Traditionally, journal clubs are for professionals in their field to critically evaluate the research literature, scrutinise methodologies and explore real-world applicability. I had the opportunity to deliver a journal club for the North West Coast Research Collaborative (NIHR NWC ARC) with the primary audience being their public advisors. We discussed the qualitative paper ‘Patients’ and healthcare workers’ recommendations for a surgical patient safety checklist – a qualitative study’ by Harris et al. The study used semi-structured interviews to identify key elements that both patients and healthcare professionals felt were important to include in a patient-driven surgical safety checklist.

Interestingly, this was a paper that I had previously critically appraised amongst a group of surgeons. Revisiting the paper in a public-facing discussion was thought-provoking. While the core critical appraisal process was similar, structured using the CASP checklist, the perspectives of patient advisors challenged some of the conclusions reached in our earlier appraisal amongst surgeons.

One of the most striking discussions centred around the methodology of the study. The researchers kept patient and healthcare worker focus groups separate, presumably to encourage openness in discussions. Some participants in our journal club questioned whether mixed focus groups could have allowed richer and more balanced conversations, leading to collaborative solutions, rather than reinforcing existing power dynamics between professionals and patients.
Another important debate revolved around ‘lived experience’ versus a ‘professional stance’. As clinicians, we often focus on what we believe patients need to know, yet hearing directly from patient advisors revealed how traditional approaches to patient education and safety planning can sometimes miss the mark. For instance, the study identified clinical risk factors for surgical safety, but patient advisors highlighted that these must be considered in the context of broader social determinants of health—such as access to post-operative support at home, financial constraints, and health literacy levels.

The journal club was also a useful exercise for public advisors – “The CASP checklist helped focus on various parts of the paper with some evaluative questions in mind. An example was it prompted questions around recruitment strategies for the study. None were specified, but this led us to identify that there had been no carer involvement in the project, which we felt to be a significant omission. As a public advisor, I have found it since to be a useful tool when asked to review research proposals and supporting papers. The checklist can be modified to cover those issues most relevant for the reader and we discussed how it would be good to include prompts around viewing the research with an equity lens.” – Hilary Garett, Public Advisor NIHR NWC ARC.

For me, the journal club was more than just an academic exercise, but a lesson in the value of co-production and the power of diversity. Discussions among people trained in the same way often lead to similar viewpoints, shaped by shared experiences and professional norms. The best research emerges not from echo chambers, but from a space where patients, clinicians, and researchers bring their unique insights together—each challenging the other in ways they never anticipated.
My own experience of research, prior to taking time out of surgical training to undertake a PhD, is reflective of the landscape of research conducted by many resident doctors in the UK. Resident doctors are required to publish research as a part of their training and yet face significant barriers to engaging in meaningful research. These barriers include time constraints due to service provision amongst the demands of training, lack of dedicated research support and structured academic mentorship. Many of us carry out research with minimal exposure to patient and public involvement and engagement or qualitative research methodologies. If we truly want to foster a culture of patient-centred research, training programs must provide equitable support and protected time for trainees to engage in meaningful, co-produced research.

Donna Shrestha Bio
Donna is a senior general surgical resident doctor (ST7) in the Northwest with a specialist interest in colorectal surgery. She is currently undertaking an NIHR NWC ARC funded PhD at Lancaster University researching health inequalities in the surgical patient journey. She was granted an NIHR short placement award for research collaboration (SPARC) with the Manchester Biomedical Research Centre, where she worked with the Inclusive Research Team. In 2020, she co-founded the Blackburn Research Innovation and Development in General Surgery (BRIDGES) with the aim of making research and education more accessible regionally. She has been an active member of the Nepalese Doctors Association for over 15 years and previous Joint Secretary (2019-2021), supporting international medical graduates with equitable training and mentorship.

Hilary Garett Bio
In addition to her current role as a Primary School volunteer Hilary is an experienced patient and public contributor to health and social care research. She is currently a public contributor with:
HDR UK PIONEER Health Data research Hub for Acute Care, HDR UK North Executive Board member.
NIHR – ARC North West Coast Theme Co-Lead – Equitable Place based Health and Care,
Cross NIHR Collaboration on Multiple Long Term Conditions Patient advisory group and the Models of Care work stream.
Lancashire & South Cumbria Safe Data Environment Public Advisory & Accountability Group,
Northern Health Science Alliance,
EMIS UK Research Executive Board.