Episode 1: Mental Shortcuts and antibiotic resistance

Ever wondered why your work friend always takes short-cuts at work, saying she’s saving time by doing so? Wondered why so many interventions and programs seem like they’ll work in a boardroom but have massive failures when implemented?

That’s a question Kellie Thomas, a pHD candidate at Charles Sturt University, is making sure to focus on in her work. Studying antibiotic resistance may seem like a hard science topic, something that’s just data and chemicals, but she says that it is critical that the human element–that is, the people–are considered in academic research.

On this episode of What’s Sociology Got To Do With It?, Thomas argues data becomes meaningless when it is divorced from its context and the stresses we face in our professional lives. She calls on scientists and policy makers to move beyond the numbers and to remember that there are individuals behind the numbers–individuals with experiences that can’t always be reduced down to a ‘y value’ or a statistical phenomenon. In other words, how do people respond to the stressors of their jobs, and what impact does this have on their work performance?

If you want to contact Thomas, she can be reached through e-mail at kethomas@csu.edu.au or at amrvetcollective.com, which will launch later this year.

A transcript of this episode is available at www.thatsociologypodcast.org

Produced by Dr Sarina Kilham with support from Charles Sturt University and The Australian Sociological Association for Social Science Week 2020. 

Transcript Kellie Thomas

Kellie Thomas: Mental shortcuts and antibiotic resistance

[00:00:00] Kellie: [00:00:00] We know, sometimes we behave in counter to what we should be doing. But I think very often people’s rationalization for their behavior is very understandable.   Sarina: [00:00:57] Hello and welcome to What’s [00:01:00] Sociology Got To Do With It? Can you start by telling us about your research? 

Kellie: [00:01:04] Yes, so , my name is Kellie Thomas. I’m a PhD candidate through Charles Sturt University. And my research is a one health project that’s looking at how and why we use antibiotics, the way we do, across human and animal health. And what the potential consequences of that are for selection pressure in our environment.

 Sarina: [00:01:28] So I’m just gonna totally rewind very fast there. ‘One health.’ What do you mean by one health? 

Kellie: [00:01:34] Yeah, good point. There’s a couple of terms I think I’ll probably need to break down there. So one health is any work that considers human, animal and environmental health and tries to give equal weight to all three. So rather than coming to projects from a purely human-centric perspective, we try to have a broader view. 

Sarina: [00:01:52] So, how did you get into your research topic, Kellie? 

Kellie: [00:01:57] I got into my research topic, I [00:02:00] think, by having my imagination set on fire as a final year veterinary student, probably. And then having the opportunity to work with a supervisor who I had just bucket loads of respect for. I went to a one health international conference in 2016. And I, you know, I saved up and paid for it myself as a birthday present to myself and I just went. 

This is what feels like the future should be, for how we look at infectious diseases and things like antimicrobial resistance and, you know, emerging potential viral pandemic diseases, like the one we’re experiencing now. So it’s kind of just the more experiences I’ve had in life, the more it’s just confirmed that this is really important, an important space. 

Sarina: [00:02:42] So tell us, what-what has sociology or social sciences has got to do with your research? 

Kellie: [00:02:49] Yeah, interesting question. I was thinking about this when I was making a coffee before speaking to you. And actually, I think you’d be harder pressed to find something that sociology doesn’t have much to do with. What [00:03:00] I’ve really found interesting with, you know, the literature I’ve been looking at in the early stages of this research is there’s a lot of quantitative work that can show what’s happening on a lab level. Or I can talk about percentage change in practice. But it doesn’t factor in the human element. And I just think that that can lead to some massive gaps. And the example I wanted to talk about was a research project in the United Kingdom, where they looked at trying to change the way human general practitioners were prescribing antibiotics across a number of conditions.

Sarina: [00:03:35] Okay.

Kellie: [00:03:35] And they captured some information in sort of surveys and used quantitative analysis and said, look at this, we’ve had this amazing response, you know, we’ve decreased inappropriate prescribing by 66% and it looked just like a no brainer. Like we should all be doing this program because it was clearly very effective.

