Thursday 11 April 2013

Learning and Developing - Blog 2

What do we mean by  'Learning'?


For many of us, learning remains associated with our school days and the formal acquisition of facts that were subsequently measured in a variety of tests or examinations. The outcome being, for the most part, qualifications and future employment. This approach often assumes that we have little knowledge prior to the educational experience and that we will have gained information as a direct result of the process.


Patients, carers and members of the public who become involved in research do not necessarily need knowledge in that formal sense. Learning for involvement in research is like walking across different stepping stones. It is rather like the old TV programme Blockbusters, where  a contestant seeks their way across a playing board, knowing some of the letters and guessing at others.

The questions that often need addressing for active involvement are far more basic: What am I doing here? What is expected of me? Why is this of value? What do we each get from the experience? Will it make a difference?

This puts a different emphasis on the idea of learning. These questions place the learner at the centre with their needs as the starting point. 

Members of the public, patients and/or carers do not need to know about all matters relating to research and science or all the issues about health and medicine in order to function effectively. In fact it would entirely negate and defeat the whole purpose of involvement if people needed to learn everything although there are examples of people becoming researchers.

It is their experience, either as a patient or carer. It is the experience gained in other walks of life that can be brought to the table by members of the public.


The purpose of involving people is fundamentally to bring the insight of the person who has and may use a service, the carer’s viewpoint and/or an external perspective into any aspect of research from study development to trial management. It is the direct experience and/or different lens that is being offered from outside the normal research community to help add value and maybe bring fresh thinking. The concepts are of informing, forming and influencing research  for an  individual study or in national policy. The wisdom of experience.
A person asked to give their views about a research proposal or consulted about the questions to ask only needs to express their opinion. They may also want to get more involved.

People who get involved do not really need to know anything other than their own experiences and be clear about why they are involved and what is needed. The rest is an added bonus that is made more meaningful by meeting others involved on the same endeavour.


It can be of benefit to know that involving people is Government Policy, that it is a condition of NHS research funding and that it is supported by many, many people. It is helpful to know that there are still some people have still to be convinced of its value. It is therefore as much about changing culture and practice as it is about improving research. The overriding goal is about improving the value of people's lives and experiences of health and social care services.

People who become actively involved do need information to assist them in whatever endeavour they are involved. If it is about reviewing a trial protocol the need may be to understand what is being looked at and what is required. If it about membership of a committee, it might be helpful to understand the purpose of the group, how it functions and it's decision-making responsibilities as well as what is expected of the person. It is also important to know and record whether the involvement has made a difference as this will help us measure impact.

It is often the combination of the experiences together with the information that builds a base of understanding that can then be used elsewhere. It is an empirical approach - knowledge being developed and learned through experimentation, observation and reflection.

It can be desirable to understand some basics about research and some general information about health, medicine and science as that language permeates much of the discussion. Not knowing these should never exclude anyone from getting actively involved.


People do, of course, need some support, advice and help. People need to know how to find the information and knowledge that can assist them understanding the why, what and how of being involved. There is a need for signposting, alongside translation and interpretation of culture and language.

Opportunities for learning help clarify the purpose of the involvement, the impact that is being sought and the expected outcomes. This clarity of purpose can help us all function more effectively.


We all learn in different ways. These are sometimes broadly divided into hearing, picturing and doing. We learn best through combinations of praise and challenge. We learn more when we have the chance to practice what we have learned. However central to all learning is building confidence, engendering self belief and helping people realise and develop their own potential.

The learner should, therefore, be able to choose from a variety of written information, workshops or self learning manuals. There should be choice about when and where the learner can access opportunities to learn and develop both in person and online.

Learning is about building new skills, experiences and knowledge that can help develop the effectiveness of involvement and the individual. In research, as in other parts of the NHS, is really about developing relationships, partnership working, seeking solutions together, managing each other's expectations and coping with conflicting opinions.

Richard P Feynman, offers a great opinion on learning:

"Study hard what interests you most in the most undisciplined, irreverent and  original manner possible."


This whole approach applies equally to researchers and managers who want to involve others in their work in either partnership or merely a consultative manner. They too need support, information and knowledge to help them understand why they want/need to involve patients, carers and the public in their work.

The next Blog will focus on the needs of researchers and managers about involving people.

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