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[Auto-generated transcript. Edits may have been applied for clarity.]
So welcome everyone. My name is Marshall, the one at uh.

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And together with UN Ferri. We are very happy to welcome you to our guest speaker as part of our module.

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And also welcome to everyone who is not part of the module as well.

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Um, this is um, have a um, a lecture around the importance of behavioural science and interdisciplinary work.

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And we are absolutely delighted to welcome back to, um, that came a call from UCL, um, who, um, has very interesting career.

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So I hope she will tell you a little bit about that.

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But she's bringing 20 years of medical journalism and expertise and also arts and design and behavioural science,

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and showing how all these different and contrasting disciplines can really bring,

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uh, to life the importance of the clinical problems such as antibiotic resistance.

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And we are absolutely across and I think by this digital storytelling as well as a tool to, uh, think about this important topic.

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So we're absolutely delighted to have you here. So thank you quickly.

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Well, thank you for inviting me. And, um, give me the opportunity to speak about my work.

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Um, so, yeah, so I'm Becky and I actually wear two slightly different hats.

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Um, one is as as Moser said, a long standing journalist and medical journalist.

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Um, and the other one is somebody who has just completed her doctoral work. Um, and that was in looking at digital storytelling, um,

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as a way of communicating around the topic of antimicrobial resistance or Amr with the public.

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Um, how many of you of, uh, clinicians or medically related and understand about AML?

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Anybody here we've got I think it's a few fun. Okay, good.

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Um, and my work has been at University College London.

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So I'm going to talk to you about storytelling generally,

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but also about digital storytelling and the role of storytelling in engagement, um, with the public.

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Um, and later on, I'm going to work through and, and watch and work through an example of one digital story.

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These are very short videos, if you like, 3 to 5 minutes in length.

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Um, and we're going to sort of look at how this explores the lived experience of somebody who is part of this infection.

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Okay. Um, and storytelling really the way I'd like to illustrate this, how it humanises, uh, scientific issue of a medical issue.

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Um, and then finally, I'd like to sort of relate that to how we can change the way people think, um, potentially change beliefs, attitude.

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And I'm not going to make big claims about behavioural change, but perhaps it contributes along that pathway to pay for change.

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Okay, so as a, uh, freelance medical journalist of over 20 years now, um,

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I have written for a vast array of different magazines, newspapers, you name it, websites, trade consumer.

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So just a quick spattering there of things I've done. Um, so I have interviewed hundreds of people.

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Okay. For example, the market research as they might be, uh,

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I seem to constantly be writing about weight loss drugs at the moment, um, seems to be the topic everyone's into.

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Um, other things I might perhaps talk to health policymakers sometimes.

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Um, the over covet. There was quite a lot there. Um, do you need to reopen schools, to reopen schools, etc.?

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What's, you know, how do we protect the health of the children and education for all the various reasons, for mental health reasons.

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And then sometimes I might talk about, um, what it's like to talk to a patient, what it's like to live with a chronic disease.

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Um, this in the sort of middle of the bottom there that was all about, um, the skin anatomy.

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Okay. So this was actually probably less medical as a bit of dermatology, but it sort of moved into the field of,

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you know, psychology and the social impact of this skin whitening, um, activity.

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Okay. So all sorts. But I guess the point here is what has always struck me is how stories with all the nuance and the inbuilt emotion, if you like,

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um, actually puts a very human face onto the science to the stuff and the other facts that we're hoping more familiar with.

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Um, from a from a scientific point, um, I actually believe that, you know, think stories build a bridge, okay, between science and stuff, if you like.

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Um, in fact, the lay public possibly making is a bit more digestible.

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Okay. And as one of my storytellers said to me.

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They bring statistics and life for people. Okay, we're not going to watch her film today.

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But you know, she she felt she really had the chance to put all this messiness and effort into a story.

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And she said, yeah, this really means something for her as a storyteller. But to people around her that she could share the story with.

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So I just thought that if you all were interested in storytelling and writers, um, you might be interested in finding out more.

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Is a guy called Arthur Frank. He's a health psychologist based at the University of Alberta in Canada.

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Um, and he really explores, you know, how people tell stories, why they tell stories.

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And often he's looking at illness experiences, how we actually structure an illness experience.

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Often people tell stories about their illness experiences to, um, perhaps reshape an identity.

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Okay. So they might come out of that experience feeding thing like a survivor.

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Perhaps they feel like a victim. You know, there's lots of stories we hear, misdiagnosis, etc.

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Perhaps I want to be an advocate. Okay.

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That often happens if they're, you know, maybe they're part of a patient organisation and they might want to advocate for that disease.

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So lots of ways they can shape stories.

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Um, that's sort of the sort of line of thought in The Wounded Storyteller, this book on the right and letting the stories breathe.

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I love this idea. It's the idea that there are multiple perspectives.

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Okay. When we look at a medical experience.

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Storytelling means that we don't have to look at it from a privileged perspective.

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So often, you know, stories around illness, medicine, disease are also from the, you know, taking the view of the medical hierarchy.

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Stories mean that we we have a level playing field.

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Patients have a say. Patients put their point across to.

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And actually storytelling has been used a lot in medical education which I'll return to later.

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So yes there you go.

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That's it's storytelling is all about multiple perspectives, all about opening up and listening to patients, people who live with disease.

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But of course I realise this is about behavioural science, this course, um,

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and how people and why people behave as they do and probably think how they do, um,

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and how we as practitioners and researchers actually may want to intervene and perhaps influence those behaviours for,

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for improved health and well-being.

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Um, and so just for transparency, I'm not a behavioural science expert, but I do touch on behavioural science in my storytelling work.

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Um, and I think there are clear commonalities between storytelling, maybe, but new stories or indeed creating digital stories,

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audio visual stories and behavioural interventions because it's really important with either face, with a story or a behavioural intervention.

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We understand the purpose when we write. We always work with purpose.

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If we everything think like just to know what's right next or this is too long.

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Is there a purpose to this sentence, to this paragraph? And if you can find one and it serves the the overall aim of your, your,

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your story or indeed the aim of your intervention, you always need to identify behavioural change you want to see.

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Does it have a purpose? Yes. That's good. Okay. Knowing the audience is really important.

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Um, you could have fantastic behavioural science. Behavioural intervention.

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But if you've got the audience wrong, it's probably going to be a bit wasted.

