'Drama classes help GPs handle difficult patients' c/o BBC

'Hull Truck Theatre has just won the Innovation prize at the Stage Awards for their new training scheme for GPs. Associate Director Tom Saunders and GP Dr Eman Shamsaee discuss why drama classes are helping doctors treat patients.' 

BBC Radio 4 'Front Row' https://www.bbc.co.uk/sounds/play/m002q2jz (15 mins ...)

◇

Holly Phillips, East Yorkshire and Lincolnshire and Ian Youngs, Culture Reporter

Published - 21 January 2026

'A theatre company is using drama training to help doctors deal with challenging patients.

Hull Truck Theatre's classes feature actors performing difficult GP consultations, with GPs giving feedback before taking over the consultation themselves.

The theatre recently won the Innovation Award at the Stage Awards for the programme.

Dr Eman Shamsaee, who has taken part in the training scheme, described it as a "really creative way of doing GP training".'

BBC News:  Drama classes help GPs handle difficult patients

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The training programme has completed its pilot stage and is now in the delivery phase

A reminder of co-working to deliver STORM training with a Clinical Psychologist colleague. 

See also: 'communication' : 'primary care' : 'GP' : 'drama'

'Maths Without Numbers' by Milo Beckman

'Before you go tell your loved ones that you read a book about math and learned that a square is a circle, keep in mind: Context matters. A square is a circle, in topology. A square is most certainly not a circle in art or architecture, or in everyday conversation, or even in geometry, and if you try to ride a bike with square tires you won't get far.' pp.7-8.

'Like a line:

(Illustration - pen drawing of a line, a 'C' and an almost closed circle.)

A line can be bent almost into a circle, but to finish the job we'd need to click the ends together--not allowed. No matter how you manipulate a line, you'll always have those two special points on either end, where the shape just stops. You can't get rid of end-points. You can move them around and stretch them apart, but the two end-points are an unchanging feature of the shape.

For a similar reason, a figure-eight is a different shape too. There aren't any end-points, but there's still a special point in the middle where the lines cross, where there are four arms reaching out instead of the usual two at any other point. Stretch and squeeze all you want, you can't get rid of a crossing-point either. p.9.

Math Without Numbers

'The circle (aka S-one) and the infinite line (named R-one) are the only manifolds in the first dimension. To avoid end-points, you either have to loop back around or just go on and on forever. And don't forget: Because all the shapes in topology are stretchy, this also covers any closed-loop shape and any goes-on-forever shape. It doesn't have to be literally a circle or a straight line.' p.16.

The third dimension, dough-type manifolds, is pretty well understood at this point, though it took a hundred years and a million-dollar prize to get there, and we still don't have a totally neat and clean classification like the lower dimension. In dimensions five and up, topologists use a set of techniques called "surgery theory" to operate on manifolds and construct new ones.

That just leaves dimension four.

I wish I could tell you what's going on in dimension four. I'm not sure there's anyone who really knows. It's a weird boundary case: too many dimensions to do visually, but not enough to use sophisticated surgery tools. There are entire textbooks dedicated to what little we know about four-manifolds, and I couldn't make sense of anything past the opening pages. A professional topologist once told me she'd wanted to work on four-manifolds as an undergraduate but was advised to steer clear.' pp.23-24.

"Like a line" ... Yes. Take two that cross. Then the universes open up. 

Milo Beckman (2021) Math Without Numbers. London, Penguin Books. Illustrated by M. Erazo.

Previously: 'surgery'

Affordances

Affordance

An affordance is a perceptual pattern with survival significance. Affordances are relational, rather than objective or subjective properties. As Gibson, who coined the term, observes, 'An important fact about the affordances of the environment is that they are in a sense objective, real, and physical, unlike values and meanings, which are often supposed to be subjective, phenomenal and mental. But, actually, an affordance is neither an objective property nor a subjective property; or it is both if you like. An affordance cuts across the dichotomy of subjective-objective and helps us to understand its inadequacy' (Gibson 1979, 129). 
[Proust, Glossary, p.309.]

