Critical Thinking in Health and Social Care
Publication Year: 2007
Critical Thinking in Health & Social Care is designed to equip practitioners with the knowledge and tools they need to critically examine practice in their own workplace. The book presents a range of different approaches, each of which is explained and grounded in practice using case studies, problem-solving scenarios and workplace examples. The practical tools which form the core of the book are contextualised by an exploration of what constitutes knowledge and evidence and the types of assumptions which are commonly held and which have a bearing on practice.
- Front Matter
- Back Matter
- Subject Index
- Section 1: A Theoretical Overview
- Chapter 1: Thinking Critically about Critical Thinking
- Background and Development
- Definitions of Critical Thinking
- Possible Boundaries of Critical Thinking
- Purpose and Politics of Contemporary Critical Thinking ‘Studies’
- Chapter 2: The Authenticity of Knowledge
- The Development of a Knowledge Industry Society
- Transition from Manufacturing Economy to Knowledge Production Economy
- Knowledge and Professional Autonomy
- Chapter 3: Assumptions
- Identifying Assumptions
- Physical and Perceptual Assumptions
- Context and the Manufacture of Assumptions
- Assumptions and Professionalism
- Chapter 4: The Nature of Evidence
- Evidence: Where's the Problem?
- Scientific Approaches to Evidence
- The Scientific Use of Evidence
- Criticisms of Scientific Approaches to Evidence
- Section 2: Key Theoretical Tools of Critical Thinking
- Chapter 5: Political Ideologies
- Principal Political Ideologies
- Application of Political Ideologies to Contemporary Issues in Health and Social Care
- Political Ideologies as Critical Thinking Tools in Health and Social Care
- Chapter 6: Moral Reasoning
- Key Ethical Theories
- Contemporary Issues in Health and Social Care
- Moral Reasoning as a Critical Thinking Tool in Health and Social Care
- Chapter 7: Feminism and Post-Feminism
- Key Concepts Associated with Feminism and Post-Feminism
- Similarities and Differences between Feminist and Post-Feminist Theories
- Application of Feminist/Post-Feminist Theories to Contemporary Issues in Health and Social Care
- Chapter 8: Critical Realism
- Critical Realism: Key Concepts
- Application of Critical Realism to Contemporary Issues in Health and Social Care
- Chapter 9: Chaos and Complexity Theories
- Chaos Theory: Key Concepts
- Complexity Theory: Key Concepts
- Links between Chaos and Complexity Theories
- Contemporary Issues in Health and Social Care Using Chaos and Complexity Theories
- Chaos and Complexity Theories as Critical Thinking Tools in Health and Social Care
- Chapter 10: Postmodernism and Post-Structuralism
- Postmodernism: Key Concepts
- Similarities and Differences between Modernism and Postmodernism
- Post-Structuralism: Key Concepts
- Contemporary Issues in Health and Social Care Using Postmodernism and Post-Structuralism
- Postmodernism and Post-Structuralism as Critical Thinking Tools in Health and Social Care
- Section 3: Application to Health and Social Care Practice
- Chapter 11: Case Studies in Health and Social Care
- Case Study 1: Medical Model or Holistic Care?
- Case Study 2: Inter-Professional Working
- Case Study 3: Developing Services for Older People
- Chapter 12: The Implications for Practice
- The Opportunities and Challenges of Applying Critical Thinking Tools in Practice
- Continuing Professional Development (CPD) in Health and Social Care
- Portfolio Development and Critical Thinking
- Personal, Professional Development Planning
- The Future of Health and Social Care Provision
- Ascendancy of Neoliberalism
- Impact on Practitioner Skills
© Stella Jones-Devitt and Liz Smith 2007
First published 2007
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, this publication may be reproduced, stored or transmitted in any form, or by any means, only with the prior permission in writing of the publishers, or in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency Enquiries concerning reproduction outside those terms should be sent to the publishers.
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To Tre, Dave and Grace
To my parents Alan and Dorothy
Liz Smith[Page vi]
Foreword[Page xi]Critical Thinking: Some Observations
Arguably, today's health and social care professionals – be they student aspirants or experienced practitioners – can be characterised as context-rich and time-poor. Why then might they wish to ‘think about critical thinking’? Is there a case to be made? Jones-Devitt and Smith demonstrate powerfully the ways in which the idea of ‘the professional’ can be deconstructed and reformed through critical thinking; how context can be explored, challenged, explained and understood by means of a channelled scepticism; and how time and tasks might be better aligned where traditional ways-of-doing are subject to reflective and systematic scrutiny.
In a world where significant human endeavour (and ideology) turns on the quest for certainty and assertions of truth, the authors encourage the reader not simply to re-focus on the question itself; but also, more profoundly, they require us to question the question. Thereby, they take issue with what might be labelled, beyond postmodernism, as the ‘cult of certainty’.
Through exposure to a well-articulated (but not unnecessarily burdensome) array of perspectives and tools, we are lured into new approaches to intellectual enquiry and innovation that will render such key activities as clinical decision-making or the design of care packages more robustly defensible in the changing context(s) of modern health and social care practice.
Importantly, the authors develop simple pedagogical devices to prevent any artificial divide or hierarchical separation of theories and practice. Questions, issues and dilemmas permeate the text. They are directed at our everyday professional experiences in ways which engage and provoke response(s). This culminates, beyond some well-articulated case-study material, in a compelling set of claims that only by acquiring the skills to recognise and address critical uncertainties, drawing on the repertoire of critical thinking approaches, will we be equipped to influence future policy and practice for improved health and social care services.
