Author: girlymicro

Clarity of Role and Its Impact: Why knowing and being clear about your professional boundaries matters

girlymicro General, Healthcare Science, Leadership, Microbiology (Clinical), Science Communication

This one’s been on my mind for a while, and by posting it the aim is to explore my thinking, not to target anyone or any group. I’ve been seeing a lot of posts on twitter and having a lot of conversations about identity, especially in relation to professional identity, and so wanted to take this opportunity to reflect and process.

I’m going to start with myself based around a non-clinical example of what I’m talking about. I am a scientist who communicates. I am not a science communicator. It took me an age to really get the difference, but the difference is this………it’s about where my expertise lies. I hope that I happen to be a scientist who has some decent communication skills, and it is a subject that I am pretty passionate about. My qualifications and expertise, however, are in the science, that’s where I sat my exams, that’s where I have almost 20 years of practice.  My expertise is in science, not just that, but my real expertise is actually in quite a small subset of science. I took a zoology degree 20 years ago, but I am not a zoologist, that knowledge is old and only at undergraduate level. My expertise is probably in Infection Prevention and Control.

Now, if I were a science communicator, my expertise would be somewhere else. My skills would be around communicating science in general. Many science communicators haven’t worked in science for some time and some may only have undergraduate levels of science specific expertise. What they have, and I don’t, are qualifications and vast levels of experience in communication and pedagogy. These skills enable them to break down highly complex topics and also pitch in a way that I can only aspire to. They have significant levels of pedagogical skills that I can’t pick up by attending a couple of courses, just like they can’t pick up mine by attending a week long course on whole genome sequencing.

So, to me, the difference is where my expertise and knowledge lies. This doesn’t mean that I couldn’t transition from one to the other, but I have to acknowledge that I’d be moving from my area of expertise and therefore would need to rebuild both it and my qualifications to demonstrate skills within a different area. It would be a growth area rather than a straight transition.

OK but why does this matter?

I’ve been reflecting that we are definitely in a period of substantial change within the NHS and one that isn’t likely to stop any time soon. This means a lot of our pathways and traditional professional boundaries are changing with it. I think, in the end, that this can only be a really good thing. (Although I think if it is going to work it needs to be implemented across staff groups with no ivory tower protections). With this change comes fluidity and, because our pathways are embedded, change can occur before we have the processes to keep up.

During this period of change and recognition of different skills and pathways, for instance, the HSST, more Healthcare Scientists working in education, IPC becoming more interdisciplinary and the development of Clinical Academic pathways outside of medicine, clarity is key. I’ve been number one in a field of one when I didn’t know anyone else working as I did in IPC and it was a balancing act. I’ve been through people asking ‘are you one of the nurses’ and hanging up if you said no, but also I can’t claim to be a nurse. If we don’t understand our boundaries, it can be hard to be clear about them with others. If we can’t be clear about them with others, assumptions can occur about knowledge and skills that can lead to potentially dangerous practice or misleading those we’re interacting with. To me, it’s about owning your difference and being open to talking about the benefits it brings, whilst being very aware of when you should defer to someone else.

Labels not hierarchy

I guess what I’m talking about is actually the importance of labels. Now, this may seem a little ironic as I’m not a labels and silos kind of girl, but bear with me. The reason we use labels as human beings is that they enable a cognitive shortcut. One of the reasons that they can be bad is that they come with a bunch of assumed information that is not nuanced, and may in fact not be true. In the case of knowledge and professional roles, they come with an expectation that if you say you’re a virologist, you have a significant amount of knowledge about virology and virological processes. If you say you’re a consultant, you will be assumed to be practising at a certain level with certain qualifications behind you. These labels mean that when we interact, assumptions are made about our scope of practice based on an assumed level of knowledge or experience.

The problem with some of the developing pathways is that the information behind those labels is not yet established and embedded widely across the NHS or for the public we’re interacting with. The assumptions made linked to those labels may, therefore, be incorrect. Due to this it is really important to be clear about who we are, our experience, knowledge and boundaries, not because one label is better than the other, but to ensure that all involved have clarity in order to not increase risk. If you are in a new or developing area/role, the onus is therefore on you, to clearly communicate about you practice boundaries in the absence of a default label.

Asking, where is my expertise now?

Everyone wants to feel like they know what they are doing. Everyone likes it when someone comes to them and asks them to engage in events or answer questions due to perceived expertise. The problem comes when we respond to the request based on the pleasant feeling it creates without self-checking if we are the right people to undertake the task.

Obviously, the risks are not always the same and occur on a continuum. I’ve been asked to give talks on antimicrobial stewardship and have referred on to someone else as it was for a conference, and that’s not my area of study. If that request was to teach an undergraduate class, however, I have the knowledge base and experience to do so if there was no one better available. I would however be very open with the organiser that I might be better placed to speak on a different topic. Being clear about your boundaries in a clinical environment obviously holds much greater importance. I have FRCPath and used to regularly do ward rounds. Since the pandemic and moving entirely into IPC, I haven’t given clinical microbiology advice in the same way. This doesn’t mean I couldn’t run a round, but I would want to re-up my skills before I did so, there is a difference between what I could do on paper and what I would feel comfortable to do in practice.

When I interact with others or get requests, I always run a quick internal check with myself about whether I’m the best placed person to respond. There are tasks that are always best served by having input from multiple viewpoints and backgrounds, and these I will bring back so we can discuss them as a team. There are other things where I will refer to someone else specifically, as I know they have a greater understanding of that clinical practice. I’m aware that this all tied into our professional registration, but I am often slightly struck by how, when people are trying to define a new identity, they try to own the label they want before they have fully developed enough to go it solo. I think this is often the moment of greatest risk in any development pathway.

None of this is about restricting access

I want to be clear that I am truly excited by the change towards more dynamic progression in healthcare and recognition of the skills different professions bring to the mix. I do think that when you are already established within a profession, it can be challenging to go back to actively undertaking that gap analysis and flagging your difference all the time, especially when others don’t necessarily know what your role is or react negatively, as we are used to being the ones in the know. The thing is, the only way that you can establish the new pathway or role is to start the work but be mindful to continue to flag your scope/difference as needed. No one hangs up on me anymore when I say I’m not a nurse or a doctor. People have gotten used to it. They wouldn’t, however, if I’d not been open about it in order to engage with the conversation and just defaulted to their expectations.

It is easy to get drawn into the conversations with some conservative colleagues about whether this is the right direction for the NHS to go in and to feel defensive about it. I think that being willing to engage calmly in those conversations is part and parcel of being a pioneer. To see each conversation as a learning opportunity, both for yourself to communicate your role better and for the other person in terms of knowledge exchange. Change is unsettling, especially when it goes against traditional structures and hierarchies, and it will take time for people to adjust.

You can be passionate about something without being an expert in it

Finally, and just one side thought that is not related to clinical work as such. It is OK to have an interest in something and not be an expert in it. It is OK to say for me to say that I’m interested in science communication but not to claim expertise in it. It is OK to be an interested participant and to want to engage in an area because of the growth that engagement offers. You don’t have to enter every space wearing your expertise as a shield. It’s just worth being honest and open with yourself and others when you do it. Not claiming expertise will open doors to shared learning that you might not otherwise be able to access. We don’t always have to be the smartest person in the room. We should just should aim to be the most able to communicate our purpose and vision for being there.

All opinions in this blog are my own

Holding the Line: What it feels like to be seen as the ‘Big Bad I Said NO!’

girlymicro General, Healthcare Science, Leadership, Microbiology (Clinical)

When I was a kid there was a cartoon called Stoppit and Tidyup. It was a kids world where the baddy was the Big Bad I Said NO! This particular post was started during the pandemic when I was thinking about perceptions of the word NO but has kind of lingered as one of those things I wasn’t quite ready to get my head around. The last few weeks have kind of shown me it was still relevant outside of the pandemic however, and so this week I thought I would post about what it feels like to be seen as the gate keeper or to be the person who feels like they are holding the line. In essence, what it feels like to be the person who likes to be liked but who has, as an adult, turned into the villainous Big Bad I Said NO!

I have previously posted about the inevitability of not being liked by everyone, and the challenges of speaking truth to power. The thing that’s unique about becoming the Big Bad I Said No is that it can be a mask/hat/role that is needed in all kinds of settings, and the stakes can vary widely – anything from 1:1 relationships to impacting Trust or wider level decision making. It can therefore feel very stressful to manage, and that stress can be protracted when discussions and scenarios go on for months or longer. Having now spent some time thinking about this though, here are some of my thoughts on the how, whys, and inevitable consequences of saying NO.

Sometimes, it’s all in how you say the words

The word NO can feel pretty loaded. The very use of it often brings a feeling of judgement. Worst still, in a world where as leaders we should be trying to bring people with us, it is the ultimate reminder of hierarchy. As a leader, if I have to go there I will just saying NO can make me feel like a failure, as I feel I should have been able to find an alternate solution or compromise. Also, as a previous recipient of NO, it can make you feel powerless and lead to you questioning your understanding of your relationship or the organisational values.

It is crucial therefore, on both sides, to communicate more than just the NO. NO, without an understanding of the values and drivers that led to it can be pretty destructive. So it is important, although the temptation may be to drop the NO and get out of the room, that it comes with context to support the why.

Sometimes, you need to be direct

Sometimes, being a gatekeeper can be pretty uncomfortable. Interestingly, I find it easy with an infection control hat on versus with a Lead Healthcare Scientist hat, probably because patient safety trumps personal feelings. It can be tempting when you are in a position where the NO is going to be hard or challenging to try to say NO without saying NO. The problem with this approach is that although you may leave the encounter feeling less scarred or exposed, it is likely you are also leaving it with less clarity. Worst than this, not only have you said NO, but you also have taken away the recipients’ opportunity to question and gain a clear understanding for their own processing. It may feel easier in the moment, but you are probably just kicking the problem down the line rather than working towards a resolution.

Please note that this sketch has an 18 age certificate

Sometimes, it’s about being clear that you are living your values

I think one of the reasons that a NO and holding the line is easier (although still hard due to the stakes) in infection control is because it so clearly aligns with my core values, and ones that I hope are represented more widely within the NHS. We should all put patient safety first. Therefore, you can respond in a way that you feel enables you to speak to someone else’s shared values. I hope that the same is also true when I speak to people about equity of access, but in truth this one can be more challenging, as sometimes you are asking people to give up something for someone else, this can occasionally overrule this personal value for the recipient.

Sometimes, it’s harder to make that shared value assumption, and so it becomes especially important to share clearly why you are doing something, both from a factual, but also value perspective. This can include things like wanting someone to be in a better prepared position before they undertake training course X so they can get more out of it by starting with a better grounding. It can also be that a change would be better placed after we’ve set it up using pre steps. It’s important, though, that if it is a true NO, not to fall into negotiation, as that can result in confusion.

Sometimes, it’s about showing someone the big picture

Frequently, when I have to say NO, it’s because I have access to information that the other person doesn’t. This may be information that enables me to have a more holistic view of risk or success. When saying NO in these cases it’s crucial to talk someone through that wider picture, not only because it helps them contextualise the NO, but it may enable them to come up with an alternate approach that might result in a YES. I hope that by taking the time to do this it may result in the recipient being empowered when they leave the conversation rather than deflated. Obviously, that’s not always the case, and sometimes, individuals will need time to process the information. At least by investing the time it offers an alternative perspective and hopefully demonstrates that I value both the person and the dialogue.

Sometimes, it’s about showing your thought process

This one is a little bit of an extension of sharing your values and the big picture. In my case, as a scientist however, it also includes sharing data and evidence and using that to explain how I came to my conclusions. I sometimes go too far down this particular rabbit hole, as it’s my comfort zone, and it does not always work.

Some people will respond better to different things. Some people like me respond to evidence, some will respond to patient led and other values, some are pushing a vision, and others will respond if you share the big picture stuff. Knowing who your audience is helps you pitch, but including a bit of everything in your prep and being able to pivot to what is landing best for greater focus is a skill worth developing.

Sometimes, it’s about being prepared to defend whilst maintaining being open

Despite your best efforts to explain and justify, you like me, may end up being pulled into rooms of people who don’t particularly like your conclusion or what you have to say. This is leadership, and particularly in infection control, it’s kind of what we get paid for. Drawing a safety line and holding it is key. Now, that doesn’t mean you shouldn’t be able to re-evaluate in the face of further information. It also means you should be prepared to defend it. You will need to defend your thought process, your evidence and your conclusions.

I have to be honest, sometimes this is the one I find most challenging. Not because I don’t feel able to justify my process, but when the evidence is clear, I can struggle to understand why others don’t see it. It can also be easy to feel like you’re being personally attacked when it is actually just the scenario. As I wear my heart on my sleeve, I can find it hard though. Trying to take yourself out of the process and focus on the role and the reason you are in the room is something that I’ve found can help.

Sometimes, it’s about finding support

One of the other things I’ve found really helpful is to know where your support lies. In my case, that may be Mr Girlymicro offering me a martini as I walk through the door and telling me it will all be OK. It can be having some trusted colleagues that you talk and walk through your rationale with before meetings. Colleagues that you know may be comfortable challenging you in order to help you see gaps or assumptions in your thought process. Sometimes, it’s about knowing who’s going to be in a particularly difficult room and being aware of where their support may lie, so you know who you may count to support your rationale.

A lot of this is about the work that you need to do ahead of time to build your networks, to get to know other people and their values so you can understand their drivers when you are thrust into a gatekeeping scenario. It can be as simple as moving the dial so you know your unknowns and can therefore better prepare for the unexpected.

Sometimes, a no is actually a not yet

The other thing that’s worth addressing is knowing when a NO is a not now, or not this way. If you can work your way through a scenario so that you can see different routes or avenues to the same destination, it may open a different type of conversation. I’ve mentioned some of these things above, but again, it’s about having put in the time to think things through prior to your response. Often, in infection control, it is tempting to take the path of least resistance, when with extra resource or input, a YES may be possible. Checking ourselves to ensure our motivations are correct is always worth doing and making sure that we are open to the presentation of new ideas or new information that might impact our risk assessment or evaluation is key.

Sometimes, it’s just about sucking it up

Recent years have convinced me that you don’t join infection control to win popularity awards, hardly anyone gives us chocolates at Christmas. The job is hard. Leadership is hard. Saying NO and gatekeeping is hard. The thing is, we do it because it needs to be done. Sometimes, it needs to be done in order to not set someone up to fail. Sometimes, it needs to be done for safety. Sometimes, it needs to be done for equity across your workforce or because of resource limitations. Every now again, it has to be done because the request is just not that reasonable, and the person making it either hasn’t considered or doesn’t have access to the big picture. Denying it’s hard doesn’t get you anywhere. Denying it’s hard can lead you to avoid the hard moments and therefore dilute your impact. Someone has to be the gatekeeper, especially when it comes to patient safety. Someone has to be the Big Bad I Said NO! Some days, that person is me, and despite it being hard I think that the world is just a little safer for it. So know you are not alone, but when your moment comes, be prepared to put on your big girl pants and own the importance of being the person who both says and owns the fact that they said NO!

All opinions in this blog are my own

The PhD Edit: Links to some of the Girlymicro posts that may help PhD students

girlymicro Academic Life, Education, Healthcare Science, Microbiology (Research), Research/Academia

During July I’ve posted a series of articles aimed at supporting PhD students and those thinking about entering research or undertaking a PhD. So that you can access them more easily, along with an example of some other posts that might also help, I’ve collated them all for you as a series of links here in a single post. Hope they help.

Tips for when you are starting out

PhD Top Tips: So you’ve decided you want to start a PhD
Things I Wish I’d Known When I Was a Trainee: My top ten tips for making the most of your journey
Clarity is Key: The role of learning agreements in supporting learner success

Tips to help when you are designing experiments or struggling with challenges

PhD Top Tips: Finding the inspiration to develop your research question
PhD Top Tips: How to carry on when the experiment you’re doing just feels cursed
My Best Science Comes from a Cup of Tea: My top tip for Healthcare Science Week
The Second Year Slump: understanding the ups and downs of doing a PhD

Tips to help you share your work

Conference Season Is Upon Us: Top tips for anyone who struggles with networking
Conference Season is Upon Us: My top tips for conference presentations
Writing and Publishing Scientific Papers – Is it as hard as it seems?

Tips to help you get through your thesis and viva

PhD Top Tips: Write a thesis they said, but not like this they said
Surviving Your Viva: My top 10 tips for oral exams
I Passed my PhD 6 Years Ago This Week: What Tips do I Have for Those Who Are in the Process?

All opinions in this blog are my own

If you would like more tips and advice linked to your PhD journey then the first every Girlymicrobiologist book is here to help!

This book goes beyond the typical academic handbook, acknowledging the unique challenges and triumphs faced by PhD students and offering relatable, real-world advice to help you:

  • Master the art of effective research and time management to stay organized and on track.
  • Build a supportive network of peers, mentors, and supervisors to overcome challenges and foster collaboration.
  • Maintain a healthy work-life balance by prioritizing self-care and avoiding burnout.
  • Embrace the unexpected and view setbacks as opportunities for growth and innovation.
  • Navigate the complexities of academia with confidence and build a strong professional network

This book starts at the very beginning, with why you might want to do a PhD, how you might decide what route to PhD is right for you, and what a successful application might look like.

It then takes you through your PhD journey, year by year, with tips about how to approach and succeed during significant moments, such as attending your first conference, or writing your first academic paper.

Finally, you will discover what other skills you need to develop during your PhD to give you the best route to success after your viva. All of this supported by links to activities on The Girlymicrobiologist blog, to help you with practical exercises in order to apply what you have learned.

Take a look on Amazon to find out more

PhD Top Tips: Finding the inspiration to develop your research question

girlymicro Academic Life, Healthcare Science, Microbiology (Research), Research/Academia

In the last of July’s posts focussing on PhD tips, I thought I should probably spend some time focusing on research questions and creating an environment that supports having ideas. This sounds like the simplest thing, but I think it’s often an undisclosed struggle for many and a source of silent pressure that might benefit from being acknowledged, especially when you’re just starting out.

I think this area probably ties into who you are as a person. I, for instance, have never found ideas to be a particular issue, but I think that’s because I’m by nature a starter and not a finisher. I often have too many ideas in my head to be efficient in any form of implementation. You may, however, be the other end of the scale, great at implementation, but struggle at the start with staring at a blank sheet of paper. Both of these traits have their unique challenges when it comes to finding ideas and taking them through to realisation. As with so much else, knowing how you interact with the world will probably help in finding the best pathway to success.

So whether you are being over or underwhelmed by inspiration and ideas, I hope this week’s post may help you navigate some of the challenges of finding your next research question.

Science is a creative process

As Scientific Director of the Nosocomial Project, I’ve spent a far amount of time now working with people who are based in what is acknowledged as a creative industry. I think one of the things that has struck me is that there is more that is similar in some of the processes within the Arts and Science than is different. Although science is often seen from the outside as a process driven area, at its very heart, and to be successful, it is actually based around ideas, questions, and developing concepts. Both areas require us to be able to ask new questions and sometimes see the world or challenges in a different way to those who’ve come before.

Creativity in itself is a process. It’s something that requires the identification of time in order to allow ideas to be inspired, developed and reflected on. This is true whether you are a natural ideas person, who needs this time to be able to sort and feel less overwhelmed, or someone who needs space to allow the ideas themselves for formulate.

Now, I’m not going to say good ideas because I believe you don’t know whether an idea is good or bad until much further down the line, ideas aren’t weighted at the start, they are just ideas. Sometimes, the most far out one’s turn out to be best and sometimes the most solid appearing ones turn out to be a waste of time. Which brings me to thought number one: inspiration shouldn’t involve a value judgement. Being open to ideas requires time and occasionally bravery, but the shifting process, where you consider whether an idea has legs, comes later.

Make time for inspiration

One of the biggest challenges I’ve found with the way I see this and even when I’ve been writing this blog, is the temptation to describe and discuss productive time. The thing is, the creation of time for ideas is key but often doesn’t feel productive. I think this is because the very word productive links the time to a value judgement about the ideas produced, whereas creating the time for ideas is where the value lies, whether those ideas end up being genius or merely a stage in process.

