Sibyl Anthierens | “Researchers need to work beyond the traditional silos”

Sibyl Anthierens: I think we’re at a moment in time where social scientists can really have a voice in medical research, and in the medical field in general.  I think we need to work together. We’ve been working together for a long time but, properly together as equal partners, to improve the field of medicine and to make sure that the evidence that we’ve been building is implemented in practice and that it doesn’t take such a very long time.  It often takes more than 10 years for evidence to be implemented in the field.  But, I think if we work together with different disciplines we can take the field forward.

DMacA: What disciplines and how do we do it?

SA: If we’re talking about social sciences,  it’s a broad field. You’ve got economics, you’ve got

sociologists,  you’ve got health behaviorists, you’ve got policy specialists.  I can only talk about my own experiences as a sociologist, who is also very interested in health behavior where I work together with health psychologists and, using methods that differ from medicine,  which are often clinical trials.  These are seen as the highest level of evidence and, of course, we need those methods but, we also need the other methods as used by social scientists.  For example, we use qualitative methodologies where we do interviews with people looking at the context of the field of research, and where individual behaviors can be complex and sometimes messy. But also at the higher level where medics or primary care physicians are working.  That includes the whole context, not just at individual level but also at system level, how that influences what we do and the way we act as professionals and patients. 

The other added value of qualitative research is that it can add a different piece of the puzzle when looking at certain phenomena in research or research problems, and it can give very powerful messages that can translate into actionable findings.

DMacA: Let’s look at each different component. At the beginning, within the research component, how can primary care and wider medicine, work more closely with social scientists in creating research?

SA: I think it starts with priority setting. We need to go into dialogue together- social scientists together with medicine, together with politicians/policymakers- and ask what are the priorities that we need to address, and how can we tackle them together not in silos?  How can we work more closely to really improve the field of research?  Social scientists are often seen as people who create ‘big theories’ far away from the field but I think we really need to work more closely together and maybe even adapt our methodologies, sociologists and medical scientists, and start talking the same language, a common language, and transform our methodologies so we work together and integrate our findings.  Often, and I’ve been doing research now for the past 20 years, we’re seen as the little add-on studies or that we work next to the medical field.  I think it’s important to work together and that we integrate our findings, think about how we can look at it from a different angle, but truly integrate our results.

DMacA: I was really interested in what you said about priority setting but you said something that really caught my attention and that was about including the politicians.  How can we include politicians in research priority setting in medicine?

SA: For priority setting we need direction on how to move forward.  I think it’s important to engage with policy makers from early on in order to create research that’s relevant to the public, to healthcare professionals, and that politicians can ultimately use the findings in creating policy.  I think it’s something that we’ve learned during the pandemic that when we work with politicians or policy makers from early on, engage with them, share our findings early on, it is easier to translate them into practice.

DMacA: We’ve got policy makers, we’ve set our research priorities, we’ve done our research, how are we going to communicate it?  How can social science help us communicate our research?

SA: That’s the added value of engaging with social science- that we engage with stakeholders from early on. We talk to the people early in the research, even in clinical trials.  We talk with different stakeholders whether it’s politicians, healthcare professionals or the public.  We engage them in the research from early on, talk to them about our findings in the meantime, know how we can translate these findings to different stakeholder groups, even with patients, know what their priorities are, what their needs are, and know how to communicate finding that are relevant to them, that they can understand.  So, we need to work together more closely with all the different stakeholders at different times.

DMacA: One of the problems with qualitative research is that everyone thinks they can do it and sometimes qualitative research is, perhaps, not that good.  What do you think?

SA: I totally agree.  There’s a lot more qualitative research out there and I think it’s very important that we train young researchers and supervise them.  It’s a lot of work to properly supervise  qualitative researchers, or beginners in qualitative research, because it takes special skills.  It’s not that you can do just anything.  That’s often what they think-  that qualitative research is just summarizing interviews and what people have said, but there’s a lot more to it. You really have to work with the data and must have good analytic skills.  I think it’s very important that we continue to take a critical approach towards qualitative research, guide it properly so that it achieves standing and is recognised as an essential component. We need qualitative research in the medical field but it needs to be done properly by skilled trained researchers.