Accordingly, I believe the book will serve well a diverse audience – in policy formulation and practice determination at all levels – who are committed to the nation's health and well-being.[Page xii]
This book aims to explore key concepts of critical thinking and it considers their application to health and social care practice. The book helps the reader to examine the nature and relevance of critical thinking per se; it also seeks to familiarise the reader with a number of critical perspectives which can then be used to examine contemporary issues in health and social care. To contextualise the learning, workplace exercises and theoretical scenarios are suggested, in order to engage the reader in considering any implications for their own professional practice and operational effectiveness.
So why is this book needed and why now? We drew upon our own sense of ‘muddling through’ and considered the critical uncertainties bound up in health and social care in the present day. We perceive that the pace of change and fragmentation has escalated across both sectors: throughout this book we allude to the prevailing perceptions of the emergent knowledge economy, based upon key neoliberal suppositions of flexibility, accountability and active consumerism; the growth of this economy appears to have gathered an irresistible momentum, spawning new types of ‘professional’ worker roles that are developing across many occupational sectors. This book seeks to help the practitioner make sense of this pace and fragmentation through developing an understanding and awareness of the wider ideological drivers for policy provision and change, whilst providing some tools that can help to reconnect and locate everyday practice in the emerging context.
At the time of writing this book, we found little published material concerned with enabling health and social care practitioners at strategic/consultant level to conduct critical examination of their own practice, alongside applying some newer ways of thinking to specific contexts: we hope that this book begins to occupy that space.
Given the shifting contexts and blurring of boundaries between health and social care domains, we have taken some liberties with the word ‘professional’ within this text: the term is used euphemistically to imply a professional approach via an implicit set of values, responsibilities and strategic obligations that being ‘professional’ involves. It is not our intention to delineate between the qualified and non-qualified; hence, we recognise that career development, professional roles and nomenclature are not only [Page xiv]linked to profession-specific occupations in either domain. We also found that certain areas within health and social care are difficult to segregate as belonging wholly to one or other faction; thus within the book, public health examples are used to illustrate this shared agenda.
The book is divided into three discrete sections. Section 1, ‘A Theoretical Overview’ provides an insight into how critical thinking skills knowledge is constructed, privileged and applied, covering: some of the key debates about definitions and use of critical thinking; the authenticity of knowledge and resonance for the contemporary social infrastructure; how assumptions effect thinking and influence professional stereotyping; alongside the nature of ‘evidence’ in which specific paradigms are presented, contrasted and debated.
In Section 2, ‘Key Theoretical Tools of Critical Thinking’, we examine some of the conceptual tools available for sense making in the domain and consider the possible implications for practice. Where appropriate, chapters in this section examine theoretical similarities and differences amongst selected theories and assess their relationship to strategic application. All the conceptual tools are selected according to their relevance to current health and social care policy-making and practice. Five theoretical critiques were chosen by the contributing authors, but many more could have been selected. Given the plethora of potential tools, readers are encouraged to apply any theoretical tool of their own personal choosing, as they see fit for their own context.
In Section 3, ‘Application to Health and Social Care Practice’, several case studies and scenarios are explored through the application of critical thinking skills, allowing the reader to actively apply the learning to the workplace and examine the implications and further resonance.
It is worth noting that this book is about ‘applied’ critical thinking skills within the health and social care domain. Given these parameters, we decided to exclude mathematical notions of reasoning and exercises in numerical analysis, psychological theories of thought processing and developmental learning alongside ‘heavy’ philosophical theorising about the nature of thinking per se. Ideally, we are hopeful that the book provides the health and social care strategist with an array of tools that can be applied to first order practice; it is not aiming to be a comprehensive tome about critical thinking in all its forms, nor to fulfil any kind of purist academic agenda. We encountered some difficulties when trying to tease out the precise boundaries for health and social care respectively; consequently, fluid contemporary interpretations of both aspects have led us to assume a ‘blurred boundary’ position in the book on many occasions.
Each chapter contains specific pedagogical features that comprise a concise introduction, learning objectives, an end-of-chapter summary, case [Page xv]studies (where appropriate), specific problem-solving scenarios, additional workplace exercises, and sources of further reading and exploration. The latter provide detail of specific print and web-based resources in critical thinking skills development, and are complementary to the exercises in the text.
To use this book most productively, we suggest that all readers familiarise themselves with Section 1, which gives a good grounding in essential critical thinking debates, principles and concepts. Once completed, the reader can then selectively discern the most appropriate tools from Section 2 to apply to their own workplace context. Section 3 then acts as an aide-memoir of critical thinking skills analysis, in relation to some contemporary health and social care issues.
