When, what and how to engage and disseminate research evidence during a pandemic?

Posted by Peter van der Graaf, Teesside University, Jenni Lynch, University of Hertfordshire, and Liz Such, University of Sheffield, three NIHR Knowledge Mobilisation Research Fellows

In this blog, we share lessons from working with local authorities on the development of action learning sets (bringing people together to reflect on research evidence) when they are faced with the many challenges of COVID-19.

Why do we need action learning? 

(Best-laid plans)

We know that local authorities value research evidence to improve their decision-making about public services in times of austerity; however, making evidence fit for purpose and getting it actively used in local government remains challenging.

So, we decided to test a potential new approach to knowledge mobilisation by convening and supporting action learning sets (ALS) across three local authorities (Hertfordshire, Gateshead and Doncaster Councils). This was supported by the NIHR Centre for Engagement and Dissemination (NCED), which not only aims to share knowledge and outputs from NIHR-funded research, but to develop the evidence base about “what works” in knowledge mobilisation.

The ALS would bring together a group of approximately 15 stakeholders in each local authority, including public health and social care commissioners, front-line practitioners, third-sector representatives, service users and local academics to reflect on research related to a priority topic of their choice. Using deliberative dialogue, including structured questioning and reflection, participants explored different types of knowledge and relationships between knowledge producers, users and mobilisers. By applying this approach, the ALS aimed to help mobilise research and other forms of knowledge on wellbeing and equity in local government into collectively agreed action plans.

As we started discussions with our local authority partners in Spring 2020, the full implications of the COVID-19 pandemic hit. Despite various attempts to start the ALS we regrettably had to decide to abandon the project in its current form. In this blog, we share our lessons from working with the local authorities on the development of ALS during a pandemic and what this means for future knowledge mobilisation activities from NCED when engaging with public health and social care. Our reflections focus on the when, what and how of knowledge mobilisation with local authorities.

Research capacity during a pandemic: unethical conversations? (When)

What the pandemic taught us is that when public health and social care research is most needed (e.g. to inform the response to COVID-19), capacity for using this research is very limited. With local authority staff being spread thin and reassigned to other parts of their councils, it was not feasible and even borderline unethical to ask them to join and prepare for action learning set (ALS) meetings. In particular senior staff within local government, who are key participants for the ALS, were in some cases absent from our early conversations. A serious question was posed: 

"How could we mobilise research evidence to help local government in their response to COVID-19, when they hadn’t got the time or mind space to even look at a one-page summary brief?"

We tried to make the process more accessible by moving the ALS meetings online, involving smaller groups to optimise interaction (five instead of 15 participants) and shorter sessions, with individual activities and reflection time between sessions. This helped to some extent to engage with local authority partners, but the capacity problem remained and even short online meetings where often not feasible for senior staff. However, it illustrated the value of a blended approach to ALS with a potential combination of online and face-to-face sessions to allow stakeholders to engage differently at various times in the process. We also urged them to consider topics that were immediately relevant to their current situation, e.g. working virtually through the pandemic.

The need for relevant evidence (What)

The Hertfordshire County Council Social Work team chose to reflect on how to interpret the Mental Capacity Act and apply strengths-based approaches when discharging patients from hospitals into the care of local authorities (discharge to assess pathways). Strengths-based approaches are a collaborative process between service users and providers to determine an outcome that draws on the person’s strengths and assets. We found a small number of NIHR funded studies but also identified useful knowledge from other sources, such as a Health Services and Delivery Research (HS&DR) Evidence Synthesis Centre Topic Report, which provided a systematic review of evidence on different strengths-based approaches within adult social work, and guidance documents produced by a law firm.

Knowledge Mobilisers Assemble!

Similarly, Gateshead Council selected the topic of community-based approaches to public health, focusing on how to implement these approaches with staff within the Council across different departments by applying a whole system approach. We were able to identify relevant work through our network of NIHR-funded Knowledge Mobilisation Research Fellows. For example, researchers at the University of Hertfordshire had teamed up with Hertfordshire County Council to set up a whole systems programme team and developed a joint masterclass on the topic that summarised the latest evidence.

