Research as if people were human

In this post guest blogger Dr Cathy Sharp, Director Research for Real, describes how stories can be used in action research. 

Stories are a big part of action research.  Drawing on a mix of stories as an explicit inquiry practice and source of experiential learning can generate great insight and motivation for change.   Not just the stories told by people who live in the communities in which we work or those who use services, but the stories of staff who work in those services.  Almost certainly we could all make much better use of this most overlooked source of existing ‘data’, using them as a kind of ‘living case study’ to motivate and inform our action.

Stories are descriptive accounts of something that has happened, that bring things to life and, in sharing, compel people to ask questions.  They’re best told in the first person.  Stories involve relationships, events, notions of cause and effect and priorities; they may be complex, yet memorable and galvanizing for action: When people can locate themselves in the story, their sense of commitment and involvement is enhanced’ (Shaw, 1998) More recently Brené Brown calls stories ‘data with a soul’. (Brown, 2013)

A friend and former colleague of mine used to say that she didn’t like the term stories ‘because where I come from a story means a lie!’  I said that I didn’t mind too much what she called them as long as she didn’t dismiss them as ‘not proper research’.  A lot of the time stories are told informally and dismissed as anecdotal.  We’d all have our own ideas about what makes a good story or turns a good story into good evidence, but credibility is clearly important.  That seems to stem from a sense of the authenticity of the teller, the plausibility or believability and our ability to empathise with the story.  Action researchers would want to add that the stories should be drawn from multiple voices and should not just generate insight, but should also encourage and enable action for positive change.

A fairly typical response to hearing a story is that you can’t dispute the emotion.  People have described stories as ‘honest and compelling’ and are often profoundly moved by the stories they hear, and so are encouraged to find out more.  They may be surprised or challenged in their perceptions and assumptions, especially those of which they were previously unaware.   In this way, stories provide new insights and help to shape deeper understanding of other peoples’ experience, helping us to make sense of the world.

The tone and atmosphere created by stories, by their very nature, is often attractively equal and democratic (Bate and Robert, 2007).  Sharing stories and making links between them often allows new meaning to emerge; in this way they are an important approach to knowledge co-creation and a great way to create a real appetite for evidence, a hunger for more stories, more feedback and shared sense making.  Sharing stories is the bedrock of relationship-centred practice:  when people talk with each other in this way about high points or challenges, they naturally build empathy, mutuality, respect, trust and genuineness – in short, they build high quality relationships (Dewar and Mackay 2010).   Just the qualities we need to preserve and build in health and social care and across the public service reform agenda.[1]  The Chief Medical Officer Sir Harry Burns has described this sharing as a ‘vital ingredient in involving people more in shaping and running public services in the future’.[2]

The recent IRISS Insight provides a good account of some of the issues for researchers and practitioners interested in making more of stories[3].  An important question for action research is about how the stories are analysed, when and by whom; I believe that this is where their real potential as a driver for change lies.

My own ‘story about stories’ is one of a slowly changing acceptance of their validity and value.  Research on the quality of health and well-being in south east Glasgow used a collaborative and appreciative process to gather and analyse the stories collected from the community (Kennedy and Sharp 2010). This was described as an ‘unexpected reality-check’ – quite different from a focus group or survey process.  By focusing first on what was working well, practitioners got some valuable and unusual feedback.  Further exploration of the stories helped them to see their own assumptions about the people and services they encountered. The stories revealed telling messages about the attitudes faced by local people using services, the lack of joined-up practice and the hurdles they faced when trying   to access basic information. The stories prompted more stories from within the system too and enabled a different kind of conversation to happen.

In the evaluation of the Cedar pilot the ‘Stories of Practice’[4] were composite stories based on themes drawn from 2 years of data and accounts from children and mothers in recovery from domestic abuse (Sharp, C and Jones, J with Humphreys, C and Netto, G, 2011).  For the final Cedar evaluation event, it was necessary to find a way of retaining the integrity of the voices of children and their mothers and to enable a small number of them to participate in the event alongside professionals (Sharp, 2014 forthcoming).    At the event, the stories were ‘re-told’ by volunteer story tellers for whom they had some resonance.  The story tellers and listeners included young people and mothers who had completed the Cedar group work as well as programme staff and facilitators.    The stories were collectively analysed in small groups through a dialogical group process which drew out key themes and learning and from which the participants together developed recommendations for the Scottish Government.   This process was adapted from the Storydialogue method for health promotion knowledge development and evaluation (Labonte, R. and Feather, J. 1996).

