Poetry as a reflective method for research and practice

The theme of this year’s Society for Academic Primary Care Conference was informed and inclusive primary care. Hosted in Brighton, the flavour of the conference was consistent with this theme; it had a creative enquiry stream inviting creative and reflective pieces that could include art, dance or poetry. I welcomed the opportunity to blend my interest in creative and academic writing and composed a poem and reflective summary.

I was quite nervous about how to deliver this at a conference attended by academic GPs and researchers. I was also concerned the session might not appeal to participants, given the competition of parallel sessions on many interesting topics including COVID, GP workforce, research methods and care of older adults.

I need not have worried. The conference organisers were supportive in giving me a longer session of 30 minutes that followed on from a workshop exploring sexual health care for people who are trans, gender diverse and non-binary. A number of the participants in the workshop stayed for my session and we were also joined by others. We were able to create a space for open discussion.

Discussion from the poem

The poem (and reflection) explored compassion and empathy in researchers and clinicians. It was a personal response to an interview I conducted in 2022 with a patient who had received social prescribing as part of our study into the implementation of link workers in primary care. The link worker helped restore this patient’s self-confidence and supported her to emerge from the trauma of a coercive relationship. Writing the poem allowed me to explore my own empathic response to the interviewee, whose story had moved me to tears.

In the conference session, we discussed how as researchers and clinicians we deal with our emotional response to hearing about distress. We also discussed the responsibility we might feel to honour stories like these rather than just seeing them as ‘data’ to be analysed. Points raised in the discussion included: 

• Researchers described using a variety of methods to reflect after experiencing empathic responses in interviews – including writing reflective notes and poetry.
• De-brief and emotional support for researchers after interviews, when needed, could be helpful.
• Clinicians employed a variety of strategies to deal with emotions raised in appointments where patients reveal distressing situations; they mentioned stress-relieving activities like listening to music, going for a walk, talking to other clinicians. Some admitted that years of hearing these stories, which are often caused by social and structural factors that they might not be able to assist with, may have desensitised them. Desensitisation might protect them from burnout.
• We discussed contradictory research findings showing that on the one hand, experiencing empathy might lead to professional ‘burnout’, alongside other evidence that suppressing natural reactions of empathy and compassion might lead to a loss of professional integrity and sense of self.
• Clinicians commented that their capacity to make referrals and ‘do something’ for people, rather than only listening to someone’s story, meant they might not experience the same sense of powerlessness that researchers could encounter. 

Relating comments from the conference to our study

Hearing patient distress about social issues outside their remit can prompt empathetic clinician responses. Taking action, for example by referring patients to social prescribing or third sector organisations, can help alleviate the emotional burden on clinicians. Our data highlights that social prescribing link workers' empathetic listening is as crucial to patients as connecting them to resources. Yet, this may pass on the emotional burden to link workers and potentially to third sector workers. A new study we are starting, about recruitment and retention of link workers, will explore emotional burden and its impact on their experience of the role.

Sharing research methods and ideas

Being at an in-person conference fosters valuable space for discussion during and outside of scheduled presentations, and facilitates new connections. I was able to network with researchers at the conference from other universities, who discussed their use of poetry as a qualitative method to both interpret and present narrative accounts in data and for self-reflection as researchers. We have arranged some further meetings to discuss this creative method and potential future collaborations.

Debra is working on a study funded by the National Institute for Health and Care Research (NIHR130247). The views expressed are her own and not necessarily those of the NIHR, the Department of Health and Social Care, or her host institution.