We have enjoyed putting this book together for health and social care practitioners and our sincerest thanks go to all those who have contributed both directly and indirectly to its production. Specific thanks go to Peter Draper and Julie Dickinson for their well considered contributions to several chapters in this text. During the process, we have also extended our own knowledge and enthusiasm for using critical thinking approaches within health and social care, and trust that this book does the same for its readers.and [Page xvi]
List of Illustrations[Page xvii]Tables
- 1.1 Definitions of critical thinking 7
- 2.1 Traditional economy and knowledge economy: key differences 23
- 2.2 Traditional economy and knowledge economy: disputed concepts 23
- 3.1 Analysis of assumptions performance indicators 33
- 5.1 Socialism and social democracy – underpinnings of political ideology 61
- 5.2 Political wings: key differences 64
- 5.3 Political ideologies applied to health and social care 65
- 7.1 Feminist theories: key similarities and differences 94
- 8.1 Key differences between positivism, post-positivism and critical realism 109
- 8.2 Critical realism applied to wellbeing 111
- 8.3 Critically ‘realistic’ public health? 115
- 10.1 A comparison of modern and postmodern thinking 137
References[Page 172]1989) Independent Inquiry into Inequalities in Health Report. London: HMSO.(2000) Introducing Social Policy. Harlow: Prentice Hall., and (2004) ‘Health consumer groups in the UK: a new social movement?’Sociology of Health and Illness, 26 (6): 737–756. http://dx.doi.org/10.1111/shil.2004.26.issue-6, and (1998) Exploring Ethics: A Traveller's Tale. Oxford: Blackwell.(2000) Continuing Professional Development: A Guide for Therapists. Oxford: Blackwell Publishing. http://dx.doi.org/10.1002/9780470690314(2002) Postmodernism and Social Research. Buckingham: Open University Press.(2000) Reflexive Methodology: New Vistas for Qualitative Research. London: Sage.and (1987) Unravelling the Mystery of Health: How People Manage Others and Stay Well. New York: Wiley.(1999) Introducing Postmodernism. Duxford: Icon Books.and (1995) Realist Social Theory: The Morphogenetic Approach. Cambridge: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511557675(Archer, M., Bhaskar, R., Lawson, T. and Norrie, A. (eds) (1998) Critical Realism: Essential Readings. London: Routledge.1984) Medicine and the Management of Living: Taming the Last Great Beast. Chicago, IL: University of Chicago Press.and (1605) The Advancement of Learning. Online version available at: http://www.classic-literature.co.uk/british-authors/16th-century/francis-bacon/theadvancement-of-learning/(Bacon, F. (1620) in L.Jardine and M.Silverthorne (eds) (2000) Francis Bacon: The New Organon. Cambridge: Cambridge University Press.2004) Ethics, Accountability and the Social Professions. Basingstoke: Palgrave Macmillan.(1997) Higher Education: A Critical Business. Buckingham: The Society for Research into Higher Education and the Open University.(1993) in G.Siann (1994) Gender, Sex and Sexuality: Contemporary Psychological Perspectives. London: Taylor and Francis.(2000) Introduction to Modern Political Theory. Basingstoke: Palgrave Macmillan.(2003) LTSN Generic Centre Continuing Professional Development Series No. 3 Supporting Portfolio Development. York: Learning and Teaching Support Network.([Page 173]1995) ‘Evaluating community development projects for health: an opportunity for dialogue’, Health Education Journal, 54: 465–472. http://dx.doi.org/10.1177/001789699505400409(2003) ‘Methods and principles in biomedical ethics’, Journal of Medical Ethics, 29: 269–274. http://dx.doi.org/10.1136/jme.29.5.269(2001) Principles of Biomedical Ethics (and (5th edition). New York: Oxford University Press.2003) Individualization: Institutionalized Individualism and Its Social and Political Consequences. London, Thousand Oaks and New Delhi: Sage Publications. http://dx.doi.org/10.4135/9781446218693and (2000) ‘Boundaries and silences in a post-feminist sociology’, Sociology of Religion, 61 (4): 399–408. http://dx.doi.org/10.2307/3712523(Bendelow, G., Carpenter, M., Vautier, C. and Williams, S. (eds) (2001) Gender, Health and Healing: The Public/Private Divide. London: Routledge.1998) Ethics. London: Routledge.(1985) From Novice to Expert: Excellence and Power in Clinical Nursing Practice. San Francisco, CA: Addison-Wesley.(2001) ‘Opening the closed mind: making assumptions, jumping to conclusions’, Etc., 58 (4): 429–439.(1979) The Possibility of Naturalism: A Philosophical Critique of the Contemporary Human Sciences. Brighton: Harvester.(‘The knowledge economy’, Annual Review of Sociology, 30: 199–220.and (2001) in and (2004)1995) ‘Knowledge, knowledge work and organizations: an overview and interpretation’, Organization Studies, 16 (6): 1021–1046. http://dx.doi.org/10.1177/017084069501600605(1995) Unbearable Weight: Feminism, Western Culture and the Body. Berkeley and Los Angeles, CA: University of California Press.(1999) ‘Catching the wave: understanding the concept of critical thinking’, Journal of Advanced Nursing, 29 (3): 577–584. http://dx.doi.org/10.1046/j.1365-2648.1999.00925.x(1987) Developing Critical Thinkers: Challenging Adults to Explore Alternative Ways of Thinking and Acting. San Francisco, CA: Jossey-Bass.