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Okay, so knowing the audience is really important. And underpinning all of this I believe, is relate ability.

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So if there's one thing you take from this, relate ability is the most important thing with storytelling.

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And I imagine that plays into behaviour size too. But um, I will leave that to the experts to talk about some more.

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Um, no, I wanted to just expand slightly. Have you seen this this week in your calls?

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Yes, a few notes. Okay. The owner of the behaviour change that I said.

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Yes. I think you should tell you too much about the other than to say that I just said that storytelling is one form of communication.

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Okay, that's the basis I work on. Um, so in behavioural science terms, I see it as a delivery mechanism, if you like.

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Um, um, communication down the outer ring, the circle you've got, um, the, the, um,

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what I've call delivery methods or policy categories, communication and marketing.

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So it does fit on the behaviour change wheel, which is great.

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Um, it has a role, um, I see storytelling purpose as a form of communication to inform, to entertain.

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Or maybe we could expand that, to engage, um, and to trigger change.

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Okay. Change in thinking, changing behaviour. Now, ideally we storytelling we want to hit table three.

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We want to trigger behaviour change. We want to make it informative.

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So we call to embed knowledge. And ideally you know if we can make it entertaining that's great too okay.

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People will engage with it. Um so we may ask, you know, when people engage with stories,

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why is it that some stories really stink and change behaviour and others think this was in one ear, not the other?

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Well, let's look at this. Anyone recognise and tell me what this was?

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No. Yes, please. Thank you. Oh, yeah.

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How many of you you're from the UK or mixed?

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Mixed? Yeah. Okay, so. Well, just so this was a TV drama, okay?

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Which was run in January 2024, and it was all about what we call became known as a post off scandal.

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Now, it was a very successful drama.

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And for me, this is this epitomises this idea of story and storytelling leading to action.

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I'm using the word action, rather behaviour change. We tend to think populations.

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You will see the parallels, I hope. Okay. This is just a potted history of what happened.

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So 1999, 3000 subpostmasters that the owners of the post offices, um, reported shortfalls in their takings.

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So what they took in their till versus what was sort of what was recorded on the computer were different.

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It was a shortfall. And um, clearly this this led to accusations of of stealing money from the Post Office account.

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Um. Lots. I can't remember the total number of subpostmasters, but lots of cases came forward and there was a drip feed of news.

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It didn't really didn't even hit trade press.

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We, or maybe a few local press up to about 2010 when Computer Weekly, which is a big national trade magazine, broke the story.

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Okay, 2012 picked up my BBC Panorama investigation show on on on our deep sea channels.

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Um, and then campaigning began. Things started to pick up a little bit, but still not a lot.

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Not a lot of action. Move on fast track all the way up to 2024.

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Okay, this has been sort of trickling on for two decades.

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These poor subpostmasters have had a hellish time, and then they make a drama and they make this drama and all of a sudden everything changes.

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Okay, I think there were some figures that there was a, you know, the number of mentions in media of post office scandal prior to this.

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I think it was 3 or 4 nights over a week prior to the broadcast.

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Um, this is after the broadcast went up by 10,000%.

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That's just UK media. Um, but the important point is it led to action.

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Okay, so four days after the broadcast, we had, um, the Prime minister at the time, Rishi Sunak,

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who we decided to have an emergency debate in parliament, he publicly apologised to the, the victims of this, this, this scandal.

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Um, and he fast tracked legislation to ensure these people got compensation.

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Okay. So there you have a direct link between your storytelling, albeit a TV drama, um, and action.

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Okay. So I hope that demonstrates to you the power story.

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Well told. So let's move on to the next part.

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Okay. So digital storytelling. This is the form of digital storytelling, if you like, that.

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I studied for the past few years. Um, and the subject area is I am on 96 and I'd like to show you how perhaps we could

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we can use digital storytelling to shape perceptions the way people think.

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And then later I get to touch on how that fits into the causal pathway to behaviour change.

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Do you time? Okay. Um. Just like I realise a few of you in the audience is very familiar with AML, but just a very, very quick overview.

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So we're all up to the same sort of level. Um. These are like terms, okay.

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But basically what happens when bacteria develop defences to drugs that used to kill them in a line?

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Okay. Antimicrobial resistance refers to resistance in bacteria, viruses or parasites or fungi specifically that gut bacterial resistance okay.

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So biotic resistance. Um, and what does this mean?

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Well, for patients this means that, um, the infections they get if they're driven by resistant bacteria will be harder to treat.

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Okay? Sometimes they can be life threatening.

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Okay. And that, um, I can't remember the exact figures, but something like, I think 2019 figures of 1.2 million global deaths due to AML.

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There are problems with nginx. Sorry, I'm definitely tracking all because as far as I know in the UK, you don't like that on the death certificate.

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Okay. That's that's changed. Okay. Um.

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So, based on my figures, what you've got here is a picture of, um,

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a reproduction of the famous story about Alexander Fleming in 1928, in his lab in St Mary's Hospital.

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Apparently he went on holiday, came back, had sort of left a messy lab bench, um,

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only to find that some of his petri dishes were contaminated and one of them was contaminated, as you see here with Penicillium mould.

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And you can see a sort of radius around that where there's an inhibition of bacterial growth.

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Um, and that was well, is often considered the first major discovery of antibiotic action.

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Okay. And it's a long story. And it goes on.

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And, you know, there's lots of other people that really should recognise this too, like Florey and the other guy.

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And if that's the story, what does it mean for patients today? Well, this is a microbiology um, report and otherwise support.

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And you can see that with, with, with the resistance and lots of different antibiotics in the resistance.

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Um, and this patient is sensitive to what that person.

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So they, that you see, um, and I think really important point is that he calls these antibiotics across medicine.

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Okay. I think you'd be hard pressed to find you probably will be hard pressed to find one speciality,

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but I've got six aren't used for some reason at some point. Okay, so this is Evans transplants.

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You know, cancer chemotherapy. You often have sex with that or after that.

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Um, cystic fibrosis. Cystic fibrosis.

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You need to keep the lungs clear of infection. So people with with that disease, you know, fortunately have to keep taking out six.

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We need to keep these drugs with them, okay. For these sorts of people who could be gravely ill without them.

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Um, and that's a difference between healthy people who could probably and probably have very

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often self-limiting infection and due to viral infection and don't need antibiotics,

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sleep. Um, so. Because antibiotic overuse drives them all.