This is one of the challenges with science being a process driven environment, with a focus on outputs. If we are not ‘doing science’ time is considered to be wasted. One of the things I try to encourage in my students is that a walk in the park just letting your mind wonder, or staring at the rain through a window to free your mind, is sometimes the most valuable time you will spend during your PhD. Especially if you’ve come up against a tricky problem. Staring at something head on can only get you so far.

Sometimes it’s hard to be passive, I’m really not that great at just ‘being’. If you are like me therefore you may decide a kitchen disco is the best way to free your mind or to go for a run. Finding a way that allows you to distract your mind to enable you to see things in a different way, whatever way that works for you, is the main thing.

Spend time reading and reflecting

Occasionally, the pressure to solve things or come up with ideas can feel a lot like writers’ blocks. Staring at empty screens, lab books, or grant templates. Although space often helps, sometimes you need a kick-off point. I find reading (or going to listen to people speak) can often be helpful at this point. I’m not talking about reading for critique here but reading for inspiration.

Often, when we are reading papers etc we are reading it to evaluate how good it is or to support technical understanding. I think reading for inspiration is probably a different skill. It’s the opposite of the trying to focus on the details we normally do. It’s reading and almost actively listening and recognising those little side tracking ‘what if’ thoughts that we would often try to ignore.

When reading for inspiration, you may also want to try different content that you would normally engage with. You might want to read about your subject from a different disciplines perspective, for instance, infection control but from a human factors perspective. If you are working in a translational area, you might want to read about another use of the technique that isn’t within your specialism or some fundamental science papers. You may even want to read articles and blog posts from patients or advocacy groups in order to get a different perspective. The main thing is to be cognisant in your approach and be open to going down some mental rabbit holes to see where they lead.

Sometimes, you need to act on your thoughts

Once you’ve done your reading for inspiration and have your thoughts the next step is deciding what to do with them. This requires some form of action, often doing some further reading or sitting down to grow that thought, and specifically reflect and write about how that germ of an idea might grown into a more fully formed question or piece of work.

This step is not always easy, but I think it is the part that most of us are more used to as scientists. That said, there are some days where my mind is a hell to me, and I think if it was visualised, it would just be a cloud of buzzing flies. On days like this, I write. I write blog posts. I write postit notes. I scribble notes in books. Writing things down, even if not to do with my research thoughts, creates a little space so that I can see the wood for the trees. It empties my mind on specific topics so I can gain clarity on other things and do the development work needed.

If being overwhelmed isn’t your issue, this is probably the time to hit the reading for research portion of development. This is where you would read more closely around the idea itself and start to see what others have done, undertake your gap analysis, and begin to think about the practicalities of undertaking the work.

Be prepared for failure

A wise person once told me that ‘science is 80% failure’ and that ‘the earlier I got used to that concept, the easier my journey would be’. As you hit the evaluation phase of idea development, you need to be OK with throwing out or needing to redefine a bunch of the thoughts you had in the earlier phases. This is the phase where you take your researched concept and try to change it into a fully formed research question or practical experiment. It is also the phase where you find out whether your idea truly translates into something workable.

Although this part can feel painful, it’s actually the core part of being a scientist and where a whole heap of the learning that occurs. The more you do it the better you get at spotting a good idea in the earlier stages, and actually the easier it is to be inspired and have ideas as it’s a skill that needs to be developed like anything else.

Sometimes it’s better to just start

Because the question develop part can be painful it’s something that, if you are like me, you may procrastinate over. You may just want to sit in the lovely inspiration phase where all your thoughts are still possibilities. The truth of the matter is that it is easy to justify staying in the thinking phase as it can be hard to know when you’ve done enough thinking and prep to move an idea to the next stage. However, if you never try moving from an idea to a reality you will also never succeed, and so sometimes we all need to pull off the psychological band-aid and just try it out. There are also times when you just frankly need to stop being scared and JFDI it to see where it goes.

Appreciate the role of translational reasearch

In my kind of research, which is clinical as part of Infection Prevention and Control, I have found something else that sometimes helps. Sometimes it can be easy to become hyper focussed on scientific issues and challenges. On days when I’m stuck and just don’t feel a way forward I play a little mental game with myself. Now, it’s no secret that I spent a bunch of time in hospital and experiencing healthcare as a child, and I now work in paediatrics. I therefore run myself through different scenarios as a paediatric patient visiting or being admitted to hospital. Scenarios with different incidences, organisms, and experiences. Sometimes inspired by real patient challenges I’ve been involved with, sometimes entirely theoretical. I then try to use that process to better understand what might be important to me, what the significant moments may have been and where we could do better. I find that running this from a patient centred viewpoint can provide me fresh perspectives, which in turn enables me to have better ideas. If you don’t work an environment where you meet patients, but your work is on a specific organism for example, maybe reach out to an advocacy or similar group, to help you also get a fresh perspective, or even just speak to family and friends about their lived experience.

Don’t worry too much about everyone else

I wanted to finish by talking about something that has been a bit of a theme in my academic life and the main thing I have learnt to manage it. That is the fear or reality of ideas being taken by either those more senior or those with more power/access. I don’t think I can say with any good conscience that this doesn’t happen, I have myself previously come in to access my desk to find a senior PI searching it for my lab books containing data they weren’t working with me on.

The thing I’ve learnt is not to hold onto any one thing too tightly. This isn’t justifying the fact that this behaviour exists, it’s just the way I have learnt to maintain my mental health and wellbeing. There are times when you need to defend and maintain ownership of concepts, especially if something is key to your PhD. For the most part, however, I’ve discovered that I will always have other ideas, and there will always be different ways I can spin the original concept. Some of my best work has actually come because of the external push due to someone published some of our shared work as a solo author instead of together. It forced me to take the next thought step and develop more than I may have otherwise.

So I’d like to finish on the note that no matter where you are on your scientific journey, trust yourself. Trust your instincts. Trusts you will always have another idea. Trust that you will always be able to come up with a plan B. Trust that there are people out there who will want to help and support. Sometimes, developing and maintaining that trust is our biggest challenge as individuals working in science, but it is worth doing the work as it will provide long-term dividends both in and out of work.

All opinions in this blog are my own

If you would like more tips and advice linked to your PhD journey then the first every Girlymicrobiologist book is here to help!

This book goes beyond the typical academic handbook, acknowledging the unique challenges and triumphs faced by PhD students and offering relatable, real-world advice to help you:

  • Master the art of effective research and time management to stay organized and on track.
  • Build a supportive network of peers, mentors, and supervisors to overcome challenges and foster collaboration.
  • Maintain a healthy work-life balance by prioritizing self-care and avoiding burnout.
  • Embrace the unexpected and view setbacks as opportunities for growth and innovation.
  • Navigate the complexities of academia with confidence and build a strong professional network

This book starts at the very beginning, with why you might want to do a PhD, how you might decide what route to PhD is right for you, and what a successful application might look like.

It then takes you through your PhD journey, year by year, with tips about how to approach and succeed during significant moments, such as attending your first conference, or writing your first academic paper.

Finally, you will discover what other skills you need to develop during your PhD to give you the best route to success after your viva. All of this supported by links to activities on The Girlymicrobiologist blog, to help you with practical exercises in order to apply what you have learned.

Take a look on Amazon to find out more

PhD Top Tips: Write a thesis they said, but not like this they said

girlymicro Academic Life, Healthcare Science, Microbiology (Research), Research/Academia

Dear gentle reader, let me tell you a tale, a tale of a naive PhD student and of her nemesis, the notorious villain known as The Thesis. Grab a comforting beverage, as this tale is filled with both thrills and peril for your delectation.

The final 12 months of my PhD were tricky. I had simultaneously signed up to do FRCPath and a PGCert in education on top of thesis writing, which in hindsight was beyond stupid, but made a strange sense at the time. So I was writing not only a thesis, but a Fellowship of the Higher Education Academy (FHEA) portfolio as well, and trying to submit my thesis a year early in order to allow revision time for my final clinical exams. I’d also run into supervision challenges as my primaries vision of my thesis, both in the required level of content and how that content was presented, was different to mine.  Needless to say, it was a bit a grim time.

Fast forward to my viva, I have submitted my thesis without supervisor sign off, and to be honest, there was a good chance I was entirely wrong and had set myself up for failure. The viva had lasted an hour, including having a cup of tea with my examiners. This is either a really good or hella bad sign, right? I’m standing outside the room whilst they deliberate, and I am seriously considering just running away as I’m in the midst of a full-on panic with my rational brain having entirely left the party. Suddenly, I hear them laughing, and I know that I am doomed. I’m about to just leave when the door opens, and they are standing there, staring at me expectantly. I have no choice, I enter the room to hear my fate.

The first words out of their mouths are “can you take a seat, we have some bad news for you and it’s probably better that you’re seated whilst we go through it”. At this point, I almost vomit, and it takes everything I have not to cry. I had been wrong. My primary was right, I’m a disaster, what was I thinking. I sit, and all I can think is that I just need to get out of this room and back to Mr Girlymicro, and the sooner I get it over with, the better. They look at each other and then at me, the external says “we have to ask for some changes and I’m afraid that they are substantial” they look at each other again pausing for what felt like forever before continuing “we need you to add an extra page of conclusions and it MUST NOT be more than 350 words”. They burst into laughter and shake each others hands and then mine. I stare at them blankly and ask them to repeat. When they are done laughing with each other they say, “also, when you have PhD students NEVER show them your thesis, show them a chapter of your thesis, that’s what a thesis should look like”. They then dump the examiner copies of my thesis into my hands to carry from the room so I can experience the weight….still smiling at each other, and the whole thing is over.

I therefore include my PhD thesis below not as an example of the thesis you should write, but perhaps as an example that is so long you might get away with a short viva and the examiners saying they never want to see it again. I also thought that this week I might include some of the lessons that that 12 month period taught me, as well as what I have learnt since from being both a supervisor and examiner.

Elaine_Cloutman-Green_final_soft_bound_Thesis_for_submission_dated_2015.pdf._REDACTEDDownload

Your thesis should tell a story, so be aware of what serves the tale

You may have a much better vision for your thesis than I did for mine, but whatever that vision is, it needs to involve telling your reader/examiner a coherent story. You may have done 20 small bits of work that you did because they were individually interesting, but when it comes to your thesis it’s time to put those together into chapters that read like you’d planned all of them together and a tale that hold logical progression from 1 chapter to another.

There are plenty of different ways to do this, and you can take any approach that makes sense for your work, but there are a few things to consider:

  • Think about having a thesis structure diagram so how your work hangs together doesn’t have to be intuited by your examiners, but is clearly laid out
  • Think carefully about the number of chapters and chapter order to ensure they are supporting the overall tale you are telling, be that of scientific discovery or adversity over failure
  • Try to embed being clear about your why and impact throughout, especially if you are doing a clinical PhD. Be conscious about picking the points where you can make your ‘so what’ clear
  • Rationalise what you should include to serve the story you are telling. You do not need to include every single thing you’ve done, in fact it could make it harder to read

Think about what purpose your thesis will serve

This one may sound a little weird, as surely everyone’s thesis serves the same purpose, to convey the work done during the PhD and provide a route for assessment. That is true. However, in terms of longevity, some thesis serve a different purpose. For me, as my research area is also in my area of work, my thesis is a manual I still go back to to remind myself of how to do pieces of work, such as decontamination validations. This won’t be true for some people. Some people write a thesis that will never be read again,  and so the thesis is written to please their examiners as a primary function. Mine, as you’ve read, was less pleasing to my examiners, but acts as a reference text for me to this day, and so fulfils the purpose that I had in mind when I wrote it.

Know your process

We all work differently, but the more you understand how you work the more you will reduce your stress around thesis writing. Are you a, write it up as I go kind of person? Are you a, I need to have all the info to decide what my story it before I start gal?

My process was that, because I was still working clinically part time, I took a month for each chapter of my thesis.  Week 1 I undertook a literature search and collated all the relevant papers, read them and made bullet points, week 2 I created figures and started writing, week 3 I finished writing the chapter,  week 4 I edited and sent it out for comment. Repeat for 5 months, and I was pretty much done.

My PhD students are far superior to me, they are well read, keep spreadsheets of notes, as well as writing up as they go along. As I was balancing responsive IPC and my PhD that just never worked out for me. There’s no point in pretending to be in a category that you aren’t or wishing it were different. Discover how you work, acknowledge it, and then find a practical framework where you can use it to your advantage.

Do your research

Now we are getting the nitty gritty of what I had wished I had known before I started, and this part all comes down to research. There are a few things which I wish I’d invested more time in before I even started writing my thesis as they would have removed a bunch of the wall contemplation and anxiety, as well as saving a heap of time:

  • There are lots of different ways to structure a thesis, and as long as you obey the broad university rules, the detail of how you do it is up to you. Spend time looking at other people’s, as the best flattery is to borrow, to identify the bits you like, the bits you don’t like, and find inspiration for what works for your way of thinking. All of the UCL ones are available online, and I’m sure many other universities are the same
  • Learn how to make/edit writing templates, or find ones that are pre-done. This may be the old person in me but I just didn’t know enough about how to set up word or other document templates to auto generate lists. My poor friend came in at the end and spent 8 hours correcting my thesis so all of it would work and I didn’t have to manually change my indexing
  • Find reference software that you like and spend time making sure your inputs are high quality and not missing details. The last thing you want to do for hours pre submission is to correct hundreds of incomplete references as you didn’t check on upload
  • Know your university submission rules inside and out. You will hopefully never be in the position I was in, where I had to know what would happen if I submitted without supervisor sign off, but even so it is worth familiarising yourself. These rules will help you choose examiners, understand time scales, and be sure your thesis structure is acceptable. Best always to be prepared.

More is not always better

As much as my thesis was long at 95,000 words plus references, for a short time it looked like it might be even longer and I was going to struggle to keep it under the 100,000 word limit. I had an entire other data chapter to put in and just had a lot of self doubt about dropping it as I thought it was the ‘lazy’ option (BTW I often struggle as I think of myself as a pretty lazy person and so find it difficult to self check). The thing is, it didn’t serve my story, and I would have been adding it in just to show how much work I’d done. That really isn’t the purpose of a thesis so in the end I was persuaded to edit and drop it out. It was such a good call but required the help and support of others. Making sure that you are either able to do a brutal edit yourself, or can call in the support of someone else who can, will make your thesis so much better.

Find a critical friend

Which brings me onto having critical friends. These are the people you like and trust to tell you the things you may not want to hear but will make your work better. You need to find a couple of these who will read though and discuss your work with you, preferably ones who will also help edit as they go. You need people doing this who understand what you are doing and you have pre-existing relationship capital with, so it won’t destroy your friendship when they point out that something isn’t making sense and you haven’t slept for a week. Pre build these relationships ahead of time during your PhD, nurture them, they will stand you in good sted, not just for your thesis but for life.

Take advice, but have the courage of your convictions

Writing a thesis is like planning a wedding, once you mention it everyone will just start offering you advice. I understand the irony of this statement in the context of this blog post, but it’s true, and honestly no one is forcing you to read these words 😉 All of this advice can become very challenging, as the likelihood is that some, if not all of it, will end up being conflicting, especially if you have too much of it. It’s one of the reasons I suggest having just a couple of good critical friends, obviously in addition to your supervisors.

I would also suggest reviewing all of the advice you receive on the basis of three things before you take it onboard:

  • The level of knowledge and experience of the person giving it you in the specific task you are doing – accepting a history PhD’s thoughts on your genomic thesis may not be that helpful, although they may inspire a new approach that could work
  • Understand the drivers behind the advice – some people will give you advice just because they feel they have to contribute, and some people will genuinely want to help. Not all advice is benign, however, and so understanding the drivers behind it is key
  • Evaluate whether the suggestion works for the way your mind works – some people will have really good suggestions that don’t work for the way you process the world or your vision – ideas are like dresses, the same ones don’t fit everyone

Be prepared to find your own way forward as you are the person who needs to write it. Keep enough of an open mind to accept a challenge that will lead to improvement, but don’t try to incorporate everything, otherwise you will lose your voice at the centre of it.

Be prepared for revisions

It’s so tempting to think that if you put enough time into your first draft that you will be saving time further down the line. The problem is that that is not always true. Sometimes, spending a lot of time on your first draft just means you go further down an inappropriate rabbit hole. You can lose not only lose a lot of time when you have redo it, but it can also become challenging psychologically to make the change. Think me and the Adenovirus chapter, unnecessary agonising occurred which took up emotional band width and time. In the initial structural work up phase, it is probably worth therefore getting early commentary before you are too attached to a specific approach, so that if you have to pivot you can do more easily.

The other thing to note is that it will always take you waaaay longer to edit than you anticipated. For most of us, we have never had to work on a document this long, and so don’t generally have good projection skills for the length of time it will take. You will also want so many more versions and edits of your thesis than of any other document you’ve done, as you won’t want all those spelling mistakes coming back as corrections, and I for one didn’t realising I would be on ‘final version’ 20 something.

Finally, your supervisors and others reading and editing it will take much longer to get it back to you than other things you’ve sent on because they also have to find larger chunks of time than they normally would. It is also worth knowing ahead of time how many times your supervisors are prepared to look at it, so that you make the most of the opportunities you have and pick the key moments for input. Make sure whatever time you think you’ll need for editing is probably tripled on your project plan.

Remember to take time to decompress

I write this as someone who quite literally lost her hair and developed a bald patch during her PhD, make sure you take breaks. Your brain is processing vast amounts of information during your writing up period and it is easy to become laser focussed. That’s good but it can also be trouble. You need to walk away from a piece of work to see the problems and the gaps within it. From a basic point of view, you will get to the point where you read what you think is there rather than what it actually is there, and that is no good to you in the long run.

So, from someone who didn’t and still lives with the physical consequences, make sure that both your mind and body are able to do what it needed of them by ensuring you rest. Sometimes, all you’ll need is a day in the lab away from the laptop, but some days you will need to have a long soak or a walk in the woods to enable your mind to see what’s right in front of it when you return. Also, I highly recommend booking a holiday between submission and your viva date so you walk into that viva room in the best physical and mental shape you can.

Your thesis is YOUR thesis

Your thesis, like your PhD is one of the few times in your career where the work should be entirely yours, and at the end of the day you will be the person sat alone in a room to defend your choices. I’m not advocating ignoring your supervisors, they will have huge amounts of experience and it is always worth getting the benefit of what they have to say. If the crunch time happens however you can’t use the ‘my supervisor told me to’ defence when you are sat in that room and looking your examiners in the eye. Your work has to make sense to you and be presented in a way that you can walk someone else through and defend it, there’s a reason a viva is called a defence in the US. So, as much as it’s important to get the best possible advice, input and support, when it comes to being in that room you are alone, and so you have to own the decisions you’ve made and the work you’ve done. You will come out of that room all the more developed as a scientist because of it, and whatever happens you should be proud of what you’ve done.

In the end, this princess and general could have chosen to slaughter the villainous Thesis, but instead she adopted it and made it her friend. Now it serves her as a memory charm and library guardian for all the work that came before, and acts as a reminder for her to be kind to all those that are following in her footsteps.

All opinions in this blog are my own

If you would like more tips and advice linked to your PhD journey then the first every Girlymicrobiologist book is here to help!

This book goes beyond the typical academic handbook, acknowledging the unique challenges and triumphs faced by PhD students and offering relatable, real-world advice to help you:

  • Master the art of effective research and time management to stay organized and on track.
  • Build a supportive network of peers, mentors, and supervisors to overcome challenges and foster collaboration.
  • Maintain a healthy work-life balance by prioritizing self-care and avoiding burnout.
  • Embrace the unexpected and view setbacks as opportunities for growth and innovation.
  • Navigate the complexities of academia with confidence and build a strong professional network

This book starts at the very beginning, with why you might want to do a PhD, how you might decide what route to PhD is right for you, and what a successful application might look like.

It then takes you through your PhD journey, year by year, with tips about how to approach and succeed during significant moments, such as attending your first conference, or writing your first academic paper.

Finally, you will discover what other skills you need to develop during your PhD to give you the best route to success after your viva. All of this supported by links to activities on The Girlymicrobiologist blog, to help you with practical exercises in order to apply what you have learned.

Take a look on Amazon to find out more

PhD Top Tips: How to carry on when the experiment you’re doing just feels cursed

girlymicro Academic Life, Education, Healthcare Science, Microbiology (Research), Research/Academia

A decade ago, I posted this on my Facebook page:

The thing is, it will not have been the only bad science day I will have posted about. You see, science is wonderful, but some days, it can also be heartbreaking. Before the breakthroughs, there is often a period where it feels like nothing is ever going to work again. I currently have a few PhD students who are in the ‘I just need data phase’ and so I thought I would take this week to acknowledge how challenging it can be and share some things I learnt that got me through.

