Storytelling evidence into practice in health and social care

Storytelling

Nick Andrews, John Gabbay, Andreé Le-May, Emma Miller, Alison Petch and Martin O’Neill

Getting research into practice is easier said than done, particularly in fast-paced and often under-resourced health and social care services. This is the story of how we achieved a good measure of success by taking a caring, inclusive and storytelling approach across six sites in Wales and Scotland, involving older people, carers, practitioners, managers and researchers talking and learning together.  

On the understanding that human beings are relational and storytelling animals, who make sense of the world through narrative and dialogue, we developed a story-telling approach to using evidence, which started by developing what has been described as an ‘enriched environment of care and learning’[1]. Within such an environment, everyone involved should gain a sense of security, continuity, belonging, purpose, achievement and significance. To enable this, we started with their priorities and valued their evidence (i.e. practice knowledge, lived experience of older people and carers and organisational knowledge), alongside the research evidence, which we were careful not to impose on them. A challenge for the research team was how to do this.

We started by translating the research ‘Challenges’ into fictional micro-stories. These were shared with participants and used as a catalyst to gather similar or contrasting real life stories from practice (Figure 1).

Figure 1: Practitioners, older people, carers, managers and researchers exploring evidence together

The collective stories were then used as a stimulus for dialogue-focused action learning involving older people, carers, practitioners, managers and researchers. We achieved this by applying techniques from children’s education, including Exploratory Talk[2]. All too often, participants told us that they had poor experiences of talking together within their organisations, and they valued the inclusive techniques we used which gave everyone a voice. This also allowed for the folding-in of additional and related research evidence as part of the ongoing conversation, which helped participants to develop their ‘mindlines’[3], the collectively internalised, ‘knowledge-in-practice-in-context’ that informs day-to-day practice. This required skilled and sensitive facilitation, which encouraged the acknowledgement and exploration of different and sometimes conflicting perspectives. Research evidence was also carefully formatted by the facilitators before being presented, including in the form of poems and short summaries that were accessible and engaging.

As the project progressed, participants readily engaged with this blending of stories, associated research and organisational evidence, leading to changes in practice and policy. For example, one third-sector provider organisation embraced the ‘Challenge’ All good support is founded in and reflects meaningful and rewarding relationships. This resulted in relationship-centred revisions to its professional boundaries policy and associated practice (Figure 2).

Figure 2: Practitioners and older people engaging in meaningful and rewarding relationships

Another output from this work was a care-homes learning resource, which gained national support from the Older People’s Commissioner for Wales and Care Forum Wales.

In summary, the project identified and demonstrated five key elements to using evidence, all of which need to be addressed:

  • creation of supportive and relationship-centred research and practice environments;
  • valuing of diverse types of evidence;
  • use of engaging narratives to capture and share evidence;
  • use of dialogue-based approaches to learning and development;
  • recognition and resolution of systemic barriers to development.

These are the key elements of what we call the DEEP approach to research implementation.  Although existing literature covers each element, this project was novel in collectively exploring and addressing all five elements and in using multiple forms of story, which engaged hearts and minds. The DEEP approach is currently being implemented in diverse projects in Wales and Scotland.


[1] Nolan, M., Brown, J., Davies, S., Nolan, J. and Keady, J. (2006) The Senses Framework: Improving Care for Older People Through a Relationship-centred Approach. Getting Research into Practice (GRiP) Project Report No 2, Sheffield: University of Sheffield

[2] Mercer, N. and Littleton, K. (2007) Dialogue and the Development of Children’s Thinking: A Sociocultural Approach, London: Routledge

[3] Gabbay, J. and le May, A. (2011) Practice-based Evidence for Healthcare – Clinical Mindlines, Abingdon: Routledge


You can read the original research in Evidence & Policy:

Andrews, N. Gabbay, J. Le-May, A. Miller, E. Petch, A. and O’Neill, M. (2020). Story, dialogue and caring about what matters to people: progress towards evidence-enriched policy and practice, Evidence & Policy, DOI: 10.1332/174426420X15825349063428. [Open Access]


By Nick Andrews, Research and Practice Development Officer, Swansea University; John Gabbay, University of Souhampton; Andreé Le-May, University of Souhampton; Emma Miller, University of Souhampton; Alison Petch, Institute for Research and Innovation in Social Service (retired);and Martin O’Neill, Cardiff University.


Image credit: Photo by Nong Vang on Unsplash


If you enjoyed this blog post, you may also be interested to read:

From concept to implementation: challenges facing evidence-based social work [Open Access]

Evidence synthesis for knowledge exchange: balancing responsiveness and quality in providing evidence for policy and practice [Open Access]

Evidence and policy: the case of social care services in Sweden

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