Category: Methodology

Book Review: How to Take Smart Notes

This review relates to the book ‘How to Take Smart Notes’ by Sonke Ahrens. It is available on Amazon here and you can also download the first chapter, free, here and learn more about the book.

Introduction

‘Imagine if we went through life learning only what we planned to learn or being explicitly taught. I doubt we would have even learned to speak. Each added a bit of information, filtered only by our interest, is a contribution to our future understanding, thinking and writing. And best ideas are usually the ones we haven’t anticipated anyway.

Ahrens

I can’t remember how I first fell across this book. No, actually I do. I was recommended Roam Research (I’ll come back to that in another post) on Twitter when I was asking for advice about note taking apps and then through trying to learn about Roam and how to best use it, I came across discussion of the Zettlekasten technique of note-taking. This book is an explanation of the Zettlekasten technique. That’s the name of the ‘one simple technique’ which is referred to on the front cover, that will ‘boost writing, learning and thinking – for students, academics and non-fiction writers’. And being of a curious mind, I bought the book.

Context

‘Studying does not prepare students for independent research, it is independent research’

‘Zettlekasten‘ is a note-taking technique devised by Niklaus Luhmann, a well -known sociologist in Germany who wrote vast numbers of papers. He used this method of note taking and storing and it has been debated ever since. This book explains the system that Luhmann used and refines some of the discussion around in as times have changed and notes are more likely to be digitised now.

The book doesn’t just describe a system though, it seeks to provide an understanding of what note taking is used for and how and particularly to challenge those who might (and I include myself here), underline vaguely interesting paragraphs while I was reading something and rarely return to it.

The idea of the Zettlekasten is that notes would all be linked to each other by topic so you create notes from everything you read/watch/discuss/learn around topics and draw links together in themes which you might not have seen, if you create ‘book’ or ‘lecture’ notes in a traditional way.

By not restricting notes to the book or the paper you are making notes about and linking by ideas, you might fall across links that the authors haven’t and find your own topics or see things you didn’t know you didn’t know, that you want to follow up.

Summary

The initial premise of the book is interesting to start with. It is that the skill of good note-taking has been left out of many study skills books. When we might have books about how to write essays or dissertations and how to think critically, there is little literature available and far less teaching, about how to take good notes. While, considering this, it is important to understand that writing and taking notes isn’t the ‘end-game’ for a writer (and we are all writers). But taking and storing notes well, means you don’t need to rely on memory, or scraps of post-its or chronological notes that don’t make sense in context so you can’t remember what it is you were trying to remember anyway.

In order to think, the premise goes, you need to write. That writing usually starts with notes. There are some simple guides the author ‘teaches’, which is about always having a pen or something to write with (it might be a smartphone app or a notebook) especially when you are reading.

You make three types of notes with this ‘system’. There are the fleeting notes, which are these notes you might make as you write. These are notes about initial thoughts and feelings and responses. You ‘decant’ these notes to your ‘literature notes’ which are the notes which are about particular texts or pieces that you might watch or listen to. The literature notes shouldn’t be verbatim, nor should they contain any quotations. They are about your recollection of the text and how you interpret it through writing about it.

Then from the literature notes, you develop permanent notes. This is where the ‘Zettlekasten’ sits, the repository of themes and ideas that have developed from the literature you read. You link these together as you understand them and it helps you to build connections or locate gaps more easily. Permanent notes should be notes you return to. They are the ‘memory’ you don’t need to retain, because, the idea is, you will come back to the permanent notes and have those connections and references all in place which will make writing about them, more useful.

Ahrens is very much focussed on moving away from too much planning when you are approaching texts and research and to find where you are going, by doing. Perhaps I’m not explaining it as clearly as he does but when I read it, it made a lot of sense.

“A truly wise person is not someone who knows everything but someone who is able to make sense of things by drawing from an extended resource of interpretation schemes’

Ahrens p119

Reflections

There were parts of this book that made a lot of sense to me, and made me cheer as if a curtain was being removed in my mind. Yes, I thought, why DIDN’T I think about being more flexible about note-taking, about adding my thoughts and commentary alongside the key ideas. Do I write too many notes that I will never return to? And particularly, summarising books or articles as I read them, in my own words so I will be able to come back to them. I also enjoy making links between articles and I use Roam to do that.

I am not sure I’m a purist though. My ‘permanent notes’ are as refined as I think they are ‘supposed’ to be, but the book has given me ways to think about note taking and using notes that I think will be useful. I see it as giving me tools and ideas, some of which I will use and some I will not.

