music // The title card reads Back to Basic Toronto, 2014. Dr. James Lavery. The single biggest problem in HIV science communication. James Lavery stands alone on the main stage of the Back to Basic conference and addresses the audience. An on-screen graphic identifies his affiliation with St. Michael’s Hospital and the Dalla Lana School of Public Health and Joint Centre for Bioethics, University of Toronto.
Lavery displays a slide showing three overlapping circles, which he describes below. On the left side, a circle labelled “science” overlaps with a circle labelled “science communication.” On the right side, a circle labelled “public” overlaps with “science communication.” There is a gap between the public and science circles.
James Lavery: So, one of the popular models — it’s called the gradient model, from Hans Peter Peters, is this notion of, you know, over here, on the one side, you have science; this kind of thing. It’s a circle. And then you, on the other side, you have a similar circle, and it’s the public. And then there’s this notion that there’s a gap between them and somehow science communication needs to be — needs to be filling this gap.
And so, the focus, the emphasis, tends to be then on the one direction; for the scientists, then, to be developing communication skills in the direction of the gap, and of the public, then, to be developing scientific literacy in the opposite direction to close the gap.
So, another way to think about what’s happening, then, in this in this model, is that we’re really laying out the groundwork for some sort of obligation on the part of science or scientists to explain what they’re doing. And then, on the other side, we’re laying out some kind of obligation on the part of the public to understand. And so, we could do a little sidebar where we all go to the bar and grab a drink and talk for half an hour about what the hell it might mean to have an “obligation to understand.” It’s a little bit easier to understand what it means to have an obligation to explain. And I think that’s, in part, why we’ve — why we’ve kind of gravitated there.
Lavery displays a slide labelled “The stellar model” which he describes below. Photos on these slides depict journalist Jon Cohen and an advertisement for the CBC Radio show Quirks & Quarks in which the host is prominently featured. A diagram depicts two circles labelled “scientists” and “journalists” and shows information moving from the science circle to the journalist circle, and then out to the wider world.
So, another model is, you know, what’s called this stellar model. And this is — the underlying thinking here is that scientists don’t do well, and we don’t have a natural forum, for direct interactions with the public. And I’ll come back to that thought in a second. And so, really, science needs to rely on journalists — dedicated journalists — to play that role. In a sense, there are brokers or skilled intermediaries, if you like, in trying to close that gap.
You know, one of the underlying ideas behind that the gradient model, and the way that we tend to think about science communication, is what’s called the deficit model. And this is just one account of it, but it’s from a meeting at the Copenhagen Business School, talking about science communication. And so, here are some of the, kind of, underlying assumptions around this, kind of, deficit model.
Number one: that there is a “public for science.” So, in other words, that there is an entity, like that little circle that says public in it, that is a receptor for communications about science.
Number two: that that public is ignorant and uninformed about science. And that’s not meant to be ignorant in the in the really offensive way. It’s meant to be ignorant in the slightly less offensive, but still offensive way, which is that, you know, just not having the same level of understanding and awareness that you would have as a well-trained scientist — which you would expect and, on the surface, isn’t completely unreasonable.
The third is that criticism and resistance, then, is created by an absence of knowledge and understanding, so that the gap, if you like, is a gap of this knowledge and understanding. And then, the purpose of science communication is to fill this gap.
The video jumps forward to another point in Lavery’s presentation.
Okay, so what about the communication part of science communication?
I really tried to lay out there the overarching model, but what is it about the communication part, itself? So, if you think about the, kind of, deficit model, communication from the scientist side is about explanation. It’s about providing interpretation or, sometimes, we talk about “translation” of findings into ways that people can, in the public, then, can understand. Often, the underlying notion, there, has something to do with simplification. You know, here’s a gel with sixty lanes and 500 different colors — the chances you’re going to be able to interpret that yourself are pretty small. So someone’s going to get up and say, “Oh, obviously if you look at lane three, and it’s red, and it’s, you know…” So, there’s a kind of simplification of those complex ideas.
When we talk about communication with communication professionals, there’s a real tendency to gravitate towards messages. Get your key messages, organize them, clarify them. Messages are important, but they’re not the only thing.