This illustrated a need to tap into a wide range of databases that included studies and evidence from sectors beyond health and links to a network of knowledge mobilisers to access ongoing work and publications that were not routinely published on scientific databases. We plan to support this in the development of our own website as Knowledge Mobilisation Research Fellows united in the Knowledge Mobilisation Alliance.

Localising and tailoring of evidence: the value of dialogue (How)

Thirdly, our conversations with partners about the planning of the action learning sets (ALS) demonstrated that local authority staff value conversations with academic researchers about the meaning of research and how-to tailor evidence to their local needs. Evidence is made fit for local commissioning and planning purposes by localising it (relating evidence to local context and needs) and tailoring it (presenting actionable messages). ALS provide a mechanism for this translational activity and a collaborative space for local authority staff to take time out from their busy jobs and reflect on research evidence (and other types of knowledge).

Constructive dialogue was seen as most useful in supporting decision
 making, instead of researchers parachuting in with findings   

Various staff members in local government who we talked to were already research active, engaging with research through conferences and some by undertaking PhD studies themselves. They were already mobilising local intelligence, national data and tacit knowledge in their decision making. Instead of academic researchers parachuting in with their research findings, constructive dialogue about the meaning of different types of knowledge - and where researchers and practitioners worked together as equal partners - was seen as most useful for supporting local government decision making. Facilitated conversations over a series of meetings would enable them to effectively blend different types of knowledge together to inform the commissioning of health and social care services.

Being humble and open to challenge and dialogue are key components of any knowledge mobilisation strategy for engaging with local authorities and dissemination of health research findings.


More commentary on action learning sets and engaging with local authorities in knowledge mobilisation below:

• Escobar O, Faulkner W, Rea HJ. Building capacity for dialogue facilitation in public engagement around research. Journal of Dialogue Studies. 2014;2(1):87-111. http://www.dialoguesociety.org/publications/Journal-of-Dialogue-Studies_Volume-2_Number-1.pdf#page=89

• Pounder T. Using action learning to drive organizational learning and performance. Strategic HR Review. 2009 Apr 17. https://www.emerald.com/insight/content/doi/10.1108/14754390910946530/full/html

• Van der Graaf P, Cheetham M, Redgate S, Clare H, Adamson A. Co-production in local government: process, codification and capacity building of new knowledge in collective reflection spaces. Workshops findings from a UK mixed methods study. Health Research Policy and Systems. 2021 Jan;19(12). https://rdcu.be/cesKm

• Van der Graaf P, Blank L, Holding E, Goyder E. What makes a ‘successful’ collaborative research project between public health practitioners and academics? A mixed-methods review of funding applications submitted to a local intervention evaluation scheme. Health Research Policy and Systems. 2021 Jan;19(1):1-3. https://rdcu.be/cdWGC

Images:

1. "… of Mice And Men …" by Kristian Bjornard via Flickr.com, copyright © 2010: https://www.flickr.com/photos/bjornmeansbear/4294131461 (CC BY-SA 2.0)
2. Pat Loika, CC BY 2.0, via Wikimedia Commons

Things I wish I’d known when I started my PhD… (part 2)

Posted by members of the Population Health Interventions Programme at the MRC Epidemiology Unit

This is Part 2 of our PhD SURVIVAL GUIDE. In Part 1 we found out that doing a PhD (or any research) is challenging but the ‘this might be okay’ stage always comes; continuously comparing your work, and yourself, to others is the thief of joy; and research is a team sport and you're the boss so start channelling your inner Arsène Wenger!

Like most research groups, ours comprises an ever-changing cast of early, mid and senior career researchers. Our training is in a variety of academic disciplines and we all have different short, medium and long term life and career aspirations. While our experiences of public health research are naturally individual, we have noticed some commonalities. We share these here to provide reassurance to those new to the game that whatever they’re feeling is almost certainly ‘normal’. Challenging experiences are often interpreted negatively, particularly when they are first met. We propose that they can often be reassessed and reframed in ways that make them positive parts of a continuous learning and career development journey. Other people might have different experiences, this is ours…

 

Licensed to YouTube by: UMG (on behalf of Walt Disney Records); UNIAO BRASILEIRA DE EDITORAS DE MUSICA - UBEM, ASCAP, AMRA, LatinAutorPerf, Walt Disney Music Company (Publishing), LatinAutor - SonyATV, LatinAutor - UMPG, CMRRA, UMPI, and 15 Music Rights Societies

4. We’re all in this together – don’t take it personally

It is impossible to overstate the importance of not taking feedback personally. Opening a document containing feedback from your supervisor or peers and seeing a page full of colourful tracked changes and comments can sometimes feel like personal criticism. It’s all too easy to see this as a setback but in reality, this is what teamwork looks like. Your supervisor is there to ask the difficult questions, and to stretch you intellectually. All feedback is intended to be helpful, so you can produce a stronger output.