Use in Practice

This book has changed some of my practices regarding making and considering notes as I have mentioned above. I’ve created ways of storing and taking notes which have adjusted on the basis of the writings even if there are parts I have discharged. I love making links between what I am reading and thinking though.

For example, this is my note about the book on Roam – you can see the blue links which take me to other pages – each hashtag is also a link and this is how my ideas are pulled together.

And some of the links I have made between these ideas look like this

In a work context, I have started using OneNote through Microsoft 365 for which I have a work account, to make ongoing daily notes as things happen and then link them to other things which are going on at work but also ideas I have as they pop up.

Conclusion

I have been really inspired by this book and even though I’m not following the Zettlekasten method religiously, it has helped me to understand how to gain a different perspective on studying and note-taking. Studying isn’t a means to an end, but can be an end in itself. The good thing about this book is that while it will ‘click’ with some people and won’t with others, the first chapter is available free (see link at the top of the page) and that will be more than enough to make a decision as to whether it’s a book you want to buy or not.

Paper review: Health and social care practitioners experiences of assessing mental capacity in a community learning disability team

This paper, authored by Daniel Ratcliff and Melanie Chapman, was published in the British Journal of Learning Disabilities 2016 Vol 44 (4) p329-336

Introduction

This is an article which is very much located outside the ‘social work research’ space although it is occupied with a topic which is very much in our areas of interest, indeed, my own research is focussed on the Mental Capacity Act and ways of assessing it so there may be a tilt towards articles in this area. And this one has been enormously useful.

The premise of the paper is to look at the experiences of different professionals when undertaking the assessment task. It’s interesting to note that the study was undertaken by one practitioner (Ratcliff) and one academic (Chapman) working together. This adds another layer of interest to the paper and its analysis.

Methodology

The study was very much located within the qualitative space, exploring the experiences of eight professionals, from health and social care backgrounds, using semi-structured interviews which were then analysed using thematic network analysis.

All those interviewed worked within a community learning disability team and had done for at least seven years. In terms of professional breakdown, there were three nurses, a physiotherapist, a speech and language therapist and two social workers. All of the team members worked in the same team and had received the same in-house training.

The data, which was the transcribed interviews, was analysed using thematic network analysis. Thematic analysis looks at identifying common themes which emerge from the data and the researchers focussed on networks within the data which linked to the themes identified.

Context

The paper starts with a brief literature review relating to the current situation regarding the use of the Mental Capacity Act (2005) in England and Wales. It identifies, from previous research, that there are known variations in the quality of work around use of the MCA in practice including gaps in knowledge and lack of confidence in implementation of knowledge and that despite training, this had not, seemingly, led to improved practice.

The Mental Capacity Act (2005) while being generally acknowledged as a positive move in legislation relating to those whose capacity to make specific decisions may be doubted, has led to continuing conversations, over 10 years after implementation (which was in 2007) about the lack of embeddiness in health and social care services. The Act is used in all areas of health and social care practice (apart from under 16s) but it has been particularly used relating to adults with cognitive impairments, whether permanent or temporary. In terms of social work practice, this is most commonly identified in work with adults with learning disabilities and work with older adults where deteriorating cognitive functioning may be identified, for example, with some dementias.

Key learning points

The study identified five significant themes which emerged from the thematic analysis of the interviews.

  • Systematic barriers to assessment
  • Capacity assessment as a challenging process
  • Person-specific challenges
  • Protective practices
  • Protection of a fundamental human right

Basically, there were organisational and structural issues in place which might impede quality assessments. This could be about the workload pressure of staff or the ethical tensions between organisational need and outcome of specific assessments, particularly noted around attitudes towards risk

…there was service level pressure to ensure that risks of harm to individuals were limited as far as possible, thereby conflicting with the practice of positive risk taking and allowing capacitious individuals to make unwise decisions.

p332

There was also an expression that a ‘capacity assessment’ could take time and effort to ensure it was carried out in the best way, particularly with involvement of carers. While the legislation explicitly encourages family involvement it can be more challenging when there are differences around the decisions made.

Practitioners raised the challenge of difficult decisions where it was not a straightforward outcome but where there might be a different interpretation, for example, relating to specific decisions.

Participants noted that joint decision-making was helpful and support from other colleagues in thinking through the processes. They also said more specific guidance could be helpful.

There was a general positive response to the impact the MCA had made on practice. It had put into legislation, some of the importance of emphasising the individual and their human rights. There was a feeling it had improved practice and the rights of people who used the services they provided.

The researchers identified a ‘global theme’ which enveloped the data collected as ‘freedom to act versus restrictions on action’. Without understanding more about the coding process, I relate this back to the initial title, which summarises the experiences of those using the MCA in this setting.

