Friday 18 May 2012

A case of mistaken identity?

Posted by Janet Shucksmith

Towards the end of my undergraduate days I was directed to the notoriously duff University Careers Service. With no inclination to follow traditional Cambridge careers – think Burgess, Philby and MacLean spy ring or Cleese, Cook, Fry, Frost showbiz alumni – I told the careers officer that I wanted to make a difference to the world. Lacking information on entry level schemes to Supergirldom, he gave me a leaflet on the UN. Luckily for the world’s population, I grew up shortly thereafter.

Traditional Cambridge career: Footlights, 1981
My grown up understanding is more modest: as public health researchers we should perhaps be content to make small contributions. It is also morally unacceptable to claim more power for one’s work than is sensible when recruiting participants. I remember community education workers telling me how difficult it made life when youngsters naively believed things would change as a consequence of their research contribution – that they would get a dedicated playground with skateboard ramp or a sexual health service. The workers were the ones who had to cope with the let down kids when commissioners shelved our research report in the drawer marked ‘Pie in the Sky’.

Now our participant information letters are tediously correct in pointing out to people that they will get nothing personally from contributing to our research and nothing may change as a consequence. The best we can promise is that they will suffer no harm or detriment to the service they receive. Given this rather depressingly realistic estimate of how unimportant and inglorious research is, it still takes me by surprise that the general public occasionally invests the researcher with power beyond anything I currently dream of.

Lawrence, my PhD researcher, was castigated frequently by the citizenry of Gateshead last year for having singlehandedly introduced the National Child Measurement Programme. Whilst trying to explore the impact of the policy, a number believed him to be the original perpetrator of a rather unpopular regime, and called him to account for not having thought through the impact on children and parents.

Recently, invited to present research evidence to a local health scrutiny committee, my colleague and I spoke about a specific project on the impact of Human Resources leave policies on carers of those at end of life. At the conclusion, a councillor drew herself up to her full height and demanded to know why I had decided to close their local palliative care hospital? What on earth had convinced her that I had the responsibility and power to do any such thing? Me? I’m only a researcher, madam. You mistake me for someone with power and authority.

My worst case of mistaken identity came when we undertook research prior to the implementation of HPV immunisation. Despite ethically approved invitation letters and information sheets, it became evident that many parents thought we had come not to ask their views, but actually deliver the ‘jag’: despite our lack of medical qualifications or kit. We were more alarmed when it became apparent that many parents believed the vaccination was a precautionary small dose of cancer, and delivered straight into the cervix! The very limited permission we had to explore perceptions was construed by some as being sufficient to allow us to lay their children out and perform an intimate intervention. So much for informed consent?

As a researcher, one often feels relatively distant from the intervention that is being evaluated. But Joe Public sometimes has a great deal of difficulty working out our researcher role and distinguishing us from the rest of the cohort of powerful but unnamed and unspecified authorities who ‘do things’ to them.

2 comments:

  1. Great piece with an important underlying message. From an exercise science perspective, there is considerable mistaken identity just from having the "Dr." tag from a PhD. I have often been communicating with research participants about a study or protocol, and they suddenly take their shirts off (or sometimes trousers) to see if I 'can do anything about' their various aches and pains at various body sites. I actually dread flights now just in case there is a medical emergency and I'm called from my seat to save some unfortunate sole's life.

    Greg Atkinson
    HSCI - Teesside

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  2. Thanks for this thought-provoking piece Janet. Reminded me of our experience in evaluating welfare rights advice for older people, which suggests we may be best sticking to interventions that we know do some good. Our researcher benefited greatly (usually in the form of a box of chocolates at each follow up visit) because, in addition to bringing a little sunshine into their lives with her 90 minute social calls (aka interviews), participants held her personally responsible for their £55/week additional income following the intervention!

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