As researchers we sometimes face asking people about issues and experiences which are very sensitive, highly personal and / or emotionally charged. Nevertheless, if handled carefully, such subjects can be successfully explored and understood.
We faced this challenge when asked by the General Medical Council to undertake research first with doctors who had been through their Fitness to Practise procedures and then with complainants who had been through that same process from the other side.
Understanding the issues
The GMC wanted to understand how their processes might be improved from both perspectives. This was clearly important work, however we faced a situation where:
- In the case of doctors, the process may have led to loss of their reputation, loss of earnings and (in the case of doctors who had ultimately been struck off the register as a result of the process) loss of their entire careers.
- In the case of complainants the process might relate to events that had caused (for them or for a loved one) serious injury or harm or resulted in a bereavement, sometimes under extremely traumatic circumstances.
Clearly, under these circumstances the utmost care had to be taken. There was a clear danger that parties on either side might be very upset at even being approached about taking part in the research. Or, they might wrongly perceive the research as being an opportunity to re-open and re-investigate their case.
In designing the research we had to make sure that:
- We achieved a balance in terms of timing – that the research was programmed not so long after the case was closed that recall would be difficult; but not so soon that the potential trauma and emotion would still be too raw.
- All participation would be on an ‘opt-in’ basis. Initial communications came from the GMC themselves. We collaborated very carefully over the wording of the letters ensuring that the followng points were emphasised and made completely clear:
- That no contact details would be passed on to Community Research by the GMC.
- That no case-specific details would be shared with us; leaving it in the control of the participant how much they wanted to divulge about their case.
- That the aim of the exercise was to improve processes for the future, not to review their case.
- That they would not be named or identified within our report and that the GMC would never know who had taken part in the research.
- The research process was as comfortable as possible for respondents. A combination of self-completion and telephone based interviews was used. Only very senior and experienced researchers undertook interviews and certainly, all of our experience was vital. It was important to judge how the participant was feeling and be sensitive to this. We had many tearful and emotional discussions but underneath it all, we were able to draw out a wide range of findings for the GMC.
In the end, many research participants told us that the research, whilst asking them to relive experiences that they might rather forget, was cathartic for them. The chance that they might help the GMC to make the process easier for others in the future, was a comfort for many that took part.
Our reports from the research with both audiences have now been published in full on the GMC’s website here, together with an agreed action plan.