The results of your experiment do not define you as a scientist

I want to say this first, and I want to say it loudly and on repeat, especially for all of those PhD and other scientists who are currently struggling with experiment failure – failed experiments DO NOT make you bad scientists! I shall say it again – failed experiments DO NOT make you bad scientists! All scientists fail, some of us have failed for months at a time, and challenging science is the name of the game. If you were doing something that had been done before, you wouldn’t be doing PhD level work. Therefore, failure, far from being a flaw, is to be expected. The sooner this is accepted, the better your mental health will be.

It’s incredibly challenging some days, but we all have to remember that our success at ticking actions off our list does not define who we are as people. Science is also far more than undertaking experiments. Did you sign up and deliver some kick ass outreach? Did you ask a great question in lab meeting? Did you make your struggling peer a cup of tea or help them with a figure they couldn’t get right? Sometimes, when the thing we’re obsessing about doesn’t go right, that is all we can see, and we ignore all the rest that is going well, make sure to acknowledge the good stuff.

Sometimes, you need periods of failure to get to the success

PhD’s are apprenticeships in research, and all of the failed experiments are far from a waste. They are part of the learning. You will use them to create your method development sections of your thesis, and they will give you great discussion points for your viva. In fact, if you had a completely clean sailing PhD that might be the more unexpected thing if I was your examiner, I’d be forced to dig more about where your learning happened.

Also, and I hate to do this as it’s the most trite thing ever, but some of the best science comes from mistakes and screw ups. Think Fleming and penicillin. The main thing is the mind set through which we view the failure. If we take it personally and let it get in our heads, all we can see is failure. Some of my best science has happened when failure has made me take a step back and pause, and suddenly I’ve seen the problem in a new light, or it’s forced me to make connections I wouldn’t have normally thought about. Sometimes, we need to be sure we see the failure as an opportunity rather than the end of hope.

It can be soul destroying when an experiment you’ve worked on for weeks or months crashes and burns, but the thing I’ve learnt is that often that happens when I push through too much, or don’t give it the attention it deserves. For me, experimental failures can also be warning signs about the pace and intensity of my work and can, in the end, offer a useful way to self check and force me to review my working patterns to give me a better more sustainable pathway to success. If you are crying over a failed run, it’s probably an indication that you need a break or to work differently.

Know when to continue down the rabbit hole and when to pivot

One of the biggest lessons I’ve learnt during my time working in science and doing research is that sometimes you have to be prepared to stop what you’re doing. During my PhD I spent 18 months trying to separate Adenovirus from viro cells using centrifugation to reduce whole genome sequencing read loading towards monkey rather than viral DNA. You know what, I got a bit of a reduction, but not enough to make a real difference, and to get that I worked till midnight for months as that was the only time the ultra centrifuge was available. What I didn’t do was a) set some success criteria b) stick to them and c) have a cut off that was based on effort vs reward. I just carried on…..and on……and on for very little payoff when I should have just stopped.

There will be times when you just need to persevere, as the work you are doing in central to the project and definitely achievable (anything core should be designed at the project level as attainable). There will, however, always be other aspects that need to be evaluated for the resource they are requiring (time, money, etc) vs what they are adding to your body of work. There is no point in spending 18 months on something that will be 2 pages in your thesis, there is point in spending 12 months fixing something that will be a chapter or more.

So one of the main skills I’ve had to develop is the ability to step back and see where the piece I am currently working on fits into the whole, and I can then evaluate what level of effort it is worth. If you haven’t set your success criteria etc beforehand it can be super painful to reach this decision and to walk away. This can be why having a good project timeline for your work/project/PhD can be really helpful. It helps you make pragmatic decisions and gets you out of the weeds in order to help you move forward with a view of the work as a whole.

Some days, you need to walk away to gain clarity

One of the things that has helped me with the ‘rabbit hole or pivot’ conundrum is getting to know myself enough to understand when I am in a spiral. My willpower and persistence are probably the only reasons I’ve managed to get as far as I have. The downside to these aspects of my personality is that I become hyper focused on a goal and the fact that it has to happen, I get in my own way and can’t always do the needed reflection piece. The end result of this is that it takes me longer than it should to realise I should have stopped (this is true of everything for me, not just experiments).

Believe when I say that it is worth developing the self-awareness to be better at this, as combined with the self reflection skill described above, it will be a powerful tool throughout your career. For me, this involved knowing when I need to walk away and distract my brain with some trashy TV or process it by writing a blog. My husband wishes it was the decision to go and load a dishwasher or clean, but no one can have everything. Pre-pandemic it was also things like going for a run, although I have to be honest and say I haven’t got back there. Whatever your technique, it took me a long time to realise this was a key part of my process. I needed to distract my brain, and the very process of doing this enabled me to gain clarity. Far from berating myself for my prevarication, it was actually key to achieving my aims and objectives.

Know when to get support

Frankly, sometimes you can’t manage alone. In fact, in my case, I hardly ever can. It’s why I really believe that science is a team sport. Sometimes, you will need someone else to help you recognise that it’s time to evaluate. Sometimes, you will need the support of others as part of the reflection process, and when it comes to troubleshooting why things are not working, two heads are definitely better than one. Far from being a sign of weakness, seeking support and building networks so you have identified that support are key parts of your career development. There will always be people out there who have more experience than us and learning from them so we don’t just replicate each others mistakes is just good resource management.

Always have a plan b, and ideally c and d

As I’ve already said, failure is just part and parcel of science. There’s no escaping this fact. What I have learnt though is there are routes to being more savvy about anticipating that failure. I had a fairly horrid experience during one of my masters degrees, where the project was designed as just one thing that either worked or it didn’t. Inevitably it didn’t, and I was forced to write 10,000 words on 3 results. This taught me 2 valuable lessons, 1) never blindly follow a project designed by someone else, if you feel it isn’t right for you own the fact that it is your project and you need to input to get it where it needs to be, and 2) never design a project that is entirely dependent on plan A working, as the chances are it won’t.

Taking a modular approach to any project design will enable you to combine parts that work and still have an over arching narrative that makes sense and enable you to succeed, even if individual components fail. If you are designing a project around a core component that you are then attaching spokes to, that component needs to be guaranteed in terms of process success, even if not result outcomes, as you can discuss the results in the context of your work, but you can’t risk not being able to get them. Take time to map this out and to undertake a SWOT analysis, so you can pre-plan for how you will manage any failures. That way you won’t lose time panicking when things go wrong, as you will have a defined pathway already.

Don’t benchmark against the success of others

A lot of the way in which we experience failure is defined by how we emotionally respond to the context of that failure. Sometimes benchmarking against others can be helpful, but more often than not if you are already feeling challenged it can just add to the pressure you are already feeling. I think this especially true when taking a PhD, as both you and your project are highly individual. It can be to look at others and their outputs and not compare, but the truth of the matter is you are likely comparing apples and oranges. PhD’s by their very nature need to be unique pieces of work, and so someone can appear to be killing it but their track record will look different to yours as they might face their challenges in the future, or may have to justify their work in a different way. So look to peers for support rather than affirmation of your progress, as every pathway in different. Otherwise you can make a challenging time even worse for yourself.

Know that we have all been there

I started out by saying that failed experiments do not make you a bad scientist and I want to finish by saying that the way I know this to be the case is that I have yet to meet any scientist who hasn’t spent dark days dealing with failed experiments, or just failure in general. No matter how lonely it feels in the moment, know that we have all been there. That may not make it feel any better, but I hope it empowers you to reach out and let your supervisors/peers know how you are feeling in order for them to support you through it. No one should judge you in this, because in judging you we would be judging ourselves. Science can be a really lonely profession, but it doesn’t have to be, and so reach out to your networks, and if you can’t reach out to them reach out to me. The better job we do of supporting each other the better placed we will be to create work that matters and improves the world just a little bit.

All opinions in this blog are my own

If you would like more tips and advice linked to your PhD journey then the first every Girlymicrobiologist book is here to help!

This book goes beyond the typical academic handbook, acknowledging the unique challenges and triumphs faced by PhD students and offering relatable, real-world advice to help you:

  • Master the art of effective research and time management to stay organized and on track.
  • Build a supportive network of peers, mentors, and supervisors to overcome challenges and foster collaboration.
  • Maintain a healthy work-life balance by prioritizing self-care and avoiding burnout.
  • Embrace the unexpected and view setbacks as opportunities for growth and innovation.
  • Navigate the complexities of academia with confidence and build a strong professional network

This book starts at the very beginning, with why you might want to do a PhD, how you might decide what route to PhD is right for you, and what a successful application might look like.

It then takes you through your PhD journey, year by year, with tips about how to approach and succeed during significant moments, such as attending your first conference, or writing your first academic paper.

Finally, you will discover what other skills you need to develop during your PhD to give you the best route to success after your viva. All of this supported by links to activities on The Girlymicrobiologist blog, to help you with practical exercises in order to apply what you have learned.

Take a look on Amazon to find out more

PhD Top Tips: So you’ve decided you want to start a PhD

girlymicro Academic Life, Education, Healthcare Science, Microbiology (Research), Research/Academia

It’s that time of a year, the time of year when I get a number of appointments put into my diary from people who want to talk about doing a PhD. This will range from undergraduates, where I’ve taught on their course, to established healthcare professionals with over a decade worth of lab or clinical experience. I thought it might be useful, therefore, to write a post where I go through some of the stages of discussion that take place in these meetings in order to help anyone else thinking about the same thing.

Over the last decade I’ve spent time talking with a lot of people who come to me saying they want a PhD and my first question is always why? I ask this not just because it is the question you will always get asked in your PhD interviews but because your answer will determine a number of things, some of which I’ve covered below.

How much thinking have you done?

Starting a discussion with someone where you ask why they’ve decided to do a PhD is a good way to check how much thinking they’ve done about a) what a PhD actually is and b) how it will enable to them to achieve their aspirations, a PhD is not the end game after all, it’s a step on a pathway. Now, if someone is an undergraduate, they may be focussed on a PhD as the next educational step and not yet have clarity about where it will lead. However, for someone whose already a working scientist, this question holds a lot more weight as they are more resource limited (in terms of time) and probably need higher levels of clarity prior to committing. The way someone answers this question (and it’s one I also use in interviews) helps me gauge how far along in the thought process someone is. In an interview, it also helps me gauge how committed someone is, as they have invested the time to really think about their why and how it serves their purpose and values.

This then leads onto some more specific questions:

  • What subject of PhD? are you looking to progress via a scientific route or via other channels in leadership or education.
  • What type of PhD – if you are coming to me as a Healthcare Scientist looking to progress a traditional research doctorates are no longer your only option. You can now undertake a professional doctorate via a number of different routes.
  • Where do you see a PhD taking you to in 15 years time? Which doors will it open? Are any of these restricted by doctorate type?
  • Why now? What are the opportunities or support you have available to you now. How have these changed (if you’ve been in post) to allow this to be an option now and how might they change in the future? Could any of these changes impact you in the time course of the PhD?

Thinking about what route to PhD you will want to follow is key. Some, like fellowships, come with substantial resource in terms of matched salary and both educational and consumables funding, but are highly competitive and will likely take you over a year to prepare. Others are much more under your control, like self funded, but require you to have resource of your own to begin with.

The route that might work best will therefore depend a bit on where you want to end up, but also on personal factors, such as finances and available time. Some of these routes may also limit progression down certain pathways, if you want to become a full research academic for instance you will probably need a research PhD rather than a taught doctorate. If you choose your route without knowing your why you could therefore close off some possibilities without truly being aware at the time:

  • Unfunded route, where you register but undertake an unfunded PhD alongside your post. Often your employer will pay your PhD fees and you apply for consumables money
  • Self funded route, where you take time out to do your PhD but you fund your own fees and consumables, usually in an academic department
  • Stipend funded, the route most people think of when undertaking a PhD. You apply for a project where the funding and requirements of the PhD have been set out by a supervisor. These are more like fixed term jobs where you deliver on a set of parameters
  • Fellowship, this route in probably the most competitive and requires substantial preparation. On the other hand it can offer a route by which you can undertake a PhD whilst still retaining your salary, and have access to funding for training and consumables
  • Training post, this route will often offer a taught doctorate rather than a traditional research PhD. It is also a way in which you may be able to develop clinically at the same time as developing leadership and research skills, and so might be the most appropriate route if you are aiming to undertake a PhD in order to get a specific role

How much research have you done?

When I talk about research here, I’m not talking about the academic kind, I’m talking about the fact finding and speaking to people kind. One of the ways I can often judge how seriously someone has thought about undertaking a PhD, and establish how far they are along with the process, is talking in a little more detail about what kind of research questions they are thinking of and the practicalities of undertaking a PhD in that area, such as what institution? or what supervisors? This is where the nitty gritty really starts to matter:

What thinking have you done on your research question, how far is it progressed? Do you have a broad subject like Clinical Microbiology, a more specific subject area such as Gram negative sepsis, or something really developed, such as comparison of molecular detections of antimicrobial resistance techniques and their impacts on antimicrobial prescribing decisions. There are pros and cons about having reached different levels of thought. It is good to leave enough conceptual room where your supervisors can support you in ensuring that your research question is both achievable and of PhD level. Coming in with only the broadest level of thinking however, tends to imply you may not have thought about it enough and may limit how much support and sign posting someone can give you, as it will be harder to tell which funders might be interested or academically where it might sit.

Who are you thinking in terms of supervision? Have you approached anyone? Making the right supervision decision is key, not just in terms of topic but also in terms of PhD experience. It is therefore always worth doing your due diligence in terms of research who is working in the area, but also in asking what is their working style? What is the experience of others in their lab? Can they help you in the kind of career path you are envisioning for yourself? If you want a clinical career you may not want to go and work with a fundamental scientist, as their networks will be different and may not support your trajectory.

What institution are you thinking of? Have you read up or spoken to others about what is like to study there? Institutions, like supervisors, tend to have a specific style, and it may be one that works for you but it also may be one that doesn’t. Your institution in some ways may be determined by your supervisors, but you may have the option if you are doing a combined clinical/academic placement to choose. You may also want to bear the institution in mind when identifying your supervisors in the first place and use it as part of your matching criteria. Sometimes, you may also have no choice in institution, especially if you are studying linked to a training scheme – in which case, be aware of travel or other requirements, when decided your route to PhD, as it may impact your experience.

Have you thought about the realities?

PhDs can often be idealised as experiential learning, the reality of them can be very different however, and I’ve already posted about the challenges of the second year slump. The truth of it is that all PhDs are challenging, and sometimes I think that achieving a PhD is more a measure of stubbornness and refusal to give up than of academic competence. There are some things that can be made much easier if you think about them and how they will work for you and your life style before you embark on this particular journey.

The first of this is how will you balance a PhD with your other life commitments? Each of the routes to a PhD have different pros and cons. If you don’t have loads of money in the bank, and like me don’t have a lot of savings, then doing a self funded PhD may not be an option for you. Other options, like a PhD with a stipend, may also be off the table, if you need your current salary to make ends meet. This in itself may determine which route you take. You may have resource in terms of finance but not in terms of time, you may therefore want to self fund or do an unfunded PhD, in a way that enables you to stretch the process out over several years, so your annual time commitment is less. On the other hand, you may be time limited and need to get it done in the next 5 years, and therefore not have the time resource to put all your eggs into the same basket and apply for a fellowship that takes a year to prepare and has a 20% success rate. Being honest with yourself about the different drivers is essential so that you can make the right choices in terms of route.

It is also key to know what kind of learner you are, I’ve already posted a bit about learning agreements, but even in the absence of one you still need to be aware of your needs. Do you need a supervisor who is going to have a lot of pastoral time? Do you want to be in a group with plenty of other PhD students so you have access to peer support? Do you hate micro management and pretty much want high level accessible support when you need it, but a light touch the rest of the time? These things will determine what kind of supervisor and setting you will need to identify, and the questions should be asking (outside of the scientific) in the process.

Finally, and this one is oh so important, what’s your end game? If you want to end up as a Consultant Clinical Scientist but have little interest in a research career, a taught doctorate may be right for you, it will not be the right choice if you want a Clinical Academic career however. If you want to follow a clinical pathway you may want to ensure that this aspect is retained in your research question, to enable follow on post docs and other progression that supports your clinical role. Not to harp on, but if you don’t know your why no one else can, and it can mean that you make decisions that close future routes rather than keeping progression pathways open. Also, did I mention doing a PhD is hard? If you don’t know your why it can be super challenging to just keep going when the tough times do arrive. If you know your why however, at least you can cling to that vision and end game in order to get you through.

I hope this post helps show that there are many different choices open to you if you are thinking about undertaking a PhD, but that it’s worth doing some thinking and fact finding as part of the process to make sure you make the decisions that are right for you and your life style. For those of you who decide to jump down this particular rabbit hole here are some things I wish I had known when I started, and good luck, you will rock it!

All opinions in this blog are my own

If you would like more tips and advice linked to your PhD journey then the first every Girlymicrobiologist book is here to help!

This book goes beyond the typical academic handbook, acknowledging the unique challenges and triumphs faced by PhD students and offering relatable, real-world advice to help you:

  • Master the art of effective research and time management to stay organized and on track.
  • Build a supportive network of peers, mentors, and supervisors to overcome challenges and foster collaboration.
  • Maintain a healthy work-life balance by prioritizing self-care and avoiding burnout.
  • Embrace the unexpected and view setbacks as opportunities for growth and innovation.
  • Navigate the complexities of academia with confidence and build a strong professional network

This book starts at the very beginning, with why you might want to do a PhD, how you might decide what route to PhD is right for you, and what a successful application might look like.

It then takes you through your PhD journey, year by year, with tips about how to approach and succeed during significant moments, such as attending your first conference, or writing your first academic paper.

Finally, you will discover what other skills you need to develop during your PhD to give you the best route to success after your viva. All of this supported by links to activities on The Girlymicrobiologist blog, to help you with practical exercises in order to apply what you have learned.

Take a look on Amazon to find out more

Celebrating National Pathology Week (Delayed): Talking about routes to registration as a Healthcare Scientist

girlymicro Education, Healthcare Science, Microbiology (Clinical)

I have the best job in the world, and people often ask me a) how I got here and b) how to get here themselves. Now, I have gone a long and circuitous route as you can see below, so I’m not necessarily the best person to ask, although personally I think the circuitous route had quite a lot of unexpected benefits:

That said, when I was a lass the world was much more straight forward with the routes and options being much more restricted and a much greater need to establish your own pathway. There was only one place where you could register, and that was with the Health and Care Professions Council (which even had a slightly different name), where yo reach registration in 1 of 3 ways:

  • Registration as a Clinical Scientist via the Association of Clinical Scientists (route one) – this was the route I followed as a grade A trainee, which later developed into the STP (Scientific Training Programme) as offered by the National School of Healthcare Science
  • Registration as a Clinical Scientist via the Association of Clinical Scientists (route two) – this route still exists and it involves the following ‘those who may not have completed the formal training associated with Route ONE, but have extensive experience in the relevant field sufficient to demonstrate our competences based on a cross referenced portfolio of evidence, and (if approved) an interview.’ This is usually for those entering the field with a PhD who then spend some time working in the role of a supervised pre-registered clinical scientist with the supervision of a registered Clinical Scientist or medic.
  • Registration as a Biomedical Scientist via the Institute of Biomedical Science

All of these routes led to you being registered with the HCPC and the ability to practice as an independent practitioner. The market place has changed a lot since then however and the profession is now filled with so many opportunities and entry points to permit an enriched career progression. So in order to celebrate National Pathology week I’m hoping to answer some of questions about how to become a Healthcare Scientist and sign post to some great resources that others have created.

Although in many ways I still believe the system was great when I joined, it cannot be denied that there were a number of flaws. There was no pathway as such, it was incredibly difficult to move from a starting non-registration requiring position to registration and onwards. Also, once you had your registration there was no structured progression route. It was hard to demonstrate pathways to Consultant Clinical Scientist posts, Advanced Practice posts didn’t exist, and so it was also difficult to demonstrate parity or equity of access. Thus modernising scientific careers was born, an example is below although it’s been through many interactions since. Many aspects of this are still in place, but some like the clinical academic careers route are still being developed, whilst others like the apprenticeships have been developed significantly further. Other entry routes, like T-Levels in Healthcare Science, didn’t exist at all when this was last updated.