 

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subjective	objective

Re. 'Survival significance' ...

Does this make affordances relevant in clinical education, and education more generally?

What of assisted dying in theory, policy, law and practice?

Are there any implications for the models employed by artificial intelligence - LLMs, neurosymbolic reasoning / AI (wave x)?

Source: Joëlle Proust (2013). The Philosophy of Metacognition: Mental Agency and Self-Awareness.  Oxford: Oxford University Press, Oxford. ISBN: 978-0-19-960216-2

Précis of The Philosophy of Metacognition:
https://joelleproust.org/wp-content/uploads/2012/09/pdf15.pdf 

See also: 'subject' : 'object' : 'affordance' : 'interface'

Optimism - Pessimism c/o Baggini & Macaro

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Cognitive flaws, or psychological adaptations? 'Van der Lugt: "reality confound" ... Optimists believe they have more control over what happens than they actually do.'   Dunning-Kruger Effect:  people tend to overestimate their own expertise. Baumeister:  "The negativity effect"   Norem: "defensive pessimism"	Optimism and Pessimism are independent scales. 'Age also makes a difference, for the simple reason that life and its potential future vary accordingly.' 'Designated Cassandra'^ Rotation of role. 'When your prospects are bleak, a gloomy outlook is realism, not pessimism.'
'... how optimistic we feel depends not just on us, but on our life circumstances.  Think about how race, class and social inequality have real impacts on life chances.'	'In western culture, optimism is valorised more than pessimism.' 'To suggest that people struggling in an unequal system should simply adopt a more positive attitude is to turn social and economic problems into psychological ones.'

^With apologies.

Source: J. Baggini, A. Macaro. In defence of pessimism. Or. why optimism is not quite a prerequisite for achieving a valued goal. FT Weekend Magazine, 1131: June 28, 2025, pp.18-20.
https://www.julianbaggini.com/in-defence-of-pessimism/

Books noted in the above article:

Sharot, T. (2011). The optimism bias: A tour of the irrationally positive brain. Pantheon/Random House.

Tierney, J., & Baumeister, R.F. (2019). The power of bad: How the negativity effect rules us — and how we can rule it. New York: Penguin.

Van der Lugt, M. (2025). Hopeful Pessimism. Princeton University Press. https://doi.org/10.2307/jj.17707125

See also:

Baumeister, R. F., Bratslavsky, E., Finkenauer, C., & Vohs, K. D. (2001). Bad is stronger than good. Review of General Psychology, 5(4), 323–370. https://doi.org/10.1037/1089-2680.5.4.323

NANDA-I Newsletter - theme of clinical reasoning

'This month at NANDA-I, we have been exploring the theme of clinical reasoning.

Clinical reasoning is at the heart of nursing; it’s how nurses make sense of complex patient information and choose the best path forward. While many nurses think of diagnosis as the centerpiece, it’s really the thinking that leads up to it, gathering cues, interpreting what matters most, and then safely determining goals and actions, that makes all the difference in outcomes. Strong reasoning helps nurses notice subtle changes and act with confidence.

As healthcare grows more complex, understanding how nurses think, not just what tools they use, helps elevate care for every patient. We’ll be sharing insights throughout the year to help you stay connected to nursing knowledge and its impact on care delivery and education.'

 

Teaching Tip: Clinical Reasoning in Practice

Start With Assessment to Improve Reasoning

When nurses work with standardized languages and clinical judgment tools, it’s tempting to dive right into diagnosis. But the most accurate and useful nursing judgments always come from strong, systematic assessment first. Quality assessment supports better interpretation of patient needs and more precise identification of nursing responses. Quick Tip: Use a flexible assessment framework, whether it’s a conceptual model or a tool like functional health patterns, to make sure you’re capturing the data that matters most first. When you build a solid foundation with assessment, everything that follows (including diagnostic thinking) becomes clearer and more grounded.

