Authentic PPIE – the (re)search for authentic engagement

Image: https://www.reddit.com/r/DnD/comments/78i8k7/oc_hey_i_made_a_dnd_class_logo_wallpaper/

When I drive to work in the mornings I like to listen to a podcast. There are a variety I pick from, but they’ll tend to be related to my work, or things around wellbeing and emotional health. I see it as CDP (continuous professional development) time – extra time when I can learn something or get new insights into the areas I’m interested in. By the time I come home I’m usually very tired, so we’re back to music at that point, but in the morning I’m awake, so I make the most of it!

(What podcasts do you listen to? Drop me a line at authenticppie@gmail.com , as I’d love to know!)

This morning I was listening to an episode of Listen to THIS from The Healthcare Improvement Studies Institute. It was an episode exploring co-production and engagement with service users and you can listen to it here.

One of the guests, Oli Williams was talking about ‘phase zero’. He described this as the period of time before the grant has been awarded and which the grant funding doesn’t usually cover, but which is crucial to relationship building and planning for the project. I’ve mentioned this before when I’ve said that ‘the talking is the work’ but crucially, there is rarely any funding for this planning period. You can apply to the Research Support Service for a small pot of PPIE funding, but that’s £300 – sufficient to pay 6 people for a one hour meeting – not quite the sustainable relationship building we’re aspiring to*.

Oli’s comment about ‘phase zero’ resonated with me, and the topic of the need for sustainable relationship building came up several times at the Wessex Health Partners Research Showcase today. The showcase was specifically about research into the health of Women and Girls and ranged from the impact of menstrual health, to cancer, bra science and pelvic floor dysfunction. It was an excellent collection of projects focussed on practical ways to improve women’s health.

But back to the podcast: Oli’s comment about ‘phase zero’ reminded me that within DnD** (Dungeons and Dragons) games, there is a ‘session zero’. This is a crucial session before the actual game/campaign begins, when the players will meet with the Game Master/Dungeon Master and agree together what kind of game they’d like to play (lots of fighting; more puzzles please; character building opportunities; shopping episodes!)

Importantly, the group also shares about their ‘lines and veils‘. These are things which people may feel uncomfortable about and would prefer not to feature in the game. In my case, I don’t really like gratuitous violence or gore and I definitely don’t want any incidence of violence against women and girls. These are my preferences and other players may have different veils and lines. (It’s worth saying here that some women may not be bothered by violence against female characters, and see it instead as an opportunity to take agency in the story against an aggressor. Everyone’s different, so it’s important not to assume – always ask!)

Now, what if we were to swap the Games Master for Senior Researcher or Chief Investigator…and what if the players were public contributors and members of the study team? In this context, Session Zero would be the part at the very beginning of the project, where everyone involved shared their hopes and aspriations for the study as well as discussing anything they might be worried or concerned about. It would also provide the opportunity for people to agree their ‘lines and veils’ – things they might prefer not to discuss, or boundaries they want to set. This could be around topics such such as trauma or grief but could also be things like: “I’m giving you my mobile phone number for any concerns about the project or meeting changes, but please don’t ring me on the evenings or weekends as that’s family time”.

Within DnD there are also check-ins throughout the game. If’s a ‘One Shot’ (i.e. it could theoretically be played in one sitting***) then this is less necessary, but in a longer campaign (that is a series of sessions which could cover several months), then check-ins become a useful way of making sure that everyone is still having fun, that we haven’t come across any topics which stray too close to anyone’s lines or veils and for people to share what they’ve enjoyed so far and what they’re looking forward to. Again, if we transfer that analogy to the context of research, then check-ins become a little bit like Study Management Meetings, where we continually check in on the progress**** of the study. This enables everyone involved to have the opportunity to feel engaged and to have a sense of ownership.

So this is why I think healthcare research needs DnD!

And yes, I do recognise there’s probably a thesis in there, or an op-ed at the very least, but it’s only Monday…give me a chance!

*I raised this point during a panel Question & Answers session and my lovely colleague/friend Prof Mel Hughes from Bournemouth University made this comment after I’d raised my point, so credit to her for that gem!

** DnD is an interactive storytelling game, where players assume character roles and create a story together. They will face a range of tasks and challenges as the story progresses and the outcome is decided by rolling dice. The score on the dice will determine whether they fail or succeed in their task or action. This helps makes sure that the narrative is more fluid and unpredictable, rather than everyone automatically succeeding at everything, which is very boring!

***Almost everyone who’s ever played DnD or any other roleplaying games knows that ‘One Shot’s are rarely ever played in one sitting, despite all intentions to the contrary….

**** “Roll for Recruitment…oh, you rolled 17! Excellent. So your coffee morning goes really well and lots of people are interested in signing up to get involved. Before we move on, can you do a quick Coffee Check for me? Ah…you rolled a 4. I’m sorry to say that the coffee is awful and everyone has politely managed one mouthful and then put it down somewhere. At the end of the morning you realise you have 20 cups to wash and only one small tray to carry them all. I hope you’ve got good stats for Dexterity…”