Reflections and gaps

The study is acknowledged to be a small-scale study which has taken place within one team where professionals have worked with the same organisation and often with the same people (they have all been in the team for a minimum of seven years). This means there may be a further risk of extrapolating from this data where practises and the culture of the team and organisation may have embedded and reflected on the responses.

Language, attitudes and values can be shaped by the organisation as well as the individual attitude. The study does not reflect (possibly because it is not different and the same size was so small they could be identified) if the professional background of the interviewee was a factor in reflecting the differences.

It is useful to see practitioners directly involved in research, particularly noting the interviews were carried out by the practitioner. It would have been useful, although this might be for a longer piece, to know if he had links to the team in which the research was taking place. It makes no difference to the outcomes, but it an interesting context in which to place the research.

Use in practice

It is good to see an example of research of practice taking place involving a practitioner and academic working together, particularly as the issue is one that can have an impact on the way teams work.

There were a number of issues identified in the study that I can take with me to practice. One is about the usefulness of support. Often this can be looking at supervision and training but the key that this piece draws out is those informal conversations with colleagues, highlighting a need which emerges from the paper, for a consideration of peer groups among professionals. Personally, I’m wondering if there is a scope for multidisciplinary peer groups which a focus on learning from each others’ practice and reflecting on potential improvements in practice together, in my work setting.

Training is necessary for legal literacy but use of training can vary. It is worth considering how understanding and knowledge can be on a continuous basis rather than a snapshot in time. I come back to the peer support groups and wonder whether this is an aspect that can improve.

The paper talks about the need for organisational changes to ensure that there is sufficient time to ensure that work can happen in the best environment. This could be written about any aspect of health and social care and isn’t something we can often change as individuals. There is an aspect about usefulness of templates and examples which might be able to be shared to make the decision-making better informed. Perhaps sharing some model anonymised good practice examples which are referenced with up to date case law and research. Sometimes the time spent searching for new information can be saved if it is well-disseminated.

Conclusion

This is a useful study and a useful paper in all. As someone who has developed an interest both in how the MCA is used and understanding different research methodologies, it has been an interesting piece. The research is clearly explained and the gaps identified.

I think while the literature review is well-presented, the sample size is small but produces some useful content which reflects some of the previous research in the field. The commentary around the piece including the themes identified, in some ways seems more useful than the specific data. It is very useful to see practice-focussed research. I’d like to see more about any differences between professionals and how that links to attitudes to the legislation as well as the experiences of people who have differing levels of post-qualification experience.

Saying that, the paper is useful, particularly as the researchers identify explicitly, the potential use in practice. It does leave us begging a lot of questions for more research in this area though.

Paper Review: An Australian perspective on Community Treatment Orders

A review of  ‘Using Social Work Theory and Values to Investigate the Implementation of Community Treatment Orders, Australian Social Work, 66:1, 72-85, DOI: 10.1080/0312407X.2011.651727‘ Lisa Brophy and Fiona McDermott 2013

Introduction

By looking at this paper, I am reviewing some of the content to make it more accessible and combining a summary of what I find to be the key points, with my own understanding and interpretation. I am no expert and I am no academic. I am interested and with that proviso, I will continue.

I came across this paper as I was looking at the way that ethics and values reflect on social work decision-making and while my focus is more on decisions made about best interests and mental capacity, there is a clear line in comparison with studies completed in other areas, particularly the use of compulsion in social work and how we, as practitioners respond to it. I found the explanation of the methodology and the theoretical approach clear and helpful in my own thinking on two levels.

I’m interested in research design and comparing the robustness of the evidence gathered and different approaches taken, and secondly, when looking at how I integrate theory, both social work theory and broader social research theories into both my own practice and my research work, the most useful learning is reading papers where it has been done and other doctorate level theses available through EThOS (British Library free repositary of over 500,000 theses – and worth checking).

Background to the study

This is a paper written for Australian Social Work. It is looking at the use of community treatment orders specifically in the state of Victoria, Australia. It seems that CTOs have a longer history than their use in the UK and at the time of writing, the authors claim that there are around 5000 current CTOs. The paper looks at how compulsion links with social work values and practice particularly around theoretical perspectives. It is useful as it links the use of theory to practice in a setting where compulsion is used and reflects the tensions in the social worker’s role. It was definitely something that spoke to me, not just in terms of the research, which is useful for my own work in this area, but more interestingly, perhaps, for me when I go to work on Monday to consider with people I work with who do not choose to work with me and, indeed, are compelled to do so.