 

My source: 'Friends of NANDA®-I Newsletter' subscription (with my emphasis).

See also:
https://nanda.org/2025/12/nanda-360-for-educators-and-researchers-strengthening-nursing-knowledge-through-diagnosis-centered-reasoning/

Assessment, plus planning, implementation - action, evaluation (plus, formulation).

Functional and cognitive [Health, Illness, Climate, Poverty, Political, Security, Prevention, Self-care, ...] patterns.

'... make sure you’re capturing the data that matters most first' - Situated, Context, Salience.

For a competent practitioner an assessment can also be 'therapeutic' for the patient.

Previously: 'classification' : 'diagnosis' : 'NANDA' : 'ICD'

v Book: Bill Ross - 'Order and the Virtual'

'The Philosophy and Science of Deleuzian Cosmology'

Systemists will find much here: 'principle of least action', 'principle of least resistance', equilibrium, open / closed systems, and entropy. A useful question is posed: 'Is complexity increasing? Is that average complexity across the universe; or the complexity of the most complex object? Deleuzes's Difference and Repetition is quoted:

'The values of implication are centres of envelopment. These centres  are not the intensive individuating factors themselves, but they are their representatives within a complex whole in the process of explication. ...' (p.255-6)'

Reading this I immediately thought of Bohm, who followed shortly after (still in Chapter 1!). In chapter 1, 'Chaos' could be read as Cosmos, hence the term rolling them together - chaosmos. This is the tract from which existence and becoming arise (re-reading). Deleuze's awareness of physics and quantum theory and its influence on his work is discussed, with chapter 2 providing continuity reaching to Leibniz (and 'The Calculating God'), also contributing is 'the complete concept', 'principle of sufficient reason', 'intensive individuating factors' and 'principle of identity of indiscernibles', for example. Even while the context is metaphysics (and it is not!), (for me) this seemingly presages a comprehensive health assessment:

Order and the Virtual

'The necessity in question is the necessary inclusion of all predicates pertaining to an individual in the complete concept of that individual.' p.24.

A reason to look up Lautman's philosophy is that it - 

'... entails a dialectic; a dialectic comprised of the movement of Ideas. While a given theory may achieve the desired tractability of the paradoxical element in question, this can only be the provisional resolution of the problem. This does not imply that the paradoxical element is in itself resolved; it retains its disruptive powers, its `remainder` within the explanatory framework, which will itself once again redistribute, redeploy, in an inevitable encounter with the next explanatory framework. In this sense (a sense which Deleuze embellishes), the 'problem' and the 'solution' are profoundly different in kind to question and answer. Whereas an answer might be understood to put a question to rest, the solution cannot resolve the problem finally.'

Plato's perpetual questioning wins the day and night (that is 24 hour care). This is why, for me Hodges' model is powerful - "Nursing: Be the difference"^ - and more relevant than ever:

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Self-Knowledge/Care Literacies Reasoning*	KNOWLEDGE - FACTS ... Self-Knowledge for Self-care
Dialectic* Guided discovery Perpetual questioning	Education Government provision Access for all Voice(s): being heard*

Ross explains that Deleuze is not limited to the realm of mathematics: 

and: 'By Ideas, we do not mean models whose mathematical entities would only be copies, but in the true Platonic Idea sense of the term, the structural schemas acccording to which effective theories are organised.'

Is the 'paradoxical agent' at work here, now a digitalized homonculus ready to preside acting as a superior dialectic that runs over the stream of conciousness? Hodges' model is a conceptual framework and ever-ready (we hope) aide-mémoire:

'Problems are always dialectical; the dialectic has no other sense, nor do problems have any other sense. What is mathematical (or physical, biological, psychical or sociological) are the solutions' (DR, 179).' (p.43).

In Hodges' model, the solutions are fixed in time, for what is (usually) an ongoing situation and context. Certain results in mathematics may be fixed, appear as a standing wave, but the flux, dyanamic remains. And, with it noise that is incessant and increasingly political.

