Is there a doctor in the house? Lessons from a public engagement event at the Bloomsbury theatre

On Wednesday 23^rd October, Sophie Park and Ruth Abrams, (researchers based within UCL’s Primary Care and Population Health department), in collaboration with the Menagerie Theatre Company opened the doors to Bloomsbury Theatre to introduce, ‘Is there a doctor in the house? A performance and theatre workshop’. This event was a unique theatre experience, following the journey of a patient and carer as they navigated the twists and turns of our healthcare system.

The purpose of our event was to discuss, with healthcare practitioners, patients, students and the general public, the three important issues identified in our evidence synthesis on delegated home visits within primary care. This research was funded by the School for Primary Care Research as part of a bigger collaborative project on evidence synthesis, the evidence synthesis working group. Our findings suggest that (1) whilst patients report short-term satisfaction when visited by an alternative health professional, the impact this has on their health (and long-term outcomes) is less clear; (2) a GP may feel home visit delegation is a risky option unless they have high levels of trust and experience with the wider multidisciplinary team; and (3) the healthcare professional receiving the delegated home visit may benefit from being integrated into general practice. In the longer-term however, these posts may not be sustainable if staff feel their clinical autonomy is limited by the delegation process.

Collaboration

Having seen the success of previous theatre performances and their role in engaging audiences in research dissemination, using the medium of theatre was an organic response from the research team, who felt called to do something different with their research. Using the professional skills of The Menagerie Theatre Company allowed us to conceptualise a way to both perform our research findings and include the audience at the same time. The Menagerie Theatre Company are highly adept at performing academic research, having previously collaborated with THIS Institute for their play, ‘Not Quite Right’. We worked with both THIS Institute and the Menagerie Theatre Company to construct a new scene specifically relating to some of the issues raised in our evidence synthesis.

Performance

Nerves aside, on the night we very much got to sit back and enjoy. The Menagerie Theatre Company made the performance funny, poignant and endlessly clever, dropping in on key moments of the patient journey, highlighting contemporary challenges in the experience, organisation and delivery of primary healthcare, and its interface with secondary healthcare services. 

Following the short performance, audience members were invited to participate in a facilitated, interactive session that involved debate, feedback and the shaping of actors’ re-performance of choices. Audience members halted the performance at various different points as it was re-played by the actors. In doing so they were invited to reconfigure the scene by, for example changing the stage lay-out, suggesting alternative lines for the actors or even joining the actors on stage to re-perform the scene. This allowed us as researcher to see how our research findings may be useful to practice by observing some of the challenges expressed by audience members during the night.

In the last 20 minutes of the evening, audience members were asked to consider the following three questions:

1. How are the current shifts in GP work roles producing positive changes for patients and staff?
2. How are the current shifts in GP work roles producing challenges for patients and staff?
3. What three recommendations would you make to support the future sustainability and effectiveness of patient care in the general practice setting?

These questions helped to guide audience members to think critically about how the evening’s performance related to current practice in primary care. Responses to these questions helped to reinforce the messages conveyed in the forthcoming publication of our research, Towards an understanding of effective delegation of home visiting services in general practice: A realist review. Further information about the release of this paper can be found by contacting Ruth Abrams (r.abrams@ucl.ac.uk).  

Lessons learned

For researchers seeking to disseminate their research using alternative mediums such as theatre, there are a number of points to consider. Our advice is:

• Take time to introduce your research and your research team. This will help guide the audience to the purpose of the event and enable you to stay focused. This introduction can also help to steer your audience to thinking about matters related to your research.
• Provide handouts or brief summaries of your research to act as reminders of the event’s purpose. We provided each audience member with an A5 handout of our research including the main issue, what we did, what we found and its overall relevance to patients and practise.
• Think about what you want to get from the event and use this in a way that encourages audience members to engage with key aspects. For example, our guiding questions above helped us to steer the performance back to our research and conclude the event.
• On a practical note, bring technicians together early and be involved in discussions about microphones, sound and lighting but ultimately leave this to the professionals!