This means that anyone wanting to entering the career now has a lot more points at which they can enter, A-Level equivalent (T-Levels), undergraduate, post-graduate, post PhD. There also routes available to move from stage to stage in a variety of ways. Having so much choice can be a little overwhelming however, so I thought I would try (with the help of the wonderful Dr Jo Horne) to collate some of the different info in one place in case it might help.

Apprenticeships

Apprenticeship standards change frequently and are tweaked based on what we learn and the workforce needs. They are great however as they are not only entry points, but progression points no matter what level you are coming in at. The Level 7 apprenticeship will also soon be a thing, and so for a Clinical Scientist like me, training may look a bit more like it did when I was a grade A trainee. They are also great as you can balance progression with your needs in terms of non-work demands, as you have control about when you choose to access them, permitting a lot of flexibility.

Entry Overview Clinical Microbiology and Clinical Virology

Dr Jo Horne has been pulling together some really amazing infographics on healthcaresciencenews.co.uk in order to help clarify not only the apprenticeship routes, but also the direct entry routes into the various formal and informal training programmes that can lead to HCPC registration. She is also actively working with Healthcare Scientists via her coaching website to help support them in their careers and making career progression decisions.

Other Routes to Clinical Scientist Registration

Finally, I’ve previously posted about my experience applying for Higher Specialist Scientific Training programmer equivalence. This is a way of demonstrating that you have an equivalent skill set to those coming out of the HSST programme, which is a formal training programme to support training to consultant level.

There is an equivalent scheme for equivalence to the Scientist Training Programme, but this isn’t the only route to registration as a Clinical Scientist if you haven’t gone through the formal STP programme. I think there is an understandable excitement and engagement with the STP equivalence programme and I am a big supporter of that engagement. I do however think we have to be conscious of the word equivalence. If the STP equivalence process is about demonstrating equivalence to the STP then not everyone will be able to go down this pathway, as the training they have to demonstrate is very broad and, with the new curriculum, very clinical. This doesn’t mean that they should not be able to gain registration as a Clinical Scientist. As I said at the very start, the ACS route 2 existed when I was training and it still exists now. If someone has vast amounts of specialist knowledge and meets the requirement for having practiced in a clinical setting then they may not be suitable for equivalence, but more than suitable for route two via the ACS. I’ve know a number of candidates put in a lot of time and end up being delayed by going for the more well known AHCS route and struggling, when they would have been much more suitable for the ACS route. I think we need to talk more about these alternate routes, and the ones that are available across the profession to recognise advanced practice, in order to support people applying for the right schemes and not getting disillusioned in the process. The route needed will be varied based on the individual but the end point is the same, and we should therefore embrace all of these options.

Hopefully some of these links will be helpful to those of you who are looking to enter this awesome career, and for those of you who are already working as a HCS, maybe they will inspire you to take the next exciting step in your career. Please let me know if helpful and thanks again to Jo.

All opinions in this blog are my own

Would You Like That Explained in Words of One Syllable? Thriving in the world of a mansplainer

girlymicro Academic Life, General, Healthcare Science, Leadership, Microbiology (Clinical), Microbiology (Research), Research/Academia

This post is in honour of international women’s day, I hope by talking about this and sharing some thoughts it will make us all more able to stand up for ourselves and support others in moments like the one below, when we encounter the mansplainer in their natural habitat.

I was at a conference last week, and I was struck yet again by the number of questions that were asked that were commentary and not indeed questions. I paid attention, and, in this case, 100% of those undertaking this behaviour were older men. The reason I started to pay attention was because the first session I attended was filled with a panel of young female scientists. The Chair of the panel, however, was an older man, and when this commentary occurred from one of the attendees, instead of shutting it down, he actively participated and even exacerbated the issue. Not only that, but the commentary was also inherently incorrect and was not even helpful. I must admit I found myself becoming pretty infuriated and later found other women who’d been in the room who found it equally maddening. So this week I thought I would channel some of that science rage into a productive place and talk about survival in the world of the mansplainer.

NB please note I recognise that there are also some women that exhibit these behaviours routinely (and we probably all do periodically). In this post I talk about mansplaining as the behaviour and not linked to gender, unless I’m recounting specific personal experiences.

In the interests of full disclosure, I’ve also had a fair amount of men recently lecturing me about what it is I do and do not know, as well as some ‘interesting’ comments on my blog. I therefore may not be feeling as balanced about this topic as I would otherwise. The thing is, it’s not like it is as unusual as it should be, and you would think, therefore, that I should be less bothered by it. In fact, the opposite is true. Now I’m aware and see it happen to others. I’m even less tolerant. I’m pretty fortunate that it only happens to me 3 or 4 times a year to a level that irritates me. It happened less when I became a Consultant, and I suspect that it will happen less (to my face) now I’m a Professor. Even so, with all of these benchmarks of knowledge and experience, it still happens. So here are my thoughts on living in the world of the mansplainer and how we might all work together to make it more tolerable.

Don’t worry little lady

Let’s start with talking about some classic mansplaining that has happened to me. I’m partly starting out with this because I had a really lovely male boss who just didn’t believe that these things happened as no one had talked to him about it. By putting it down here prior to talking about what we can do in response, I hope to contextualise some of what it’s like for any allies out there who have experienced it less as individuals.

My all-time ‘favourite’ example of mansplaining that has happened to me was an email sent to myself and a female colleague that actually started with the words ‘don’t worry little ladies’. The email in question was sent in response to a query about engineering standards. Now, these days I would respond with ‘that’s Professor Little Lady and I am worried so please explain………and what you are going to do about it’. At the time, though, I was completely thrown by how 4 words could effectively minimise my years of experience, my authority to ask the question, and impact my feelings about my ability to follow up. In my defence, I did follow up and insist on further information and a review, but something so small could actually have impacted my ability to do my job and would never have been undertaken with my male consultant boss. These comments, therefore, are not insignificant when, especially in healthcare, they could lead to a reduction in safety. That said, did I escalate? No, did I forward the email to his boss and explain? Also, no. It’s so normal that it never even occured to me. I suspect if I had, it would have just been called ‘banter’ and waved off.

One of my other favourite things (not really) is when I’m called into a room to have a technical discussion, and when it becomes apparent I’m not convinced by the argument, the room full of men call in yet more men, not to enhance or bring more information to the discussion, but because they somehow believe that having more men in the space repeating each others words will somehow intimidate me or force me into conceding that their science is suddenly correct. I do not enjoy conflict and I generally believe it’s bad form to point out the flaws in someone’s argument in front of others, in a way that could be seen as aggressive or embarrassing for the individual. However, if you pull >20 men into a room to lecture me on, for instance how HPV works, when you are neither a microbiologist or have any experience with viral loading or kill, and think that calling in a further 10 will change the underlying fact that I have just finished writing about it for my thesis, my argument is unlikely to change. All that will happen is that I will cease trying to cover up my level of knowledge in order to play nice and I will quote papers and research at you until you let me leave.

Have you thought about?

One of the other scenarios I’ve found where some interesting male commentary occurs is on some of my blog posts. Now, don’t get me wrong a) most of the commentary I receive on my blogs is super supportive and is what gives me the impetuous to continue to write them and b) I acknowledge that by writing and (over)sharing the way I do I also invite engagement and discussion of the content I put out. Every now and again I get a comment that I don’t approve for public sharing and just leave in the archives as I’m not sure that they are part of the discussion I want to have.

When I posted earlier this year about being overwhelmed and shared some tips that have helped me to get through I received some comments from various male subscribers. These comments were very different from those of my female subscribers, who shared how grateful they were that we were talking about the fact that everyone has days when they struggle and that coping mechanisms are key. These comments all came from a place which I assume was kind and supportive, but ran along the lines of ‘if you feel overwhelmed maybe you should have spent the extra time working and clearing your emails rather than writing this blog’.

On the surface I kind of get it, but also a) it is my right to choose how I spend what free time I manage to have for myself, without commentary from others as long as I’m breaking no laws and hurting no one b) blog writing, for me, has become a method of processing my work load and stress levels and therefore suggesting I abandon it would be removing a key coping strategy I utilise c) the blog post was about sharing experiences and methods to move through feeling over whelmed, not a pity party post about how it sucks, therefore the suggestion that I focus my time on not supporting my community is against the ethos of what this blog is about and frankly kind of sucks and finally d) the assumption that I wouldn’t have considered doing less and not over stretching myself probably doesn’t give me very much credit in terms of self reflection or self awareness. So, I suppose my point is this, sometimes by stating the obvious and your opinion about it, it can come over as pretty patronising, as if it wouldn’t have occured to me and I haven’t done the thinking myself. That said, intent matters, and I don’t believe that these are often meant with any ill intent, so I leave them as unapproved and a source of future consideration and move on.

If you look for it, you will see it

Frankly, some of this is insidious, as I discussed in the intro, I only really started paying attention at the conference because there was such an extreme version of it that it drew my attention and I became deliberately aware of it. Sadly, when I posted about it on twitter the almost universal response was ‘only one’ to my retelling of the male commentator. It’s so universal as a stereotype that we laugh about it, but my thinking is also what can we do to challenge it or support others when we see it.

Summary.   

Role incredulity is a form of gender bias where women are mistakenly assumed to be in a support or stereotypically female role — an administrative assistant, nurse, wife, or girlfriend, for instance — rather than a leadership or stereotypically male role, such as CEO, professor, lawyer, doctor, or engineer. While this slight or mistake might seem innocuous, it can have real ramifications for women. Women must expend extra energy and time to assert and prove their role. Their words may lack the credibility and authority inherent in their position. And when women are not seen as a leader, they may be less likely to be hired into male-dominated roles or to be considered for promotions.

While the real issue of role incredulity is systemic, there are steps organizational leaders, workplace allies, and women themselves can take to prevent and correct it., including setting organizational norms, being an ally, owning your mistakes, and, if you’re a woman, proactively identifying your role.

https://hbr.org/2021/12/when-people-assume-youre-not-in-charge-because-youre-a-woman

I suspect there are few women amongst us who haven’t been asked to ‘sort the coffee’ despite being one of the most senior people in the room, or who haven’t had their bank card saying Dr handed back to their partner. These are little things, and I for one am completely OK with getting coffee, but not because I’m a woman, but because I think we should all take our turn and hierarchy shouldn’t remove us from that. I find it hard therefore to know when to draw the lines over such things, I’m a team player and want to do my part, but I also don’t want to sustain a stereotype that might negatively impact others. Honestly, even thinking about these things in the moment and having that constant dialogue with yourself can be pretty exhausting when it happens over years or decades.

Do these things actually matter?

Even though I feel that I own my place and have so much more strength than I did when I was younger, these comments, decisions, and moments still take up cognitive space. I may rebound more quickly but I still go through the ‘experience-self recrimination spiral-replay’ cycle in order to process it and decide where fault may lie with me or where the learning is.

“What we found was that women largely had negative outcomes as a result of being mansplained to, whereas it didn’t affect men as much,” said Briggs, whose research was published in the Journal of Business and Psychology. “They tended to register that their competence was being questioned more than men did, and to attribute this to a gender bias – so, maybe this person doesn’t think highly of me or doesn’t like me because of my gender.”

This feeling wasn’t shared by male volunteers who were given a condescending explanation by a woman. “Maybe they perceived it as ‘this person is being rude to me’, but they didn’t perceive it any differently if it came from a man or woman, and they didn’t attribute it to a gender bias,” Briggs said.

https://www.theguardian.com/science/2023/feb/03/let-me-mansplain-studies-reveal-negative-impacts-of-behaviour?CMP=Share_iOSApp_Other

It may be therefore that we have to acknowledge the role we play in how we receive the information and the fact that some of the behaviour we experience really does not have any ill intent. However, that also doesn’t mean that those undertaking such behaviours don’t equally have a responsibility to understand how their behaviour impacts others, and in some cases leads to the active detriment of the women who are the recipients. Especially if this behaviour is endemic in institutions/settings or originates from the same individual over protracted periods of time.

So, how do we handle it?

I’ve previously posted about how I learnt to own the place I found myself in with some tips on managing this as individuals. I do think that dealing with direct interactions rather than our own imposter syndrome needs a different set of skills, ones that may indeed help with how we see the world over all. It all starts with being conscious of ourselves in the moment, where do we sit, what do we say when we introduce ourselves, how do we respond in the moment and how do we let our view of ourselves drive these dialogues?

Below are some areas of thinking that have helped me and I hope might also help you in traversing the particular challenge.

Decide which truths to believe

I am often considered over emotional because I wear my heart and values on my sleeve. It’s a running joke within my team that I have absolutely no poker face, and the time to be concerned when in a room with me is when I stop being expressive, as it probably means I have become coldly annoyed.

For a long time, I thought that this was the biggest weakness. I had many a person (male and female) explain to me that I couldn’t be successful as I was and that to proceed I really needed to change and fit the stereotype of what a boss/consultant/professor should be. Well, frankly, screw that. Hiding who we are and pretending to be someone else should not be the only path to success. Being open and honest about my values and who I am is not a weakness. It requires integrity and fairly often bravery to function openly as who you are. We are supposed to be assertive but not too assertive, smart but modest about it, passionate but not emotional. I, for one, don’t want to play that game and, in many ways, just opted out and found ways around it. I strongly believe that we no longer need to play by the rules of those who came before us, let’s set our own rules, let’s choose our own truths and empower the future to be different and better for those who will follow on behind us. Choose your own path and let that be your truth.

Practice makes perfect

Now, I’m not sure I would be comfortable saying any of the below as they are written, I think I would be too scared of coming off as aggressive. For all you women out there who could and own being that assertive, I am not worthy. That said, I have used many of these responses, if not these exact words, in order to manage conversations.

The thing for me is you need to know what language you are comfortable with and practice it before you need it. In the moment I am often surprised and lose my mental footing, therefore if I haven’t practiced how to hold my ground and be assertive I lose it to hesitancy and upset. Practicing enables it to almost be a reflexive approach that you can draw on, so that you don’t have the cognitive additional load of making those nuanced word choices in the moment. So the sentences above may not fit you, but find ones that do and try them on for size well before you need them.

One of the things that also helps me is wearing a different head space when I go into rooms where this is likely to be an issue. ‘Dream’ would never hold up in these spaces, and when I leave them, she often crumbles in the replaying of the moment. Professor Cloutman-Green, however, is much more able to hold her own. It’s almost like my science shield enables me to suffer less from impact in the moment and so allows me to maintain or re-establish myself in that moment much more readily. This is different from not being my authentic self in a space, I am still me, but it gives me the emotional distance to process things later rather than being overwhelmed in the moment.

Self-awareness is key

Ever walk into a room, and there’s a single chair left and you offer it to everyone else who comes in after you? I do this all the time. It’s just polite, right? Absolutely. However, if you are in a room that internalises hierarchy and everyone sitting is a Consultant like you and everyone else standing is more junior, by undertaking this action you are unconsciously giving away your seniority in the room. You are signally you’re difference to your other consultant colleagues. Being aware of your surroundings and what cues you are sending out is important.

Ever sat listening whilst a colleague towered above you? The person who deliberately chooses to lean against your door frame whilst you sit in order to explain X or Y to you. Dominance positioning is a thing, we are primates after all. If we have small and closed body language it says a lot more than our verbal responses in the conversation. Sometimes, when you find yourself in a mansplaining situation the mere act of repositioning yourself can impact the conversation. Stand up, gesticulate using wide body language when speaking. It may be that this merely changes the way you receive the exact same dialogue, but sometimes that is half of the battle. If it also supports you in using some of your practiced dialogue, all the better!

How do we help others?

When sat in the conference room mentioned at the start of this article, I had so much rage at the way these young scientists were being treated. My PhD student who saw and understood my response asked ‘are you going to say something?’. I responded ‘no, these girls are going to handle it’, and they did. They did so perfectly. I think one of my biggest pieces of learning over recent years is not to run in like an amazon warrior to save people, as this can in actual fact be diminishing and takes away their opportunity to act. My response now is to be there as a back up if they signal they need help and to offer support and reinforcement with ‘you were amazing in how you handled that’ afterwards to let them know how successful they were from an independent observer view. By rushing into save we can be as bad as the mansplainer as it indicates we don’t have faith in their ability to handle the moment. That said, if I’d had an official role, such as Chair, I feel it would have been my responsibility to stop the situation from happening in the first place. My take home is this, how you respond has to depend on your role and the situation.

I still love the females from the Obama administration who used their voices to amplify those of other women in the room. Not all actions need to be direct or confrontational, sometimes just being there to repeat the voices of others is enough. I wish that I had been able to breath through my rage and find an amazing follow up question to allow that panel to shine even more in that moment, but I didn’t and that’s my learning. That moment wasn’t about me, it was about them and next time I will have practiced how I can then act to amplify them better in the moment, rather than worry so much about the mansplainer in the room and giving him my energy. Every day I learn a little more.

Right, I’m off to the growlery until I find myself in a better mood. See you on the other side.

All opinions in this blog are my own

Guest Blog from Dr Claire Walker: Turning criticism into a catalyst for change, or how I learned to stop worrying and to love negative feedback

girlymicro Academic Life, Education, General, Guest blog, Leadership, Research/Academia

I am currently away enduring the heat of Houston, Texas, at the American Society of Microbiology annual conference. Hopefully, I will find lots of lovely inspiration whilst I’m here to share with you all. In the meantime, and whilst jet lag is kicking my ass, the wonderful Dr Claire Walker has swooped in and saved me by writing another awesome guest blog.

Dr Walker is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for The Girlymicrobiologist, including one on the transition from lab to academia.

So, the other night before a conference @girlymicro and I were sat in a hotel bar, drinking martinis and listening to me bemoan some fairly harsh feedback I recently received anonymously from a student in the form of the oft dreaded ‘Module evaluation feedback form’. The conversation went a little like the Deep Space 9 meme of Julian and Garek that’s doing the rounds – you know the one….

I love the internet. Meme generators entertain me no end.

Back to the story, I was complaining and @girlymicro, quite rightly, reminded me of two important facts. One, all constructive feedback is always useful even if we don’t particularly like hearing it. And two, not everyone is going to love us even if we really, really want them to.

I went to bed reflecting on this conversation and my poor feedback. Constructive critical feedback is a powerful tool for growth, yes it stings a little at the time, but when we take time to reflect can we see why we received it? This particular individual found me to be blunt and rude, and in honesty, in this specific instance I would say they aren’t totally wrong. This year, my decision to support University College Union strike action prevented me from giving the first lecture of my module. I use this lecture not only to introduce myself and describe the content of the module, but to set the expectations for behaviour in my classroom. I’m what has been described by my friends and colleagues as ‘old school’, and this makes me something of a marmite individual for students. I want to provide a safe space for discussions, and I cover a lot of triggering subjects. I have no time for disruptive behaviour that detracts from the groups collective learning experiences, and I have a low threshold for calling students out on this. Am I blunt? Probably. Could it be perceived as rude? Absolutely. Without these early conversations the students this year weren’t aware of my expectations and thus my behaviour had no context. Does this make the feedback fair? Possibly. In my honest opinion when you come to a place of learning you put your phone down and respect the teacher as well as your fellow students, and at University level teaching you shouldn’t need to be reminded of this. However, what I’ve learnt is just how important those conversations are, and I will be having them come hell or high water next year.

Girlymicro’s second point also gave me pause for thought. Not everyone is going to adore me. My teaching style isn’t guaranteed to work for everyone. So after finishing my martinis I returned to my feedback and applied the Pareto Principle. The Pareto principle asserts that 80% of outcomes result from 20% of causes. When I view negative feedback through the lens of the Pareto principle, I see that a significant proportion of this feedback comes from a small percentage of students. And the same is true of the positive feedback. Understanding this principle lets me focus on how I can direct my efforts to addressing their concerns specifically and prioritise improvements across my teaching to make meaningful change. However, it’s also crucial to recognise the silent majority the 80% who are, apparently, content enough not to provide an evaluation of the module. A major overhaul probably isn’t necessary, but there are tweaks to be made to make the content work for everyone.