Methodology

Looking at the methodology, it is a mixed methods study. This means that there are both qualitative and quantitative aspects to the study. I tend to enjoy reading the methodology parts of papers. To me, it is what distinguishes research from opinion and most of the papers I read are pure qualitative studies, not by design, but because I am trying to learn more about qualitative research so approach this by reading more papers where these approaches have been taken.

This project started with a broad-ranging cluster analysis of 164 people who were on the community treatment orders used in Victoria, Australia. Cluster analysis is a specific quantitative methodological approach to using statistics to establish common ‘clusters’ of data, in this case, types of people who would be subject to community treatment orders. The specific methodology may be related to creating clustering algorithms and assigning different features so that the types or clusters emerge from the data. With some biographical and socioeconomic factors being allowed to emerge from the data, this allowed researchers to use the emerging key ‘clusters’ to identify a smaller group of people, reflecting some of the key ‘clusters’ identified, to be interviewed in more detail using semi-structured interviews. This was followed up with additional interviews of family or carers, case managers (presumably, although this is not explicit, who would be for the most part, social workers) and doctors involved.

There were then follow up interviews conducted after 6-12 months with people involved around the use of CTOs including those subject to them, professionals involved in working with them and family or carers. Additional interviews were undertaken with those involved in tribunal (or equivalent) hearings, senior managers and those involved in policy.

This is a brief summary so does not include all the complexities but it does reflect the thought process behind the choices of methodologies involved and reflects back how social work theories have led to each of these steps, including the involvement of people who are subject to these orders being at the heart of the process of researching about them.

Outcomes

The paper identified ‘significant clusters’ relating to being ‘connected’, ‘young males’, ‘chaotic’. The research team used these differing clusters to recruit for the interview stages of the research study.

The researchers, linking back to previous studies which had looked at the use of CTOs, identified five principles which could improve practice based on the interviews. While, they identified that these principles reflected some of the guidance currently in use in practice, the difference that the research was able to tap into was to highlight diversity within the groups of people subject to CTOs. I think these principles are valuable to reflect on and while this research is about a specific intervention in Victoria, Australia. It isn’t an enormous leap to see how they may reflect some potential to improve practice in areas where compulsion is used by and with social workers.

The following are identified on p78 of the paper:

  • Use and develop direct practice skills
  • Take a human rights perspective
  • Focus on goals and desired outcomes
  • Aim for quality of service delivery
  • Enhance and enable the role of key stakeholders

Theoretical perspective

The paper establishes it’s focus on the framework of critical theory, which allows a discussion about the role of power in social work and particularly in areas of social work where compulsion is used. This is also carried through to understanding the role of power within research. The authors have acknowledged this and reference their awareness of the principles of emancipatory research by ensuring that those who are subject to CTOs have been central to the research design. One of the principles the authors reflect, is that of empowerment and by giving people a voice through research carried out about them, it is enabling change to be made.

Additional reflections and gaps

I think of this research both in connection to my own studies and my own work. The first thing that jumped to my mind is that the need to have an international perspective when it is relevant but to be aware of the differences as well. This study is very much about one system of compulsion within mental health with adults. I don’t know the age range or diagnosis types of those who were interviewed and didn’t need to for the scope of the study. One thing that struck me, which may, very well reflect differently to a social worker based in London, is the analysis of race. This is not as a criticism of this study but one which might have different focus in different settings. Critical theory looks at the differing, sometimes competing and often co-existing ‘labels’ determined by studies and organisations to typify people who receive different types of input and I am particularly interested in where internal biases from professionals might impact outcomes.

Learning for practice

The key learning that I have taken from this study is an understanding of how we work within paternalistic frameworks of compulsion as social workers and I found some of the discussion around theoretical approaches and particularly the use of critical theory, to be most useful in both identifying this tension and acknowledging some of the hypocrisy between values which say they promote empowerment but work within frameworks which can be the most oppressive. The authors acknowledge this tension in trying to pull out ‘best practice’ guidance using the input of those subject to these interventions, while also acknowledging the purpose of the study was not to challenge the existence of CTOs and frameworks of compulsion, but that doesn’t mean we can’t and shouldn’t, indeed, we should, continue to constantly challenge the way we work with compulsion in mental health care and look at other options.

Regarding the specific good practice identified, as listed above, some are about organisational needs, such as ensuring that social workers have specific training and space to reflect on the use of compulsion in practice, rather than just being expected to ‘pick it up on the job’. As social workers in the UK, if we are trained as AMHPs, there will be a focus on this as part of the training, but that doesn’t mean there isn’t room for more learning as this training is not necessary to work with people who are compelled to work with social workers. And it is not enough in itself to give people training at key points and then leave them too it. This is the way one can become overly familiar with compulsion as a tool and desensitised to it. We need to guard against this which can be done through supervision and reflection.