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And I'm just talking about humans. I am all over the big field and we call it one health.

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It applies to animals, environment, farming, you name it. Focusing.

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Just don't we right team and use. Yeah. Um, we need to ensure public understanding, okay?

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We need to not only do people need to know that we should use expertise cautiously, but also we need to understand how Amr happens,

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okay, how it drives how how antibiotic use and overuse and misses drives the development of AML.

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And that actually AML affects both healthy and people who have underlying disease.

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So we are all in risk. There are lots of messages. Okay. Um, we need public involvement.

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We need professional involvement and engagement here.

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And there are examples of campaigns.

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This is actually the current one on the left. This is the UK campaign.

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Um, in fact, I think they've launched a new version of it this week because it's world that's Antibiotic Awareness Week.

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Um, and you know, the message in the back is a bit faded, but you can see antibiotics don't work for everything.

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Very clear what I would call sort of a didactic message, really.

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Again here, an older one, um, you know, European CDC message.

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You know, they don't like colds increase. Okay. It's very clear there's a place for these this type of communication.

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Okay. There is um, I think it's great to keep this front of mind.

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Um, possibly more so certain times a year.

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Flu season might be a very good example. You know, around that.

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Now, really, if you and your GP surgery have them or the tubes, whatever you like.

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Um, it just keeps it there. But they're all the way I would like to approach or have approached it with my storytelling is there are

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a lot of ingrained to some assumptions about who gets to resist infection and shifting these findings,

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which are long held habits, things that, you know, antibiotics are a quick fix.

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Let's go. Let me get back to work. I'll take an antibiotic. Okay.

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They work, you know, they work for everything they do. Tap into that here. There are a lot of assumptions you have.

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You are immuno compromised. If you're immuno compromised, perhaps if you're elderly, if you're frail or weak.

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Sure air miles a problem for you, but hey, it's not for me because I'm healthy.

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But that's not true. So how do we address this?

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Um, we need people to engage with resistance.

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How it happens. Who it affects. What is the lived experience?

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That's what storytelling has to do.

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We've got to shift them off from the biomedical and the abstract to something that's much more concrete, much more real life and death.

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So we want you to go away and think that though progress has been made with antibiotic prescribing because it has, um,

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and I would dare to say I think a lot of this in the UK, I'm talking from a UK perspective,

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has been with your professionals, your health care professionals. Um, I sort of put it back in the sounds of 2014.

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A big report was commissioned then looking at the state of play regarding email and actually quoting case in this country.

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National Action Plan started then um, and then just just this is the only stuff I use.

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Uh, 16.6 defined daily doses of antibiotics down to 14.1, um, over, well, approximately ten years.

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Um, so it's a bit of a drop off in prescribing. Okay.

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However, um. There is still a perception amongst the public when it comes to AML that they are low risk.

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They only look disinterested and often draw a contrast here with things like, um, anti-vaccine talk.

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If you like anti-vaccine sentiment and hesitancy, which is very negative.

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Okay, so it's a different sort of communication that that is needed.

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Perhaps with this we are just dealing with disinterest, right.

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Psychological distance doesn't apply to me.

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You know, it applies to people who are socially different to me.

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For example, um, in time, it might happen in the future or become a crisis in the future in some other place.

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So this concept of psychological distance, which really turns into this idea of disinterest,

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it's what we're basically things because actually it is a problem.

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And it would and it can affect us all. Okay.

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And the other inevitability that I really need to point out is that even if we create new antibiotics and very few new class classes,

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new classes, vegetables itself, um, being developed, delicious bacteria will always evolve resistance.

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It's natural, the way they reproduce. Anything we come up with, there will be resistance.

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So this is my project. Um, this is the home page of the website where you can find the videos.

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Um, and I'd like to explore further how we use digital storytelling as a means of communication or engagement, if you like.

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Um, through the telling of personal stories, personal experience.

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Um, I'll refer to it as DST digital storytelling.

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Easier to say.

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Um, started in the late 90s over in California, um, by some artists who, um, we just sort of digital communication started taking off more.

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Okay. It's been used widely in, um, education, secondary education, also medical education,

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often to place the clinician in the in the shoes of the patient to get some idea of how it feels.

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Um, and this, as far as I know, is the first time it has been used in the communication.

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Um, so it's very co-creative process. That's the first thing to note is something quite distinctive about DST.

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Is my self serve as a facilitator in the process?

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I train the storyteller, the person with the lived experience, with the skills.

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So that might be script writing. It might be video editing, so they can actually make the story themselves that they can create.

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It is quite nice. Um, okay. So.

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I conducted a study called Storybook Study. Created five digital stories.

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Um, and these were, as I said, about these personal experiences.

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We created the stories, and afterwards I interviewed each storyteller to get their impressions of the process.

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Um, interestingly, I didn't go into this with the therapeutic content at all.

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I was making these probably engagements under the umbrella of engagement and, um, educationalist.

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Um, but they all kind of waking up. I feel so relieved.

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I said, this is like a catharsis I think makes some sense, which is really lovely to hear.

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They said I finally had the chance to talk about my experience and all due respect for clinicians,

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the people who've worked so hard to help them through their illness and that the medical side,

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they don't have time to sit and talk about the other parts of their lives that were affected by this.

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And all of a sudden they had the chance to do it. Um, and it's quite amazing how it can help people.

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It really can, um, you know, one, one girl, she she seems to be over her illness now.

242
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It's it's quite remarkable. Um, we then took these stories.

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We created those five stories and shared them at a screening, which I recorded.

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We had a discussion around that, recorded that. I analysed that, um, thematically, and that became my primary data.

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Um, and then I map systematic findings to the behaviour change meal,

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which we saw at the start of the study, key principles of digital storytelling, key principles.

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So, um, very importantly, the storyteller has control.

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I think it's really important. The buck stops with them. If they want to do that, make the story a particular way.

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That's fine. I can guide, I can facilitate, I can advise it's their story.

250
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Right? Um, and this is actually quite different to, um, when we have a, a traditional film, say, where you have filmmakers, editors,

251
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producers, directors, you name it, every person you put between the storyteller and that, um, project brings an interpretation.

252
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Okay. By the time you get to the end product, it's totally quite different to to the version that storyteller told you in the beginning.

253
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So with this storytelling, we try and flip this around and say, it's not going to be polished, it's not going to be perfect.