Sharing stories in this way gave access to the real and emotional content of experience in a relatively raw and anonymised form that also enabled wider participation in the analysis process.   It is this kind of co-analysis of stories that is particularly powerful in facilitating a different and more appreciative dialogue which motivates participants to identify existing good practice, brings this to life and propels mutual learning, collaborative action and the embedding of change and practice development (Dewar and Sharp, 2013).

For further guidance and inspiration see ‘Changing Places with Stories’ developed by Glasgow’s Space Unlimited which provides two ways to enable collective analysis of stories so that they get shared in ways that lead to collaborative learning  and change (Space Unlimited 2013).

At the end of the day, the full potential of these kinds of dialogical methods lies in their use in a wider ‘whole cycle approach’ to research and evaluation that is built into the fabric of what we do and how we design and deliver our services (Wadsworth, 2011)  Ultimately they energise and restore people’s connections with work and motivate people to work together.  A humane approach to inquiry; truly, ‘research as if people were human’[5].

 

References

Bate, P and Robert, G (2007) Bringing User Experience to Healthcare Improvement, The concepts, methods and practices of experience-based design, Radcliffe

Brown, B (2013) Daring Greatly, Penguin

Dewar B, and Mackay R, (2010) Appreciating compassionate care in acute care setting caring for older people International Journal of Older People Nursing, 5, 299-308

Dewar, B and Sharp, C (2013) Appreciative dialogue for co-facilitation in action research and practice development, International Practice Development Journal 3 (2) [7]  http://www.fons.org/library/journal.aspx

Kennedy and Sharp (2010) Modest and mighty: stories of health and well being from Langside and Linn, Final report http://library.nhsggc.org.uk/mediaAssets/CHP%20South%20East%20Glasgow/Langside%20and%20Linn%20Final%20Report%20Jan%202010.pdf

Labonte, R. and Feather, J. (1996) Handbook on Using Stories in Health Promotion. Ottawa: Health Canada

Sharp, C (2014 forthcoming) Creating a community of reflective practice – supporting children and mothers in recovery from domestic abuse, in Promoting Change Through Action Research: Current Trends In Education, Social Work Health Care And Community Development,  (Eds) Stern, T., Rauch, F., Schuster, A., and Townsend, A , Sense

Sharp, C., Jones, J., with Netto, G  and Humphreys, C (2011) “We thought they didn’t see” Children and Mothers Experiencing Domestic Abuse Recovery, Evaluation Report, Scottish Womens’ Aid, June

Shaw et al, Harvard Business Review (May-June 1998 v76 p41-8) Quoted in Wadsworth, Y., Wierenga, A. and G. Wilson (2nd ed. 2007) Writing narrative action evaluation reports in health promotion – manual of guidelines, resources, case studies and Quick Guide, State of Victoria, Department of Human Services and the University of Melbourne, Australia.

http://docs.health.vic.gov.au/docs/doc/62DE26A64376FED8CA257B1E0020CAE4/$FILE/near.pdf

Space Unlimited (2013) Changing Places with Stories http://www.spaceunlimited.org/media/91137/changing%20places%20with%20stories%20(260713).pdf

Wadsworth, Y (2011) Building in Research and Evaluation, Human Inquiry for Living Systems, Allen and Unwin


[1] See for example NHS Education for Scotland (2013) Listen Learn Act Harnessing the power of personal stories to drive service improvement  Information and guidance for staff on story-gathering http://lx.iriss.org.uk/sites/default/files/resources/final_pdf_listen_learn_act.pdf

[2] Quoted in Space Unlimited (2013)  Changing Places with Stories

[5] This phrase is used by John Rowan (2001) The Humanistic Approach to Action Research in Reason, P and Bradbury, H (eds) Handbook of Action Research, Sage.

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