Trust us, your supervisor doesn’t expect perfection. Think they don’t receive similar feedback from their colleagues? Think again. But they’ve learned from experience that falling short of perfection is okay. Few imperfect ideas are that imperfect!

Also, what does perfect look like? There’s rarely a ‘right’ answer to any question, and there are different but equally valid ways to approach most things. Different is not necessarily better. Although you’re bound to immediately presume what you’ve done is ‘wrong’, our advice is to take a breath, remind yourself why you did what you did, and be prepared to defend that. This will be an essential skill for your viva! But remember to respect the time it took for someone to really consider your work, by reciprocating and carefully considering their ideas.

Your supervisor wants to see you succeed because your success is also theirs. Seeing your student flourish is immensely gratifying. It rewards everyone’s intellectual contribution to the work, and validates that seedling of an idea, planted by your supervisor, which has since blossomed under your care. Lastly, don’t forget that as much as you’re learning from them, they’re learning from you, too. You wouldn’t be doing that systematic review if they knew the answer already. 

"Piled Higher and Deeper" by Jorge Cham www.phdcomics.com

5. A PhD is a job, not a way of life

For most of us, reaching the start of a PhD represents lots of hard work and effort. It is tempting to think that means you should pour your life into research, and nothing but research, for three or more years, to do justice to that opportunity.

But your PhD can benefit from some down time. Giving yourself a mental break from research means you can return to work with renewed enthusiasm. Time away can also offer clarity and sometimes inspiration! Setting boundaries between research and the rest of your life can make the entire PhD process more sustainable and ultimately, more enjoyable. It can be easier to work efficiently and effectively in distinct working hours (even if those aren’t 9-5), with the incentive of doing something else that you enjoy at the end of it.

However, intending to take time off work and actually doing it are two very different things. During busy periods, it is easy to prioritise your PhD over other areas of life. It also becomes harder to switch off thoughts like “should I read that extra paper?” or “maybe I should do that analysis?” while you are trying to relax.

There are simple ways you can give yourself a better chance of achieving the elusive ‘work-life’ balance. Scheduling time – and protecting that time – to do a particular hobby, sport or social activity can help. It is much easier to rearrange a “hope to do yoga at some point this week” than a class you have booked at 7pm on Wednesday. Similarly, committing to doing things with other people is a great way to cultivate new friendships with colleagues, enjoy their company, and follow through with a plan. At times of self-doubt, it is also a good reminder that there are many other things you are capable of, and that life isn’t all about the PhD! 

6. Some bad things may happen that are not okay

A healthy PhD experience should be challenging, yes, but if this starts to have a negative impact on your physical or mental health and affects how you would normally function, something could be wrong. There are fantastic resources on the Mind website which are a great starting point to help you be more aware of your feelings. Struggling with mental health is very common in life and you are not alone. Seeking help and support is important though. Don’t be afraid to tell your supervisor if you’re struggling.

Sometimes though, the cause of these struggles can be external, and in particular, your relationships with supervisors. Supervisors are responsible for challenging you but also encouraging and supporting you. If there is a problem with your relationship, it is always wise to talk to your supervisor if you can, as they may not realise there is a problem. People are not always immediately compatible in their working styles; this is okay and can be worked through.

If a dysfunctional relationship is caused by a supervisor who is behaving inappropriately, this is not okay. Harassment or bullying of any kind should be escalated through the proper channels in your university. Speak to fellow students you trust candidly about your experiences too; you may not be the only one suffering and they could help support you through it.

