A Change in View? Using visual and co-design methods in interdisciplinary studies to address HAIs and AMR

We cannot tackle complex problems like HAI (Healthcare Acquired Infections, and AMR (Antimicrobial Resistance) without taking a holistic view that includes people as actors in the mix, to understand who they are, why they do what they do, and how their behaviours might be modified. With their close people-centric, and experience-based concerns, what might the arts and design communities be able to offer? Can we co-design effective IPC training tools using visual techniques? > make the invisible visible? > improve understanding of issues? > change perception of risk? > intent to change behaviour? > influence behaviour? > reduce infections? > reduce antibiotics use? This presentation reflects on the findings of previous linked but separate studies (all funded by the AHRC), to developing IPC training tools for a range of healthcare professionals (HCP) using a transdisciplinary approach. Each involved an inter-disciplinary team, the co-development of content, novel visual methods to ‘make the invisible [pathogens and behaviours], visible’, and an interactive digital model of the environment in which infection scenarios were acted out on a tablet or mobile app. Each study involved a mixed team of research disciplines including co-design, software engineering, microbiology, IPC training, and nursing or veterinary practice. The first two studies were based in the context of the hospital ward. The first was very experimental, taking a 'what if?' approach exploring the viability of imaginative digital visual techniques to 'make the invisible (pathogens), visible'. In the second study, content was heavily influenced by microbiological sciences and proven efficacy of IPC regimes, naming common healthcare acquired infections (HAI) found in the hospital ward setting, their locations within environments or people, routes of transmission, persistence, and impact of IPC measures. The novelty was in portraying typical IPC scenarios in a visual and interactive manner within a digital model of the hospital ward. Participant trainees reported improved awareness and understanding of the pathogens responsible for HAI, and the types of information relevant for different staff cohorts. The tool appeared to offer staff a new perspective on pathogens, being able to ‘see’ them contextualised in the virtual ward, making them seem more real. The third and fourth studies were set in the veterinary practice environment, the first of these producing proof-of-concept, the second a beta-version digital training tool designed to be evaluated in a subsequent study. The content and approach departed from typical microbiological and IPC training content and approaches. Pathogens were not named but implicated in scenarios inviting trainees to identify primary and secondary sources of infection, behaviours (risky or precautionary) potentially spreading or containing infections and mitigating IPC measures. Driving the central narrative was the question: ‘What can be done to get the patient [the dog] into theatre with as little contamination as possible?’. This approach was found to change perception of risky behaviours in a sample population of veterinary practitioners; after experiencing training, 92% participants agreed to change their behaviour and stated an intention to implement an IPC behaviour that aligned with training objectives. Trainees also found that the 3D graphics enhanced the delivery of training content by making difficult and abstract contamination concepts easy to understand. There is little robust evaluation of the effectiveness of current IPC training. This presentation questions the epistemological conventions of IPC training as the sole approach to be considered when engaging the wider, non-IPC specialist audience. It also questions the necessity of extended training programmes for busy, time-pressed non-IPC professionals and the wider public and asks what might be achieved through short, generic and engaging IPC training packages that might quickly change perception of infection risk sufficiently to change behaviour