254
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It's actually can be really authentic. Okay. That's the idea. I got that storytelling.

255
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Hey, pick up your phone. It's quite democratic in the way that, you know, most people could do this, right.

256
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It's not it's not a social media video. No, it's beyond that.

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It's somewhere between that and a, uh, a film made by film crew, say.

258
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Um, but the idea is that they can take photos. They can take moving images from their phone.

259
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You know, they're very personal. It's the way they sell their experience, and they bring this into it.

260
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Um, and the final point I wanted to add there was it really is a form of participatory research or an intervention,

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if you wish to use it that way, because you actually ask people from that community to develop the stories themselves and share it with others.

262
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Okay, so it's all about that peer to peer communication and engagement.

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Okay. Four phases. Um, we find the story.

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We tell the story across the story. We share the story.

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This is quite simplistic, but it's a nice guide. Okay.

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Um, so I'm going to refer this was actually I didn't mention my should.

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This process was developed by a guy called Mike Klein in Canada.

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Um, and it's called the Common Language Digital Storytelling Process.

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So if you want to find out more, look him up. That's the story that the, the, um, paper that explains the process.

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Okay. And it's great. You can do courses on sports.

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Fantastic. Any any week. So finding the story number, the first step if you want to phase.

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So this in practice means I would probably sit down with the storyteller for about 1 to 2 hours and talk through everything that happened to them.

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Okay, tell me the events. Tell me the emotions that went through that event with that event.

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And the idea is that we have a reflective session where we try and find controlling idea.

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Okay. So you will see when you watch later what I mean,

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there'll be one big controlling idea in the story that finds and all those sorts of disparate different elements of that experience,

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the cognitive, emotional, you know, it could be something to do with a medical sequence of events,

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all these things that were falling together into one coherent whole and within an audio visual representation of four minutes.

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It's got a whole thing to do. Um, but we talk through it, we find it together.

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Um, and this is a very nice way of putting it. This guy, Robert McKee, he's a screenwriter in, in Hollywood.

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Um, and he says the powerhouse of creativity and I extend this to digital storytelling,

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is connecting two seemingly unrelated things to create something that's new, real nice.

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Okay. And within the context of digital storytelling, what we're trying to do is hear the medical story.

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And then I say to the person, can you just tell me something else about your life? Nothing to do with your illness.

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What's your hobby? What's your pastime? Hiking. You like Star Wars? Tell me about Star Wars.

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Could be anything like that. Think so? Don't mind.

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And the reason we do that is because we want to be able to relate the medical story, which is probably be obscure to some viewers.

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They wouldn't know much about airmail, you know. So we want to find a way of relating it.

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And we would build an image system and metaphor system through the other hobby pastime, if you like.

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And you will see this play out when you watch the film. So that's the idea that it's all about building a bridge between the science and the

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biomedicine and the the lived experience and the public's interpretation of communicating,

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telling. Well, this is how should we put this? This is the manifestation of the meaning we have discovered in that finding face into a structure.

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Okay. So this is an example of script. This is what I'm doing at the moment.

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Um. We'll aim for about 5 to 600 words.

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It should be about 3 to 5 minutes in length. This is where we bring in things like flashback or foreshadowing.

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Is probably taking back to English class at school. Um, but it's all about how you can create tension, um, inciting incidents.

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Let me just show you quickly this back to school.

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Yeah. Story arc here. How do you write a good story? Well, the idea is you you encourage change or transformation.

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So you have your exposition at the beginning. One state of affairs.

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You have inciting incidents. You create tension. You have rising action story climax, which is a turning point where it's irreversible.

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Things could have been going on for this in the story world hit and then the falling

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action is where all the pieces of the puzzle come together to create a new whole,

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a new normal. Okay. Um, so yeah, so that's what we do.

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And at this point as well, very importantly, I ask that person to record a voiceover.

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Very patiently. Then what was an anonymous English test like? Ask somebody to do that for them.

306
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Um, but ideally we have them. Okay. Next point crafting.

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Okay, so anyone who's used make social media videos will be familiar with this.

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Probably this sort of screen. This is something called we video.

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So we video is they use it in schools. It's um, you know it's good.

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It's not too complicated. It's not too basic. Okay. You can do lots of different things.

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So this is where we we take our voiceover, we load this onto the tracks, we load perhaps a, uh, a track full of photos,

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a track with our moving images, and we combine them all together and we start using things like transitions and effects.

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The point is, we want to somehow instil a sense of innovation, to bring in the empathy of the viewer.

314
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Okay, so the things we might do pasting of images is a really good example.

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So, you know, if we linger on one image for about six seconds, that will, that will really give you a feeling of, of calm or something reflective.

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Okay. It if we do the opposite and we say, okay, let's change this and stop images in under a second,

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then we're going to move to a much more chaotic feel, a sense of urgency.

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Okay. So that's how you can convey your, your emotions through, um, use of transitions and effects.

319
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Okay. And of course, there's lots of things you can crop and overlay using all sorts.

320
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Um, sharing. Yes. This is the final bit where actually you bring in your friends and family.

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It could be. Or if you're part of a patient organisation, you might decide you want to,

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um, bring in other members of your patient advocacy group or indeed you can.

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The idea with these is that you can put them online and and you could, you know, the general public view, the outreach.

324
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That is something I have to think about later on. Okay, that's the next part of the dissemination.

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But basically you could, you know, you can use it for advocacy purposes, education purposes, um,

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therapeutic purposes and indeed research purposes for sort of distinct purposes for digital storytelling.

327
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Okay. And that was mainly, uh, my research, meaning, um, I started with ten and it was a training stroke.

328
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So not quite as many as I take, but hey, but these are my select stories.

329
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Um, and basically these just to break it into two, two rationales.

330
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On the left you have what I would call the young and healthy.

331
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So the rationale here is that we want to illustrate how young and healthy people can get resistant infections too.

332
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Okay. And over here, um, we've got the idea that actually this is I thinking behaviour science has been talking modelling by consequence.

333
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Okay. So we're showing the impact of resistant infections.

334
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Um, and indeed the trauma in some cases. Okay.

335
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So we're looking at that. So I'm going to move straight on to viewing a story.

336
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How would I think about these questions. It's only a I think about 4.5 minutes.

337
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How does it make you feel.

338
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Any images worth it stick with you afterwards as you shift how you think about I am on a slightly different because you're not general public.