Finally, I reflect on the words of wisdom from the great Obi Wan Kenobi himself:

“ You’re going to find that many of the truths we cling to depend greatly on our own point of view.” / “The truth is often what we make of it; you heard what you wanted to hear, believed what you wanted to believe.”

My ‘truth’, my point of view has been that my teaching style is interactive and engaging, and certainly some of my students share this opinion. But this isn’t everyone’s point of view and through receiving feedback I am able to see the opinions of those individuals that differ from my own. I often say that teaching is an iterative process, dependent on a cycle of reflection and growth. I may enjoy a particular style of lecture but if it’s not working for the majority, I have to put it down and build something new. Based on both the negative and positive comments, I have been able to introduce more lab sessions, simulated clinical experiences and data analysis workshops to my modules, and move away from traditional didactic teaching. Yes, it’s more work over the summer but hopefully this will lead to a significant improvement in the learning experience of my students. Who knows? Hopefully that quiet 80% like the changes. Either way I’ll await my next critique and take it from there.

TLDR: You can’t win ‘em all. But you can have a lot of fun with meme generators.

All opinions in this blog are my own

Talking About the Taboos: My experience of informed consent and organ donation

girlymicro General, Science Communication

CONTENT WARNING: MY FAMILY SHOULD SKIP THIS ONE.

This post is traumatic (at least for me) and is likely to be triggering for some people. I think it may also be important, which is why I’m writing it. It is highly personal, and for once, I’m not up for debate about how it made me feel, although I’m hoping it might trigger wider discussion with others. That said, it is only the experience of 1 girl in 1 room.

Please note that I am a passionate advocate for organ donation, which is why I’ve never talked about this as I’ve always felt worried it might put off others. Now, with people objecting to ‘opt out’ change to the donation rules I feel the time may be right for me to talk about it, as I’m hoping it will change for others the hardest experience I’ve ever gone through.

Here’s the background

My sister died in 2010. At that point, despite the existence of organ donor databases, if you wanted to donate the organs of a loved one, you had to go through a process of informed consent and opt into the process.

Defining consent

Informed consent – the person must be given all of the information about what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment does not go ahead.

https://www.nhs.uk/conditions/consent-to-treatment

In 2020 this situation changed and the English system changed to what is known as presumed consent or the opt-out system, and means that unless the deceased has expressed a wish in life not to be an organ donor then consent will be assumed.

This means that there are now three ways to approach organ donation in England, vs the one that I experienced back in 2010.

I was at a workshop this week, and as part of the ethics discussion, the issue of switching to an opt-out system of organ donation came up. It was a really interesting discussion in order to support seeing a complex issue from multiple viewpoints. Is opt out coercive? Will it actually address some of the issues around numbers of donors?

I found myself talking about something that, to be honest, I never talk about. Something that I think has been locked away in my head (and for me, a completely different reason), beyond the numbers and ethics, why I think opt out is a good thing. Why? Despite passionately believing that organ donation is the right, logical, and good thing to do, for someone to ever go through what I had to go through to donate my sisters organs was not something I’d wish on anyone. When I lie awake at night and cry, it is not over the moment that I found out she was not going to make it. It is over the 24 period that I lived through trying to do the right thing. Informed consent is the gold standard, but it can also be highly traumatic to those who have to go through it. This didn’t even come up as part of the discussion, but I wanted to share my experience of informed consent to aid understanding of why I think that moving to presumed consent might also be a good thing.

Knowing is different to doing

I’ve written before about how the circumstances came about of losing my sister, but I sort of glossed over some of the 48 hours between her effectively dying and being declared brain dead. This part was obviously traumatic but not perhaps because of the reasons people think.

From when we were kids my sister and I always talked about organ donation and how we would always participate. Maybe an odd thing, but we came from a pretty science based household where all kinds of conversations were common. I remember going to get our first Boots cards together and being very impressed that on the application form, you could also tick to confirm you’d like to be an organ donor. I can see the form in my head even now. We both ticked very thing but eyes. I don’t know why we didn’t tick eyes, but I clearly remember we didn’t.

So, when we were given the news that my sister was brain dead and that there were going to start the 24-hour confirmation process, I knew what the next conversation would be. I’m fact because I knew her wishes. I actually instigated it. It was the right thing to do.

Never, as it transpired, has doing the right thing been easy.

Experiencing informed consent

They said they’d get the transplant nurse come to speak to us, they were so pleased they hadn’t had to broach the subject, you could see the relief. I had a friend who’d just started working as a transplant nurse and they had told me how hard it was and so I wanted to make the process as straight forward as possible. I wish I’d asked them.more questions and known more, but I hadn’t, and I didn’t.

Here is the assumption I had made. My sister had been on the organ donor registry, she had ticked her boxes, we knew and supported her decision. We would therefore go into a room where we would sign a paper to that effect and walk out in order to wait for her official demise. Spoiler alert – this I not what happened.

What happened instead is you walk into a room, with a very nice and kind nurse, with a clipboard loaded with papers. They warn you that this will take some time and will be personal. Bear in my my brother in law is understandably distraught and therefore most of this process is being covered by my mum and I, to be honest I can’t even remember, but I don’t think he was in the room. Then it begins.

It starts with the scene setting, what was my sisters sex life like, how frequently and with whom? As a scientist I know this information is key and it aids risk assessment, as a person I’m talking about my dying sisters dating history and I have to say frankly it’s a bit jarring. I also only have the answers because we spoke every day and we were super close.

For the next (what feels like several hours) you proceed to verbally dissect your loved one organ by organ, piece by piece. For each piece you go through numerous options. Are you happy to donate her pancreas, if so who are you happy to donate it to, the cells? To an academic lab? To a privately run company? How do you want it disposed of once they are finished with it? If they take parts of her gut but then can’t use them (in case she is too fat, but they don’t have that info yet as they haven’t got my sisters info) is it OK if they throw them away? Every time you believe there can’t be more there is.

I know where this comes from, from multiple organ scandals, and I know the importance of informed consent. In the room it feels like none of that matters, in the room it feels like some kind of psychological torture that will never end. I’m lucky, I’m in doctor mode and all the horror is not happening at the front of my brain, doctor brain is evaluating and deciding and ignoring the screaming from the girl who is experiencing the pain. I have no idea how my mother survived it, she just calmly went through and discussed bits with me as if we were talking about a shopping list. To this day I don’t know how we survived. At one point I turned around to the nurse and asked, surely we can just blanket consent, and she confirmed that she had to read the text for each bit and that we had to actively make decision and understand.

When I have nightmares about this process I see my sister in the dress we picked for lying her out in and as each organ is called out I get a dolly zoom onto the anatomically correct part. My brain does love to torment me.

Once we reached the end of the list, I took a deep breath, relieved it was over, but it wasn’t over. As a thank you for agreeing to donate her organs you then get another form to go through. She gets to be laid out in the Chapel of Rest post surgery. Please could we go and find something (now) so that she can be laid out in, they need it to make everything ready. Also, would we like some of her hair to keep? If so what colour ribbon would we like? This was the bit that blew my mind. I had coped with the organ by organ dissection, but what fucking ribbon do I want for me dead sisters hair, how the hell do I know. I know all of things that mean I should know, I know her favourite colour is purple, but it feels like one decision too far. You get to keep one piece of her, now make decisions for the one thing in the world you will have left of someone who has been part of your life every day since you were born. Something simultaneously so simple and yet crushing. Colour picked, now off you go, find an outfit that is clean, she would have liked and still fits the body of someone who was 5 months pregnant but had yet to buy maternity gear as she was worried about what would happen to her child. Oh, and I forget the second best bit. Whilst you’re there, you can pick a personal item or toy for her to have in the theatre whilst they vivisect her. It’s not like it’s going to be an infection risk to her.

So off we go, we pick a dress, we pick her huge black stuffed cuddly dog. Then you wait for the 24 hours to be up do she will be called.

At this point my willpower failed me. I couldn’t be there when she went into theatre. I couldn’t wait for them to come out and tell us it was over. I’ve been in theatres and this is where we come to the part that I still can’t really deal with. After all these years I still have days when I feel it. I feel like I killed my sister. I feel I gave someone permission to open her up and whilst her heart was still beating remove bits of her one at a time until she died. I can see it in my head, with that cuddly toy on the end of the bed. I can see it all so clearly. It’s like a horror movie and I know every single piece because I went through them all like it was a shopping list. It doesn’t matter that there was no way back, it doesn’t matter that it was what she wanted, it doesn’t matter how many lives were saved, it matters that I went through a list of her body like she was a joint of meat and said which parts could be sold to who.

Time heals most wounds

I didn’t even find out who those organs went to. All of that info went to her husband as next of kin, and he didn’t bother to share it, and I never had the strength of will to ask. Just recently a wonderful colleague gave me the number of someone who might be able to tell me, but I don’t know if I’m ready to re-open this particularly deep wound, maybe after writing this post I will be able to get there.

I’m horribly aware that this post might put others off signing off on donation but I’m hoping that by contextualising at the start you’ll know that that is not is what I want to achieve. It is however the reason I don’t talk about it. I believe so much that it is what we should do. At the same point I know that I don’t think I could ever go through that experience again. Which brings me to presumed consent. I am desperately hoping, although I have no idea, that by having some assumptions in relation to consent, that no one else will have to go through the same process I did. I know why it’s there, I also know how complex it is sitting on the other side. Giving people options is key, there should be choice about what goes where, but I believe there should also be the option to have a blanket ‘I donate everything but this and it can go everywhere but here”. Otherwise, you harm people trying to do the right thing in ways I can’t even fully explain. This isn’t a neutral opinion, though, and I get that. It is one driven by pain and horror, so perhaps I am not the best person to have an opinion on this after all. Either way, the time has probably come to talk about it. Nothing in this area is simple and so maybe by talking about it more, it will enable better conversations so that if you ever end up in that room, you won’t be as blind sided as I was.

I have no regrets, I am OK with the choices we made. Deep down, I know I respected the wishes of someone I loved. I just can’t deny that every now and again, the guilt still knocks me for six, usually when I least expect it. That isn’t a reason to not do the right thing. It’s just a cost worth acknowledging.

All opinions in this blog are my own.

Conference Season is Upon Us: My top tips for conference presentations

girlymicro Academic Life, Education, Healthcare Science, Research/Academia, Science Communication

I’m off to ASM in Houston in a few weeks and conference season is well and truly upon is. I’ve been fortunate enough to get asked to speak at a number of events over the years, but I still clearly remember how terrified I was when as a trainee I spoke to my first big room. Last year, I gave my first key note lectures. I’d been asked to do a couple in 2020, and then the pandemic hit, so all of those events were cancelled. I felt as nervous as that trainee again. I prevaricated, I self flagellated and then finally managed to force myself to sit down in front of a blank screen and just get started. If you are in any of those stages, this post is for you, I hope it helps.

No one can tell you the best way – only what is the best way for them

First things first. When as a trainee I was preparing my first talk I got A LOT of advice. My first problem was trying to use all of it, even when it was conflicting. I was advised to rehearse over and over until I had it memorised, I was advised to have a script and notes. I was advised to do none of those things as it would be too staged. So, my first tip is this. Seek advice, gain knowledge from those more experienced, but then use what helps you and discard the rest. Your personal process will be different to everyone else’s, and it’s worth acknowledging this early and accepting that you will find a way that works best for you and refine it with experience.

For instance, I hate rehearsals, and I never have a script. It makes me stressed and forces me to feel like I have to deliver the same way every time. I know my content, I know my story and the audience and I are a team who deliver the final product together. I bounce off them and try to read the room, and fingers crossed, it seems to work OK.

The one time I don’t work this way is for extremely time restricted presentations, such as 5 minute fellowship interviews. For those I practice so much I can recite the words in my sleep. These are different because:

  • you HAVE to get all your content in, your career kind of depends on it
  • the time lines are short and hard, they will just cut you off and so you need to know you will finish in the window given
  • there will be no audience bounce, there will be no reading the room, they are going to remain neutral to what you are presenting, and so focussing on them can make the scenario even more stressful.

What I hope you take away from this is that there are no hard and fast rules, there will always be exceptions, but if you can, do what works for you and don’t try to be anyone else.

Ask for learning objectives and check what other talks/speakers are in your session

There is little worse than sitting, waiting to go on for your talk, and hearing the person before you give the talk that you have basically written to give next. I have learnt the hard way to make an effort to ask what an organiser would like me to cover, and to always check what the agenda is before I turn up for the day to see the lay of the land from other speakers titles. A little repetition is not a bad thing, ground hog day is unlikely to land well. This one is more of an issue for invited speaker sessions, although even if you are presenting novel research data it’s worth seeing who else is in your session, as you may be able to reallocate slide time if the 3 people in front of you are talking about the same virus. They are likely to have covered a lot of the generics and you can then invest time elsewhere.

I don’t always get very far, but these days I also ask for learning objectives when I’m invited to speak – what would you like me to cover? any particular highlights that you are interested in? what is the audience size and mix likely to be? All of these things can dictate not just your content but how you think about delivery, such as how much interaction you can include.

Think about your audience

This one seems like a no brainer, but I often think that it’s forgotten. It is really easy as the person delivering to get caught up with your nerves and write a presentation that you feel comfortable with, without thinking about those that will be listening. Now, I’m not suggesting that you deliberately produce content that makes you uncomfortable, but sometimes it is easy to teach in a way that suits us rather than the learners. It can be really worrying to include interactive content, what if no one responds, but if you are on at the end of the day after 7 hours of didactic teaching, your learners may be ready for something that re-engages them.

The thing that scientists and clinicians also often do when they are nervous is to resort to technicality and jargon. It can act as a shield. If you are presenting to a mixed cohort, of either different levels of knowledge or professional backgrounds, this defence mechanism can end up making your content inaccessible to a number of people within the room. It’s OK to have a couple of slides that stretch people, it’s usually not OK to have a whole talk like that, unless you know your audience really well.

Think about the tone of the presentation

I struggled a lot when I was asked to do the talk below. I struggled thinking that maybe I should turn up as ‘Dr Cloutman-Green’ with formality and pretend gravitas. You would not believe how long I went around in my head about it. I then decided that they had asked me to speak about my blog, and my blog is anything but formal and hierarchical, and so I turned up as me, with all the sarcasm and self mocking that entails. In the setting, at the end of the last day of the conference, when everyone was tired, including a little humour felt like the right way to go.

I would however have made different choices if I was turning up to present my PhD thesis in a viva, or if I was presenting to the board, I would have still been me, but a slightly less overt version. Some settings require a formal tone, some lend themselves to informality and some you can decide the path you wish to walk. The key thing is to make an active decision based on the invite, topic and audience to ensure that you match what your tone is with what you wish to achieve.

Find out if you need to allow room for questions

One of the things that often catches people out at research meetings is there is not always a standard of whether there will be time for questions or not, you can sometimes guess by slot length but not necessarily with any certainty. It is always worth explicitly asking if you need to allow time for questions so you can plan your talk length accordingly. I’ve Chaired conference sessions where this wasn’t handled well and it meant that it was really challenging to keep everyone to time and some speakers had much better opportunities for audience interaction than others. If you aren’t told definitely ask, not least so you can prepare for what your answers might be.

Think about what you want for your slides

This again might be a really obvious one, but if you are teaching on an MSc you are likely to want a lot more information on your slides, as they are likely to be annotated and used for later learning. Your conference talk may be recorded, the slides may get circulated, but the reality is that they are much less likely to be used as a later teaching resource. Therefore you will want to pitch your slide content based on your participants/learners, which is another good reason to find out a bit about them.

It is also worth thinking about how important it is for the people in the room to be able to read and understand what you have included on a slide. I’ve lost track of the number of times I’ve seen speakers apologise for tables and overwhelming numbers of charts that are not visible to anyone sitting beyond the front row. Unless it’s high level conceptual stuff there is little point including slides that are not going to be accessible to your audience. It is also worth (and I am not good at this) ensuring that colours and fonts etc do not present unnecessary challenges to engagement.

Plan in your breaks/interactive moments

Even if you are the best speaker in the world, and I am definitely not, there are always slots in any agenda or meeting which will make it more challenging. The post lunch slot, where everyone is digesting and sleepy, and the end of day slot where everyone wants to make sure they catch their trains are just a couple of examples. If you are allocated one of these slots, or are given a 3 hour lesson slot, planning how to keep learners engaged is key. More than 20 minutes staring at your powerpoint is going to be enough for anyone. So can you include things like videos or other types of content to break it up? Can you include live quizzes that embed some of the discussion topics? Can you get people to talk to neighbours or even do some group work? It is sometimes easy to stand up and go through 60 slides, when the experience of everyone in the room might have been better with 6 and a modified activity based approach. Again, it depends on the setting and audience, but if you can be brave and consider stepping beyond the lectern during your session.

Make sure you have backups

No matter how prepared you believe you are for giving a session there are some days when it will not be enough, for this one you need to make sure you are the master of your own destiny. There have been numerous events where I have turned up to speak believing that my slides will be already loaded as I had sent them to the organiser well ahead of time, and had the tech guy look at me in bewilderment as they had nothing. I always carry my talks on a USB stick, having emailed them so I can also get access to an email version in case my USB files is corrupted, and I will have them stored on cloud storage as a back up in case I need to download directly onto a system. The fear of having to just get up and talk without slides haunts me too much to leave anything to chance.

Know how you might wing it if needed

The reason I know very clearly what it feels like to have a slide deck that doesn’t work is because it happened to me at a conference in 2021. I rocked up having sent my slides ahead of time, having been told that the organiser had checked them when they were loaded onto the laptop. I started my talk and then realised that every single slide that had a table or anything other than a textbox was entirely blank. I then proceeded to give my 30 minute with a variety of blank slides. When you’re up there there is nothing that you can do but wing it. I pivoted to a session where instead of trying to focus on my slides I talked about clinical experiences linked to the visible titles. I survived, it was even well reviewed, but I never want to do it again. That said, those 30 seconds staring at the first blank slides and working out what to do taught me a valuable lesson, and now I do my ‘what if’ worst case scenario planning ahead of staring at the audience whilst on my sofa with tea, so that I know what I will do if something goes wrong. I also now try to make sure I personally check my slides prior to any session.

Have a watch or phone that you take up with you

You would be amazed at the number of teaching and conference rooms that don’t have a clock on the wall or visible from the stage. I’ve been caught out by this a few times, and when you full screen your slides you can’t always seen the clock. That means you are subject to the session Chair giving you a 5 minute wrap up when you are only half way through your slides, as time feels different when you’re staring into 1000 faces and hoping not to screw up. I always take my phone (on silent) these days and set a stopwatch so that I can gauge where I am in relation to time without having to rely on someone else. I find the slide rush just waaaaay too stressful otherwise.

Be prepared to handle the question that is a actually a comment

This may be a shock to you, but I’m a woman. This means at any given presentation with questions I have a ~30% chance of a male colleague standing up and giving me the question that isn’t a question, but a comment on how they would have a) done my work better b) point out some key point I have missed c) tell me about their work and their experience. This may not be my most attractive feature but I have made a life choice to shut all of these options down hard. I am open to questions and shared learning, I am not open to someone taking question time from someone else in order to rail road a session into something different. If someone starts with “this isn’t really a question but more of a comment” I will generally reply before they get any further with “that’s really great and I’d love to hear it over coffee but I think we need to address the questions in the room first” and then actively call on someone else. You may wish to have a different technique, you may wish to pivot the comment back into something relevant to your talk so you effectively answer it as if it was the question you wanted to hear. You may have a completely different approach (I’d love to hear them all). If there is plenty of time I also sometimes let it slide, but it is a particular bug bear of mine.

Bring yourself into the room

I’ve touched on this one a little throughout, but I think you will have a much better experience, as will your audience if you can bring yourself into the room. That can be anything from including your favourite colour as part of your slide colour scheme to sharing parts of yourself, in terms of stories or experiences, as part of your session. The more you are prepared to share of yourself, the more your audience will connect with you and the better the chance of your content landing. If you are giving your research presentation, maybe take 10 seconds to share why you chose you that given topic, especially if you have a passion for it – like mine for Klebsiella and Adeno. Don’t be afraid to include humour and light and shade within what you are presenting. Audiences often want to know why they should care about what you are talking to them about, so feel free to convince them, and not just by sharing raw data.