This is a challenging, but rewarding read. 

^Have constant regard for representation, creation, being, becoming and how this affects and impacts (the) becoming.

Many thanks to Edinburgh University Press for my review copy.

More to follow here ...

Bill Ross (2024) Order and the Virtual: The Philosophy and Science of Deleuzian Cosmology. Edinburgh: Edinburgh University Press.
https://edinburghuniversitypress.com/book-order-and-the-virtual.html

iv Book: Bill Ross - 'Order and the Virtual'

'The Philosophy and Science of Deleuzian Cosmology'

Order and the Virtual

Systemists will find much here: 'principle of least action', 'principle of least resistance', equilibrium, open / closed systems, and entropy. A useful question is posed: 'Is complexity increasing? Is that average complexity across the universe; or the complexity of the most complex object? Deleuzes's Difference and Repetition is quoted:

'The values of implication are centres of envelopment. These centres  are not the intensive individuating factors themselves, but they are their representatives within a complex whole in the process of explication. ...' (p.255-6)'

Reading this I immediately thought of Bohm, who followed shortly after (still in Chapter 1!). In chapter 1, 'Chaos' could be read as Cosmos, hence the term rolling them together - chaosmos. This is the tract from which existence and becoming arise (re-reading). Deleuze's awareness of physics and quantum theory and its influence on his work is discussed, with chapter 2 providing continuity reaching to Leibniz (and 'The Calculating God'), also contributing is 'the complete concept', 'principle of sufficient reason', 'intensive individuating factors' and 'principle of identity of indiscernibles', for example. Even while the context is metaphysics (and it is not!), (for me) this seemingly presages a comprehensive health assessment:

'The necessity in question is the necessary inclusion of all predicates pertaining to an individual in the complete concept of that individual.' p.24.

There are several 'completes' to be unwound, and so better understood. Ross provides a key. This isn't a book to read and pass-on to a student, second-hand bookshop. It really deserves re-reading, mandatory here - to get hold of the ideas and interplay of Deleuze, Ross's understanding and it must be said interpretation, that also calls upon Dan Smith's Essays on Deleuze, (EUP) and directly Leibniz's work. 

'The complete concept idea of predication is furnished to map faithfully onto these principles concerning the nature of things.' p.26.

The expanse of thought and literature from across the channel, 'French Theory' has long tempted, teased and taunted (not-quite as severely as mathematics!). At least here you can get a sense of the traffic in thought and ideas. Deleuze is difficult (in-/compossibilities, kuklos exothen ...), until you relate: becoming over being, difference over identity, and creation over representation. Order and the Virtual helps in this task. Delueze is 'embedded' in the mechanics of complexity, and mathematics, but Deleuze and Ross can see - across - to the humanities (virtual and actual). 

'Lastly, while mathematical concepts are frequently adopted to illuminate Deleuze's argument, they should not be taken as metaphorically representative of processes in the world; this would be to ignore the broadside and extended attack on representation as a mode of thinking as such which occupies so much of Difference and Repetition. Rather, they serve as a particularly direct example of the differential processes to which all phenomena - natural, social, psychological are subject. In an unambiguous sense, it is eminently possible for problems prompting a mathematical response to express themselves in altogether different domains - natural, social, etc. The problem is, so to speak, a common root of all domains.' p.39.

Still grappling, I noted integration, actualization, parity of esteem, maths - the linear and non-linear. It seems Deleuze was challenged by the question of integration. Leibniz's contribution of the calculus is acknowledged. History and even the present remain preoccupied with finding boxes. Ross explains how for Deleuze, we should not discount turbulent phenomena that cannot be simply integrated, written off as random disorder.

If we associate complication, with implication and explication, do we invite two-fold (as a minimal - keyhole) 'surgery': (re-)constructive and destructive? Thank you Mr Ross. I see now, how the (infinity →) continuum will not be exhausted. Exploring axioms for Hodges' model, and what is axiomatic, I must check Albert Lautman's model of dynamic structuration, especially when set (against / with?) the problematic mode:

'The two modes relate to each other dialectically - a period of exploration followed by the resulting period of axiomatisation. Deleuze recognises both modes and their respective utility, but for his philosophy the problematic mode is by far the more important.' p.41.