(2003) Evidence-based Research. London: Open University Press., and (1991) ‘Organizational learning and communities of practice: towards a unified view of working, learning and innovation’, Organizational Science, 2 (1): 40–57. http://dx.doi.org/10.1287/orsc.2.1.40and (2004) ‘Redesigning the curriculum for social work education: complexity, conformity, chaos, creativity, collaboration?’Social Work Education, 23 (2): 163–183. http://dx.doi.org/10.1080/0261547042000209189(2004) Managing Change. Harlow: Prentice Hall.(1979) Sociological Paradigms and Organizational Analysis. London: Heinemann Educational Books.and (1999) Knowledge Capitalism: Business, Work and Learning in the New Economy. Oxford: Oxford University Press. http://dx.doi.org/10.1093/acprof:oso/9780198296225.001.0001(2001) Against the Third Way. Cambridge: Polity Press.(2003) The New Mandarins of American Power. Cambridge: Polity Press.(2005) Medical Ethics (, and (4th edition). Melbourne: Oxford University Press.1983) The Turning Point. London: Flamingo Books.(1994) Child and Infant Pain. London: Chapman & Hall.([Page 174]2004) ‘Personal, social and health education (PSHE) certification programme for community nurses’, Evaluation of the pilot programme (Phase One). London: Thomas Coram Research Unit. Available at: http://www.wiredforhealth.gov.uk, and (2004) ‘National service frameworks and UK general practitioners: street-level bureaucrats at work?’Sociology of Health and Illness, 26 (7): 951–971. http://dx.doi.org/10.1111/shil.2004.26.issue-7(2000) Postmodern and poststructural approaches to nursing research. Thousand Oaks, CA: Sage. http://dx.doi.org/10.4135/9781452204895(1989) Necessary Illusions: Thought Control in Democratic Societies. London: Pluto.(2001) ‘Private thoughts in public spheres: issues in reflection and reflective practices in nursing’, Journal of Advanced Nursing, 36 (4): 512–519. http://dx.doi.org/10.1046/j.1365-2648.2001.02003.x(1981) Behind the Blue Door: The History of the Royal College of Midwives 1881–1981. London: Bailliere Tindall.and (2005) Critical Thinking Skills: Developing Effective Analysis and Argument. Basingstoke: Palgrave Macmillan.(1997) ‘The truth is no longer out there’, British Journal of Occupational Therapy, 60 (2): 50–52.(1997) ‘The dialectic of knowledge-in-production: value creation in late capitalism and the rise of knowledge-centered production’, Electronic Journal of Sociology, 2 (3). Available at: http://epe.lac-bac.gc.ca/100/201/300/ejofsociology/1999/991102/content/vol002.003/curry.html(1998) ‘Critical thinking as an outcome of nursing education. What is it? Why is it important to nursing practice?’Journal of Advanced Nursing, 28 (2): 323–331. http://dx.doi.org/10.1046/j.1365-2648.1998.00783.x(2003) ‘The role of nurses in public health’ in A.Watterson, Public Health in Practice. Basingstoke: Palgrave Macmillan.(2002) ‘What about the girl next door? Gender and the politics of professional self-regulation’ in G.Bendelow, M.Carpenter, C.Vautier and S.Williams, Gender, Health and Healing: The Public/Private Divide. London: Routledge.(2001) ‘Sociology’ in J.Naidoo and J.Wills, Health Studies: An Introduction. Basingstoke: Palgrave.(1993) ‘Facing the 1990s: Problems and possibilities for women's studies’ in J.de Groot and M.Maynard (eds) Women's Studies in the 1990s: Doing Things Differently?Basingstoke: Macmillan Press.and (2004) ‘World assumptions and combat-related posttraumatic stress disorder’, Journal of Social Psychology, 144 (4): 407–420. http://dx.doi.org/10.3200/SOCP.144.4.407-420, , and (Department for Education and Employment (DfEE) (1999) National Healthy School Standard Guidance. Available at: http://www.wiredforhealth.gov.ukDepartment for Education and Skills (DfES) (2001) Schools: Achieving Success. London: Department for Education and Skills.Department for Education and Skills (DfES) and Department of Health (DOH) (2004) ‘Guidance for Healthy School Coordinators’. Available at: http://www.wiredforhealth.gov.ukDepartment for Education and Skills (DfES) and Department of Health (DOH) (2005) National Healthy School Status: A Guide for Schools. Available at: http://www.wiredforhealth.gov.ukDepartment of Health (DOH) (1993) Changing Childbirth: Report of the Expert Maternity Group. London: Department of Health.[Page 175]Department of Health (DOH) (1999) Saving lives: Our Healthier Nation. London: Department of Health.Department of Health (DOH) (2000) Coronary Heart Disease: National Service Framework – Modern Standards and Service Models. London: Department of Health.Department of Health (DOH) (2000) The NHS Plan: A Plan for Investment, a Plan for Reform. London: Department of Health.Department of Health (DOH) (2001) National Service Framework for Older People. London: Department of Health.Department of Health (DOH) (2002) Liberating the Talents: Helping Primary Care Trusts and Nurses to Deliver the NHS Plan. London: Department of Health.Department of Health (DOH) (2004) Choosing Health: Making Healthier Choices easier. London: Department of Health.Department of Health and Social Security (1980) The Black Report on Inequalities in Health. London: HMSO.1974) Of Grammatology. Translated by G. C.Spivak. Baltimore, MD: John Hopkins University Press.