DMacA: Let’s look a little at some of the research that you’ve done as some of this work is absolutely fascinating.

SA: Lately I’ve been working a lot on international research, particularly clinical trials, during the pandemic to see how we can help professionals in the field, especially in primary care.  The second component of my work is on the silent pandemic on antimicobial resistance – how can we change prescribing behavior, optimize it, and how can we help the public with the messages on antimicrobial resistance.

During the pandemic we’ve been working a lot with primary healthcare professionals and developing research to look at interventions that were set out by the government such as, for example, infection prevention strategies within the household.  But households are essentially social systems so, we really need to know what’s going on within those systems in order to see how those prevention measures will help.  We talked a lot with households, with patients who had had a Covid infection, and how they used measures to prevent infection within their household.

DMacA: You’ve done a lot of work on antimicrobial resistance.  Tell me a little more about that work.

SA: Yes I’ve been working for over a decade, together with the social science team and with my colleague in Oxford,  Sarah Tonkin-Crine and team.  We’ve been working together with primary care clinical trial leaders in the field of antimicrobial resistance and we’ve been looking mainly at how we can change behavior of both clinicians and patients on seeking help for acute or common respiratory tract infections. I think it’s an ideal example of a field where we  can work really well together and get actionable findings that we can translate into practice.  You can find interventions that work well but we need to know why they work well-  is it the whole intervention or is it different aspects of the intervention?  It’s really opening up the ‘black box’ of the intervention.  Its not just the clinical effectiveness of the intervention itself but, if we think further along, how can we Implement  those interventions in the future. If they’ve proven effective, what do we need to know, what do we need to address before we roll it out on a big scale. It’s a perfect opportunity for social scientists and clinicians to work together on antimicrobial resistance.

DMacA: Clearly you’re very passionate about your research, have huge interest in research and the whole breadth of research. It sounds to me like a task with no end.  How do you manage work-life balance in that context.

SA: Indeed, it’s a very difficult field to work in if you’re passionate, and when all your colleagues are passionate about their work,  and it can easily become a seven days out of seven job, which happened a bit in the pandemic.  I think we need to set boundaries for ourselves but also for our colleagues because we need to have work-life balance and need to be able step out of it a bit.  Also, I find that when you take time to rest, you get new ideas.  I think it’s better and healthier to have proper work life balance. 

Another thing is that the people we work closely with are, most of the time, people that we trust and have high respect for.  I think most of the people I’ve been working with have become friends over the years which makes it even better. It also makes the research better because we work as a team, we trust each other, and we can speak freely.

DMacA: Earlier this year you recorded an interview on women in science and how to develop your career as a woman in science.  What is your message for women in medical research?

SA: You need to believe in yourself. Imposter syndrome is a very common phenomenon within academia,  within universities.  You need to find yourself a good mentor and work together with a supervisor or with a team of supervisors. I think it’s very important to work with a complementary team and people who really support you so that you can make mistakes.  You can learn from those mistakes as long as you talk about it.  And, that you set priorities for yourself- where do you want to work towards? It’s not the end goal that’s the most important thing but it’s the journey along the way.  You can move away from that journey but keep doing what you like doing, what’s important to you and, what’s important to society.  Surround yourself with kind intelligent people who can support you and that you  help other people, not just females but also males, help each other and cheer for each other, and celebrate success, even little successes.  I think it’s very important to do that.

DMacA: What a super note to end on.  Thank you very much for talking to us today. It’s been fascinating to hear about your interests, and how we can work more closely with social science, but also in teams and supporting each other. Thank you very much indeed.

Thank you