Patient and Public Involvement in Research - Passing the town hall meeting test
Dr Adam Gordon is Consultant and Honorary Associate Professor in Medicine of Older People at Nottingham University Hospitals NHS Trust. He also edits this blog.....
Last week I was invited to present some outputs from the Medical Crises in Older People programme to a Comprehensive Local Research Network (CLRN) Meeting in Leicester. It was one of the most mixed audiences I have ever presented to. There were researchers, nurses, care home managers, consultant neurologists and members of the public. Many of the members of the public were older. A couple had hearing impairment. One couldn't see.
I had one hour to present three year's worth of research. Complex research. Nuanced research. Research of which I was very proud.....and suddenly, faced by this audience, I was filled with dread at the prospect of having to do so.
I was nervous because what I had to present included difficult statistics about the health and functional status of care home residents and, more worryingly, qualitative data which described the relationship between primary care, secondary care and care home staff. Presenting this honestly and truthfully, without offending somebody in the room, would have been difficult at the best of times but doing so whilst constantly sense-checking my presentation for lay understanding left me feeling that I would inevitably come up short.
But - to coin a Bushism - it seems I misunderestimated Joe public.
I carefully chose my words, I avoided three letter acronyms and jargon and hoped that I'd take them with me. Half way through, they started to do the most astonishing thing, interrupting me with the most bright and perceptive questions. They made suggestions about what my research really meant. They told me how services ought to change in response to the findings I was presenting. They even suggested new and interesting ideas for research proposals in the future. The talk shifted from feeling like a lecture to feeling like a collaborative research venture, or a town hall meeting, or a bit of both. At the end, when I put up my slide with the research conclusions and suggestions for future projects, it became clear that everything on there had already been suggested from the floor and mostly by members of the public, rather than my research colleagues.
So what did this do for me? It left me with a warm fuzzy feeling on a Thursday afternoon before Easter...which was sort of nice. It also presented me, though, with a powerful test of the face validity of my research conclusions. My research has now passed the town hall meeting test - and to a certain extent that beats the international research symposium test hands down.
Patient and public involvement (PPI) can sometimes feel to a researcher like an exercise in political correctness. It can be seen as a need to "go through the motions". But last week, the Leicester CLRN meeting taught me it can be something much more powerful than that.