Put your nerves into context

It is almost always nerve racking speaking in front of people, even after you’ve done it for years. One of the things I always say to both myself and my students is “what is the worst that can happen”. I’ve seen some truly terrible talks in my time, but I don’t remember who gave any of them, I remember the topic and why it was bad. Even if I did give a bad session and someone remembered it was me, would they remember in 3 years? If they did, the worst outcome is that they may not invite me back to speak, there will be plenty of other people who will, plenty of people who weren’t in that room that day or who won’t remember. Everyone, and I mean everyone, has bad days at the office. Everyone has sessions that don’t go well or land in the way they hoped. The important thing is to learn from them. Sometimes there isn’t even that, I have given the same activity sessions dozens of times, and every now and again it just won’t work. The participants may be in a bad mood, or there’s tech failure. It happens. Bring your best to every moment and that is all you can do, the rest doesn’t matter, the rest isn’t permanent. So good luck and be bold and I can’t wait to hear you speak!

All opinions in this blog are my own

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  • Embrace the unexpected and view setbacks as opportunities for growth and innovation.
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This book starts at the very beginning, with why you might want to do a PhD, how you might decide what route to PhD is right for you, and what a successful application might look like.

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Learning to Take Your Place: The path to owning the space you find yourself in

girlymicro Academic Life, General, Healthcare Science, Leadership, Microbiology (Clinical)

I remember my first attendance at the CSO Healthcare Science awards incredibly clearly. It was probably around 2015, and I had been nominated for the Rising Star award (I didn’t win, the amazing Lisa Ayres rightfully rocked it). It was my first dinner event, and I didn’t really know anyone. Everyone was in their finest evening wear, they’d all done their make up, they all knew each other. I remember sitting there on my own and feeling how much I just didn’t fit into this world. When the Lead Healthcare Scientist award was given out (we didn’t even have one at that point) I remember the banter on stage about where the winner had brought their dress from. I wouldn’t even know where my dress was from, at best M and S, not something that would be discussion worthy for over 100 people. I was so aware on that night that this was a world where I didn’t fit in, or have the tools to navigate.

Despite being Girlymicro, I’m not actually particularly good at the getting dressed up thing. I’m not one of those girls who has ‘wardrobe choices’ and saints help me if I have to paint my nails. It’s just outside of my wheel house. I’ve also posted before about how bad I am at networking and how I’ve had to develop coping strategies to be able to feel comfortable in rooms at conferences. I have friends and colleagues who are naturally gifted in this regard, but I am not one of them. I am not ashamed of who I am, or where I come from, I’m a proud brummy girl who has worked hard, but that doesn’t change the fact that in 2015 I stared at out at a room full of people from my profession, supposedly from my world, and just felt as other as it was possible to be.

Roll on eight years, and through some twist of fate I don’t think I will ever truly understand, I find myself standing outside of Westminster Abbey, waiting to go in to witness the Coronation of King Charles III. I have gone through a lot of emotions in the journey to this spot, but when standing here I didn’t feel like the girl who didn’t fit in. I arrived through those doors comfortable in my own skin, proud to be representing my profession and not scared to represent all that I am in the process. So how did I get from there to here? How I did I change and grow to feel like I could (most days) own the space I find myself in?

Honour the reason you’re here

The first thing for me was the realisation of how many people, woman in particular, have fought and sacrificed so that I could have the opportunity to even feel like an imposter in a space. I’ve posted about my mum and her journey to support science before, but there are so many woman who have faced so many challenges just so I would have the opportunity, or the door opened. Over time I’ve realised how important it is to seize those opportunities in order to honour those that came before. To move the dialogue on and to ensure that I leave things more open and equal requires me to do my bit, to make my sacrifices for those who will come after, to go through that open door and wedge it open so that others can follow behind and then take even bigger strides than I will. The cost of my feeling uncomfortable and experiencing self doubt is nothing compared to what those who went before experienced. If I think of myself as part of a wider picture, of just another brick on the yellow brick road, then it becomes less about me and more about the journey, and what I do to support others. That doesn’t require me to know anything about hats, false lashes or designers, that only requires me to be passionate about why I’m doing what I am doing. Suddenly everything else feels slightly less intimidating, after all, I know my why.

Be decisive: decide who you want to be in that space

So, you are not like everyone else, congratulations! I think that may just be a very good thing. When you enter a new world, a new network, a new experience, you have an opportunity to be deliberate in deciding who you want to be. You aren’t carrying the baggage of being know as ‘the new girl’ even though you’ve been there 20 years now. You aren’t that girl who spilled adenovirus tissue culture. You are shiny and new. You therefore have the opportunity to tell your tale, to share your why and really focus on the impact you want to have. Most of the time you have been invited into that space, so try to reflect on why that is and what you want to achieve. If, like me, you want to move the dialogue forward than it is OK not to be like the other people in the room, you have probably been invited into that space for just that reason. Don’t lose sight of who you are because of the newness, see it as opportunity to be the essence of what you want to bring into that space. If you can focus on why you have chosen to be there, rather than being overwhelmed by the choices of others, then I find it very grounding. For me, that reason can be anything from, I came to have 1 conversations with X that I couldn’t have other wise, to I came because I want to raise awareness of Y. Sometimes, for me, that can just be me actively introducing myself as a Healthcare Scientist and opening the door for people to ask me what one of those is, so I can discuss how awesome this work force are.

Acknowledge your fears

One of the things that has helped me most is to not just ignore my fears and pretend they don’t exist, but to spend time in reflecting on why they exist and what triggers lead to them overwhelm me. For me, it’s often about letting people down, or standing out in the wrong way – thus diluting my message and meaning I lose my voice. For the Coronation, because I knew not feeling like I was fitting in appearance wise would be a trigger for me and therefore not achieving the representation I wanted to achieve, I took steps before I went. I researched what to wear, I learnt to understand the dress code. This meant on the day I didn’t worry about that part at all, I could just focus on representing IPC and the Healthcare Scientist profession, this isn’t hard, because I have the best job in the world and love my profession. Suddenly I’m freed up to focus on joy and not fear. In 2015, I hadn’t done this work and it’s not something that happened over night. I had to take the time to learn more about me so I could then manage my responses. The work is worth it though. Obviously, this doesn’t always mean you won’t be taken from left field, but most of the time if you’ve put in the work you can free yourself up to be present and enjoy the moment.

Understand that the world is not you centric

The other things is, and I don’t want to ruin anyone’s egos here, you’re just not that important. The BBC did not care what I was wearing at the Coronation, in 2015 I was probably hardly noticed at that event, let alone anyone bothering to think enough about me to judge my outfit or elevator pitch. Frankly, we are mostly just not that important to other people. Therefore a lot of the fears we have about being judged are really not that relevant, we’re just not that seen. Also, even if the worst happens, and you spill that red wine all over the carpet at the House of Commons drinks reception (yep, I did that) the likelihood is that no one will remember. In my case the only person who remembers is Professor Mark Fielder, mostly because I almost spilled it on him too, and we just laugh about it now. I have been to some truly awful conference presentations, but I remember the topics, I don’t remember the speaker. Even if the worst happens, when you get over the mortification, you will be the one that remembers it, it is unlikely that anyone else will. So be braver, the worst is probably not that bad, spend less time worrying over it and embrace the good that could happen instead.

Have the bravery to keep being you

Finally, and this may be because I’m just growing old disreputably, but be brave enough to be you. You find yourself in this moment, and no matter the reason you arrived at it you are the master of your own destiny. Be brave enough to bring all of you into that moment and be who you want to be. It’s not always easy in the moment but I promise you, you will regret the moments when you wuss out and toe the party line or try to be someone else so much more then any moment when you were truly yourself, no matter what the reception. For me, I guess its always about having honesty with myself, and building relationships with others based on the trust that I will be seen. Relationships and moments built without that honest and courageous authenticity will never be really real, you’ll always question them and yourself within them. By being who you are then, good or bad, what you create with others is the truth and has real meaning. I feel it is only by being bravely who we are that we can have the impact that we want for our lives and for changing the world for those who will come after. So lets raise a glass, to being authentically and completely us, and celebrate all that we are, both the good and the work in progress!

All opinions in this blog are my own

An Unexpected Invitation: Representing the Healthcare Science & IPC workforce at the Coronation of King Charles III

girlymicro General, Healthcare Science, Leadership, Microbiology (Clinical), Science Communication

Please note, this is a rather self indulgent post written to help me remember in future years what was a truly spectacular day and set of events.  Please forgive me and feel free to skip.

Let me start off by saying what an incredibly normal person I am.  I have a job I am passionate about, friends and family I love, but apart from quite how fortunate I count myself to be, I am incredibly normal.  I don’t have ‘connections’, I didn’t go to private school, and neither I nor my family are part of any clubs or other exclusive societies.  So imagine my outright shock when in March this email dropped into my inbox on a Friday afternoon:

This is a joke………right?

On the 31st January 2020, I was fortunate to be awarded the British Empire Medal for services to healthcare and I wrote a little about how I didn’t believe it in a blog post.  That was a fascinating process in itself, especially as I couldn’t tell anyone. When this email dropped into my inbox however, frankly it felt like someone was playing a bit of a joke.  I opened and returned the form, almost on auto pilot because it felt like the kind of thing you should do, but as soon as I hit send I phoned my mum and Mr Girlymicro and had a bit of a breakdown after I calmly got the words out.  Just saying the words ‘I think I’ve just been invited to the Coronation’ put me into a complete spin.  You see, I’m the girl that snuggles down with a cup of tea and Agatha Christie when I manage to get time off, or to be completely honest, some truly awful reality TV (hated by my husband 🙂 like Love is Blind.  I am not the girl that gets invited to fancy dinners or big events, let alone something to be seen on the international stage.  Writing the Girlymicro blog is often the most down time I get on a weekend.  So after sending my reply I sat back and just assumed that they would at some point realise their mistake and life would carry on.

Costume drama

As time went on and more emails went back and forth it gradually hit me that I may, in actual fact, need to attend the Coronation.  I went through a period of properly freaking out about how I wouldn’t fit in, and how I’d have nothing sensible to say, my family pointed out it was too late for that, I’d accepted the invitation.  I was locked in.

Then I proceeded to have, what a dear friend, referred to as a ‘Costume Drama’. Now, I get up in the morning and dress in the clothes in front of me.  I am guaranteed to have covered myself in food/tea/detritus within an hour of dressing.  I don’t wear makeup, and when I do I am lucky to not poke my own eye out with my eye liner.  As the reality dawned on me, it also occured to me that I was going to need to have something to wear.  Bear in mind that when I went to the Garden Party at Buckingham Palace I had a tail spin because I had never brought a hat and I just didn’t know what to expect. It took me 6 months to find something to wear and I had a little less than 6 weeks to get this sorted.  This also felt like a complete level above what I had needed to achieve for afternoon tea.

I have previously posted about how I feel about clothing expectations.  In this case, I began to increasingly feel like clothing would have a role as armour, as a way to step into a space where you felt like you needed to put your best foot forward.  I needed to find something to wear that would help me feel like I deserved to be there and could occupy the space I had been given.  At the same time, I wanted to balance the costume with who I am, I wanted to feel both like I belonged and still feel like me.  So, being a scientist, I hit research mode and pulled together as many sources as I could to find the ‘uniform’ that was likely to be worn at such an event, and then to find ways to modify it so I could ‘fit in’ and still be me.  I know some of you will be reading this and feel disappointed that I was not prepared to stand out. To make a statement.  Sometimes, I feel that the freedom to make a statement comes from a position of privilege.  Not always, sometimes it’s merely bravery and not worrying about the consequences.  In this case, I didn’t feel I wanted to make a statement, I don’t feel like I come from a place where I have enough privilege to go against the tide. You may think it shows a lack of bravery, but the last thing I wanted was to stick out in anything but a ‘that’s a nice dress’ way.  I was nervous enough, and a lot of those nerves stemmed from knowing that I was representing not just myself but all of you, my family, my profession, and my friends.  What I wanted most was to make everyone proud, and so standing out needed to be done in the best possible way by rocking a look that acknowledged the event and still felt like me.

Feeling the weight of representation

You see, as time went on, I became more and more aware that the invitation I’d received wasn’t really about me, it was about us.  I didn’t get a BEM for my work in isolation, it was for the work we had done as a community, I was just lucky enough to be the one who got a medal pinned to her chest.  As the event drew nearer, I was so aware that I was representing both Healthcare Scientists and Infection Prevention and Control on an enormous stage.  I am so proud to be part of both of those groups.  I am prouder than I can state about my profession, a profession that is so often hidden and doesn’t get mentioned at the big events.  I knew that the one thing I would be able to do on the day was talk about it and shine a spot light, if even just to a few people, on the amazing work my colleagues do and the sacrifices that they all made during the pandemic.  I was aware that even though it was my name on the invite, in point of fact, in many ways, it wasn’t about me at all.  I needed to use this unique opportunity to shine that spotlight on the people who deserve to be seen.

Coming, ready or not

Knowing it wasn’t really about me didn’t stop me from feeling nervous, however. I often get in my own head about big moments or events, especially things like this that feel too big and outside of the normal, for someone as normal as me.  At times like this, I like to remember a quote of one of my favourite TV series:

“Bottom line is even if you see ’em coming, you’re not ready for the big moments. No one asks for their life to change, not really. But it does. So what, are we helpless? Puppets? No. The big moments are gonna come, can’t help that. It’s what you do afterwards that counts. That’s when you find out who you are. You’ll see what I mean.”

Whistler – Angel Season One

My family, friends and colleagues did a great job of helping me get out of my own way.  I really struggled at first with people asking me why I’d been invited.  I didn’t know, I didn’t have an answer, but with the help of those around me I practiced an answer I could use on the day, ‘I got invited because of the great work that IPC and Healthcare Scientists did during the pandemic, coming together to really make a difference for children and young people, in terms of not only testing but also in keeping them safe in healthcare.  I’m representing a great group of people who all go above and beyond every day, and I’m really honoured to be invited.’ I was as prepared as I was going to be.

A fairy tale day

So, the day arrived.  I continued to be nervous, but I had all the lists and instructions to make me feel prepared.  In the end, everyone I have to say was simply wonderful.  I had been prepared for the formality, but I don’t think I had been prepared for the nice bits, the bits where we laughed and the bits where the event was in some ways just like every other event, just bigger and shinier, and with some of my hero’s present.

The day started at 5:15 am.  I knew that there wouldn’t be many bathroom opportunities and so I could only have one (yes, that’s right, one!) cup of tea.  Because I also knew that doing my hair and make up would stress me out and I wanted to enjoy the day, and because London has people who will do this for a very reasonable price at 6am, a wonderful lady arrived to make me feel pretty.  I was made up, hat on and in a taxi by 7:45.  All the time, with the news running in the background saying people were arriving and making me feel like I was already late.

I had that strange anxiety, like getting to an airport, where you just want to get through security and take your seat.  I have to say that from the minute I showed my invite and started walking from Victoria Gardens down towards the Abbey, everyone was just so lovely and the nerves started to fade.  Security was easy, and the atmosphere just felt really special.  I felt like I do when running a half marathon, when everyone on the side of the road cheers you on, with less running and more hat.  This part was made even nicer by running into another IPC legend Clare Johnstone as I was nearing the Abbey.  This was great because not only did I have someone to experience it with, but we could also take a photo of each other to record the occasion. 

Clare and I weren’t sitting in the same area, so I made my way to find my seat, just behind the North Quire.  I was in some way saddened to realise that I wouldn’t have a good view of the procession, although to be honest, I’d not been expecting one.  What I hadn’t expected was that everyone from Rishi Sunak to Ant and Dec would have to walk right by me both before and during the ceremony, as the Quire was mostly blocked with performers.  This meant I got to do some grade A up close people watching in the 2 hours plus you had to be seated prior to the arrival of King Charles III, including Lionel Richie being a complete gentleman as he went by, asking how I was doing and saying he like my dress.  The other thing that was interesting to note was that everyone had to scrum for seats.  Now, as a pleb I’d expected this to be the case for me, but no, it was also the case for those much more famous than I.  Those entering through the West Door had reserved seats, but everyone else was very much equitable in terms of finding your own within the section you had been allocated to.  I found this somewhat pleasing.

We all knew the toilets were going to be locked down at 10am, and having been sitting since 8am it seemed sensible to try to get a visit out of the way as there would be no further opportunity until after 13:30.  I state this here because, although the event was spectacular, the fact that toilets are always an issue somewhat amused me.  There were 3 female toilets for the entire of the Abbey, for everyone from Hollywood celebrity to little old me, it made no difference.  My colleagues have often heard me swear I will never use a portaloo, as I hate them from an IPC perspective.  The available toilets were a step up, but they were still just temporary toilets.  Of the 3 cubicles available, 1 did not have a working lock on the door, and 1 was blocked, only leaving 1 toilet in reality for everyone to use.  Also, the cubicles were small.  Normally, this would be less of an issue, but as I’m not someone who has often tried to negotiate such things with a rather large hat, it was challenging.  Toilets are an issue, even if you are a King.

When the ceremony started I was fortunate enough to have found a seat next door to the seating reserved for the Heralds.  This was very cool as I got to see them process, but also got to sit and get an up close view of all their regalia and to see a lot more of their roles.  The advantage to being off to one side and therefore not quite on camera was that although the event was still very formal, I got to enjoy some informal moments that made us all laugh.  Some parts of the order of service did not quite go as planned, such as the Prince and Princess of Wales entering iut of order. Because we were in quite close quarters together there was a real sense of comradery, which I hadn’t expected, as we all got up at incorrect points or couldn’t work out when to sit down when things were not quite as stated.

There was also some slight drama, when during the first hymn, the older lady next to me tried to drink some water, choked and then vomited water all down her, me and quite a chunk of the floor.  Trying to silently signal and collect tissues, check she was OK and clean her up was significantly easier given where we were seated, but again our whole section silently pulled together to try and help.  This is the disadvantage of telling people that bathroom access is limited, as over 5 hours is a long time for some people to not feel like they can drink.

There was never really a dull moment during the service, and it felt like the congregation were constantly involved in small ways during the service.  The moment when the enormity really struck me however, of where I was and what was happening, was during the singing of the national anthem, it made me choke up a little, it just felt truly historic, it really felt like I was living through a never to be repeated moment, and I felt so lucky to be there to witness it.

And then it was over, and yet somehow the time after the Coronation itself felt like the nicest bit.  You could almost feel the collective sigh of relief, and the atmosphere suddenly became much more informal, with people taking selfies with each other, talking and introducing themselves and mingling much more freely.  At this point I could really talk to people about the amazing work my colleagues do and what an honour it was to be there.  It also meant I could get a couple of pics of the Abbey in a way you weren’t permitted before the ceremony.

Then, as I was leaving the Abbey something happened that really made my day.  I got to leave the Abbey and walk with Dame Judy Dench and Sir Kenneth Branagh.  I mean, I didn’t have the courage to say anything, especially as they were just talking to each other in a really normal way, but I got to wander down the road with 2 complete legends, and then say hi to Stephen Fry.  The only way I could have been  more excited was if I’d gotten to meet Michelle Obama, but it appears she didn’t get an invite.

It was a truly magical day that exceeded all my expectations, I got to talk to people about the work we do, I got to feel part of history, and I got to visit a world, however briefly, which I never believed would welcome someone like me, and yet it did with open arms.  I felt like I was welcome, I felt like I was seen and unexpectedly I felt like I deserved to be there.

My 7 seconds of fame on the BBC, plus the legend that is Dame Judy Dench again!!

Carrying your family with you

My friends and family mean so much to me, and they properly stepped up to the occasion, from sending gin minis for after the service that I could use to celebrate, to sending me pieces of jewellery that I could wear on the day and therefore carry them with me to help me deal with the nerves, and to help me feel like I belonged.  They helped me move from feeling worried about the need to represent people and a profession who mean so much to me, to feeling the joy of doing the same.  They helped me stay in the moment and understand that rather than fearing letting people down, I should celebrate making them feel seen.

Seeing their excitement, feeling their support for me stepping onto this enormous stage and celebrating me embracing all of who I am and where I’ve come from made all the difference, and no amount of drizzle could dampen the day.

I was collected by my husband Jon after the ceremony, and not only did he bring me an umbrella, but he also brought me comfortable shoes to switch into. I’ve rarely loved him more. Sharing the build-up and the day with people I love, as well as seeing the responses on social media, really did make it a day I will never forget. Thank you for sharing it with me.