The student always becomes the master

7. Enjoy every step of the journey

The good things that come from doing a PhD are not necessarily what you might expect. For some, the highest high is indeed right at the end, the crescendo, when the thesis is submitted. But for many this can feel like an anti-climax. The more you can learn to embrace and enjoy the process, and the less you anticipate what you think will be the good things, the more good things will come your way. A breakthrough with your data collection, your first set of meaningful results, mastering a new skill, or even just a meeting with your supervisor that goes particularly well, are all cause for celebration. Each milestone is a block that forms the foundation of your PhD and each one is a vital move towards your end goal. There is nothing more rewarding than the sense you are on the right track.

As you progress, you will also start noticing that people begin treating you like the expert you are becoming. You might not feel like it, but the student always becomes the master. As strange as these moments feel, you should enjoy them. They are an external reminder that you know more than you think you do. 

Occasionally you will sit back and realise, "I'm doing a PhD! And that’s pretty cool". Stop thinking that you need to have all the answers, or even that you know where your research is going, and instead realise you are there to learn and there to explore, wherever that takes you.

That’s it!

We hope that these points have been helpful, and that you are able to look back at these blog posts when it feels like everything is going wrong. Trust us, it most probably isn’t. We have all been where you are and have lived to tell the tale. Most of us would love to be in the position you are right now again, even just to spend time reading those papers that we still can’t get around to. Try your best to enjoy this incredible experience. You’ve got this!

Authors: Catrin Penn-Jones, David Ogilvie, David Pell, Dolly Theis, Emma Lawlor, Hannah Forde, Jean Adams, Jenna Panter, John Rahilly, Kate Ellis, Martin White, Matt Keeble, Nina Rogers, Rich Patterson, Roxanne Armstrong-Moore, Tom Burgoine, Yuru Huang.

Video: 

Song: We're All In This Together (From "High School Musical"/Soundtrack Version)

Artist: High School Musical Cast

Writers: Robbie Nevil, Matthew Gerrard

Licensed to YouTube by: UMG (on behalf of Walt Disney Records); UNIAO BRASILEIRA DE EDITORAS DE MUSICA - UBEM, ASCAP, AMRA, LatinAutorPerf, Walt Disney Music Company (Publishing), LatinAutor - SonyATV, LatinAutor - UMPG, CMRRA, UMPI, and 15 Music Rights Societies

Images:

1. "Piled Higher and Deeper" by Jorge Cham www.phdcomics.com

2. Courtesy of Henry_RS via Pixabay: https://pixabay.com/photos/darth-vader-luke-lego-star-wars-4344381

Things I wish I’d known when I started my PhD… (part 1)

Posted by members of the Population Health Interventions Programme at the MRC Epidemiology Unit

“By three methods we might learn wisdom: first by reflection, which is noblest; second by imitation, which is easiest; third by experience, which is the bitterest.” 

Confucius

Like most research groups, ours comprises an ever-changing cast of early, mid and senior career researchers. Our training is in a variety of academic disciplines and we all have different short, medium and long term life and career aspirations. While our experiences of public health research are naturally individual, we have noticed some commonalities. We share these here to provide reassurance to those new to the game that whatever they’re feeling is almost certainly ‘normal’. Challenging experiences are often interpreted negatively, particularly when they are first met. We propose that they can often be reassessed and reframed in ways that make them positive parts of a continuous learning and career development journey. Other people might have different experiences, this is ours…

1. Research is challenging but you’ve got this

"Piled Higher and Deeper" by Jorge Cham www.phdcomics.com

Research is certainly challenging. One of the first hurdles of the PhD will be trying to figure out how your research will contribute new knowledge to the area - this is one of the toughest challenges! Stick with it, because thankfully it does get a bit easier over time as you immerse yourself in the research and build your specialist knowledge. But even the most accomplished still find research hard. All the papers you read are from months (often years) of thinking, hard work, and negotiating multiple barriers - it doesn’t happen overnight. As a PhD student, you have the additional challenge of trying to do this in a short time frame, and it doesn’t always go to plan (which is usually out of your control). But, if good research was easy, anyone could do it.

