Medicine, Myth and Memory – Trusted Voices in the Pandemic

Repositioning Medical Museums as collaborative, trusted and effective assets for communities to better understand and respond to health emergencies

Nat Edwards, CEO Thackray Museum of Medicine

What is the best new format to communicate scientific information to non-specialist decisionmakers?

Which dissemination channels are most effective at communicating to marginalised or at-risk communities?

During the pandemic, we have seen stark differentials both in terms of impact (cases per 000 and deaths per 000) and response (trust of established authorities, effectiveness of channels and prevalence of 'fake news' alternative social media sources and anti-vaccination messages) among poorer, marginalised and minoritised communities. 

Evidence cited in the BMJ (Covid-19 vaccine hesitancy among ethnic minority groups | The BMJ) shows for example that fewer than half as many black over 80s are likely to be vaccinated as whites of the same age and fewer than half of black healthcare workers are likely to be vaccinated as their white colleagues. UK BAME likely mortality is reported by ONS as greater than twice that of whites and similar differentials are reported for deprived and non-deprived communities.

This problem mirrors wider issues of Equity and relative Science/Medical Capital among communities and the decision-makers who represent them.

Our solution directly targets underserved communities in the UK and local non-specialist agencies working within them.

We will make sure that we identify our target audience needs by involving them directly in setting the challenges for each of our action research projects and collaborating to achieve meaningful outcomes. The targeted participant audiences will be determined by the partners in consultation with participating groups. A few examples of the groups that partners have engaged during the pandemic (who will shape our audiences and collaborators) include:

• BAME young people (TMM/Catch/Getaway Girls/Space 2)
• Frontline care and healthworkers in Worcester (WRH/GMM)
• Veterans living with PTSD (Combat Stress/Age Exchange/GMM)
• Social prescribing clients (TMM/Leeds Links)

Priority will be given to groups who have been under-represented or else at-risk within the pandemic. This will be different according to the location of each museum but will include people living in poorer inner-city neighbourhoods, people in rural isolation, BAME communities, D/deaf and disabled people, students, asylum-seekers and recent migrants and people experiencing poor mental health. In addition, the programme will target key stakeholders, specialists and non-specialist decision-makers within local authorities and community organisations, seeking to pair activities involving more vulnerable audiences with relevant advocates within decision-making structures. The intent is that by doing so, a measurable and meaningful transformation of the sense of personal agency will entail.

A key outcome of the project will be to identify strategies for resourcing successful initiatives beyond the life of the project (eg identifying strategies for the funding and delivery of social prescribing within medical museums)

We will make all research outputs from the project freely accessible online - published through the UKMCG and also selected articles published through open access journals as appropriate.

We will provide free public access to online collections and archives - including legacy archives such as oral histories

We will create learning resources linked to Key Stage Curriculum learning objectives and publish these for teachers to access, free of charge, internationally

We will produce a final report and white paper recommendations to be freely accessible to peers, key stakeholders and funders (and publicly published)

We will share findings at conferences and other peer and stakeholder events

• We will identify community advocates for vaccination and public engagement with infectious disease control. 
• We will build projects around these advocates that encourage participation - normalising discussion of infectious disease within communities and breaking down barriers relating to institutional legacies and authority.
• We will create tangible resources for learning and cultural activity relating to public health for agencies to use with the community.
• We will create shared spaces (real and virtual) within the medical museums for communities to use on an ongoing basis.
• Using the Equity measures developed by UCL, we will measure growth of medical capital and STEM equity among participants from target groups
• We will provide transferable methods and exemplars to peers to promote wider adoption of successful methods and activities

We will scale our project beyond immediate participants and communities in four principal ways. These are:

• digitally, through the roll out of learning resources and virtual outreach to the UK Key Stage 1-4 cohort
• internationally - we have an international partner within the team (Museum Dr Guislain, Ghent) to explore potential roll out of activities and methods to the European network of medical museums (and potentially beyond this)
• sectorally - through networks such as the Culture Health and Wellbeing Alliance and industry lead bodies such as the Museums Association, we will promote successful practice more widely through key sectors
• follow on projects - we would identify opportunities for projects to build on successful outcomes and work with agencies such as the Kings Fund and Paul Hamlyn Foundation to resource discrete legacy projects

Individual Action Research Projects will focus on key research questions and outcomes, informed by our overarching research questions (see above). For each action research project, partners will collaborate with target groups to co-author project specific evaluation strategies and measures.

To tie the diverse action research outputs together, we will adopt the STEM Equity compass developed by UCL (see 2020-YESTEM-Insight-1-Equity-Compass-revised.pdf ) to measure the baseline engagement of participants at the beginning of the project, at its midpoint and at its conclusion.

Cost is the principal barrier - largely due to the catastrophic impact on museum revenues due to COVID. In the UK many museums have been closed continuously since March 2020 and those few that were able to open during interim lifting of restrictions were required to do so under significant limitations. Across the network, this represents a shortfall of c. £250K or hard project costs

Another impact of COVID has been reduction on workforce and capacity - either with staff members seconded to frontline care; furloughed or lost to redundancies (some participants have seen up to 60% reduction in pre-COVID rosters). Quantitative reductions mirror reductions in corporate knowledge - an added imperative to greater shared working and data.

Through the collaborative approach proposed, we believe that a fairly small investment in capacity and project costs to support action research can have a significantly greater impact than discrete, individually funded projects at each network site.

• UKMCG
• Thackray Museum of Medicine
• Anaesthesia Museum
• Florence Nightingale Museum
• Dr Jenner's House
• Royal College of Surgeons England
• Alexander Fleming Museum
• Chelsea Physic Garden
• Gordon Museum of Pathology
• George Marshall Medical Museum
• Royal College of Physicians London
• College of Optometrists
• Royal College of Nursing  Library
• Museum Dr Guislain

Cashflow remains the single biggest challenge for the project as the bulk of available funding has had to be diverted to  cover operational costs and lost income as a result of the pandemic. As articulated in media coverage (such as the NY Times' feature on Dr Jenner's House) - survival has been an issue for medical museums. However, they also have been remarkably agile and effective at finding new purpose (see attached supporting evidence) and responding to new  public need. 

In addition to money, the Trinity Challenge also offers potential access to expert insight into using our unique data sets - our historic and contemporary collections - in more interoperable, accessible and effective ways. The specific challenge we are responding to - to cut through the infodemic - appears to us to be perfectly aligned with our own rediscovered sense of purpose and citizen medicine principles.

Finally, the Challenge's willingness to fund distributed and collaborative teams is also a key motivator. We have found many museum funding sources are prescriptively aligned to single institutions. This seems to be the opposite in the case of the Challenge and we find your  ethos resonates far more strongly with our own.

Challenge members that we would welcome support from would include:

Any of the University members - particularly in flagging ant=y UK-based projects that might benefit from action research elements as proposed

Google - for help with data interoperablility and accessibility - and finding ways of integrating our datasets with existing public platforms (eg Google Arts and Culture/Street View/maps)

Non Challenge Members we are seeking guidance from include the Centre for Cultural Value at University of Leeds and University College London STEM research unit