All opinions in this blog are my own

Just One More Block: Sometimes, the Only Way is Through

girlymicro Academic Life, General, Healthcare Science, Leadership

Many years ago, before Mr Girlymicro walked me down the aisle, we went on a trip. This was rather a special trip and involved him, mummy Girlymicro and me taking the trans siberian express from Moscow to Beijing. As a way to meet my mother, it could be said to be a rather extreme introduction! At one point, in Ekaterinburg, we had gone shopping and brought a LOT of food to last us the next train leg. It was hot, and to be honest, I wither in anything above 23 degrees. Our collective Russian was pretty poor, and so there was no choice but to walk from the supermarket back to the hotel. It quickly became apparent that we were unprepared for carrying so much stuff in the rather excessive heat. Mr Girlymicro was in charge of directions. Every block he  would turn to us and say ‘nearly there, just one more block’. Every time we believed him until after 17 blocks we made it back. Thus, the phrase ‘just one more block’ was born in our household as a way to tackle a challenge that feels truly insurmountable.

The last few weeks have been pretty hard, and this phrase has been used quite a lot. I’ve not been feeling great post COVID, and when I don’t feel great physically, I also struggle mentally. I tend to spiral about interactions and struggle to find the perspective to determine if anything I’ve done is any good. At the same point, I am aware that this is a transient state, and I’m cognisant that I am in it. It’s just, weirdly, sometimes knowing that doesn’t make it feel that much better. The thing is though, life doesn’t stop when you’re not at your best, when you’re not having your best day. Life continues, and sometimes you just have to put on your big girl pants and deliver anyway.  Sometimes, the only way is through. So, here are some of my thoughts on just making it through the day when the world gets tough.

Take one step (or block), one action at a time

Sometimes, when I’m finding things very challenging, I have to focus on super short term goals. Sometimes that can be getting through the week, sometimes that can be getting through the day and frankly sometimes that can mean I take the world 10 minutes at a time and focus my world down to a pin point. This may seem a little crazy, but it’s the way I trick my mind and stop being either physically or mentally overwhelmed by the big picture. I may not know how I’m going to survive running a week long course when ill, but I can picture myself surviving the next 10 minutes. All I have to then do is rinse and repeat.

If it’s workload that is overwhelming me, I do the same thing, just with tasks. Instead of focussing on all the things I have to achieve and feeling panicked, I make a commitment to myself that I will complete a single thing. That single thing can then flex depending on my capacity, it could be as simple as making a single call or sending a single email, it could be as complex as reading through a PhD thesis. It’s not the complexity that matters, it’s the commitment to a single act. Doing enough of these then means that without worrying about the whole, I’m still making headway. Now, obviously, in an ideal world you would do this in order of priority, but frankly some days that just doesn’t work for me. Sometimes, I’m just in too deep. Something is better than nothing.

Progress is not always visible, find/make what markers you can

The more senior I become, the less able I seem to be to be able to see progress. So much of what I do now can feel really amorphous. Sometimes, I really miss the days when I would spend a Friday Sanger sequencing, with the radio on. I would start the day with nothing and end it with results that I would phone out to support patient care. The achievements were visible. They felt tangible. The world I live in now is more strategic and tasks run for months, if not years often. It’s harder, therefore, to KNOW you’ve achieved or made a difference. This is the nature of the work, but I’ve learnt that I need some form of progress markers, just to maintain momentum. I therefore try to make sure that I make some milestones, even if the project as a whole doesn’t require them for reporting.

This sounds easier than it is sometimes, and to be honest, I’m still a work in progress on how to do it well. Mostly it’s challenging as this takes time and space to reflect in order to determine what these milestones should be, and this is not something I always grant myself until necessity hits. If you make the time investment in the planning phase it does make it easier in the long term to see the wood for the trees. These milestones may need to be a little inventive as not all long term tasks lend themselves to this process easily. Mine can be anything getting X to produce document Y (or even seeing a draft), to managing to pin A down for a meeting that’s been cancelled for the last 3 years. Whatever it is, it’s about acknowledging that just managing to get that small piece of the puzzle in place is progress.

Acknowledge that you don’t have to spend every day changing the world

I’m super guilty of this one, I have delusions of superhero status, but I am not wonder woman, and neither are you. Some days, everything comes together, and we make massive leaps forward. What we often don’t acknowledge in these moments of great success is the the number of days it took to get us there where it felt like zero progress was occurring. Any big change is not a single moment. It’s many much smaller, less visible moments that suddenly come together in a way that is apparent. In the words of Hamilton, ‘I’m not standing still, I’m lying in wait’. It can be hard to recognise and value those ‘waiting’ moments however.

Not just that, though. We can’t function at 100% all the time, we’ll at least I can’t.  If you try, it means that you end up with huge peaks and troughs as you drain your battery. I’m rubbish at doing this in practice, but I acknowledge that what is needed is consistency in order to create impact. Small steps often get you further than single huge leaps. If we set all of our energy on trying to leap tall buildings rather than putting one foot in front of the other, we may actually be making life both harder for ourselves and be less effective. We have to know when to look at the sky and when to look at our feet.

Don’t treat yourself in a way you wouldn’t treat a friend

My inner critic is not kind. Right now, for instance, I’m having a real ‘you don’t really achieve or do anything’ inner dialogue. The thing is, I would never treat someone else the way I treat myself. I would remind someone else of all the progress they’ve made, I would remind them of their benchmarks, I would give them a reality check on their expectations of both themselves and the environment they are in. I would remind them that mistakes and failure are human and, in fact, a crucial part of learning and having a growth mindset. I would do all these things for others, but I struggle to do them for myself. I guess writing this blog is often my way of having kinder conversations with myself.

The way we speak to ourselves matters. Our self-talk, our inner monologue really does impact on how we see the world and how we respond to challenges. I’m trying to be cognisant of this and (between blog writing) actively pep talk myself when trying to manage challenges, or sometimes just get through the day. I’m also super lucky to be able to reach out to Mr Girlymicro for a ‘just one more block’ conversation when I can’t get there myself.

Know who you can show your real face to

Sometimes, as I mentioned above, our inner critic is just too strong, or the external forces are too overwhelming. In this case, you may not be able to get there on your own. You may have to reach out and have that moment of vulnerability with someone else to get through. I love a good sounding board, I think they add so much value, and I’m fortunate to have a number of people who I can show the true unpolished version of myself to who will take the appropriate cues of what I need in the moment. I also have you guys who give your time to read my rambling thought processes and always support my thinking and discussion around it.

Reaching out can be a double-edged sword however, you need to know who you can go through this process with. If you are at point where you are already slightly crushed by your inner dialogue, the last thing you need is someone who will escalate that voice. At the same point, you need to have someone who you trust to call you out if that’s what’s needed. There are times when you just tea and sympathy, there are times when you want coaching, there are times when you want advice, there are times when you need someone to call bullshit on your excuses and push you over the hump you’ve created. You need to know that you are with someone who can pivot to what is actually needed in the conversation, and who knows you well enough to be able to read what you need. Either that or you need to be able to reflect enough and go to the right person for the right things. There’s nothing worse than really needing a sympathetic ear and ending up with a lecture on how to do it better that echoes all the criticism you’ve already been giving yourself. Support is invaluable, but choose your route wisely.

Bribery works, for me anyway

I’ve already talked about breaking the world down into manageable chunks of time, or tasks, in order to be able to move forward by inches if needed. If you are strong of mind and have will power this approach on it’s own may be enough, I however still feel like I have the mind of somewhat upset toddler, and so sometimes will power enough doesn’t cut it for me. Sometimes I need to bribe myself. This shouldn’t work as I know as an adult that I can just decide to get these things anyway, and yet for me it still does. I bribe myself with anything from a biscuit and a cup of tea if I manage the next 1000 words to if I make myself run a half marathon I can buy myself that dress I’ve been lusting after. Sometimes completion of the task in itself is enough reward, especially if getting it off my list leads to a decrease in stress level, but honestly right now I just move from one immovable deadline to the next and something more is needed.

There is also something to be said for celebrating some of the milestones, for celebrating progress rather than waiting for the pay off or success. This means that you are more aware of those milestones happening and value them, instead of using an end point to determine how you feel about a task or yourself. Sometimes you might not succeed at the end goal, but you will have learnt a lot along the way, by celebrating the milestones you can therefore remember progress made rather than focussing on the failure.

Some days, it’s merely the act of showing up that counts

If all of the tips and tricks don’t work, if all the chocolate on the globe still wouldn’t cut it, sometimes you have to remember that you are still showing up. You are still working on being present. You may not make the progress that day you wished to make, that deadline may have flown past with you barely able to engage with it, but there is always tomorrow and the hope that it will be better than today. It may not be the perfection that you wanted, but that doesn’t mean that what you’ve produced doesn’t have value. Finally, and I mean this with every ounce of my being, your value as a human being is not tied to what you produce. You have value irrespective of your successes and failures. You have value in just being you, and there is no deadline on that.

All opinions in this blog are my own

Guest Blog by Dr Claire Walker: Bots, ChatGPT and AI – Is this the end to assessments in Higher Education as we know it?

girlymicro Academic Life, Education, Guest blog, Healthcare Science, Research/Academia, Science Communication

Whilst SARS CoV2 continues to kick my ass and make doing much other than getting out of bed a challenge, the wonderful Dr Claire Walker has stepped up yet again in order to ensure that whilst Professor Cloutman-Green may be dozing, Girlymicro still delivers!

Dr Walker is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for The Girlymicrobiologist, including one on the transition from lab to academia.

Bots, ChatGPT and AI – Is this the end to assessments in Higher Education as we know it?

The impact of ChatGPT on assessment is a hot topic in high education at the moment, you can scarcely open a newspaper without seeing scaremongering headlines shouting this is the end to course works as we know it.

I’m not sure I really agree with this, I’ve had a play with ChatGPT and remain fairly confident that I can spot a bot at forty paces. Students have always had access to a use a ghost-writer for take-home exams and essays, and from this perspective, ChatGPT is hardly a new problem. I’m also convinced that my  students are honest, and genuinely believe that they want to prove their knowledge and understanding through coursework’s and examination. Afterall, they will need these skills when they venture out into the world of work so there is no benefit to committing academic fraud. Even if you aren’t caught on day one, it’s going to catch up with you eventually.

That said, there is a question being whispered around higher education institutions at the moment regarding the coursework questions and exam papers – ‘have you run it through ChatGPT? What did you think? Could you tell it was a bot answer?’. So before I throw the baby out with the bathwater and panic, I thought I’d take time to note down some of the flaws that I see in ChatGPT. Currently, ChatGPT only has access to information up to 2021 and cannot access papers behind paywalls so if you design your questions to reflect on current knowledge and practice, the bot will return an error. I often create a new virus, disease or genetic defect for a paper, the bots also error when presented with these and cannot hypothesise the way a student can.  Bots cannot make personal reflections which are essential in synthesis of clinical information, it’s very obviously if a reflection is generated by AI.. Also we know our students, we know their writing styles and have a very good idea of what level of knowledge they have – it’s our job (!). We do teach the content of the modules after all. Finally, we already have AI detecting tech built into our anti-plagiarism systems. This is a cat and mouse game, and the bots won’t stay ahead for very long. 

Even so, this is just one lecturer’s opinion so I thought I’d go right to the source – and ask ChatCPT itself. And you can read for yourself. I’m not convinced we’ll be getting it to write any more blog posts any time soon….

Input Question: Write a 500 word blog post on the impact of ChatGPT and AI on student take home exams in biomedical science education

ChatGPT Blog Post:

The rise of artificial intelligence has been transforming various sectors of society, including education. One area that has seen significant changes is in student take-home exams in biomedical science education. With the advent of ChatGPT and other AI tools, students have a new level of accessibility and support in their studies. In this blog post, we will discuss the impact of ChatGPT and AI on student take-home exams in biomedical science education.

Firstly, ChatGPT and other AI tools have revolutionized the way students can access information. Instead of spending hours poring over textbooks, students can simply ask ChatGPT to find the relevant information they need. This saves a lot of time and effort, freeing up students to focus on understanding and applying the information. Furthermore, the ability to quickly access information means that students can study more efficiently, making better use of their time and ultimately improving their academic performance.

Secondly, ChatGPT and other AI tools have enhanced the quality of student work. These tools can provide students with instant feedback on their work, allowing them to identify areas for improvement and make corrections before submitting their assignments. This means that students can produce higher-quality work and learn from their mistakes more quickly. Additionally, AI tools can help students catch errors that they might have missed on their own, leading to more accurate and thorough work.

Thirdly, ChatGPT and other AI tools have increased the accessibility of biomedical science education. For students who may have difficulty accessing traditional classroom-based education, these tools offer a new avenue for learning. With ChatGPT, students can learn at their own pace and on their own schedule, making education more accessible to those who may have other responsibilities such as work or family commitments. This also means that students who live in remote or underprivileged areas can access high-quality education that might otherwise be out of reach.

However, while there are many benefits to using ChatGPT and other AI tools in student take-home exams, there are also some potential drawbacks to consider. For example, there is a risk that students may become overly reliant on these tools, leading to a reduction in critical thinking skills. Additionally, the use of AI tools may make it easier for students to plagiarize, as they can simply copy and paste information without fully understanding it.

To mitigate these risks, it is important to ensure that students are taught how to use these tools responsibly. This includes educating them on the importance of critical thinking and encouraging them to use AI tools as a supplement to their learning, rather than a replacement for it. It also means teaching students how to properly cite and reference sources, and providing them with opportunities to practice these skills.

In conclusion, ChatGPT and other AI tools have had a significant impact on student take-home exams in biomedical science education. These tools have improved the accessibility and quality of education, while also helping students learn more efficiently. However, it is important to approach these tools with caution and ensure that students are using them responsibly. By doing so, we can continue to harness the power of AI to enhance biomedical science education for students around the world.

Certainly ChatGPT has a high opinion of itself but there are some good points made here. This could be a useful study tool to help students learn and revise topics. With this in mind, you can’t uninvent a technology. Now is the time to elevate the different assessment methods that we use. So with that I’m off to mark an in-person practical exam, set a group work project and spend a week listening to students present a critical evaluation of papers written after 2021. I don’t think ChatCPT has me out of a job just yet…

TLDR – It’s not like the Bot started the blog post with ‘I am become death the destroyer of the higher education assessment system’, just yet.

All opinions in this blog are my own

The Paths that Made Us: Learning to be grateful for the moments that made us who we are

girlymicro Academic Life, General, Healthcare Science, Leadership

April is always a time of heightened emotion for me, and as time progresses, it is also increasingly a time for reflection. April was the month where the life I had planned for myself vanished over a period of 48 hours and when I lost one of the only constants I’d ever had, my sister, as well as my unborn niece. I’ve written about what happened before, and this post isn’t really about that. This post is about what came after and how I have come in recent years to appreciate the person that those experiences made me. I’m not saying I’m not sometimes sad for the person I may have been if those 48 hours hadn’t happened, I’m saying that I am grateful for where this alternative path has led me. The result is miles away from anything I could have pictured, but I have still found myself in a place of joy and love. So this post is to acknowledge that sometimes we have to accept the paths that made us.

As a result of this thinking I thought I would share some of the places my path has led that I didn’t expect, and share some of the lessons I’ve learnt that I am grateful for, in case it helps you also see things through a slightly different lens.

Be scared, but do it anyway

I often talk about how blessed I am. The truth is that I am always a little scared. There’s a part of my brain that always fears when the good happens, what the cost will be. I do have a blessed life, but I have also experienced some pretty significant trauma. I am very aware at all points in my life how quickly everything could just go away. I am also still painfully aware of the memory of how that made me feel. At first, this made me scared of the good things because I just then waited for the bad to follow. I still have spirals when this is the case, but for the most part, it means I try to value every single moment. Every compliment, every moment of joy, every step on the path. It also means that I know I have survived. I have survived days that I thought would be unsurvivable, so on my worst days I still know I will survive what’s to come.

This learning to live with fear has had some other benefits. It’s so easy to let fear limit us in other aspects of our life, fear of failure, fear of humiliation, and fear of being seen. All of these things can stop us from grabbing opportunities when they come our way. The thing is, my biggest fear is that linked to my own mortality and those of the people I love, and I am still forced to face that every day. It makes the other fears I hold feel a little smaller. They have a little less control. They have a little less impact. I say yes to things I wouldn’t have dreamed of if I had been on a different path, and saying yes has opened doors I could not have imagined existed. So bring on the fear, I’ve walked through it and survived, and so will you.

A child free life still has value and meaning

I’ve posted before and included a plea before about the fact that childless individuals still have lives with meaning, and asking that we are not the people who are always defaulted to working late or moving our leave, as we still have commitments to family and people that love us.

In recent years (and I still stand by the original plea) I have come to appreciate the flexibility that my child free status has given me and how that has enabled me to seize opportunities I would not have been able to otherwise. I don’t know if I had children that I would have been able to gain my PhD in the way I did, as it involved a fair few nights when I worked to midnight. I don’t know that I would have been able to balance achieving FRCPath if I had children, as I was studying at 5am before work and again when I got home. I’ve been able to build a research career because I can travel overseas to conferences and at weekends, and I am regularly the person who leaves work at 7 pm. All of these things would have been harder if not impossible if I needed to be home for pick up or take my child to football on the weekend.

I don’t know that my eyes would have been so firmly fixed on the horizon and thinking what’s next if I was focussed a raising another human being (and if I didn’t have a husband with the patience of a saint). All of these freedoms have led to me being able to attain things I’d never dreamed of, I became a Consultant, a Professor, I got a New Year’s Honour and an invite to the Coronation. I don’t for one minute think I would have felt that I’d missed out on anything by having children, as I really don’t think I would have realised many of these things are possible. I do, however, feel truly blessed by the wealth of the life that I live and the time I get to spend with my wonderful husband partaking in some once in a lifetime events. My life is rich. Perhaps rich is a different way to the way I’d planned, but rich non the less.

Sometimes you need to hear no enough to realise that yes, you can

For a chunk of my life I was told certain things might not happen for me. When I was unwell in my teens I’ve talked about how I was told university might not be for me. As a trainee I was often told that it would be unlikely that someone like me would achieve FRCPath working in a paediatric setting and I would therefore not make consultant, and I was told for years that someone like me wouldn’t make professor.

The thing is, from my position now, I am grateful for every single one of those no’s. Those no’s made me really focus on what was important to me and brought clarity to my thinking. Those no’s taught me about the barriers and attitudes that weren’t openly discussed and the occasional prejudice than hearing a yeses ever could. Those no’s made me smarter by teaching me how to work around barriers and to be a more strategic thinker, which has benefits elsewhere. Those no’s were sometimes what I needed to light a fire under me and make me decide to prove others wrong in order to really achieve change, not just for myself but for those following me.

The other thing that those no’s taught me is to differentiate when a no is really a ‘not yet’. This has been a crucial life skill for me, sometimes my enthusiasm drives me forward at pace, and there are some times in life when actually slowing down means that you will get more benefit from the process/experience. Sometimes, a ‘not yet’ means that you will be better able to do the task when you reach your destination. Being able to know when no means no is sometimes the most useful skill in any interaction.

Instability can sometimes help you thrive

I was at GOSH for over 13 years before my temporary contract became a permanent job, and even then it only occured because of a HR error when I transitioned from my PhD contract back onto a GOSH one. That instability caused me huge levels of stress the uncertainty of whether I would have a job from one year to the next, or where I would end up if something I loved so much just disappeared. It meant that I seized every opportunity that came to me, as I didn’t know which networks would be important for my future or if I would ever have an opportunity presented to me again. I took exams early or in a very planned way in order to ensure that future pathways and options were not closed off to me, as I could never know when I might need them.

Now, don’t get me wrong, all of this meant that I overcommitted and worked waaaaay harder than I might otherwise have. It meant that, at one point, I didn’t have a weekend off for three years. It has also meant that I have the career that I have now. Sitting on my laurels and becoming comfortable was never an option. Saying no to others was never really an option, as you never knew if you would need their support in the future. This has meant that the breadth of experiences I’ve been able to access has been wonderful. It also means that I know find myself as a Consultant, having maintained an interest in research and in education, both of which mean so much to me. I have gone above and beyond to ensure I could maintain all three.