And more so — more and more, now — there is a movement, I think, to storytelling, and narrative, and coming to understand the value of that. I spent three years at NIH and, when NIH — when the institutes and centers go to Congress and request funds — they have to do this exercise called the Congressional Justification or the CJ. And it used to be that they would provide the, you know, the congressional panels with these arse-numbing science packages, and the Congress, you know, people in Congress, would be saying, like, “No one understands this stuff. Tell us a story. Tell us what the hell you’ve done.” Like, “Tell us why we’re better off now than we were then.” And so, even at the level of places like NIH, start seeing the this role of narrative in the way that the institutions start communicating with Congress, the people that are going to be parting with money for them.
On the public side, this deficit model of communication really is a more of a, kind of, receptive model. It’s about acknowledging the importance of science. It’s about listening to science. It’s about trying to understand, and it’s, I think, implicit in all of that is, it’s about changing your behavior in ways that are going to be useful in certain ways. But, if you look at these — if you look at the sort of verbs that are going on here, these notions of “acknowledgement,” and “listening,” and and “honest attempts to understand,” and “changing behavior,” of course, the question that arises for anyone thinking carefully about these things at all: to what extent these verbs should also apply to scientists.
They tend to show up scarcely in the literature about science communication. But it seems to me that it’s the kind of foundation of what we have to start thinking about in a meeting like this, for example. What does it mean to acknowledge those other interests? Acknowledge that they exist, that they have some legitimacy? What does it mean for scientists to listen? Who do they listen to? What do they listen for? How do they try to understand? How do they change their behaviors?
So, you know, there’s this other model — and there are a number, but I’ll just focus on these, just to give you a sense — the democratic model, then, that acknowledges that there are multiple publics engaging with science in different ways. And I’ll extend that by saying that they each have their own interests — and legitimate interests — in the science — in the conduct and the outcomes of the science — and that these public groups can be highly knowledgeable within the context of everyday life. I wouldn’t have added that extension to the sentence; I would have just said that they could be highly knowledgeable. I grew up in my training in HIV and AIDS, and I don’t think I’ve ever been in a community where there’s a greater level of knowledge and understanding than there is in HIV and AIDS. And that this criticism and resistance is often based on wider social and political assessments, and that the purpose of science communication is to create and support active citizens. So this starts to sound and feel a little bit healthier. But I’ll come back to it a little bit later.
The video jumps forward to another point in Lavery’s presentation.
I think the social value of any science project is not determined by scientists alone. Scientists often believe that it is, but it’s not. And I think those examples that I just described are really good examples of that. Scientists sometimes overestimate the social value of their science and they rarely underestimate it.
The democratic model that I showed you a few seconds ago — as we start to move away from the deficit model, thinking about science communication — doesn’t mean that scientists don’t have unique knowledge. We all know that they do — that it’s unique, it’s highly valuable. and it’s critically important. But it means they don’t have all of the relevant knowledge for the science to make its way out of the lab into lives and actually have an impact in public health.
And I’ll — I mean, I have a PhD in medical science, so I’m counting myself in this — but scientists need, I think, more humility. And it needs to be incorporated more successfully into scientific training, and into the socialization of scientists. I think scientists are basically taught to be right, and to argue and present data in support of being right, and we’re not taught enough about how to do those other elements of communication that I described.
So: almost there, almost there.
So, again, I want to emphasize — and, in terms of the ethics — that communication entails relationship. But we’ve really paid very little attention, in general, to what it means in the context of science communication. Ethically, I think we need to acknowledge the interests of a wide range of stakeholders in HIV science, and we need to avoid what I think of as disregarding stakeholders who have those interests, but who may not look, phenotypically, like scientists. We need to think about what it means to create the appropriate opportunities for engaging scientists and stakeholders in meaningful relationships.
And, to come back, then, to conclude, thinking about the George Bernard Shaw line, in some respects, I think the science communication in HIV — maybe not so much an HIV, actually, but in general — is an illusion. Because we haven’t created the proper context for those relationships, not because we haven’t been paying attention to how to take an impenetrable abstract from a clinical — or, you know, a lab thing, and distill it down into the right words for a general audience, but because we haven’t done precisely what you guys are doing here.
So, for me, the end point for this talk is that I think that what you’re doing, assembled here in this conference, is highly unusual. And I think it gets to the absolute heart of what I see as the fundamental problem in science communication, which is the need to develop context for the kinds of relationships where these communications, and acknowledgments, and listening across this kind of gap, can happen.
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