339
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You do have some medical background, some of it, but let's go for it.

340
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So yeah. Thank you. I'm just gonna ask you about these questions.

341
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Thank you for watching. Um. That was Layla's story.

342
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Well, I've been doing research on Ironman for the last eight years, and I have to say that, uh.

343
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Uh, still, I still would be thinking about it in a different way after watching that.

344
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I think because what we tend to think about is we think about, uh,

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people prescribing for coughs and colds and stuff like that, but I think that, um, extreme level,

346
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extreme side of continuum of people really, um, suffering from consistent infection is something,

347
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as you said, that we haven't really spoken about, especially in high income setting.

348
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Yes. Yeah. So yeah, really bringing that to the forefront.

349
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Thank you. Thank you for that. Yes. And there are a lot of ways of looking at it.

350
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You could look at that say well that's an extreme case. Kind of relate to that.

351
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But the point is we need to remember what we're observing antibiotics for.

352
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Okay. These are the people as well. Um, anyone else have any images, words, anything in production?

353
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Um, you know, as I said, it's not a polished film.

354
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Okay? We realise that it's not supposed to be a this film. It's supposed to be real and authentic.

355
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You know, there were some stock stock images in there. Looking at it now may be able to switch studies, but you know, it's.

356
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Yes, this. Strikes me how the whole journey is like that.

357
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It is likened to like a journey up upwards the mountain with the map.

358
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It is off of the mouth of an all encompassing. And I think that, um, impulsive emotion is um.

359
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So I think it's a good way to make, uh, readers emotionally hooked and, like,

360
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wanting to know how does the end of the story really want to follow the journey?

361
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I think that's the impression I get. Thank you. Brilliant. Thank you for saying that, because I was hoping that, like, you consult with you.

362
00:35:15,280 --> 00:35:18,790
Good. Okay. Um, and we've heard how it might shift, how you think about it.

363
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So let's let's, um. And anything else, I mean, what? That'll help you with that?

364
00:35:23,890 --> 00:35:27,040
Okay. Just reflecting back to you.

365
00:35:27,190 --> 00:35:30,880
Okay, good, good. So. Oops stuff again.

366
00:35:30,940 --> 00:35:34,349
There we go. Yeah. This is a bit where I feel like it's getting shabby.

367
00:35:34,350 --> 00:35:37,650
So get your responses like and this is what our survey said.

368
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Um, so basically I obviously screened the film to get responses, um, to a bunch of but the,

369
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a group of the general public small group, um, and recorded their views on it.

370
00:35:51,370 --> 00:35:53,430
Okay. And these are their interpretations and insights.

371
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Um, we have touched I think the lady here in the middle touched on the idea here about vulnerability and emotion.

372
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Okay. So it was really clear that actually vulnerability comes through very strongly okay.

373
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Not only have biological vulnerability and clinical vulnerability,

374
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but emotional vulnerability and indeed her existential vulnerability very, very clearly.

375
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Um, so the idea is you can see a direct, um, connection there between what the tenor is showing us and indeed,

376
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um, the viewer on that emotional connection through empathy.

377
00:36:31,080 --> 00:36:40,500
Um, so that that comes through strongly. Um, you know, particularly this point where she says, I'm scared I'm going to die sex thing and no responses.

378
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Um, I remember she told me that that was really piercing, really meaningful, the fact no one said anything.

379
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And I'm sure there's all sorts of reasons why, I don't know.

380
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But that was a real moment. A pivotal moment that crystallised all that emotion.

381
00:36:58,290 --> 00:37:04,320
Next quick metaphor we have speaking about metaphor. Um, basically the the point I guess here would be.

382
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That she uses hiking very, very well.

383
00:37:12,170 --> 00:37:19,150
Okay, so she chooses hiking as a vegetable. It works well with the mountains, the Scottish mountains.

384
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It was very personal to her. When she's well enough, she does hike.

385
00:37:23,390 --> 00:37:26,540
Um. And it's something we can all relate to.

386
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So even if you haven't hiked the mountain, you've probably walked up a steep hill from here,

387
00:37:30,920 --> 00:37:34,850
and then you go, oh, that's another peak beyond that, as I'm sure you've all been there.

388
00:37:35,450 --> 00:37:43,219
Um, so that was the point. You know, she thought her cancer was going to be the biggest threat to her, but actually infection was a far greater.

389
00:37:43,220 --> 00:37:47,780
That was the peak. Cancer was a false peak, right? The real peak was the infection.

390
00:37:48,050 --> 00:37:55,940
And to this day, it continues to be said, from my understanding, um, that infection could could it could be sensitive to antibiotics,

391
00:37:55,940 --> 00:37:59,870
but obviously if it's resistant then you have a much bigger problem. Okay.

392
00:38:00,140 --> 00:38:05,330
So metaphor was used very well. The other point is stories embed knowledge.

393
00:38:05,930 --> 00:38:10,000
And there is um a lot of knowledge that needs to be imparted about am.

394
00:38:10,010 --> 00:38:17,749
Um, okay. One key thing is the fact that the the agency of resistance is confirmed by the bacteria, okay?

395
00:38:17,750 --> 00:38:26,900
It's not the human body. And if I had a penny for if a person said to me my body is tolerant, 2006 they no longer work on me.

396
00:38:27,470 --> 00:38:31,010
And I think, no, no, no, no, no, no, it doesn't work like that.

397
00:38:31,400 --> 00:38:36,440
And, you know, it doesn't matter what their educational background might be, say, when you people think this.

398
00:38:36,890 --> 00:38:40,370
So we know that obviously the bacteria becomes resistant of bacteria everywhere in the environment.

399
00:38:40,370 --> 00:38:43,730
We pick them up and we get resistant infection that way. Okay.

400
00:38:43,940 --> 00:38:50,240
And risk levels vary of course. Um, but we are all vulnerable to infection, susceptible to infection.

401
00:38:50,570 --> 00:38:55,150
Um, so what we do in a story is being fed that it's not, uh, didactic.

402
00:38:55,400 --> 00:38:57,860
A message is embedded within the story.

403
00:38:58,100 --> 00:39:06,670
And, you know, some of my viewers came away as it is, a cancer patients had such a high risk of infection, probably greater risk of infection.

404
00:39:06,680 --> 00:39:10,280
And indeed the cancer. That's often the the worst thing about it.

