistant, needs describing further.
More detail of how to actually do this new practice, how tensions are resolved, a more operational account wanted.

Getting back to this article, so much later, is difficult, my time is dedicated to other things.
I finally got back to it, some 4 weeks after receiving the feedback, checked with the editor that this was ok, for the life of me i could not find where it was written that i have until May.
8 pomodoros later and some peer support, and i have made all the changes requested regarding change of words, describing the PDA, and some deleting in anticipation of making a little more space for readers to ahve more info about what they might actually do.

Article 4.
Received an automatically generated acknowledgement of receipt. Followed by a polite, supportive rejection letter.
We have pre-reviewed your manuscript and decided that it is not a good fit for xxxx. Although the paper makes some nice observations, and we appreciate your efforts, the manuscript as a whole lacks the clear focus and solid grounding in the literature that would be necessary for it to make its points effectively. For this reason we feel that it will not be of significant interest to a broad spectrum of xxxx readers.
I was not too surprized. I felt i was rushing it, I also felt it was more a show and tell rather than being suited to the theoretical stance of this journal. At some point i need to select a better space for this one.

I am feeling positive about the peer review process.
Its been a good thing to have some expert knowledge and academic focus on the content of what i had written of. While having had excellent feedback previously from my PhD supervisor and fellow peers on the PhD journey, I had not yet had feedback specific to the content rather than the process of research.

Here's some other expert advice on peer revew from the Emerald Publishing group
It really is great that others have taken the time to look at what i might do better. This article also provides a format, and example, for responding to comments so the next submission post revisions might be itemised.

And some advice on phrasing rebuttal of comments made in the peer review.

And from Springer publishers a similar request for a covering letter to address the points raised, and for the tone to remain respectful.

If feeling somewhat deflated on having to resubmit or even resubmit elsewhere, take heart, here's some research that suggests more citations occur for resubmitted papers, though seemingly counter intuitive, it provides a reasonable argument that the process of rejection is making better articles than those accepted on a first run.
Nature doi:10.1038/nature.2012.11583
Discussed here

Thursday, January 16, 2014

post phd writing

I committed to writing 3 articles in 3 months, with my phd university having advertised writing scholarships. I hadn't taken this up imeediately on handing in the phd because at that stage of not knowing if it had passed, my voice was was my energy and creativity, but 6 months after gearing I had passed was perfect for me and fortunately my phd uni was re-advertising these.
My own workplace uni i then had to negotiate this time with. My inline manager was very supportive figuring it was a win for them also, so all my teaching time (just about) was bought out. Juggling my other roles continued.

I achieved 3 articles and a conference paper done in 3 months 3 weeks. Thanks hugely to my phd supervisor, and particularly also to my friendship with Anne a colleague that shared the phd student and post-doc writing journey.
It still involved late night writing, my time management never seems to stay within 'normal working hrs'.
And now they are coming back to bite me post the scholarship time with changes/amendments.
Still it was an excellent opportunity, I cant imagine being so productive without the impetus of the scholarship committment having driven me.
Success at this was also made possible by undertaking 4 writing retreats across this time, one with two friends from my phd at a distance student days with fellow phd journeyers Anne and Heather at a hired bach in Waikenae on the Kapiti coast north of Wellington.

This was just before starting the post doc scholarship so i used it to read Heather's copy of Thomson and Kamlers book on writing for peer review journals. There is now an ebook version, but at the time i was waiting 3 weeks for my own copy so had photographed pages from the copy borrowed :)
This was followed by a work-place organized writing retreat of 5 days at Waiwera,30 mins north of Auckland,not quite so good- workplace conversations intrude. At this one ai slavishly attempted an article in the 5 days, done but dull and deservedly got the feedback from my phd supervisor that I had vanished in it, my own voice gone..rewrote it over the following 10 days.
I then did one a month later with Anne at her family's bach at Waimarama, about 3/4 of an hour south of Napier. Particularly challenging, and surprizingly advantagious to have no internet, sms could be achieved halfway along the beach if desperate
but also working within the constraints of charged computer time with a dodgy generator made for extreme bursts of concentrated writing alongside enforced thinking time.
Then at the beginning of the third month I did a further writing retreat with the Tauhara academic women's writing retreat. Well structured with small group work for 4/4 an hour each night that could edit or do a sustained conversation on one's 'work in progress' plus optional hr sessions on things like first sentences, last sentences, pomodoros,, and at which myself another colleague also introduced Thompson and Kamler's tinytext method of abstract through to article writing. Excellent role models/resources to call on, and lunch and dinners catered. Well balanced time between writing, getting feedback, creative writing, and fun.

The timing for this was good: end of academic year so minimal teaching load to escape from, and summer 'holidays' when amendments can be considered in an unrushed way.
Some time with a colleague online via skype for pomodoros and also at a uni library with another colleague in the week before Christmas got things done.
Other useful learnings along the way; formulaic writing does not work for me (or perhaps for anyone?). The book by Thomson and Kamler writing for peer review journals was useful, providing the confidence of a tinytext where i could check what i was doing was meeting the 'needs of editors' but it was an error on my part to skip past the section on voice. Rewriting with voice greatly improved the writing i was doing.
However there is no silver bullet, no paint by numbers solution and writing a journal article in 7 days defied my best intentions. Writing 3 in 4 weeks was more doable. This one was one of the resources i accessed on the women's writing retreat, I know Ive looked at this one before but didnt consciously use it this time around, Writing your journal article in 12 weeks
Mapping out potential articles in advance and revisiting it during the writing was also useful so i would not be repeating myself in different venues and so i could sustain the momentum. Choosing journals was something i became more comfortable with as my 'voice' altered and as i became more conscious of the spaces those articles i liked were coming from.
And Marianne at the Tauhara retreat was beautifully grounding in pointing out the cinderella ness of trying to put a thesis into a journal article and how hard if not impossible a task this was. Loved the empathy.
The other success to be gained from the scholarship was in confidence gained.
The feedback gained so far extends this, there is nothing as sweet as getting real feedback saying things like:
"We really like this paper and its bold, playful style. A couple of points for addressing..."