Sarina: [00:03:54] Yep. 

Kellie: [00:03:55] But then they had another research component that came out and was published a year later that [00:04:00] actually spoke to people about how and why they experienced this program. And basically came out that everyone had gamed the system. So they had started reclassifying disease so that they would look correct on paper, but they actually had changed nothing at all about what they’d done. 

Sarina: [00:04:15] So  in-you mean in terms of prescribing? So they were still prescribing the same amount of antibiotics. They were just recording it differently.

Kellie: [00:04:23] Absolutely. And that what they were doing was essentially, yeah, finding a way to make it look good on paper without actually changing their behavior. So I think any research where you’re looking into human behavior or how we interact in different spaces or the social pressures that are ecouraging us to behave in certain ways that we may not even be aware of, you can’t not consider sociology. 

I just think you’re setting yourself up for failure. You can have the perfect system, but if you don’t think about how we live and how we interact and why, then your perfect solution may never, ever be engaged with. 

Sarina: [00:04:58] So take us back to your [00:05:00] research. Who are you talking to? What does it look like on the ground? What are the actual nuts and bolts of what you’re doing and how you’re doing it? 

Kellie: [00:05:08] Yeah, well, actually it’s interesting because with coronavirus, there’s just been a bit of a reshape of my project. So what we’re looking at doing is focusing in on one geographical location. So I’m actually based in Queensland originally, that was going to be the Murrumbidgee, but not allowed down to you guys at the moment. 

So, we’ve sort of been able to shape the project based on the Murrumbidgee. And I’m looking at moving it now up here to Queensland and the Darling Downs. What we’re essentially doing in the sociological component is talking to people who are prescribing antibiotics about how, why, the pressures that they feel to prescribe in certain situations, how they feel about health and disease and how they see their own role when they’re having that engagement with a client or a patient. 

Sarina: [00:05:53] So-

Kellie: [00:05:53] We’re talking to, those people from human and animal health.  But then we’re also talking to those other people that are associated with [00:06:00] antibiotic use in human and animal health. So whether that’s pharmacists, nurses, stock feed manufacturers and animal husbandry workers or farmers. To really understand their opinion and their perspective as well. 

Sarina: [00:06:13] Uhuh.

Kellie: [00:06:13] Because everybody’s acting under sort of different pressure and in different environments. So we really want to get a good understanding of the interplay between all the different contributing groups, really.

Sarina: [00:06:23] So you haven’t actually started interviewing people yet. Is that right?

Kellie: [00:06:27] No I’ve started, but I haven’t finished. So I’m about a third of the way through with interviews so far.

Sarina: [00:06:33] So from the first couple of interviews that you’ve done then, what have been your epiphany moments or what has been a case study that you would love to share with our listeners?

Kellie: [00:06:44] Oh, I think the thing that I find infinitely relatable that works across any profession is we look for mental shortcuts when we’re under pressure and we’re busy. And we, we don’t ever mean to have negative or unintended [00:07:00] consequences with just trying to get through the day.  But I think the impact of the way we live currently and are sort of constantly being on the move and constantly being available and constantly having to have an answer, how that can actually impact our ability to think, and-and our ability to apply evidence-based clinical reasoning-

Sarina: [00:07:19] Yep.

Kellie: [00:07:20] -makes it-makes it really tough. And I think that’s something in interviews, people will sit down with me and say, ‘I know what I should be doing’ and ‘I know it should be like this, but the reality is that the context in which I’m operating make it so hard that I have to reserve that process for those few really, really sick patients where I really do have the time, or those it was really bad disease outbreaks in different, herds or flocks.’ So I find that really fascinating. And like I said, I think so relatable. It’s not, you know, it’s not just veterinarians and doctors that are experiencing that in the modern world.

Sarina: [00:07:51] Yep. So in that way, with the people that you’ve interviewed, does that mean they’re prescribing antibiotics, even though they know that might [00:08:00] not be the best way, not based on clinical evidence, but they, like the rest of us, have got a busy day that they’ve got to get through. And this is one-one way that might work. And it’s quick and it’s easy to do that.