Do our boxes still have a purpose? To tame the situation - at hand/mind/virtual?

More to follow here ...

Bill Ross (2024) Order and the Virtual: The Philosophy and Science of Deleuzian Cosmology. Edinburgh: Edinburgh University Press. 
https://edinburghuniversitypress.com/book-order-and-the-virtual.html

European Character and Virtue Association (ECVA) Conference 2026

Theme: Bridging the Knowledge – Action Gap in Character Development

Re: invitation to the ECVA 2026 conference: reminder ...

Established in 2022, the European Character and Virtue Association offers a forum for promoting research, training and networking in the field of character education. We bring together educational institutions in Europe and scholars from around the world, providing unrivalled opportunities for members to share best practices and shape European policies affecting higher education and research. 

The 2026 conference of ECVA will take place in Trnava University, Slovakia, in cooperation with the Jubilee Centre for Character and Virtues, University of Birmingham, the Private University College of Teacher Education of Christian Churches, and the Virtues and Values Education Center of Francisco de Vitoria University. 

The Executive Board of the European Character and Virtue Association (ECVA) cordially invites you to attend the 2026 ECVA Conference in Trnava, Slovakia. 

• President: Prof. Dr. James Arthur (Harvard University)
• Vice President: Prof. Dr. Verónica (Francisco de Vitoria University Madrid)
• Secretary: Prof. Dr. Tom Harrison (Jubilee Centre for Character and Virtues, University of Birmingham)
• Treasurer: Prof. Dr. Roland Bernhard (University of Teacher Education of Christian Churches Austria)

Conference Information Trnava, Slovakia, 2026, 24th to 26th of June 

We expect more than: 📍100+ researchers 🏫 40+ universities 🌍 20+ countries 🎤 60+ presentations & keynote addresses 

📝 Submit your abstract and find all conference details at the link below:

👉 https://ecva-character.org/ecva-conference-2026

Deadline for Abstract Submission: 31st of January, 2026.

All abstracts will undergo a review process over the course of the following month. Once your proposal has been accepted, you will receive detailed information about registration, conference fee (275,- EUR) processing, accommodation options, and other necessary information.

Notification of Acceptance: 1st of March 2026.

Contributions that demonstrate high quality and close relevance to the main theme of the conference will be accepted for review in preparation for the next scientific monograph produced by the ECVA.

Warm regards,

Dr. Martin Brestovanský
(Trnava University, Slovakia)

on behalf of the ECVA Steering Group

Prof. James Arthur (Harvard University)
Prof. Verónica Fernández (Universidad Francisco de Vitoria, Madrid)
Prof. Tom Harrison (Jubilee Centre for Character and Virtue, University of Birmingham)
Prof. Roland Bernhard (University of Teacher Education of Christian Churches, Vienna)
Prof. Claudia Navarini (Università degli Studi Europea di Roma)
Prof. Ines Weber (Paris Lodron Universität Salzburg)

Conference description 

Bridging the Knowledge – Action Gap in Character Development 

Moral education often assumes that ethical knowledge or cognitive competence alone will result in moral behaviour. Yet lived experience, philosophical reflection, and empirical research consistently show otherwise. A persistent gap exists between what individuals know is right and what they actually do—a phenomenon recognized since antiquity. 

Aristotle observed that “we reason here not to know what virtue is, but to become good” (Nicomachean Ethics, 1103b), highlighting that moral reasoning is directed toward formation, not just information. Immanuel Kant similarly acknowledged that a person may clearly understand moral duty and yet lack the will to act accordingly, pointing to the human struggle between reason and inclination. 