(2001) Writing and Difference. London: Routledge Classics.(1628) Rules for the Direction of the Mind. Online version available at: http://faculty.uccb.ns.ca/philosophy/kbryson/rulesfor.htm(2003) ‘Health-promoting practice’ in D.Palmer and S.Kaur (eds) Core Skills for Nurse Practitioners. London: Whurr Publishers.and (2002) ‘Gender equity in health: debates and dilemmas’ in G.Bendelow, M.Carpenter, C.Vautier and S.Williams, Gender, Health and Healing: The Public/Private Divide. London: Routledge.(1993) Post-Capitalist Society. New York: Harper Business.(2001) ‘Lifelong learning: a postmodern condition of education?’Adult Education Quarterly, 51 (4): 273–287. http://dx.doi.org/10.1177/07417130122087296and (2005) ‘What is socialist feminism?’Monthly Review, 57 (3): 70–77.(2002) ‘Distinguishing between inferences and assumptions’, Journal of Developmental Education, 25 (3): 34–35.and (1986) The Origin of the Family, Private Property and the State. London: Penguin Books.(1993) ‘Intuition as a function of the expert nurse: A critique of Benner's novice to expert model’, Journal of Advanced Nursing, 18 (3): 387–393. http://dx.doi.org/10.1046/j.1365-2648.1993.18030387.x(1995) Critical Thinking. Upper Saddle River, NJ: Prentice Hall.(2002) ‘The successes and failures of feminism’, Journal of Women's History, 14 (2): 118–25. http://dx.doi.org/10.1353/jowh.2002.0040(1995) The Spirit of Community: Rights, Responsibilities and the Communitarian Agenda. London: Fontana.(2004) ‘Shifting the balance of power? UK public health policy and capacity building’, Critical Public Health, 14 (1): 63–75. http://dx.doi.org/10.1080/09553000310001658789(1996) ‘Externalizing the critical thinking in knowledge development and clinical judgement’, Nursing Outlook, 44 (3): 129–136. http://dx.doi.org/10.1016/S0029-6554%2806%2980005-9and (1992) Backlash: The Undeclared War against Women. London: Chatto and Windus.(2001) ‘Knowledge and the enterprising self: workplace refugees navigating entrepreneurial discourse’, Studies in the Education of Adults, 3 (2): 127–134.(2001) Critical Thinking: An introduction. Cambridge: Cambridge University Press.([Page 176]1984) A Dictionary of Philosophy. London: Pan Books.(1995) Women and the Health Care Industry: An Unhealthy Relationship. Milton Keynes: Open University Press.(1989) The Birth of the Clinic: An Archaeology of Medical Perception. London: Routledge.(2001) ‘Coping with complexity: educating for capability’, British Medical Journal, 323: 799–803. http://dx.doi.org/10.1136/bmj.323.7316.799and (1996) Ideologies and Political Theory: A Conceptual Approach. Oxford and New York: Oxford University Press.(2006) After the Neocons: Where the Right Went Wrong. London: Profile Books Ltd.(1975) Truth and Method. London: Sheed and Ward.(2004) Releasing Resources to the Front Line: Independent Review of Public Sector Efficiency. London: HMSO.(1976) New Rules of Sociological Method. London: Hutchinson.(1998) The Third Way: The Revival of Social Democracy. Cambridge: Polity Press.(2001) ‘Reflective practice and clinical supervision: meticulous rituals of the confessional’, Journal of Advanced Nursing, 36 (2): 199–205. http://dx.doi.org/10.1046/j.1365-2648.2001.01960.x(1993) In a Different Voice: Psychological Theory and Women's Development. Cambridge, MA: Harvard University Press.(2004) ‘Genealogies and generations: the politics and praxis of third wave feminism’, Women's History Review, 13 (2): 165–182. http://dx.doi.org/10.1080/09612020400200767and (2003) ‘Ethics needs principles – four can encompass the rest – and respect for autonomy should be “first among equals” ’, Journal of Medical Ethics, 29: 307–312. http://dx.doi.org/10.1136/jme.29.5.307(2004) ‘PTSD and world assumptions following myocardial infarction: a longitudinal study’, American Journal of Orthopsychiatry, 74 (3): 286–292. http://dx.doi.org/10.1037/0002-94184.108.40.2066(1996) ‘Chaos theory’ in K. A.Ransom (ed.) Academic American Encyclopaedia, Volume 4. Danbury, CT: Grolier Inc.and (1935) in A.Heywood (2003) Political Ideologies: An Introduction. ((3rd edition) Basingstoke: Palgrave Macmillan, pp. 8–9.2003) Straw Dogs: Thoughts on Humans and Other Animals. London: Granta.(1999) Qualitative Research in Health: An Introduction. London: Sage. http://dx.doi.org/10.4135/9781446218662(Great Britain (1998) Human Rights Act 1998 Elisabeth II. Chapter 42. London: HMSO.1999) The Whole Woman. London: Doubleday.(1996) Care in Chaos. London: Cassel.and (1999) ‘Marginalization revisited: critical, postmodern and liberation perspectives’, Advances in Nursing Science, 22 (1): 88–102.(1989) Thought and Knowledge: An Introduction to Critical Thinking. Mahwah, NJ: Laurence Erlbaum Associates Inc.(1996) Thought and Knowledge: An Introduction to Critical Thinking ((3rd edition). Mahwah, NJ: Laurence Erlbaum Associates Inc.1995) The Politics of Social Research. London, Thousand Oaks and New Delhi: Sage Publications.