Joy and humanity in communication: A design-based research approach to developing and understanding the impact of a novel education programme on hospital staff, co-designed and facilitated by clown doctors.

Aim: Clown doctors have a unique skill set and role, particularly in paediatric settings. Yet, there is limited research on whether clown doctors themselves could play a role in sharing these skills with health professionals. Acknowledging uncertainty in what our intervention should be, we used a design-based research (DBR) approach with the aim of (i) shaping the educational design and content of communication skills-based workshops for clinicians and (ii) understanding the educational impact on participants.

Methods: Data were collected from initial key stakeholder consultations, then through the delivery of evolving iterations of the workshop in the form of post-workshop group discussions, follow-up short participant surveys and observations of the workshops themselves. Reflexive thematic analysis of group discussions and short survey responses was undertaken to understand the impact.

Results: Forty participants participated in five workshops, including staff from medical, nursing, allied health and administrative backgrounds. Five educational principles emerged: self-awareness, curiosity, play, spirit and self-reflection. Four central themes regarding educational impact were generated: creating joy and breaking barriers; the heart, not the science of communication; workplace tensions challenge change; and communication training but not as we know it.

Conclusions: A novel education programme facilitated by clown doctors at a hospital offered unique communication skill learnings, while bringing joy and connection to the workplace through education. The DBR approach enabled this programme to be shaped, implemented, and evaluated, with the results attesting to the value of more novel approaches to communication training. The challenge remains to embed, sustain, and potentially scale the programme to other settings.