David Hume went further, arguing that “reason is, and ought only to be the slave of the passions,” insisting that moral knowledge without rightly ordered desires lacks the power to move us to action. And Martin Buber wittily adds: “The worst notorious liar in the classroom will write a brilliant treatise on the destructive power of falsehood”. 

This enduring challenge – now referred to as the knowledge–action gap – remains a pressing concern across education, psychology, and the social sciences. Scholars have described related phenomena in various conceptualizations, such as the reason–action gap, attitude–behaviour gap, intention–behaviour gap, or the knowledge–attitudes–practice (KAP) gap. Each term reflects a common concern: knowing what is right does not reliably lead to doing what is right. 

Bridging this divide is a complex task, compounded by the dynamic, deeply personal, and context-sensitive nature of character formation. Educational and behavioural sciences are increasingly turning to integrative approaches that go beyond cognitive instruction. Interventions such as moral sensitization, dramatization, habit training, and reflective practice are being explored to enhance the coherence between values and actions. 

There is growing consensus that this so-called “gappiness problem” cannot be resolved through one-size-fits-all solutions (e.g., moral emotions alone or identity-based interventions). Instead, promising “multi-component” models are emerging that draw on diverse disciplines and methodologies to address the challenge. 

Conference Goals 

By bringing together interdisciplinary perspectives and diverse methodologies, the ECVA 2026 conference aims to deepen our understanding of the knowledge–action gap and to promote innovative, research-informed strategies for strengthening moral coherence and character development in real-world settings. 

We look forward to welcoming those committed to advancing theory-informed practice and practice-informed theory in the service of ethical integrity and flourishing lives.

Previously: 'character' 

Progress? In the age of uncertainty

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	The Age of
	Uncertainty

'Over a relaxed weekend, a distinguished international gathering at John Kenneth Galbraith's Vermont farm offer their views on the themes outlined in the series and on other major anxieties facing the modern world.' 

BBC iPlayer
https://www.bbc.co.uk/iplayer/episode/m002l708/the-age-of-uncertainty-series-1-13-13-weekend-in-vermont

Webinar “From Global to Local: Enhancing the UK Healthcare System with Lessons from CEI in LMICs” 10 February, 3–4PM (GMT)

The NIHR Patient and Public Involvement and Engagement (PPIE) team are pleased to invite you to our fourth webinar in the PPIE/CEI Bidirectional Learning Series “From Global to Local: Enhancing the UK Healthcare System with Lessons from CEI in LMICs”.

Date: 10th February 2026

Time: 3.00–4.00 PM GMT, London UK (Online via zoom)

Join us to explore how Community Engagement and Involvement (CEI) approaches developed in Low and Middle-Income Countries (LMICs) are actively shaping health research and service delivery in the UK. This session will demonstrate how global CEI principles —collaboration, equity, and shared learning - can be translated into local action to build trust and create more responsive healthcare systems.

What you will hear about:

- Global to local CEI strategies: Insights into how CEI strategies from LMICs can be used to strengthen community relationships and healthcare practice in the UK. 
- Driving Innovation through Reciprocity: Discover how a "virtuous circle of learning" between global and local systems enriches inclusion and equity. 
- Translate Insight into Action: Practical examples and expert perspectives on turning global health CEI approaches into practical, equitable healthcare solutions within the NHS.

Speakers include: - Farrah Lunat (Research Operations Manager at Lancashire & South Cumbria NHS Foundation Trust and Joint Lead Author of the NIHR ROSHNI-2 study) - Professor Nusrat Husain (Professor of Psychiatry and Director of Global Health at the University of Manchester and NIHR Senior Investigator) - Dr. Matthew Harris (Clinical Senior Lecturer in Public Health at Imperial College London and Honorary Consultant in Public Health Medicine)

Submit your questions & register via Eventbrite: 

https://www.eventbrite.com/e/from-global-to-local-cei-lessons-from-lmics-enhancing-the-uk-healthsystem-tickets-1976864265233?aff=oddtdtcreator

Sarah Betts

*Programme Manager (PPIE)* | NIHR Coordinating Centre

My source: HIFA