Following the New Generations workshop at the Wellcome Trust on Febraury 10th 2015, New Generations Programme member Jamie Stark writes:

What do the former instructions issued by a rugby union referee at a scrum have in common with public engagement and the medical humanities?

Dr Allison Cameron may have hated sports metaphors, but I’m going to build the foundations of this piece on one. The process of putting together a research project is arguably dependent on just three key criteria: academic necessity, institutional support and time. It is perfectly feasible (but not necessarily entirely desirable) to design and implement a fully-funded and successful programme of research as an individual, from the first tentative germ of an idea through to the final monograph. Of course, some of the best academic projects are collaborative, very often bringing together scholars from multiple disciplines and institutions, and carving out a rich trajectory of mixed interdisciplinary metaphors along the way. Collaborations of this type are now integral components of academic research, and the mechanisms for working are consequently becoming more refined and sophisticated. Another layer of sophistication comes from engaging not just with peers in the academy, but with audiences beyond the confines of higher education. As a member of the Arts Engaged project at the University of Leeds, I have been closely involved in local, national and international debates about the role of the arts and humanities in public life, and their societal impact. In the midst of all this, however, I have tried to remain discipline-neutral, considering not my own disciplines – medical humanities and the history of medicine – but rather the full range of subject areas which come under the banner of “arts”. Today the gloves are off, and it is medical humanities all the way.

PublicEngagement Image_smIn truth, I think that the medical humanities and its practitioners are uniquely placed to not only bring their research to bear on what we might loosely call “societal challenges”, but also for the process of engagement to enrich that research. The case which we make for this at present in the discipline is still in its infancy; the question “what can the medical humanities do for medicine, health and well-being?” is currently playing second fiddle to the more nebulous and less interesting question, “what is/are the medical humanities?”. Here I am going to suggest how we might approach the former question and, in the process, also attempt to put the torch to a few concepts related to collaboration beyond the academy. In my sights: “knowledge exchange”, “public engagement”, and the most recent arrival, “the impact agenda”.

I promised you a scrum. Until 2013, the referee responsible for overseeing the scrum in rugby union used four commands to ensure that the players were prepared and to try and stabilise the scrum, as well as preventing serious injuries often associated with this particular facet of the game. I think they bear a striking resemblance to the process known as public engagement…


The first instruction bellowed by the referee officiating at a scrum indicates that the eight participants from each side should assemble in the pre-ordained configuration and await further instructions. The analogous situation for the purposes of medical humanities is that, before approaching potential collaborating partners, it is important that your house is in order. There is little point in trying to come together with another organisation if your own internal structures are not robust and the participants are not clear on their individual roles.


For our purposes, the instruction to “touch” – a literal reaching out of hands from the front row of each side to demonstrate correct alignment of the two halves of the scrum – is critical. This represents the initial point of contact where, although both parties can see that the other is there and in a state of readiness, there is confirmation of this at a more fundamental, relevant level. Scoping activity and pilot projects fall into this category, so that there is confirmation of institutional and individual alignment for the proposed activity.


It is difficult to overemphasise the importance of time and space. After the initial contact, both parties have the opportunity to refine their approach, and this is critical for a robust collaborative relationship. Although it is clear that the ideas and the setup might already be in place, it is nevertheless vital to have the opportunity to reflect on how the initial contact with partner organisations, groups or individuals might allow for slight adjustments in strategy.


The final stage. After gathering together in both sides, aligning goals and expectations, initiating contact and then reviewing practices in light of those conversations, the moment finally comes when both sides are ready to put the preparation into action. At this stage, of course, my metaphor breaks down like a badly-made watch. The goal of a scrum is to physically dominate the opposition and retain possession of the ball, something best avoided in the context of engaging with non-academic audiences. Instead, we could perhaps think about our own scrum of engagement like something you would do as a ten-year-old, where the scrums are uncontested…or whatever.

The key point is that working with audiences does not entail stasis, the abstract passing on of research, or a passive role for these groups. Rather, they are themselves dynamic, interested, flexible and responsive, and we must be careful not to default to the out-dated straitjacket of the deficit-diffusion model against which science communicators and communication theorists have long-since railed. Instead, the focus should be on cultivating a productive two-way relationship with audiences beyond academia, recognising that they bring their own forms of expertise and that the process itself can not only be valuable, but sometimes essential in shaping research ideas and questions. The notion of “applying” research in the medical humanities doesn’t really wash with me: we should start with both research and potential application dovetailing one another from the outset.

The term “public engagement” has been a useful working model for researchers, funders and, to an extent, non-academic audiences for some time now. Yet for me it fails to capture two important features of what we should aim for through this type of activity. The first is that the term “public” is highly misleading (I penalise my third-year undergraduates for talking about the monolithic “public”, so I don’t see why we should tolerate its malign influence in our own research), the second is “engagement”, which suggests that we are actively engaging this “public” through our efforts and, critically, that being engaged is enough. The real endpoint should be the things achieved through this engagement, whether they are policy refinements, an improvement in health or wellbeing, or a significant contribution to professional debates. It then goes without saying that engaging public audiences is not necessarily a desirable thing: the audience depends very much on what you hope to achieve and who might find your work and the process of working together the most instructive and rewarding.

Without saying it, this seems to be what research “impact” is all about: demonstrable change (although sometimes staying the same can be impact as well) for the better. We are lucky in the medical humanities; many of my colleagues working in other disciplines across the arts and humanities struggle to meld their research with social challenges which might yield impact. The focus of our research – topics linked to medicine, health and well-being – is a natural field for generating impact in ways often beyond the reach of the arts. We should embrace this opportunity and use the transformative potential of the medical humanities not only as a positive end in itself for our own engagement, but as a distinctive feature of the discipline. By demonstrating the ability of our research to speak to societal challenges, we are also emphasising the value of this approach to research, whilst still having the opportunity to answer the questions that we want to interrogate as researchers.

We heard many fine examples of public engagement at the workshop, but they serve to show that the conceptual framework for this mythical and irritating beast of “public engagement” lacks the sophistication we should be aiming for. Flexibility, openness, and clear communication are the key features of successful collaboration with non-academic audiences, and those are realised by cultivating the right attitude towards the activity, not by reducing collaboration to a schematic or flow-chart.

What can the medical humanities do for medicine, health and well-being? It should be clear that my answer is “plenty”, but it is important that the way we approach individuals and groups who can help us to realise the practical benefits of research in the medical humanities must be carefully crafted so as not to obscure the inherent intellectual value of that research. Lectures, science festivals and exhibitions are all essential and valuable outlets for our work, but we must also think more deeply about the purpose of these, their benefits, and how we can involve relevant groups in the process of our research as well as in the final products.

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