(2006) ‘Self Care – Essentials of 21st Century Health Care Reform’. ASI Think Piece, Adam Smith Institute. Available at: http://www.adamsmith.org/health/index.php/tools/think_print/selfcare/(1991) ‘Clinical decision making in nursing’, Journal of Advanced Nursing, 16: 404–407. http://dx.doi.org/10.1111/jan.1991.16.issue-4([Page 177]1999) ‘Doctor in the house: the Internet as a source of lay health knowledge and the challenge to expertise’, Sociology of Health and Illness, 21 (6): 820–835. http://dx.doi.org/10.1111/shil.1999.21.issue-6(2001) in R.Alfara-Lefevre (2004) Critical Thinking and Clinical Judgment; A Practical Approach ((3rd edition). Philadelphia: W. B. Saunders Company.Health Development Agency (HDA) (2004) National Healthy School Standard and Local Strategic Partnership: Working Together. London: Health Development Agency.1988) Management of Organizational Behaviour (and (5th edition). Eaglewood Cliffs, NJ: Prentice Hall.1998) Political Ideologies: An Introduction ((2nd edition). Basingstoke: Palgrave Macmillan.2003) Political Ideologies: An Introduction ((3rd edition). Basingstoke: Palgrave Macmillan.2004) Political Theory: An Introduction ((3rd edition). Basingstoke: Palgrave Macmillan.Holland, J. and Adkins, L. (eds) (1996) Sex, Sensibility and the Gendered Body. Basingstoke: Macmillan.2000) Feminism, Femininity and Popular Culture. Manchester: Manchester University Press.(2004) Medical Ethics: A Very Short Introduction. New York: Oxford University Press.(2001) ‘Transcending the fissure in risk theory: critical realism and child welfare’, Child and Family Social Work, 6 (3): 219–228. http://dx.doi.org/10.1046/j.1365-2206.2001.00205.x(1982) Three Faces of Hermeneutics: An Introduction to Current Theories of Understanding. Berkeley, CA: University of California Press.(2005) New Approaches in Ethics for the Caring Professions. Basingstoke: Palgrave Macmillan.(2005) Managing for Health. London: King's Fund Publications.and (2001) in R.Paul, The State of Critical Thinking Today: The Need for a Substantive Concept of Critical Thinking. Available at: http://www.criticalthinking.org/resources/articles/the-state-ct-today.shtml(2006) Truth, Trust and Medicine. London: Routledge.(2001) ‘Teaching health care ethics: the importance of moral sensitivity for moral reasoning’, Nursing Philosophy, 2: 131–142. http://dx.doi.org/10.1046/j.1466-769X.2001.00045.x(1989) ‘Assumptive worlds and the stress of traumatic events: applications of the schema construct’, Social Cognition, 7: 113–136. http://dx.doi.org/10.1521/soco.19220.127.116.11(Jardine, L. and Silverthorne, M. (eds) (2000) Francis Bacon: The New Organon. Cambridge: Cambridge University Press.1996) in R.Hadley and R.Clough, Care in Chaos. London: Cassel.(2005) Nanny or Steward? The Role of Government in Public Health. London: King's Fund Publications.(1996) ‘Women of the future: alternative scenarios’, The Futurist, 30 (3): 34–38.(1997) The Challenge of Promoting health: Exploration and Action. Basingstoke: Macmillan Press Ltd.and (1997) ‘Authoritative knowledge and its construction’ in R.Davis-Floyd and C.Sargent, Childbirth and Authoritative knowledge: Cross Cultural Perspectives. Berkeley, CA: University of California Press.([Page 178]1995) ‘Unity without uniformity: lesbians in Ireland in the 1990's’ in G.Griffin (ed.) Feminist Activism in the 1990s. London: Taylor & Francis., , and (1781) Critique of Pure Reason. Online version available at: http://www.fordham.edu/halsall/mod/kant-cpr.html(2002) ‘The pathbraking, fractionalized, uncertain world of knowledge’, Chronicle of Higher Education, 49 (4): B7–B11.(1994) ‘How the feminist establishment hurts women’, Christianity Today, 38 (June 20): 20–25.(2006) Wanless Social Care Review Report. London: King's Fund.(2004) ‘Negotiating spaces for/through third-wave feminism’, NWSA Journal, 16 (3): 124–153. http://dx.doi.org/10.2979/nws.2004.16.issue-3(1997) Postmodernism. http://www.colarado.edu/English/courses/ENGL2012Klages/pomo.html(2002) Understanding Philosophy of Science. London: Routledge.(2002) ‘Alternative societal models of learning in the knowledge economy’, International Social Sciences Journal, 54 (171): 67–82. http://dx.doi.org/10.1111/1468-2451.00360(1998) ‘Health promotion in the acute setting’ in S.Kendall (ed.) Health and Empowerment: Research and Practice. London: Arnold.(1999) ‘Fieldwork education as evidence of CPD’, British Journal of Therapy and Rehabilitation, 6 (3): 150–152.and (2006) Gadamer: A Guide for the Perplexed. London: Continuum International Publishing Group.(1980) Street Level Bureaucracy: Dilemmas of the Individual in Public Services. New York: Russell Sage Foundation.(2005) ‘Psychological adaptation to disability: perspectives from chaos and complexity theory’, Rehabilitation Counselling Bulletin, 49 (1): 17–28. http://dx.doi.org/10.1177/00343552050490010301and (2002) Chaos Theory and Education. http://www.libraryreference.org/chaos.html(1984) The Postmodern Condition: A Report on Knowledge. Manchester: Manchester University Press.(1999) Neo-liberalism or Democracy? Economic Strategy, Markets and Alternatives for the 21st Century. London: Zed Books.(2003) ‘Applying the four principles’, Journal of Medical Ethics, 29:275–280. http://dx.doi.org/10.1136/jme.29.5.275(1999) ‘Postmodern health economics’, Health Care Analysis, 7 (3): 255–272. http://dx.doi.org/10.1023/A:1009400926449and (2005) ‘Social determinants of health inequalities’, The Lancet, 365 (9464): 1099–1104.