405
00:39:10,790 --> 00:39:15,320
Um, couple of other things. Related ability we mentioned before, authenticity.

406
00:39:15,560 --> 00:39:22,730
There's lots of ways of interpreting related reality here. I think she has a lot of her own photographs in hospital and some video from hospital.

407
00:39:23,210 --> 00:39:26,240
Um, that brings a sense of authenticity. It's from her mobile phone.

408
00:39:26,240 --> 00:39:30,370
Okay. There were a few, as I said, a few stock images. Sometimes you have to.

409
00:39:30,370 --> 00:39:33,890
You don't have the imagery. Some people go off and do their own filming. Fantastic.

410
00:39:34,280 --> 00:39:40,510
Um, so I think hopefully through metaphor, through the authentic photos, relatable.

411
00:39:40,520 --> 00:39:46,280
She comes through, um, and the last point and oh, actually, no, let me just one thing about emotion, okay?

412
00:39:46,820 --> 00:39:49,970
Storytelling. There aren't that many.

413
00:39:50,670 --> 00:39:55,790
Editors note there isn't one coherent theory behind digital storytelling.

414
00:39:55,790 --> 00:39:59,090
Okay? There's lots of ideas and small theories and academic thinkers,

415
00:40:00,380 --> 00:40:10,340
but one that strikes me as particularly sort of suitable for this is something about green and rock, and it's all about, um, narrative transportation.

416
00:40:10,940 --> 00:40:14,330
It's that idea that when you become immersed in a story world.

417
00:40:15,420 --> 00:40:20,970
Your resistance to any ideas that you might have held prior to entering that story?

418
00:40:21,180 --> 00:40:25,470
Story world dissipate. Okay, so your resistance drops.

419
00:40:26,010 --> 00:40:33,209
You get so engaged in the story and so immersed to all the different devices and techniques of filmmaking,

420
00:40:33,210 --> 00:40:38,100
digital storytelling that you start accepting whatever you're being told.

421
00:40:38,430 --> 00:40:41,670
And I always say, if you ever see Breaking Bad, it's a really good example.

422
00:40:41,900 --> 00:40:49,520
Does anyone see Breaking Bad? There must be someone here. But, um, it's really good example because you've got this, you know, family man.

423
00:40:49,530 --> 00:40:53,099
He's a teacher, a lovely guy. Yeah. He's so nice.

424
00:40:53,100 --> 00:40:56,100
We all support him. His love, his, like, having a second baby.

425
00:40:56,520 --> 00:41:01,049
Dee dee dee dee. And then he gets his diagnosis of cancer.

426
00:41:01,050 --> 00:41:07,170
And he has to make money quickly to pay off debts and things, and, hey, he sells drugs, right?

427
00:41:07,740 --> 00:41:12,250
Um, but somehow we go with him. We know it's wrong.

428
00:41:12,270 --> 00:41:17,099
Walter White is doing a really bad thing, but somehow we are with him all the way.

429
00:41:17,100 --> 00:41:21,630
Because we are in that character. We are immersed in his world.

430
00:41:21,660 --> 00:41:29,940
Okay, so that's that point. And then the final point is all about, we think, storytelling between teller and viewer as a transactional process.

431
00:41:30,830 --> 00:41:39,470
They encode a story. We decode the story as the decoder, as the viewer, and we interpret it in our own world.

432
00:41:39,620 --> 00:41:45,290
We take an ownership of that story. Okay. That, for me, makes storytelling so unique.

433
00:41:45,890 --> 00:41:50,209
We bring our background, our historicity, everything to that interpretation.

434
00:41:50,210 --> 00:41:57,890
We take it back with us. Um, and this guy, he said when he saw it, this idea of running out of antibiotics at work, he has a dog.

435
00:41:57,890 --> 00:42:03,080
And he said, it's just like my dog is really ill. We've tried everything. There's only one antibiotic that's ever going to work for my dog.

436
00:42:03,080 --> 00:42:06,890
Now, that was his world, right? And that's how he interpreted it.

437
00:42:07,730 --> 00:42:10,850
Okay. And this summarises it rather nicely.

438
00:42:11,480 --> 00:42:17,840
Michael Wilson, if you're interested in storytelling, brilliant storytelling, ultimate university, look for lots of ideas.

439
00:42:17,840 --> 00:42:25,730
He runs courses on this sort of thing. Every moment of telling or retelling a story without telling any of that story dies.

440
00:42:26,210 --> 00:42:31,280
Okay? Because each one of us, we've watched the same story, but each one of us will have a different adaptation.

441
00:42:31,760 --> 00:42:35,330
Okay? Because in that telling, we have received it in a very personal way.

442
00:42:36,980 --> 00:42:43,160
Three things. When I looked across more, I'm not going to go through them all. Um, unless particularly you want me to expand on something?

443
00:42:43,490 --> 00:42:47,840
Um, we have spoken about it is stories bring forward the lived experience.

444
00:42:47,840 --> 00:42:54,320
We read things that are often unrecognisable. Um, realised if you just look at the medical picture, the medical story alone.

445
00:42:54,740 --> 00:43:02,330
Um, and that's knowledge, I say, as I explained, um, things infection being very important, people who are healthy,

446
00:43:02,330 --> 00:43:07,460
getting resistant, infection, pieces of knowledge in bed, um, that become more meaningful.

447
00:43:08,000 --> 00:43:13,489
Um, we have lots of devices and techniques nurtures emerge and we've spoken about that.

448
00:43:13,490 --> 00:43:17,030
These are the things that came through of the phonics story structure as a whole.

449
00:43:17,360 --> 00:43:23,840
And then finally, um, it was kind of interesting. A lot of people brought in their widest sort of values into their interpretation.

450
00:43:24,290 --> 00:43:32,119
Um, sort of one guy in particular, he he was particularly he was a Buddhist, and he said, I believe we should be living in harmony with that.

451
00:43:32,120 --> 00:43:36,560
Jesus was interesting take. You know, often we use language and metaphors with them.

452
00:43:36,890 --> 00:43:39,950
We fight infection. We tackle resistance.

453
00:43:40,370 --> 00:43:43,549
It's a war metaphor. How about we switch that round?

454
00:43:43,550 --> 00:43:49,520
You know, I know there are various academics spoken about this sort of thing, but it's quite interesting that he said the same.