An obvious interpretation of experiencing something as being difficult is to think that we, as individuals, are not up to it. The cycle of creativity suggests, rather glibly, that all projects are associated with a thought cycle that goes something like: this is awesome, this is difficult, this is terrible, I am terrible, this might be okay, this is awesome. We are not sure that we routinely experience the second ‘this is awesome’ stage. But push through because the ‘this might be okay’ stage always comes.

If you have been selected to pursue the PhD, your supervisors think that you are capable. You wouldn’t be on this journey if there were any real doubts about your ability. Encountering difficulties and making mistakes is normal and expected. Even those researchers you admire the most have moments of self-doubt, numerous journal and grant rejections and bad days when nothing goes right.

2. Comparison can be the thief of joy

Academic research is often experienced as highly competitive. In many ways it is. There is competition for limited research, studentship and fellowship funding; limited space in ‘prestigious’ journals; and limited podium time at conferences. This leads to the tendency to continuously compare your own work, and yourself, to others - and to experience a feeling of falling short.

It’s worth pointing out the selection bias present in the successes others share, and how most of the time we’re not seeing the full picture. Despite knowing this, we understand it is sometimes hard to see everyone else seemingly thriving, while you feel you’re just about surviving! Keep in mind that everyone’s PhD is different, and our successes will run to different timelines. And remember, you bring to your PhD your own unique skills and experiences. We’re confident that others are comparing themselves to you, too…

However, rather than continuously comparing yourself to others, we recommend trying to learn from them. If others appear to be succeeding where we are not, what, if anything, can we learn from their approach? Sometimes this will lead to the conclusion that there are better ways of doing things. Other times it might lead to the conclusion that the sacrifices required to achieve a particular outcome are not something we as individuals are willing to make. Or, indeed, that the outcome is not something we want.

We suggest being clear about what our own success criteria are and trying to stick to judging ourselves by those alone. These criteria can be set alone or with others in the context of formal or informal regular appraisals and personal review. At the risk of getting too SMART*-arsed, they should, at a minimum, be realistic.

Rather than interpreting others’ achievements as indicators of our own lack of success, we propose embracing and celebrating them. Informal and formal research group meetings achieve many things, but we see the sense of community that they build amongst ourselves as one of the most important. By embracing each other’s achievements we can support and build each other up, rather than letting comparison get us down.

 

Channel your inner Arsène - "Le Professeur"

3. Research is a team sport and you’re the boss

Completing a PhD might be seen as a lonely, individual pursuit. But while the end result is your own, you aren’t alone on the journey. In fact, research is a team sport.

Your home team is the one you share with your supervisor(s), and you’ll revel in the highs (and lows) of your PhD experience together. In this team you’re the captain. Lead from the front and manage your supervisors by communicating clearly with them, arranging supervision meetings and keeping them up to speed with your progress. As the captain, you make the final decisions related to your research and you are responsible for defending them. If you don’t agree with your supervisor then you should say so, and explain why. Your supervisor doesn’t want you to nod along, as the idea is to learn from each other and make better research (i.e. win) as a team. This can often feel really hard, especially early on while they’re still the experts, but they expect you to take the lead.

In other teams to which you’ll belong, you might play a different role but still make an impact. For example, you might run a writing group, attend group meetings or present in a seminar series; these are all important aspects of teamwork and becoming a valued member of the research community. You are also a member of teams that are less obvious. You probably aren’t sure now how the Facilities or IT department are going to help you achieve your PhD, but when you need a new chair or an obscure software package installed, be glad that you have them as teammates.

In part 2 next week: learning how not to take things personally, life isn't all about the PhD, bad things may happen that are not okay, and enjoying every step of the journey.

Authors: Catrin Penn-Jones, David Ogilvie, David Pell, Dolly Theis, Emma Lawlor, Hannah Forde, Jean Adams, Jenna Panter, John Rahilly, Kate Ellis, Martin White, Matt Keeble, Nina Rogers, Rich Patterson, Roxanne Armstrong-Moore, Tom Burgoine, Yuru Huang

*SMART Goals: Specific, Measurable, Assignable, Realistic, and Time-related

Images:

1. "Piled Higher and Deeper" by Jorge Cham www.phdcomics.com

2. Mr. Alexander Ottesen, CC BY-SA 2.5 <https://creativecommons.org/licenses/by-sa/2.5>, via Wikimedia Commons