Abstract
ObjectiveTo understand how current funding expectations that applied health research is undertaken in partnership with research institutions, health service providers and other stakeholders may impact on patient and public involvement (PPI).BackgroundWhile there is considerable research on the potential impact of PPI in health research, the processes of embedding PPI in research teams remain understudied. We draw on anthropological research on meetings as sites of production and reproduction of institutional cultures and external contexts to investigate how these functions of meetings may affect the potential contributions of patients, carers and the public in research.MethodsWe present an ethnography of meetings that draws from a larger set of case studies of PPI in applied health research settings. The study draws on ethnographic observations, interviews with team members, analysis of documents and a presentation of preliminary findings through which feedback from informants was gathered.ResultsWe identified four means by which the oversight meetings regulated research and constrained the possibilities for PPI: a logic of ‘deliverables’ and imagined interlocutors, the performance of inclusion, positioning PPI in an ‘elsewhere’ of research, and the use of meetings to embed apprenticeship for junior researchers.ConclusionsPPI is essentially out of sync from the institutional logic of ‘deliverables’ constituting research partnerships. Embedding PPI in research requires challenging this logic.
Highlights
THE MISSING JIGSAW PIECE ‘You’ve got lots of different people around with [...] different areas that they’re ... fabulously good at and have lots of different kinds of expertise
While there is considerable literature on patient and public involvement (PPI) in research and quality improvement,3-6 as well as on how different modalities of collaboration organize knowledge production,7-9 little explicit attention has been paid to how the choreography and performance of collaborative research affects how PPI in particular is imagined and practised.[10,11]
We first summarize the general character of the meetings so that readers can orient themselves in relation to four overarching themes that comprise our findings: (i) the spatio-temporal logic of deliverables; (ii) maintaining the appearance of inclusion; (iii) installing PPI as a constitutive ‘elsewhere’; and (iv) acculturating junior researchers: meetings as sites of apprenticeship
Summary
THE MISSING JIGSAW PIECE ‘You’ve got lots of different people around with [...] different areas that they’re ... fabulously good at and have lots of different kinds of expertise. Patient and public involvement (PPI) in health research positions patients and members of the public as actors undertaking or contributing to research rather than as its recipients or beneficiaries.[2] Yet, while there is considerable literature on PPI in research and quality improvement,3-6 as well as on how different modalities of collaboration organize knowledge production,7-9 little explicit attention has been paid to how the choreography and performance of collaborative research affects how PPI in particular is imagined and practised.[10,11] Thompson, and subsequently Vermeulen, have deployed the term ‘choreography’ to demonstrate and understand how aspects of the world commonly thought to belong to ‘different ontological orders’ come together.[12,13] We use choreography to think through how collaborative projects involving PPI attempt to hold together different ways of doing research and envisaging expertise They bring together heterogeneous people, infrastructures and technologies (such as meetings and minutes); the manner in which they do so –the kinds of sequences and spatial dynamics that unfold –end up centring certain people and priorities at the same time as pushing others to the margins. Understanding such temporal and spatial processes is important at a moment in which PPI is being consolidated within highly regulated and governed collaborative settings, such as funded health research, beholden to numerous stakeholders and conditioned by tight timelines.[14]
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