Is laughter the best medicine?

When I heard about O.N.V's big research project I was envious. The serious clown in me would love to have scientific validation of the work we do in Scotland. Of course, the assumption being that any study we did would prove that we had a hugely positive impact, and not the opposite...

I find myself caught between thinking, 'if i know the work has a positive effect, and the children, parents and healthcare staff that see us do, then why pay for a research paper to prove it?' and 'Academic research will give scientific weight to the work we do, contribute to the way people see clowning in hospital as a profession, and have a positive impact on relations with healthcare staff'.

When Beatiz Quintella and Susana Ribeiro started their research project in 2009, their mission was to increase knowledge of the work, and to be able to spread that knowledge to people who don't witness the effect of the work and to have scientific approval. They designed a research project with academics on board from the start, and with Doutores de Alegria as consultants (Mogana Massetti has been conducting academic research into their work in Hospitals for years). They were clear that they wouldn't interfere with the artistic programme in any way - no manipulating partnerships, for example. It was important that the research was a real reflection of the work.

I spoke to Susana, whose job it is to take care of research at O.N.V about the project.

The idea was to start working in a new hospital in Braga, financed by A Brazil/Portugal Social Exchange Fund. What started as a 3 year research project in one hospital, grew into a research project that spans all ONV's hospitals, includes 6 different studies and has taken 6 years.
Susana identifies one of the main reasons for this success is their good partnerships. With Morgana Massetti in Brazil, with the academics in Portugal, who really took care to understand clowning and the work they were researching, and the  Centro de Investigação em Educação da Universidade do Minho and the  Instituto Universitário de Lisboa (Cis-IUL).

The research they have undertaken is pretty comprehensive:

• MA degree concerning the expectations of healthcare professionals before the Clowndoctors started work in Braga
• MA Degree two and a half years later to asses whether the clowndoctors reached those expectations
• Phd that focussed on the actual work in Braga and how the children responded to the Clowndoctors.  
• Phd in oncology to look at the effect of clowning in this specific context. 
• Phd looking into the perceptions of healthcare staff of effect of the Clowndoctors on children, parents and themselves. This was done in collaboration with Morgana Masetti in Brazil, who has done similar studies with Doutores de Alegria. This study took in 10 hospitals and gained more than 300 responses.
• MA degree studying the perspective of the clowns –their difficulties, necessities and worries in relation to the work. This study is nearing completion now.

All of this, bar one PHD (where the funding was raised by the academic) has been funded by this international exchange fund.

The priority with the funding was to get the information out there in an open and accessible way. O.N.V published a book ('Rir é o Melhor Remédio?') with their findings, in both English and Portuguese, that is easily digestible to a non-academic. They distributed this to all of the units they work in, giving copies to staff after the presented their findings. They have also presented the data and distributed the book at the national paediatrics conference.

In the near future, they plan on publishing in scientific journals, to reach the scientific and medical community.

They are also keen to see if the data highlights any areas where O.N.V could improve,  but this requires a deeper and more specific look at the results.

As far as fundraising goes, it seems that at the very least, it is a good advert for the job - O.N.V are able to communicate serious content about the Clowndoctors, which helps people to see them as professionals. In fact, Susana said she sees that the biggest contribution of this research is that public and donors see this as an important job. It helps a lot to dispel the myth that anyone can do it. The results reflect the quality of the work, the training, skill and expertise that goes into it.

It has clearly taken a huge amount of work and resources for O.N.V to get this far. In an ideal world, we would all have the opportunity to gather this kind of data - not only as a way of selling ourselves and getting stakeholders to take us seriously, but to really see what works and how. What I was most excited by is to hear that as part of the data collection, O.N.V have huge amounts of film footage of the work. As an artist, that is like gold dust! So much learning potential!

I didn't bring my book out here with me, but will share some findings from it when I get home. And, of course, you can buy a copy for yourself!

Me and Susana looking slightly manic...!