455
00:43:50,000 --> 00:43:53,389
And he was saying that, you know, maybe we should think about living in harmony. Okay.

456
00:43:53,390 --> 00:44:02,629
So the disrupting of, you know, biological ecosystems, our microbiomes, skin, gut, lung, whatever, you know, this is more preventative, I realise.

457
00:44:02,630 --> 00:44:07,970
But perhaps if we did that more often, when we're healthy, relatively healthy and have a mild infection,

458
00:44:08,420 --> 00:44:16,040
we have the people who really need these antibiotics and it comes back to back, um, relaxed ability.

459
00:44:16,040 --> 00:44:20,510
Yes. Remember why I put this slide in? I wasn't going to add this chair picture.

460
00:44:20,540 --> 00:44:25,100
Okay. This is an outpatient waiting room in a hospital. But my viewers really liked it.

461
00:44:25,550 --> 00:44:28,880
Okay. We put it in again. Storytelling. I want you to put it in. It was their control.

462
00:44:29,390 --> 00:44:34,940
And they said, gosh, I I'm totally drawn into the anxiety, the anticipation.

463
00:44:35,660 --> 00:44:39,350
How am I going to get a diagnosis? This is waiting to see the doctor.

464
00:44:39,350 --> 00:44:45,049
Okay. And so a layperson this actually rings bells in their head okay.

465
00:44:45,050 --> 00:44:50,630
So sometimes the simple pictures are the best. Um, and I won't go into this too much, but this is another story I have.

466
00:44:50,930 --> 00:44:54,440
Um, she was a belly dancer as she wanted to describe.

467
00:44:54,440 --> 00:45:00,589
She had a resistant urinary tract infection. Um, she found that was triggered through physical intimacy.

468
00:45:00,590 --> 00:45:05,510
And she actually said, you know, she used belly dancing as a metaphor.

469
00:45:06,020 --> 00:45:11,900
She said, I used to feel free. I used my relationship for fun, you know, it was all fluid and fun.

470
00:45:12,170 --> 00:45:18,709
And she said, then I got my UTI. She said, my whole life just reduced to being rigid.

471
00:45:18,710 --> 00:45:23,030
I can't move, I can't dance, I can't feel free. And this has gone on for years.

472
00:45:23,030 --> 00:45:26,120
Dancing is this resistant human infection.

473
00:45:26,450 --> 00:45:30,529
But she used her belly dancing. Um, I've used clips from her doing that.

474
00:45:30,530 --> 00:45:33,920
Which is what? This. Mapping. Final part.

475
00:45:33,930 --> 00:45:37,080
Okay, we're all we. Five minutes. Even less possibly.

476
00:45:37,260 --> 00:45:39,720
I do realise it's behaviour change behaviour science course.

477
00:45:39,990 --> 00:45:49,229
As I said, I'm not an expert, but I did take my thematic findings and thought hey, this is somehow perfect on the causal pathway to behaviour change.

478
00:45:49,230 --> 00:45:52,959
Would be nice if it did. You know, I'd like to think we've got a, you know, we can change something.

479
00:45:52,960 --> 00:45:58,620
The story's storytelling. Um, so I use this tool called, um, the theory and Techniques tool.

480
00:45:58,650 --> 00:46:01,760
Have you seen this at all in your work? Um. Today?

481
00:46:01,880 --> 00:46:08,760
No. Okay. Um, basically, you take a look at the mechanisms of action, of digital storytelling.

482
00:46:09,480 --> 00:46:14,310
And this was based on literature, lots of conversations with experts in storytelling.

483
00:46:14,850 --> 00:46:18,329
Um, and then I referred to this. And this is linked to the behaviour change.

484
00:46:18,330 --> 00:46:21,720
Well, I think there is an updated version from this summer.

485
00:46:22,230 --> 00:46:28,440
I didn't actually use that a bit late for my thesis, but what I did was I took emoji at the top.

486
00:46:28,440 --> 00:46:33,780
If you can see, um, these are different, different mechanisms of action.

487
00:46:34,020 --> 00:46:37,740
Okay. And I related digital storytelling to that.

488
00:46:38,280 --> 00:46:43,589
And then you, you, you come down in across and you can find behaviour change techniques.

489
00:46:43,590 --> 00:46:49,920
Beseeches. You might have heard of Beseeches which have linked to the com the domains and any.

490
00:46:49,980 --> 00:46:58,830
Yeah. Okay. The idea being if you can map it across then perhaps you could better link the okay, a bit of a conflict.

491
00:46:59,040 --> 00:47:06,970
So I looked at my thematic findings and I said, hey, um, where do they relate on the domains of referee?

492
00:47:07,020 --> 00:47:13,410
You know, for example, with, okay, you've got physical, you've got a psychological capability, and likewise all the way down,

493
00:47:13,500 --> 00:47:21,210
the ones that were particularly relevant for psychological capability, social opportunity, and both the automatic and the reflective motivation.

494
00:47:22,020 --> 00:47:25,259
Okay. And here is a tiny snippet okay.

495
00:47:25,260 --> 00:47:30,540
This is quite a long process as you can imagine. Sort of the whole mapping, uh, sequence of events.

496
00:47:30,900 --> 00:47:40,560
Um, but so if we look here at the top, if we look at the one in yellow psychological capability we've got, I'm going to read off here to tiny the, um.

497
00:47:41,610 --> 00:47:47,610
You know this idea that. Who would have thought? There's one story I haven't shown you yet, but about side effects of antibiotics.

498
00:47:48,000 --> 00:47:51,569
So a lot of people think, hey. Oh, good. No home antibiotics.

499
00:47:51,570 --> 00:47:56,610
Have one of those. Be fine. Um, actually, they can have serious side effects.

500
00:47:57,150 --> 00:48:00,809
And this story was about that. Okay. A young guy, healthier.

501
00:48:00,810 --> 00:48:07,730
She had ski accident, um, had surgery, and then later found out there was an infection inside the wings.

502
00:48:08,040 --> 00:48:11,339
Okay. Had to take antibiotics. Well, the ski accident was nothing.

503
00:48:11,340 --> 00:48:16,440
It was the side effects that really sort of put him out of action for about a year.

504
00:48:17,430 --> 00:48:26,370
So anyway, the point to be made was that it's overturning this assumption that antibiotics are all good and at home on quick fix wonders if you like.