An interesting aspect of the human rights perspective, was identified as well – which recommended ensuring people who are under compulsion are aware of their rights and why the limitations to liberty have been imposed. The study refers to procedural fairness and thoughtful decision-making being a key factor. This phrase is something we can always work harder on.

Involving other stakeholders, and in my role, I am thinking particularly of family members, friends, carers, is something that I can always do better. It is true that sometimes the conversations are not easy and there are issues of confidentiality around information sharing but support can be offered and must be in order to work best for people. There are other stakeholders in the form of commissioners, regulators etc but for my own work ‘on the ground’ the involvement of those people around the person I am working with is the key learning.

Finally, the importance of being able to deliver a quality service when people are compelled to have treatment is something that I might not be able to change individually, but it is key factor and it certainly reflected my concerns as an AMHP when I was practising as one (I am no longer warranted). If we compel someone to a hospital admission but the hospital care is poor, we can be complicit in harm rather than help. It is difficult to justify compelling someone to treatment when the treatment is of a poor quality. This is something we must always challenge and complacency can be easy.

Conclusion

I am no academic, but sometimes finding papers which can speak to me in practice can provide a real motivation to the value of research and the importance of being aware of what research is and has happened around the world that can lead to better outcomes tomorrow. What’s more, we can tell our managers that we can link our need for additional training (for example) to evidence.

I’m not pretending my analytical skills are on a par with any academic, they aren’t. But by trying to portray what I can take from this paper, I am hoping that it will encourage others to read more where the papers are accessible, at least, and learn about the profession and how it has and will continue to grow.

I’m absolutely sure as I’ve read through this paper, there are key points I’ve missed, misunderstandings and poor analysis. I am not setting myself up as a font of knowledge but rather, in my ramblings, hoping to take an opportunity for others to try to learn with me but the original research is always the best place to start, rather than any commentary I might be able to ramble through.

Finding research questions

When I started along this journey, I had a topic which I wanted to cover. I had some ideas about the direction I thought my research would take me. I didn’t have a particularly well-developed ‘research question’. As I’ve read more over the last year or so, it has been relating a lot to the importance of a robust research question and that the research question itself needs to be at the core of the topic but also focus on what the purpose of the research is.

At the end of the last academic year, I was pretty happy with the way my research questions looked. I’d been tinkering with them for a while. Then I read a few more books about the process of research (I’ll post some reviews of the books I’ve been reading at some point) and reflected on how the topic I was focusing on had changed through political developments (Mental Capacity amendments going through Parliament at the moment and the discussions around that) and realised that maybe the questions didn’t do quite what I wanted them to do in the way I wanted them to.

I have tweaked them pretty much on a weekly basis since then. I started with some exercises suggested in some of the books I read and worked on some ‘brain storming’ processes where I wrote down (or typed because I actually did this on OneNote – so I could go back and ‘remember’ my workings in the weeks/months/years to come).

Sometimes I tweeted my random thoughts as well – when I was considering how to approach the topic and refine the detail. One of the books I read suggested as an exercise to ‘encapsulate’ the core of the research in a ‘tweet’ of 140 characters (pre-twitter changes!). I tried that along the way – even thought the exercise wasn’t meant to be an actual tweet – rather getting to the core of the issue you want to explore in a few characters. The responses I got from the tweet led me thinking along different lines.

While I’ve never been one for mind maps, or at least, I didn’t think I was, I transferred my brainstorming into a mind map. The mind map grew and actually being able to visualise where the branches and connections were, really helped me make sense of what I knew, what I wanted to know and how to try and make connections between them.

Mind maps and doodles and notes can be very personal. I mention it because it was something I hadn’t really used more than superficially but making sure I ended up with more than a bundle of random scribbles was important to me as I needed to be able to refer back to all the dead-ends and the paths which I decided not to go down. I should mention as well, as context, that at this point, I had done a lot of reading around the topic areas and reading recent research to check for ‘gaps’ so it wasn’t entirely taking a stab in the dark.

The mind map has become a central document now to my approach to this piece of work. I have refined questions and am still tweaking. I expect more tweaking constantly, but I like to know I have a starting point – even if that starting point can change.

So while I’m pretty sure that I still haven’t ‘found’ my research question/s as they will look in a year, or two years or three years time – I’m relatively happy with the work in progress that I have and by reading about the importance of robust research questions in research design, which is very much the point at which I am focusing now, I am happy to work with that.

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