‘Inspiring Stories’ with Gary Hickey
Senior Public Involvement Manager, Wessex Institute
This is part of the Engaged Medicine ‘Inspiring Stories’ blog series. The blogs explore the stories behind outreach and patient-public engagement activities of staff and students from the University of Southampton’s Faculty of Medicine.
Engagement: the key to building trust between the public and ‘experts’
Recent years have seen concerns about sections of the population’s level of trust in ‘experts’ such as scientists. A degree of scepticism can be healthy, and no one wants to go back to the deferential and paternalistic days when challenging professionals was rare and frowned upon. But a degree of trust is important; it is the glue that holds relationships together. We need, for example, the public to trust experts over the safety and effectiveness of vaccinations – otherwise why would they risk taking them? We need the public to have trust that scientists and researchers are undertaking work that is relevant to and beneficial to them – otherwise why would they bother to get involved or participate in research?
I have been working on two projects – one in Southampton and one in the South East region – in which we have sought to engage with ethnic minority communities that have historically been under served by health and social care research. What has struck me is the level of distrust of researchers and the organisations for whom we work, the perception that researchers ‘zoom in and out’ as and when we need something for our relatively short term projects, strong doubts that the work being undertaken is necessarily what the community needs and that what the communities say will make any difference.
However, equally striking has been an appetite for the development of longer term relationships between communities and researchers to build trust. A desire for a move away from the short term, transactional relationships that often characterise the relationships that researchers have with communities. A belief that if we engage, and develop trusting relationships with communities, then this will lead to them helping shape the research agenda, a greater commitment from communities to being involved in and participating in the research, and leading to improved relevance of the research, better outcomes, and ultimately an improved quality of service. Engagement then is crucial.
But what can universities and researchers do? We operate in a world in which we have to demonstrate what it is we do and achieve. And if we can’t demonstrate what it is, we do and achieve then it ceases to be valued. There is then a focus on predefined, measurable outcomes that are an indicator of success or otherwise.
We need to create an environment in which engagement and the development of trusting long term relationships becomes valued in itself. The outcomes, at least in the short term, may not be clear and linear. And we need to look again at what outcomes and outputs should be valued. Academic papers are good … for researchers. But what about the community? We also need to value the personal growth and development that will likely follow for individuals and communities, for example increased confidence and expanded social networks. We also need to value the increased cultural competence that researchers will likely acquire.
We need to acknowledge power differentials that often exist between ourselves and the public and find a way of engaging with people on terms on which they find comfortable rather than what suits us. A university setting can be alien and intimidating for some people. Our world of meetings with formal agendas, minutes and (usually!) carefully prepared papers is not how many people usually interact. We value people being able to express themselves verbally (clearly and within their allocated time slot) within these meetings. This is the world in which we have trained and developed. We know are well versed in our protocols and rituals.
We need to ‘go out’ to communities and meet in settings in which they feel more comfortable. We need to recognise that some people may feel more comfortable expressing themselves in ways other than verbally in meetings, for example through art or storytelling. We need to be more creative in how we engage with people. We need to use language that is accessible – no one can ‘unpack that concept’ quite like us.
But, with the best will in the world, are these changes likely given the environment in which we work, and the demands put upon us? Universities do not operate in a vacuum – we operate in an environment shaped, for example, by the demands of the Research Excellence Framework (the system for assessing the quality of research in UK higher education institutions) and of research funders. If the Research Excellence Framework and research funders place an emphasis on engagement and the development of long term relationships, then we really will see change. That said, it is possible to detect moves toward an emphasis on engagement. For example, we now have the Civic University Network; the notion that universities are connected with the public and have a proactive role to play in education, economy and culture of their community. Southampton University is signed up to developing a Civic University Agreement and doing some great work in this area. And, I strongly suspect (watch this space), that we will see some research funders funding and/or encouraging researchers to engage with and develop longer term relationships with various communities.
Engagement is about to have its ‘moment’.
Stay Connected! To find out more about the ‘Inspiring Stories’ series, Faculty of Medicine educational programmes and research, or to get involved use the links below or contact Dr Lucy Green.
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