505
00:48:26,820 --> 00:48:32,010
Um, and this was a quote from one wife, one of my people, who would have even the thought that,

506
00:48:32,010 --> 00:48:36,030
you know, antibiotics could actually break down the bone marrow and damage the liver.

507
00:48:36,750 --> 00:48:43,020
Well, this is telling me something psychological capability that across, um, the mode of action involved here,

508
00:48:43,020 --> 00:48:49,530
as you can see, knowledge, it's it's imparting some knowledge, beliefs about consequences of using antibiotics.

509
00:48:49,920 --> 00:48:55,139
And it relates to the beasties. I've just highlighted one that in the information about health consequences.

510
00:48:55,140 --> 00:49:03,600
Okay. So it's just quite a nice way of showing how you can look at an interventional tool is a I've tried to use it here and say,

511
00:49:03,600 --> 00:49:07,530
where does it fit on that causal pathway to behaviour change?

512
00:49:08,010 --> 00:49:11,550
Okay. And I've done similar, um, reflected motivation there.

513
00:49:11,910 --> 00:49:15,809
We were looking at um, oh yeah.

514
00:49:15,810 --> 00:49:20,310
This is for her using the Layla, using the metaphor of mountains hiking in the mountains.

515
00:49:21,000 --> 00:49:25,440
It makes you makes you think. I mean, it also applies to automatic motivation.

516
00:49:25,440 --> 00:49:28,650
Actually, as we said, it was very strong in emotion and empathy.

517
00:49:29,370 --> 00:49:32,460
Um, and I would say that relates to both sides.

518
00:49:32,910 --> 00:49:39,240
Um, and here you can see, you know, the beseeches is all about, um, sense making.

519
00:49:39,510 --> 00:49:43,080
Framing is important here. There are prompts and there are cues.

520
00:49:43,140 --> 00:49:48,720
Another buck to which, you know, when you look at the mountains, when you look at the pictures of her with all the tubes in her arms,

521
00:49:49,020 --> 00:49:53,010
you know, pumps and cues, there's lots of ways you can relate it across.

522
00:49:53,370 --> 00:49:58,259
Okay. So conclusions.

523
00:49:58,260 --> 00:50:03,379
So I hope that you share some of my thesis in full.

524
00:50:03,380 --> 00:50:10,010
Seeing that storytelling and digital storytelling, um, can be a tool for both research and interventional purposes.

525
00:50:10,490 --> 00:50:15,710
Um, and indeed in helping shape beliefs, attitudes and contribute as they contribute.

526
00:50:16,190 --> 00:50:23,629
Of course, digital storytelling on its own is not going to change behaviour, but I believe to use with other different sort of tools.

527
00:50:23,630 --> 00:50:31,550
If you like behaviour change tools, there could be a route there to changing the way people use antibiotics, unnecessary antibiotics.

528
00:50:32,060 --> 00:50:41,480
Um, and so I believe it does have a role as communication and engagement tool and just a just a list really of of a few points.

529
00:50:41,900 --> 00:50:45,530
I think digital storytelling makes me feel very real and relatable,

530
00:50:46,070 --> 00:50:51,920
makes it understandable whether it's imparting knowledge through story, for example, there's various devices and techniques.

531
00:50:52,370 --> 00:50:59,360
It makes it much more meaningful if you if we interpret it and and understand it in the context of a lived experience,

532
00:50:59,480 --> 00:51:06,620
it humanises a very scientific issue. Um, it relates to psychological capability, which we've looked at.

533
00:51:06,860 --> 00:51:10,070
You know, it's sort of this idea of learning without realising you're learning.

534
00:51:10,640 --> 00:51:17,750
It strengthens your, uh, reflective motivation, reframing, able, um, automatic motivation.

535
00:51:17,750 --> 00:51:21,460
It appeals to the emotion, uh, social opportunity.

536
00:51:21,470 --> 00:51:27,530
We haven't spoken about that at length, but there are lots of social norms and a lot of assumptions that have been around

537
00:51:27,530 --> 00:51:32,300
for a long time about antibiotic use in starting back in the mid 20th century.

538
00:51:32,750 --> 00:51:38,750
Know quick fixes, habitual use. Grandmother did this, so I better do this with my baby sort of thing.

539
00:51:39,020 --> 00:51:46,400
You know, using antibiotics, you know, not a sexual um and it I believe it does sit on the course of perfect behaviour change.

540
00:51:46,670 --> 00:51:50,299
Um, and I don't believe it. Um, replaces contextual messaging.

541
00:51:50,300 --> 00:51:55,070
I think we need both. Um, it humanises biomedical issue and I feel.

542
00:51:55,430 --> 00:51:59,600
Yeah, I feel there's a place for this. Future work.

543
00:51:59,960 --> 00:52:05,240
Well, you don't really need to know all this, but, you know, I think I think really importantly,

544
00:52:05,420 --> 00:52:12,710
we need to be able to come up with, um, a validated evaluation method for digital storytelling.

545
00:52:13,190 --> 00:52:18,829
I'd like to see it use that storytelling generally much more in the field of health research,

546
00:52:18,830 --> 00:52:23,390
interventional research and, um, with, um, health issues.

547
00:52:24,140 --> 00:52:27,870
So I think, first of all, we have to use it much more widely and we need to evaluate it.

548
00:52:27,920 --> 00:52:32,630
Okay. Once we got that method of evaluation, I think we're taking a step in the right direction.

549
00:52:33,260 --> 00:52:36,820
Um, I do like to expedite the process of making these stories.

550
00:52:36,830 --> 00:52:40,970
It does take quite a long time and a big commitment for new storytelling.

551
00:52:41,360 --> 00:52:45,739
Okay. And that recruitment can be a bit of an issue. So is there a way can we bring in?

552
00:52:45,740 --> 00:52:47,690
I have various ideas.

553
00:52:48,290 --> 00:53:01,100
Um, but to finish okay, if storytelling and just add one thing above and beyond other more conventional forms of email communication,

554
00:53:01,970 --> 00:53:05,750
then I think it boils down to connecting with emotion.

555
00:53:06,710 --> 00:53:12,920
So I'm going to give the final word to poet and civil rights activist Maya Angelou.

556
00:53:14,150 --> 00:53:22,400
And she says, I've learned that people forget what you said. People will forget what you did, but people will never forget how you made them feel.

557
00:53:24,360 --> 00:53:24,960
Thank you for listening.