(2006) ‘Learning to lead’, Nursing Management, 12 (9): 34–37.(1846) in K.Marx and F.Engels (1976) The Communist Manifesto. Harmondsworth: Penguin.(1971) The Farther Reaches of Human Behaviour. Harmondsworth: Penguin.(2003) ‘Critical realism: a way forward for evaluation research in nursing?’Journal of Advanced Nursing, 43 (4): 411–420. http://dx.doi.org/10.1046/j.1365-2648.2003.02730.xand (2002) ‘The role of representation in teaching and learning critical thinking’, Educational Review, 54 (1): 57–67. http://dx.doi.org/10.1080/00131910120110884, , and ([Page 179]1997) ‘Leading professionals: towards new concepts of professionalism’ in J.Broadbent, M.Dietrich and J.Roberts (eds) The End of the Professions?London: Routledge.and (2005) Lessons in Leadership: Meeting the Challenges of Public Services Management. Abingdon: Routledge.and (1992) The Strategy Process: Concepts and Contexts. Harlow: Prentice Hall.(2000) The Rise and Fall of Strategic Planning. Harlow: Prentice Hall.(1996) ‘Postmodernism, health and illness’, Journal of Advanced Nursing, 23: 201–205. http://dx.doi.org/10.1111/jan.1996.23.issue-1(1516) Utopia. Online version available at: http://oregonstate.edu/instruct/ph1302/texts/more/utopia-contents.html(2002) ‘Joined-up thinking in theory and practice: the case of healthy schools’, The Curriculum Journal, 13 (3): 313–337. http://dx.doi.org/10.1080/0958517022000014691, , and (National Institute for Clinical Excellence (2004) Research and Development Strategy. Available at: http://www.nice.org.uk/page.aspx?o=295953New York Feminists (1969) in S.Smith (1994) ‘Mistaken identity: or can identity politics liberate the oppressed?’International Socialist Journal, 62 (Spring): 3–50.2001) ‘Not without heat and dust’: the moral bases of the ‘new’ academic professionalism, British Journal of Educational Studies, 49 (2): 173–186. http://dx.doi.org/10.1111/1467-8527.00170(1984) The Captured Womb: A History of the Medical Care of Pregnant Women. Oxford: Blackwell.(1993) Essays on Women, Medicine and Health. Edinburgh: Edinburgh University Press.(2000) Experiments in Knowing: Gender and Method in the Social Sciences. Cambridge: Polity Press.(Office of Government Commerce (2006). Description of Third Sector Organisations. Available at: http://www.ogc.gov.uk/social_issues_in_purchasing_third_sector_organisations.asp2005) ‘Neoliberalism, higher education and the knowledge economy: from the free market to knowledge capitalism’, Journal of Educational Policy, 20 (3): 313–345. http://dx.doi.org/10.1080/02680930500108718and (Organisation for Economic Co-operation and Development (OECD) (1996) The Knowledge-based Economy. Paris: OECD.1791) The Rights of Man. Online version available at: http://www.infidels.org/library/historical/thomas_paine/(1987) ‘Gadamer's hermeneutics and social theory’, Critical Review, (Summer) 91–108. http://dx.doi.org/10.1080/08913818708459497(2003) ‘Catastrophe, chaos and complexity models and psychosocial adjustment to disability’, Rehabilitation Counseling Bulletin, 46 (4): 234–241. http://dx.doi.org/10.1177/003435520304600404, and (2000) ‘After post-positivism? The promises of critical realism’, International Studies Quarterly, 44 (2): 213–237.and (2004) The State of Critical Thinking Today: The Need for a Substantive Concept of Critical Thinking. Available at: http://www.criticalthinking.org/resources/articles/the-state-ct-today.shtml([Page 180]2005) Learn the Tools the Best Thinkers Use. Upper Saddle River, NJ: Prentice Hall.and (1995) ‘Critical thinking and intuitive nursing practice’, Journal of Advanced Nursing, 22: 40–47. http://dx.doi.org/10.1046/j.1365-2648.1995.22010040.xand (1974) ‘The nature and role of presupposition: and inquiry into contemporary hermeneutics’, International Philosophical Quarterly, 14 (1): 209–222.(2001) ‘The challenge of complexity in health care’, British Medical Journal, 323: 625–628. http://dx.doi.org/10.1136/bmj.323.7313.625and (2001) ‘Complexity, leadership and management in health care organisations’, British Medical Journal, 323: 746–749. http://dx.doi.org/10.1136/bmj.323.7315.746and (1959) The Logic of Scientific Discovery. London: Hutchinson.(1992) Unended Quest: An Intellectual Autobiography. London: Routledge.(2004) ‘The knowledge economy’, Annual Review of Sociology, 30: 199–220. http://dx.doi.org/10.1146/annurev.soc.29.010202.100037and (1988) ‘Empiricism’ in A.Bullock, O.Stalybrass and S.Trombey (eds) The Fontana Dictionary of Modern Thought. London: Fontana.(1999) The Elements of Moral Philosophy. Boston, MA: McGraw-Hill College.(2004) ‘Miandad's six is a metaphor for chaos and complexity’, British Medical Journal, 328: 1500. http://dx.doi.org/10.1136/bmj.328.7454.1500-a(1987) in L.Segal, Is the Future Female? Troubled Thoughts on Contemporary Feminism. London: Virago Press.(1993) Women, Motherhood and Childrearing. Basingstoke: Macmillan.(1992) in G.Siann (1994) Gender, Sex and Sexuality: Contemporary Psychological Perspectives. London: Taylor and Francis.(1990) ‘Maintaining the independence of the midwifery profession: a continuing struggle’ in J.Garcia, R.Kilpatrick, and M.Richards (eds) The Politics of Maternity Care: Services for Childbearing Women in the Twentieth Century. Oxford: Clarendon Press.