I sometimes think that if I had had a permanent band 7 or even band 6 post, then that is where I might have stayed, instead I have a job that challenges me every day to be better and I continue to have access to a diverse portfolio of things that inspire me and bring me joy. And finally, a job that is permanent and in a field that I love. So that instability may have been worth it and the driver I needed to get to my dream job.

Some days the only way is through

I’m writing this whilst feeling pretty dire, I’m still post COVID and struggling with the day to day. I am however still working and still functioning. I have posted before about some of the health challenges I live with on a day to day basis, none of them are massively severe but they do impact how easy I sometimes find life. It’s sometimes easy when it takes me this long to recover from something to feel down about it. Instead I’d like to say that there is an upside. I spend a lot of time focussing on the end goal and pushing through when I feel tired or unwell, it’s a regular life event for me. This means that I have developed the skill of being able to become incredibly focussed in order to get something done. If I say I will deliver, I will deliver, come hell or high water, short of incapacitation I will deliver on my word. Without it, I wouldn’t have managed to sit my GCSE’s, I wouldn’t have been able to manage at university, and I certainly wouldn’t have completed my Clinical Scientist training.

Now, sometimes I admit that I take this too far, and sometimes it means that I don’t take the rest I need or tap out when I should. It does mean, however, that if push comes to shove, I am able to just push through and make things happen. This is something that has been invaluable in delivering in a world where I have a tendency to over commit, and it’s led to me being able to deliver on things like this blog, which means so much to me. So, although it may not always be the healthiest trait, it is a trait that I see the value in and am grateful to have developed.

There are so many times in life when all we can see is the gloom and the dark clouds on the horizon. It is often difficult to find the distance emptionally or the time to really put some of our challenges into context and to see all that they bring to us as individuals, the good and the bad. We may sometimes be broken, but that does not make us less beautiful. In fact, sometimes, the fires that forge us enable us to emerge as truer versions of ourselves than we may otherwise have been.

So if you are still surrounded by the flames hang in there, there will be a time when you too can look at your past and see it as the source of your strength rather than the thing that was trying to break your spirit.

All opinions in this blog are my own

Guest Blog by Dr Claire Walker: Is there a place for Simulated Placement in Biomedical Science Education?

girlymicro Guest blog, Healthcare Science, Research/Academia

Well, it finally happened, on the third anniversary of lockdown I got faint lines on my SARS CoV2 lateral flow test and my first infection. I’m currently sofa bound and feel like I’ve been hit by a truck and the ever wonderful Dr Walker has stepped in and written me a post so you were not left hanging for a second week without your Girlymicro fix.

Dr Walker is a paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci), education (PgCert) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln. She has previously written many great guest blogs for The Girlymicrobiologist, including one on the transition from lab to academia.

Op-Ed. Is there a place for Simulated Placement in Biomedical Science Education?

Hi all, it’s me again, banging the drum for getting students to come and complete an IBMS accredited degree, to get their portfolios and to become members of the NHS pathology workforce. I left my position in clinical pathology and research to come and teach on an accredited degree course to get bums on seats in the NHS – but specifically the best, most talented bums on the best seats in the house. I wanted to inspire the most able, talented students to come and work in the greatest profession around. And to top that off, in the most interesting of all the disciplines, you know, Immunology (Sorry @Girlymicro but it’s clearly superior). All opinions in this blog are very much my own. 

As some of you will know students studying an iBMS accredited degree typically engage in a 39 week generally unpaid placement in a clinical laboratory to collate a portfolio of evidence sufficient to gain Health and Care Professional (HCPC) Registration on completion of their degree. This lets them apply to jobs as a registered Biomedical Scientist when their degree is complete. Sadly, this placement is completed only by a minority of students for a variety of different reasons. There are significant challenges in the implementation and supporting of clinical placements. One only has to consider the high clinical workloads in pathology, especially post-COVID, the increasing complexity of equipment and techniques, as well as the high demand for placements from students which many labs simply lack time and capacity to support. Particularly as there is no guarantee that a student will return to the training lab to work full time at the end of the degree. Put simply, it’s a lot of effort for no guarantee of reward for the lab’s investment. It doesn’t feel like a very sustainable system, and we need innovative solutions.

And the team at Staffordshire University have got them in spades. I was extremely fortunate to attend an ideation event at the Staffordshire Uni on ‘The Role of Simulated and Alternative Placement in Evidencing Standards of Proficiency for Biomedical Scientists’ hosted by Ian Davies and Aimee Pinnington. I was absolutely bowled over by the work they are putting into developing an authentic clinical experience in their biomedical science degree programmes. It’s not hurt by their great links with local hospitals, the fact they both have extensive experience in the NHS as HCPC reg scientists, and their obvious enthusiasm for the subject matter.

Clinical simulation is an exciting component of healthcare education which to date has largely been overlooked in the training of our biomedical scientist workforce. Simulation is a well-established method that allows learners to practice in a controlled environment with no risk of harm to patients. In many healthcare professions, simulation-based activities are used as discrete learning opportunities throughout the curricula as part of academic modules but perhaps there is a need to do more to integrate this learning to create a more authentic learning experience. There is much enthusiasm amongst those of us walking the clinical/academic line as HCPC registered Senior Lecturers to do more to support our students to get their registration. The ideation event at Staffordshire University gave us the opportunity to discuss different options to embed skills and behaviours within the University experience. Overall, I felt that this was not with the aim of replacing a traditional laboratory placement, but rather to find tools to support routes to registration and really consolidating the value of the student placement experience. I feel we need to work out exactly what students get from their time, and if any of this can be done in the University environment to reduce pressure on the pathology laboratories.

Meme from Biomedical Sciences day – what does a biomedical scientist do? Created by the haematology team at Hull and East Yorkshire Hospitals

I came to this meeting not really knowing what to expect, and feeling that nothing could really replace the unique and essential experience of working for a full year in the clinical lab. And I walked away from this meeting excited and brimming with ideas to put into practice on my own immunology course. I’ve no interest in getting rid of placements entirely but I do think the University needs to do more to get students ready for practice, and that as a profession we need to shake off some cobwebs and look at what we can do to enhance recruitment. After all, I left a much beloved research career to get the most talented bums on the most important seats in pathology.

TL:DR What do we want? Simulated and alternative placements to be introduced to accredited degrees. When do we want it? When they have been properly devised to replicated an authentic placement experience ideally by HCPC registered healthcare scientists collaborating with University staff (who may or may not be the same people!).

All opinions in this blog are my own

Learning to Live in the Grey: Moving back to a risk assessment based approach for IPC

girlymicro Microbiology (Clinical)

This is the post I was supposed to get out last week but didn’t quite make it as my mind latched onto dealing with what was directly in front of me, rather than being in a more conceptual space. That said, after having just run a course, where the main theme was supporting participants to be able to use frameworks to make risk assessments, it still feels like an important conversation to have. Now, these are just my observations and thoughts. They are not meant to be criticisms of any person or indeed the system itself. I hope it will just continue the conversation about what serves us and our patients best, and we all know there is not a one size fits all approach.

Pre-pandemic it felt, to me, that there were guidelines frameworks out there, particularly linked to things like Carbapenemase Producing Enterobacteriales (CPE’s), but in the main part Infection Prevention and Control (IPC) teams used a lot of personal judgement and experience to determine routes to management, with input from Health Protection Units as needed. The pandemic led to a big switch, where a command and control approach was undertaken. This made complete sense, as resources were restricted and shared across the system. Therefore, frameworks supported us all practising in similar ways and with expectation setting. They also supported large scale evidence collection to improve interventions. We were also in a scenario where some of the diversity of what we were dealing with was removed, in terms of IPC, the focus was mainly on one key organism. Now we are moving back into ‘business as usual’ both in terms of patient flow, and in terms of organisms, that one size fits all approach feels like it may do us a disservice, as the challenges are now so much more diverse. We therefore need to think about how me move back to a much more risk based approach, where instead of having a single organism focus, we also take the setting and the patient into consideration.

Risk assessment and risk based decision making

Those of you who have read some of my other blogs, about the fact that I genuinely believe that IPC is 90% risk assessment will not be surprised that I believe that we need to empower people to undertake these risk assessments better. For 3 years we have given everyone very specific instructions for their actions on every part of the pathway, when to test, what test to use, what PPE to wear, all possible because we were focussed on one thing, much like the standard risk matrix below: risk = SARS CoV2, and all risk mitigations are rated against this in a 2:2 matrix.

We are moving back to a world where, instead of using a matrix where everything is measured for it’s efficacy against against a single pathogen, we need to consider multiple pathogens, their characteristics, and how these play out differently in different patient populations and in different settings. Therefore a standard risk matrix approach does not serve the outcome of increased patient safety we all want to achieve.

Sadly, it also gets even more complicated. We have been living in a healthcare system for the last 3 years where everything, action wise, felt like it was determined by testing and test results. That means that we have been functioning using a test based action algorithm for a very long time. Now, I’m a scientist, and therefore love a good diagnostic test. However, in healthcare there are so many things that can impact on test outcomes: timing of the sample, factors such as antibiotics, quality of the sample, test requesting accuracy, specimen type etc etc etc. We are not just optimising all of our testing pathways for improved sensitivity in relation to a single organism, we are trying to use the best choice we can in order to maximise information output for a wide range, there will therefore be things that bias the accuracy of those results. So we are back in a healthcare world where we need to stop being so focussed on the test and the test result, and start seeing the patient in front of us again, irrespective of what the negative test may say. We need to move back from a test based approach to a symptom based approach. If my patient has respiratory symptoms, they should be in droplet/airborne precautions, irrespective of what the test results say. If my patient has diarrhoea, then we need to put them in contact precautions irrespective of a negative gastro panel, unless you have clinically evaluated other reasons for the symptoms. This clinical evaluation step is key, and you can’t put all of the information linked to that in a flowchart, therefore we need to switch from command and control responses, to supporting the experts at the bedside to use their clinical knowledge to evaluate patients, and support them in better risk based decision making to support IPC. We have to acknowledge that the assessment process is complex, but also feel that we have supported staff enough to be able to make those complex judgements.

https://hbr.org/2022/08/solving-tough-problems-requires-a-mindset-shift?

Acknowledging the uncertainty in the system

The problem with a risk assessment based strategy, managed primarily at the bed side, is two fold. Firstly, you have to be prepared to support with the education to enable it to succeed and to know when to escalate and question. This can be time consuming and it is a task that needs to be continuously supported, as staff, patient mix and environments change. Secondly, we have to have honest conversations with staff to help them to understand and become more comfortable with some of the principles of uncertainty. This is because algorithm based approaches often offer, sometimes unreal, certainty. If I do A and then B in compliance with a flow chart everything will be alright. By increasing complexity in decision making, you also introduce uncertainty, and that needs to be acknowledge and addressed as part of our approaches. Otherwise staff will never feel empowered to take the steps required.

Types of uncertainty

The first thing to say, is that not all uncertainty is the same, and therefore you need to approach different types using different tools. Epistemic uncertainty, is the one in healthcare we can probably do the most about. It’s the kind of uncertainty which we can, sometimes, address by asking better questions. Questions like, I notice you seem to be using a lot of tissues, do you have have a cold or feel like you have a bad chest? Questions like, have you been in contact with anyone who has had an infection or been unwell recently? Or have you been travelling a lot recently? If we can support our staff to feel more confident in collecting the information they need, and then knowing what to do with it, they will feel more confident in making decisions without escalating all of those decisions up to someone else for sign off.

Other forms of uncertainty, such as aleatoric uncertainty are harder to address. This isn’t uncertainty that you can address by gaining more or better information, it’s the kind of random chance events that you have to manage by becoming more comfortable with the fact that healthcare is multifactorial, and you may never be 100% about any action or solution. An example I always use in my head for this is a 4 bedded bay where someone has just vomited due to norovirus. We know on the balance of evidence all 3 other patients are likely to acquire norovirus, as it will stay in the air for ~2 hours and up to a million copies of the virus will circulate prior to deposition. What we don’t know is, did 1 of those 3 patients have norovirus last month after a wedding, and therefore currently has sufficient immunity against the circulating strain? Is 1 of the others one of the small number of people who have receptor variance which means they are less likely to acquire infection? You can’t get that information by looking at them, you are unlikely to be able to get that information by testing or asking questions. Therefore you have to manage the uncertainty and deal with the decision making you can undertake, with the information available to you. That decision making also becomes much more complex when consensus making is difficult, and so supporting staff to know how and when to escalate when this occurs is really important.

So how do we deal with uncertainty better?

For me, the first step is to acknowledge that it is there, rather than trying to persuade ourselves that bedside risk assessment is a) easy and b) doesn’t come with any discomfort for the staff we are asking to undertake it. It takes time and space to be able to this well, both for the required educational component and for the staff to be able to have the cognitive space to ask and process the questions, as well as undertake any follow up. It also takes us to really recognise that we are a single team working across that healthcare pathway, this isn’t about IPC putting their responsibilities onto someone else, it’s about improving patient outcomes by having the people evaluating patients as close as possible to the ones making informed decision about those patients. It does not stop the requirement for complex decision making to be escalated or remove the need to be able to ask for support. It also requires feedback and monitoring so that staff do not feel like they are being left alone to carry a risk or fearing consequences for inappropriate decision making. It is about empowerment in patient care, not resource saving.

I personally believe that we need to move away from central dictates for IPC decision making, patients are unique, and combining that with different environments and organisms means that numerous factors need to be taken into consideration if we are to provide the best possible care. That cannot be done well centrally, where we never see the patient and are not aware of the minute by minute changes in their wellbeing. Supporting those at the bedside to make better decisions and empowering them to be the people who respond to those changes is key to moving away from the single organism focus of the pandemic. IPC teams are key, they should be the ones educating, empowering and being the escalation points, but there are simply not enough of them to have one at every bedside and so we need to look at spreading the knowledge and IPC love!

his-dipc-day-2022Download

All opinions in this blog are my own

You Spin Me Right Round Baby, Right Round: Getting through the day when it’s all a bit too much

girlymicro General

I had great plans about what I was going to post today, but to be honest, it hasn’t quite worked out. It hasn’t worked out because I can’t focus on the post I had drafted because I am currently feeling so overwhelmed by the day job. I’ve been prepping and then running a course for three weeks, and the emails have mounted up to a point where I can’t see a way forward. I have lectures coming up that aren’t written. I feel run down and grotty because I pushed myself too hard physically, and to top it all off, yesterday was filled with frustrating politics. So, instead of posting about Infection Control, today’s post will be about reminding myself of some of the tools I use to re-centre myself when I feel like I’m spinning out of control.

Know tomorrow is another day

I am sadly not one of those people who always look like a graceful swan, working frantically under the water but appearing calm and graceful to all observers. I am the person who wears her heart on her sleeve and quite frankly gets stuff done but looks like a cartoon Tasmanian Devil in the process. I ride the emotional roller coaster and just try not to scream too loudly. Sometimes, I just need to take a step back from the chaos and try to realise a) what’s real, b) what is just because of tiredness, c) what really matters. Some things that feel so challenging in the moment feel so different once they are resolved, like the sun coming out. Therefore, getting worked up about them hardly seems worth it. When things feel like they currently do, I try to remind myself that everything will feel different tomorrow, or when I start to feel more like myself. This means that I also need to try to remind myself not to react so much in the moment. I find that taking a brief moment to focus on a point in the future that feels removed from where I’m at can really help me reset my thinking, be that planning for a future holiday, focussing on sorting a future talk etc, focussing on the future whilst also not losing time I don’t have to fix the present.

Just like any roller coaster, this too will end

When everything is coming at you, it can feel like the end of a game of Tetris, when everything is coming at you so fast you don’t have a moment to even recognise what pieces you are juggling, let alone how to fit them in. The thing is, even this is a state of mind, if I was in a different place I would be excited by the challenge rather than feeling a rising state of panic. The key thing, for me, is that I recognise when I am entering a mental space where I am losing perspective. I have two approaches to this:

Step one (a) is to make a total list that will enable me to get a better idea of where I’m at with things. Step one (b) happens when I’m too far into my stressing, in this case making a complete list actually freaks me out even more, and so I make a next day list. I list enough that I feel like I have identified the urgent things, but make sure not to be so extensive that I worry about how I’m going to get the entire list done.

The second approach is that I go through my diary and try to gain some time I can block out as ‘task time’, so I actually have some time to make the things on my list happen. I may not have solved the issues but at least I know what it will take to make me feel like I’m back in control enough to get off the roller coaster.

Focus on one thing, directly in front of you

If it all else fails, and I can’t even cope with ‘The List’ I pick one thing. The biggest, most urgent, most panic inducing thing and just give that 100% of my focus. I split it down into pieces that are easier to mentally digest and just start at the very beginning. I’ve said there are times when looking to the future helps me, there are also times when I just need to look at my feet and take one step at a time. I also find that, to stop the prevaricator in me, I need to put the ‘Do not disturb’ sign on my door to buy me not just the physical time, but the undisrupted mental time to get into the task and enable me to find a rhythm. Sometimes, I need to pick at a couple of easy things to lead into the big thing, but often, for me, it’s better to just pull off that band aid and get to it.

Even if it’s as bad as you think, how bad is that really?

All of this is about process managing my way out of where I’m at, but there is also recognising what are the real consequences of where I am. I’ve previously written a blog post about the reality of deadlines, but there is also the aspect that we feel these things so keenly because we are the centre of our worlds, therefore when we feel things aren’t correct we assume that everyone else clearly sees the same. The reality is that most of the people we interact with aren’t all that focussed on us. If there are deadlines that are real, then we manage them, but just like others aren’t fully aware of our individual workloads, they are also not as aware of our weaknesses and failures as we perceive them to be. This can be especially true if you’re a perfectionist, and you feel that if something is delivered and it is not as you envisioned that it is a massive reflection of your failure. As far as I’m aware, I have yet to meet a mind reader and so the only person who is benchmarking against the vision in your mind is you, therefore cut yourself a break. When it comes to outputs on days like today I tell myself ‘done is better than good’ and that my benchmark for done is usually pretty damn high. Therefore, just get it done!

Plan your way out

When I have given myself a good talking to, and dealt with the immediate panic in front of me, it’s time to work out how I’m going to tackle the rest. I’ve already talked about blocking out some task time and moving towards making a list, but for me, this part is also about being able to visualise my progress. What are my quick wins, so I feel like I’m getting somewhere. What if any bits can I seek help with, we are not one women armies after all. Are there any bits in hindsight I can drop, or are no longer needed, to buy me some extra time? Any deadlines I can move? Once I’ve got myself to a space where I feel brave enough to look at the entire list and see the big picture, I can be proactive about moving forward. Or the BIG question……..do I just feel this way because I’m feeling run down and ill, in which case I need to stop worrying about it and get some rest.

Sometimes, you just have to get a little distance

If the answer to the question ‘do I just feel this way because I’m feeling run down and ill?’ is ‘yes’ then the answer is to down tools and get some space. I started this post on Friday but just couldn’t manage it and so took Friday night and Saturday off. I’m finishing it on Sunday so as not to put extra pressure on myself to finish it on my Monday morning tube journey in. I have a tendency to work harder when I feel out of control, and that is fine, to a point. The issue with pushing harder when the tank is already empty is, as my husband regularly says to me, ‘ease down you’re only grinding metal’ (it’s an Aliens quote). You have to know when you are in a space where it’s productive to work, versus when you are in a space where it’s more productive to rest. If you step away you will come back refreshed, with a new perspective, and sometimes the challenges are either just not as great any more, or you can see solutions you wouldn’t have seen otherwise. I have a great team around me, who really help flag to me when I’m just doubling down when I should step away, them and my husband are absolute lifesavers in terms of reminding me that I’m more productive long term if I rest. Be aware however, that resting is different to ostriching, so being honest with yourself is key.

Anyway I’m still pretty tired but I’m better for the rest. Hopefully you all won’t judge me too harshly for my honesty and that by sharing how I feel we can all support each other a little bit better when the deadlines are looming and the sky feels like it might come crashing down. Here are the tips I’ve been channelling this weekend to help get me through:

  • Take a deep breath
  • Work out whether you actually have an issue or whether what you really need is rest
  • Decide whether to look to the future (to gain perspective) or to identify a single task to work on (to support focus)
  • Use the resources you have available to you, you are not in this on your own

If all else fails, phone a friend, we are after all here to help.

All opinions in this blog are my own