Kellie: [00:08:13] Absolutely. 

And I think further to that, it’s not only the prescribing of the antibiotic, but sometimes it’s the type of antibiotic. So, there’s antibiotics that might cover a broader spectrum of types of bacteria. And we really only want to use those when we need to because they also have a little bit more pressure t-to increase resistance in bacteria. So we want to reserve them where we can. But sometimes when we don’t have time, when our clients don’t have time or-or financial means actually to go ahead with diagnostic processes, we’re doing these things, you know, as a, sometimes a mental shortcut  as a opportunity for minimizing risk.

Sarina: [00:08:49] Yep.

Kellie: [00:08:50] So. We know, sometimes we behave in counter to what we should be doing. But I think very often people’s rationalization for their behavior is very [00:09:00] understandable.

 Sarina: [00:09:01] So, how would you say, that sociology is disrupting or innovating the normal hard science way of thinking about your research?

 Kellie: [00:09:11] I think in the, in the sciences in general, there is a real capacity for social research to start to shake the tree because there’s been this real  reliance on quantitative data and quantitative research as being what really matters and what’s real and concrete and physical. But I think, just over time, probably seeing that that’s not always the answer and with these really complex problems we’re trying to  deal with, you  can’t necessarily solve them by easily measuring something. We don’t necessarily have the funding to easily measure something over time. So I think sociology, we can look into how and why, and in what way and what are the other reasons and sometimes we can control something without having to measure that end point outcome. And that’s brilliant! So. 

Sarina: [00:09:55] You hit it 

Kellie: [00:09:55] think it’s really important.

Sarina: [00:09:56] You heard it here listeners, sociology is brilliant, if you didn’t already [00:10:00] know. 

Kellie: [00:10:00] Definitely. It is brilliant. 

Sarina: [00:10:02] Kellie, how do you hope to change the world with your research? 

Kellie: [00:10:07] Look, my plan is, step one: solve anti-microbial resistance. 

Sarina: [00:10:12] Yep. She got that. Under her belt, everyone.

Kellie: [00:10:17] No problem. no, but I think. You know, I would really like to, just, dig into the way we think about these small daily tasks that we can always do on autopilot and just really encourage people to think and be aware of what they’re doing and why. I guess. Figuring out where people are, why they’re where they are. And you know, maybe there’s two or three horses before the cart that we need to sort out first. 

So I think what I’d really love to say is people instigating programs and services that actually get the foundations right, so that by the time we actually put, you know, these fully funded interventions into place, we’ve got our ducks in a row, so to speak. I know we can never be perfect, but. You know, I [00:11:00] think there’s a lot of money spent on interventions that look fantastic on paper, but if we don’t have that leading work to understand the humans in the scenarios in which we’re trying to make interventions, then that can be a real lot of wasted effort and it can really be de-motivating. Yeah, I guess, like I said, step one: AMR. Step two: climate change.  

Sarina: [00:11:16] And, get you a social scientist or your local sociologist involved in your research project from step one. 

Kellie: [00:11:24] Absolutely! Because I think that’s another thing that sometimes in the hard science is concept of like, discussing and-and problem solving and talking through things isn’t valued to the same level, which is so ironic because it’s what we use in every other facet of our life. So I really liked that sociology kind of says ‘yeah, you know what? It’s really important that we talk about this and figure it out and you need to talk it through with another person.’ Like not just sit quietly in your own brain. 

Sarina: [00:11:51] Yeah. Kelly, where can our listeners find you on social media or by your institutional website? What’s the best [00:12:00] way for people who are interested in your research and would like to find out more?

Kellie: [00:12:04] Hmm. The best place. I’m pretty average on social media, but the best place would be through the Charles Sturt University veterinary sciences website. And later in the year, we will also be launching our own website, which is going to be at the AMRvetcollective.com. So either of those places would be great. 

Sarina: [00:12:23] Fantastic. Thank you so much for joining us today on What Sociology Got To Do With It?  I’ll include all those details in our show notes. 

Kellie: [00:12:32] Awesome. Thanks so much for having me. This is a really good thing you’re doing so good luck with it. 

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