(2001) ‘Postmodernism for healthcare workers in 13 easy steps’, NurseEducation Today, 21: 38–47. http://dx.doi.org/10.1054/nedt.2000.0509(1996) ‘Evidence based medicine: what it is and what it isn't’, British Medical Journal, 312: 71–72. http://dx.doi.org/10.1136/bmj.312.7023.71, , , and (Sapsford, R. and Jupp, V. (eds) (1996) Data Collection and Analysis. London, Thousand Oaks and New Delhi: Sage Publications.2000) Realism and Social Science. London, Thousand Oaks and New Delhi: Sage Publications. http://dx.doi.org/10.4135/9781446218730(1997) Health Promotion: Philosophy, Prejudice and Practice. Chichester: John Wiley and Sons.(1994) Straight Sex: The Politics of Pleasure. London: Virago Press.(1994) Contested Knowledge-Social Theory in the Postmodern Era. Oxford: Blackwell Scientific.(2004) ‘Civic and ethnic identity: the case of Croatia’, Ethnic and Racial Studies, 27 (3): 455–483. http://dx.doi.org/10.1080/01491987042000189240(1993) A Bit about Phrenology. Available at: http://www.neurosurgery.org/cybermuseum/pre20th/phren/phrenology.html([Page 181]2006) ‘Lessons in Life: Why I'm Teaching Happiness’, The Independent Online. Published 19 April 2006. Available at: http://education.independent.co.uk/news/article358571.ece(2003) ‘Valuing both critical and creative thinking in clinical practice: narrowing the research-practice gap?’Journal of Advanced Nursing, 42 (3): 288–296. http://dx.doi.org/10.1046/j.1365-2648.2003.02618.x, and (2004) ‘A wellbeing manifesto for a flourishing society’, The Power of Wellbeing3. London: New Economics Foundation.and (1994) Gender, Sex and Sexuality: Contemporary Psychological Perspectives. London: Taylor and Francis.(1776) An Inquiry into the Nature and Causes of the Wealth of Nations. Online version available at: http://www.adamsmith.org/smith/won/won-index.html(1994) ‘Mistaken identity: or can identity politics liberate the oppressed?’International Socialist Journal, 62 (Spring): 3–50.(1993) ‘Critical thinking: a foundation for consumer-focused care’, Journal of Continuing Education in Nursing, 24 (5): 206–210.(Society for Health Education and Promotion Specialists (SHEPS) (2006) Practice, Principles and Philosophy. Available at: http://www.hj-web.co.uk/sheps/vision.htmStangor, C. (ed.) (2003) Stereotypes and Prejudice: Essential Readings. Philadelphia and Hove, East Sussex: Psychology Press.1997) Empowerment and Women's Health: Theory, Methods and Practice. London: Zed Books.(2001) ‘Paradigms lost, paradigms regained: defending nursing against a single reading of postmodernism’, Nursing Philosophy, 2 (2): 143–150. http://dx.doi.org/10.1046/j.1466-769X.2001.00050.xand (1997) Does God Play Dice? The Mathematics of Chaos. Harmondsworth: Penguin.(1998) ‘The place of portfolios within continuing professional development’, British Journal of Therapy and Rehabilitation, March (5): 5.(2003) ‘What's new about “the new femininity”?’Feminism, Femininity and the Discourse of the New Decade, 29 (2): 182–198.(1997) Developing Learning in Professional Education: Partnerships for Practice. Buckingham: Society for Research into Higher Education and the Open University.(2000) Nursing Ethics (, and (4th edition). Edinburgh: Churchill Livingstone.1999) Critical Reasoning in Ethics: A Practical Introduction. London: Routledge.(2001) Birth Counts: Statistics of Pregnancy and Childbirth. London: HMSO.(1996) ‘The future of epidemiology’, British Medical Journal, 313: 436–437. http://dx.doi.org/10.1136/bmj.313.7055.436(2003) Ethics in Nursing: The Caring Relationship ((3rd edition). Edinburgh: Butterworth Heinemann.Ussher, J. (ed.) (2000) Women's Health: Contemporary International Perspectives. Oxford: Blackwell.1971) Explanation and Understanding. London: Routledge and Kegan Paul.([Page 182]1997) ‘Critical realism and realist research in human geography: a method or a philosophy in search of a method?’Progress in Human Geography, 21 (1): 51–74. http://dx.doi.org/10.1191/030913297668207944(1998) ‘New directions in systems theory: chaos and complexity’, Social Work, 43 (4): 357–372. http://dx.doi.org/10.1093/sw/43.4.357, and (1995) Modern Feminist Thought: From the Second Wave to ‘Post-Feminism. Edinburgh: Edinburgh University Press.(2000) Contemporary Moral Problems ((6th edition). Belmont, CA: Wadsworth Publishing Company.1999) ‘Metacampbell: the epistemological problems of perspectivism’, Review of International Studies, 25: 311–316. http://dx.doi.org/10.1017/S0260210599003113(1996) Unhealthy Society: The Afflictions of Inequality. London: Routledge. http://dx.doi.org/10.4324/9780203421680(Wilkinson, R. G. and Marmot, M. (eds) (2005) Social Determinants of Health. Oxford: Oxford University Press. http://dx.doi.org/10.1093/acprof:oso/9780198565895.001.00011989) About Interpretation: From Plato to Dilthey – a Hermeneutic Anthology. New York: Lang.(2001) ‘Complexity and clinical care’, British Medical Journal, 323: 685–688. http://dx.doi.org/10.1136/bmj.323.7314.685and (1990) The Beauty Myth. London: Chatto & Windus.(World Health Organisation (WHO) (1946) World Health Organisation Constitution: Basic Documents. New York: WHO.World Health Organisation (WHO) (1986) Ottawa Charter for Health Promotion. Geneva: WHO.